CN105769153A - Endovascular pressure measurement conduit - Google Patents
Endovascular pressure measurement conduit Download PDFInfo
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- CN105769153A CN105769153A CN201610095320.9A CN201610095320A CN105769153A CN 105769153 A CN105769153 A CN 105769153A CN 201610095320 A CN201610095320 A CN 201610095320A CN 105769153 A CN105769153 A CN 105769153A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
- A61B5/0215—Measuring pressure in heart or blood vessels by means inserted into the body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/02007—Evaluating blood vessel condition, e.g. elasticity, compliance
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6851—Guide wires
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6852—Catheters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6852—Catheters
- A61B5/6855—Catheters with a distal curved tip
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2562/00—Details of sensors; Constructional details of sensor housings or probes; Accessories for sensors
- A61B2562/02—Details of sensors specially adapted for in-vivo measurements
- A61B2562/0247—Pressure sensors
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- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
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- Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Abstract
The invention provides an endovascular pressure measurement conduit.The endovascular pressure measurement conduit comprises a far-end sleeve, a pressure sensor and a near-end part, wherein the far-end sleeve is provided with a guide wire inner cavity receiving an individual medical guide wire in a sliding mode, the pressure sensor is arranged outside the far-end sleeve and used for measuring endovascular pressure and generating a blood pressure signal, the near-end part is connected with the far-end sleeve and comprises a signal channel used for transmitting the blood pressure signal from the pressure sensor and a connecting conduit used for supporting the signal channel and moving the far-end sleeve, an annular sleeve serving as a positioning identification is arranged at the front end of the far-end sleeve, and the annular sleeve is flexible and comprises a material non-transparent to X-ray.By arranging the annular sleeve which is flexible and comprises the material non-transparent to X-ray in the endovascular pressure measurement conduit as the positioning identification, the pressure sensor can be positioned conveniently, and damage to blood vessels during operation is reduced.
Description
Technical field
The present invention relates to a kind of intravascular pressure and measure conduit.
Background technology
For many cardiovascular diseasess such as coronary heart disease, percutaneous coronary intervention (pci) (PCI) is current relatively effective treatment means.Tradition judges whether that the method implementing interventional therapy (such as angioplasty or support are placed) is that doctor estimates the stenosis of arteria coronaria blood vessel by coronary angiography.But, this traditional determination methods can not help doctor to make to judge accurately very much, and it is possible to can cause doctor's over-treatment.
In recent years, in order to judge whether patient really needs to implement interventional therapy more accurately, the blood flow reserve mark (FractionalFlowReverse is called for short FFR) that assessment stenotic lesion blocks the degree that blood flows through blood vessel is used increasingly to be applied and promote.FFR is defined as the ratio of the maximum blood flow in artery stenosis and normal maximum blood flow.The FFR of narrow (namely likely placing the position of intravascular stent) is given in order to calculate Ink vessel transfusing, need to measure and gather narrow distal side respectively (such as, narrow downstream) and the blood pressure readings of narrow proximal lateral (such as narrow upstream, near aorta).Clinical research shows, narrowness is more high, and FFR value is more low, and whether FFR value can, as useful criterion, may decide that whether such patient implements interventional therapy based on this standard doctor less than assessed value (such as 0.8).The effectiveness of this criterion has also obtained the confirmation of American-European multiple large-scale clinical study results (such as FAME clinical research).
At present, as measuring the method for blood pressure in patient's blood vessel, for instance there is the method using pressure-sensing seal wire.This pressure-sensing seal wire is internally provided with pressure transducer at seal wire.Before carrying out calcification score, by pressure-sensing seal wire through narrow distal side and proximal lateral, record far-end blood pressure and near-end blood pressure respectively.Thus, it is possible to calculate narrow FFR value.
Summary of the invention
But, for existing pressure-sensing seal wire, owing to being provided with pressure transducer inside seal wire, therefore the conventional guidewire (such as placing the seal wire of foley's tube or scaffold tube) that its performance and doctor use there are differences, this type of usual hardness of pressure-sensing seal wire is bigger, operation controllability also declines to some extent, is likely to not easily pass through for complex lesions region.Therefore, doctor, when complex lesions region carries out intravascular pressure measurement and interventional therapy, generally requires replacing seal wire, and changes seal wire and can increase complexity and the risk of operation.It addition, for a lot of doctors, get used to using some specific dimensions, possess good pliability and turn round the seal wire of control property.Therefore, allow doctor reuse other kinds of seal wire and carry out interventional therapy, it is also possible to time and the difficulty of interventional therapy (such as seal wire being navigated to stenotic lesion) can be increased.
The present invention completes in view of the situation of above-mentioned prior art, its object is to provide a kind of and can be easy to the intravascular pressure measurement conduit being applicable to interventional therapy that doctor uses.
For this, the invention provides a kind of intravascular pressure and measure conduit, it is characterised in that: including: distal cannula, it has the guidewire lumen slideably received within independent medical guiding wire；Pressure transducer, it is arranged on the outside of described distal cannula, is used for measuring endovascular blood pressure and producing blood pressure signal；And proximal part, it couples with described distal cannula, and including for transmitting the signal path of the described blood pressure signal from described pressure transducer and for supporting described signal path the connection conduit of mobile described distal cannula, front end in described distal cannula, being provided with the ring-shaped sleeve as positioning mark, described ring-shaped sleeve has pliability and comprises the opaque material of X ray.
Measure in conduit at intravascular pressure involved in the present invention, only distal cannula is limited by medical guiding wire, therefore, doctor can change intravascular pressure rapidly and measure conduit, and can the compatible conventional guidewire that doctor uses at present, it is thus possible to allow doctor complete the measurement of intravascular pressure under familiar operating environment, reduce the measurement time, reduce operational risk, convenience and the operability of intravascular pressure measurement are substantially improved.Further, since in the front end of described distal cannula, be provided with and there is pliability and comprise the ring-shaped sleeve to the opaque material of X ray as positioning mark.Therefore, the position of pressure sensors can be facilitated, even if the blood vessel near sliding along medical guiding wire in distal cannula and touching, the ring-shaped sleeve foremost owing to being arranged on distal cannula has pliability, also therefore is able to reduce the damage that blood vessel is caused.
It addition, measure in conduit at intravascular pressure involved in the present invention, alternatively, it is also equipped with the outer tube being coated with described distal cannula and described pressure transducer.Thereby, it is possible to protection distal cannula and pressure transducer.
It addition, measure in conduit at intravascular pressure involved in the present invention, alternatively, described distal cannula couples via described outer tube with described proximal part.Thereby, it is possible to realize coupling with proximal part by distal cannula by outer tube.
It addition, measure in conduit at intravascular pressure involved in the present invention, alternatively, described guidewire lumen is about the medical guiding wire of 0.2mm to 1mm slideably received within having external diameter.Thereby, it is possible to improve intravascular pressure involved in the present invention to measure the suitability of conduit.
It addition, measure in conduit at intravascular pressure involved in the present invention, alternatively, described guidewire lumen includes tubular inner chamber and extends to the bending inner chamber of side of described outer tube from described tubular inner chamber.In this case, it is possible to make the guidewire lumen of pressure measurement conduits in medical guiding wire intravasation more easily, be conducive to medical guiding wire in the movement of guidewire lumen.
It addition, measure in conduit at intravascular pressure involved in the present invention, alternatively, described pressure transducer is arranged on the outer surface of described distal cannula, and near described ring-shaped sleeve.Thereby, it is possible to facilitate doctor etc. to be positioned for pressure transducer by the position of ring-shaped sleeve.
It addition, measure in conduit at intravascular pressure involved in the present invention, alternatively, described distal cannula has the perforate of the length direction along described distal cannula, and described perforate allows blood flow to flow into described guidewire lumen.Thereby, it is possible to reduce intravascular pressure to measure the use resistance of conduit.
It addition, measure in conduit at intravascular pressure involved in the present invention, alternatively, described outer tube has the opening allowing described pressure transducer to measure blood pressure.Thereby, it is possible to facilitate intravascular pressure to measure conduit endovascular blood flow is carried out pressure measxurement.
It addition, measure in conduit at intravascular pressure involved in the present invention, alternatively, described signal path is at least partially recessed in described connection conduit.Thereby, it is possible to provide protection structure for signal path.
It addition, measure in conduit at intravascular pressure involved in the present invention, alternatively, described distal cannula is coaxial with described ring-shaped sleeve.Thereby, it is possible to make medical guiding wire pass in and out distal cannula and ring-shaped sleeve easily.
Accompanying drawing explanation
Fig. 1 shows the intravascular pressure involved by embodiments of the present invention and measures the three-dimensional structure diagram of conduit.
Fig. 2 shows the intravascular pressure involved by embodiments of the present invention and measures the decomposing schematic representation after separating outer tube in conduit.
Fig. 3 shows the intravascular pressure measurement conduit involved by embodiments of the present invention and slips over the schematic diagram of medical guiding wire.
Fig. 4 shows the intravascular pressure shown in Fig. 1 and measures the schematic section of conduit.
Fig. 5 shows the intravascular pressure measurement conduit involved by embodiments of the present invention and includes the surface figure of ring-shaped sleeve and pressure transducer.
Fig. 6 shows the intravascular pressure involved by Fig. 5 and measures the close-up schematic view of conduit.
Fig. 7 is the schematic cross-section that the intravascular pressure involved by embodiments of the present invention measures the blood vessel of conduit.
Fig. 8 is that the intravascular pressure involved by embodiments of the present invention measures the conduit schematic cross-section along length of vessel direction.
Fig. 9 shows the flow chart of the method using the intravascular pressure measurement conduit involved by embodiments of the present invention.
Symbol description:
1 ... intravascular pressure measures conduit (blood pressure measurement conduit), 2 ... medical guiding wire, 10 ... distal cannula, 12 ... guidewire lumen, 14 ... ring-shaped sleeve, 20 ... proximal part, 22 ... signal path, 30 ... outer tube, 32 ... opening, 34 ... side opening, 40 ... pressure transducer, 100 ... blood vessel.
Detailed description of the invention
Hereinafter, with reference to accompanying drawing, the preferred embodiment of the present invention is explained.In the following description, giving identical symbol for identical parts, the repetitive description thereof will be omitted.It addition, accompanying drawing is simply schematically schemed, the ratio of parts size each other or the shape of parts etc. can be different from reality.
Fig. 1 illustrates that the intravascular pressure of embodiment involved in the present invention measures the three-dimensional structure diagram of conduit.Fig. 2 shows and measures the decomposing schematic representation after separating outer tube in conduit (dotted portion represents the partial-length eliminating intravascular pressure measurement conduit) at the intravascular pressure involved by embodiments of the present invention.Fig. 3 shows the intravascular pressure measurement conduit involved by embodiments of the present invention and slips over the schematic diagram of medical guiding wire.
As it is shown in figure 1, intravascular pressure measures conduit 1 (following, sometimes also referred to as " blood pressure measurement conduit 1 ") includes distal cannula 10 and the proximal part 20 coupled with distal cannula 10.It addition, in the present embodiment, distal cannula 10 can couple via outer tube 30 with proximal part 20.
Although illustrating that distal cannula 10 couples via outer tube 30 with proximal part 20 in the present embodiment, but present embodiment being not limited to this.Such as, distal cannula 10 can also couple with proximal part 20 by welding, it is also possible to proximal part 20 is integrally formed, outer tube 30 is formed draw bail.
As in figure 2 it is shown, in the blood pressure measurement conduit 1 involved by present embodiment, distal cannula 10 has guidewire lumen 12.Guidewire lumen 12 is slideably received within independent medical guiding wire 2.Therefore, by making distal cannula 10 receive and sliding along medical guiding wire 2, distal cannula 10 and the pressure transducer 40 being arranged in distal cannula 10 can be sent to the precalculated position of patient body's interior (such as vein, tremulous pulse).Thereby, it is possible to this precalculated position (such as lesions position) is carried out blood pressure measurement to obtain the reading of the blood flow reserve mark (FFR) of this position, provide reference for follow-up interventional therapy.
As it has been described above, the value of blood flow reserve mark (FFR) (being called for short " FFR value ") can be used for assessing stenotic lesion obstruction blood flows through the degree of blood vessel, provide, for doctor etc., the decision-making whether carrying out interventional therapy.It is said that in general, in order to calculate given narrow FFR value, it is necessary to measure and gather narrow distal side (such as, narrow downstream) and the blood pressure readings of narrow proximal lateral (such as narrow upstream, near aorta) respectively.The blood pressure gradient of stenotic lesion reflects the instruction of narrow seriousness.Stenosis is more serious, and pressure drop is more big, and FFR value is more low.
Proximal part 20 mainly includes the signal path 22 for transmitting the blood pressure signal from pressure transducer 40 and for supporting signal path 22 the connection conduit 24 of mobile distal cannula 10.In the present embodiment, the constituent material of proximal part 20 is not particularly limited, material that hardness higher is preferably used, to guarantee that doctor can pass through proximal part 20 in interventional procedure and distal cannula 10 (and the pressure transducer 40 being arranged in distal cannula 10) is advanced in patient's blood vessel along medical guiding wire 2, and then location is to stenotic lesion place.
Proximal part 20 is generally harder than distal cannula 10 and has more rigidity, so as to moves better and advances distal cannula 10.In the present embodiment, proximal part 20 can be made up of medical stainless steel.It addition, proximal part 20 can also be made up of other materials such as Nitinol, nylon, plastics etc..
In the present embodiment, signal path 22 is communicated to and is positioned at the armarium such as equipment such as processor, display, computer, monitor outside patient.It addition, signal path 22 can also be arranged in connection conduit 24, making connection conduit 24 be coated with signal path 22 at least in part, namely signal path 22 is at least partially recessed in connection conduit 24.Thus, connect conduit 24 and can play support and protection signal path 22.It addition, in certain embodiments, signal path 22 can also configure along the outer surface of proximal part 20.
Fig. 4 shows the intravascular pressure shown in Fig. 1 and measures the schematic section of conduit.Fig. 5 shows the intravascular pressure measurement conduit involved by embodiments of the present invention and includes the surface figure of ring-shaped sleeve and pressure transducer.Fig. 6 shows the intravascular pressure involved by Fig. 5 and measures the close-up schematic view of conduit.
In the present embodiment, as shown in Figure 2, Figure 5 and Figure 6, pressure transducer 40 is arranged on the outside of distal cannula 10.Pressure transducer 40 (being more specifically the measuring point 41 of pressure transducer 40) can sense and/or measure the Ink vessel transfusing blood pressure of patient, and produces blood pressure signal.Pressure transducer 40 and signal path 22 be connected, blood pressure signal produced by pressure transducer 40 is sent to such as external process equipment (not shown) via signal path 22.
It addition, in the present embodiment, pressure transducer 40 can be capacitance pressure transducer, resistive pressure sensor etc..It addition, pressure transducer 40 can also be MEMS pressure sensor.Such as, the measurement of pressure transducer 40 ranges for about-50mmHg to about 300mmHg.Type according to pressure transducer 40, signal path 22 can be conducting medium such as electric lead.Additionally, in certain embodiments, signal path 22 can also be wireless communication line, infrared communication link or ultrasonic communication circuit.
In the present invention, blood pressure measurement conduit 1 can enter respectively as independent device with medical guiding wire 2 or exit in patient body.In this case, doctor can independently controlled blood pressure measurement conduit 1 and medical guiding wire 2.By using blood pressure measurement conduit 1 and medical guiding wire 2 as independent device, it is possible to make doctor operate blood pressure measurement conduit 1 and medical guiding wire 2 more easily.
It addition, the length of blood pressure measurement conduit 1 and medical guiding wire 2 is not particularly limited, from the viewpoint being easy to interventional therapy, for instance length is about 160cm to 220cm.It addition, distal cannula 10 length is it is not also specifically limited, such as can be about 5cm～20cm.In this case, owing to distal cannula 10 is much smaller than the length of medical guiding wire 2, therefore, doctor etc. are when operating blood pressure measurement conduit 1, it is possible to change blood pressure measurement conduit 1 rapidly.
Generally speaking, in the process of interventional therapy, guiding catheter (not shown) is advanced to the coronary artery place of such as heart by the operator such as doctor certain position (such as thigh tremulous pulse place) first from a patient along blood vessel, then, by such as contrast agent, medical guiding wire 2 is propelled further into it may happen that the position of less blood vessel of pathological changes along this guiding catheter.In this case, blood pressure measurement conduit 1 by by distal cannula 10 through (referring to Fig. 3) on this medical guiding wire 2, guidewire lumen 12 is made to slip over medical guiding wire 2, and it is operated by connection conduit outside (such as push away and/or draw) patient 24 (or be connected the operation device (not shown) that conduit 24 connects) and moves distal cannula 10 (and the pressure transducer 40 being arranged in distal cannula 10), until pressure transducer 40 is in predetermined position.
In the present embodiment, the size of guidewire lumen 12 is not particularly limited, for instance can receive and slip over the medical guiding wire of about 0.2mm to 1mm overall diameter.It addition, guidewire lumen 12 can also receive and slip over the medical guiding wire of specific criteria size in interventional therapy field.
It addition, in the front end of distal cannula 10, be provided with the ring-shaped sleeve 14 as positioning mark.Ring-shaped sleeve 14 has pliability and comprises the opaque material of X ray.Owing to ring-shaped sleeve 14 has pliability, therefore blood pressure measurement conduit 1 is when the blood vessel of patient moves, and can realize noinvasive for blood vessel.In the present embodiment, ring-shaped sleeve 14 is preferably provided at (end) foremost of distal cannula 10.Ring-shaped sleeve 14 as mark, it is possible to navigate to pressure transducer 40 position in the blood vessel under X ray.
In the present embodiment, as it has been described above, in carrying out interventional procedure, it is necessary to be operated by proximal part 20 (specifically connecting conduit 24) and move distal cannula 10.When along medical guiding wire 2 when Ink vessel transfusing moves or adjusts distal cannula 10, distal cannula 10 likely can touch the blood vessel near distal cannula 10 or the bigger position of blood vessel curvature.In this case, even if the blood vessel near sliding along medical guiding wire 2 in distal cannula 10 and touching, the ring-shaped sleeve 14 foremost owing to being arranged on distal cannula 10 has pliability, also therefore is able to reduce the damage that blood vessel is caused.
It addition, in the present embodiment, owing to ring-shaped sleeve 14 comprises the opaque material of X ray, therefore, when human body is when the irradiation being subject to X ray, ring-shaped sleeve 14 can form opaque pattern.By this opaque pattern, doctor etc. can quickly find corresponding positioning mark.Therefore, in the present embodiment, ring-shaped sleeve 14 is also used as distal cannula 10 and the mark of pressure transducer 40 location being arranged in distal cannula 10 uses.Furthermore it is preferred that pressure transducer 40 is arranged in distal cannula 10 near the position of ring-shaped sleeve 14, the approximate location of pressure transducer 40 thus can be oriented by the mark action of ring-shaped sleeve 14.
As an embodiment of present embodiment, outer tube 30 can be coated with distal cannula 10 and pressure transducer 40.It addition, outer tube 30 has measures the opening 32 of blood pressure and the side opening 34 corresponding with the guidewire lumen 12 of distal cannula 10 for pressure transducer 40.The size of opening 32 is not particularly limited, if the size of the measuring point 41 corresponding to pressure transducer 40.
In the present embodiment, owing to outer tube 30 has the opening 32 corresponding with the measuring point 41 of pressure transducer 40, therefore, endovascular blood flow can enter the opening 32 of outer tube 30, and thus pressure transducer 40 can measure the blood pressure near opening 32.
Further, since outer tube 30 is coated with distal cannula 10 and pressure transducer 40, distal cannula 10 therefore can also be improved and the structural stability of the pressure transducer 40 being arranged in distal cannula 10.
It addition, the outer surface of outer tube 30 is preferably tangent with ring-shaped sleeve 14, the operability of distal cannula 10 and ring-shaped sleeve 14 thus can be improved.The material of outer tube 30 can be polyester, polyamide, nylon, nylon elastomer, polyurethane, polyimides etc...
It addition, in the present embodiment, it is possible to by outer tube 30, use mode physically or chemically to include the modes such as sweat soldering, laser weld, medical bonding and distal cannula 10 is coupled with proximal part 20.Pressure transducer 40 owing to being arranged in distal cannula 10 is coated with by outer tube 30, and therefore, pressure transducer 40 obtains the protection of outer tube 30 at least in part.
It addition, outer tube 30 can become a part for distal cannula 10 forming process.Such as, by using welding manner by outer tube 30 and distal cannula 10 compact siro spinning technology.The guidewire lumen 12 of distal cannula 10 formed it addition, can melt molding by heat.
In embodiments of the present invention, it is possible to the gel filled such as Medical silicone gels in the inner side of outer tube 30.If filling medical gel around the pressure transducer 40 inside outer tube 30, then foreign matter will not be easily penetrate into the inside of outer tube 30, thus improving the reliability of the signal path of the blood pressure signal that pressure transducer 40 is produced by pressure transducer 40 with transmission.It addition, Silica hydrogel can also provide, for pressure transducer 40, the structural capacity added.
As shown in Figure 4, in distal cannula 10, guidewire lumen 12 includes tubular inner chamber 12a and extends to the bending inner chamber 12b of outer tube 30 side (side opening 34) from tubular inner chamber 12a.Here, tubular inner chamber 12a connects with bending inner chamber 12b, and bends inner chamber 12b and connect with the side opening 34 of outer tube 30, so that it is guaranteed that medical guiding wire 2 can enter guidewire lumen 12 via the side opening 34 of outer tube 30 or exit from side opening 34.
The inside of the remotely located sleeve pipe 10 of tubular inner chamber 12a.It addition, as shown in Figure 4, tubular inner chamber 12a and the ring-shaped sleeve 14 of distal cannula 10 are coaxial and/or concentric.It addition, the internal diameter of tubular inner chamber 12a can be substantially the same with the internal diameter of ring-shaped sleeve 14.In certain embodiments, ring-shaped sleeve 14 can be bonded in the end (namely foremost) of distal cannula 10 by such as welding.
It addition, in certain embodiments, the external diameter of ring-shaped sleeve 14 can slightly larger than the external diameter of tubular inner chamber 12a.In this case, the external diameter of ring-shaped sleeve 14 can be roughly the same with the external diameter of outer tube 30.Additionally, in certain embodiments, ring-shaped sleeve 14 can be shaped generally as hollow round table shape, and its outer distal cannula 10 without leave is gradually reduced.
Additionally, in the present embodiment, owing to pressure transducer 40 is arranged on the side of distal cannula 10, therefore, from in order to wrap up pressure transducer 40 and the viewpoint of distal cannula 10 better, ring-shaped sleeve 14 can be formed adjacent to the ellipticity that the ring wall thickness of the side of pressure transducer 40 is bigger.
In guidewire lumen 12, bending inner chamber 12b extends to outer tube 30 side from tubular inner chamber 12a.Correspondingly, outer tube 30 is formed with the side opening 34 corresponding with bending inner chamber 12b.Specifically, the internal diameter axis of guidewire lumen 12 gradually changing to bending inner chamber 12b from tubular inner chamber 12a, and bend the internal diameter axis of close outer tube 30 side of inner chamber 12b and the tubular inner chamber 12a internal diameter axis generation deviation of guidewire lumen 12.By this configuration of guidewire lumen 12, it is possible to allow medical guiding wire 2 to enter the guidewire lumen 12 of distal cannula 10 via side opening 34, thus being conducive to medical guiding wire 2 to slide in guidewire lumen 12.In the present embodiment, during owing to measuring at the FFR utilizing blood pressure measurement conduit 1 to carry out interventional therapy, blood pressure measurement conduit 1 only distal portions 10 is limited in the interior slip of medical guiding wire 2, therefore, doctors etc. can operate and change the blood pressure measurement conduit 1 involved by present embodiment rapidly, it is possible to improve the procedure efficiency of interventional therapy.
In the present embodiment, the precalculated position being sent in patient's blood vessel owing to distal cannula 10 moves along medical guiding wire 2, therefore, it is not required to reorientate medical guiding wire 2 when operating the blood pressure measurement conduit 1 involved by embodiments of the present invention.
Specifically, for instance when the pressure transducer 40 on blood pressure measurement conduit 1 is positioned in narrow far-end (such as narrow downstream), the blood pressure of narrow remote end side is first measured.Then, can without adjusting the position of medical guiding wire 2, by movement (such as, advance and/or retract) distal cannula 10 just can make pressure transducer 40 arrive narrow proximal lateral, thus, it is possible to read the blood pressure readings of narrow remote end and narrow width proximal when not moving medical guiding wire 2.Thereby, it is possible to reduce the operation complexity of interventional therapy and save operating time.
Fig. 7 is the schematic cross-section that the intravascular pressure involved by embodiments of the present invention measures the blood vessel of conduit.Fig. 8 be blood pressure measurement conduit involved by embodiments of the present invention along length of vessel direction schematic section.
In fig. 7 it is shown that the schematic cross-section that blood pressure measurement conduit 1 moves at Ink vessel transfusing.As it is shown in fig. 7, when medical guiding wire 2 has been placed, blood pressure measurement conduit 1 can move along medical guiding wire 2 at Ink vessel transfusing, thus convenient to the given stenosis navigating to patient.
In fig. 8 it is shown that there is narrow schematic diagram in the blood vessel 100 of patient.As shown in Figure 8, being formed with speckle 110 on the blood vessel of blood vessel 100, the formation of speckle 110 causes that this part blood vessel presents narrow under X ray.Here, the blood flow of blood vessel 100 flows to the far-end 100a of blood vessel 100 along blood flow direction D from the near-end 100b of blood vessel 100.
FFR in order to carry out this narrow blood vessel measures, and doctor etc. is operated by being placed in blood pressure measurement conduit 1 the distal side 100a (namely near the downstream of blood flow) of narrow blood vessel (such as coronary artery) 100.Now, pressure transducer 40 is positioned at the distal side (downstream) at narrow 100a place, distal side, records the blood pressure Pd of distal side.Then, pressure transducer 40 is placed in the blood pressure Pp of proximal lateral (i.e. the upstream of blood flow, for instance near the aorta) 100b of narrow position (such as stenotic lesion 110).FFR can abbreviation be the remote pressure ratio relative to proximal pressure, i.e. FFR=Pd/Pp.In the present embodiment, term " downstream " and " upstream " are for the normal direction " D " (referring to Fig. 8) relative to blood flow.
Although the above-mentioned intravascular pressure that describe in detail involved by embodiments of the present invention measures conduit 1, but the present invention is not limited to above-mentioned embodiment.Such as, in certain embodiments, it is possible to the sidepiece along distal cannula 10 arranges multiple perforate (not shown).The setting of perforate can reduce the probability of the blocking in outer tube 30 (including distal cannula 10).Such as, when blood pressure measurement conduit 1 is moved through tremulous pulse, speckle 110 grade of blood vessel wall likely can enter outer tube 30, is provided with perforate and can suppress this effect in the sidepiece of outer tube 30.
Hereinafter, with reference to Fig. 9, describe the intravascular pressure involved by embodiments of the present invention and measure the using method of conduit.
Fig. 9 shows the flow chart that the intravascular pressure involved by embodiments of the present invention measures the using method of conduit.When using blood pressure measurement conduit 1, first, from certain position of patient such as thigh tremulous pulse, medical guiding wire 2 is placed into internal precalculated position (step S10).Then, (namely medical guiding wire 2 configures blood pressure measurement conduit 1, by the medical guiding wire 2 guidewire lumen 12 through blood pressure measurement conduit 1), and blood pressure measurement conduit 1 is entered along medical guiding wire 2 (such as by other guiding catheter (not shown)) the stenotic lesion place of human vas 100, the pressure transducer 40 on blood pressure measurement conduit 1 is made to be positioned the vicinity (such as, the upstream of stenotic lesion or downstream) (step S20) in above-mentioned precalculated position.In certain embodiments, distal cannula 10 is made to slide along medical guiding wire 2 and advance distal cannula 10 when medical guiding wire 2 need not be moved.
In step S20, the pressure transducer 40 of blood pressure measurement conduit 1 is used to measure the blood pressure (i.e. the blood pressure Pd of distal side 100a) in this downstream, pre-position.Then, the position of medical guiding wire 2 need not be reorientated, by adjusting the position of blood pressure measurement conduit 1, blood pressure measurement conduit 1 is moved to the upstream of stenotic lesion, measure the blood pressure Pp (i.e. the blood pressure Pp of proximal lateral 100b) (step S30) of stenotic lesion upstream.Produced by pressure transducer 40, blood pressure signal (the blood pressure Pd of distal side and the blood pressure Pp of proximal lateral) is output to such as external process equipment (not shown) via signal path 22.It addition, in this process equipment, it is possible to calculate the ratio of the two measured value and the downstream blood pressure ratio Pd/Pp to upstream blood pressure as FFR value, i.e. FFR=Pd/Pp (step S40).
Although the present invention having been illustrated above in association with drawings and embodiments; but it is not meant to limit the present invention; it is to be understood that; to those skilled in the art; when not necessarily departing from the spirit and scope of the invention; the present invention can being deformed and change, these deformation and change each fall within the scope of the claimed protection of the present invention.
Claims (10)
1. an intravascular pressure measures conduit, it is characterised in that:
Including:
Distal cannula, it has the guidewire lumen slideably received within independent medical guiding wire；
Pressure transducer, it is arranged on the outside of described distal cannula, is used for measuring endovascular blood pressure and producing blood pressure signal；And
Proximal part, it couples with described distal cannula, and includes the signal path for transmitting the described blood pressure signal from described pressure transducer and for supporting described signal path the connection conduit of mobile described distal cannula,
In the front end of described distal cannula, it is provided with the ring-shaped sleeve as positioning mark,
Described ring-shaped sleeve has pliability and comprises the opaque material of X ray.
2. intravascular pressure as claimed in claim 1 measures conduit, it is characterised in that:
It is also equipped with the outer tube being coated with described distal cannula and described pressure transducer.
3. intravascular pressure as claimed in claim 2 measures conduit, it is characterised in that:
Described distal cannula couples via described outer tube with described proximal part.
4. the intravascular pressure as described in any one in claims 1 to 3 measures conduit, it is characterised in that:
Described guidewire lumen is about the medical guiding wire of 0.2mm to 1mm slideably received within having external diameter.
5. intravascular pressure as claimed in claim 3 measures conduit, it is characterised in that:
Described guidewire lumen includes tubular inner chamber and extends to the bending inner chamber of side of described outer tube from described tubular inner chamber.
6. the intravascular pressure as described in any one in claims 1 to 3 measures conduit, it is characterised in that:
Described pressure transducer is arranged on the outer surface of described distal cannula, and near described ring-shaped sleeve.
7. the intravascular pressure as described in any one in claims 1 to 3 measures conduit, it is characterised in that:
Described distal cannula has the perforate of the length direction along described distal cannula,
Described perforate allows blood flow to flow into described guidewire lumen.
8. intravascular pressure measures conduit as claimed in claim 2 or claim 3, it is characterised in that:
Described outer tube has the opening allowing described pressure transducer to measure blood pressure.
9. intravascular pressure as claimed in claim 1 measures conduit, it is characterised in that:
Described signal path is at least partially recessed in described connection conduit.
10. intravascular pressure as claimed in claim 1 measures conduit, it is characterised in that:
Described distal cannula is coaxial with described ring-shaped sleeve.
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201610095320.9A CN105769153A (en) | 2016-02-19 | 2016-02-19 | Endovascular pressure measurement conduit |
| CN201610911057.6A CN106388800A (en) | 2016-02-19 | 2016-02-19 | Catheter capable of measuring pressure in blood vessel |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
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| CN201610095320.9A CN105769153A (en) | 2016-02-19 | 2016-02-19 | Endovascular pressure measurement conduit |
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| CN201610911057.6A Division CN106388800A (en) | 2016-02-19 | 2016-02-19 | Catheter capable of measuring pressure in blood vessel |
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| CN105769153A true CN105769153A (en) | 2016-07-20 |
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| CN201610095320.9A Pending CN105769153A (en) | 2016-02-19 | 2016-02-19 | Endovascular pressure measurement conduit |
| CN201610911057.6A Pending CN106388800A (en) | 2016-02-19 | 2016-02-19 | Catheter capable of measuring pressure in blood vessel |
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| CN201610911057.6A Pending CN106388800A (en) | 2016-02-19 | 2016-02-19 | Catheter capable of measuring pressure in blood vessel |
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| CN107320068A (en) * | 2017-06-12 | 2017-11-07 | 长飞光纤光缆股份有限公司 | A kind of preparation method of insertion type probe body |
| CN107736884A (en) * | 2017-10-19 | 2018-02-27 | 深圳北芯生命科技有限公司 | Intravascular pressure measurement conduit with supporting mechanism |
| WO2018166195A1 (en) * | 2017-03-15 | 2018-09-20 | 深圳北芯生命科技有限公司 | Intravascular pressure measuring catheter having mounting base |
| CN109646053A (en) * | 2018-12-27 | 2019-04-19 | 深圳北芯生命科技有限公司 | Intravascular ultrasound catheter |
| CN112336328A (en) * | 2019-08-07 | 2021-02-09 | 深圳北芯生命科技有限公司 | Intravascular pressure measuring catheter with developing ring |
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| CN109124608A (en) * | 2017-10-21 | 2019-01-04 | 深圳北芯生命科技有限公司 | Intravascular pressure with developing ring measures conduit |
| CN209136594U (en) * | 2018-11-05 | 2019-07-23 | 苏州润迈德医疗科技有限公司 | New catheter for invasive angiosthenia monitoring |
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| CN106388800A (en) | 2017-02-15 |
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