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The invention relates to a stent for reduction of the diameter of a duct in the body of a living being, in particular of a transjugular intrahepatic portosystemic shunt, comprising a sleeve-like part having walls provided with perforations, widened ends and grid Varizen intermediate section whose grid Varizen is reduced Reduction stent, device with this stent and use of this stent EP A1.
The invention relates to a http://lycanthropia.de/creme-gut-die-wahrheit-von-krampfadern.php for reduction of the diameter of a duct in the body of a living being, in particular of a transjugular intrahepatic portosystemic shunt, comprising a sleeve-like part having walls grid Varizen with perforations, widened ends and an intermediate section whose diameter is reduced by a constriction, grid Varizen thrombogenic threads provided on the outside grid Varizen the sleeve-like part between the widened ends.
A stent for reducing the diameter of a canal in the body of grid Varizen living being, such as in particular a transjugular intrahepatic portosystemic shunt with a sleeve-like part 2the walls provided with openings, flared ends as well as a reduced by a constriction in its diameter intermediate portion, grid Varizen having provided on the outside of the sleeve-like part 2 between the widened ends thrombogenic threads 8.
The stent of claim 1, characterized in that the sleeve-like part 2 is self-expanding at elevated grid Varizen. Stent and claim 2, characterized in that the sleeve-like part 2 consists of a nickel-titanium alloy. Stent according to one of the preceding claims, characterized in that the sleeve-like grid Varizen is formed like a grid.
Stent according to one of the preceding claims, characterized in that the thrombogenic threads are arranged substantially axially parallel. Reduzierstent according to any one of the preceding claims, characterized in that the maximum end diameter is slightly larger than the diameter of grid Varizen shunt stent, into which the Reduzierstent to reduce the free flow area is inserted in Shuntstent. Apparatus for grid Varizen a channel in a living body, in particular a transjugular intrahepatic portosystemic shunt with a grid Varizen hold open shunt stent 7gekennnzeichnet by the free flow area reducing reducer stent 1 according to one of the preceding claims.
Comprises the use of a reducer stent with a sleeve-like part, the perforated walls, flared ends and reduced by a constriction in its diameter intermediate portion and having on the outside of the sleeve-like part between the widened ends thrombogenic threads, in particular in a further embodiment of any of claims 2 to 6, for reducing the free flow cross section of a channel in the body of a living being, such as in particular a transjugular intrahepatic portosystemic shunt.
Use of a device comprising grid Varizen substantially cylindrical shunt stent relative diameter and with a Reducing stent with a sleeve-like part, for creating a flow passage in the body of a living being, such as in particular a transjugular intrahepatic portosystemic shunt. The invention relates to a Reduzierstent to reduce the flow opening of a grid Varizen in a living body, such as in particular a transjugular intrahepatic portosystemic shunt, a device for applying a transjugular intrahepatic portosystemic grid Varizen, and the use of a Reduzierstents and said device.
This grid Varizen in an increase in blood pressure on the Pfortaderseite that, so can cause varicose veins in the esophagus to esophageal varices. Platzen diese auf, so besteht die Gefahr eines Verblutens des Patienten. Burst on this, there is a risk of bleeding to death of the patient.
Es ist bekannt, zur Reduzierung des Blutdrucks eine grid Varizen, mesocavale oder splenorenale Anastomose vorzunehmen, also eine Verbindung durch Anastomose des Grid Varizen und der Vena cava inf. It is known to carry a portocaval, splenorenal grid Varizen mesocavale or to reduce blood pressure, so a connection by anastomosis of the vena cava and Pfortaderstammes. Hierdurch erfolgt eine Druckentlastung bei der beschriebenen portalen Hypertension.
Grid Varizen results in a pressure relief in the described portal hypertension. If only such a connection shunt placed, it can be resealed. A certain amount of Shuntlumens operatively not clearly predictable. Today, the shunt is thus reliably held open by inserting a stent in the form of a cylindrical, preferably flexible about its axis grid Varizen stents.
Im Notfall grid Varizen man zur schnellen Senkung des Pfortaderhochdrucks einen Shunt mit erheblichem Durchmesser legen, um eine rasche und ausreichende Drucksenkung grid Varizen damit Stillstand der Varizenblutung zu erreichen. In an emergency, it is for the rapid reduction of grid Varizen hypertension put a shunt with considerable diameter to achieve rapid and sufficient pressure reduction and thus stoppage of variceal bleeding. However, the current flowing through this shunt blood flows without purification by the liver into the brain so that it there, or by the non-filtered from the blood substances, such as ammonia, may also amines and phenol body of cerebral intoxication and thus of hepatic encephalopathy and thus the reduction may cause substantial impairment of brain function of the patient.
Also, advance the size of a suitable stent diameter generally not be predicted because the properly defined size between relatively large diameter to avoid portal hypertension on the one hand and on the other hand, a reduced diameter to minimize unpurified blood by the liver and the greatest possible proportion of the grid Varizen of to undergo liver grid Varizen, various factors such as the viscosity of the blood, and therefore depends heavily vote.
The invention further provides an apparatus for applying a transjugular intrahepatic portosystemic shunt, a substantially cylindrical stent and a relatively large diameter Reduzierstent for reducing the diameter has created thereby to hold open the shunt in the embodiment described above. Furthermore, the invention provides grid Varizen Reduzierstent of the type described for reducing the diameter of a liquid-carrying passage grid Varizen the human body, as just such a transjugular intrahepatic portosystemic shunts, and the use of a substantially cylindrical stents of relatively large diameter and a Reduzierstents of the grid Varizen described for the creation of a grid Varizen its diameter tuned into a reduced passage.
According to a preferred grid Varizen, it is contemplated grid Varizen the Reduzierstent is self. In a grid Varizen embodiment learn more here can be provided that it is made of Nitinol and pre-treated in grid Varizen a way that it has a relatively elongated configuration of small diameter has more info a low-temperature position so that it can be introduced through a catheter and in a body-temperature position high-temperature position is in the extended form described sets up.
The configuration in the operating position at an elevated temperature may be different. Thus, the stent may be formed as a single-shell or double-cone-shaped hyper- boloid. The discussed walls can be designed in various shapes. Thus, in a preferred embodiment in that the walls are grid Varizen or grid-like manner.
Alternatively, the sleeve-like member be woven or knitted. The thrombogenic threads are preferably aligned substantially axially parallel. Depending on the strength of the desired thrombogenicity of the thread material, different materials are suitable, such as monofilament plastics, Dacron, cotton, silk, linen. The maximum diameter of Reduzierstents to its flared ends is preferably in the operating position slightly greater than the diameter of the cylindrical, the shunt conditional stent so that the Reduzierstent both sides can get caught anywhere on the shunt stent and is thus reliably determined.
In a preferred embodiment, it is also provided that the length of the Reduzierstents below that of the shunt stent is essential, so that, if necessary, for example, if the flow of a first down Reduzierstents is still too large, axially grid Varizen another Reduzierstent grid Varizen with lower minimum diameter can be.
Grid Varizen thrombogenic threads in Reduzierstent initiate blood clotting in the outer region of the Reduzierstents, thereby increasing the diameter of the channel is effectively reduced.
For a given yarn material, grid Varizen thrombogenicity of the grid Varizen can be adjusted by suitable choice of the length of thread. Further advantages and features of the invention will become apparent from the claims and from the following description in which an embodiment of the invention is explained with reference to grid Varizen drawings in detail.
The Reduzierstent 1 grid Varizen the invention consists of a sleeve-like part grid Varizen with a honeycomb-like openings 3 in the form of a grid. It can be prepared by a sheet metal part with one behind the other and arranged side by side short slots is provided, each having spaced apart a finite distance, wie Krampfadern und Sternchen entfernen slots arranged side by see more rows of slots are staggered in their direction, usually by half the length of a slot.
The Reduzierstent 1 is pretreated such that it has a biconical contour in grid Varizen body temperature or operating position, ie, its two front sides are extended and have a relatively large radius, while the central region is provided with a smaller diameter causing constriction.
At the ends of peaks 6 are formed by means of which the Reduzierstent 1 can jam in a pre-defined shunt stent 7, as shown in Figure 1a, so that in this way a complete definition of the Reduszierstents 1 is grid Varizen. On its outside in the grid Varizen between the expanded ends of the threads with Reduzierstent 8 is provided from thrombogenic material which, as shown, for example, can be determined by knotting at nodes of the grid 2.
After exposing the Reduzierstents form on the filaments in the outer region of the stent clot, whereby the effective flow area to the grid Varizen cross-section of the stent is reduced in its central region http://lycanthropia.de/betadine-von-trophischen-geschwueren.php approximately.
As a result, an effective reduction of the flow lumen is achieved. In Figure 1b the Reduzierstent 1 is shown in its insertion or low-temperature position. In this position, it can be inserted into the contact continue reading through grid Varizen catheter. Die Figur 2 zeigt schematisch eine Leber 11 mit Pfortader 12 und Lebervene Both hepatic veins usually ramify in the liver tissue.
It can be seen that depart from the grid Varizen vein to the stomach to the esophagus 21 and 23 leading blood vessels, which can form varices Grid Varizen heart 25 and pushed from the neck of the patient at the heart 25 by up to a hepatic vein catheter 26 can be seen. Es ist weiterhin ein Shunt 14 zwischen Pfortader 12 grid Varizen Lebervene 13 dargestellt, der durch Durchstechen des Lebergewebes hergestellt wurde.
It is furthermore a shunt 14 between portal vein and hepatic vein 12 13 shown, which was prepared by piercing the liver tissue. In which shunt 14 is to hold open the same, a shunt stent 7, in which grid Varizen further Grid Varizen 1 was placed in the grid Varizen described above for the reduction of the free flow lumen. The Shuntstent http://lycanthropia.de/strapper-varizen.php may in principle be made of the same material as the Reduzierstent 1 and thus also have a grid or honeycomb shape, wherein the grid or honeycomb, in the same manner as described above is generated.
The Shuntstent 7 has basically cylindrical shape. By grid Varizen separating the nodes of the grid, or a honeycomb bendability of the axis of the Shuntstents 7 is achieved, so that it can also be used grid Varizen a curved shunt. The subject invention is used as follows.
First, a shunt between the portal vein 14 12 13 and hepatic vein puncture is created by means of a puncture needle. In these is then introduced by means of a catheter of the Shuntstent 7 by held after insertion of the shunt containing the catheter of the shunt by a slide or the grid Varizen at the place of investment and the catheter is withdrawn, whereby the shunt stent 7 shown in its in the figure 2 abutment position expands, which, when it is made of a grid Varizen nickel-titanium alloy Nitinolits high-temperature position.
Having thus described the acute Verblutungsgefahr a corresponding patients was avoided, can then be inserted in the same way by means of a catheter and grid Varizen pusher of the stent reducer in the pre-specified shunt stent in order to reduce the effective flow area in hepatic encephalopathy. Kind code of ref document: Country of ref document: Date of ref document: Ref legal event code: Year of fee payment: Dr HauensteinJosef Lindenberg.
EspacenetEP Register. Endoprosthesis and delivery device for implanting such endoprosthesis. Devices for connecting anatomical conduits such as vascular structures.
Methods and apparatus for connecting openings formed in adjacent blood vessels or other anatomical structures. Stent Tinktur von Krampfadern kit of stents for adjustable interventional reduction of blood flow. A1 Designated state s: Lapsed in a contracting state announced via postgrant inform.
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