CN106236341A - A kind of stepped scaffold being applicable to tapered blood vessel - Google Patents

A kind of stepped scaffold being applicable to tapered blood vessel Download PDF

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Publication number
CN106236341A
CN106236341A CN201610698316.1A CN201610698316A CN106236341A CN 106236341 A CN106236341 A CN 106236341A CN 201610698316 A CN201610698316 A CN 201610698316A CN 106236341 A CN106236341 A CN 106236341A
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China
Prior art keywords
unit
blood vessel
applicable
adjacent
asymmetric apertures
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Granted
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CN201610698316.1A
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Chinese (zh)
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CN106236341B (en
Inventor
申祥
邓永泉
纪松
谢中敏
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Jiangsu University
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Jiangsu University
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Publication of CN106236341A publication Critical patent/CN106236341A/en
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Publication of CN106236341B publication Critical patent/CN106236341B/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2210/00Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0061Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof swellable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections

Abstract

The invention provides a kind of stepped scaffold being applicable to tapered blood vessel, the brace sections being axially arranged in order including several at described support, described brace sections expansion bore is different, by connecting unit connection between adjacent stent section;Each brace sections includes several identical asymmetric apertures unit being axially arranged in order at described support, each asymmetric apertures unit includes the non-parallel quadrilateral hole that several shapes are identical, is sequentially connected with at apex between the non-parallel quadrilateral hole in same asymmetric apertures unit;Share the part on a limit between adjacent two non-parallel quadrilateral holes of adjacent two asymmetric apertures unit, make between the non-parallel quadrilateral hole of adjacent four, to form dislocation support ring.The present invention is used for taper lesion vessels, and the adherent performance of near-end, distal dilation performance are good, improves support radial rigidity, improves blood flow environment, reduce the adverse consequences that high metal coverage rate causes.

Description

A kind of stepped scaffold being applicable to tapered blood vessel
Technical field
The invention belongs to medical instruments field, relate to a kind of employing percutaneous coronary endoluminal vascular support interventional procedure treatment The balloon-expandable intravascular stent of taper lesion vessels.
Background technology
As a big killer of harm human health, cardiovascular disease is increasingly subject to people's attention.Due in blood Metabolism is abnormal, and lipid material is deposited on endarterium, is gradually piled into speckle, thus causes blood flowing hindered, Cause heart ischemia, have a strong impact on the metabolism of human body, jeopardize human health.Eighties of last century mid-term, get involved operation start into Enter this treatment field, and with its Wicresoft, efficiently and safety receives extensive concern, at present, endovascular stent gets involved operation Have become as the current major way treating angiemphraxis disease.
The round Vasa recta support of the hollow that current existing metal rack metal material is made, the support after expansion, Extruding atherosclerotic plaque, supports narrow blood vessel, recovers blood vessel diameter and blood flowing.
But Physiological Anatomy is it has been proved that part of arteries blood vessel is not that circle is straight, but tapered conical pipe, its blood A certain distance is there is in pipe near-end to distal end tapers down, two ends diameter.Local hemodynamic studies ring in tapered conical blood vessel Border is complicated, is more likely formed atherosclerotic plaque.It is adherent bad that circle straight bracket can produce blood vessel near-end after expanding in conical blood vessel With the problems such as far-end overdistension, adherent bad upset blood flow environment, the easy neointimal hyperplasia in gap;Overdistension causes blood vessel to be answered Power, strain increase, and increase vascular damaged degree, and therefore, blood vessel near-end is adherent bad and far-end overdistension all becomes inner membrance The hidden danger of the untoward reaction such as hypertrophy, thrombosis, in-stent restenosis.Meanwhile, the tapered feature of blood vessel also influences whether support Local hemodynamic studies environment etc. after implantation, increases untoward reaction odds further.
Support atherosclerotic plaque to be extruded, supports narrow blood vessel, it is necessary to possess good support performance, current state Using radial rigidity as the deliberated index of enabling capabilities on border.Balloon expandable stent radial rigidity is not enough, not only results in and props up Frame radially retraction, it is also possible to collapse or buckling deformation, cause serious medical consequences.
Summary of the invention
Present invention aim to address deficiency of the prior art, it is provided that a kind of stairstepping being applicable to tapered blood vessel props up Frame, is similar to the narrow taper lesion vesselses such as carotid artery, femoral artery, left anterior descending branch coronarius, makes blood vessel near for treatment Hold adherent performance, distal dilation performance to be improved, improve support radial rigidity, improve blood flow environment, reduce blood vessel stress, answer Become, reduce the adverse consequences that high metal coverage rate causes, reduce the generation of untoward reaction.
The technical scheme is that
A kind of stepped scaffold being applicable to tapered blood vessel, the support being axially arranged in order at described support including several Section, described brace sections expansion bore is different, by connecting unit connection between adjacent stent section;If described each brace sections includes Dry the identical asymmetric apertures unit being axially arranged in order at described support, each asymmetric apertures unit includes several shapes Identical non-parallel quadrilateral hole, the non-parallel quadrilateral hole in same asymmetric apertures unit radially exists on two summits at described support On same vertical line, it is sequentially connected with at apex between two adjacent non-parallel quadrilateral holes;Adjacent two asymmetric apertures lists Unit non-parallel quadrilateral hole at axial two drift angles of described support the most in the same horizontal line, adjacent two non-parallel quadrilateral holes Between share a limit a part, make between the non-parallel quadrilateral hole of adjacent four formed dislocation support ring.
Preferably, the one during described connection unit is V-type dowel, M type dowel.
Preferably, from described mount proximal end to far-end, described brace sections expansion bore is that adjacent stent section expands bore 1.10~1.40 times.
Preferably, from described mount proximal end to far-end, in described each brace sections, asymmetric apertures unit axial length L is adjacent In brace sections 1.10~1.30 times of asymmetric apertures unit axial length L.
Preferably, from described mount proximal end to far-end, each brace sections of described stepped scaffold and connection unit muscle width W are phases Adjacent brace sections or connect 1.10~1.40 times of the wide W of unit muscle.
Preferably, described dislocation support ring area is the 20~50% of its non-parallel quadrilateral hole area.
Preferably, side-play amount h of axial two drift angles of described non-parallel quadrilateral hole is non-parallelogram hole height H 5~30%.
Preferably, round-corner transition is all used to connect between described non-parallel quadrilateral hole.
Preferably, the material of described stepped scaffold is laser 316L rustless steel at molten quarter or L605 cochrome.
Beneficial effects of the present invention:
1, the intravascular stent of the present invention is all cylindric in naturalness and compressive state, it is simple to by complex-shaped blood Pipe reaches diseased region, has good penetrance and compliance.
2, intravascular stent presents step-like architectural feature after expanding, and can conform better to human vas the most gradually The objective reality of contracting change, improves the matching of intravascular stent and human vas, thus improves traditional round straight bracket at tapered blood The untoward reaction such as the adherent bad and far-end overdistension of near-end produced after expansion in pipe, effectively suppression in-stent restenosis.
3, non-parallel quadrilateral hole structure can be effectively improved the radial rigidity of support, and asymmetric apertures unit Heterogeneous Permutation produces Raw dislocation support ring can be offset the asymmetric structure caused of hole unit and rotate, it is to avoid reduce bending stiffness, such support Radial rigidity is greatly improved, and does not has a negative impact.
4, strut width W is in axial direction successively decreased to far-end by near-end, keeps dislocation support ring size simultaneously, can reduce The compact metal coverage rate caused of supporting structure is too high, reduce far-end and local because of the too high initiation of metal coverage rate bad instead Should.
5, adjacent non-parallel quadrilateral hole is joined directly together, and reduces the introducing of transversary, is formed after reducing stenter to implant Blood flow cessation district and low endothelium shear stress district area, be of value to the Hemodynamic response produced after improving stenter to implant;Respectively Connect round-corner transition, wedge angle injured blood vessel wall will not be produced, adapt to flow characteristic simultaneously, reduce stenter to implant further to local The interference of blood flow.
6, adjacent stent section support uses V-type dowel or M type dowel to connect, when can better conform to stent-expansion because of The sudden change that adjacent stent section bore difference causes, the blood vessel stress caused is less.
Accompanying drawing explanation
Fig. 1 is the structural representation of the stepped scaffold embodiment one being applicable to tapered blood vessel of the present invention.
Fig. 2 is described non-parallel quadrilateral hole structural representation.
Fig. 3 is adjacent asymmetric apertures unit dislocation connection diagram.
Fig. 4 is the structural representation of the stepped scaffold embodiment two being applicable to tapered blood vessel of the present invention.
In figure,
1-the first asymmetric apertures unit;2-the second asymmetric apertures unit;3-the 3rd asymmetric apertures unit;4-the 4th is asymmetric Hole unit;5-the 5th asymmetric apertures unit;6-the 6th asymmetric apertures unit;10-proximal stent section;20-intermediate support section;30- Distal stent section;The non-parallel quadrilateral hole of 41-;42-misplaces support ring;51-the first V-type dowel;52-the second V-type dowel; 53-M type dowel.
Detailed description of the invention
Below in conjunction with the accompanying drawings and specific embodiment the present invention is further illustrated, but protection scope of the present invention is also It is not limited to this.
The stepped scaffold being applicable to tapered blood vessel of the present invention is similar to carotid artery, femoral artery, hat for treatment The narrow taper lesion vesselses such as the left anterior descending branch of shape tremulous pulse, make the adherent performance of blood vessel near-end, distal dilation performance be improved, carry The physiological adaption of high trestle, improves blood flow environment, reduces blood vessel stress, strain, and that reduces that high metal coverage rate causes is bad Consequence, increases the radial rigidity of support, reduces the generation of untoward reaction.
Described stepped scaffold includes the brace sections that several expansion bores are different, and adjacent stent section is by connecting unit phase Even, proximally rising, each brace sections expansion bore is sequentially reduced, and is stepped after distending the blood vessels.Each brace sections is according to its position Proximal stent section 10, intermediate support section 20 and distal stent section 30, wherein proximal stent section 10 and distal stent section 30 can be divided into Being respectively 1, intermediate support section 20 can be not provided with, it is possible to arranges 1 to multiple;Each brace sections and connection unit muscle width W are successively Reduce.
Described each brace sections includes that several asymmetric apertures unit, each asymmetric apertures unit include several shape phases Same non-parallel quadrilateral hole 41 circumferential array;Asymmetric apertures unit Heterogeneous Permutation in each brace sections, dislocation divides formation dislocation Support ring 42;It is joined directly together with adjacent non-parallel quadrilateral hole 41 in a brace sections;Axial two drift angles of non-parallel quadrilateral hole 41 The most in the same horizontal line, there is certain deviation amount up or down in one of them drift angle relative to centrage;With a brace sections In adjacent asymmetric apertures unit non-parallel quadrilateral hole 41 occur skew position contrary.
It is excessive that described stepped scaffold each unit connects all employing fillets, to avoid producing wedge angle injured blood vessel wall, simultaneously Adapt to flow characteristic, reduce the stenter to implant interference to regional flow's environment further.Described stepped scaffold is carved by laser is molten The net tubular structure that 316L rustless steel or L605 cochrome are made, this structure maintains the integrity of described intravascular stent.Institute State stepped scaffold each brace sections length to be regulated by the asymmetric apertures element number increasing and decreasing in this brace sections.Described stairstepping Support can adapt to the lesion vessels of different length by increase and decrease brace sections length and quantity with the length of increase and decrease support.
Case study on implementation one:
Fig. 1 show a kind of embodiment of the stepped scaffold being applicable to tapered blood vessel of the present invention: described blood Pipe holder is three stepped supports, including the brace sections that 3 bores are different, i.e. and proximal stent section 10, intermediate support section 20 and remote End support section 30, adjacent stent section connects unit by V-type and connects.Wherein proximal stent section 10 includes the first asymmetric apertures unit 1 and the second asymmetric apertures unit 2, intermediate support section 20 includes the 3rd asymmetric apertures unit 3 and the 4th asymmetric apertures unit 4, far End support section 30 includes the 5th asymmetric apertures unit 5 and the 6th asymmetric apertures unit 6.Proximal stent section 10 is by the first V-type even Connecing muscle 51 and connect intermediate support section 20, intermediate support section 20 connects distal stent section 30 by the second V-type dowel 52.
The non-parallel quadrilateral hole 41 that shape that described each asymmetric apertures unit includes 7 circumferential array is identical, such as Fig. 2 Shown in, the most in the same horizontal line, one of them drift angle is relative for two drift angles on described non-parallel quadrilateral hole 41 axial direction It is the 5-30% of non-parallelogram hole 41 height H in disalignment amount h, substantially to increase the radial rigidity of support, and protects Hold less support axial deformation, the most do not reduce the axial compliance of support.Asymmetric apertures unit Heterogeneous Permutation in each brace sections, wrong Bit position forms dislocation support ring 42, is joined directly together with adjacent non-parallel quadrilateral hole 41 in a brace sections.As it is shown on figure 3, with In one brace sections, the deviation post of adjacent two row's asymmetric apertures unit drift angles is contrary, and Heterogeneous Permutation, and dislocation position forms dislocation Support ring 42, wherein dislocation support unit 42 area is that the 20-50% of non-parallelogram hole 41 area is to offset asymmetrical junction The support that structure causes reverses, and avoids the dislocation too small localized metallic coverage rate caused of support unit too high simultaneously.Described adjacent non- Parallelogram hole 41 does not use connecting rod to be directly connected to, and to avoid introducing transversary, causes bad regional flow environment.
The ladder sign of described stepped scaffold refers to, each brace sections proximally rises, and its expansion bore is adjacent stent section Expansion 1.10~1.40 times of bore, i.e. the expansion bore of proximal stent section 10 be intermediate support section 20 expand bore 1.10~ 1.40 times, it is 1.10~1.40 times of distal stent section 30 that intermediate support section 20 expands bore, to adapt to after ensureing stent-expansion The physiological feature that blood vessel is tapered.
The change of described asymmetric apertures unit axial length refers to proximally rise, and in each brace sections, asymmetric apertures unit is axial Length L is in adjacent stent section 1.10~1.30 times of asymmetric apertures unit axial length L, the i.e. first asymmetric apertures unit 1 He Second asymmetric apertures unit 2 axial length is the 3rd asymmetric apertures unit 3 and the 1.10 of the 4th asymmetric apertures unit 4 axial length ~1.30 times, the 3rd asymmetric apertures unit 3 and the 4th asymmetric apertures unit 4 axial length are the 5th asymmetric apertures unit 5 and 1.10~1.30 times of six asymmetric apertures unit 6 axial lengths, different with each brace sections expansion diameter after ensureing stent-expansion.
Each brace sections and the connection unit of described stepped scaffold proximally rise, and its muscle width W is adjacent stent section or connection Wide first V-type of wide 1.10~1.40 times of unit muscle, i.e. proximal stent section 10 muscle connects 1.10~1.40 times that unit 51 muscle is wide, First V-type dowel 51 muscle is wide is wide 1.10~1.40 times of intermediate support section 20 muscle, and intermediate support section 20 muscle is wide is the second V-type Wide 1.10~1.40 times of dowel 52 muscle, the second V-type connect unit 52 muscle wide be distal stent section 30 muscle wide 1.10~ 1.40 times, this structure can improve stent-expansion uniformity, and reduces the distal vessels that support causes because distal structure is compact Metal coverage rate is too high.
Case study on implementation two:
Fig. 4 show the another embodiment of the stepped scaffold being applicable to tapered blood vessel of the present invention: described Intravascular stent is two-step support, and including the brace sections that 2 bores are different, adjacent stent section is connected by M type dowel 53.
2 brace sections are respectively proximal stent section 10 and distal stent section 30, and wherein proximal stent section 10 includes that first is non- Symmetrical holes unit the 1, second asymmetric apertures unit 2 and the 3rd asymmetric apertures unit 3, distal stent section 30 includes the 4th asymmetric apertures Unit the 4, the 5th asymmetric apertures unit 5 and the 6th asymmetric apertures unit 6.
In actual application, described stepped scaffold each brace sections length can be by increasing and decreasing the asymmetric apertures list in this brace sections Unit's quantity regulating;Described stepped scaffold can be adapted to not with the length of increase and decrease support by increase and decrease brace sections length and quantity Lesion vessels with length.
The present invention make intravascular stent expansion after can preferably with blood vessel proximally to far-end be tapered physiological feature phase Coupling, in the adherent performance of proximal vessel after raising stent-expansion, slows down or eliminates the support overdistension in distal vessels, building Vertical preferably Hemodynamic response, reduces the stenter to implant damage to blood vessel, reduces in neointimal hyperplasia, thrombosis, support Restenosis equivalent risk;Improve the radial rigidity of support, do not reduce simultaneously or reduce the axial compliance of support and bending stiffness on a small quantity, Can suitably reduce the thickness of support on this basis, to reduce blood flow disorder and the low endothelium shear stress that wall thickness support causes District, reduces the bad phenomenon occurrence probability such as in-stent restenosis;To avoid too high localized metallic coverage rate;Reduce or eliminate horizontal stroke To structure, the wedge angle impact on Hemodynamic response, thus weaken after support is implanted in tapered conical blood vessel local The impact of blood flow environment.
Described embodiment be the present invention preferred embodiment, but the present invention is not limited to above-mentioned embodiment, not In the case of deviating from the flesh and blood of the present invention, any conspicuously improved, the replacement that those skilled in the art can make Or modification belongs to protection scope of the present invention.

Claims (9)

1. the stepped scaffold being applicable to tapered blood vessel, it is characterised in that: include that several are at described support the most successively The brace sections (10,20,30) of arrangement, described brace sections expansion bore is different, by connecting unit connection between adjacent stent section; Described each brace sections includes several identical asymmetric apertures unit (1~6) being axially arranged in order at described support, each Asymmetric apertures unit includes the non-parallel quadrilateral hole (41) that several shapes are identical, non-parallel in same asymmetric apertures unit Quadrilateral hole (41) on described support radially two summits on same vertical line, two adjacent non-parallel quadrilateral holes (41) it Between be sequentially connected with at apex;The non-parallel quadrilateral hole (41) of adjacent two asymmetric apertures unit (1~6) is at described support shaft To two drift angles the most in the same horizontal line, share the part on a limit between adjacent two non-parallel quadrilateral holes (41), make Dislocation support ring (42) is formed between four adjacent non-parallel quadrilateral holes (41).
The stepped scaffold being applicable to tapered blood vessel the most according to claim 1, it is characterised in that: described connection unit is One in V-type dowel (51,52), M type dowel (53).
The stepped scaffold being applicable to tapered blood vessel the most according to claim 1 and 2, it is characterised in that: from described support Near-end is to far-end, and described brace sections expansion bore is 1.10~1.40 times of adjacent stent section expansion bore.
The stepped scaffold being applicable to tapered blood vessel the most according to claim 1 and 2, it is characterised in that: from described support Near-end is to far-end, and in described each brace sections, asymmetric apertures unit (1~6) axial length L is asymmetric apertures list in adjacent stent section 1.10~1.30 times of unit's (1~6) axial length L.
The stepped scaffold being applicable to tapered blood vessel the most according to claim 1 and 2, it is characterised in that: from described support Near-end is to far-end, and each brace sections of described stepped scaffold and connection unit muscle width W are adjacent stent sections or connect unit muscle width W 1.10~1.40 times.
The stepped scaffold being applicable to tapered blood vessel the most according to claim 1 and 2, it is characterised in that: described dislocation is propped up Pushing out ring (42) area is the 20~50% of its non-parallel quadrilateral hole (41) area.
The stepped scaffold being applicable to tapered blood vessel the most according to claim 1, it is characterised in that: described non-parallel four limits Axial two drift angles in shape hole (41) are the 5~30% of non-parallelogram hole (41) highly H relative to side-play amount h.
The stepped scaffold being applicable to tapered blood vessel the most according to claim 1, it is characterised in that: described non-parallel four limits Round-corner transition is all used to connect between shape hole (41).
The stepped scaffold being applicable to tapered blood vessel the most according to claim 1, it is characterised in that: described stepped scaffold Material to be that laser is molten carve 316L rustless steel or L605 cochrome.
CN201610698316.1A 2016-08-19 2016-08-19 A kind of stepped scaffold suitable for tapered blood vessel Expired - Fee Related CN106236341B (en)

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CN108742778A (en) * 2018-04-09 2018-11-06 宋朝阳 A kind of machinery takes bolt holder and thrombus withdrawing device
CN112089511A (en) * 2020-08-28 2020-12-18 江苏大学 Self-expansion type conical intravascular stent applied to multiple stenosis of conical blood vessel
CN112089512A (en) * 2020-08-28 2020-12-18 江苏大学 Balloon expansion type intravascular stent applied to multiple stenosis of circular and straight blood vessels

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Publication number Priority date Publication date Assignee Title
CN108742778A (en) * 2018-04-09 2018-11-06 宋朝阳 A kind of machinery takes bolt holder and thrombus withdrawing device
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CN112089511A (en) * 2020-08-28 2020-12-18 江苏大学 Self-expansion type conical intravascular stent applied to multiple stenosis of conical blood vessel
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CN112089511B (en) * 2020-08-28 2022-07-22 江苏大学 Self-expansion type conical intravascular stent applied to multiple stenosis of conical blood vessel

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