CN107684657B - Double-layer elbow micro catheter for artery chronic occlusion lesion interventional operation - Google Patents
Double-layer elbow micro catheter for artery chronic occlusion lesion interventional operation Download PDFInfo
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- A61M25/00—Catheters; Hollow probes
- A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
- A61M25/0023—Catheters; Hollow probes characterised by the form of the tubing by the form of the lumen, e.g. cross-section, variable diameter
- A61M25/0026—Multi-lumen catheters with stationary elements
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- A61M25/00—Catheters; Hollow probes
- A61M25/0043—Catheters; Hollow probes characterised by structural features
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- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
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- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
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- A—HUMAN NECESSITIES
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- A61M25/00—Catheters; Hollow probes
- A61M2025/0004—Catheters; Hollow probes having two or more concentrically arranged tubes for forming a concentric catheter system
- A61M2025/0006—Catheters; Hollow probes having two or more concentrically arranged tubes for forming a concentric catheter system which can be secured against axial movement, e.g. by using a locking cuff
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- A61M25/00—Catheters; Hollow probes
- A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
- A61M25/0023—Catheters; Hollow probes characterised by the form of the tubing by the form of the lumen, e.g. cross-section, variable diameter
- A61M25/0026—Multi-lumen catheters with stationary elements
- A61M2025/0039—Multi-lumen catheters with stationary elements characterized by lumina being arranged coaxially
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- A—HUMAN NECESSITIES
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- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M2025/0175—Introducing, guiding, advancing, emplacing or holding catheters having telescopic features, interengaging nestable members movable in relations to one another
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- A—HUMAN NECESSITIES
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- A61M2210/12—Blood circulatory system
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Abstract
The invention discloses a double-layer elbow micro-catheter for artery chronic occlusion lesion interventional operation, which comprises: the tail end of the outer layer micro catheter is provided with a rotary locking mechanism for realizing rotation and locking; the inner layer micro-catheter is arranged in the outer layer micro-catheter in a penetrating mode, and the length of the inner layer micro-catheter is larger than that of the outer layer micro-catheter; an axial movement structure for realizing the axial advance or retreat of the outer layer micro-catheter and the inner layer micro-catheter is arranged between the outer layer micro-catheter and the inner layer micro-catheter; the head end of the inner layer micro catheter is provided with an elbow which can be automatically straightened in the outer layer micro catheter. Also discloses a using method of the double-layer elbow micro-catheter. This double-deck elbow pipe that declines can accomplish smoothly that the seal wire puncture gets into the true chamber of blood vessel, and simultaneously, the pipe can also follow the seal wire and get into true chamber, need not to change another can accomplish the radiography of pipe that declines and prove getting into true chamber and accomplishing the seal wire exchange through little pipe, makes the operation more simple and convenient, has saved time and operation cost.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a double-layer elbow micro catheter for coronary artery or lower limb artery chronic occlusion lesion interventional operation and a using method thereof.
Background
Cardiovascular diseases such as arteriosclerosis, stenosis and occlusion are the biggest enemies of human health. With the development of interventional treatment technology, lesions including coronary artery stenosis, occlusion and lower limb artery stenosis, occlusion and the like can be effectively treated by an interventional method. However, interventional treatment of chronic total occlusion of coronary or lower limb arteries is still one of the clinical problems. The vessel wall structure of the human middle-aorta vessel can be divided into three structures of the intima, media and adventitia (figure 4). The inner membrane is loose connective tissue and is thin; the tunica media consists of smooth muscles which are arranged in a ring shape, and elastic fibers are arranged among the smooth muscles and are thicker; the adventitia is thinner than the media and is composed of connective tissue. Because the vessel is occluded for a long time, the head end of the occluded vessel is often formed into a hard fiber cap, when interventional therapy is carried out, the guide wire is difficult to accurately penetrate through the fiber cap to enter the true lumen of the occluded vessel, and easily penetrates through the thinner vascular intima to enter the subintimal or media layer of the vessel, namely a so-called 'false lumen' (fig. 5), so that the guide wire is difficult to enter the true lumen of the vessel to cause the failure of the interventional operation. For most chronic occlusive lesions, especially those with long occlusive segments, or calcification and tortuosity, it is almost impossible to ensure that the guide wire is always in the true lumen of the blood vessel, and the guide wire is quite common to enter the subintimal space of the blood vessel. In this case, the key to success of the interventional procedure is how to return the subintimal guidewire back into the true lumen of the vessel. This technique of forward subintimal regression lumen is clinically known as the ADR technique (Antegrade differentiation Re-EntryTechniques).
The currently clinically-used return-to-true lumen catheters include two major categories, namely application in coronary artery occlusion and application in lower limb artery occlusion.
The clinically common reentry lumen system for coronary occlusive lesions is the crossBoss & Stingray system. The return-to-true lumen catheter commonly used in clinical lower limb arterial occlusion comprises an Outback LTD catheter, a Pioneer catheter, an OffRoad catheter and an Enteer catheter. They all have the common disadvantage that after the guide wire returns to the true lumen smoothly, the catheters cannot follow directly through the guide wire, and need to exit the catheter, and exchange the common small-caliber microcatheter to follow the guide wire into the true lumen of the blood vessel to complete the angiography through the microcatheter or exchange the working guide wire with a softer head end. This, in turn, results in increased economic expense, both in terms of complexity of the procedure and in terms of operating time.
Chinese patent literature (publication date: 2009, 7/29, publication number: CN 101495171) discloses medical devices and methods comprising a catheter system for the vasculature. The catheter system includes a re-entry catheter for use with a number of guide wires that direct the guide wires from the abluminal or subintimal space back into the true lumen after the guide wires have entered the subintimal space. An example of a re-entry catheter is a single lumen catheter configured to facilitate guidewire and catheter access and positioning in the vasculature. One embodiment places and positions the guidewire and catheter in the surrounding vasculature. More specifically, the re-entry catheter allows the guidewire to re-enter the true lumen of the surrounding vasculature from the subintimal space.
Chinese patent literature (publication date: 2014, 12 and 10, publication number: CN 203988135U) discloses an intravascular ultrasound double-lumen microcatheter, which consists of an intravascular ultrasound catheter and a treatment microcatheter connected with the intravascular ultrasound catheter in parallel. The utility model discloses the apparatus external diameter is little, and the puncture seal wire gets into the pathological change along with the little pipe synchronization of supersound two-chamber easily, and the little pipe of two-chamber increases the nature controlled of seal wire effectively. Simultaneously the utility model discloses can show pipe wall and pathological change characteristic, because two pipes are conjuncted, when the seal wire puncture is guided to intravascular supersound, puncture seal wire and ultrasonic probe's position relatively fixed, confirm more easily and guide the relation between seal wire and the target, help correctly holding the puncture direction, can improve the success rate that the seal wire got into true chamber greatly, improve the operation success rate.
The technical scheme also relates to the micro-catheter, but the technical scheme solves the problem of improving the success rate of the guide wire entering the true cavity with the working efficiency. But the increased complexity of the procedure and the time of the procedure also result in more economic costs.
Disclosure of Invention
The invention aims to solve the problems that other clinical micro catheters for assisting puncture of a real cavity cannot directly enter the real cavity along with a guide wire after successful puncture, the common micro catheter needs to be replaced to realize follow-up and guide wire exchange of the catheter, the operation is complex, the operation time is long, the cost is high and the like.
The technical scheme adopted by the invention for realizing the first invention purpose is as follows: a double-elbow microcatheter for use in arterial chronic occlusive lesion interventions, comprising:
the tail end of the outer layer micro catheter is provided with a rotary locking mechanism for realizing rotation and locking;
the inner layer micro-catheter is arranged in the outer layer micro-catheter in a penetrating mode, and the length of the inner layer micro-catheter is larger than that of the outer layer micro-catheter;
an axial movement structure for realizing the axial advance or retreat of the outer layer micro-catheter and the inner layer micro-catheter is arranged between the outer layer micro-catheter and the inner layer micro-catheter;
the head end of the inner layer micro catheter is provided with an elbow which can be automatically straightened in the outer layer micro catheter.
This a little pipe of double-deck elbow for chronic occlusive lesion of artery intervenes art, through setting up the little pipe structure of a double-deck elbow, be provided with one inside little pipe of inlayer that can follow the outer little pipe slip-in roll-off of outer little pipe at outer little pipe, and the head end at the little pipe of inlayer sets up an elbow, when needs are fixed between little pipe of inlayer and the outer little pipe, will lock through rotatory locking mechanism, and when needs inlayer little pipe stretches out outer little pipe, unscrew rotatory locking mechanism and make the little pipe of inlayer outwards stretch out through the axial motion structure, the little pipe of inlayer outwards stretches out its head end after outer little pipe and naturally bends into the elbow. This double-deck elbow pipe that declines utilizes a pipe, realizes assisting the true chamber of puncture and pipe follow-up seal wire and get into two main functions in the true chamber, need not to change the pipe in addition, convenient operation. When the guide wire and the double-layer elbow micro catheter enter the blood vessel under the membrane, the guide wire is withdrawn, the outer layer micro catheter is withdrawn, the head end of the inner layer micro catheter can be automatically bent into the elbow at the moment, the direction of the elbow of the inner layer micro catheter is controlled, the elbow of the inner layer micro catheter points to the blood vessel true cavity, the double-layer elbow micro catheter is fed into a puncture guide wire with a hard head end at the moment, and the puncture guide wire punctures in the direction of the blood vessel true cavity pointed by the elbow end of the inner layer micro catheter to help the guide wire to return to the blood. At the moment, the inner layer micro catheter is withdrawn to the inner part of the outer layer micro catheter, the elbow is automatically straightened, the whole system is restored to the function of a common micro catheter, and at the moment, the catheter can be sent forward along the guide wire to enter the true lumen of the blood vessel. This double-deck elbow pipe that declines through a pipe, realizes assisting the true chamber of puncture and pipe follow-up seal wire and get into true chamber two major functions, need not to reuse other pipe that declines, has saved the operation cost.
Preferably, the tail end of the inner layer micro-catheter is provided with a flaring structure. The tail end of the inner layer micro catheter is provided with a flaring structure which can be arranged in a trumpet shape so as to facilitate the insertion of a guide wire.
Preferably, the rotary locking mechanism is a rotary fixed handle. The rotary locking mechanism is set as a rotary fixing handle, the inner-layer micro-catheter and the outer-layer micro-catheter can be operated to respectively move forwards or backwards when the rotary locking mechanism is loosened, the outer-layer micro-catheter and the inner-layer micro-catheter can be fixed when the rotary locking mechanism is screwed, and operations such as integral returning, forward feeding and the like of the double-layer elbow micro-catheter are facilitated.
Preferably, the axial motion structure including set up the sand grip on outer layer microcatheter tail end inner chamber wall and set up the recess on the outer wall of inlayer microcatheter tail end, sand grip and recess correspond the cooperation setting. The arrangement of the convex strips and the grooves is to ensure that the inner and outer layer micro-catheters can only do relative movement back and forth but can not rotate mutually so as to ensure the accuracy of operation.
Preferably, the axial length of the groove is greater than the axial length of the rib. The length of the groove is larger than that of the raised line, so that the raised line can conveniently slide back and forth in the groove, and the forward and backward movement is realized.
Preferably, the head end of the outer layer micro-catheter is provided with a light-tight L-shaped mark. The elbow side that outer layer pipe head end and the little pipe of inlayer correspond is equipped with an impervious L type sign, is convenient for adjust the direction of good pipe under DSA, lets the elbow point to true chamber direction.
Preferably, the rod part of the outer layer microcatheter is an integral pipe, the inner part of the outer layer microcatheter is made of polytetrafluoroethylene, the outer part of the outer layer microcatheter is made of a stainless steel net in a weaving mode, and the outer surface of the whole rod part is provided with a hydrophilic coating.
Preferably, the rod part of the inner layer microcatheter is an integral pipe fitting, the inner part of the inner layer microcatheter is made of polytetrafluoroethylene, the outer part of the head end of the inner layer microcatheter is woven by stainless steel meshes, and the outer surface of the head end of the rod part is provided with a hydrophilic coating.
The technical scheme adopted by the invention for realizing the second invention purpose is as follows: a method for using a double-elbow microcatheter for arterial chronic occlusive lesion interventional procedures, characterized by comprising the following steps:
step 1: preparing a double-layer elbow micro catheter, an ultra-smooth puncture guide wire with a hard head end and a common soft guide wire;
step 2: the ultra-smooth puncture guide wire with the hard head end penetrates through the double-layer elbow micro catheter, and after the ultra-smooth puncture guide wire enters the blood vessel subintima, the double-layer elbow micro catheter enters the blood vessel subintima along the ultra-smooth puncture guide wire;
and step 3: the double-layer elbow micro catheter and the ultra-smooth puncture guide wire integrally enter the position required by the far end of the blood vessel, when the ultra-smooth puncture guide wire and the double-layer elbow micro catheter integrally enter the far end of the blood vessel, the ultra-smooth puncture guide wire and the outer-layer micro catheter are retracted, the head end of the inner-layer micro catheter is exposed, the head end of the inner-layer micro catheter automatically returns to an elbow of 120 degrees, and the direction of the elbow is adjusted by twisting the double-layer elbow micro catheter;
and 4, step 4: the direction of the double-layer elbow micro catheter is adjusted under DSA through the lightproof L-shaped mark arranged at the elbow side corresponding to the head end of the outer-layer micro catheter and the inner-layer micro catheter, so that the elbow points to the true lumen direction of the blood vessel;
and 5: the ultra-smooth puncture guide wire is fed along the double-layer elbow micro catheter and is punctured in the direction pointed by the elbow end of the inner-layer micro catheter to help the ultra-smooth puncture guide wire enter the true lumen of the blood vessel;
step 6: when the ultra-smooth puncture guide wire returns to the blood vessel true cavity at the far-end blood vessel, the ultra-smooth puncture guide wire is reserved in the blood vessel true cavity at the far-end, and the double-layer elbow micro catheter integrally enters the blood vessel true cavity at the far-end along the ultra-smooth puncture guide wire.
And 7: and withdrawing the ultra-smooth puncture guide wire, keeping the double-layer elbow micro catheter in the distal blood vessel true cavity, replacing the common soft guide wire to enter the distal blood vessel true cavity, and smoothly finishing the interventional operation.
The invention has the beneficial effects that: the double-layer elbow micro-catheter for the artery chronic occlusion lesion interventional operation and the use method thereof can smoothly complete guide wire puncture and enter a true cavity, meanwhile, the catheter can also enter the true cavity along with the guide wire, and can complete contrast confirmation through the micro-catheter and complete guide wire exchange without replacing another micro-catheter, so that the operation is simpler and more convenient, the time is saved, and the operation cost is also saved.
Drawings
FIG. 1 is a schematic diagram of a double-bend microcatheter of the present invention for use in chronic occlusive arterial disease interventional procedures;
FIG. 2 is a partial cross-sectional view of the double-bend microcatheter of the present invention in use in an interventional procedure for chronic occlusive arterial lesions;
FIG. 3 is a sectional view A-A of FIG. 2;
FIG. 4 is a wall structure view of a medium-large artery blood vessel of a human body;
FIG. 5 is a schematic view of a prior art guidewire entering a subintimal or media "false lumen" of a blood vessel;
FIG. 6 is a schematic structural diagram of a double-elbow microcatheter used in an interventional procedure for chronic arterial occlusion as a conventional microcatheter;
FIG. 7 is a schematic view of a double-bend microcatheter of the present invention in a configuration for chronic occlusive arterial disease interventional procedure, entering under the intima of a blood vessel;
FIG. 8 is a schematic structural diagram of the head end of the inner micro-catheter automatically bending into an elbow in the double-layer elbow micro-catheter for the intervention of artery chronic occlusive lesion;
FIG. 9 is a schematic diagram of a structure of a double-elbow microcatheter for artery chronic occlusive lesion interventional procedures to assist in ultra-smooth puncture of a guide wire into a true lumen of a blood vessel;
FIG. 10 is a schematic diagram of a double-layer bend micro-catheter with ultra-smooth puncture guide wire entering the true lumen of a blood vessel for the intervention of artery chronic occlusive lesion;
FIG. 11 is a schematic view of a configuration of the present invention after withdrawal of the ultra-smooth piercing guidewire and inner microcatheter;
in the figure: 1. the utility model discloses a little pipe of outer, 2, rotation locking mechanism, 3, the little pipe of inlayer, 4, axial motion structure, 5, elbow, 6, flaring structure, 7, sand grip, 8, recess, 9, light tight L type sign, 10, puncture seal wire.
Detailed Description
The technical solution of the present invention is further described in detail by the following specific embodiments with reference to the accompanying drawings.
Example 1:
in the embodiment shown in fig. 1, 2 and 3, the double-layer elbow micro-catheter for artery chronic occlusion lesion interventional operation has two types of total lengths, namely 130cm and 150c respectively, and comprises:
the tail end of the outer layer micro catheter 1 is provided with a rotary locking mechanism 2 for realizing rotation and locking;
the inner layer micro catheter 3 is arranged in the outer layer micro catheter 1 in a penetrating mode, and the length of the inner layer micro catheter 3 is larger than that of the outer layer micro catheter 1;
an axial movement structure 4 for realizing the axial advance or retreat of the outer layer micro catheter 1 and the inner layer micro catheter 3 is arranged between the outer layer micro catheter 1 and the inner layer micro catheter 3;
the head end of the inner layer micro-catheter 3 is provided with an elbow 5 which can be automatically straightened in the outer layer micro-catheter 1. The bend 5 has an obtuse angle.
The tail end of the inner layer micro-catheter 3 is provided with a flaring structure 6.
The rotary locking mechanism 2 is a rotary fixed handle.
The axial motion structure 4 is including setting up sand grip 7 on the 1 tail end inner chamber wall of outer little pipe and setting up the recess 8 on 3 tail end outer walls of inlayer little pipe, and sand grip 7 and recess 8 correspond the cooperation setting. The axial length of the grooves 8 is greater than the axial length of the ribs 7. The length of the groove 8 is at least twice the length of the protrusion 7.
The head end of the outer layer micro-catheter 1 is provided with a light-tight L-shaped mark 9. The elbow side that outer layer pipe head end and the little pipe of inlayer correspond is equipped with an impervious L type sign, is convenient for adjust the direction of good pipe under DSA, lets the elbow point to true chamber direction.
The pole part of outer layer pipe 1 is an integral pipe fitting, and the inside polytetrafluoroethylene that is of the material of outer layer pipe 1, the outside is the stainless steel net weaving, and the holistic surface in pole part is hydrophilic coating.
The pole part of the inner layer micro-catheter 3 is an integral pipe fitting, the inside of the material of the inner layer micro-catheter 3 is polytetrafluoroethylene, the outside of the head end of the inner layer micro-catheter 3 is woven by stainless steel meshes, and the outer surface of the pole part head end is a hydrophilic coating.
The head end of the double-layer elbow micro-catheter can be integrally bent and deformed, so that the double-layer elbow micro-catheter enters a far-end blood vessel true cavity along with the guide wire and can stay in the far-end blood vessel true cavity, the common soft guide wire can be conveniently replaced to enter the far-end blood vessel true cavity, and the intervention operation can be smoothly completed.
In this embodiment, the total length of the double-layer elbow micro-catheter in this embodiment is 130cm, and the length of the head end of the inner-layer micro-catheter 3 is 2mm longer than that of the outer-layer micro-catheter; the bending angle of the elbow is 120 degrees, and the length of the elbow is 1 mm; the flaring structure 6 is arranged in a trumpet shape; the two convex strips 7 in the axial movement structure 4 are symmetrically arranged, the two corresponding grooves 8 are also arranged, the length of the convex strips 7 is set to be 10mm, and the length of the grooves is set to be 20 mm.
Example 2:
the double-elbow microcatheter for arterial chronic occlusive lesion interventional procedures described in the example is substantially the same as the technical solution of the example 1, except that: the total length of the double-layer elbow micro-catheter is 150cm, and the length of the head end 3 of the inner-layer micro-catheter is 3mm longer than that of the outer-layer micro-catheter; the bending angle of the elbow is 135 degrees, and the length of the elbow is 1.5 mm; the flaring structure 6 is cylindrical; three convex strips 7 in the axial movement structure 4 are symmetrically arranged, three corresponding grooves 8 are also arranged, the length of the convex strips 7 is set to be 10mm, and the length of the grooves is set to be 20 mm.
The double-elbow microcatheter for chronic occlusive lesion intervention in coronary or lower limb arteries as described in the above embodiments (see fig. 1). The flaring structure at the tail end of the inner layer micro catheter 3 is in a horn shape, so that a guide wire can be conveniently inserted. The rotatable rotary fixing handle is arranged at the tail end of the outer-layer micro-catheter, the inner-layer micro-catheter can be operated to respectively carry out forward feeding or backward feeding when the rotary fixing handle is loosened, the outer-layer micro-catheter can be fixed with the inner-layer micro-catheter when the rotary fixing handle is screwed, and operations such as integral backward feeding, forward feeding and the like of the double-layer elbow micro-catheter are facilitated. The inner layer and the outer layer of the double-layer elbow microcatheter are tightly connected, the double-layer elbow microcatheter can be divided into two types according to the inner diameter of a lumen, the two types of the double-layer elbow microcatheter are respectively used for coronary arteries, and the lumen of the double-layer elbow microcatheter can only pass through a guide wire of 0.014 inch. While for lower extremity arterial occlusion a 0.018 inch guidewire may be passed. The head end of the inner layer micro-duct is provided with a 1mm elbow with an angle of 120 degrees, and the total length of the double-layer elbow micro-duct is 130cm and 150 cm.
When the tip of the outer layer microcatheter is flush with the tip of the inner layer microcatheter, the function of the outer layer microcatheter is equivalent to that of a common microcatheter which is commonly used clinically. When the outer layer micro catheter is retracted, the head end of the inner layer micro catheter is exposed, and the head end is automatically bent into an elbow 5. At the moment, the direction of the elbow of the catheter is controlled to enable the elbow to point to the true lumen of the blood vessel, then the puncture guide wire 10 with the hard head end is sent into the double-layer elbow micro catheter, the puncture guide wire 10 is worn to enter the true lumen of the blood vessel through puncture in the direction of the true lumen of the blood vessel pointed by the elbow end of the inner layer micro catheter, then the double-layer micro catheter integrally follows the puncture guide wire to enter the true lumen of the blood vessel, the guide wire with the soft head end is exchanged after the micro catheter is confirmed by angiography, and the operation is completed.
The double-layer elbow micro-catheter is of a double-layer structure, the inner-layer micro-catheter 3 and the outer-layer micro-catheter 1 are made of polytetrafluoroethylene, and stainless steel woven layers are arranged outside the inner-layer micro-catheter 3 and the outer-layer micro-catheter 1 respectively, so that the double-layer elbow micro-catheter can effectively resist kinking; the outer surface of the whole pipe parts of the inner layer micro catheter 3 and the outer layer micro catheter 1 is a hydrophilic coating, so that the micro catheter can pass through the blood vessel conveniently. The inner layer of micro-catheter 3 is at least 2mm longer than the outer layer of micro-catheter 1. The head end of the inner layer micro catheter 3 is designed with an elbow 5 with the length of at least 1mm, the bending angle of the elbow 5 is an obtuse angle, preferably 120 degrees, when the inner layer micro catheter 3 is retracted into the outer layer micro catheter 1, the elbow 5 can be straightened, and the function of the elbow is equivalent to that of a common micro catheter used clinically (see fig. 4).
The specific use method of the double-layer elbow micro-catheter comprises the following steps:
step 1: preparing a double-layer elbow micro catheter, an ultra-smooth puncture guide wire 10 and a common soft guide wire;
step 2: the double-layer elbow microcatheter is fed with an ultra-smooth puncture guide wire 10 with a hard head end, and after the ultra-smooth puncture guide wire 10 enters the subintium of the blood vessel, the double-layer elbow microcatheter then enters the subintium of the blood vessel along the ultra-smooth puncture guide wire 10 (see figure 7);
and step 3: when the ultra-smooth puncture guide wire 10 and the double-layer elbow micro catheter integrally enter the far end of the blood vessel, the head end of the inner layer micro catheter 3 can be exposed by retracting the ultra-smooth puncture guide wire 10 and the outer layer micro catheter 1, the head end of the inner layer micro catheter 3 can automatically recover to be an elbow of 120 degrees (see figure 8), and the direction of the elbow 5 can be adjusted by twisting the double-layer elbow micro catheter;
and 4, step 4: the direction of the double-layer elbow micro-catheter is adjusted under DSA through the lightproof L-shaped mark 9 arranged at the side of the elbow 5 corresponding to the head end of the outer-layer micro-catheter 1 and the inner-layer micro-catheter 3, so that the elbow 5 points to the true cavity direction;
two 10mm long convex strips 7 protruding into the tube cavity and arranged on the inner wall of the tail end tube cavity of the outer layer micro-catheter 1 and two 20mm long grooves 8 arranged on the outer cavity of the tail end of the inner layer micro-catheter 3 are overlapped with each other (see figures 2 and 3), so that the inner layer micro-catheter and the outer layer micro-catheter can only move back and forth relatively and cannot rotate mutually. When the L-shaped mark 9 is aligned to the direction of the true lumen of the blood vessel, the outer layer micro catheter 1 is retracted, and the direction pointed by the elbow 5 of the inner layer micro catheter 3 is the accurate direction of the true lumen.
And 5: at the moment, the ultra-smooth puncture guide wire 10 is fed along the double-layer elbow micro catheter, and the ultra-smooth puncture guide wire 10 punctures in the direction pointed by the elbow 5 end of the inner-layer micro catheter 3 to help the ultra-smooth puncture guide wire 10 in the false cavity to enter the true cavity of the blood vessel (see figure 9);
step 6: after the ultra-smooth guide wire 10 returns to the blood vessel true cavity at the far end blood vessel, the double-layer elbow micro catheter integrally enters the far end blood vessel true cavity along the ultra-smooth puncture guide wire 10 (fig. 10).
And 7: the ultra-smooth puncture guide wire 10 is withdrawn, the double-layer elbow micro catheter is kept in the far-end blood vessel true cavity (figure 11), the common soft guide wire 11 is replaced to enter the far-end blood vessel true cavity, and the interventional operation is smoothly completed.
The inner and outer layer micro-catheter are connected through a rotary locking mechanism at the tail end of the outer layer micro-catheter: the fixed handle is rotated to fix the double-layer elbow pipe, the inner-layer micro-catheter and the outer-layer micro-catheter can be operated to respectively move forwards or backwards when the fixed handle is loosened, the outer-layer micro-catheter and the inner-layer micro-catheter can be fixed when the fixed handle is screwed, and the double-layer elbow pipe is convenient to integrally retreat, forwards and the like.
(1) The operation is simplified. By utilizing the catheter with the double-layer elbow and the micro catheter, two functions of assisting puncture of a real cavity and assisting the catheter to follow a guide wire into the real cavity can be realized, the catheter does not need to be exchanged additionally, and the operation is convenient. When the guide wire and the double-layer elbow micro catheter enter the blood vessel under the membrane, the guide wire is withdrawn, the outer layer micro catheter is withdrawn, the end of the inner layer micro catheter can be automatically bent into the elbow at the moment, the direction of the elbow of the catheter is controlled, the elbow points to the blood vessel true cavity, the double-layer elbow micro catheter is fed into a puncture guide wire with a hard head end at the moment, and the puncture guide wire punctures in the direction of the blood vessel true cavity pointed by the elbow end of the inner layer micro catheter to help the guide wire to return to the blood vessel true cavity again. The double layer microcatheter can now be advanced directly over the guidewire into the distal vascular true lumen. At present, other micro catheters for assisting puncture of a real cavity cannot realize that the catheter follows the real cavity after successful puncture clinically, and the common micro catheter needs to be replaced to realize the following of the catheter and exchange of guide wires.
(2) The cost is saved. The double-layer elbow micro-catheter utilizes one catheter, simultaneously realizes two functions of assisting in puncturing a real cavity and enabling the catheter to follow a guide wire to enter the real cavity, does not need to reuse another micro-catheter, and saves operation cost.
Claims (6)
1. A double-elbow microcatheter for use in arterial chronic occlusive lesion interventions, comprising:
the tail end of the outer layer micro catheter (1) is provided with a rotary locking mechanism (2) for realizing rotation and locking; the rod part of the outer layer micro catheter (1) is an integral pipe fitting, the inner part of the outer layer micro catheter (1) is made of polytetrafluoroethylene, the outer part of the outer layer micro catheter is made of stainless steel meshes in a weaving mode, and the outer surface of the integral rod part of the outer layer micro catheter is a hydrophilic coating;
the inner layer micro catheter (3) penetrates through the outer layer micro catheter (1), and the length of the inner layer micro catheter (3) is greater than that of the outer layer micro catheter (1); the rod part of the inner layer micro catheter (3) is an integral pipe fitting, the inner part of the inner layer micro catheter (3) is made of polytetrafluoroethylene, the outer part of the head end of the inner layer micro catheter (3) is woven by stainless steel meshes, and the outer surface of the rod part head end of the inner layer micro catheter is provided with a hydrophilic coating;
an axial movement structure (4) for realizing the axial advance or retreat of the outer layer micro catheter (1) and the inner layer micro catheter (3) is arranged between the outer layer micro catheter (1) and the inner layer micro catheter (3);
when the inner-layer micro-catheter and the outer-layer micro-catheter need to be fixed, the inner-layer micro-catheter is locked through the rotary locking mechanism, when the inner-layer micro-catheter needs to extend out of the outer-layer micro-catheter, the rotary locking mechanism is unscrewed to enable the inner-layer micro-catheter to extend out through the axial movement structure, and the head end of the inner-layer micro-catheter naturally bends into an elbow after the inner-layer micro-catheter extends out of the outer-layer micro-catheter;
the head end of the inner layer micro catheter (3) is provided with an elbow (5) which can be automatically straightened in the outer layer micro catheter (1); the head end of the double-layer elbow micro-catheter can realize bending deformation integrally.
2. The double-elbow microcatheter for arterial chronic occlusive lesion interventional procedures of claim 1, wherein: the tail end of the inner layer micro-catheter (3) is provided with a flaring structure (6).
3. The double-elbow microcatheter for arterial chronic occlusive lesion interventional procedures of claim 1, wherein: the rotary locking mechanism (2) is a rotary fixed handle.
4. The double-elbow microcatheter for arterial chronic occlusive lesion interventional procedures of claim 1, wherein: axial motion structure (4) including setting up sand grip (7) on outer little pipe tail end inner chamber wall and setting up recess (8) on the outer wall of inlayer little pipe tail end, sand grip (7) and recess (8) correspond the cooperation setting.
5. The double-elbow microcatheter for arterial chronic occlusive lesion interventional procedures of claim 4, wherein: the axial length of the groove (8) is greater than that of the convex strip (7).
6. The double-elbow microcatheter for arterial chronic occlusive lesion interventional procedures of claim 1, wherein: the head end of the outer layer micro-catheter (1) is provided with a light-tight L-shaped mark (9).
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| CN201710708882.0A CN107684657B (en) | 2017-08-17 | 2017-08-17 | Double-layer elbow micro catheter for artery chronic occlusion lesion interventional operation |
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| CN201710708882.0A CN107684657B (en) | 2017-08-17 | 2017-08-17 | Double-layer elbow micro catheter for artery chronic occlusion lesion interventional operation |
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| CN107684657B true CN107684657B (en) | 2020-09-01 |
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| CN110237402B (en) * | 2019-05-22 | 2021-10-08 | 中国人民解放军陆军军医大学第一附属医院 | Guide wire capable of forming loop |
| CN111643228B (en) * | 2020-08-04 | 2020-12-11 | 上海申淇医疗科技有限公司 | Conveying system for mitral valve repair |
| CN114849016B (en) * | 2022-05-20 | 2023-10-24 | 南京吉米医疗科技有限公司 | Variable vascular microcatheter and method of use |
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| CN104168846A (en) * | 2012-02-10 | 2014-11-26 | Dolor科技有限公司 | System and apparatus for facilitating intranasal treatment of a patient |
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