JPH078512A - Branched artificial blood vessel - Google Patents

Abstract

(57) [Summary] [Objective] To provide a branched artificial blood vessel suitable for replacement of an aortic arch aneurysm. The present invention relates to a polyester artificial blood vessel in which three side tubes used for replacing a lesion of an aortic arch are branched, and the inner diameter of the side tube having the largest inner diameter and any other internal diameter. The ratio of the inner diameters of the side tubes is within the range of 1.1 to 1.7, and more preferably, the distance between adjacent side tubes is 18
It relates to a branched artificial blood vessel having a diameter of not more than mm.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a bifurcated artificial blood vessel,
In particular, it relates to a bifurcated artificial blood vessel used to replace a lesion in the aortic arch.

[0002]

2. Description of the Related Art The blood pumped from the heart is pumped through the aortic valve of the heart and is led to the whole body through the aorta. The aorta goes up to the right behind the pulmonary trunk and enters the ascending aorta, which becomes arcuate (this part is called the aortic arch) and goes backwards beyond the left lung root It passes directly to the left of the thoracic vertebra and then to the descending aorta, which runs in front of the spine and descends, leading to a group of arteries throughout the body. (Fig. 1) This aortic arch is the main part that sends blood to the whole body, and the branches of this part are the common carotid artery (two left and right) leading to the head and the subclavian artery (two left and right) leading to the arm. And branch. In the living body, there are three direct branches from the aortic arch. When a lesion occurs in the vicinity of this bifurcation, treatment is performed by replacing the bifurcated part of the complicatedly branched living blood vessel with an artificial blood vessel. At this time, it is naturally considered that the one matching the living structure is good.

[0003]

FIG. 2 illustrates an example of replacing an artificial blood vessel with an aortic aneurysm as an example. The practitioner will excise the lesioned part of the living blood vessel, stitch the artificial blood vessels together, and replace the lesioned part with the artificial blood vessel to complete the surgery. On the other hand, if this lesion extends further to the bifurcation, that is, as shown in FIG. 3, if a preliminarily bifurcated artificial blood vessel can be obtained, the labor can be saved and the operation time can be shortened. With the extremely dangerous open heart surgery, even a highly skilled practitioner can exert outstanding effects in this type of surgery that is extremely difficult.

[0004]

DISCLOSURE OF THE INVENTION The present invention is a polyester artificial blood vessel in which three side tubes are branched, the side tubes having different inner diameters, and the inner diameter of the side tube having the largest inner diameter and others. The ratio of the inner diameters of the arbitrary side tubes of 1. is within the range of 1.1 to 1.7. Furthermore, in the branched artificial blood vessel derived from three side tubes, the distance between the side tube having the largest inner diameter and the side tube adjacent thereto is preferably 18 mm or less.

The present invention relates to a branched artificial blood vessel for replacing a lesion of the aortic arch among the artificial blood vessels, in which three side tubes are branched into the main part of the artificial blood vessel. One is a branched artificial blood vessel characterized by having a larger inner diameter than the other side tubes. The inner diameter of the main part of the artificial blood vessel is 18 to 36 m
m, preferably between 20 and 32 mm. When this inner diameter is smaller than 18 mm, it does not match the living body aorta in the case of an adult, and when it is larger than 36 mm, it does not match with the diameter of the living blood vessel and anastomosis becomes difficult or impossible. The size of living blood vessels varies from person to person, but 18 to 3
It will almost always be within 6 mm. Infants and children need smaller diameters, but there are not so many examples. This is because most of the lesions to which the artificial blood vessel is applied are usually adults.

In the branched artificial blood vessel of the present invention, three lateral tubes are derived from the main part of the artificial blood vessel.
The feature is that the inner diameter of the tube, especially at one end, is larger than at the other side. The reason for this is that in the aorta of the living body, the common carotid artery leading to the neck and the clavicle artery leading to the left arm are directly derived from the aortic arch on the left side, whereas the relatively thick brachiocephalic artery is the aortic arch on the right side. It is divided into two parts, the common carotid artery and the subclavian artery. In other words, the branch arteries directly derived from the aortic arch are a relatively thick brachiocephalic artery, a relatively small subclavian artery, and a common carotid artery, which are relatively thin. Of course, it is also understood that the blood flow in the brachiocephalic artery should be comparable to the sum of the blood flow in the subclavian and common carotid arteries.

In the present invention, the ratio of the inner diameter of the side pipe having a relatively large inner diameter to the inner diameter of any other relatively thin side pipe is 1.1.
To 1.7, more preferably 1.20 to 1.5
0, more preferably between 1.25 and 1.45.
If this ratio is less than 1.1, the blood volume on the left and right of the human body will be unbalanced, and it will be difficult to supply a sufficient blood volume to the right side of the human body. Your blood volume will increase. In other words, it becomes unnatural as it deviates from the natural appearance of the living body, which is not preferable for the living body.

Further, what is important in terms of matching with the living body is the distance between the branch side tubes of the artificial blood vessel. Since replacement of an artificial blood vessel with a living blood vessel has a branch in an extremely narrow local area, if the distance is not appropriate, replacement of a lesion in a narrow area is actually impossible. Here, the distance between the branch pipes is extremely important. In the present invention, the distance (l ₁ ) between the relatively thick side tube (A, inner diameter d ₁ ) and the adjacent side tube (B, inner diameter d ₂ ) shown in FIG. 4 is 18 mm or less, preferably 15 mm or less, Preferably 10 mm
Hereinafter, it is 3 mm or more, and the distance (l ₂ ) between the relatively thin side tubes (B, C) is 0 to 10 mm, preferably 0 to 8
mm, and more preferably 0 to 6 mm. And l ₁
> l ₂ , d ₁ > d ₂ , d ₃ , d ₁ / d ₂ = 1.1 to 1.7, and more preferably d ₁ / d ₂ = 1.20 to 1.50. As described above, if there is no dimensional compatibility, anastomosis with a living blood vessel or local matching becomes impossible or unnatural. Artificial blood vessels are naturally substitutes for living blood vessels, and it is important that they naturally fit into living blood vessels without difficulty. Satisfying these conditions leads to easier operation for the practitioner, shorter operation time, and contributes to the natural blood circulation for the patient even after the operation. become.

[0009]

INDUSTRIAL APPLICABILITY The present invention is a bifurcated artificial blood vessel used for replacement of an aortic arch, which is an artificial blood vessel for aorta derived from three lateral vessels, one of which has a larger diameter than the other two. And by defining the mutual distance of the three side tubes,
Improves compatibility with the living body, exerts power in easiness and accuracy of surgery, shortens surgery time, contributes to proper blood circulation in post-operative patients, and brings the gospel to patients and practitioners It is a thing.

[0010]

【Example】

Example 1 A side surface of a polyester woven artificial blood vessel (inner diameter 27.2 mm, length 50 cm) of porosity 50 ml was cut into a circle, and one inner diameter 10 mm and two inner diameter 8 mm were cut into this.
The same type of artificial blood vessel in the book was sutured. In this case, the ratio of the relatively thick side tube (10 mm in this example) and the relatively thin side tube (8 mm in this example) is 1.25. The distance between the relatively thick side tube and the adjacent side tube was 10 mm, and the distance between the relatively thin side tubes was 3 mm. Although the replacement of the aortic arch was actually performed clinically with this bifurcated artificial blood vessel, the operation was performed extremely smoothly, and the operation could be completed accurately in a shorter time than expected. The prognosis for this patient was extremely good. On the other hand, an attempt was made to sew something with a 18 mm space between the thick side tube and the thin side tube, but it was unsuitable as a branched artificial blood vessel due to the spatial difficulty.

Example 2 A circular cutout opening is formed on the side surface of a woven artificial blood vessel (70 cm) having an inner diameter of 25 mm, and one side tube having an inner diameter of 10 mm and side tubes each having an inner diameter of 7.5 mm and 8 mm are formed on the side. Were sewn in this order to make a bifurcated artificial blood vessel having three bifurcations. The diameter ratios of the three side tubes of the large, medium and small of this example are a large / medium ratio of 1.33 and a large / small ratio of 1.43. The distance between the side tubes was 10 mm between the large side tube and the middle side tube, and 4 mm between the middle side tube and the small side tube. This artificial blood vessel was highly evaluated by the practitioner and was put to practical use without any problems.

[Brief description of drawings]

FIG. 1 shows the location of the aortic arch and associated arteries in the human body.

FIG. 2 shows an example in which an arch aortic aneurysm is replaced with an artificial blood vessel without a branch.

FIG. 3 shows an example in which an arch aortic aneurysm is replaced with a branched artificial blood vessel.

FIG. 4 is a schematic diagram of a branched artificial blood vessel.

Claims (2)

[Claims] 1. A polyester artificial blood vessel in which three side tubes are branched, the inner diameters of the side tubes are different, and the inner diameter of the side tube having the largest inner diameter and the inner diameter of any other side tube are A branched artificial blood vessel having a ratio within a range of 1.1 to 1.7. 2. The branched artificial blood vessel according to claim 1, wherein in the artificial blood vessel obtained by deriving three side tubes, the distance between the side tube having the largest inner diameter and the side tube adjacent thereto is 18 mm or less. .