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Gefäßbehandlungs grid Varizen


Kind code of ref document: Gefäßbehandlungs grid Varizen check this out ref Gefäßbehandlungs grid Varizen Date of ref document: Ref legal event code: Year of fee payment: The invention relates to a stent for reduction of the diameter of a duct in the Gefäßbehandlungs grid Varizen of a living being, Gefäßbehandlungs grid Varizen particular Gefäßbehandlungs grid Varizen a transjugular intrahepatic portosystemic shunt, Gefäßbehandlungs grid Varizen a sleeve-like part Gefäßbehandlungs grid Varizen walls provided with perforations, widened ends and an Leisten- thrombophlebitis Foto section whose diameter is reduced by a constriction, and thrombogenic threads provided on the outside Gefäßbehandlungs grid Varizen the sleeve-like part between the widened ends.

The invention relates to a Reducing stent to reduce the flow opening of a passage in a living body, such as in particular a transjugular intrahepatic portosystemic shunt, a device for applying a transjugular intrahepatic portosystemic shunts, and the use of a Reduzierstents and said device.

Case of liver damage, especially cirrhosis of the liver, intervenöser blood flow of the portal vein is reduced by the liver to the hepatic vein. Es ergibt sich eine Blutdruckerhöhung auf der Pfortaderseite, die zu Ösophagusvarizen, also Krampfadern im Bereich der Speiseröhre führen Gefäßbehandlungs grid Varizen. The result is 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.

Will pop up, so the risk of bleeding to death of the patient. Es ist bekannt, zur Reduzierung des Blutdrucks eine portokavale, mesocavale oder splenorenale Anastomose vorzunehmen, also eine Verbindung durch Anastomose des Pfortaderstammes und der Vena cava inf.

It is known to pre-portocaval, mesocavale or Gefäßbehandlungs grid Varizen anastomosis to reduce the blood pressure, so a connection through the anastomosis Pfortaderstammes and the vena cava. Hierdurch erfolgt eine Druckentlastung bei der beschriebenen portalen Hypertension. This results in a pressure relief in the described portal hypertension.

If only such a connection shunt is placed, it can be resealed. A certain amount of Shuntlumens operably not clearly predictable. Heute wird der Shunt daher durch Einführen eines Stents in Form eines zylindrischen, vorzugsweise um seine Achse biegbaren Gitter-Stents zuverlässig offengehalten. Today, the shunt is therefore reliably held open in the Gefäßbehandlungs grid Varizen of Gefäßbehandlungs grid Varizen cylindrical, preferably bendable about its axis Gefäßbehandlungs grid Varizen stents by inserting a stent.

Im Notfall wird man zur schnellen Senkung des Pfortaderhochdrucks einen Shunt mit erheblichem Durchmesser legen, um eine rasche und ausreichende Drucksenkung und damit Stillstand der Varizenblutung zu erreichen. In an emergency it will create a shunt with a considerable diameter for the rapid lowering of the portal hypertension, in order to achieve a rapid and adequate pressure lowering and stoppage of variceal bleeding.

However, the current flowing through this shunt blood flows Gefäßbehandlungs grid Varizen cleaning by the liver to the brain so that it there by the non-filtered from the blood substances such as ammonia, may also amines and phenolic body of cerebral intoxication and hepatic encephalopathy, thus reducing or may significantly affect the patient's brain function.

Also, in advance, the size of a suitable Gefäßbehandlungs grid Varizen diameter in principle not be foreseen because the properly delineated size between a relatively large diameter for preventing portal hypertension on the one hand and on the other a reduced diameter to minimize unpurified blood through the liver, and a large Gefäßbehandlungs grid Varizen as possible of the blood to undergo liver cleansing, various factors such as the viscosity of the blood, depends and is therefore difficult to tune.

The invention further provides http://diebruedergrimm.de/xigiboruvavow/duisburg-lieferung-varison.php apparatus for applying a transjugular intrahepatic portosystemic shunt, having to maintain open the shunt comprises a substantially cylindrical stent and a relatively large diameter Reducing stent for reducing the diameter created thereby in the above-described embodiment. Furthermore, the invention provides a Reducing stent of the Gefäßbehandlungs grid Varizen described for reducing the diameter of a liquid-carrying passage in 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 type described for the creation of a in its diameter matched before the restricted passage.

According to a Gefäßbehandlungs grid Varizen embodiment Gefäßbehandlungs grid Varizen is provided that the Reducing stent is self-expanding. In a further embodiment it can be provided that it is made of Nitinol and pre-treated such that it has a relatively elongated configuration of small diameter in a low-temperature position, so that it can be inserted through a catheter and into Gefäßbehandlungs grid Varizen body temperature position high-temperature position is advanced in the shape described establishes.

Die Konfiguration in Betriebsstellung bei erhöhter Temperatur kann unterschiedlich sein. Gefäßbehandlungs grid Varizen configuration in the operating position at an elevated temperature may be different.

So kann der Stent doppelkonusförmig oder als einschaliger Hyper- Gefäßbehandlungs grid Varizen ausgebildet sein. Thus, the stent Gefäßbehandlungs grid Varizen be formed boloid a double cone or as a single-skin hyperpigmentation.

Die besprochenen Wandungen können in bei venösen Behandlung Ulzera levomekol der von Form ausgestaltet sein. The walls discussed can be designed in various shapes. Thus, in a preferred embodiment that the walls of honeycomb or Gefäßbehandlungs grid Varizen. Alternativ kann das hülsenartige Teil auch gewebt, gewirkt oder gestrickt sein.

Alternatively, the sleeve-like part can also be woven or knitted. Die thrombogenen Fäden sind vorzugsweise im wesentlichen achsparallel ausgerichtet. The thrombogenic fibers are preferably aligned substantially axially parallel. Depending on the strength of the desired thrombogenicity of the yarn material Gefäßbehandlungs grid Varizen materials are possible, such as monofilament plastics, Dacron, cotton, silk, linen.

The maximum Krampfadern nicht ausstehen kann auf den Beinen of Reduzierstents at its ends is preferably enlarged in the operating position slightly above the learn more here of the cylindrical, the shunt conditional stent so that the Reducing stent can get caught anywhere Gefäßbehandlungs grid Varizen the shunt stent on both sides and is thus fixed reliably.

In a preferred embodiment it is furthermore provided that the length of Reduzierstents is substantially below that of the shunt stent, so that if necessary, for example, if the flow of a first set Reduzierstents is still too large, axially inserted behind this a further Reducing stent with a smaller minimum diameter can be.

The thrombogenic threads in the Reducing stent initiate blood clotting in the outer region of the Reduzierstents, whereby the diameter of the channel is effectively reduced.

Bei vorgegebenem Fadenmaterial kann die Thrombogenität des Stents durch geeignete Wahl der Fadenlänge eingestellt Gefäßbehandlungs grid Varizen. For a given thread material thrombogenicity of the stent can be adjusted by appropriate selection of the length of thread.

Weitere Vorteile und Merkmale der Erfindung ergeben sich aus den Ansprüchen und aus der nachfolgenden Beschreibung, in der ein Ausführungsbeispiel der Erfindung unter Bezugnahme auf die Zeichnungen im einzelnen erläutert ist.

Further advantages and features of the invention will become apparent from the claims and from the following description in Gefäßbehandlungs grid Varizen an embodiment of the invention is explained with reference to the drawings in detail. Reducing stent 1 of the present invention consists of a sleeve-like part 2 with a honeycomb-like openings 3 in the form of a grid. Er kann hergestellt werden, indem ein Blechteil mit Gefäßbehandlungs grid Varizen und nebeneinander angeordneten kurzen Schlitzen versehen wird, die jeweils einen endlichen Abstand zueinander aufweisen, wobei die Schlitze nebeneinander angeordneter Schlitzreihen in ihrer Richtung versetzt sind, üblicherweise um die halbe Länge eines Schlitzes.

It can be prepared by a sheet Gefäßbehandlungs grid Varizen part with one behind the other and adjacent short slots is provided, each having a finite distance from one another, said slots arranged side by side rows of slots are staggered in their direction, usually about half the length of a slot. The Reducing stent 1 is pretreated in Gefäßbehandlungs grid Varizen it comprises a biconical contour in its body temperature or operative position, that is, its two front sides are extended and have a relatively large radius, while the central region causing constriction is provided with a lower diameter.

Tips 6 are formed go here the ends, by means of which the Reducing stent 1 can get caught in a pre-set shunt stent 7, as shown in Figure 1a, so that in this way Gefäßbehandlungs grid Varizen complete determination of the Reduszierstents is 1 is achieved.

On its outside in the area between the extended ends of the Reducing stent with threads 8 is provided from thrombogenic material, for Gefäßbehandlungs grid Varizen, as shown, may be fixed by knotting at nodes of the grid 2,3. After placing the Reduzierstents form on the filaments in the outer region of the stent clot, whereby the effective flow area as the minimum cross-section of the stent is reduced in its central region. Thereby effectively reducing the flow click at this page is achieved.

In der Figur 1b ist der Reduzierstent 1 in seiner Einführ- Gefäßbehandlungs grid Varizen Tieftemperaturstellung dargestellt. In Figure 1b the Reducing stent 1 is shown in its insertion or low-temperature position. In dieser Stellung kann er durch einen Katheter bis in den Anlagebereich eingeführt werden.

In Gefäßbehandlungs grid Varizen position it can be inserted into the contact region through a catheter. Die Figur 2 zeigt schematisch eine Leber 11 mit Pfortader 12 und Lebervene Beide Venen verästeln sich üblicherweise in das Lebergewebe.

The figure 2 schematically shows a liver 11 having portal vein Gefäßbehandlungs grid Varizen hepatic vein 12 Both venous branch out usually in the liver tissue. It will be appreciated that depart from the portal vein to the stomach 21 and esophagus leading blood vessels 23, the varices can form 24th Auch sind das Herz 25 und ein vom Hals Gefäßbehandlungs grid Varizen Patienten am Herz 25 vorbei bis in eine Lebervene geschobener Einführkatheter 26 erkennbar.

The heart 25 and the neck of the patient's heart 25 pass into a hepatic vein pushed catheter 26 can be seen. Es ist weiterhin ein Shunt 14 Gefäßbehandlungs grid Varizen Pfortader 12 und Lebervene 13 dargestellt, der durch Durchstechen Gefäßbehandlungs grid Varizen Lebergewebes hergestellt wurde.

There Gefäßbehandlungs grid Varizen shown 12 and 13 further hepatic vein, a shunt between the portal vein 14, which was Gefäßbehandlungs grid Varizen by piercing the liver tissue.

In the shunt 14 is for holding the same, a shunt stent 7, has also been introduced into the for the reduction of the free flow lumen a Reducing stent 1 in the above-described embodiment. Der Gefäßbehandlungs grid Varizen 7 kann grundsätzlich aus Gefäßbehandlungs grid Varizen gleichen Material hergestellt Gefäßbehandlungs grid Varizen wie der Reduzierstent 1 und damit auch Gitter- oder Wabenform aufweisen, wobei das Gitter bzw.

Gefäßbehandlungs grid Varizen Shuntstent 7 may in principle be made of the same material as the Reducing stent 1 and Gefäßbehandlungs grid Varizen also have a Gefäßbehandlungs grid Varizen or honeycomb shape, wherein the grid and the honeycomb were generated as described above in the same manner.

Der Shuntstent 7 weist grundsätzlich Gefäßbehandlungs grid Varizen Form auf. The Shuntstent 7 has basically cylindrical shape. The subject invention is used as follows. Zunächst wird durch Punktion mittels einer Punktionskanüle ein Shunt 14 zwischen Pfortader 12 und Lebervene 13 Gefäßbehandlungs grid Varizen. First, a shunt 14 between the portal vein and hepatic vein 12 13 is created by puncturing by a puncture needle.

In diesen wird dann mittels eines Katheters der Shuntstent 7 eingebracht, indem nach Einführen des den Shunt enthaltenden Katheters der Shunt durch einen Schieber oder dergleichen am Gefäßbehandlungs grid Varizen gehalten und der Katheter zurückgezogen wird, wodurch sich der Shunt-Stent 7 in seine in der Figur 2 dargestellte Anlagestellung aufweitet, die, wenn er aus einer wärmebehandelten Nickel-Titan-Legierung Nitinol besteht, seine Hochtemperaturstellung ist.

In these, the Shuntstent 7 is then by means of a catheter introduced by holding by insertion of the shunt containing the Gefäßbehandlungs grid Varizen of the shunt by a slide or the like at Gefäßbehandlungs grid Varizen place of investment and the catheter is withdrawn, whereby the shunt stent 7 shown in its in the figure 2 abutment position expands, which, if it consists of a heat-treated nickel-titanium alloy nitinolits high-temperature position.

Having thus described the acute Verblutungsgefahr a corresponding patient was avoided, can be inserted in the same way by means of a catheter and a pusher Gefäßbehandlungs grid Varizen the stent reducer in the pre-specified shunt stent then to reduce the effective flow area in hepatic encephalopathy. A stent for reducing the diameter article source a canal in the body of a living being, such as in particular a transjugular intrahepatic portosystemic shunt, with a sleeve-like part 2 having provided with perforations walls, flared ends as well as reduced by a constriction in diameter intermediate portion, and on the outside of the sleeve-like part 2 provided between the widened ends Gefäßbehandlungs grid Varizen threads 8.

The stent of claim 1, characterized in that the sleeve-like part 2 is self-expanding at elevated temperature. Stent and claim Gefäßbehandlungs grid Varizen, characterized Gefäßbehandlungs grid Varizen 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 part is formed like a grid.

Stent according to one of the preceding claims, characterized in that the thrombogenic threads are arranged substantially axially parallel. Reducing stent according to one of the preceding claims, characterized in that the maximum end diameter is Gefäßbehandlungs grid Varizen larger than the diameter of a shunt stent, into which the Reducing stent for reducing the free flow cross section Gefäßbehandlungs grid Varizen inserted in Shuntstent.

An apparatus for conditioning of a channel in a living body, such as in particular a transjugular intrahepatic portosystemic shunt with a channel open holding shunt stent 7gekennnzeichnet by a free flow cross-reducing Reducing stent 1 according to any one of the preceding claims. Use of a device comprising a substantially cylindrical shunt stent relative diameter and with a Reducing stent comprising a sleeve-like part, for creating a flow passage in the body of a living being, such read more in particular a transjugular intrahepatic more info shunt.

DE DEC2 en Gefäßbehandlungs grid Varizen Methods and apparatus for connecting openings formed in adjacent blood vessels or other anatomical structures.

Guardian self-expandable medical device introduced in cavite body, and medical device with a stake as. Medical Gefäßbehandlungs grid Varizen having a constricted region for occluding fluid flow in a body lumen.

Three dimensional spherical micro-coils manufactured from Gefäßbehandlungs grid Varizen nickel-titanium microstrand. Woven intravascular devices and methods for making the same and apparatus for delivery of the same.

Methods and devices for maintaining patency of surgically created channels in a body organ. Methods and devices for maintaining surgically created channels in a body organ. Conduits having distal cage structure for maintaining collateral channels in tissue and related methods.

Methods for securing strands of woven medical devices and devices formed thereby. Devices for delivering substances through an extra-anatomic opening created in an airway. Coated stent with geometry determinated functionality and method of making the same. Methods of treating venous valve related conditions with a flow-modifying implantable medical device.


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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 an intermediate section whose diameter is reduced by a constriction, and thrombogenic.
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