CN114305673B - Microwave ablation catheter and device for portal vein cancer embolism - Google Patents
Microwave ablation catheter and device for portal vein cancer embolism Download PDFInfo
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- CN114305673B CN114305673B CN202111593999.1A CN202111593999A CN114305673B CN 114305673 B CN114305673 B CN 114305673B CN 202111593999 A CN202111593999 A CN 202111593999A CN 114305673 B CN114305673 B CN 114305673B
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- ablation catheter
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- 208000005189 Embolism Diseases 0.000 title claims abstract description 21
- 230000005855 radiation Effects 0.000 claims abstract description 20
- 239000004020 conductor Substances 0.000 claims abstract description 17
- 239000004696 Poly ether ether ketone Substances 0.000 claims description 5
- 239000000463 material Substances 0.000 claims description 5
- 229920002530 polyetherether ketone Polymers 0.000 claims description 5
- 239000011810 insulating material Substances 0.000 claims description 4
- 230000001681 protective effect Effects 0.000 claims description 4
- JUPQTSLXMOCDHR-UHFFFAOYSA-N benzene-1,4-diol;bis(4-fluorophenyl)methanone Chemical compound OC1=CC=C(O)C=C1.C1=CC(F)=CC=C1C(=O)C1=CC=C(F)C=C1 JUPQTSLXMOCDHR-UHFFFAOYSA-N 0.000 claims 1
- 210000003462 vein Anatomy 0.000 abstract description 8
- 238000007674 radiofrequency ablation Methods 0.000 description 8
- 201000007270 liver cancer Diseases 0.000 description 7
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- 201000009454 Portal vein thrombosis Diseases 0.000 description 1
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- 208000007232 portal hypertension Diseases 0.000 description 1
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Abstract
The invention provides a portal vein cancer embolus microwave ablation catheter which comprises a flexible catheter body, and an axially parallel coaxial cable and a guide wire guide tube which are arranged in the flexible catheter body, wherein the coaxial cable consists of a coaxial cable inner conductor, a coaxial cable insulating layer and a coaxial cable outer conductor from inside to outside; the far end of the coaxial cable is connected with a microwave radiation head. The catheter has small diameter, can meet the requirement of internal vein passing, can accurately reach the cancer plug part of the portal vein for ablation through the guide wire, and can effectively open the portal vein.
Description
Technical Field
The invention relates to the technical field of medical appliances, in particular to a portal vein cancer embolus microwave ablation catheter and a portal vein cancer embolus microwave ablation device.
Background
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide, with about 35-50% of liver cancer patients also presenting with portal vein thrombosis (PVTT), leading to serious negative prognostic factors and high risk of recurrence due to an increased risk of tumor spread into the blood. Current research regards PVTT as a complex anatomical and clinical condition, including a wide range of patients with different prognosis and new treatment possibilities and resistance to anti-tumor treatment, depending on the extent of involvement of the portal system, tumor biological invasiveness, complications caused by portal hypertension, clinical characteristics of the patients.
It is reported that the median survival time of patients with liver cancer combined with portal cancer embolism is only between 2.7 and 4 months without treatment, but the survival time is also variable from 5 months to 5 years, and the situation is extremely variable. In recent years, diagnosis and treatment of liver cancer complicated with portal vein cancer embolism are continuously progressed, but how to further improve prognosis of liver cancer complicated with portal vein cancer embolism patients, especially middle and late stage liver cancer patients, still has a lot of challenges.
The minimally invasive treatment is a major trend of treating liver cancer combined portal vein cancer suppositories, and the minimally invasive ablation treatment of the liver cancer combined portal vein cancer suppositories has the advantages of small trauma, definite curative effect, accurate positioning, good selectivity and the like. The minimally invasive treatment means commonly used in clinic are mainly radiofrequency ablation (RFA) and Microwave Coagulation Treatment (MCT). However, microwave Coagulation Therapy (MCT) uses a rigid straight bar microwave needle to ablate the region of the portal cancer plug from outside the portal vein, and cannot function to open the portal. Whereas the radiofrequency ablation (RFA) method requires the placement of the return electrode at the back of the patient, the physician cannot control the flow of high frequency current along the region of the portal cancer plug that needs to be ablated for effective ablation. Although the HAB I B radio frequency ablation catheter which can be clinically used at present can be subjected to conformal ablation, the catheter is suitable for being used in biliary tract and digestive tract cavities, and the influence of radio frequency ablation on heat sedimentation effect is large, so that the catheter is not suitable for being used in blood vessels.
Disclosure of Invention
In order to solve the problems, the invention provides a microwave ablation catheter and a device suitable for a portal vein cancer plug, wherein the diameter of the catheter is small, the catheter can adapt to the requirement of internal vein passing, and the catheter can accurately reach the portal vein cancer plug position for ablation through a guide wire, so that the portal vein can be effectively opened.
In order to achieve the aim of the invention, the invention provides a portal vein cancer embolus microwave ablation catheter which comprises a flexible catheter body, and an axially parallel coaxial cable and a guide wire guide tube which are arranged in the flexible catheter body, wherein the coaxial cable consists of a coaxial cable inner conductor, a coaxial cable insulating layer and a coaxial cable outer conductor from inside to outside; the far end of the coaxial cable is connected with a microwave radiation head.
Preferably, the soft tube body and/or the guide wire guide tube are made of PEEK materials.
Preferably, the distal end of the coaxial cable is connected to the microwave applicator via a coaxial cable inner conductor.
Preferably, the coaxial cable is a semi-rigid coaxial cable.
Preferably, the flexible pipe body is provided with a handle at one end far away from microwave radiation, the handle partially wraps the flexible pipe body, one end of the handle far away from the flexible pipe body is provided with a first outlet and a second outlet, the coaxial cable extends out of the first outlet, and the guide wire guide pipe extends to the second outlet.
Preferably, the first outlet is axially parallel to the coaxial cable.
Preferably, the handle further comprises a protective sleeve wrapped outside the flexible tube body.
Preferably, the microwave applicator extends distally a length greater than the length of the guidewire guide tube.
Preferably, the guidewire guide tube is capable of receiving a guidewire of 0.035 inches or less.
The invention also provides a portal vein cancer embolus microwave ablation device which comprises the microwave ablation catheter and the microwave generator.
Compared with the prior art, the invention has the beneficial effects that:
due to the limitation of the diameter of the coaxial cable, although a guide wire and the coaxial cable are combined together by utilizing a multi-cavity catheter in some prior art, the diameter of the whole catheter is generally more than 2mm, the diameter of the whole catheter is larger, the whole catheter is difficult to pass in a portal vein, particularly a narrow pulmonary vein, and the requirement of microwave ablation treatment of the portal vein cancer embolism cannot be met. The coaxial cable is generally composed of four layers of materials, namely an inner conductor of the coaxial cable, an insulating layer wrapping the inner conductor, a netlike conductor and an insulating sheath at the outermost layer from inside to outside. The invention creatively arranges the guide wire guide tube inside the coaxial cable insulation sheath, greatly reduces the whole tube diameter of the microwave ablation catheter, ensures that the microwave ablation catheter is suitable for passing in a narrow vein to reach the cancer plug area of the portal vein, and provides the realization possibility for precisely ablating and opening the portal vein.
The microwave ablation catheter provided by the invention has at least the following advantages:
(1) The microwave ablation catheter can pass through a narrow vein (such as a pulmonary vein and the like) to reach a portal vein cancer suppository to be ablated, so that the purpose of outwards ablating from the inside of the portal vein is achieved;
(2) The microwave ablation catheter can accommodate a guide wire, and the flexible catheter can accurately reach the area to be ablated and treated under the guidance of the guide wire by using the guide wire for accurate positioning;
(3) The microwave radiation head at the far end of the microwave ablation catheter can effectively ablate cancer tissues inside and outside the portal vein, and the portal vein cancer plug is gradually opened along with the guiding and pushing of the guide wire;
(4) Compared with the external ablation and the radio frequency ablation of the traditional portal vein cancer suppository, the external ablation and the radio frequency ablation of the portal vein cancer suppository do not need to be placed with additional loop electrodes, the ablation site is more accurate and controllable, and the damage to normal tissues can be reduced to the greatest extent.
Drawings
In order to make the objects, technical solutions and advantages of the present invention more apparent, the technical solutions of the present invention will be described in detail below. It will be apparent that the described embodiments are only some, but not all, embodiments of the invention. All other embodiments, based on the examples herein, which are within the scope of the invention as defined by the claims, will be within the scope of the invention as defined by the claims.
FIG. 1 is a schematic view of a microwave ablation catheter according to the present invention;
FIG. 2 is a schematic view of the handle structure of the microwave ablation catheter according to the present invention;
FIG. 3 is a schematic view of a microwave ablation device according to the present invention;
wherein: 1 is a microwave radiation head, 2 is a microwave ablation catheter, 3 is a handle, 4 is a microwave generator, 5 is a guide wire, 6 is a connecting wire, A is a distal end of the microwave ablation catheter, 21 is a flexible tube body, 22 is a guide wire guide tube, 23 is a coaxial cable, 231 is a coaxial cable inner conductor, 232 is a coaxial cable insulating layer, 233 is a coaxial cable outer conductor, 234 is a first guide wire outlet, 31 is a first outlet, 235/32 is a second outlet/second guide wire outlet, 33 is a handle shell, and 34 is a protective sleeve.
Detailed Description
The technical scheme of the present invention will be described below with reference to the accompanying drawings. It will be apparent that the described embodiments are only some, but not all, of the implementations of the present application; and the structures shown in the drawings are merely schematic and do not represent a physical object. It is intended that all other embodiments obtained by those skilled in the art based on these embodiments of the present invention fall within the scope of the present application.
The terms "first" and "second" are used herein for the purpose of explaining an angular or positional relationship only and are not limiting of their absolute positions or sequences, as will be appreciated by those skilled in the art. The term "distal" refers to an end that is remote from the microwave generator or that is closer to the patient when in use; "proximal" refers to an end that is proximal to the microwave generator or relatively distant from the patient in use.
As shown in fig. 1-3, the invention provides a portal vein cancer embolus microwave ablation catheter, which consists of a flexible tube body 21, and an axially parallel coaxial cable 23 and a guide wire guide tube 22 which are arranged inside the flexible tube body 21, wherein the coaxial cable 23 consists of a coaxial cable inner conductor 231, a coaxial cable insulating layer 232 and a coaxial cable outer conductor 233 from inside to outside; the far end of the coaxial cable 23 is connected with a microwave radiation head 1. The guide wire guide tube 22 is used for accommodating guide wires, the coaxial cable 23 is used for receiving microwave power of the microwave generator and transmitting the microwave power to the microwave radiation head 1, the microwave radiation head 1 is used for carrying out microwave radiation to realize microwave ablation, the flexible tube body 21 wraps the coaxial cable 23, the guide wire guide tube 22 and the microwave radiation head 1 to form a flexible microwave ablation tube with small tube diameter, so that the microwave ablation tube can conveniently pass through the inside of a vein to reach the inside of a portal vein, and the ablation inside the portal vein cancer plug can be completed. The microwave ablation catheter can be provided with a plurality of developing marks for tracking, and can also be marked in other marking modes.
In the invention, the flexible tube 21 is easy to bend, and can meet the requirement of passing in a non-linear vein, so that the microwave ablation catheter can smoothly reach the portal vein cancer thrombus position through the guide of the guide wire, thereby avoiding damaging the vein of a patient, and avoiding damaging normal cells of the patient through superfluous puncture. In the present invention, the flexible pipe body 21 is typically made of an insulating material; in some embodiments of the present invention, flexible tubular body 21 is made of a PEEK (polyetheretherketone) material.
In the present invention, the guide wire guiding tube 22 mainly provides a space for the guide wire, axially penetrates through the inside of the flexible tube body 21, is provided with a first guide wire outlet 234 at the distal end, is provided with a second guide wire outlet 235 at the proximal end, and the guide wire 5 enters and exits the guide wire guiding tube 22 through the first guide wire outlet 234 and the second guide wire outlet 235. Preferably, the distal end of the first guide wire outlet 234 extends to a shorter length than the microwave radiation head, so that the microwave radiation head can deeply ablate at the cancer plug position of the portal vein until gradually deeply opening the portal vein. In order to control the tube diameter of the microwave ablation catheter of the present invention, the guidewire guide tube 22 is preferably sized to accommodate an inner diameter of a guidewire of 0.035 inches or less. In the present invention, the guide wire guide tube 22 is preferably made of an insulating material; in some embodiments of the present invention, the guidewire guide tube 22 is made of a PEEK material.
In the present invention, the coaxial cable 23 is preferably a semi-rigid coaxial cable. The coaxial cable 23 is connected with a microwave radiation head 1 at the far end, and the microwave radiation head 1 is also parallel to the axis of the guide wire guide tube; in some embodiments of the present invention, the distal end of the coaxial cable is connected to the proximal end of the microwave applicator 1 by a coaxial cable inner conductor 231; preferably, the connection between the coaxial cable inner conductor 231 and the microwave radiation head 1 is partially exposed.
In the present invention, microwaves are radiated to surrounding tissues through the microwave radiation head 1, water molecules in the surrounding tissues are moved at a high speed by a microwave magnetic field, and the tissues are heated by molecular friction to solidify, dehydrate and necrotize. The tumor tissue ablated by the microwaves can be absorbed by the matrix, so as to achieve the aim of treating the portal vein cancer suppository. In the present invention, the microwave applicator 1 is preferably cylindrical in shape so as to be able to pass through the portal vein rapidly.
Preferably, the microwave ablation catheter further comprises a handle 3. The handle 3 can be arranged at the end part of the microwave ablation catheter, such as the proximal end of the flexible tube body, so that the handle is convenient to hold; the handle 3 may also be disposed at a non-end portion of the microwave ablation catheter, such as a connection as a segmented microwave ablation catheter, a section fixedly attached to the microwave ablation catheter, or a position-adjustable arrangement on the microwave ablation catheter. In some embodiments of the invention, the handle 3 is disposed at the distal end of the flexible tube 21, the handle 3 partially encloses the flexible tube 21, the end of the handle 3 remote from the flexible tube 21 is provided with a first outlet 31 and a second outlet 32, the coaxial cable 23 and the guidewire guide tube 22 are separated inside the handle, the coaxial cable 23 extends beyond the first outlet 31, and the guidewire guide tube 22 extends to the second outlet 32. Preferably, the first outlet 31 is axially parallel to the coaxial cable 23. Preferably, the handle 3 further comprises a protective sleeve 34 wrapped around the flexible tube 21.
The invention also provides a portal vein cancer embolus microwave ablation device which comprises the microwave ablation catheter and the microwave generator 4. Microwave generator functions known in the art can be used in the present invention. In the present invention, the microwave ablation catheter and the microwave generator may be directly connected, or may be connected through a section of connecting wire 6, or may be connected through other switching or connecting structures. The structure of the connecting wire 6 may be the same as that of the microwave ablation catheter according to the present invention, or may be different (e.g., a conventional coaxial cable is used as the connecting wire). In some embodiments of the invention, the connecting wire 6 is connected to a coaxial cable extending from the first outlet 31 on the handle.
The microwave generator is a source of ablative microwave energy. The microwave generator generally uses a solid state microwave oscillator and a power amplifier to generate 2.45GHz microwaves. In some embodiments of the invention, the microwave generator may further comprise a power controller for controlling the microwave output at different levels, e.g. 30W, 50W, 70W and 90W. The power level is used depending on the size of the object to be ablated. In some embodiments of the invention, the microwave generator may further comprise a timer for displaying the ablation time. In some embodiments of the invention, the microwave generator may further comprise a front panel provided with a plurality of windows for monitoring the operation of the system, such as timers, temperature sensors, power monitoring sounds, power display windows.
In some embodiments of the present invention, the microwave generator may further comprise a temperature sensor for monitoring the temperature of the ablation catheter body during an ablation procedure. Further preferably, a digital display window may be provided to display the real-time ablation catheter temperature, and a temperature knob may be provided to set an upper temperature limit. Once the temperature of the ablation catheter reaches the limit temperature, an alarm sound sounds, and microwave emission is terminated; the limit temperature may preferably be set, for example, to 40 degrees celsius. In some embodiments of the invention, the microwave generator may further comprise a temperature control device, the temperature control device being used to modify the limit temperature.
The microwave ablation catheter of the present invention is connected to a microwave generator prior to use. After confirming the part needing microwave ablation, the guide wire 5 is guided into the cancer plug in the portal vein through puncture, and the guide wire passes through the guide wire guiding tube, so that the microwave ablation catheter enters the vein of a patient along the guide wire 5 until reaching the part needing ablation of the portal vein. The microwave generator is powered on, microwaves are radiated to surrounding tissues through the microwave radiation head 1, a high-temperature ablation area is ablated at a target position, and the microwave ablation catheter is moved back and forth to form a longer-distance ablation area, so that the therapeutic effect of opening the portal vein is achieved. If the ablation area is required to be large, the guide wire can be moved to reposition and then the steps are performed.
In one embodiment of the invention, the microwave ablation catheter use procedure includes: (i) Accessing the correct PV through the 18G needle using real-time ultrasound guidance; contrast injection shows a portal map "above" the cancer plug, showing the "upper" boundary of the PV cancer plug; (ii) A 0.035 inch diameter guide wire was introduced through the thrombus into the Superior Mesenteric Vein (SMV) using a 5Fr guide catheter and portal angiography was performed "under" the thrombus, recording the PV cancer thrombus "lower" boundary. The microwave ablation catheter was introduced through a 0.035 inch diameter wire to a location between the upper and lower boundaries and ablation was achieved by power activation. The microwave ablation catheter may be repositioned within the upper and lower boundaries to form a more cylindrical ablation zone.
The foregoing is merely a preferred embodiment of the present invention and it should be noted that modifications and adaptations to those skilled in the art may be made without departing from the principles of the present invention, which are intended to be comprehended within the scope of the present invention.
Claims (8)
1. The microwave ablation catheter for the portal vein cancer embolus is characterized by comprising a flexible tube body, and an axially parallel coaxial cable and a guide wire guide tube which are arranged in the flexible tube body, wherein the coaxial cable comprises a coaxial cable inner conductor, a coaxial cable insulating layer and a coaxial cable outer conductor from inside to outside; the far end of the coaxial cable is connected with a microwave radiation head;
the guide wire guide tube is made of an insulating material;
the soft pipe body is made of insulating materials;
the end, far away from the microwave radiation, of the flexible pipe body is provided with a handle, the handle wraps the flexible pipe body, the coaxial cable and the guide wire guide pipe are separated in the handle, the end, far away from the flexible pipe body, of the handle is provided with a first outlet and a second outlet, the coaxial cable extends out of the first outlet, and the guide wire guide pipe extends to the second outlet; the first outlet is axially parallel to the coaxial cable.
2. The portal vein cancer embolus microwave ablation catheter of claim 1, wherein the flexible tube and/or guide wire guide tube is made of PEEK material.
3. The portal vein cancer embolus microwave ablation catheter of claim 1, wherein the distal end of the coaxial cable is connected to a microwave applicator by a coaxial cable inner conductor.
4. The portal vein cancer embolus microwave ablation catheter of claim 3, wherein the coaxial cable is a semi-rigid coaxial cable.
5. The portal vein cancer embolus microwave ablation catheter of claim 1, wherein the handle further comprises a protective sheath wrapped around the flexible tube body.
6. The portal vein cancer embolus microwave ablation catheter of claim 1, wherein the microwave radiation head extends distally longer than the guidewire guide catheter.
7. The portal vein cancer embolus microwave ablation catheter according to claim 1 or 6, wherein said guidewire guide tube is capable of receiving a guidewire of 0.035 inches or less.
8. A portal vein cancer embolus microwave ablation device comprising the microwave ablation catheter of any of claims 1-7, and a microwave generator.
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| Application Number | Priority Date | Filing Date | Title |
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| CN202111593999.1A CN114305673B (en) | 2021-12-23 | 2021-12-23 | Microwave ablation catheter and device for portal vein cancer embolism |
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| Application Number | Priority Date | Filing Date | Title |
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| CN202111593999.1A CN114305673B (en) | 2021-12-23 | 2021-12-23 | Microwave ablation catheter and device for portal vein cancer embolism |
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| CN114305673A CN114305673A (en) | 2022-04-12 |
| CN114305673B true CN114305673B (en) | 2024-03-22 |
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| GB2573823A (en) * | 2018-05-19 | 2019-11-20 | Creo Medical Ltd | Electrosurgical ablation instrument |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| US5971983A (en) * | 1997-05-09 | 1999-10-26 | The Regents Of The University Of California | Tissue ablation device and method of use |
| CN104523333A (en) * | 2015-01-28 | 2015-04-22 | 张洪义 | Microwave ablation antenna for ablation therapy of cancer embolus and obstruction and manufacturing method of microwave ablation antenna |
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| CN110063789A (en) * | 2019-05-31 | 2019-07-30 | 南京康友医疗科技有限公司 | Microwave ablation device |
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| CN114305673A (en) | 2022-04-12 |
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