CN1226150A - 身体管道的修补物修复 - Google Patents
身体管道的修补物修复 Download PDFInfo
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Abstract
弹性衔接身体管道的修补物包括一圆形夹环,它可沿径轴折合,以插入身体管道。一旦在身体管道就位,夹环便适于弹性弹向外面,并不断弹性偏转,靠在身体管道内表面。一个或一个以上的夹环可连接管状移植物对置端。圆环和连接的移植物可用操作装置配置在身体管道内,在一些实施例中,该装置可有选择地使圆环膨胀和/或收缩在身体管道应有位置。换句话说,可采用保持机构把圆环保持在压缩状态,直到处于身体管道内所需位置为止。在其他可能的用途中,本发明作为血管移植片固定膜,医治腹主动脉瘤是非常有用的。
Description
本发明涉及保持在身体管道内的装置,特别适用于血管移植片固定膜(stents),以修复称为动脉瘤的动脉扩张。
由于动脉硬化,部分血管可能变薄和极端扩张。这些扩张的脉管可采用脉管修补物(假体)在扩张或变薄延伸区搭桥进行治疗。这样脉管病变部分便有效地与血管中压力隔离。
采用外科手术,打开脉管,缝合修补物就位,将血管修补物插入脉管病变部分,不过,最好采用导管系统,由远距离开口,如靠近腹股沟的股动脉插入修补物。这是由于避免需要打开主体腔,把外科手术引起的潜在并发症减少到最低程度。
一般说来,最好使用导管在折合或压缩状态插入修补物(prosthesis),然后就位时,膨胀修补物,这样做的一种原因是希望在插入过程中基本上避免闭塞血液流动。因此,通过修补物折合,可使修补物很快地置入脉管内,在一些情况下基本上不使血液流动闭塞。
一般说来,在修复地点一次就位膨胀修补物有两种方法,一种是用有两种构型的韧性金属修补物。其中一种构型直径很小,另一种构型径向非常膨胀,接触并紧固到脉管病变区任一侧颈部。修补物可以是韧性金属环,靠气胀导管膨胀,将膨胀的直径修补物设置在颈部内,邻近脉管病变部分。
另一种通用方法是采用膨胀修补物,可以压缩,防回弹偏斜。修补物一旦就位,便可弹性膨胀,与脉管壁接触。
尽管推出各种各样解决问题的方法,有效绕过病变组织,但现行各种修复装置结构仍存在一定缺陷。例如,在某些情况下,病变脉管部分任一侧颈部非常短,这就使得修复装置难以充分衔接动脉瘤任一侧细颈。
此外,一些现有修补物,在插入修补物过程中会造成血液流动阻塞,这在生理上起到相反作用。另外还有问题是现有许多修补物不能对脉管内表面充分密封,而使血液泄漏,透过修补物进入修补物与变薄血管之间地区。这种型式的泄漏可能造成损伤后果。有些结构的装置不适合非圆形或形状不规则的颈区。
有些常用修补物还有另外的问题是要求医院备置各种尺寸的修补物,供不同的情况和不同的患者生理使用。而且有些结构要求修补物定制,适合于每个具体患者。
另外还出现一旦修补物膨胀,难于使修补物准确定位,在有些情况下,因定位不准而出现问题。而且在许多现有修补物中有可能有的修补物移位,离开所需位置,以致不能发挥有效作用,保护变薄的脉管。
所以,由于这些和其他原因,需要继续提高解决修复病变脉管问题的方法,通常是解决修复装置有效固定在身体管道内壁的问题。
本发明的一个方面是在身体管道保持修补物的装置包括一环状弹性元件。该元件有一不变形直径,大于身体管道直径。
本发明的另一方面是插入身体管道的修补物包括一环状弹簧元件和一管状移植物。移植物连接元件。该元件有一不变形直径,大于移植物直径。
本发明再有一方面是修复病变第一脉管的血管修补物包括一弹性圆环,它有第一对和第二对环线,前者向一个方向延伸,后者则向相反方向延伸。第一和第二对环线连接一起。管状移植物与圆环相连。布置的移植物沿第一脉管长度延伸,而布置的第一对环线则延长,至少部分经过第二脉管与第一脉管交叉点。第二对环线之一形成一开口,使第一与第二脉管连通,至少部分经过修补物。
本发明还有一个方面是身体管道修复装置的固定方法。包括工步有折合弹性圆环,呈现第一构型,其横截面积小于不变形圆环的横截面积。圆环置于身体管道所需位置,使能弹性变形到第二构型,其直径大于第一构型直径,但横截面积仍小于不变形圆环的横截面积。
但按照本发明另一方面,病变脉管修复方法包括的工步还有圆环径轴折合,呈现小横截面构型,形成一对环线,向离开径轴方向延伸。圆环布置在脉管内,其径轴邻近交叉脉管,致使环线延伸至少部分经过交叉脉管,而不闭塞交叉脉管。
按照本发明还有一方面是身体管道修复装置的固定方法再有一工步是沿径轴折合上述弹簧,使环状弹性弹簧变形。弹簧设置在身体管道内。弹簧弹性膨胀,靠在身体管道。弹簧不断压向外面,靠在身体管道。
但按照本发明另一方面,修复装置包括有人造心脏瓣膜,柔性管套,后者有可连接瓣膜的第一端和第二端。还有弹性变形圆环与第二端相连,并准备将移植物连接到升主动脉部分的内表面。
按照本发明再有一方面是身体管道插入修补物至少包括两个环状弹性弹簧元件和一个柔性管状移植物,后者与每个元件相连。刚性元件纵向连接元件。刚性元件的柔性低于移植物。
本发明一个或一个以上的实施例详情表示在附图和以下说明中。本发明的其他特性,目的及优点从说明和附图以及权利要求中一目了然。
图1是本发明一个实施例的夹环综合顶视平面图;
图2是在身体管道最佳就位的图1实施例缩小透视图;
图3是夹环插入身体管道前的立面正视图;
图4是夹环插入身体管道后的立面正视图;
图5是图4所示实施例立面侧视图;
图6是带有操作装置的修补物立面正视图;
图7是图6通常沿7-7线的剖面图;
图8是图6所示固位装置部分放大剖面图;
图9是图8通常沿9-9线的剖面图;
图10是图8通常沿10-10线的剖面图;
图11是固位环线保持的修补物放大立面正视图;
图12是固位环线部分放大立面正视图;
图13是修补物和插入装置另一实施例立面正视图;
图14是图13所示修补物放大图;
图15是插入身体管道前图11所示实施例放大剖面图;
图16是插入身体管道前图13所示实施例剖面图;
图17是在分段主动脉叉就位的另一实施例立面正视图;
图18是在分段主动脉叉就位的又一实施例立面正视图;
图19是图18所示组件放大立面正视图;
图20是图19通常沿20-20线的剖面图;
图21是图19通常沿21-21线的剖面图;
图22是与图14相对应所示另外实施例的立面正视图;
图23是另一实施例部分区段立面正视图;
图24是位于部分心脏内的修复装置立面正视图。
关于附图,在一些图中,所有相同零件都采用同一参考号码,如图1,8和10所示,由许多弹性合股线32组成圆形弹性夹环30。一段金属线缠在心轴(无图示)上构成夹环30的一个实施例,该心轴带有中心轴“C”,而后用系线34将合股线扎成线束。系线34可用外科缝线材料制成。当然,夹环30也可用其他各种方法制作,包括采用单股线,采用螺旋缠结一起的多股线制成多股线绳,或采用其他合适的方法制作高弹性圆环。
根据采用的金属线和有关具体用途,合股线32或线圈数量可有所不同。但是在一项实施例中,采用的合股线32数量大约是8~10,如图10所示。不过,合股线32或线圈数量可少至2到多达100不等,甚至可能更多。
当采用各种不同线径时,单根合股线32的直径大约为0.05到1mm。在一项有效实施例中,采用的合股线32线径约为0.1mm。
合股线32可用任何高弹性金属或塑料制作,包括镍钛合金,如尼太诺尔〔镍钛〕合金。通过常采用弹性或超弹性或马氏体形式的尼太诺尔〔镍钛〕合金。
圆环30直径DK根据有关具体身体管道而有很大变化。在主动脉血管移植物方面,环径大约30mm就可满足要求,而在其他使用场合,环径(DK)大约6到50mm是适宜的。在一些实施例中,环径最好为13mm。
关于图1,压缩以前的圆环32直径DK明显大于要治疗的身体管道36的直径DR。如图1所示,不变形环30两个径向对置点“A”可彼此相对地偏转。如箭头所示,这样引起圆环30沿径轴“B”折合。这种构型可使圆环30插入缩小截面构型的身体管道36。
由于沿径轴“B”折合的结果,具有折合尖端“A”的环线38,相对于沿折合径轴的“B”点接近延伸。正如本文采用的,术语“邻近”指的是关于血液流动上游方向,而术语“远侧”则指的关于血液流动下游方向。
一旦在身体管道36中就位,圆环30便不断接触脉管36内壁,即使圆环30可能产生普通正弦形式。以一级近似表示,如图2所示,高度H是径向压缩的二次函数。
如图2所示,无塑性变形最小允许弯曲直径DB取决于材料,夹环30厚度以及组成圆环30的单独合股线32。根据虎克定律,合股线32可以认为是平行连接的弹簧,其偏转特性值可相加,单独的低径向张力加到总张力上,该张力取决于合股线32的数量。当整个圆环30压缩时,每一单独合股线32弯曲直径大致与单一合股线32最小弯曲直径DB相一致。
按照近似法,最小弯曲直径DB大约10倍于线径。这样我们就可以假定,圆环30线径较小。但是,身体管道36上的圆环夹紧力是其直径的函数,相反,可以假定,线径得到增加。这种比较评定方法可以优化,即采用许多合股线32,由其直径控制最小弯曲直径,再形成线束,由其复合直径控制夹紧力。因此,形成的夹环30具有很大张力,而压缩构型很小。例如,具有传统直径4到6mm的圆环30,在脱开导管后,可恢复到原始形状,并依靠足够的张力,沿着身体管道36管壁牢牢压住圆环30。
如图3所示,修补物40包括有圆环30和移植物42。移植物42通常为管状,由织物或薄膜制作,一端固定在圆环30上。移植物42的直径DP小于夹环30的直径DK。由于夹环30与移植物42端部之间连接,在夹环与移植物42接合点形成直径DKP。夹环30可将管状移植物42膨胀到阻挡或变形极限,此后不会再发生膨胀。因此,夹环30可在邻近夹环30的区域移植物42上膨胀,以致移植物42直径在区域44,向下到相当恒定的直径区域46逐渐变细,终结在自由端47。换句话说,移植物42可预成形,呈图3所示喇叭形状。
任何一种适合人体植入的织物材料都可采用制成移植物42。例如,制作移植物42可以是由涤纶,特氟隆制成的柔性纺织品或针织品或是其他材料。如果管状移植物42由周边不易变化的材料制作更为有利。而且如果移植物42部分46的直径DP大致与要修复的身体管道36直径DR相同则更加有利。
夹环30可通过缝合或粘结与地区44相连。如果夹环30设置在移植物42内表面,以致在夹环30延伸,靠在身体管道36管壁时,移植物42插入管道36与夹环30之间更为有利。因此,很有利的是夹环30直径DK要显著大于移植物42部分46的直径。
关于图4,修补物40可置于腹主动脉48,邻近左肾动脉50和右肾动脉52。环线38延伸,经过动脉50和52,而部分53则恰好位于动脉48和50远侧开口。因此,如图5所示,动脉48和50开口决不会因设置邻近的圆环30而被闭塞,因为圆环30截面通常呈C形构型。
由于这种构型,圆环30可紧固在约束动脉瘤55高度很矮的基本不变形颈部区54。这是因为至少部分圆环30延伸接近超出颈部54以外,故在任何方面都未影响流过动脉48和50。此外,由于夹环30决不会完全膨胀到未折合的构型(如图1所示),故可适用于不规则构型的颈部54截面。
例如,如果颈部54截面是非圆形,则压缩成正弦形的圆环30可适用于不规则的身体管道形状。要使圆环30未压缩的直径(DK)大于预定衔接的身体管道直径(DR),从而在圆环30与身体管道36之间产生连续弹性衔接,甚至身体管道超时膨胀,仍可连续。这种情况是由于正常的脉搏血压或超时血管舒张而有规律地产生。
此外,要使圆环30直径(DKP)大于移植物42直径(DP),以致使用的移植物直径与身体管道36内就位的圆环30压缩截面直径(DK)接近一致。这就减小围绕颈部54不必要的移植物42聚束。
现介绍修补物40设置在管道内所需位置的方法,如图6所示,固位装置56可紧固在圆环30至少两个径向对置方位上,以便使装置56延伸,通常平行于修补物40的轴线。装置56包括一端的管道58和紧固装置56与圆环30的固定架60。换句话说,管道58可用线制动架(无图示)代替。在某些情况下,装置56一端带有倒刺62。不过,在多数情况下,倒刺62是不必要的。
如图7所示,装置56可用金属线64和套管66衔接,前者延伸进入管道58,后者则包入金属线64。最有利的是装置56和套管66用足够刚性的材料制作,因为金属线64或套管66会造成管道36内的修补物40位移,而推向装置56。金属线64直径约为0.3到1mm。
修补物40可以压缩,装入空心导管68,将修补物从远距离入口点输送到修复现场。例如导管68可插入股动脉切口,到达腹主动脉内位置,例如,人们想要设置圆环30的地方。一旦就位,通过套管66便将修补物40推出导管68。特别是外科医生使套管66从身体外部向内延伸,同时保持导管68在固定位置,从而使修补物40在导管68退出时,仍留在应有位置。如果需要,固定架60可用不传导X射线的材料,如铂,铱或金制作,用作X射线标志器。
尽管在某些使用场合,上述设置修补物40的方法非常有用,但最好还要更加准确控制地将修补物40置于特殊位置。一旦圆环30膨胀靠在管道管壁,便要重新设置,克服圆环30的回弹力。因此,最有利的是在修补物40离开导管68后,继续控制圆环30,直到修补物40准确定位为止。为此,如图11和12所示,波顿管70可伸缩固定线环72。线环72轴向延伸,穿过套管70,形成圆环74,再穿过邻近波顿管70自由端的孔76。这时,线环72的环端78承接闭塞线80,而环线78则伸出孔76。
关于图11,波顿管70沿修补物40外部延伸到邻近环线38的部位。圆环74环绕环线38,在其长度最中心位置周边延伸,衔接在与圆环30固定的孔眼82上。这样,闭塞线80可轴向抽出,脱开环端78,从而可使线环72抽出,脱开圆环30,使之在所需位置弹开。在波顿管70内的闭塞线80回到入口点或通过间隙71,退出波顿管70,如图11所示。
关于图15,导管68包住修补物40,修补物再包住一对带金属线64的套管66,金属线穿过套管。必要时可设置导线104,用来在开始时将导管导向所需位置,并保持附加元件在必要时回到同一位置的路线。带有环线72和闭塞线80的波顿管70同样在导管68内在导管与修补物40之间延伸。
在又一个实施例中,如图13和14所示,有一保持机构84,将修补物40保持在压缩形状,准确地固定在管道内所需位置。机构84可控制有一对圆环30的修补物40′,在导管68内压缩位置,靠移植物42连接起来。导线导管86穿过修补物40′轴向延伸出去。有许多小环88伸出导管86。每个小环88连接线环90,线环再在环线38自由端与孔眼92相连。
关于图14,每个线环90穿过孔眼92滑动松脱延伸出去,构成环端94。闭塞线96穿过环端94延伸出去。每个圆环30部分沿折合轴线“B”包上线环98,线环再在自由端用闭塞线100衔接起来。线环98包围全部圆环30,沿导线导管86整个外部再穿过开口102进入导管86内部。移植物42对置端每个圆环30均有相同零件,可用相同方式操作。
所以,如要调整如图14所示方位圆环30的折合程度或邻近一远侧高度,只需要向外拉金属线98,该线同时接到单根线103上,而单根线则延伸到患者外部。为了降低高度和减少圆环30的压缩,可放松线环98张力,使圆环30的自然弹力引起圆环30弯曲而下降,降低圆环高度。
在导管68置于所需位置后,采用前述方法,可将组件从导管推出。圆环30压缩量可调整,以便使装置84暂时处于所需位置。如果测出,位置调整的不精确,则可操作线环98重新压缩装置,使装置84重新调整到新位置。这样,即使修补物预先已松脱,衔接身体管道后,也有可能有选择地调整修补物40′的位置。如果开始有错误,根据需要,也易于重调修补物的位置。一旦修补物位于所需位置,便可简单地通过导管68将闭塞线100和96拉出组件。这样可使修补物40′单向膨胀。然后取出导管86。
如果需要,可用单独的金属线,将每个环线98连接到患者外部。或者加上所述,这样连接环线98,即只有一根单线伸到外面。
现参照图16,表示脱开导管68前,图13和14所示实施例的导管束,导管68包围修补物40′。在修补物40′内部是导线导管86,它带有一根或一根以上的金属线103,用来控制圆环30折合部分的位置。在导线导管86外面是一对与闭塞线96和100相对应的金属线。
按照本发明另一实施例,如图17所示,修补物40补充一个或一个以上的附加组件,如修补物106。第二修补物106可伸缩衔接第一修补物40,衔接采用圆环30,向外膨胀,克服移植物42产生的阻力。第二修补物106包括上圆环30′和下圆环30″。上圆环30′衔接移植物42,而下圆环30″则衔接远侧颈部54b。由于第二修补物106进入第一修补物40的伸缩延长量可以调整,所以可适应对各种纵向尺寸的脉管作广泛布置。
包括一对圆环30′和30″的修补物106具有一根防纵向扭力线31,如图23所示。该线31包围圆环30′和30″,控制修补物106环绕纵轴扭转或扭曲,提供附加纵向支持。金属线31被移植物42覆盖,或是在修补物106内部设置金属线31,或是通过织物制作的移植物42编织金属线31。如果需要,可环绕圆环30′和30″周围设置一根或一根以上的附加金属线31。
第二修补物106可设在第一修补物内,使用导线104,在设置第一修补物所用全部金属线已拆下后,仍保持在应有位置。然后使第二修补物106回到同一位置,使用导线104,在第一修补物40定位后,仍保持在应有位置。
导线104同样保持移植物开口。但是,在实践中,血液流过修补物40造成的作用,就象打开的膨胀风袋一样。因此,利用导线104的引导作用,可使第二修补物106衔接移植物42的内表面。这样,两个修补物40和106的组合,可通过改变修补物106进入修补物40的延长程度来调整颈部54a与54b的间距。
如图22所示,修补物40和106还可用机构84定位。已位于修补物40内的修补物106,可用一组附加闭塞线96′插入患者。闭塞线96′穿过下环线94和修补物40内部延伸出去。这样修补物106可单独进行操作,在修补物40范围内进行伸缩调整。在这种情况下,金属线98和98′可分开移到患者外部,便于单独操作修补物40和106。
与上述相同的修补物也可用来构成叉状移植片固定膜120,如图18所示,该模伸出腹主动脉48及其相关颈部54a,经过下颈部54b,进入髂动脉或骨盆动脉108和110。此外,设置如上所述的修补物40,衔接颈部54a。其次采用专门配置的修补物112代替前面所述的修补物106。如图19所示,修补物112可包括上端的圆环30′和下端的一对圆环114。圆环114不需要压缩,因为修补物112下端完全保持开口构型。
如图20和21所示,修补物112上端有一前述型式的环状结构。下端则是双管状结构,包括一对由连接部118组成的管道116,连接部沿修补物112轴向延伸,形成两个单独的小室116,端接圆环114。圆环114定向,与修补物112轴线成一定角度,使易于从髂动脉108和110进入。
一对小直径的修补物120双向插过各个髂动脉108或110,以衔接修补物112。特别是上环30″穿过圆环114,再进入管道116内部,在此向外膨胀,靠在移植物42。与此同时,每一修补物120另一端122衔接髂动脉108或110处颈部54b。采用配置预先定位的修补物所用同一导线可插入修补物120之一。但是其他的修补物120必须单独配置,不受那一导线制约。为此,圆环30″和114可采用防X射线材料,便于圆环114定位和修补物120穿过,不用预先设置的导线便可插入。
非常明显,在采用上述装置和方法情况下,甚至在外科手术过程中,基本上不用阻塞血液流动便可配置修补物40,40′,120。此外,配置的修补物40,40′或120,基本上不妨碍交叉脉管,如肾动脉。同时可采用定型方法对不同的生理进行调整。配合需要的圆环30决不延伸到全未变形形状,这意味着,不需要备置各种不同的移植片固定膜。而是有可能有着很大的限制,乃至一种尺寸装置,就能适应各种患者情况。
因为圆环30在身体管道就位是C形构型,故有可能将修补物设置在相当狭窄的颈部54地区。由于圆环30保持在压缩状态使用,故可适用于短期和长期医治管道的扩张。此外,由于恒定向圆环30施加弹簧偏转压力,故在圆环30(和修补物)与身体管道管壁之间,即使是管道是不规则的形状,仍能保持良好的密封接触。
在采用上述配置方法条件下,有可能将修补物准确设置在所需的身体管道内。这是因为修补物在装运到所需位置时,保持在最初压缩状态,以致不必克服修补物与脉管管道之间摩擦力就能置于适当位置。一旦处于所需位置,修补物便能激活,衔接管壁。另外还有可能在衔接管壁后,需要时,重新配置修补物。这样便于精确配置,避免在呈现不可改变的膨胀构型后,需要试图重新配置修补物。这样,外科医生就很能控制(例如,通过导线和套管),将修补物准确地置于最有效的位置。
此外,还可使用修补物40,代替升(上行)主动脉病变部分,如图24所示。在主动脉部分,通过外科手术去除后,圆环30可安置在升主动脉“D”其余部分。夹环30本身,如上所述固定在主动脉“D”内表面。夹环连接柔性管套或移植物42,而移植物42再连接缝合环130,便于与机械心脏瓣膜132相连。技术熟练人员通晓瓣膜和移植物细节,而且在Sauter等人发表的美国专利No.5,123,919中有所阐述,本文特此编入,以供参考。
根据有关组织量,移植物42可以有任何不同的长度。移植物42可以延伸的比图示要远,也可以很短。例如,凡是只需要置换心脏瓣膜的地方,移植物42所占比例几乎等于连接机械瓣膜132与圆环30的柔性短套。
尽管本发明就有限数量的最好实施例作了描述,技术熟练人员仍可鉴定作许多修改和变动。例如,尽管在某些情况下,装置作为治疗动脉瘤的血管移植片固定膜作了描述,但本发明还可适用于任何装置在内部管道上的固定。此外,不言而喻,本发明的一些实施例只有上述一项或一项以上的优点,而没有本文专门所述的其他优点。这意味着,只要属于所附权利要求的真正精神和范围之列,则所附权利要求就适用于所有这些修改和变动。
Claims (51)
1.在身体管道保持修补物的装置,包括环状弹性元件,其不变形直径大于上述身体管道直径。
2.权利要求1的装置,其中上述环状弹性元件在不变形时是环状截面。
3.权利要求1或2的装置,其中包括一管状移植物连接上述元件。
4.插入身体管道的修复装置,包括环状弹性弹簧元件和连接上述元件的柔性管状移植物,上述元件的不变形直径大于上述移植物直径。
5.权利要求3或4的装置,其中上述移植物用织物构成。
6.权利要求3到5中任一的装置,其中上述元件连接上述管状移植物一端,上述管状移植物有第一直径和第二直径,前者邻近上述元件的连接部,后者则与上述元件隔开,上述第一直径大于上述第二直径。
7.权利要求6的装置,其中上述元件只在上述织品移植的一端连接织品移植物。
8.权利要求3到6中任一的装置,其中:包括一对元件,上述元件用上述管状移植物连接。
9.权利要求3到6中任一的装置,其中:移植物是叉状移植物,连接上述元件,上述叉状移植物包括连接上述元件的第一管段,和一对连接上述第一管段的管段,上述每对管段有自由端和环状弹性变形元件,该元件连接上述成对管段的上述自由端。
10.上述权利要求中任一的装置,其中:在一共用芯体缠绕许多线圈,并将上述线圈连在一起制成上述元件。
11.权利要求10的装置,其中:上述金属线系用超弹性相镍-钛合金制成。
12.权利要求1的装置,其中:上述元件位于身体管道内,成C形变形配置,绕上述元件径轴折合。
13.权利要求3到12中任一的装置,其中:上述环状元件在不变形时为圆形截面,而且上述元件由许多环形定向的弹性金属制的合股线制成,上述移植物有一对对置自由端,上述环状元件连接上述移植物的上述自由端之一。
14.权利要求3到5中任一的装置,其中上述移植物有一对对置自由端,上述元件连接上述自由端之一,邻近上述元件的上述移植物区域直径大于与该元件隔开的上述移植物部分直径。
15.权利要求3到5中任一的装置,其中上述元件连接上述移植物两个对置自由端之一,上述移植物在与上述弹簧元件相连端的直径大于与上述元件隔开的上述端直径,上述移植物直径从与上述元件相连的上述端逐渐变细到直径缩小,并在移植物剩余部分具有相当恒定的直径。
16.权利要求3到5中任一的装置,其中上述移植物为管状,包括一对对置自由端,弹簧元件连接各上述自由端。
17.权利要求3到5中任一的装置,其中上述移植物包括一对对置端,弹簧元件只连接上述移植物的上述端之一。
18.上述权利要求中任一的装置,其中,包括定位线接收装置。
19.权利要求18的装置,其中上述装置包括一内部管道,可松脱接收上述定位线。
20.上述权利要求中任一的装置,其中,环状元件直径大致为13mm。
21.修复第一病变脉管用的血管修补物,包括一折合弹性圆环,有第一对环线,其向一个方向延伸,和第二对环线,其向相反方向延伸,上述第一和第二对环线连在一起,而管状移植物则连接上述圆环,布置的上述移植物沿上述第一脉管长度延伸,布置的上述第一对环线延伸至少部分经过第二脉管与上述第一脉管的交叉点,上述第二对环线之一形成一开口,使上述第一与第二脉管之间连通,至少部分经过上述修补物。
22.权利要求21的修补物,其中,布置上述第二对环线,以避免在上述修补物置于腹主动脉时阻塞肾动脉。
23.权利要求21或22的修补物,其中上述管状移植物直径小于上述圆环不变形直径。
24.权利要求21,22或23的修补物,其中上述圆环由许多基本是共同中心轴的弹性合股线构成。
25.权利要求21到24中任一的修补物,其中上述圆环在不变形时是圆形截面。
26.权利要求21到25中任一的修补物,其中上述管状移植物有一对对置自由端,圆环连接各个上述自由端。
27.权利要求21到25中任一的修补物,其中上述管状移植物有一对自由端,而圆环只连接上述自由端之一。
28.权利要求21到27中任一的修补物,其中,包括轴向接收导线的装置,上述装置适合伸缩和可松脱地接收上述导线。
29.修补物与身体管道内表面的紧固装置,包括弹性变形圆环,管状移植物有一对对置自由端,上述自由端之一连接上述圆环,而装置适合使上述圆环能够远距离压缩和膨胀。
30.权利要求29的装置,其中上述装置包括导线导管。该导管轴向贯穿上述修补物,上述导线导管适合在以径轴折合成C形时可松脱地衔接上述圆环,而各个环线从上述轴线向外伸出,构成导线导管与圆环和环线之间连接部,以便使上述环线变形量能够彼此之间进行调整。
31.权利要求30的装置,其中各个上述连接部均可从远距离位置脱开。
32.身体管道的插入修补物,包括第一修补物部分和第二修补物部分,前者具有弹性变形环状弹簧元件和管状移植物,上述管状移植物有一对自由端,上述环状弹簧元件则连接上述自由端之一,后者布置则以其同轴向相互对准,衔接上述第一修补物部分内部,上述第二修补物部分包括弹性变形环状弹簧元件,适合衔接上述第一修补物部分的上述管状移植物内表面,以便调整修补物的合成长度。
33.权利要求32的修补物,其中上述第二修补物部分包括连接上述环状弹簧元件的管状移植物,上述管状移植物有一对自由端,上述自由端之一连接上述弹簧元件,而上述另一自由端则连接保持上述自由端为开口构型的装置。
34.权利要求32或33的修补物,其中上述装置包括一对相对刚性的元件,形成一对单独的管道,进入上述第二修补物部分的上述自由端。
35.权利要求34的修补物,其中包括第三和第四修补物部分,可伸缩衔接在上述第二修补物部分的上述自由端上的相对刚性的元件,各个上述第三和第四修补物部分包括一对环状弹性变形弹簧元件和管状移植物,上述弹簧元件连接上述管状移植物的自由端,至少上述弹簧元件之一适合衔接上述第二修补物部分内部。
36.权利要求32到35中任一的修补物,其中上述第二修补物部分包括移植物,它一端构成单管道,而对置端则形成一对叉状管道,与上述单管道连通。
37.在身体管道内紧固修复装置的方法,包括的工步有:折合弹性圆环,呈现第一构型,其横截面积小于上述不变形环的横截面积,上述圆环置于身体管道内需要位置,并使上述圆环弹性变形到第二构型,其横截面积大于上述第一构型的横截面积,但具有的横截面积仍然小于上述不变形圆环的横截面积。
38.权利要求37的方法,其中:包括的工步有:上述圆环插入上述身体管道之前,使上述圆环变形,上述圆环设置在身体管道所需位置,造成上述圆环膨胀和衔接该身体管道。
39.权利要求37或38的方法,其中:包括的工步有:采用远距离致动器,有选择地压缩上述圆环或松开压缩,使在身体管道内就位。
40.权利要求37到39中任一的方法,其中:包括的工步有:通过上述修复装置插入管状导管内部,使上述修复装置插到身体管道所需位置,导管置于身体管道内所需位置,和从上述导管内部推出上述修复装置。
41.病变脉管的修复方法,包括的工步有:环绕径轴折合圆环,呈现较小截面构型,组成一对环线,向离开上述径轴方向延伸,而上述圆环布置在上述脉管内,其上述径轴邻近交叉脉管,这使上述环线延伸,至少部分经过交叉脉管,阻塞上述交叉脉管。
42.权利要求41的方法,其中:包括的工步有:当上述圆环在患者身体就位时,引起该环弹性偏压在上述病重脉管上。
43.在身体管道内紧固修复装置的方法,包括的工步有:沿径轴折合上述弹簧,使环状弹性弹簧变形,将上述弹簧置于身体管道内,引起上述弹簧弹性膨胀,靠在上述身体管道上,从而引起上述弹簧持续向外压靠在上述身体管道上。
44.权利要求43的方法,其中上述修复装置包括连接上述弹簧的管状移植物,上述方法另外包括的工步有:第二修复装置在上述管状移植物内部可伸缩插入,引起环状弹性弹簧元件向外延伸,衔接上述移植物内表面。
45.权利要求43的方法,其中:包括的工步有:第二修复装置可伸缩插入上述第一修复装置,调整上述修复装置的长度。
46.权利要求44或45的方法,其中:包括的工步有:在第二修复装置内可伸缩插入一对移植片固定膜,构成从髂动脉到腹主动脉的管道。
47.修复装置,包括人工心脏瓣膜,具有连接上述瓣膜的第一端和一第二端的柔性管套,和连接上述第二端的弹性变形圆环,以连接上述装置与上行主动脉部分的内表面。
48.插入身体管道的修补物,至少包括两个环状弹性弹簧元件,和一个连接上述各个元件的柔性管状移植物,以及一个纵向连接上述元件的刚性元件,上述元件的柔性低于上述移植物。
49.权利要求48的修补物,其中上述构件是一连接上述元件的金属线。
50.将修补物插入身体管道的方法,包括的工步有:使一对管状修补物一同插入身体管道,并在上述另一修补物内可伸缩调整上述修补物之一的位置。
51.权利要求50的方法,其中:包括的工步有:在将上述修补物一同插入上述管道以将所述元件固定于所述通道并相互固定之前,在上述各个修补物上,折合环状弹性弹簧元件。
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