CN104068910A - Blood vessel thrombus extracting system - Google Patents
Blood vessel thrombus extracting system Download PDFInfo
- Publication number
- CN104068910A CN104068910A CN201310100144.XA CN201310100144A CN104068910A CN 104068910 A CN104068910 A CN 104068910A CN 201310100144 A CN201310100144 A CN 201310100144A CN 104068910 A CN104068910 A CN 104068910A
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- China
- Prior art keywords
- inner tube
- getting
- bolt device
- thrombus
- bolt
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
- A61B2017/22065—Functions of balloons
- A61B2017/22067—Blocking; Occlusion
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22079—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with suction of debris
Abstract
The invention provides a blood vessel thrombus extracting system which comprises a leading guide wire, a pushing-pulling guide wire, an inner tube capable of moving relatively to an outer sheath tube, a thrombus extracting device and a suction device. The leading guide wire penetrates the inner tube which is sleeved in the outer sheath tube, the inner tube can move along the leading guide wire, the thrombus extracting device is connected with the pushing-pulling guide wire, the pushing-pulling guide wire and the thrombus extracting device which are mounted well are pressed and held in the inner tube, the thrombus extracting device can be pushed and pulled to convert between a retracting position and an unfolding position through the pushing-pulling guide wire, and is retracted into the inner tube when at the retracting position and pushed out of the inner tube when at the unfolding position, the suction device is communicated with the inner tube, and suction holes are formed in the inner tube. According to the blood vessel thrombus extracting system, big thrombi can be captured conveniently, and shedding of small thrombi can be prevented through suction, so that the problem of re-embolization of remote-end blood vessels is solved, and probability of complications after thrombus extracting is effectively lowered.
Description
Technical field
The present invention relates to medical apparatus and instruments, be specifically related to a kind of medical apparatus and instruments of getting involved blood vessel, particularly a kind of taking thrombus system.
Background technology
Intravascular Thrombus is commonly encountered diseases and frequently-occurring disease clinically, and Intracranial thrombus is the most important thing, and it causes cerebral embolism, has the advantages that sickness rate is high, disability rate is high, mortality rate is high and relapse rate is high, is the principal disease that middle-aged and elderly people is lethal and disable.And along with continuous increase and the growth in the living standard of aging population, the sickness rate of cerebrovascular is in continuous rising.According to investigation, China has 3,000,000 newly-increased cerebral thrombosis colony at present every year, also rises to 81.6% by 55.8% and acute cerebral thrombosis accounts for the ratio of apoplexy, becomes the first disease of brain.
The logical again of blood vessel is the key for the treatment of acute ischemic cerebral apoplexy.The Therapeutic Method of Intracranial thrombus mainly contains two kinds at present: medicine thrombolytic and machinery are got bolt.
Medicine thromboembolism treatment is that thrombolytics is injected near the endovascular focus at pathological changes place, local moment of focus form very high thrombolytics concentration, accelerate thromboembolism speed, and then increase the chance of revascularization.But according to the state-run sacred disease of the U.S. and apoplexy academy's (NINDS) result of study, intravenous thrombolysis should be carried out in 3 hours in morbidity, tremulous pulse thrombolytic time window is within 6 hours.Because medicine thromboembolism treatment time window is shorter, and thromboembolism treatment is only applicable to the thrombosis of small volume, and its therapeutic effect to large volume thromboembolism is unsatisfactory, so finally approximately only have 3~5% patient to be applicable to doing medicine thromboembolism treatment.
It is to be delivered to lesion locations by getting bolt device that machinery is got bolt, then thrombosis is taken out to external by sheath pipe.Machinery is got bolt and is comprised following several method: bolt is got in seizure, bolt is got in suction, bolt etc. is got in rotary-cut.It is best that bolt effect in the time getting massive is got in seizure, causes new thromboembolism but flow to distal vessels after easily causing speckle in blood vessel wall and broken thrombi to come off; It is better that bolt effect in the time getting fritter embolus is got in suction, in the time getting massive, aspirates after stopping up suction tube need to smash thrombosis to pieces repeatedly in order to prevent again, process bothers and be easy to hurt blood vessel; It is larger that the damage that bolt causes blood vessel wall is got in rotary-cut, is easy to lead to complications.
Chinese utility model patent CN201020104685.1 discloses a kind of for thrombus suction catheter in human vas, and it comprises the base, reinforced pipe, single lumen catheter, double lumen tube, most advanced and sophisticated pipe and the developing mark that connect successively.This is got, and tying unites has 1-4 perforate at the far-end of suction chamber, has increased trafficability characteristic and the thrombosis suction capactity of conduit, and has reduced the damage to human vas in operation process, improves the tracing property of conduit and propelling movement property simultaneously.
Chinese invention patent application CN201110222609.X and Chinese utility model patent CN201120281795.X disclose a kind of thrombus suction catheter, it comprises suction tube, described suction tube comprises base, described base connecting duct, mobilizable sleeve pipe that is arranged with on the outer wall of described suction tube, described sleeve pipe comprises Y type union joint, double lumen tube and sacculus, described Y type union joint connects double lumen tube, sacculus is arranged on the far-end outer wall of double lumen tube, in described suction tube, can insert interference tinsel, outside the far-end of the extended suction tube of described interference far-end wiry.This is got and ties system and can remove fast and be dispersed in the thrombosis of blood vessel extensive region and process arteria coronaria tip microvascular thromboembolism, and in the time running into the large and heavy bodied thrombosis of volume, aspirates after can utilizing interference tinsel to break up thrombosis again.
U.S. Patent application US2010/0049147A1 discloses another thrombus suction catheter.U.S. Patent application US2007/0161963A1 also discloses a kind of thrombectomy aspiration catheter system.
Above-mentioned suction gets that to tie system effect in the time getting fritter embolus better, but aspirates after stopping up suction tube need to smash thrombosis to pieces repeatedly in order to prevent in the time getting massive again, process trouble and be easy to hurt blood vessel.
Chinese invention patent application 01114889.6 discloses a kind of recyclable temporary thrombus filter that can be used for intracranial vessel, and it is made up of filter, guide head, guide bar, connector and epitheca, and its middle filtrator is formed by shape-memory alloy wire braiding.U.S. Patent application 2011/0160763 also discloses a kind of pin device of getting that can be used for intracranial vessel, and it comprises skeleton, and skeleton can be formed by shape-memory alloy wire braiding, to catch thrombosis.
Above-mentioned getting ties system while reclaiming catching thrombosis after, and that thrombosis is fixed is insecure, easily come off, and complex structure.
In addition, utilize the current pin device of getting, be easy to come off in speckle and the broken thrombi of getting on bolt process medium vessels wall, flow to distal vessels, cause new thromboembolism.It is reported approximately have 70% blood vessel to get involved to get and in bolt operation, observed thrombosis fragment and fragment flows to distal vessels, this has increased patient vessel's risk of thromboembolism again.
Therefore, need a kind of improved taking thrombus device, this device should meet following condition: 1) get bolt process simply, conveniently; 2) compliance is good, and capture rate is high, and support force is moderate, and getting in bolt process not can injured blood vessel inwall; 3) while recovery after catching thrombosis, thrombosis fixation, difficult drop-off.In a word, should there is the good bolt effect of getting, can effectively prevent that again coming off of [Dan from can not cause serious complication by injured blood vessel again simultaneously.
Summary of the invention
In view of this, the invention provides a kind of improved getting and tie system, this system has solved the blood vessel wall speckle and the broken thrombi that in prior art, exist and has easily come off and cause the distal vessels problem of thromboembolism again, and compliance is good, capture rate is high.
According to an aspect of the present invention, the present invention proposes a kind of taking thrombus system, it comprises guiding wire, push-and-pull seal wire, epitheca pipe, the inner tube that can move with respect to epitheca pipe and the netted bolt device of getting, guiding wire is through inner tube, inner tube is enclosed in epitheca pipe, and inner tube can move along guiding wire, this is got bolt device and is connected with push-and-pull seal wire, mounted push-and-pull seal wire and get bolt device and held in inner tube by pressure, and described in get bolt device and can between retrieving position and expanded position, change by the push-and-pull of push-and-pull seal wire, at retrieving position, getting bolt device is recycled in inner tube, at expanded position, get bolt device and be pushed out inner tube, shown in get and tie system and also comprise aspirator, this aspirator is connected with inner tube, and inner tube is provided with suction socket.Of the present invention getting ties system and seizure is got to bolt gets bolt with suction and combine, both can catch easily massive, can prevent coming off of fritter thrombosis by suction again, solve the blood vessel distal vessels problem of thromboembolism again, effectively reduce the probability of getting bolt infectious-related complication simultaneously.
According to a preferred embodiment of the invention, epitheca pipe is also provided with inflatable shutoff sacculus at far-end.
According to a preferred embodiment of the invention, inner tube is provided with 1~4 suction socket, and these suction socket can be the openings of distal end of catheter, can be also the perforate on duct wall.The shape of opening and perforate can be circular, oval or other shapes.Perforate can symmetrical, spaced apart or random distribution.
According to a preferred embodiment of the invention, get bolt device and both can obtain by laser cut metal tubing, sheet material, also can obtain by metal wire knitted, wherein metal tube, sheet, silk material can be Nitinol, cobalt-nickel alloy, rustless steel etc.The compliance and the adherent property that make like this to get bolt device are good.
In addition, preferably, get the near-end of bolt device and far-end and can be all opening or sealing.Getting bolt device entirety can also be approximate circle column, inner concavity or outer gibbosity etc.Getting bolt device can also be single layer structure, or bilayer or multiple structure.
According to a preferred embodiment of the invention, getting bolt device entire length is 15~60mm, and diameter is 2~6mm, and wall thickness is 0.04~0.12mm.
Preferably, push-and-pull seal wire is arranged to press close to blood vessel wall at expanded position with the traction junction point of getting bolt device.Can improve so effective capture rate of large volume thrombosis.
Preferably, get bolt device and be near cylindrical in expanded position entirety.Making like this to get bolt utensil has good radial support power, has good blood vessel adherent property after being discharged into blood vessel from inner tube.
While getting bolt, determine the position of thrombosis by angiography, then inner tube is delivered to thromboembolism place far-end, withdraw inner tube, will get bolt device and discharge in the middle of thrombosis, utilize shutoff sacculus to block blood vessel at far-end, then first withdraw and get bolt device and enter in inner tube, open again afterwards aspirator and aspirate.Then, close aspirator, inner tube is moved to 5~20mm to far-end, again open afterwards aspirator suction residue fritter thrombosis, then close aspirator.Finally, inner tube is taken in epitheca pipe, withdrawn from external.
According to taking thrombus system of the present invention, can effectively catch speckle and thrombosis fragment, increase thrombosis and caught stability, prevent that thrombosis from coming off, thereby reduced again the risk of thromboembolism.In addition, taking thrombus system structure of the present invention is simple, gets bolt process conveniently easily.
Brief description of the drawings
By the detailed description of with reference to the accompanying drawings embodiment of the present invention being carried out, feature of the present invention and advantage thereof will be apparent.In the drawings:
Fig. 1 is the general illustration that getting of the embodiment of the present invention ties system.
Fig. 2-9th, the schematic diagram of the embodiment of inner tube of the present invention.
Figure 10-20 have shown the schematic diagram of the embodiment that gets bolt device of the present invention.
Detailed description of the invention
Describe embodiments of the invention in detail below with reference to Fig. 1-2 0.
For convenience of description, below describe and used term " near-end " and " far-end ", wherein " near-end " refers to from the one end close to operating side, and far-end refers to the one end away from operating side.
As shown in Figure 1, get and tie turnkey and draw together aspirator 1, epitheca pipe 2, inner tube 3 and get bolt device 10 and form.Get bolt device 10 for netted and with get the push-and-pull seal wire (not shown) that ties system and be connected, mounted push-and-pull seal wire and get bolt device 10 and held in inner tube 3 by pressures.Getting bolt device 10 can change by the push-and-pull of push-and-pull seal wire between retrieving position and expanded position, at retrieving position, gets bolt device 10 to be recovered in inner tube 3, at expanded position, gets bolt device 10 and is pushed out into outside inner tube 3.In addition, get and tie system and also comprise guiding wire (not shown), guiding wire, through inner tube 3, is got and is tied system in order to guiding in blood vessel.Epitheca pipe 2 is provided with inflatable shutoff sacculus 4 at far-end.
In addition, get on bolt device 10 and be also provided with developing mark (not shown), to help location to get bolt device 10.Be understandable that, on inner tube 3 and epitheca pipe 2, also can be provided with developing mark.
Inner tube is provided with 1~4 suction socket, and these suction socket can be only the openings of inner tube far-end, as shown in Fig. 2 and 6, can be also on distal openings basis, on duct wall, to open some suction socket, as shown in Fig. 3~5 and Fig. 7~9 again.Opening and perforate can be circular, oval or other shapes, can be separately, symmetry, interval or random distribution.
Getting bolt device can be single layer structure, as getting as shown in bolt device 10 of Figure 10~14.That get the near-end of bolt device 10 and far-end and can be all sealing or opening.In addition, as shown in figure 14, get bolt device 10 and can be configured with evagination and concave inward structure.
Getting bolt device can be also double-decker.As shown in Figure 15~20.Get bolt device 10 ' for support casing supporting structure, entirety is near cylindrical, and it comprises two parts, i.e. internal layer support 20 and outer support 30, and wherein ectonexine support is all configured to nettedly, and outer support is coated on outside internal layer support, and leaves gap between the two.The proximal-distal of getting the ectonexine of bolt device 10 ' can be that a near-end connects, and as shown in Figure 16,17,19 and 20, can be also that nearly far-end all connects, as shown in Figure 15 and 18.Connection can be welded to connect, utilize metal canula to connect or utilize tinsel to be intertwined and connected etc.
Certainly, getting bolt device can be also multiple structure.
Get that metal pipe material (as dilval etc.) that bolt device has a shape memory effect by cut forms and through heat treatment shaping.Certainly, getting bolt device also can have by cutter the metal sheet of shape memory effect, then curling, heat treatment shaping and forming.The suitable dimension of getting bolt device is as follows: length is 15~60mm, and diameter is 2~6mm, and wall thickness is 0.04~0.12mm.Also can replace metal material with elastomeric macromolecular material.Above-mentioned suitable material is well-known to those skilled in the art, is not described in detail at this.
Push-and-pull seal wire is arranged as at expanded position and presses close to blood vessel wall with the traction junction point of getting bolt device.Can improve so effective capture rate of large volume thrombosis.
Of the present inventionly get that to tie the using method of system as follows.
When interventional therapy, first determine vascular lesion position by angiography, then will get pin device 1 imports in blood vessel, make guiding wire pass lesion locations, make again inner tube 3 locate through lesion locations and by the developing mark (not shown) in inner tube 3 along guiding wire, get during this time bolt device 10 and be positioned at inner tube 3 always, in retrieving position.Then, withdraw guiding wire, will get bolt device 10 by push-and-pull seal wire and shift inner tube 3 far-ends onto, withdraw inner tube 3 to lesion locations, will get bolt device 10 and discharge, can locate and get bolt device 10 by getting developing mark on bolt device 10.Due to the shape memory effect of shape memory metal or the elastic reaction of high resiliency macromolecular material, get bolt device 10 and be transformed into expanded position under the effect of blood heat, blood vessel wall reclines.Then, utilize shutoff sacculus 4 to block blood vessel at far-end, pull push-and-pull seal wire, withdraw and get bolt device 10 and catch thrombosis, be recovered in inner tube 3 until will get bolt device 10.Then, open aspirator 1 and aspirate, close afterwards aspirator, then inner tube is moved to 5~20mm to far-end, again open afterwards aspirator suction residue fritter thrombosis, then close aspirator.Again inner tube 3 is recovered in epitheca pipe 2.Finally, will get pin device 1 entirety and withdraw from outside human body, complete the bolt process of getting.
Adopt current getting to tie system while getting bolt, the speckle in blood vessel wall and broken thrombi are easy to because External Force Acting fragmentation comes off, and flow to distal vessels and cause new thromboembolism, increase patient's operation risk.Design of the present invention is got bolt by seizure and is got these two kinds of modes of bolt with suction and combine, in the time getting bolt, can the fritter thrombosis coming off be sucked to suction tube by suction, the thrombosis of large volume can be drawn in to suction tube by catching simultaneously, having avoided catching fritter thrombosis while getting bolt easily comes off and aspirates the shortcoming that is difficult for catching massive while getting bolt, and easy to operate, recanalization rate is high.
Of the present invention getting ties system and can be suitable for intracranial vessel and get bolt, also can be suitable for getting bolt in other blood vessel.It will be understood by those skilled in the art that above description is exemplary.In the situation that not deviating from thought of the present invention and scope, those skilled in the art still can make numerous modifications and variations to the present invention.
Claims (7)
1. get and tie system for one kind, it is characterized in that, it comprises guiding wire, push-and-pull seal wire, epitheca pipe, the inner tube that can move with respect to epitheca pipe and get bolt device, guiding wire is through inner tube, inner tube is enclosed in epitheca pipe, and inner tube can move along guiding wire, this is got bolt device and is connected with push-and-pull seal wire, mounted push-and-pull seal wire and get bolt device and held in inner tube by pressure, and described in get bolt device and can between retrieving position and expanded position, change by the push-and-pull of push-and-pull seal wire, at retrieving position, getting bolt device is recycled in inner tube, at expanded position, get bolt device and be pushed out inner tube, described getting ties system and also comprises aspirator, this aspirator is connected with inner tube, and inner tube is provided with suction socket.
2. according to claim 1 getting ties system, wherein gets bolt device and comprises outer support and internal layer support, and ectonexine support is all configured to netted, and outer support is coated on outside internal layer support, forms gap between the two.
3. according to claim 2 getting ties system, and its ectomesoderm support is connected or is all connected with far-end at near-end at near-end with internal layer support.
4. tie system according to getting described in claim 2 or 3, wherein the near-end of ectonexine support and/or far-end have elliptical openings or circular open, or are what seal.
5. tie system according to getting described in any one in claim 1-3, wherein push-and-pull seal wire is arranged to press close to blood vessel wall at expanded position with the traction junction point of getting bolt device.
6. tie system according to getting described in any one in claim 1-3, wherein get bolt device and be near cylindrical in expanded position entirety.
7. tie system according to getting described in any one in claim 1-3, wherein get bolt device and be constructed the structure of indent and/or evagination.
Priority Applications (1)
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CN201310100144.XA CN104068910A (en) | 2013-03-26 | 2013-03-26 | Blood vessel thrombus extracting system |
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CN201310100144.XA CN104068910A (en) | 2013-03-26 | 2013-03-26 | Blood vessel thrombus extracting system |
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Cited By (42)
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CN107260252A (en) * | 2017-06-29 | 2017-10-20 | 武汉大学 | Encephalic phlebothrombosis is aspirated and venous return device |
CN107874811A (en) * | 2017-12-06 | 2018-04-06 | 北京久事神康医疗科技有限公司 | New cerebral thrombus withdrawing device and the method that bolt is taken using the device |
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