CN1108782C - 人造血管 - Google Patents

人造血管 Download PDF

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CN1108782C
CN1108782C CN95120294A CN95120294A CN1108782C CN 1108782 C CN1108782 C CN 1108782C CN 95120294 A CN95120294 A CN 95120294A CN 95120294 A CN95120294 A CN 95120294A CN 1108782 C CN1108782 C CN 1108782C
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布川三樱子
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    • 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
    • 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
    • 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
    • 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
    • A61F2002/065—Y-shaped blood vessels

Abstract

本发明的人造血管具有第一管状部分和端部接合在第一管状部分外面上的第二管状部分，第二管状部分内的血流通路与第一管状部分内的血流通路相连通。按照该人造血管，由于其端侧吻合的部分全部形成在人造血管上，所以，在使人造血管同活体血管吻合时可以首先除去活体血管病变部分、通过端端吻合将活体血管的各端吻合在其中的第一管状部分的两个端部上。在这种情况下，由于不需进行在活体血管外面上形成狭缝状开口部分或在其周缘部分进行折叠处理，从而使吻合处理容易，其作业性能提高。

Description

人造血管
本发明涉及在活体的血管发生堵塞性病变或扩张性病变时需要置换病变部分或傍路病变部分所用的人造血管。
在活体血管发生堵塞性病变或扩张性病变时，需要利用代用血管进行傍路和置换手术。作为该代用血管可以有从人体获得的血管按原样使用的情况或利用由聚四氟乙烯等基材成形的人造血管的情况。
在把人造血管同活体血管相接合的方法中有如图5(a)所示把人造血管2的端部2a吻合在活体血管1的端部1a上的端端吻合，和如图5(b)所示把人造血管2的端部2a吻合在活体血管1的外面1b上的端侧吻合。
为了利用端侧吻合把人造血管吻合在活体血管上，首先要象图6所示那样在活体血管1的外面1b上形成狭缝状的开口部分。然后在为了使人造血管2的端部2a同开口部3形成基本相同形状而对端部2a进行整形的过程中，使端部2a的周缘部分吻合在开口部分3的周缘部分上。这时，一般地讲，象图7所示那样，使端部2a的周缘部分和开口部分3的周缘一起向外折叠，使端部2a的周缘部分的内侧同开口部分3的周缘部分的内侧接触，通过用缝合线4缝合该接触位置进行吻合。
由于在血管的外面侧上有使血液凝固的作用，所以采用象这样地使内侧同内侧吻合的方法。
当血管内的血液流速迅速变慢时，血液流中产生层间分离和使血液内的剪切应力或大或小，这两种情况都成为在血管中引起各种病变的主要原因。
随着上述的端侧吻合，就人造血管内的血液流动就而言，由于在人体血管2的端部2a附近的狭缝状的变形部分和血液从人造血管2流入活体血管1的部分的两个位置上血液通路的截面急剧变化，而出现血液的流速和剪切应力发生大变化的问题。
在把人造血管2吻合在活体血管1上时，必须确保作为血管所必需的截面积，由于对于相同的截面积而言，截面变得细长时周长也稍变长，所以通过上述使人造血管2的端部2a变形为狭缝状的方法会使缝合部分变长。因为在血管的外面上形成狭缝状开口的同时，对其周缘部分向外折叠的处理是比较麻烦的操作，所以存在吻合时费工夫的问题。
此外，由于在将血管2的端部2a整形使其与活体血管1吻合时，在活体血管1的吻合位置附近受到多余的力，往往使活体血管1的断面发生变化。因此，加在活体血管上的力或者由于该力所引起的截面变形可能是在吻合位置附近在活体血管1中产生障碍的主要原因这是已有技术存在的另一个问题。
本发明是鉴于上述课题提出的，把提供一种既能使因吻合产生的血液流动变化减小又能使吻合处理作业性提高的人造血管作为目的。
为了达到上述目的，本发明提供一种人造血管，其包括：
一限定有内部血液流动通路的第一人造管状部分；和
一限定有内部血液流动通路的第二人造管状部分，所述第二管状部分与所述第一管状部分分开制成；
所述第二管状部分的一个端部的周缘部分与形成在所述第一管状部分的外表面上的开口的周缘部分相连接；
其特征在于，
所述第二管状部分的所述一个端部的所述周缘部分是由一个在基本上垂直于所述第二管状部分的轴线的方向上形成的端侧边缘部分和一个从所述端侧边缘部分沿着倾斜于所述第二管状部分的轴线及所述端侧边缘部分二者的方向延伸的切入边缘部分构成；
所述第一管状部分的所述开口的所述周缘部分具有与所述第二管状部分的所述一个端部的所述周缘部分基本上相同的形状。
在上述的从造血管中，所述第一管状部分的所述开口的所述周缘部分和所述第二管状部分的所述一个端部的所述周缘部分都向外侧弯折，而所述第一管状部分的邻近其开口的内表面与所述第二管状部分的邻近其一个端部的内表面相粘接。
采用本发明的人造血管，由于端侧应该吻合的部分全部形成在人造血管上，所以，在把人造血管吻合在活体血管上时，首先去除活体血管的病变部分，通过端端吻合将活体血管的两个端部分别吻合在其中的第一管状部分的两端部上。在这种情况下，由于不在活体的血管外面形成狭缝状的开口，也不进行使其周缘部分折叠的处理，所使吻合处理容易，其作业性能提高。
在本发明的人造血管中，第二管状部分的端部周缘部分接合在第一管状部分外面所形成的开口周缘部分上。因此，在流过第二管状部分内的血流通路的血液流入第一管状部分的血流通路内时，没有从血液通路壁向内突出的部分，由于没有遮挡血流，所以可以使血液流动变化减小。
在本发明的人造血管中，在第二管状部分同第一管状部分接合的位置上，第一管状部分的血流通路和第二管状部分的血流通路具有同样的横截面形状。在这种情况下，由于没有必要把第二管状部分端部整形成狭缝状，所以可以减少断面急剧变化的位置，另外，由于两个管状部分具有相同的断面形状，所以在从第二管状部分向第一管状部分连通的血流通路上，可以没有断面急剧变化的位置，因此，可以使血液的流动变化减小。
在本发明的人造血管中，第一管状部分同第二管状部分的夹角在20度至45度的范围。由于血液从第二管状部分向第一管状部分光滑地流动，所以可以使血液流动的变化减小。
图1是表示本发明的人造血管一个实例的斜视图。
图2是表示同例中的人造血管的局部斜视图。
图3(a)、(b)是表示利用同例的人造血管的吻合方法的侧面图。
图4是表示利用同例的人造血管另一吻合方法的侧面图。
图5(a)、(b)是表示已有技术中的吻合方法的侧面图。
图6是表示已有技术中的端侧吻合方法的斜视图。
图7是表示吻合位置的主要部分的斜视图。
下面参照图1至图4说明本发明的人造血管的一个实施例。本实施例的人造血管是把两个管状的人造血管接合形成的人造血管。在一般的情况下，该管状的人造血管是由聚四氟乙烯等原料的成形品或由该原料的纤维编织形成的。
在图1中，人造血管10由具有相同断面形状(基本上为圆形)的管状部分12(第一管状部分)和管状部分13(第二管状部分)构成，在每个管状部分上分别形成血液流动的通路14和15。
在人造血管12的外面12a上形成开口部18，管状部分12同管状部分13相交成30度角，管状部分13的端部13b的周缘部分接合在开口部18的周缘上。这时，如图2所示那样，在管状部分13上形成切入部分19a，通过切入部分19a和端侧部分19b形成管状部分13的端部13b的周缘部分19，使管状部分12同在接合部分附近的管状部分13的变形为最小值，管状部分12的开口部分与周缘部分19形成基本上相同的形状。关于周缘部分间的连接，与上述的端侧吻合相同，使各个周缘部分向外折叠，使内侧同内侧配合，通过缝合、粘接、熔接手段使该接触位置接合。
人造血管10的管状部分12和13形成得稍长一些，对照吻合处理时的使用条件切断管状部分12和13，以便可以形成适合的长度。
为了把上述构成的人造血管10吻合在活体血管上，首先对照使用条件将管状部分12和13切成合适长度后，如图3(a)所示，除去活体血管20的病变部分20a，形成端部20b、20b。接着，如图3(b)所示，通过端端吻合使管状部分12的端部12b、12b吻合在活体血管20的端部20b、20b上。这时，使端部12b同端部20b的内侧按上述的端侧吻合要求合在一起，用缝合线22缝合该接触位置，以便进行吻合。
采用上述的人造血管10，可以使靠近管状部分12的接合位置的管状部分13的变形变为最小，管状部分12和管状部分13具有相同的断面形状，以便于管状部分12的开口部18的周缘部分同管状部分13的端部13b的周缘部分接合，并使从血流通路14和15的壁部没有向内突出的部分，在从管状部分13连接到管状部分12的血流通路中去除断面急剧变化的部位，从而使血流的流动的变化减小。
在管状部分12同13接合时，如果相交角度变小则接合部分的长度将变长。此外，由于在相交角度变大时，在从血流通路15向血流通路14流入的血液方向角度变大的情况下，会在血液流中产生紊乱，所以相交角度最好从20度至45度为最适合，因为本实施例的人造血管10的相交角度是约30度的范围，所以血流从血流通路15向14可以光滑地流动，从而使血液的流动变化减小。
另外，由于可以通过端端吻合使人造血管10同活体血管20吻合，所以如同是同一断面积，这与吻合部分是狭缝状的情况相比，缝合长度明显变短，还由于不要在活体血管20的外面形成狭缝状开口部分，也不用对其周缘部分进行折叠处理，所以使吻合处理容易，其作业性能提高。
可是，关于上述的人造血管10，也可以考虑图4所示的使用方法。
通过切断管状部分12同管状部分13的接合部分的周围部分，使人造血管10形成如图4所示形状的人造血管25。在用该人造血管25进行同活体血管26的吻合时采用端侧吻合。在本使用方法中关于使血流流动变化减小方面也可以获得与上述的使用方法相同的效果。
本发明的人造血管不受上述实施例的限定，使第一管状部分的外面同第二管状部分的端部接合，在使两个管状部分的血流通路连通的结构条件下可以有各种设计上的变更。例如，虽然在上述实施例中，是使第一和第二管状部分形成在其长度方向断面相同的结构，但是也可以对应连接的活体血管的大小，使血流通路在长度方向上逐渐扩径或缩径，具有这种构造的管状部分是可以采用的。
虽然在上述实施例中，是使第二管状部分的端部周缘部分接合在第一管状部分开口部的周缘部分上，但是也可以采用下述的构造：在第二管状部分的端部上形成向外扩大的部分，该部分是比上述开口部分大的扩张部分，把该扩张部分从上述开口部分压向第一管状部分的内部，使该扩张部分同第一管状部分的内壁之间用粘接、缝合等手段封住而形成使第一管状部分同第二管状部分相接合的构造。

Claims (2)

1.一种人造血管，其包括：
一限定有内部血液流动通路的第一人造管状部分；和
一限定有内部血液流动通路的第二人造管状部分，所述第二管状部分与所述第一管状部分分开制成；
所述第二管状部分的一个端部的周缘部分与形成在所述第一管状部分的外表面上的开口的周缘部分相连接；
其特征在于，
所述第二管状部分的所述一个端部的所述周缘部分是由一个在基本上垂直于所述第二管状部分的轴线的方向上形成的端侧边缘部分和一个从所述端侧边缘部分沿着倾斜于所述第二管状部分的轴线及所述端侧边缘部分二者的方向延伸的切入边缘部分构成；
所述第一管状部分的所述开口的所述周缘部分具有与所述第二管状部分的所述一个端部的所述周缘部分基本上相同的形状。
2.根据权利要求1所述的人造血管，其特征在于，所述第一管状部分的所述开口的所述周缘部分和所述第二管状部分的所述一个端部的所述周缘部分都向外侧弯折，而所述第一管状部分的邻近其开口的内表面与所述第二管状部分的邻近其一个端部的内表面相粘接。
CN95120294A 1994-10-27 1995-10-27 人造血管 Expired - Fee Related CN1108782C (zh)

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US5643340A (en) 1997-07-01
EP0709066A1 (en) 1996-05-01
KR100385258B1 (ko) 2003-08-21

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