CN106963516A - Intracavitary orthotopic fenestration sting device - Google Patents
Intracavitary orthotopic fenestration sting device Download PDFInfo
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- CN106963516A CN106963516A CN201710179335.8A CN201710179335A CN106963516A CN 106963516 A CN106963516 A CN 106963516A CN 201710179335 A CN201710179335 A CN 201710179335A CN 106963516 A CN106963516 A CN 106963516A
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- push rod
- puncture
- handle
- sacculus
- intracavitary
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/954—Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/958—Inflatable balloons for placing stents or stent-grafts
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Pulmonology (AREA)
- Gastroenterology & Hepatology (AREA)
- Prostheses (AREA)
Abstract
The invention discloses a kind of intracavitary orthotopic fenestration sting device, including foley's tube and coaxial package the puncture needle component in foley's tube；Foley's tube includes the sacculus push rod with least two cavitys, the foley's tube seat for being arranged on the sacculus utricule of sacculus push rod distal end, being arranged on sacculus push rod near-end；Puncture needle component includes puncturing push rod, is arranged on the piercing needle for puncturing push rod distal end, puncture handle；Puncturing handle includes proximal handle and distal handle, distal handle is fixedly connected or is detachably fixed with foley's tube seat and is connected, proximal handle is connected with puncturing push rod, proximal handle is set along distal handle, and being provided between distal handle and proximal handle is used to control lancet puncture depth and locks the puncture controlling organization of puncture needle.The present invention, which provides one kind, can accurately control that paracentesis depth, paracentesis depth are adjustable, can lock punctures, and accurately puncture holding point of puncture positioned at the central intracavitary orthotopic fenestration sting device of branch vessel.
Description
Technical field
The invention belongs to technical field of medical instruments, it is related to a kind of intracavitary intervention apparatus, more particularly to a kind of intracavitary original position
Open a window sting device.
Background technology
With constantly carrying out in endoluminal vascular reconstruction operations, the application of overlay film frame is also more and more, but some are special
Position can influence the blood supply of arterial bifurcation vessel, such as arch of aorta, celiac trunk, bilateral renal arteries using overlay film frame
With the position such as superior mesenteric artery so that be extremely restricted at these positions using overlay film frame.Art formula can only be passed through at present
Improvement, such as using hybridization operation, or by the improvement of apparatus, such as modular rack, pre- windowing stent, branch stent, many
Layer bare bracket etc. new instruments technology carries out the stent procedure at above-mentioned position, but for most cases, the arch of aorta
Portion's lesion locations anatomical structure is extremely complex, while the difference of individual is substantially, above-mentioned technical proposal is all strongly depend on human body point
The anatomical structure of branch vessel, huge challenge is brought for its standardization of products and commercialization.
Overlay film frame orthotopic fenestration is a kind of more advanced technology, including energy windowing and machinery two major classes of windowing, energy
Amount windowing is to carry out fenestration procedure, the i.e. ablation by energy to overlay film frame using such as laser, radio frequency and thermocouple energy
To produce expected hole.But requirement of this mode to equipment is high, if energy is too high, the carbonization of support overlay film, its analyte
Thrombosis may be triggered, energy is not enough, expected windowing effect is not reached again.Energy can not only be covered with ablation support simultaneously
Film, it is also possible to cause damaging surrounding tissue, therefore, machinery windowing turn into a kind of relatively conservative, but safer windowing
Mode.
A kind of machinery mount orthotopic fenestration technology, is with the broken support overlay film of the hollow acupuncture of seal wire, with recession by one
Go out puncture needle, expanded using Cutting balloon along seal wire into overlay film frame.The problem of this mode, is that pin can not be accurate
The true middle position for finding branch vessel opening, in dynamic intravascular, easily wears partially or damages peripheral vessels.Adopt
Syringe needle and needle tubing are the structure of integral type, and compliance is not good, and rigid needle tubing is not suitable for the position of curved blood vessel；Puncture and drive
Dynamic inconvenience, so that puncture force is not enough.
Another machinery mount orthotopic fenestration technology, is the end support overlay film by a ultrahard guide wire, then respectively
With 1mm, 3mm, 8mm dilating sacculus, progressively enlarged openings position.The problem of which, is that seal wire is punctured and is only applicable to terylene material
The overlay film frame of matter, is not suitable for the overlay film frame of e-PTFE membrane materials.Seal wire can not accurately find branch vessel opening
Middle position, in dynamic intravascular, easily wears partially or damages peripheral vessels.Seal wire afterbody is held after puncture firmly, is being handed over
During changing seal wire, it is difficult to find point of puncture again.After seal wire is punctured, its aperture is smaller, it is impossible to once expanded using big sacculus
, it is necessary to progressively expanded by means of small sacculus, the time of increased operation and the cost of apparatus.
Also a kind of machinery mount orthotopic fenestration mode is to be fixed on branch vessel position, puncture needle using anchoring balloon
Head is punctured overlay film frame, is then expanded using expander point of puncture, be then fed into seal wire in the case where puncturing shank push, from
And realize orthotopic fenestration.Determining for puncture needle is improved by anchoring balloon auxiliary positioning to a certain extent in the technical scheme
Position, but anchoring balloon is softer, in the intravascular of complexity distortion, sacculus is easily deformed, it is difficult to ensure that point of puncture is in branch's blood
Pipe center, exists and pierces inclined risk.The technology uses coaxial configuration, and relative displacement easily occurs for inner and outer tubes, in push
During, sacculus is easily deformed, if pinched together, and increase pushes resistance, if amount of tension is excessive, there is the risk of rupture.Wear
Pricker body is not sealed, after puncturing successfully, it is impossible to is beaten contrast solution by puncture needle and is confirmed whether to puncture successfully, while puncturing card
Push rod is easily given a discount, and other apparatuses or surrounding tissue are easily worn by mistake.And paracentesis depth can not fine adjustment as needed, hold
Easily cause paracentesis depth long and accidentally injure offside tissue, or paracentesis depth not enough cause to puncture it is unsuccessful.
The content of the invention
The technical problem to be solved in the present invention is, can not carry out fine adjustment for paracentesis depth, easily cause puncture
Depth is long and accidentally injures offside tissue, and paracentesis depth not enough causes to puncture unsuccessful problem and can accurately control to wear there is provided one kind
Pierce depth, paracentesis depth is adjustable, can lock paracentesis depth, and accurately puncture the chamber for keeping point of puncture to be located at branch vessel center
Interior orthotopic fenestration sting device.
The technical problem of the invention further to be solved is to be not easy to give a discount there is provided a kind of puncture needle push rod, punctured
More collection neutralizes effective intracavitary orthotopic fenestration sting device.
The technical solution adopted for the present invention to solve the technical problems：
The first technical scheme of intracavitary orthotopic fenestration sting device is, including foley's tube and coaxial package are led in sacculus
Puncture needle component in pipe；
The foley's tube includes the sacculus push rod with least two cavitys, is arranged on the ball of sacculus push rod distal end
Capsule utricule, the foley's tube seat for being arranged on sacculus push rod near-end；
The puncture needle component includes puncturing push rod, is arranged on the piercing needle for puncturing push rod distal end, puncture handle；
The puncture handle includes proximal handle and distal handle, the distal handle and foley's tube be fixedly connected or
Connection is detachably fixed, the proximal handle is connected with puncturing push rod, and the proximal handle is set along distal handle, described remote
Being provided between end handle and proximal handle is used to control piercing needle paracentesis depth and locks the puncture controlling organization of puncture needle.
In the first technical scheme of described intracavitary orthotopic fenestration sting device, distal end described in preferably described proximal handle
Handle is moved axially along distal handle, described to puncture the maximum that controlling organization includes being arranged between proximal handle and distal handle
Stroke control assembly and puncture locked component.
In the first technical scheme of described intracavitary orthotopic fenestration sting device, preferably described range control assembly
Including the stroke groove being arranged in proximal handle or in distal handle, corresponding distal handle or proximal handle are provided with spacing
Block；The stroke groove is axially arranged along push rod is punctured, and the limited block cooperation is slided in stroke groove and its slip is maximum
Distance is to allow the depth capacity of lancet puncture.
In the first technical scheme of described intracavitary orthotopic fenestration sting device, preferably described puncture locked component is near
Multiple position and lock grooves are set on the handle control unit of end, and corresponding distal handle is provided with springy locking member, the elastic locking
Part elastic top, which is pressed in position and lock groove, locks puncture needle position, drives proximal handle in external force so that springy locking member exists
Slided between different position and lock grooves.
In the first technical scheme of described intracavitary orthotopic fenestration sting device, preferably described puncture locked component includes
The spacing actuating sleeve in distal handle, the proximal handle of correspondence actuating sleeve is provided with sliding shoe, the sliding shoe and actuating sleeve
Engaged by screw thread, rotation driving set driving sliding shoe slides axially along push rod is punctured.
In the first technical scheme of described intracavitary orthotopic fenestration sting device, preferably described range control assembly
The stroke groove being provided with including the distal handle, the stroke groove is axially arranged along push rod is punctured, and the sliding shoe is worn
Overtravel groove is engaged with driving external threading, and the sliding shoe cooperation is slided in stroke groove and it slides ultimate range to allow
The depth capacity of lancet puncture.
In the first technical scheme of described intracavitary orthotopic fenestration sting device, preferably described piercing needle and puncture are pushed away
Bar is sent to be designed with hollow closed cavity, the hollow closed cavity UNICOM of the two.
In the first technical scheme of described intracavitary orthotopic fenestration sting device, preferably described puncture push rod is bendable
Body bent and with support force.
In the first technical scheme of described intracavitary orthotopic fenestration sting device, preferably described puncture push rod is overlay film
Bourdon tube.
It is preferably described to puncture the hollow of push rod in the first technical scheme of described intracavitary orthotopic fenestration sting device
The lining silk for strengthening puncturing push rod support force is coated with closed cavity.
In the first technical scheme of described intracavitary orthotopic fenestration sting device, preferably described sacculus push rod is at least wrapped
A guidewire lumen and a full chamber are included, the piercing needle and puncture push rod are installed in the guidewire lumen, described full
Chamber distal end is connected with the full head for being filled to sacculus utricule with sacculus utricule UNICOM, near-end.
In the first technical scheme for filling described intracavitary orthotopic fenestration sting device, preferably described sacculus utricule is non-
Compliance or semi-compliant sacculus utricule.
Second of technical scheme of intracavitary orthotopic fenestration sting device be：A kind of intracavitary orthotopic fenestration sting device, including
The puncture needle component of foley's tube and coaxial package in foley's tube；
The foley's tube includes the sacculus push rod with least two cavitys, is arranged on the ball of sacculus push rod distal end
Capsule utricule, the foley's tube seat for being arranged on sacculus push rod near-end；
The head end of the sacculus push rod is located at blood vessel center position after sacculus utricule is full；
The puncture needle component includes puncturing push rod, is arranged on the piercing needle for puncturing push rod distal end, puncture handle；
The push rod that punctures is body flexible and with support force, be coated with the puncture push rod for plus
The strong lining silk for puncturing push rod support force.
In the first technical scheme of the invention, provided with controlling organization is punctured on handle is punctured, for accurately controlling to puncture
Pin puncture depth and locking puncture needle, realize paracentesis depth adjustable, it is to avoid cause paracentesis depth long and accidentally injure offside group
Knit, or paracentesis depth not enough causes puncture unsuccessful.And puncturing controlling organization can cause piercing needle stable in puncture
Position, prevents withdrawing after puncturing successfully, after puncturing successfully, and seal wire is intravascular into main body along pin inner chamber is punctured, accurately
Find the middle position of branch vessel opening in ground so that in dynamic intravascular, seal wire is not easy to wear partially or damage week
Enclose blood vessel.In addition, the head end of sacculus push rod is located at blood vessel center position after sacculus utricule is full, that is, use foley's tube for
From division center, sacculus pushes rod head end can just be located at blood vessel center position after sacculus utricule is full, improve having for puncture
Effect property.It is non-compliance or semi-compliant sacculus utricule from sacculus utricule, in the intravascular of complexity distortion, compared to compliance ball
Capsule is easier the position for making sacculus point to branch vessel opening.
Puncture needle tube body in prior art not seal, after puncturing successfully, it is impossible to carry out radiography and be confirmed whether to puncture into
Work(, while puncturing, card push rod is submissiveer, and easily discounting, easily wears other apparatuses or surrounding tissue by mistake.Second of the present invention
In technical scheme, using body flexible and with support force, and lining silk can also be coated with push rod is punctured, carried
The support force of high puncture needle component, during puncture, it is not easy to give a discount, puncture more concentrate, it is more efficient, reduction wear by mistake
The risk of other apparatuses or surrounding tissue.
Brief description of the drawings
Below in conjunction with drawings and Examples, the invention will be further described, in accompanying drawing：
Fig. 1 is the structural representation of the embodiment of the present invention 1；
Fig. 2 is the distal structure sectional view of the embodiment of the present invention 1；
Fig. 3 is the structural representation of the foley's tube of the embodiment of the present invention 1；
Fig. 4-10 is the structural representation of the sacculus push rod cross section of the embodiment of the present invention 1；
Figure 11 is the structural representation of the puncture needle component of the embodiment of the present invention 1；
Figure 12 is the sectional view that the embodiment of the present invention 1 punctures handle；
Figure 13-14 is the structural representation that the embodiment of the present invention 1 punctures push rod cross section；
Figure 15 is that the embodiment of the present invention 1 punctures the structural representation that controlling organization punctures push rod；
Figure 16 is the structural representation that the embodiment of the present invention punctures second of embodiment of controlling organization；
Figure 17 is Figure 16 axial sectional view；
Figure 18 is J-J sectional views in Figure 17.
Embodiment
In order to which technical characteristic, purpose and effect to the present invention are more clearly understood from, now compare accompanying drawing and describe in detail
The embodiment of the present invention.
Describe in detail, first cut near right groin by taking aortic arch interlayer accumulation left subclavian artery as an example below
Mouthful, exposure right femoral artery, under the support of stiffened seal wire, by induction system through arteria iliaca communis, abdominal aorta, aorta pectoralis,
Chest overlay film frame is delivered to aortic arch near-end by descending aorta, anchorage zone between left subclavian artery and left common carotid artery it
Between, left subclavian artery is completely covered the part release main overlay film frame of chest, support overlay film, and left subclavian artery blood flow is hindered
It is disconnected.Punctured through the nearly left vertebral artery position of arteria brachialis, convey the intracavitary orthotopic fenestration sting device of the present invention, complete overlay film frame inverse
Row orthotopic fenestration, intracavitary orthotopic fenestration sting device is described in detail as follows：
Embodiment 1, the technical problem that the present embodiment is mainly solved is accurate control paracentesis depth, paracentesis depth is adjustable and
It can lock and puncture, the problem of otherwise address punctures accurate ensure the puncture position heart in the blood vessel.It is a kind of as shown in Fig. 1-17
Intracavitary orthotopic fenestration sting device, including foley's tube 100 and coaxial package the puncture needle component 200 in foley's tube 100；
The foley's tube 100 includes the sacculus push rod 101 with least two cavitys, is arranged on the distal end of sacculus push rod 101
Sacculus utricule 102, the foley's tube seat 103 for being arranged on the near-end of sacculus push rod 101；The puncture needle component 200 includes puncturing
Push rod 202, the piercing needle 201 for being arranged on puncture push rod 202 distal end, puncture handle 205；The puncture handle 205 is wrapped
Proximal handle 252 and distal handle 251 are included, the distal handle 251 is fixedly connected or is detachably fixed with foley's tube seat 103
Connection, the proximal handle 252 is connected with puncturing push rod 202, and the proximal handle 252 is set along distal handle 251, described
Being provided between distal handle 251 and proximal handle 252 is used to control the paracentesis depth of piercing needle 201 and locking piercing needle
201 puncture controlling organization 206.
As shown in figure 3, foley's tube 100 mainly includes sacculus utricule 102, sacculus push rod 101 and foley's tube seat
103.In order to aid in accurate puncture, after branch vessel expansion, point of puncture is set to be located at the middle position of branch vessel opening, preferably
Foley's tube 100 is selected from center foley's tube 100, and the head end of sacculus push rod 101 is located at branch after sacculus utricule 102 is full
The center of blood vessel.Refer to from center：Sacculus utricule 102 is full to cause the head end of sacculus push rod 101 fills to be located to divide
The center of branch vessel, it is more accurate when so puncture, it is difficult to accidentally injure surrounding tissue.In order to ensure sacculus utricule 102
It can be formed from center, then the sacculus utricule 102 is non-compliance or semi-compliant sacculus utricule 102, i.e., described sacculus utricule
The sacculus utricule of 102 non-compliance being made of materials such as nylon elastomer or polyurethane elastomers or semi-compliant,
Non-compliance or semi-compliant sacculus utricule 102 can avoid the sacculus utricule 102 in the branch vessel of distortion from many degree changes occur
Shape, so as to keep the head end of sacculus push rod 101 after sacculus utricule 102 is full positioned at the center of branch vessel；The ball
The profile of capsule utricule 102 is axially symmetric structure, and preferably taper, oval or spherical uses spherical balloon utricule in the present embodiment
102, the diameter of sacculus utricule 102 is slightly larger than the diameter dimension of branch vessel, by the radial pressure of blood vessel after its is adherent, by
Fade to ellipse.
As shown in Figure 2,3, sacculus utricule 102 is attached to the far-end of sacculus push rod 101, the distal end of sacculus push rod 101
Head end is located at outside sacculus utricule 102 so that puncture needle component 200 can stretch out from the head end of the distal end of sacculus push rod 101.
As shown in figs. 4 through 10, the sacculus push rod 101 at least includes a guidewire lumen 110 and a full chamber 111, institute
State piercing needle 201 and puncture push rod 202 and be installed in the guidewire lumen 110.Using the foley's tube of multi-cavity tubular construction
100, the problem of easily relative displacement occurs for the inner and outer tubes of coaxial saccule conduit in the prior art can be avoided, compared to coaxial
The foley's tube 100 of structure, the present invention is during push, and sacculus utricule 102 is unlikely to deform, with more preferable pushability.
As shown in figs. 4 through 10, in order that obtaining piercing needle 201 and puncturing the easily motion in guidewire lumen 110 of push rod 202,
General, the diameter of guidewire lumen 110 is available for piercing needle 201 and puncture push rod 202 smooth logical between 0.35-2.0mm
Cross, and the cross section of guidewire lumen 110 is the curve forms, circular such as circle, ellipse.Guidewire lumen 110 can be located at ball
The center of capsule push rod 101, off-center can also be set, and the quantity of full chamber 111 is not construed as limiting, and can set one
Or it is multiple, position can be set in the side of guidewire lumen 110, or around guidewire lumen 110, and the shape of cross section for filling chamber 111 can
With the arbitrary shape for being circle or being arranged according to the shape of cross section around guidewire lumen 110.Sacculus push rod
101 can be the integrative-structure or two or more tubuloses of disposal molding formation guidewire lumen 110 and full chamber 111
The structure that structure is fixed together by bonding or welding manner, while being suit or overlay film in two or more tubular structures
To increase the fixation between them.
As shown in Fig. 3,4-10, the full distal end of chamber 111 and the UNICOM of sacculus utricule 102, the full near-end of chamber 111 connection are set
Have and fill first 104 for what is filled to sacculus utricule 102.Described full first 104 are used for by full chamber 111 to sacculus utricule
102 are filled, and full first 104 are arranged on foley's tube seat 103, for being connected full liquid with compression pump.
As shown in figure 11, the primary structure of puncture needle component 200 includes puncturing push rod 202, piercing needle 201 and punctured
Handle 205.Effectively and safely punctured to realize, piercing needle 201 answers at least one inclined-plane and hollow cavity, in it
Footpath should general at least above 0.35mm, the of length no more than 10mm of piercing needle 201, piercing needle 201 is used in the present embodiment
Sterile hypodermic needle for single use.
The piercing needle 201 and puncture push rod 202 are designed with hollow closed cavity, the hollow closed cavity connection of the two
Logical, hollow closed cavity internal diameter is usually less than 0.35mm.Puncture push rod 202 and require that both there is certain compliance, comply with
Vascular bending, being compressed axially and stretching with relatively low, in order to be conveyed in curved blood vessel, while should also have certain branch
Support force, to prevent from giving a discount in puncture process, therefore the push rod 202 that punctures is body flexible and with support force.Energy
Realize that puncturing material and structure of the push rod 202 with above-mentioned characteristic has a variety of, can use metal material or high polymer material
The body with closing inner chamber being made, such as stainless steel tube, titanium alloy tube, polyamide or polyurethane tube.
In the present embodiment, as illustrated in figs. 13-15, the part that puncture push rod 202 is connected with piercing needle 201 is using preferred
For the bourdon tube 221 of overlay film 220, the closing bourdon tube 221 of overlay film 220 forms hollow closed cavity, rear portion is closed tube.Wear
Pierce in push rod 202, the length of the bourdon tube 221 of overlay film 220 is determined according to actual needs, in the near-end connection of bourdon tube 221
Empty closed tube, punctures the bourdon tube 221 that push rod 202 can also be entirely overlay film 220.General bourdon tube 221 can be with
By sub-thread silk, can also be formed by multiple thread strands coiling, the mechanical property of bourdon tube 221 can according to the quantity of silk, winding pitch and
The parameters such as the cross section of multiple thread strands are adjusted；The internal diameter size of syringe needle, the present embodiment is not to be exceeded in the internal diameter size of push rod
Middle piercing needle 201 is with puncturing push rod 202 by being welded to connect, and inside and outside wall is seamlessly transitted；In order to be able to realize injection contrast agent,
The puncture push rod 202 carries hollow closed cavity.The material of the present embodiment overlay film 220 can use polytetrafluoroethylene (PTFE), gather
Ethylene glycol terephthalate, polyamide or polyurethane etc. material are made, by hot melt or pyrocondensation in bourdon tube 221
On, make piercing needle 201 and puncture the close encapsulation of push rod 202, after puncturing successfully, by puncture the near-end of push rod 202 to
Contrast agent is injected in the hollow closed cavity for puncturing push rod 202, contrast agent reaches piercing needle 201, in fluoroscopic apparatus
Lower confirmation piercing needle 201 is intravascular in main body, while overlay film 220 advantageously reduces the stretching of the axial direction of bourdon tube 221
And compression, improve push rod and puncture support force.
As shown in Figure 2,3, it is described to puncture the lining being coated with push rod 202 for strengthening puncturing the support force of push rod 202
Silk 203.Lining silk 203 provides support force for puncturing push rod 202 in puncture process, prevents from puncturing push rod 202 because of support
Power is not enough and gives a discount, and causes to puncture unsuccessful or accidentally injures surrounding tissue, lining silk 203 includes an elastic screw mandrel and one can
The lining silk seat 232 assembled with puncturing handle 205 is constituted, and the screw mandrel that silk 203 is served as a contrast in the present embodiment is titanium-nickel wire, and lining silk seat 232 is
Public Rule, the head end of lining silk 203 passes through round end, lining silk 203 insertion piercing needle 201 and the inner chamber for puncturing push rod 202, its
Head end is in the position of piercing needle 201, and does not expose the incline position of piercing needle 201, public Rule and the end for puncturing handle 205
Female Luer is assembled together.
The proximal handle 252 is moved axially along distal handle, i.e., described proximal handle 252 is installed on the distal handle
Moved axially in 251 and along distal handle 251, or the proximal handle 252 is in the outer and suitable distal end hand of the distal handle 251
Handle 251 is moved axially, described to puncture the maximum that controlling organization 206 includes being arranged between proximal handle 252 and distal handle 251
Stroke control assembly 260 and puncture locked component 261.By adjusting the relative position of proximal handle 252 and distal handle 251,
And then realize that puncture needle head stretches out the length of the head end of foley's tube 100, the spacing position by adjusting realizes that paracentesis depth can
Adjust, while preventing proximal handle 252 from withdrawing.Puncturing controlling organization 206 has various structures, illustrates individually below：
It is as shown in figure 12 the first embodiment of puncture controlling organization 206, present embodiment can be real with fast driving
Now puncture, and realize quantitative venipuncture.The range control assembly 260 includes being arranged in proximal handle 252 or remote
The stroke groove 260a on handle 251 is held, corresponding distal handle 251 or proximal handle 252 are provided with limited block 260b；The row
Journey groove 260a is axially arranged along push rod 202 is punctured, and the limited block 260b coordinates to be slided and its cunning in stroke groove 260a
Dynamic ultimate range is allows the depth capacity of lancet puncture, and depth capacity is determined according to blood vessel diameter, typically not greater than
40mm.Stroke groove 260a transverse width is slightly larger than limited block 260b transverse width, and the two gap coordinates or is slidably matched.
The puncture locked component 261 is to set multiple position and lock groove 261a on the control unit of proximal handle 252, corresponding
Distal handle 251 is provided with springy locking member 261b, and the springy locking member 261b elastic tops are pressed in position and lock groove 261a
Piercing needle position is locked, proximal handle 252 is driven in external force so that springy locking member 261b is in different position and lock grooves
Slided between 261a.From distal end to near-end, the interval in proximal handle 252 is uniformly arranged multiple, setting number to position and lock groove 261a
Distance dependent needed for amount depth needed for puncturing and regulation.The setting for puncturing locked component 261 is in order to after piercing to puncturing
Needle assemblies are locked, and by adjusting position and lock groove 261a and springy locking member 261b mutual alignment, are worn to adjust
Pierce depth.Adjustment springy locking member 261b position before puncturing, springy locking member 261b coordinates in the positioning lock closer to distal end
Determine in groove 261a, then paracentesis depth is bigger, conversely, paracentesis depth is small.Proximal handle 252 is provided with scale, and paracentesis depth is several
Individual fixed value, for showing and adjusting paracentesis depth, realizes ration puncture.
Position and lock groove 261a is the curved surface groove that can be slid in and out, preferably semi-spherical grooves, position and lock groove 261a depth
Degree does not make specific size requirement to be conducive to locking proximal handle 252 to be defined.Springy locking member 261b has various structures, can be with
Directly it is overall elastic structure or front end is provided with elongated insertion part 266, rear portion connection elastomer 267, elastomer 267
Spring can be selected, elongated insertion part 266 is fixed on spring, spring is upheld and elongated insertion part 266 is pressed in position and lock groove 261a,
By axial force, elongated insertion part 266 is bounced back by position and lock groove 261a curved surface cell walls top pressure, is taken off from position and lock groove 261a
Go out, next position and lock groove 261a is slid into along proximal handle 252.Elastomer 267, which is externally provided with, press-fits nut 268, press-fits spiral shell
Cap 268 is used to adjust spring force and locking piercing needle position.
As shown in figs. 16-18, it is second of embodiment of puncture controlling organization 206, present embodiment paracentesis depth is
Continuously adjustabe, it is possible to achieve more accurate to puncture.The puncture locked component 261 includes spacing in distal handle 251
Actuating sleeve 269, correspondence actuating sleeve 269 proximal handle 252 be provided with sliding shoe 268, the sliding shoe 268 and actuating sleeve
269 are engaged by screw thread, and rotation driving set 269 drives sliding shoe 268 to be slid axially along push rod 202 is punctured.In actuating sleeve 269
Wall is provided with internal thread 269a, and the external screw thread 268a set with the top of sliding shoe 268 is engaged.The internal thread 269a length of actuating sleeve 269
Degree is not less than maximum paracentesis depth.
The range control assembly 260 includes the stroke groove 260a that the distal handle 251 is provided with, the stroke
Groove 260a is axially arranged along push rod 202 is punctured, and insertion causes the sliding shoe 268 to pass through stroke groove inside and outside stroke groove 260a
260a is engaged with the screw thread of actuating sleeve 269, and the sliding shoe 268 coordinates to be slided and its slip ultimate range in stroke groove 260a
To allow the depth capacity of lancet puncture.Stroke groove 260a transverse width is slightly larger than limited block 260b transverse width, two
Person gap coordinates or is slidably matched.On the one hand stroke groove 260a is used to control paracentesis depth, on the other hand for limit slippage block
268 rotation, prevents that sliding shoe 268 is rotated in rotation driving set 269.Sliding shoe 268 can be integral with proximal handle 252
Structure, can also the two be fixed together.
Implementation process：Before branch vessel is capped, orthotopic fenestration device is rinsed respectively using heparin or physiological saline
Tool pack assembly, and instrumentarium is vented, percutaneous puncture is set up between target position and point of puncture along J-type seal wire by sheath
Transfer passage, exchange sacculus silk-guiding (0.014 " or 0.018 ").Then Puncture needle sleeve is entered in foley's tube 100 in vitro
Chamber, and the head end of the distal handle 251 of puncture needle component 200 is connected with the outlet of the guidewire lumen 110 of foley's tube 100, it is ensured that wear
Pricker first 201 is withdrawn to the distal end of foley's tube 100, along seal wire, is pushed forward, until being reached from foley's tube 100TIP ends
Outer sheath TIP ends；Recession outer sheath, makes sacculus stretch out outer sheath TIP ends entirely, from full mouth Filled Balloon, it is close to left lock
Arterial blood tube wall under bone；
Under the auxiliary of medical image, it is determined that the paracentesis depth needed, adjusts the stroke limit of distal handle 251, it is determined that
Proximal handle 252 and the drivable stroke of distal handle 251, seal wire of dropping back；Proximal handle 252 is quickly driven, puncture needle will
Puncture support overlay film, by the relative position of locking nut stationary remote handle 251 and proximal handle 252 with keep puncture needle position
Put, withdraw from lining silk 203, contrast agent is injected by the cavity for puncturing push rod 202, under fluoroscopic apparatus, confirm puncture needle
Whether first 201 have arrived in sustainer；Seal wire is pushed to actively along piercing needle 201 and the cavity for puncturing push rod 202
Arteries and veins, piercing needle 201 of dropping back, takes out puncture needle component 200, and pressure release sacculus utricule 102 then takes out foley's tube 100, sets up
By outer sheath and seal wire indwelling in original position.Dilating sacculus is delivered into point of puncture using this passage progressively to expand, realizes that original position is opened
Window, windowing size, exchange guidewire and indwelling original position are determined under the auxiliary of medical image, outer sheath is exited, is subsequent support
Implantation is prepared.
Embodiment 2, the present embodiment mainly solving the technical problems that：Push rod 202 is punctured to be not easy to give a discount, puncture more
Collection neutralizes effective problem.
A kind of intracavitary orthotopic fenestration sting device, including foley's tube 100 and coaxial package wearing in foley's tube 100
Lancet unit 200；The foley's tube 100 includes the sacculus push rod 101 with least two cavitys, is arranged on sacculus push
The sacculus utricule 102 of the distal end of bar 101, the foley's tube seat 103 for being arranged on the near-end of sacculus push rod 101；The puncture needle component
200 include puncturing push rod 202, are arranged on the piercing needle 201 for puncturing the distal end of push rod 202, puncture handle 205；It is described to wear
It is body flexible and with support force to pierce push rod 202, is coated with the puncture push rod 202 and is pushed away for strengthening puncture
Send the lining silk 203 of the support force of bar 202.The concrete structure be the same as Example 1 of above-mentioned part.
Wherein the structure of foley's tube 100 can be consistent be the same as Example 1, including sacculus push rod 101 and sacculus utricule 102,
But sacculus utricule 102 of the prior art can also be used, remaining structure be the same as Example 1 will not be repeated here.
Puncture push rod 202, piercing needle 201, serve as a contrast structure also be the same as Example 1 of silk 203, will not be repeated here.
Compared to embodiment 1, puncture controlling organization 206 is selective structure, you can punctures controlling organization 206 to have, also may be used
Not have.Distal handle 251 and proximal handle 252 can unite two into one can drive puncture needle component to be punctured as one
Part.
Claims (13)
1. a kind of intracavitary orthotopic fenestration sting device, it is characterised in that：Including foley's tube and coaxial package in foley's tube
Puncture needle component；
The foley's tube includes the sacculus push rod with least two cavitys, is arranged on the sacculus capsule of sacculus push rod distal end
Body, the foley's tube seat for being arranged on sacculus push rod near-end；
The puncture needle component includes puncturing push rod, is arranged on the piercing needle for puncturing push rod distal end, puncture handle；
The puncture handle includes proximal handle and distal handle, and the distal handle is fixedly connected or removable with foley's tube seat
Unload and be fixedly connected, the proximal handle is connected with puncturing push rod, and the proximal handle is set along distal handle, the distal end hand
Being provided between handle and proximal handle is used to control lancet puncture depth and locks the puncture control machine of lancet puncture depth
Structure.
2. intracavitary orthotopic fenestration sting device according to claim 1, it is characterised in that the proximal handle is along distal end hand
Handle is moved axially, described to puncture the range control assembly that controlling organization includes being arranged between proximal handle and distal handle
With paracentesis depth locked component.
3. intracavitary orthotopic fenestration sting device according to claim 2, it is characterised in that the range control assembly
Including the stroke groove being arranged in proximal handle or in distal handle, corresponding distal handle or proximal handle are provided with spacing
Block；The stroke groove is axially arranged along push rod is punctured, and the limited block cooperation is slided in stroke groove and its slip is maximum
Distance is to allow the depth capacity of lancet puncture.
4. intracavitary orthotopic fenestration sting device according to claim 2, it is characterised in that the puncture locked component is near
Multiple position and lock grooves are set on the handle control unit of end, and corresponding distal handle is provided with springy locking member, the elastic locking
Part elastic top, which is pressed in position and lock groove, locks puncture needle position, drives proximal handle in external force so that springy locking member exists
Slided between different position and lock grooves.
5. intracavitary orthotopic fenestration sting device according to claim 2, it is characterised in that the puncture locked component includes
The spacing actuating sleeve in distal handle, the proximal handle of correspondence actuating sleeve is provided with sliding shoe, the sliding shoe and actuating sleeve
Engaged by screw thread, rotation driving set driving sliding shoe slides axially along push rod is punctured.
6. intracavitary orthotopic fenestration sting device according to claim 5, it is characterised in that the range control assembly
The stroke groove being provided with including the distal handle, the stroke groove is axially arranged along push rod is punctured, and the sliding shoe is worn
Overtravel groove is engaged with driving external threading, and the sliding shoe cooperation is slided in stroke groove and it slides ultimate range to allow
The depth capacity of lancet puncture.
7. the intracavitary orthotopic fenestration sting device according to claim 1-6 any one, it is characterised in that the puncture needle
Head and puncture push rod are designed with hollow closed cavity, the hollow closed cavity UNICOM of the two.
8. intracavitary orthotopic fenestration sting device according to claim 7, it is characterised in that the puncture push rod is bendable
Body bent and with support force.
9. intracavitary orthotopic fenestration sting device according to claim 8, it is characterised in that the puncture push rod, which is provided with, to be covered
The hollow closed cavity of film.
10. intracavitary orthotopic fenestration sting device according to claim 7, it is characterised in that in the puncture push rod
The lining silk for strengthening puncturing push rod support force is coated with empty closed cavity.
11. the intracavitary orthotopic fenestration sting device according to claim 1-6 any one, it is characterised in that the sacculus
Push rod at least includes a guidewire lumen and a full chamber, and the piercing needle and puncture push rod are installed on the guidewire lumen
In, the full chamber distal end and sacculus utricule UNICOM, full chamber near-end are connected with the full head for being filled to sacculus utricule.
12. the intracavitary orthotopic fenestration sting device according to claim 1-6 any one, it is characterised in that the sacculus
Utricule is non-compliance or semi-compliant sacculus utricule.
13. a kind of intracavitary orthotopic fenestration sting device, it is characterised in that：Including foley's tube and coaxial package in foley's tube
Puncture needle component；
The foley's tube includes the sacculus push rod with least two cavitys, is arranged on the sacculus capsule of sacculus push rod distal end
Body, the foley's tube seat for being arranged on sacculus push rod near-end；
The puncture needle component includes puncturing push rod, is arranged on the piercing needle for puncturing push rod distal end, puncture handle；
The push rod that punctures is body flexible and with support force, is coated with the puncture push rod and is worn for reinforcement
Pierce the lining silk of push rod support force.
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| CN201710179335.8A CN106963516B (en) | 2017-03-23 | 2017-03-23 | Intracavitary orthotopic fenestration sting device |
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|---|---|---|---|
| CN201710179335.8A CN106963516B (en) | 2017-03-23 | 2017-03-23 | Intracavitary orthotopic fenestration sting device |
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| CN106963516B CN106963516B (en) | 2019-07-26 |
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