CN109125885B - Intracranial transfer device for aorta and left internal carotid artery - Google Patents
Intracranial transfer device for aorta and left internal carotid artery Download PDFInfo
- Publication number
- CN109125885B CN109125885B CN201811128257.XA CN201811128257A CN109125885B CN 109125885 B CN109125885 B CN 109125885B CN 201811128257 A CN201811128257 A CN 201811128257A CN 109125885 B CN109125885 B CN 109125885B
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- sheath
- carotid artery
- intracranial
- aorta
- internal carotid
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- 238000007917 intracranial administration Methods 0.000 title claims abstract description 35
- 210000004004 carotid artery internal Anatomy 0.000 title claims abstract description 32
- 210000000709 aorta Anatomy 0.000 title claims abstract description 24
- 210000002376 aorta thoracic Anatomy 0.000 claims abstract description 20
- 210000001715 carotid artery Anatomy 0.000 claims abstract description 19
- 210000001168 carotid artery common Anatomy 0.000 claims description 10
- 238000002513 implantation Methods 0.000 claims description 7
- 210000003270 subclavian artery Anatomy 0.000 claims description 7
- 230000017531 blood circulation Effects 0.000 abstract description 10
- 230000036770 blood supply Effects 0.000 abstract description 8
- 208000006011 Stroke Diseases 0.000 abstract description 5
- 239000008280 blood Substances 0.000 abstract description 5
- 210000004369 blood Anatomy 0.000 abstract description 5
- 238000000034 method Methods 0.000 abstract description 5
- 230000000903 blocking effect Effects 0.000 abstract description 3
- 210000004204 blood vessel Anatomy 0.000 abstract description 3
- 210000002302 brachial artery Anatomy 0.000 description 3
- 208000002251 Dissecting Aneurysm Diseases 0.000 description 2
- 238000004873 anchoring Methods 0.000 description 2
- 208000007474 aortic aneurysm Diseases 0.000 description 2
- 206010002895 aortic dissection Diseases 0.000 description 2
- 210000001367 artery Anatomy 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 201000010099 disease Diseases 0.000 description 2
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 2
- 238000002695 general anesthesia Methods 0.000 description 2
- 230000003902 lesion Effects 0.000 description 2
- 239000007787 solid Substances 0.000 description 2
- 230000002792 vascular Effects 0.000 description 2
- 230000006978 adaptation Effects 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 230000002146 bilateral effect Effects 0.000 description 1
- 230000000740 bleeding effect Effects 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 238000011084 recovery Methods 0.000 description 1
- 238000002054 transplantation Methods 0.000 description 1
- 210000001364 upper extremity Anatomy 0.000 description 1
Classifications
-
- 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
- A61M25/00—Catheters; Hollow probes
- A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
- A61M25/0023—Catheters; Hollow probes characterised by the form of the tubing by the form of the lumen, e.g. cross-section, variable diameter
-
- 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
- A61F2/07—Stent-grafts
Abstract
The invention provides an intracranial flow transfer device for an aorta and a left internal carotid artery. The invention has the advantages that the temporary blood supply channel established by the external flow transfer tube can simply supply blood to the left internal carotid artery and the intracranial blood vessel when the aortic arch stent graft is covered, and the original blood flow is restored after the stent graft is windowed and branched and rebuilt. The method for external transfer flow has simple operation, smaller wound, no need of blocking carotid artery, no need of interrupting intracranial blood flow, little plaque falling off, no influence on operation and lower incidence rate of stroke of patients.
Description
Technical Field
The invention relates to the field of medical and ergonomic intersection, in particular to a temporary intracranial transfer device for an aorta and a left internal carotid artery.
Background
Aortic aneurysms and aortic dissection are a disease that threatens human life. At present, the surgical operation is still an effective treatment method for aortic dissection and aneurysm, but has the defects of high technical difficulty, high requirements for operators and operating rooms and limited popularization and application, but the technology needs general anesthesia downlink bypass transplantation, the surgical risk is relatively higher than that of simple medical intracavity treatment, the surgical time and the postoperative recovery time are long, and complications such as infection, bleeding and the like are relatively more.
In recent years, the application and development of aortic endoluminal prostheses (TEVAR) have greatly changed the conditions of treatment for the disease, and their advantages of minimally invasive, safe, effective, etc. have been widely accepted. In some patients, the treatment of aortic arch lesions is a great challenge to current vascular surgeons due to the complexity of aortic arch anatomy, the high risk of cerebral stroke. The aortic arch has complex anatomy, and has different degrees of distortion in the coronary position, the sagittal position and the axial position, and the distortion is continuously changed along with the age, so that the difficulty of accurately measuring the cross-section diameter of the aortic arch and the difficulty of accurately releasing the stent during the intracavity treatment are increased, and a longer anchoring area is required when the stent is effectively anchored. The upper branch vessel provides blood supply for the upper limb, especially the head and neck, limits the random upward movement of the anchoring area, also brings greater risk for technical operation when treating the lesion of the arch, and the variation of the branch aggravates the complexity. It is therefore important to establish a means of temporary aortic and left carotid intracranial flow.
Disclosure of Invention
The invention aims to solve the technical problem of providing an aortic and left carotid intracranial flow transfer device which is simple and convenient to operate, has smaller wound, does not need to block carotid arteries, does not need to interrupt intracranial blood flow, causes little plaque shedding, does not influence operation and has lower incidence rate of stroke of patients.
In order to solve the above problems, the present invention provides an apparatus for intracranial inversion of aorta and left carotid artery, comprising: a first sheath tube which can be implanted into an aortic arch at the proximal end through a left common carotid artery, and the tail end of the first sheath tube faces to the direction of a left internal carotid artery; a second sheath capable of being implanted into the distal end of the left internal carotid artery, the tail end of the second sheath being oriented in the direction of the left common carotid artery; and the third sheath tube can be implanted into one end, close to the aortic root, of the aortic arch at the proximal end through the left subclavian artery, the tail end of the third sheath tube is positioned in the left subclavian artery, and the third sheath tube is communicated with the second sheath tube.
In an embodiment, the device for intracranial flow of aorta and left carotid artery further comprises a flow tube, wherein two ends of the flow tube are respectively connected with the branch tube at the tail end of the second sheath tube and the branch tube at the tail end of the third sheath tube, so that the third sheath tube is communicated with the second sheath tube.
In one embodiment, the primary sheath is a sheath of greater than 12F.
In one embodiment, the second sheath is a sheath greater than 6F.
In one embodiment, the length of the secondary sheath is greater than 6 cm.
In one embodiment, the length of the second sheath is greater than the depth to which the second sheath is implanted in the left internal carotid artery.
In one embodiment, the third sheath is a 6F-8F sheath.
In one embodiment, the length of the third sheath ranges from 45 cm to 80 cm.
In one embodiment, the length of the third sheath is greater than the depth of implantation of the third sheath.
The invention has the advantages that the temporary blood supply channel established by the external flow transfer tube can simply supply blood to the left internal carotid artery and the intracranial blood vessel when the aortic arch stent graft is covered, and the original blood flow is restored after the stent graft is windowed and branched and rebuilt. The method for external transfer flow has simple operation, smaller wound, no need of blocking carotid artery, no need of interrupting intracranial blood flow, little plaque falling off, no influence on operation and lower incidence rate of stroke of patients.
Drawings
Fig. 1 is a schematic diagram of the device for intracranial flow transfer between the aorta and the left carotid artery of the present invention.
Detailed Description
The following describes in detail the embodiments of the device for intracranial transfer of aorta and left carotid artery provided by the invention with reference to the drawings.
Fig. 1 is a schematic diagram of the device for intracranial flow transfer between the aorta and the left carotid artery of the present invention. Referring to fig. 1, the device for intracranial inversion of aorta and left carotid artery of the present invention comprises a first sheath 1, a second sheath 2 and a third sheath 3.
The primary sheath 1 is a sheath of 12F or more. Where F is the unit "French" of the sheath, which is descriptive of the sheath circumference. For example, a 6F sheath may have an inner diameter of about 2mm and a 24F sheath may have an inner diameter of about 8mm. The first sheath 1 can be implanted through the left common carotid artery 10 at the proximal aortic arch 11. Specifically, in using the aortic and left carotid intracranial flow transfer device, the first sheath 1 is implanted proximally through the left common carotid artery 10 to the aortic arch 11. For example, in this embodiment, a large sheath of 12F is implanted proximally through the left common carotid artery 10 to the aortic arch 11.
The length of the secondary sheath 2 is greater than 6 cm, which is a short sheath. The second sheath 2 can be implanted distally of the left internal carotid artery 12. Wherein the length of the secondary sheath 2 is greater than the depth of implantation of the secondary sheath 2 into the left internal carotid artery 12. Specifically, in using the aortic and left carotid intracranial flow device, the second sheath 2 is implanted distally of the left internal carotid artery 12. For example, in this embodiment, a short sheath of 6F is implanted to the distal end of the left internal carotid artery 12 at a depth of 4-6 cm, and the length of the secondary sheath 2 is longer than the depth of implantation, i.e., the tail end of the secondary sheath 2 is exposed. At the tail end of the secondary sheath 2 there is at least one branch 20 to facilitate connection with other sheaths.
The length of the third sheath tube 3 ranges from 45 cm to 80 cm, and the third sheath tube is a long sheath. The third sheath 3 is a sheath of 6F-8F. The third sheath 3 can be implanted at the proximal end of the aortic arch 11 near the root of the aorta, with the trailing end of the third sheath 3 in the left subclavian artery 13. Wherein the length of the third sheath 3 is greater than the implantation depth of the third sheath 3. Specifically, in using the aortic and left carotid intracranial flow transfer device, the third sheath 3 is implanted proximally through the left brachial artery to the aortic arch 11 near the aortic root. For example, in this embodiment, an 8F long sheath (60 cm in length) is implanted through the left brachial artery toward the proximal end of the heart to the aortic arch 11 near the aortic root, and the length of the third sheath 3 is greater than the implantation depth of the third sheath 3, i.e., the tail of the third sheath 3 is exposed. At the tail end of the third sheath 3 there is at least one branch 30 for connection with other sheaths.
The second sheath tube 2 and the third sheath tube 3 are communicated. Specifically, the device for intracranial diversion of aorta and bilateral carotid arteries further comprises a diversion tube 4, wherein two ends of the diversion tube 4 are respectively connected with a branch tube 20 at the tail end of the second sheath tube 2 and a branch tube 30 at the tail end of the third sheath tube 3, so that the second sheath tube 2 is communicated with the third sheath tube 3. The transfer tube 4 is a double-ended transfer tube, which is of conventional construction in the art, and is available to those skilled in the art from the prior art. In this embodiment, the present invention is applicable to a variety of applications.
The device for intracranial transfer of the aorta and the left carotid artery can simply carry out temporary blood supply of the left carotid artery and the intracranial blood vessel when the aortic arch stent graft is covered by the temporary blood supply channel established by the external transfer tube, and restore the original blood flow after the stent graft is windowed and branched and rebuilt. The method for external transfer flow has simple operation, smaller wound, no need of blocking carotid artery, no need of interrupting intracranial blood flow, little plaque falling off, no influence on operation and lower incidence rate of stroke of patients.
The operation of the device for intracranial inversion of the aorta and the left carotid artery according to the invention is described below. When the device for intracranial transfer of the aorta and the left carotid artery is used, the flow direction of blood is shown by a dotted arrow and a solid arrow in the figure, wherein the dotted arrow is the flow direction of the blood before and during windowing of the left carotid artery, and the solid arrow is the flow direction of the blood after windowing of the left carotid artery.
After the general anesthesia is successful, the left carotid artery and the left subclavian artery are incised and exposed under aseptic conditions, and an intracranial diversion method for the aorta and the left internal carotid artery is established. The content of the following three parts is mainly included:
the first portion establishes a transfer sheath of the left common carotid artery and the left internal carotid artery. The left internal carotid artery 12 is cannulated distally with a second sheath 2, with the left common carotid artery 10 being implanted proximally with the first sheath 1 to the aortic arch.
The second portion establishes a left subclavian arterial transfer sheath. A third sheath 3 is implanted proximally through the left brachial artery to the aortic arch near the aortic root.
The third section establishes a diversion system of the left subclavian artery with the left internal carotid artery. The branch pipe at the tail end of the second sheath pipe 2 and the branch pipe at the tail end of the third sheath pipe 3 are respectively connected through a transfer pipe 4, so that the second sheath pipe 2 is communicated with the third sheath pipe 3, and the blood supply of the left intracranial artery is ensured.
Before the left internal carotid artery is windowed, a stent graft (not shown in the drawing) is implanted into the aortic arch 11, and the stent graft blocks blood circulation at the left common carotid artery 10, so that blood flows into the left internal carotid artery 12 through the third sheath tube 3, the shunt tube 4 and the second sheath tube 2 after the stent graft is implanted and during the left internal jugular vascular windowing operation, thereby ensuring blood supply to the left internal carotid artery; when the left internal carotid artery is windowed, the left common artery 11 is no longer blocked by the covered stent, and then blood flows into the left internal carotid artery 12 through the first sheath tube 1 and the second sheath tube 2, so as to ensure the blood supply of the left internal carotid artery.
The foregoing is merely a preferred embodiment of the present invention and it should be noted that modifications and adaptations to those skilled in the art may be made without departing from the principles of the present invention, which are intended to be comprehended within the scope of the present invention.
Claims (6)
1. A device for intracranial inversion of an aorta and a left internal carotid artery, comprising:
a first sheath tube which can be implanted into an aortic arch at the proximal end through a left common carotid artery, and the tail end of the first sheath tube faces to the direction of a left internal carotid artery;
a second sheath capable of being implanted into the distal end of the left internal carotid artery, the tail end of the second sheath being oriented in the direction of the left common carotid artery;
a third sheath capable of being implanted through the left subclavian artery to an end of the aortic arch near the proximal end of the aorta root, the trailing end of the third sheath being positioned within the left subclavian artery, the third sheath being in communication with the second sheath;
the device for intracranial flow of the aorta and the left carotid artery further comprises a flow transfer pipe, wherein two ends of the flow transfer pipe are respectively connected with a branch pipe at the tail end of the second sheath pipe and a branch pipe at the tail end of the third sheath pipe so as to enable the third sheath pipe to be communicated with the second sheath pipe;
the primary sheath is a sheath with the diameter of more than 12F;
the secondary sheath is a sheath greater than 6F.
2. The device for intracranial transfer between an aorta and a left internal carotid artery as recited in claim 1, wherein the second sheath has a length greater than 6 cm.
3. The device for intracranial transfer between an aorta and a left internal carotid artery as recited in claim 1, wherein the length of the second sheath is greater than the depth of implantation of the second sheath into the left internal carotid artery.
4. The device for intracranial transfer between the aorta and the left internal carotid artery of claim 1, wherein the third sheath is a 6F-8F sheath.
5. The device for intracranial transfer between the aorta and the left internal carotid artery as recited in claim 1, wherein the third sheath has a length ranging from 45 cm to 80 cm.
6. The device for intracranial transfer between an aorta and a left internal carotid artery as recited in claim 1, wherein the length of the third sheath is greater than the depth of implantation of the third sheath.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201811128257.XA CN109125885B (en) | 2018-09-27 | 2018-09-27 | Intracranial transfer device for aorta and left internal carotid artery |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201811128257.XA CN109125885B (en) | 2018-09-27 | 2018-09-27 | Intracranial transfer device for aorta and left internal carotid artery |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN109125885A CN109125885A (en) | 2019-01-04 |
| CN109125885B true CN109125885B (en) | 2024-03-22 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201811128257.XA Active CN109125885B (en) | 2018-09-27 | 2018-09-27 | Intracranial transfer device for aorta and left internal carotid artery |
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| Country | Link |
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| CN (1) | CN109125885B (en) |
Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN204072389U (en) * | 2014-10-21 | 2015-01-07 | 郭伟 | A kind of for maintaining shunt tube in the blood supply of aortic arch branch vessel |
| CN106214287A (en) * | 2016-08-24 | 2016-12-14 | 杨威 | Dissection of aorta operation overlay film frame, conveyer device and using method |
| CN106823101A (en) * | 2017-02-16 | 2017-06-13 | 杭州唯强医疗科技有限公司 | Interim shunt tube in a kind of chamber |
| CN209809267U (en) * | 2018-09-27 | 2019-12-20 | 上海交通大学医学院附属第九人民医院 | Intracranial diversion device for aorta and left internal carotid artery |
Family Cites Families (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP3789069B1 (en) * | 2008-02-05 | 2024-04-03 | Silk Road Medical, Inc. | Systems for establishing retrograde carotid arterial blood flow |
| AU2016255848B2 (en) * | 2015-04-30 | 2020-10-01 | Silk Road Medical, Inc. | Systems and methods for transcatheter aortic valve treatment |
-
2018
- 2018-09-27 CN CN201811128257.XA patent/CN109125885B/en active Active
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN204072389U (en) * | 2014-10-21 | 2015-01-07 | 郭伟 | A kind of for maintaining shunt tube in the blood supply of aortic arch branch vessel |
| CN106214287A (en) * | 2016-08-24 | 2016-12-14 | 杨威 | Dissection of aorta operation overlay film frame, conveyer device and using method |
| CN106823101A (en) * | 2017-02-16 | 2017-06-13 | 杭州唯强医疗科技有限公司 | Interim shunt tube in a kind of chamber |
| CN209809267U (en) * | 2018-09-27 | 2019-12-20 | 上海交通大学医学院附属第九人民医院 | Intracranial diversion device for aorta and left internal carotid artery |
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| Publication number | Publication date |
|---|---|
| CN109125885A (en) | 2019-01-04 |
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