CN104068911A - Blood vessel thrombus extracting implement and thrombus extracting device - Google Patents
Blood vessel thrombus extracting implement and thrombus extracting device Download PDFInfo
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- CN104068911A CN104068911A CN201310101112.1A CN201310101112A CN104068911A CN 104068911 A CN104068911 A CN 104068911A CN 201310101112 A CN201310101112 A CN 201310101112A CN 104068911 A CN104068911 A CN 104068911A
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- bolt device
- getting
- thrombus
- bolt
- inner tube
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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
- A61B17/22004—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 using mechanical vibrations, e.g. ultrasonic shock waves
- A61B17/22012—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
-
- 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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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Vascular Medicine (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Mechanical Engineering (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
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- General Health & Medical Sciences (AREA)
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- Surgical Instruments (AREA)
Abstract
The invention provides a blood vessel thrombus extracting implement and a thrombus extracting device which are especially suitable for intracranial blood vessel thrombus extracting. The blood vessel thrombus extracting implement is of a netty structure and can convert between a retracting position and an unfolding position. The blood vessel thrombus extracting implement is characterized in that at least part of the blood vessel thrombus extracting implement is structured to be a winding structure. According to the blood vessel thrombus extracting implement and the thrombus extracting device, in the recovery process after a thrombus is captured, the thrombus can be firmly fixed, so that stability in capturing is improved, thrombus shedding is prevented, and the problem of re-embolization of remote-end blood vessels due to the fact that blood vessel wall plagues and broken thrombus clots are prone to shedding is avoided. The blood vessel thrombus extracting implement is small in size and high in flexibility.
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 device.The invention still further relates to and a kind ofly comprise that this gets the taking thrombus device of bolt device, it is particularly suitable for intracranial vessel and gets bolt.
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: thrombectomy, and it is comparatively thorough that this method is got bolt, but excessive to vascular damaged, very easily causes various concurrent inflammation; The broken bolt of laser, this method operation easier is large, and laser energy is too low invalid, the too high injured blood vessel of energy, and equally easily cause various complication; Catching device is got bolt, and this method is simple to operate, very little to vascular damaged, but often can not entangle blood clot; Catch bolt net and get bolt, this method is simple to operate, but long-pending compared with using in intracranial vessel greatly because catching bolt dictyosome.
Chinese utility model patent 03210077.9 discloses a kind of elliposoidal blood vessel distal protector; it comprises and is provided with the fusiform elliposoidal protector main body of skeleton and the polymeric membrane of porous; polymeric membrane covers skeleton top; with allow normal blood flow by and the solid particles such as the speckle by coming off or the thrombosis that forms are filtered, thereby protection downstream blood vessel is not blocked.200620164685.4 of Chinese utility model patents disclose a kind ofly gets bolt device for artery of lower extremity, it is made up of umbrella, spindle rod, push-and-pull seal wire, internal and external casing, overcoat tube core, umbrella is made up of shape-memory alloy wire, by two long short three-jaws by certain angle and main shaft dry weld together form, and umbrella periphery is with network structure, to filter thrombosis.U.S. Patent application 2007/0005103,2008/0243170,2011/0098738 also discloses the pin device of catching of like configurations, and drainage screen or film that it includes framework and is attached to framework, in order to filter thrombosis.Above-mentioned to get pin device volume larger, thereby cannot in intracranial vessel, use.
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.When these are got pin device and reclaim after catching thrombosis, thrombosis fixing 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.
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 volume is little, compliance is good.
According to an aspect of the present invention, the present invention proposes a kind of taking thrombus device, described in to get bolt device be network structure and can between retrieving position and expanded position, change, and described in get bolt device and be configured at least in part winding-structure.Construct with this, getting after bolt device release expansion, can ensure to realize the multiple of thrombosis fixed, thereby reduce the risk that thrombosis comes off.
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, described winding-structure is curling around an axis or many axis.
Preferably, get the opening ovalize of bolt device in its proximal end.In the time that getting bolt device, push-and-pull can ensure effectively to catch like this area.
Preferably, the inner ring from described winding-structure reduces gradually to outer ring or increases at described winding-structure place to get the mesh of bolt device.According to a preferred embodiment of the invention, mesh size is 3-15mm
2.Construct with this, realize get the classification of bolt device to thrombosis, successively, alternately fixing.Certainly, mesh also can be big or small identical.
According to a preferred embodiment of the invention, the mesh of getting bolt device is uniformly distributed.Certainly, mesh also can intermittently distribute.
According to the present invention, preferably, get bolt device by laser cut metal tubing then heat treatment shaping obtain.Or, get bolt device and there is the metal of shape memory effect or there is elastomeric macromolecular sheet material by cut, then reel, heat treatment shaping and forming.Metal can be Nitinol, cobalt-nickel alloy etc.The compliance and the adherent property that make like this to get bolt device are good.
According to the present invention, preferably, to get bolt device and be on the whole near cylindrical, length is 15～60mm, and maximum outside diameter is 2～6mm, and the wall thickness of tubing or sheet material is 0.04～0.12mm.
According to a further aspect of the invention, the present invention proposes a kind of taking thrombus device, this is got pin device and comprises guiding wire, push-and-pull seal wire, epitheca pipe and the inner tube that can move with respect to epitheca pipe, guiding wire is through inner tube, inner tube is enclosed in epitheca pipe, and inner tube can move along guiding wire.The pin device of getting of the present invention is characterised in that: it comprises the above-mentioned bolt device of getting, 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, get bolt device and be recycled in inner tube, at expanded position, get bolt device and be pushed out inner tube.According to the pin device of getting of the present invention, can fixedly secure thrombosis, improve and catch stability, anti-tampon comes off.
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 the adherent property of good blood vessel after being discharged into blood vessel.
According to a further aspect of the present invention, provide and get pin device and get the application in bolt at intracranial vessel.When use, first determine blood vessel embolism position, then epitheca pipe is transported near thromboembolism position, guiding wire is passed to thromboembolism position, then make inner tube along guiding wire is moved through to thromboembolism position.Behind location, withdraw inner tube, make to get bolt device and launch in thrombosis centre position.Then, utilize shutoff sacculus that distal vessels is blocked, then will get bolt device and inner tube is recovered in epitheca pipe, finally epitheca pipe is withdrawn to external.
According to taking thrombus device of the present invention and get pin device, can effectively fall and 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 apparatus 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 of getting pin device of the embodiment of the present invention.
Fig. 2 is the schematic diagram of getting bolt device of the embodiment of the present invention.
Fig. 3 is the schematic diagram of getting bolt device of another embodiment of the present invention.
Fig. 4-8 have shown the bolt device coiling heteroid schematic diagram before of getting of the present invention.
Detailed description of the invention
Describe embodiments of the invention in detail below with reference to Fig. 1-8.
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.
Fig. 1 has shown the general illustration of getting pin device 1, and it comprises epitheca pipe 2, push-and-pull seal wire 3, inner tube 4 and get bolt device 10, and inner tube 4 is enclosed in epitheca pipe 2 and can moves with respect to it.Get bolt device 10 and be connected with push-and-pull seal wire 3, mounted push-and-pull seal wire 3 and get bolt device 10 and pressed and hold in inner tube 4.Getting bolt device 10 can change by the push-and-pull of push-and-pull seal wire 3 between retrieving position and expanded position, at retrieving position, gets bolt device 10 to be recovered in inner tube 4, at expanded position, gets bolt device 10 and is pushed out into outside inner tube 4.In addition, get pin device 1 and also comprise guiding wire (not shown), guiding wire is through inner tube 4, to inner tube 4 is moved along it.Epitheca pipe 2 is also provided with inflatable shutoff sacculus (not shown) 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 4 and epitheca pipe 2, also can be provided with developing mark (not shown).
Get that metal pipe material (as dilval etc.) that bolt device 10 has a shape memory effect by cut forms and through heat treatment shaping.Certainly, getting bolt device 10 also can have by cutter the metal sheet of shape memory effect, then reel, and heat treatment shaping and forming.The suitable dimension of getting bolt device 10 is as follows: length is 15～60mm, and maximum outside diameter is 2～6mm, and the wall thickness of tubing or sheet material 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.
As Figure 2-3, bolt device 10 entirety of getting after heat treatment shaping are winding-structure.Certainly, get bolt device 10 and also can only partly be winding-structure.
As shown in Figure 2, get the winding-structure of bolt device 10 curling around an axis.As shown in Figure 3, get the winding-structure of bolt device 10 curling around two axis.Certainly, getting the winding-structure of bolt device 10 can be curling around more axis.
Get bolt device 10 and reel previous shape as Figure 4-8.In this example, getting bolt device 10 consists of sheet material.As shown in the figure, get bolt device 10 for netted, a large amount of mesh are distributing on it.In this example, the area of mesh is 3-15mm
2.
In addition, mesh is towards can be identical, as shown in Fig. 4-5 and 8, or different, as shown in Figures 6 and 7.Towards different mesh can be the mesh of two end portions towards identical, and from the mesh of mid portion towards different, as shown in Figure 7.In addition, it is identical that mesh both can shape size, again can shape size different.Mesh get distribution on bolt device both can size identical to inner ring from the outer ring of winding-structure, be uniformly distributed, can reduce gradually from inside to outside or increase again, intermittently distribute, get the classification of bolt device to thrombosis, successively, alternately fix to realize.
In addition, as shown in the figure, getting bolt device 10 coilings shape before can be that width is constant from near-end to far-end, as shown in Fig. 4,6 and 7, or change, as shown in Fig. 5 and 8.Certainly, the shape of getting bolt device is not limited to shown in figure, it may occur to persons skilled in the art that other shape.
Push-and-pull seal wire 3 is arranged as at expanded position and presses close to blood vessel wall with the traction junction point of getting bolt device 10.Can improve so effective capture rate of large volume thrombosis.
Using method of getting pin device 1 of the present invention is as follows.When interventional therapy, first determine intracranial vessel lesion locations by angiography, then will get pin device 1 from femoral artery or brachial artery imports in blood vessel, make guiding wire pass lesion locations, inner tube 4 is located through lesion locations and by the developing mark (not shown) in inner tube 4 along guiding wire, get during this time bolt device 10 and be positioned at inner tube 4 always, in retrieving position.Then, withdraw guiding wire, will get bolt device 10 by push-and-pull seal wire 3 and shift inner tube 4 far-ends onto, withdraw inner tube 4 to lesion locations, discharge will get bolt device 10, 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 the shutoff sacculus on epitheca pipe 2 that distal vessels is blocked.Then, pull push-and-pull seal wire 3, withdraw and get bolt device 10 and catch thrombosis, be recovered in inner tube 4 until will get bolt device 10, then inner tube 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.The thrombosis that design of the present invention can firmly be held and catch, effectively prevents from getting pin device the coming off of thrombosis in removal process.
Above embodiment describe for be that intracranial vessel is got bolt.Be understandable that, of the present invention get bolt device and get pin device under suitable size, 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 (9)
1. get a bolt device, described in to get bolt device be network structure and can between retrieving position and expanded position, change, it is characterized in that, described in get bolt device and be configured at least in part winding-structure.
2. the bolt device of getting according to claim 1, wherein said winding-structure is curling around an axis or many axis.
3. the bolt device of getting according to claim 1, wherein gets bolt device and is near cylindrical in expanded position entirety.
4. the bolt device of getting according to claim 2, wherein gets bolt device and has approximate ellipsoidal opening at near-end.
5. according to getting bolt device described in any one in claim 1-4, the mesh size of wherein getting bolt device is identical, or the inner ring from described winding-structure reduces gradually to outer ring or increases at described winding-structure place.
6. get pin device for one kind, it comprises guiding wire, push-and-pull seal wire, epitheca pipe and the inner tube that can move with respect to epitheca pipe, guiding wire is through inner tube, inner tube is enclosed in epitheca pipe, and inner tube can move along guiding wire, it is characterized in that, what this got that pin device also comprises any one in claim 1-5 gets bolt device, 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.
7. the pin device of getting according to claim 6, 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.
8. according to the pin device of getting described in claim 6 or 7, wherein get bolt device and be near cylindrical in expanded position entirety.
9. in claim 6-8, the pin device of getting described in any one is got the application in bolt at intracranial vessel.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310101112.1A CN104068911A (en) | 2013-03-26 | 2013-03-26 | Blood vessel thrombus extracting implement and thrombus extracting device |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310101112.1A CN104068911A (en) | 2013-03-26 | 2013-03-26 | Blood vessel thrombus extracting implement and thrombus extracting device |
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| Publication Number | Publication Date |
|---|---|
| CN104068911A true CN104068911A (en) | 2014-10-01 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201310101112.1A Pending CN104068911A (en) | 2013-03-26 | 2013-03-26 | Blood vessel thrombus extracting implement and thrombus extracting device |
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| CN (1) | CN104068911A (en) |
Cited By (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN106963451A (en) * | 2017-03-29 | 2017-07-21 | 上海心玮医疗科技有限公司 | One kind takes bolt device |
| CN109247971A (en) * | 2017-07-12 | 2019-01-22 | 微创神通医疗科技（上海）有限公司 | It takes bolt bracket and takes pin device |
| CN109688945A (en) * | 2016-05-18 | 2019-04-26 | 微仙美国有限公司 | Embolism plugging device |
| CN110974350A (en) * | 2019-12-17 | 2020-04-10 | 禾木（中国）生物工程有限公司 | Bolt taking system |
| CN110974351A (en) * | 2019-12-17 | 2020-04-10 | 禾木（中国）生物工程有限公司 | Curve opening thrombus taking device |
| CN112741670A (en) * | 2021-01-21 | 2021-05-04 | 北京久事神康医疗科技有限公司 | Novel bolt taking device |
| CN117918927A (en) * | 2024-03-21 | 2024-04-26 | 杭州亿科医疗科技有限公司 | Winding type thrombus taking device |
| CN106963451B (en) * | 2017-03-29 | 2024-05-31 | 上海心玮医疗科技股份有限公司 | Thrombolysis device |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN109688945A (en) * | 2016-05-18 | 2019-04-26 | 微仙美国有限公司 | Embolism plugging device |
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| CN112741670A (en) * | 2021-01-21 | 2021-05-04 | 北京久事神康医疗科技有限公司 | Novel bolt taking device |
| CN117918927A (en) * | 2024-03-21 | 2024-04-26 | 杭州亿科医疗科技有限公司 | Winding type thrombus taking device |
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