CN102871727B - Multipolar radiofrequency ablation catheter which is applicable to being used in renal artery vessels - Google Patents
Multipolar radiofrequency ablation catheter which is applicable to being used in renal artery vessels Download PDFInfo
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- CN102871727B CN102871727B CN201210423459.3A CN201210423459A CN102871727B CN 102871727 B CN102871727 B CN 102871727B CN 201210423459 A CN201210423459 A CN 201210423459A CN 102871727 B CN102871727 B CN 102871727B
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Abstract
The invention discloses a multipolar radiofrequency ablation catheter which is applicable to being used in renal artery vessels, comprising three parts of a catheter ablation working end, a main body section and a handle. The catheter ablation working end adopts a kinematic pair mechanism structure. The kinematic pair mechanism comprises a plurality of sets of single-unit front and back crank kinematic pairs. Each single-unit front and back crank kinematic pair is connected with a set of electrode tube and convex ring electrodes to constitute an independent or linked single-unit catheter ablation working end. A plurality of convex ring electrodes are evenly distributed the periphery of vessels and are closely attached to the inner wall of renal artery for mapping and ablation. The catheter of the invention has the advantages of simple and convenient operation, flexible adjustment, precise location of ablation, real-time monitoring and adjusting of ablation temperature and radio-frequency power, reducing treatment complication and lowering the surgical risk.
Description
Technical field
The invention belongs to technical field of medical instruments, relate to one and be applicable to the endovascular multi-pole rf ablation catheter of renal artery.
Background technology
It is high that hypertension has morbidity example, and in awareness generation, endanger large feature, american heart association (American Heart Association, AHA) delivers scientific statement in 2008, and intractable hypertension is defined as; Improve through life style, take the antihypertensive drugs (wherein a kind of is diuretic) of 3 kinds of different mechanism of action simultaneously, or at least need 4 kinds of medicines systolic pressure and diastolic pressure could be controlled at target level (<140/90 mmHg).At present about the sickness rate not yet accurate count of intractable hypertension, but multinomial clinical research points out such patient to account for the 20%-30% of hyperpietic.Chinese cardiovascular diseases's report in 2007 is pointed out, the current hyperpietic of China has 200,000,000 people at least, wherein has nearly 5,000 ten thousand obstinate hypertension.Pass through 180 routine human dissections, statistics draws: renal artery length is approximately about 30 mm; The arteriorenal average caliber of male is: left side Ф 6 ± 2.4mm, right side Ф 6.7 ± 2.6 mm; The average caliber of women is: left side Ф 4.2 ± 2.4 mm, right side Ф 4.6 ± 2.2 mm.
2009 world-renowned medical journal " lancet " delivered research paper headed by Australian doctor Krum, confirm in renal artery that it is effective for getting involved radio frequency method to treatment hypertension.Therefore the perpetrator Mark Gelfand of this technology and Howard R.Levin wins 2011 annual U.S. Edison invented silver medals.
Rf ablation therapeutic instrument mainly comprises radio-frequency (RF) ablation generator, therapeutic electrode and indifferent plate electrode, and radio-frequency (RF) ablation generator can produce altofrequency electromagnetic wave that is lasting or impulse form, is made up of alternating electric field and magnetic field.The ultimate principle of radiofrequency ablation therapy is radio-frequency current target tissue being imposed to about frequency 500KHz, in-house polar molecule is made to be in a kind of foment, occur to shake friction at a high speed, and produce biological heat, when local temperature is more than 45-50 DEG C, intracellular protein denaturation can be caused, lipid layer dissolves, and cell membrane bursts apart, cell loss of water, cause target tissue coagulation necrosis
International application WO02010078175 discloses and enters renal artery and apparatus and the method for renal artery sympathetic nerve being carried out to thermal induction process.This apparatus adopts multisection type guide-tube structure, by each control line of pulling back, applies compression and bending force, make heating element heater move towards arteriorenal inwall thus to each buckled zone.But, this catheter manipulation and structure all more complicated.And this conduit can not adapt to the renal artery of different inner diameters well, thus electrode cannot realize adherent in the renal artery of different inner diameters.
Through conduit Renal denervation art (Transcatheter Renal Denervation, TRenD) or kidney go sympathetic nerve art (Renal Sympathetic Denervation, RSD) to be a kind of hypertensive method of non-drug interventional therapy up-to-date in the world.Within 2011, JIUYUE has held Asia-Pacific TRenD meeting in Hong Kong Marriott Hotel on 24th, and Medtronics company passes through the live commercial Symplicity ablation catheter unique in the world of transmission of video and on-the-spot demonstration 3 example operations in meeting.But Symplicity ablation catheter and Therapeutic Method have the following disadvantages; 1) cannot mapping renal artery sympathetic innervation point, need to melt 6 ~ 8 points at random and just can reach requirement; 2) mapping cannot melt state, judge ablation effect; 3), during treatment, ablation points is uneven, may repeat to melt to same point, have the danger of vascular puncture; 4) too much ablation points causes blood vessel wall cicatrix too much, likely causes renal artery stenosis.
Summary of the invention
The invention provides and a kind ofly simple to operate, quick and safe be applicable to the endovascular multi-pole rf ablation catheter of renal artery.
Of the present inventionly be applicable to the endovascular multi-pole rf ablation catheter of renal artery, comprise catheter ablation working end 1, main paragraph 2, handle 3, catheter ablation working end 1 is the kinematic pair mechanism with multipole electrode pipe; Main paragraph 2 is made up of trocar sheath and inner core, and trocar sheath and inner core are connected with the two ends of kinematic pair mechanism respectively; The built-in cubicle switch of handle 3 is connected with inner core.
The kinematic pair mechanism 46 that described catheter ablation working end 1 adopts forms by turning elbow kinematic pair 47 before and after some single groups, turns the list group catheter ablation working end that elbow kinematic pair 47 connects a set of independent or interlock be made up of electrode tube 8 and projective table type ring electrode 10 before and after every single group.When the twister 30 pumpback inner core 5 at control lead rear portion, indicating ring 15 on inner core and far-end indicating ring 14 on trocar sheath develop when aliging, kinematic pair mechanism has been expanded to the minimum diameter that each series of conduits specifies, continue through twister 30 and regulate the relative position of the indicating ring 15 on inner core between the two indicating rings (13,14) of trocar sheath, to adapt to the renal artery internal diameter in each serial scope, in Spindle 45 after the expansion of kinematic pair mechanism, projective table type ring electrode 10 is evenly distributed on blood vessel surrounding and adhere well to renal artery inwall so that mapping melts.
Described main paragraph 2 is divided into trocar sheath 4 and inner core 5, inner core 5 end is connected with prelocalization ball 7, prelocalization ball 7 is provided with front indicating ring 12, the end of trocar sheath 4 is connected with rear place kick 6, rear place kick 6 is provided with rear indicating ring 11, and front and back indicating ring (12,11) is by the position of X-ray development kinematic pair mechanism in renal artery.Inner core 5 is the pipe structure of real core body or hollow, and the near-end of inner core is connected with twister 30 or standard luer fittings, and inner core is provided with indicating ring 15, and inner core 5 is moved forward or backward by the propelling movement of twister 30, the enlargement and contraction of controlled motion vice mechanism.
The near-end of trocar sheath 4 is connected with handle 3 or is connected with pipe seat connector, trocar sheath is provided with near-end indicating ring 13 and far-end indicating ring 14, trocar sheath is by inner layer material PTFE, middle layer metal braiding webmaster, cladding material is the thermoplastics such as PA and PEBAX, and outer surface scribbles Hydrolene hydrophilic coating.Inner core can move in trocar sheath.
Further described kinematic pair mechanism 46 forms by turning elbow kinematic pair 47 before and after 3-6 mono-group.In spinning Duo shape structure, before turn elbow 9 and after turn elbow 16 and formed before and after single group and turn elbow kinematic pair 47, before turn elbow with after turn elbow adopt in the middle of in outside bulb 21 and centre bulb 18 fit in swing and be connected, before turn one end of elbow 9 before in bulb 22 formed to swing with front outer bulb 20 and be connected, before outer bulb 20 and prelocalization ball 7 adopt the mode such as to weld to be fixedly connected with, after turn one end of elbow 16 after in bulb 17 formed to swing with rear outer bulb 19 and be connected, after to turn in the middle of elbow one section and curve inwardly, rear outer bulb 19 and rear place kick 6 adopt the mode such as to weld to be fixedly connected with, after turn the internal stent that elbow 16 is electrode tube 8, electrode tube bends one end and is equipped with projective table type ring electrode 10 or projective table type semi-circular electrode.
Aduncate one section of described electrode tube 8 is last straight section 28, last straight section has desk-top ring electrode 10 or projective table type semi-circular electrode, projective table type semi-circular electrode retains the side boss with vessel wall contact, be convenient to there is less diameter when conduit shrinks, projective table type ring electrode or projective table type semi-circular electrode structure are conducive to fully contacting blood vessel.Projective table type ring electrode 10 is connected with copper conductor 27, the ablating electrode welding copper conductor is assemblied on the boss of last straight section 28, copper conductor distally penetrates electrode tube 8 in hole, from the afterbody of handle 3 connects electrode contact 29 after passing in the cavity of copper conductor in the inside of electrode tube and via main paragraph 2.Projective table type ring electrode 10 is built-in with temperature sensor, and temperature sensor adopts thermoelectricity corner or critesistor.The material that described electrode tube 8 adopts is that thermoplastic elastic material is made, and thermoplastic elastic material comprises one or more mixtures in Pebax, PA and polyurethane.
Turn before turning elbow kinematic pair 47 before and after described list group elbow 9 and after turn elbow 16 and be provided with three and be flexibly connected point (A, B, C), the rear interior bulb 17 turning elbow 16 behind junction point A place coordinates with the rear outer bulb 19 of rear place kick 6 internal fixtion and swings up and down and is connected, turn the rotational angle up and down of elbow after the fluting size of rear outer bulb 19 limits, and turn elbow after preventing and deflect; In turn elbow 9 before junction point C place before, bulb 22 coordinates with outer bulb 20 before prelocalization ball 7 internal fixtion and swings up and down and is connected, and turns the rotational angle up and down of elbow before the fluting size of front outer bulb 20 limits, and turns elbow before preventing and deflect; Intermediate connection point B turns the swing junction point of elbow before and after being, the cooperation of middle outer bulb 18 and bulb in centre 21 swinging up and down is connected, and turns elbow and deflect before the fluting size of the outer bulb 18 in centre prevents.
Described kinematic pair mechanism 46 is provided with spacing insurance function, and rear outer bulb 19 is provided with fluting, and the upper limit plane 23 of fluting, lower limit plane 24 turn elbow after limiting and swing up and down angle; Front outer bulb 20 is provided with fluting, and the upper limit plane 25 of fluting, lower limit plane 26 turn elbow before limiting and swing up and down angle.When kinematic pair is expanded to maximum gauge; upper limit plane (23; 25) elbow (16 is turned before and after restriction; 9) can not continue around junction point (A; C) rotate backward; prevent the overdistension of kinematic pair mechanism 46, have position limitation protection function, the degrees of expansion of kinematic pair mechanism 46 is determined according to renal artery internal diameter size.
The handle 3 at described conduit rear portion, comprise the cubicle switch 32 of handle portion 31, locking inner core, handle 3 front end is fixedly connected with trocar sheath 4, handle 3 first half is equipped with the cubicle switch 32 of locking inner core, operative combination switch 32 can make handle hold tightly or unclamp inner core, the inner chamber of handle hollow has inner core 5 and copper conductor 27 to pass through, and handle afterbody has standard component twister 30 and electrode contact 29, regulates the movement of inner core 5 thus control the folding of conduit by the pumpback of twister 30.The built-in copper conductor 27 be communicated with electrode tube 8 inside of handle 3, and be even connected with electrode contact 29 from handle 3 afterbody, electrode contact 29 is connected with radio-frequency (RF) ablation generator 44 by intermediate connections 43, intermediate connections 43 separates the single electrode joint of four band different colours and numbering, sequentially melts successively when being convenient to operation to each electrode.
The cubicle switch 32 of described locking inner core comprises the upper knob 33 of cubicle switch, the lower button 36 of cubicle switch and spring 38, press the upper knob 33 of cubicle switch 32, spring 38 compresses, the lower button 36 of cubicle switch moves and holds inner core 5 tightly simultaneously, make inner core 5 and trocar sheath 4 can not relative movement, keep the upper knob 33 pinning cubicle switch to rotate simultaneously, upper knob 33 rotates around the rotating shaft 37 of lower button, now the left screens platform 34 of upper knob, right screens platform 35 stick into slot and stop upper knob 33 to rebound, and keep handle to hold the state of inner core tightly.When needs unclamp inner core 5, the upper knob 33 of rotation combination switch, upper knob 33 rotates around the rotating shaft 37 of lower button, left screens platform 34, the right screens platform 35 of upper knob exit slot, spring 38 resilience, lower button 36 bounces back into certain position, and now handle unclamps inner core.
The invention has the beneficial effects as follows:
1, multi-pole rf ablation catheter of the present invention is by expanding under the effect of kinematic pair mechanism, to adapt to the renal artery of different inner diameters, projective table type ring electrode can be evenly distributed on blood vessel surrounding and be conducive to adhereing well to renal artery inwall so that mapping melts, and makes easy and simple to handle, flexible adjustment;
2, multi-pole rf ablation catheter has multiple distribution of electrodes in surrounding, after once placing conduit, multiple electrode sequentially carries out mapping to the sympathetic innervation point of target tissue successively and melts, and reduces number of operations, repeatedly do not adjust the position of electrode, make whole operation time short;
3, the sympathetic innervation point of accurate mapping target tissue, melts accurate positioning, reduces the drawback blindly melted;
4, built-in temperature sensor, Real-Time Monitoring melts temperature, and temperature is melted in real time adjustment, radio-frequency power and melt the time, and reduce blood vessel injury, operation controllability is stronger;
5, because accurate mapping melts, the operating time is short, therefore, it is possible to reduce the complication for the treatment of to greatest extent, reduces the risk of operation;
Accompanying drawing explanation
Fig. 1 is the overall structure schematic diagram of the embodiment of the present invention.
Fig. 2 is the morphosis schematic diagram that the embodiment of the present invention struts rear tube tip.
Fig. 3 is the three-dimensional engineering schematic diagram of the kinematic pair mechanism of the embodiment of the present invention.
Fig. 4 is the structural profile schematic diagram of the kinematic pair mechanism of the embodiment of the present invention.
Fig. 5 is the operation principle schematic diagram turning elbow kinematic pair before and after list group of the present invention.
Fig. 6 is the spacing schematic diagram of outer bulb after the embodiment of the present invention.
Fig. 7 has been the spacing schematic diagram of outer bulb before the embodiment of the present invention.
Fig. 8 is the schematic diagram of bulb routing motion in outer bulb and centre in the middle of the embodiment of the present invention.
Fig. 9 is the schematic diagram of place kick after the embodiment of the present invention.
Figure 10 is the schematic diagram of embodiment of the present invention prelocalization ball.
Figure 11 is the schematic diagram of outer bulb after the embodiment of the present invention.
Figure 12 is the schematic diagram turning elbow after the embodiment of the present invention.
Figure 13 is the schematic diagram of outer bulb before the embodiment of the present invention.
Figure 14 is the schematic diagram of embodiment of the present invention electrode tube.
Figure 15 is the main TV structure schematic diagram of embodiment of the present invention handle.
Figure 16 is the plan structure schematic diagram of embodiment of the present invention handle.
Figure 17 is the sectional structure schematic diagram of embodiment of the present invention handle.
Figure 18 is the initial condition schematic diagram that the embodiment of the present invention does not strut.
Figure 19 is the renal artery schematic diagram being suitable for minor diameter after embodiment of the present invention ductal ectasia.
Figure 20 is suitable for large diameter renal artery schematic diagram after embodiment of the present invention ductal ectasia.
Figure 21 is the using state schematic diagram of the embodiment of the present invention in RSD operation.
Reference numeral: catheter ablation working end 1, main paragraph 2, handle 3, trocar sheath 4, inner core 5, rear place kick 6, prelocalization ball 7, electrode tube 8, before turn elbow 9, projective table type ring electrode 10, rear indicating ring 11 on kinematic pair, front indicating ring 12 on kinematic pair, the near-end indicating ring 13 of trocar sheath, the far-end indicating ring 14 of trocar sheath, inner core indicating ring 15, after turn elbow 16, bulb 17 in rear, middle outer bulb 18, rear outer bulb 19, front outer bulb 20, bulb 21 in middle, bulb 22 in front, rear outer bulb upper limit face 23, rear outer bulb lower limit face 24, front outer bulb upper limit face 25, front outer bulb lower limit face 26, copper conductor 27, the last straight section 28 of electrode tube, electrode contact 29, twister 30, handle portion 31, the cubicle switch 32 of locking inner core, the upper knob 33 of cubicle switch, the left screens platform 34 of upper knob, the right screens platform 35 of upper knob, the lower button 36 of cubicle switch, the rotating shaft 37 of lower button, spring 38, the conduit 39 shunk, guiding catheter and base 40, renal artery 41, Spindle form 42, intermediate connections 43, radio-frequency (RF) ablation generator 44, Spindle form 45, kinematic pair mechanism 46, elbow kinematic pair 47 is turned before and after single group.
Detailed description of the invention
embodiment 1
One is applicable to the endovascular multi-pole rf ablation catheter (hereinafter referred to as conduit) of renal artery, when removing renal sympathetic nerve ablative surgery (RSD or TRenD) through conduit, by renal artery length and internal diameter can be known after femoral artery puncture and two renal arteriography, conduit is transported to renal artery opening part via guiding catheter, behind the position of fixing guiding catheter, conduit of the present invention is passed out in renal artery from guiding catheter, the compliance of conduit self can make it comply with the distortion of guiding catheter, then the cubicle switch 32 in conduit rear handle 3 is operated, handle is made to unclamp inner core, and the twister 30 pumpback inner core 5 after control crank, launch at the effect downcomer of kinematic pair mechanism, observed by X-ray development, when the indicating ring 15 on inner core and the far-end indicating ring 14 on trocar sheath 4 develop align time, kinematic pair mechanism has been expanded to the minimum diameter that every series of conduits specifies, regulate the indicating ring 15 on inner core at two indicating rings (13 of trocar sheath if need to continue through twister 30, 14) relative position between, and by X-ray development observe multiple projective table type ring electrode 10 at endovascular adhered state and kinematic pair mechanism 46 relative position in renal artery, after ductal ectasia, multiple projective table type ring electrode 10 is evenly distributed on blood vessel surrounding and adhere well to renal artery inwall, then the cubicle switch 32 on operating grip locks inner core and trocar sheath relative position, the expanded configuration of catheter ablation working end 1 keeps stable, open radio-frequency (RF) ablation generator (Ablation and sensing unit, ASU) radio-frequency current is excited, mapping target tissue corresponding sympathetic activation domination point, then sequentially each target spot is melted successively by multiple electrode, each electrode does primary energy release, and each persistent period is no more than 2Min, and release energy about about 6-8W, in ablation procedure, electrode temperature controls within the scope of 40-75 DEG C, progressively increases steppingly and melts temperature, because electrode temperature to take away the impact of the factors such as partial heat by artery blood flow, temperature is melted by built-in temperature sensor (thermoelectricity corner or critesistor) Real-Time Monitoring target tissue, thus regulate radio-frequency power in real time, melt temperature and melt the time, after having melted, conduit is first reduced rear propelling 5 about mm, and make catheter body rotate 45o, the mapping then implementing second group of target sympathetic innervation point by above-described step melts, to multiple electrode successively sequentially mapping melt, until melted target nerve domination point (about 6-8), shunk and closure catheter after melting, then reclaimed via guiding catheter and withdraw from external.Therefore remove renal sympathetic nerve ablative surgery through conduit, thus have adjusted renal sympathetic nerve discharge to reach the object for the treatment of intractable hypertension.
Conduit shown in Fig. 1 is divided into three parts: catheter tip is catheter ablation working end 1, and main paragraph 2 is made up of trocar sheath 4 and inner core 5, and rear portion is handle 3.
Shown in Fig. 2-14: in spinning Duo shape 45 after conduit struts, the relative motion between inner core 5 and trocar sheath 4 makes the folding diameter of kinematic pair mechanism 46 action control conduit.X-ray indicating ring (11, the 12) material at projective table type ring electrode 10 and kinematic pair mechanism 46 two ends is platinumiridio or platinum-tungsten alloys, observes conduit in the endovascular position of renal artery by X-ray development.Aduncate one section of electrode tube 8 is last straight section 28, last straight section has desk-top ring electrode 10 or projective table type semi-circular electrode, projective table type semi-circular electrode retains the side boss with vessel wall contact, be convenient to there is less diameter when conduit shrinks, projective table type ring electrode or projective table type semi-circular electrode structure are conducive to fully contacting blood vessel.Projective table type ring electrode 10 is connected with copper conductor 27, the ablating electrode welding copper conductor is assemblied on the boss of last straight section 28, copper conductor distally penetrates electrode tube 8 in hole, connect electrode contact 29 from the afterbody of handle 3 after passing in the cavity of copper conductor in the inside of electrode tube and via main paragraph 2, be connected to radio-frequency (RF) ablation generator 44 by intermediate connections 43.Projective table type ring electrode 10 is built-in with temperature sensor, and temperature sensor adopts thermoelectricity corner or critesistor.The material that described electrode tube 8 adopts is that thermoplastic elastic material is made, and thermoplastic elastic material comprises one or more mixtures in Pebax, PA and polyurethane.
Main paragraph 2 is divided into trocar sheath 4 and inner core 5, inner core 5 end is connected with prelocalization ball 7, prelocalization ball 7 is provided with front indicating ring 12, the end of trocar sheath 4 is connected with rear place kick 6, rear place kick 6 is provided with rear indicating ring 11, and front indicating ring 11, rear indicating ring 12 are by the position of X-ray development kinematic pair mechanism in renal artery.Inner core 5 is real core body, and the near-end of inner core is connected with twister 30, is spherical, inner core is provided with indicating ring 15 in the distalmost end of inner core, inner core 5 by moving forward or backward under the propelling movement of twister 30, the enlargement and contraction of controlled motion vice mechanism.The near-end of trocar sheath 4 is fixedly connected with handle 3, trocar sheath is provided with near-end indicating ring 13 and far-end indicating ring 14, and trocar sheath 4 is by inner layer material PTFE, and middle layer metal weaves webmaster, cladding material is the thermoplastics such as PA and PEBAX, and outer surface scribbles Hydrolene hydrophilic coating.Inner core 5 can move in trocar sheath 4.The material of kinematic pair is Nitinol or rustless steel etc., has the structural member of enough intensity as kinematic pair in the axial direction, has again certain compliance in the horizontal, is convenient to carry at Ink vessel transfusing.
In other embodiment: inner core is the pipe structure of hollow, handle 3 afterbody place inner core is connected with the female Luer of standard.
In other embodiment: the near-end of trocar sheath 4 is connected with pipe seat connector simply, not with there is multi-functional handle 3 be connected.
Kinematic pair mechanism 46 forms for turning elbow kinematic pair 47 before and after the single group of 3-6 group, in order to conduit is accurately suitable for the renal artery of different inner diameters, the size of Spindle after ductal ectasia is accurately subdivided into four series, I series is of a size of: after expansion, the diameter range of Spindle is≤Ф 5.0mm, Spindle axial length 16 about mm, I series is applicable to the renal artery of internal diameter Φ 4.0 mm-Ф 5.0mm; The
series is of a size of: after expansion, the diameter range of Spindle is≤Ф 6.0mm, Spindle axial length 16 about mm,
series is applicable to the renal artery of internal diameter Φ 5.0 mm-Ф 6.0mm; The
series is of a size of: after expansion, the diameter range of Spindle is≤Ф 7.0mm, Spindle axial length 18 about mm,
series is applicable to the renal artery of internal diameter Φ 6.0 mm-Ф 7.0mm; Series is of a size of: after expansion, the diameter range of Spindle is≤Ф 8.0mm, Spindle axial length 18 about mm,
series is applicable to the renal artery of internal diameter Φ 7.0 mm-Ф 8.0mm.
The expansion process of every series of conduits, such as: after the expansion of I series of conduits, the diameter range of Spindle is≤Ф 5.0mm, is applicable to the renal artery of internal diameter Φ 4.0 mm-Ф 5.0mm, the ductal ectasia of I series, when the indicating ring 15 on inner core and the far-end indicating ring 14 on trocar sheath develop align time, it is Φ 4 mm that kinematic pair mechanism has been expanded to the minimum diameter that this series of conduits specifies, conduit is suitable for the renal artery of Φ 4 mm, the last straight section 28 maintenance level of electrode tube 8 is can be observed by X-ray development, now at intermediate connection point B place, in middle outer bulb 18 and centre, the angle beta of bulb 21 formation is 180 degree (as Fig. 8), multiple projective table type ring electrodes 10 of Spindle are evenly distributed on blood vessel surrounding and adhere well to the renal artery inwall of internal diameter Φ 4.0 mm.Regulate the indicating ring (15) on inner core at two indicating rings (13 of trocar sheath if need to continue through twister 30, 14) relative position between, to be applicable to the renal artery of internal diameter Φ 4.0 mm-Ф 5.0mm, in adjustment process simultaneously by X-ray development observe multiple projective table type ring electrode 10 at endovascular adhered state and kinematic pair mechanism 46 relative position in renal artery, two indicating central spacer about 0.5mm-1.0mm on trocar sheath, namely be the distance that inner core continues adjustment, determine according to turning the setting of elbow angle, kinematic pair mechanism diameter continues expansion≤1.0mm, turn elbow kinematic pair before and after monolateral single group to need to continue expansion≤0.5 mm, therefore the position of inner core need only be finely tuned, when the indicating ring 15 on inner core and the near-end indicating ring 13 on trocar sheath develop align time, diameter after ductal ectasia is defined as Ф 5.0mm, be applicable to the renal artery of internal diameter Ф 5.0mm, multiple projective table type ring electrodes 10 after ductal ectasia on Spindle are evenly distributed on blood vessel surrounding and adhere well to renal artery inwall so that mapping melts.
Kinematic pair mechanism 46 forms by turning elbow kinematic pair 47 before and after the single group of many covers, in spinning Duo shape structure, before turn elbow 9 and after turn elbow 16 and formed before and after single group and turn elbow kinematic pair 47, front turn elbow with after turn elbow and become to swing and is connected, outside swinging the middle interior bulb 21 of connection employing and centre, bulb 18 is connected.Before turn one end of elbow 9 before in bulb 22 formed to swing with front outer bulb 20 and be connected, before outer bulb 20 and prelocalization ball 7 adopt the mode such as to weld to be fixedly connected with, after turn one end of elbow 16 after in bulb 17 formed to swing with rear outer bulb 19 and be connected, after turn one section of angle that curves inwardly in the middle of elbow, front outer bulb 19, rear outer bulb 20 and prelocalization ball 6, rear place kick 7 adopt the mode such as to weld to be fixedly connected with, after turn the internal stent that elbow 16 is electrode tube 8, electrode tube bends one end and is equipped with projective table type ring electrode 10 or projective table type semi-circular electrode.
When the relative position of trocar sheath 4 maintains static, when inner core 5 is protruding, after to turn elbow 16 just in time contrary with above-mentioned action with the front relative motion turning elbow 9, make reduced, the relative motion therefore between inner core and trocar sheath and the effect of kinematic pair thereof can control the folding diameter of conduit.
Handle 3 first half is equipped with the cubicle switch 32 of locking inner core, and cubicle switch composition comprises the upper knob 33 of cubicle switch, the lower button 36 of cubicle switch and spring 38.Press the upper knob 33 of cubicle switch 32, spring 38 compresses, the lower button 36 of cubicle switch moves and holds inner core tightly simultaneously, make inner core and trocar sheath relative movement not keep the upper knob 33 pinning cubicle switch to rotate simultaneously, upper knob 33 rotates an angle around the rotating shaft 37 of lower button, now the left and right screens platform (34,35) of upper knob sticks into slot and stops upper knob (33) to rebound, and keeps handle to hold the state of inner core tightly.When needs unclamp inner core 5, the upper knob 33 of rotation combination switch, upper knob 33 rotates around the rotating shaft 37 of lower button, the left and right screens platform (34,35) of upper knob exits slot, and spring 38 resilience is extended, lower button 36 bounces back into certain position, and now handle unclamps inner core.
Shown in Figure 18-21, multi-pole rf ablation catheter RSD (Renal Sympathetic Denervation, RSD) operation in process status schematic diagram.In RSD operation process, by twister 30 pumpback on control crank or propelling movement inner core, observed by X-ray development, when the indicating ring 15 on inner core and the far-end indicating ring 14 on trocar sheath 4 develop align time, kinematic pair mechanism has been expanded to the minimum diameter (as Figure 19) that every series of conduits specifies, regulate the indicating ring 15 on inner core at two indicating rings (13 of trocar sheath if need to continue through twister 30, 14) relative position between, and by X-ray development observe multiple projective table type ring electrode 10 at endovascular adhered state and kinematic pair mechanism 46 relative position in renal artery, when the indicating ring 15 on inner core and the near-end indicating ring 13 on trocar sheath 4 develop align time, kinematic pair mechanism is expanded to the maximum gauge (as Figure 20) that each series of conduits specifies, after ductal ectasia, multiple projective table type ring electrode 10 is evenly distributed on blood vessel surrounding and adhere well to renal artery inwall, then the cubicle switch 32 on operating grip locks inner core and trocar sheath relative position, the expanded configuration of catheter ablation working end 1 keeps stable, open radio-frequency (RF) ablation generator (Ablation and sensing unit, ASU) and excite radio-frequency current, mapping target tissue corresponding sympathetic activation domination point, is then sequentially melted each target spot successively by multiple electrode.In Figure 21, guiding catheter and base 40 thereof are for carrying conduit of the present invention in renal artery; The electrode contact 29 of the handle afterbody of the conduit of the present embodiment is connected respectively to radio-frequency (RF) ablation generator (Ablation and Sensing Unit by four single electrode joints of intermediate connections 43, ASU) on four electrode interfaces on, use the selection rotary switch on ASU to be transferred to corresponding position simultaneously, just can excite radio-frequency (RF) ablation electric current.Can ablating electrode be controlledly sequentially selected to operate like this.
Claims (3)
1. one kind is applicable to renal artery Ink vessel transfusing multi-pole rf ablation catheter, comprise catheter ablation working end (1), main paragraph (2), handle (3), it is characterized in that: catheter ablation working end (1) is the kinematic pair mechanism (46) with multipole electrode pipe (8), in Spindle after kinematic pair mechanism (46) expansion; Described kinematic pair mechanism (46) form by turning elbow kinematic pair (47) before and after some single groups, turn before and after every single group elbow kinematic pair (47) be connect a set of by electrode tube (8) and projective table type annular electrode (10) form one independently or the list group catheter ablation working end of linking; Turn elbow kinematic pair before and after described single group to turn elbow by front and back and form, after turn elbow interlude and curve inwardly, the internal stent of electrode tube (8) turns elbow (16) after being, its electrode tube bending section is furnished with projective table type annular electrode (10); Main paragraph (2) is made up of trocar sheath (4) and inner core (5), and described trocar sheath (4) is connected with the near-end of kinematic pair mechanism (46), and inner core (5) is connected with the far-end of kinematic pair mechanism (46); Handle (3) built-in cubicle switch (32), is connected with inner core (5), and described cubicle switch is by upper knob (33), and lower button (36) and spring (38) form; This conduit is used for renal artery Ink vessel transfusing mapping and melts.
2. be applicable to renal artery Ink vessel transfusing multi-pole rf ablation catheter as claimed in claim 1, it is characterized in that: turn before and after single group elbow kinematic pair (47) by front turn elbow (9) and after turn elbow (16) and form, before turn one end of elbow (9) before in bulb (22) formed to swing with front outer bulb (20) and be connected, front outer bulb (20) welds with prelocalization ball (7), after turn one section of angle that curves inwardly in the middle of elbow, after turn one end of elbow (16) after in bulb (17) formed to swing with rear outer bulb (19) and be connected, rear outer bulb (19) is welded with rear place kick (6).
3. be applicable to renal artery Ink vessel transfusing multi-pole rf ablation catheter as claimed in claim 1 or 2, it is characterized in that: described kinematic pair mechanism (46) forms by turning elbow kinematic pair (47) before and after the single group of 3-6 group.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201210423459.3A CN102871727B (en) | 2012-10-30 | 2012-10-30 | Multipolar radiofrequency ablation catheter which is applicable to being used in renal artery vessels |
Applications Claiming Priority (1)
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| CN105193498B (en) * | 2015-09-18 | 2019-03-08 | 先健科技(深圳)有限公司 | Ablation catheter apparatus |
| CN106901831A (en) * | 2017-03-23 | 2017-06-30 | 深圳市惠泰医疗器械有限公司 | The arteria renalis stimulates ablating electrode conduit |
| US11207016B2 (en) | 2018-12-28 | 2021-12-28 | Biosense Webster (Israel) Ltd. | Mapping ECG signals using a multipole electrode assembly |
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| EP1210021B1 (en) * | 1999-03-19 | 2006-05-10 | Atrionix, Inc. | Atrial annulus ablation device |
| CN101495048A (en) * | 2006-05-24 | 2009-07-29 | 艾姆西森有限公司 | Vessel sealing device and methods |
| CN202069688U (en) * | 2011-03-11 | 2011-12-14 | 北京天助畅运医疗技术股份有限公司 | Radio frequency ablation electrode capable of treating resistant hypertension |
| CN102462532A (en) * | 2011-10-25 | 2012-05-23 | 张石江 | Conduit system with label testing and ablation functions in blood vessels |
| CN202859295U (en) * | 2012-10-30 | 2013-04-10 | 陈平根 | Multipolar radio frequency melting catheter suitable for renal artery blood vessels |
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| US20040082947A1 (en) * | 2002-10-25 | 2004-04-29 | The Regents Of The University Of Michigan | Ablation catheters |
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Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP1210021B1 (en) * | 1999-03-19 | 2006-05-10 | Atrionix, Inc. | Atrial annulus ablation device |
| CN101495048A (en) * | 2006-05-24 | 2009-07-29 | 艾姆西森有限公司 | Vessel sealing device and methods |
| CN202069688U (en) * | 2011-03-11 | 2011-12-14 | 北京天助畅运医疗技术股份有限公司 | Radio frequency ablation electrode capable of treating resistant hypertension |
| CN102462532A (en) * | 2011-10-25 | 2012-05-23 | 张石江 | Conduit system with label testing and ablation functions in blood vessels |
| CN202859295U (en) * | 2012-10-30 | 2013-04-10 | 陈平根 | Multipolar radio frequency melting catheter suitable for renal artery blood vessels |
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