CN104546054B - Adjustable plugging device and release method - Google Patents

Adjustable plugging device and release method Download PDF

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Publication number
CN104546054B
CN104546054B CN201510026530.8A CN201510026530A CN104546054B CN 104546054 B CN104546054 B CN 104546054B CN 201510026530 A CN201510026530 A CN 201510026530A CN 104546054 B CN104546054 B CN 104546054B
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CN
China
Prior art keywords
push rod
lower disc
disc
ligation
plugging device
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CN201510026530.8A
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CN104546054A (en
Inventor
李博
杨永森
陈娟
罗鹏
王超
李超
张芳芳
蒲忠杰
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Shanghai Shape Memory Alloy Material Co Ltd
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Shanghai Shape Memory Alloy Material Co Ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00606Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00646Type of implements
    • A61B2017/00654Type of implements entirely comprised between the two sides of the opening
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743Type of operation; Specification of treatment sites
    • A61B2017/00778Operations on blood vessels

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention provides an adjustable plugging device and a release method. The plugging device comprises a plugging device body and a pushing rod, wherein the plugging device body comprises an upper disc piece and a lower disc piece, an elastic connector is arranged between the upper disc piece and the lower disc piece, a lower disc piece binding sleeve is arranged under the lower disc piece, the movable end of the elastic connector penetrates through the lower disc piece binding sleeve to be detachably connected with the pushing rod, the pushing rod pulls the elastic connector in the axial direction to adjust the length of the elastic connector between the upper disc piece and the lower disc piece. The purpose of adjusting the clamping force between the upper disc piece and the lower disc piece is achieved by adjusting the length of the elastic connector between the upper disc piece and the lower disc piece, so that the plugging device is stable and firm, is well fit with the lesion position and adapts to lesions different in size and length. In addition, the recoverable re-release property of the adjustable plugging device can be corrected when unexpected accidents occur in operation, and operation risk and operation difficulty are reduced.

Description

Adjustable plugging device and method for releasing
Technical field
The present invention relates to a kind of adjustable plugging device.
The invention still further relates to a kind of method for releasing of adjustable plugging device.
Background technology
Congenital heart disease does not lead to entirely mainly due to interval closing in the infant embryonic stage chambers of the heart, lacks for this Damage type pathological changes, current treatment methods are mainly closed treating, including the Occlusion therapy of surgical stapling treatment and intervention.
In Occlusion therapy, the plugging device being usually used is Marshrom shape occluder or turn, but mushroom umbrella shape Stopper in terms of chucking power be difficult to control, although and turn can control chucking power, be not suitable for big defect pathological changes. Connected using spring between the closure disc of some designs existing rather than traditional NiTi alloy network connects, but its length is solid Fixed, chucking power is also fixing, thus causing disc to be uncontrollable to the compressing of defect periphery, if applying some special When in pathological changes such as ventricular septal defect, can cause to oppress edema, Third degree heart block (unique Therapeutic Method when serious, can be caused It is to carry cardiac pacemaker all the life).
Content of the invention
The shortcoming of prior art in view of the above, it is an object of the invention to provide a kind of adjustable plugging device and releasing Put method, the chucking power for solving plugging device in prior art is difficult to control to, nonadjustable problem.
For achieving the above object and other related purposes, the present invention provides a kind of adjustable plugging device, this plugging device Including stopper and push rod, stopper includes disc and lower disc, and upper disc, lower disc are compiled by shape memory wire mesh shape Knit and form, between upper disc and lower disc, be provided with Flexible Connector, Flexible Connector be provided with the fixing end fixing with upper disc and Through the movable end of lower disc, the lower section of lower disc is provided with lower disc ligation set, and the movable end of Flexible Connector passes through lower disc Ligation set is detachably connected with push rod;Push rod pulls Flexible Connector vertically, regulation elasticity connector in upper disc and Length between lower disc;When push rod is departed from Flexible Connector, the movable end of Flexible Connector is covered with lower disc ligation Relative position keeps constant.
Preferably, push rod includes push rod shell, push rod inner core, and push rod inner core is in the interior intracavity of push rod shell Mobile or rotate along axis, the end of push rod shell is detachably connected with lower disc ligation set, the end of push rod inner core and The movable end of Flexible Connector is detachably connected.
Further preferred, the end of push rod shell is connected with lower disc ligation external threading.
Further preferred, threadeded with the movable end of Flexible Connector or connected by clip in the end of push rod inner core Connect.
Preferably, Flexible Connector is spring.
Further preferred, the movable end of spring is provided with spring retainer head, and the external diameter of spring retainer head is more than lower wall The internal diameter of piece ligation set.
Further preferred, spring is cylindric standard spring, square spring, double laminated spring or coniform spring.
Preferably, Flexible Connector is pipe type netted braiding structure, and pipe type netted braiding structure is by shape memory wire mesh Shape braiding forms.
Further preferred, the movable end of pipe type netted braiding structure is provided with braiding structure ligation set, and braiding structure ligatures Set can pass through in lower disc insertion lower disc ligation set, and braiding structure ligation set is provided with away from one end of pipe type netted braiding structure Ligation covers spacing head, and ligation covers the internal diameter more than lower disc ligation set for the external diameter of spacing head, and pipe type netted braiding structure leans on One end of nearly braiding structure ligation set is provided with the radially extending stretching, extension wing, and the external diameter stretching the wing is more than the interior of lower disc ligation set Footpath.
For achieving the above object and other related purposes, the present invention also provide a kind of using above-mentioned adjustable plugging device Method for releasing, comprises the following steps:
1) push rod is connected with stopper, pulls push rod, stopper is drawn in delivery sheath;
2) pass through delivery sheath, stopper is delivered to lesion locations;
3) push push rod shell, upper disc is discharged;
4) push push rod shell and push rod inner core simultaneously, discharge Flexible Connector;
5) push rod inner core remains stationary as, and pushes push rod shell, and lower disc part discharges;
6) push rod shell is separated with lower disc ligation set;
7) observe stopper whether stable firmly, if necessary, regulation elasticity connector is between upper disc and lower disc Length;
8) draw back push rod shell, push rod inner core is exposed with Flexible Connector and discharges completely;
9) push rod inner core is separated with the movable end of Flexible Connector.
Preferably, described step 1) comprise the following steps:
1. the movable end of Flexible Connector is connected with the end of push rod inner core;
2. push rod inner core is drawn in push rod shell together with the movable end of Flexible Connector;
3. push rod shell is fixedly connected with lower disc ligation set;
4. push rod inner core, together with the movable end of Flexible Connector, moves along axis in the cavity of push rod shell or revolves Turn, length between upper disc and lower disc for the regulation elasticity connector;
5. pull push rod, stopper is drawn in delivery sheath.
Preferably, step 7) in length between upper disc and lower disc for the regulation elasticity connector process include following Step:
1. push away before push rod shell, make push rod inner core and Flexible Connector be recovered to the interior intracavity of push rod shell;
2. push rod shell is fixedly connected with lower disc ligation set;
3. the movable end of push rod inner core and Flexible Connector is moved along axis together in the cavity of push rod shell Or rotation, length between upper disc and lower disc for the regulation elasticity connector;
4. push rod shell is separated with lower disc ligation set.
As described above, the adjustable plugging device of the present invention and method for releasing, have the advantages that:
This adjustable plugging device and method for releasing, by length between upper disc and lower disc for the regulation elasticity connector Degree, reaches the purpose adjusting upper chucking power between disc and lower disc, makes plugging device more stable firmly, with lesion locations patch Close better, be adapted to the pathological changes of different size, different length, simultaneously the recyclable release property again of this adjustable plugging device Operation is corrected when occurring unexpected, reduces operation risk and operation technique difficulty.
Brief description
Fig. 1 is shown as the structural representation of the adjustable plugging device of the present invention.
The structure that Fig. 2 is shown as the first specific embodiment of the stopper of adjustable plugging device shown in Fig. 1 is shown It is intended to.
The structure that Fig. 3 is shown as the second specific embodiment of the stopper of adjustable plugging device shown in Fig. 1 is shown It is intended to.
The structure that Fig. 4 is shown as the third specific embodiment of the stopper of adjustable plugging device shown in Fig. 1 is shown It is intended to.
The structure that Fig. 5 is shown as the 4th kind of specific embodiment of the stopper of adjustable plugging device shown in Fig. 1 is shown It is intended to.
The structure that Fig. 6 is shown as the 5th kind of specific embodiment of the stopper of adjustable plugging device shown in Fig. 1 is shown It is intended to.
Fig. 7 a to Fig. 7 b is shown as the 6th kind of specific embodiment of the stopper of adjustable plugging device shown in Fig. 1 Structural representation.
Fig. 8 a to Fig. 8 b is shown as the 7th kind of specific embodiment of the stopper of adjustable plugging device shown in Fig. 1 Structural representation.
Fig. 9 a to Fig. 9 f is shown as the first specific embodiment of the push rod of adjustable plugging device shown in Fig. 1 Structural representation.
The structure that Figure 10 is shown as the second specific embodiment of the push rod of adjustable plugging device shown in Fig. 1 is shown It is intended to.
Component label instructions
1 stopper
Disc on 11
12 lower disc
121 lower disc ligation sets
13 Flexible Connectors
131 springs
132 spring retainer heads
133 pipe type netted braiding structures
134 braiding structure ligation sets
135 ligation cover spacing head
The 136 stretching, extension wings
14 waists
2 push rod
21 push rod shells
22 push rod inner cores
23 clips
3 delivery sheaths
Specific embodiment
Hereinafter embodiments of the present invention are illustrated by particular specific embodiment, those skilled in the art can be by this explanation Content disclosed by book understands other advantages and effect of the present invention easily.
Refer to Fig. 1 to Figure 10.It should be clear that structure depicted in this specification institute accompanying drawings, ratio, size etc., all only use To coordinate the content disclosed in description, so that those skilled in the art understands and reads, being not limited to the present invention can The qualificationss implemented, therefore do not have technical essential meaning, the tune of the modification of any structure, the change of proportionate relationship or size Whole, under not affecting present invention effect that can be generated by and the purpose that can reach, all should still fall in disclosed skill In the range of art content obtains and can cover.Meanwhile, in this specification cited as " on ", D score, "left", "right", " middle " and The term of " one " etc., is merely convenient to understanding of narration, and is not used to limit the enforceable scope of the present invention, its relativeness It is altered or modified, under no essence change technology contents, when being also considered as the enforceable category of the present invention.
As shown in Figures 1 to 10, the present invention provides a kind of adjustable plugging device, and this plugging device includes stopper 1 He Push rod 2, stopper 1 includes disc 11 and lower disc 12, and upper disc 11, lower disc 12 are woven by shape memory wire mesh shape Form, between upper disc 11 and lower disc 12, be provided with Flexible Connector 13, Flexible Connector 13 is provided with fixing with upper disc 11 Fixing end and the movable end passing through lower disc 12, the lower section of lower disc 12 is provided with lower disc ligation set 121, Flexible Connector 13 Movable end passes through lower disc ligation set 121 to be detachably connected with push rod 2;Push rod 2 pulls Flexible Connector 13 vertically, adjusts Section length between upper disc 11 and lower disc 12 for the Flexible Connector 13;When push rod 2 is departed from Flexible Connector 13, elasticity The movable end of connector 13 keeps constant with the relative position of lower disc ligation set 121.Above-mentioned plugging device, by push rod 2 Pull Flexible Connector 13 vertically, length between upper disc 11 and lower disc 12 for the regulation elasticity connector 13, thus adjust Chucking power between disc 11 and lower disc 12 on section, makes plugging device more stable firmly, fits with lesion locations better, can To adapt to the pathological changes of different size, different length.
As shown in Figures 2 to 6, Flexible Connector 13 is spring 131.Wherein, the movable end of spring 131 is provided with spring retainer Head 132, the external diameter of spring retainer head 132 is more than the internal diameter of lower disc ligation set 121.Spring retainer head 132 is used for even Connect spring 131 and push rod 2, when so that push rod 2 is departed from spring 131, spring 131 will not be retracted into lower disc ligation simultaneously In set 121.
As shown in Fig. 2 between upper disc 11 and lower disc 12 in addition to spring 131 connects, connecting also by waist 14, waist Portion 14 is formed by the braiding of shape memory wire mesh shape, and spring 131 is trapped among centre.This design make on adjusting disc 11 and under During spacing between disc 12, both have adjusted the chucking power between disc 11 and lower disc 12, have adjusted the straight of waist 14 again Footpath, increased the stability that waist 14 is fixed on lesion locations.
As shown in Figures 2 to 6, spring 131 can be cylindric standard spring, square spring, double laminated spring or coniform bullet The various spring of different shapes such as spring, is adapted to the pathological changes of different shape, adaptability is wider.
As shown in Fig. 7 a to Fig. 8 b, Flexible Connector 13 is pipe type netted braiding structure 133, pipe type netted braiding structure 133 are formed by the braiding of shape memory wire mesh shape.Wherein, the movable end of pipe type netted braiding structure 133 is provided with braiding structure knot Prick set 134, braiding structure ligation set 134 can pass through in lower disc 12 insertion lower disc ligation set 121, braiding structure ligation set 134 away from pipe type netted braiding structure 133 one end be provided with ligation cover spacing head 135, ligation cover spacing head 135 external diameter More than the internal diameter of lower disc ligation set 121, pipe type netted braiding structure 133 is provided near one end of braiding structure ligation set 134 The radially extending stretching, extension wing 136, the external diameter stretching the wing 136 is more than the internal diameter of lower disc ligation set 121.
Plugging device as shown in Fig. 7 a and Fig. 8 a, it stretches wing 136 and is located between upper disc 11 and lower disc 12, when need When adjusting the chucking power between disc 11, lower disc 12, braiding structure is ligatured set 134, stretches the wing 136 together through lower wall Piece ligation set 121 is drawn out to outside, is formed by the braiding of shape memory wire mesh shape due to stretching the wing 136, pulls out when stretching the wing 136 To the outside of lower disc ligation set 121, stretch the shape that the wing 136 release expands into original setting, prevented braiding structure knot Prick set 134 and turn again to the probability in lower disc ligation set 121;Now the shape of plugging device is changed into as Fig. 7 b, Fig. 8 b institute Show, the distance between upper disc 11, lower disc 12 are relatively varied from, thus have adjusted between disc 11, lower disc 12 before Chucking power.
As shown in Fig. 9 a to Figure 10, push rod 2 includes push rod shell 21, push rod inner core 22, and push rod inner core 22 exists The interior intracavity of push rod shell 21 moves along axis or rotates, and the end of push rod shell 21 and lower disc ligation set 121 are removable Unload connection, the end of push rod inner core 22 is detachably connected with the movable end of Flexible Connector 13.Wherein, push rod shell 21 Threadeded with lower disc ligation set 121 in end.As shown in Fig. 9 a to Fig. 9 f, the end of push rod inner core 22 and Flexible Connector 13 movable end is connected by clip 23;As shown in Figure 10, the movable end of the end of push rod inner core 22 and Flexible Connector 13 Threaded.
Using the method for releasing of above-mentioned adjustable plugging device, mainly include the following steps that:
1) push rod 2 is connected with stopper 1, pulls push rod 2, stopper 1 is drawn in delivery sheath 3, it is concrete Comprise the following steps,
1. the movable end of Flexible Connector 13 is connected with the end of push rod inner core 22, the bullet as shown in Fig. 9 a to Fig. 9 c The property movable end of connector 13 is connected by clip 23 with the end of push rod inner core 22, Flexible Connector 13 as shown in Figure 10 Movable end be threaded connection with the end of push rod inner core 22;
2. push rod inner core 22 is drawn in push rod shell 21 together with the movable end of Flexible Connector 13, such as Fig. 9 d Shown;
3. push rod shell 21 is fixedly connected with lower disc ligation set 121, as shown in figure 9d;
4. push rod inner core 22, together with the movable end of Flexible Connector 13, moves along axis in the cavity of push rod shell 21 Move or rotate, length between upper disc 11 and lower disc 12 for the regulation elasticity connector 13, as shown in figure 9e;
5. pull push rod 2, stopper 1 is drawn in delivery sheath 3;
2) pass through delivery sheath 3, stopper 1 is delivered to lesion locations;
3) push push rod shell 21, upper disc 11 is discharged;
4) push push rod shell 21 and push rod inner core 22 simultaneously, discharge Flexible Connector 13;
5) push rod inner core 22 remains stationary as, and pushes push rod shell 21, and lower disc 12 part discharges;
6) push rod shell 21 is separated with lower disc ligation set 121;
7) observe stopper 1 whether stable firmly, if necessary, regulation elasticity connector 13 is in upper disc 11 and lower disc Length between 12;Wherein, the process of length between upper disc 11 and lower disc 12 for the regulation elasticity connector 13 include with Lower step,
1. push away before push rod shell 21, make push rod inner core 22 and Flexible Connector 13 be recovered to push rod shell 21 Interior intracavity;
2. push rod shell 21 is fixedly connected with lower disc ligation set 121;
3. by the movable end of push rod inner core 22 and Flexible Connector 13 together in the cavity of push rod shell 21 along axle Line is mobile or rotates, length between upper disc 11 and lower disc 12 for the regulation elasticity connector 13;
4. push rod shell 21 is separated with lower disc ligation set 121.
8) draw back push rod shell 21, push rod inner core 22 is exposed with Flexible Connector 13 and discharges completely;
9) push rod inner core 22 is separated with the movable end of Flexible Connector 13, now, if Flexible Connector 13 is as figure During spring 131 shown in 9f, then the part automatic curled outside lower disc ligation set 121 stayed by spring 131, will not be again toward lower wall Retract in piece ligation set 121, if Flexible Connector 13 is pipe type netted braiding structure 133 as shown in Figure 10, stretch the wing 136 Prevent the probability that pipe type netted braiding structure 133 is retracted.
In said method, if stopper 1 as shown in Fig. 2, discharge or withdraw Flexible Connector 13 while, also together Release or withdrawal waist 14.
In sum, the adjustable plugging device of the present invention and method for releasing, by regulation elasticity connector in upper disc and Length between lower disc, reaches the purpose adjusting upper chucking power between disc and lower disc, makes the more stable jail of plugging device Gu, fit with lesion locations better, be adapted to the pathological changes of different size, different length, simultaneously this adjustable plugging device Recyclable release property again operation is corrected when occurring unexpected, reduce operation risk and operation technique difficulty.So, The present invention effectively overcomes various shortcoming of the prior art and has high industrial utilization.
Above-described embodiment only principle of the illustrative present invention and its effect, not for the restriction present invention.Any ripe The personage knowing this technology all can carry out modifications and changes without prejudice under the spirit and the scope of the present invention to above-described embodiment.Cause This, those of ordinary skill in the art is complete with institute under technological thought without departing from disclosed spirit such as All equivalent modifications becoming or change, must be covered by the claim of the present invention.

Claims (4)

1. a kind of adjustable plugging device it is characterised in that:Described plugging device includes stopper (1) and push rod (2), described Disc (11) and lower disc (12) in stopper (1) inclusion, described upper disc (11), lower disc (12) are by shape memory wire mesh Shape braiding forms, and is provided with Flexible Connector (13), described Flexible Connector between described upper disc (11) and lower disc (12) (13) it is provided with the fixing end fixing with described upper disc (11) and the movable end passing through described lower disc (12), described lower disc (12) lower section is provided with lower disc ligation set (121), and the movable end of described Flexible Connector (13) passes through described lower disc ligation Set (121) is detachably connected with push rod (2);Described push rod (2) pulls described Flexible Connector (13) vertically, adjusts institute State length on described between disc (11) and lower disc (12) for the Flexible Connector (13);Described push rod (2) is with elasticity even When fitting (13) departs from, the relative position that the movable end of described Flexible Connector (13) covers (121) with described lower disc ligation is protected Hold constant;
Described Flexible Connector (13) is pipe type netted braiding structure (133), and described pipe type netted braiding structure (133) is by shape Memory wire mesh shape braiding forms;The movable end of described pipe type netted braiding structure (133) is provided with braiding structure ligation set (134), described braiding structure ligation set (134) can pass through in described lower disc (12) insertion lower disc ligation set (121), described Braiding structure ligation set (134) is provided with the ligation spacing head of set away from one end of described pipe type netted braiding structure (133) (135), described ligation covers the internal diameter more than described lower disc ligation set (121) for the external diameter of spacing head (135), described tubular net Shape braiding structure (133) is provided with the radially extending stretching, extension wing (136) near one end of described braiding structure ligation set (134), The described external diameter stretching the wing (136) is more than the internal diameter of described lower disc ligation set (121).
2. adjustable plugging device according to claim 1 it is characterised in that:Described push rod (2) is included outside push rod Shell (21), push rod inner core (22), described push rod inner core (22) is moved along axis in the interior intracavity of described push rod shell (21) Move or rotate, the end of described push rod shell (21) and lower disc ligation set (121) are detachably connected, described push rod inner core (22) end is detachably connected with the movable end of Flexible Connector (13).
3. adjustable plugging device according to claim 2 it is characterised in that:The end of described push rod shell (21) with Lower disc ligation set (121) is threaded.
4. adjustable plugging device according to claim 2 it is characterised in that:The end of described push rod inner core (22) with The movable end of Flexible Connector (13) is threaded or is connected by clip (23).
CN201510026530.8A 2015-01-19 2015-01-19 Adjustable plugging device and release method Active CN104546054B (en)

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