CN115998419A - Composite intelligent catheter and method for laser intervention ablation operation - Google Patents

Abstract

The invention discloses a compound intelligent catheter and a method for laser intervention ablation operation, which adopt a multi-layer structure all-fiber array arrangement design and are used for real-time ablation, imaging, thermal chromatography and multi-mode physical field intelligent treatment of plaque component identification. The catheter comprises a catheter head end tube, an in-vivo catheter, a fixed seat, a catheter seat, a guide wire, an in-vitro catheter, an optical fiber and an optical fiber plug. The circular aperture in the centremost part of the catheter is the guide wire aperture, allowing the catheter to flexibly pass through the guide wire. The circular aperture periphery in the center of the catheter is designed with annular apertures for physiological saline injection, allowing for the injection of physiological saline. The catheter design can realize real-time synchronous imaging of tissue structure and thermal chromatography temperature field in the laser ablation process, and simultaneously determine plaque category, so that intravascular imaging and intravascular treatment are combined better.

Description

Composite intelligent catheter and method for laser intervention ablation operation

Technical Field

The invention relates to the field of medical instruments, in particular to a composite intelligent catheter and a method for laser intervention ablation operation.

Background

Atherosclerosis is a common arterial vascular disease, which can cause the reduction of arterial elasticity and the narrowing of arterial lumen, and further cause ischemia of local tissues, myocardial infarction, apoplexy, angina pectoris and the like, and is one of the main causes of heart diseases and cerebrovascular diseases. The safe operation of atherosclerosis can avoid slow blood flow and thrombus, which is the basic guarantee of the personal safety of patients.

The atheromatous plaque diagnosis and treatment scheme mainly comprises ultrasonic ablation, radio frequency ablation, rotational atherectomy and the like. However, these treatments have certain limitations. The radio frequency ablation technology can raise the local temperature in the focus to (60-100) deg.C in a short time, and if the radio frequency energy is not accurately applied, the linear damage to the blood vessel can be caused. The disadvantage of ultrasound ablation is that it is not suitable for myoma with abundant blood supply, oversized blood vessel, ligament-broad myoma, cervical local myoma. Plaque tissue that may be resected during the course of treatment, rotational atherectomy, may flush distally along the blood stream, resulting in occlusion of the arterioles distally, ischemia. Because plaque thrombus is accumulated to block the blood vessel, the balloon is required to enter the blood vessel to expand the lumen for clinical treatment, so that the vascular stent is placed, and the aim of dredging blood flow is fulfilled. Plaque thrombus within the blood vessel is still present and is not completely eliminated. In addition, these techniques fail to obtain information on the location, size, and composition of plaque within the vessel, and have certain clinical complications.

Laser interventional ablation procedures are currently a typical ablation protocol for the treatment of intravascular plaque and thrombosis for the removal of coronary atherosclerotic plaque and to facilitate stent delivery, especially in severely calcified vessels. The laser ablation technology can eliminate thrombus plaque and achieve the most fundamental treatment purpose. However, in order to avoid the damage of the laser to the vessel wall and accurately act on the thrombus plaque, a laser three-dimensional targeting ablation process, a biological tissue structure, a thermal chromatography and acoustic signal multi-mode integrated catheter are needed, and the laser conformal accurate diagnosis and treatment of the intravascular diseases are facilitated. There is currently no catheter or similar product that incorporates intravascular imaging, laser ablation, thermal tomography, acoustic plaque identification.

Disclosure of Invention

The invention mainly aims to overcome the defects and the shortcomings of the prior art and provides a composite intelligent catheter and a method for laser intervention ablation operation. The invention integrates optical coherence tomography, laser ablation, thermal chromatography and acoustic sensing multimode optical fibers in a blood vessel, and performs real-time imaging, ablation, thermal chromatography and plaque identification treatment on thrombus plaque in the blood vessel.

In order to achieve the aim of the invention, the invention adopts the following technical scheme:

the utility model provides a be used for laser to intervene compound intelligent pipe of ablation operation, includes pipe head end pipe, internal pipe, fixing base, pipe seat, seal wire, external pipe, optic fibre and fiber plug, its characterized in that: the central part of the catheter head end tube is designed into a circular aperture, which allows the catheter to flexibly pass through the guide wire to reach a specific position of a lesion; annular holes are designed on the periphery of the circular aperture in the center of the catheter head end tube and serve as injection holes for physiological saline; the periphery of the catheter head end tube is sequentially arranged in an adjacent concentric circle array by a plurality of optical fibers used for optical coherence tomography, laser ablation, thermal chromatography and acoustic sensing; the outer side of the catheter wall is coated with a polyvinylpyrrolidone hydrophilic coating, so that the blood compatibility of the catheter is improved; a guide wire aperture and a physiological saline injection aperture are reserved at the lumen part of the catheter; the catheter fiber plug connects the optical fiber of intravascular optical coherence tomography to imaging equipment, the optical fiber of laser ablation is connected to an excimer laser, the thermal chromatography and acoustic sensing optical fiber is connected to a multiparameter optical fiber demodulation system, and the catheter is designed to be of an all-fiber array type with a multilayer structure, so that plaque in the blood vessel is imaged, ablated, thermally chromatographed and identified in real time.

The composite intelligent catheter is characterized in that all optical fibers in the catheter are arranged in an array mode, optical fibers used for optical coherence tomography, laser ablation, thermal chromatography and acoustic sensing are arranged in an array mode in adjacent concentric circles in sequence, multi-mode physical field composite information of intravascular tissues is collected, multi-azimuth and multi-angle sectional images of the intravascular tissues can be obtained, and the laser ablation optical fibers accurately and rapidly act on intravascular lesion tissues.

The composite intelligent catheter is hollow, and the central part of the head end pipe of the catheter is designed into a circular aperture, so that the catheter can flexibly pass through a guide wire to reach a specific position of a lesion; the circular aperture periphery in the center of the catheter head end tube is provided with an annular aperture for injecting physiological saline, and the physiological saline is allowed to be injected. The composite intelligent catheter of claim 1, wherein: the polyvinylpyrrolidone hydrophilic coating is coated on the outer side of the catheter wall and is used for improving the biocompatibility of the catheter, reducing the friction force in the conveying process and improving the operability of the catheter.

The composite intelligent catheter is characterized in that optical fibers used for optical coherence tomography, laser ablation, thermal chromatography and acoustic sensing are adopted, the intravascular optical coherence imaging optical fibers are microsphere type all-fiber lens single-mode optical fibers, intravascular high-resolution imaging is realized, and the treatment angle of the catheter is adjusted according to intravascular images; the laser ablation optical fiber is 355nm wavelength optical fiber, and the laser light source with 355nm wavelength is used for ablating the atherosclerosis calcified plaque, and the short pulse duration is less than 10ns, so that the laser ablation optical fiber generally has higher peak power, and achieves deeper treatment depth and low treatment boundary error; the thermal chromatography optical fiber has the temperature measurement resolution superior to 0.1 ℃ and the temperature control precision of +0.5 ℃ and is used for acquiring the time-space information of the intravascular temperature field in the ablation process, so that the ablation safety is ensured; the acoustic sensing optical fiber is used for identifying plaque components under the ablation acoustic signal, and adjusting the energy and pulse width of laser ablation in real time to achieve the optimal treatment result; the diameter of the fiber core in the catheter is 50-125 mu m, the number of the optical fibers is 10-40, and the number of the optical fibers is adjusted according to specific clinical conditions to prepare the close-packed intelligent catheter with the diameter of 2mm.6. A composite intelligent catheter according to claim 3, wherein: saline eliminates blood interference for optical coherence tomography and also helps to protect the vessel wall during laser ablation.

The control method for the composite intelligent catheter for the laser interventional ablation operation comprises the steps that a guide wire (3) is inserted through a catheter seat (4), the guide wire (3) guides and supports an in-vivo catheter (6) to be pushed into a blood vessel, the in-vivo catheter (6) and a catheter head end tube (7) are slowly pushed into the blood vessel, the catheter head end tube (7) moves to the vicinity of an ablation plaque, physiological saline flows out through a physiological saline injection port (13), and damage of laser ablation to the wall of the blood vessel is reduced; the laser emits pulse laser to ablate the plaque through an optical fiber (11) ablated by the laser via an optical fiber plug (1), the morphology of the plaque is observed by adopting an optical coherence imaging optical fiber (9), and a proper ablation position is selected; in the ablation process, a thermal chromatography optical fiber (8) is adopted to measure an ablation temperature field, the energy and the power of laser are adjusted in real time, the ablation effect is optimized, meanwhile, an acoustic sensing optical fiber (10) receives an acoustic signal in the ablation process, the type of plaque is judged in real time, and the energy and the pulse width of ablation laser are adjusted for different types of plaque, so that conformal accurate ablation is achieved; the thermal chromatography optical fiber (8), the optical coherence imaging optical fiber (9) and the acoustic sensing optical fiber (10) are all used for transmitting signals from the optical fiber plug (1).

By adopting the technical scheme, the invention has the following advantages:

first aspect: the multi-layer structure all-fiber array type arrangement design of the composite intelligent catheter for the laser intervention ablation operation reduces the size of the catheter so that intravascular imaging, laser ablation, thermal chromatography and acoustic plaque identification treatment are cooperatively carried out, and the safety and accuracy of laser ablation are obviously improved;

second aspect: the physiological saline injection aperture is arranged in the catheter, so that the physiological saline is injected at any time, imaging is further facilitated, and meanwhile, the vascular wall is also protected during laser ablation;

third aspect: optical fibers used by a plurality of optical coherence tomography images, laser ablation, thermal chromatography and acoustic sensing in the catheter are arranged in an array manner in adjacent concentric circles in sequence, and multiple physical field information such as sound, light, electricity, heat and the like of tissues in the blood vessel is collected, so that the three-dimensional targeted ablation process of the laser in the blood vessel, the biological tissue structure and the multi-mode integrated cooperative treatment of the thermal chromatography are realized;

fourth aspect: the hydrophilic polyvinylpyrrolidone coating is coated on the outer side of the catheter wall, so that the biocompatibility of the catheter is improved;

drawings

In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings that are needed in the description of the embodiments or the prior art will be briefly described, and it is obvious that the drawings in the description below are some embodiments of the present invention, and other drawings can be obtained according to the drawings without inventive effort for a person skilled in the art.

FIG. 1 is a schematic illustration of a laser intervention ablation procedure composite intelligent catheter structure;

FIG. 2 is an interior view of a laser interventional ablation procedure composite intelligent catheter head tube;

reference numerals in the drawings: 1. 2, an external catheter, 3, a guide wire, 4, a catheter seat, 5, a fixed seat, 6, an internal catheter, 7 and a catheter head end tube; 8. the device comprises a thermal chromatography optical fiber, 9, an OCT optical fiber, 10, an acoustic sensing optical fiber, 11, an ablation optical fiber, 12, a central hole of a catheter head end tube, 13, a physiological saline injection port, 14 and a catheter head end tube cross section;

Detailed Description

For the purpose of making the objects, technical solutions and advantages of the embodiments of the present invention more apparent, the technical solutions of the present invention will be clearly and completely described below with reference to the accompanying drawings, and it is apparent that the described embodiments are some embodiments of the present invention, but not all embodiments. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.

Referring to fig. 1-2, a composite intelligent catheter for laser interventional ablation surgery adopts a multi-layer structure all-fiber array arrangement design. Comprises a catheter head end tube 7, an in-vivo catheter 6, a fixed seat 5, a catheter seat 4, a guide wire 3, an in-vitro catheter 2, an optical fiber and an optical fiber plug 1.

The central bore 12 of the catheter head tube is a guide wire bore for flexible passage of the guide wire 3, the guide wire 3 guiding and supporting advancement of the catheter in the blood vessel. The circular hole periphery in the center of the catheter is designed with annular holes as physiological saline injection ports 13, allowing injection of physiological saline. The optical fibers used by a plurality of optical coherence tomography, laser ablation, thermal chromatography and acoustic sensing are arranged in the tube in an array manner in adjacent concentric circles in sequence. The hydrophilic polyvinylpyrrolidone coating is coated on the outer side of the catheter wall, so that the blood compatibility of the catheter in the body is improved. The optical coherence tomography optical fiber is connected to the imaging equipment, the laser ablated optical fiber is connected to the excimer laser, and the thermal chromatography and acoustic sensing optical fiber is connected to the multiparameter optical fiber demodulation system; the internal structure of the intracorporal catheter 6 is the same as that of the head end tube 7.

The first embodiment is as follows:

a central bore (12) of a catheter head tube (14) is used to pass through the guide wire 3 to reach the lesion. The external hole of the central hole 12 of the catheter tube head end is a physiological saline injection opening 13, and the injection time and the injection speed of the physiological saline are controlled, so that the possibility of damage to the wall of the blood vessel can be effectively reduced. The diameter of the whole in-vivo catheter 2 is controlled to be 2.0mm, and the imaging and laser ablation can be smoothly carried out through the vessel cavity of the aorta in the vessel.

The second embodiment is as follows:

the intravascular optical coherence imaging optical fiber (9) used in the catheter head end tube (14) is microsphere type all-fiber lens single-mode optical fiber, so that intravascular high-resolution imaging is realized, and the treatment angle of the catheter is adjusted according to intravascular images. The laser-ablated optical fiber (11) is 355nm wavelength optical fiber, and the laser source with 355nm wavelength is used for ablating the atherosclerosis calcified plaque. The temperature measurement resolution of the thermal chromatography optical fiber (8) is better than 0.1 ℃, the temperature control precision is +0.5 ℃, and the thermal chromatography optical fiber is used for acquiring the time-space information of the intravascular temperature field in the ablation process, so that the ablation safety is ensured. And the acoustic sensing optical fiber (10) is used for identifying plaque components under the ablation acoustic signal, and adjusting the energy and pulse width of laser ablation in real time to achieve the optimal treatment result. The diameter of the fiber core of the whole catheter is 50-125 mu m, the number of the optical fibers is 10-40, and the number of the optical fibers is adjusted according to specific clinical conditions to customize the compact-stacking intelligent catheter with the diameter of 2mm.

And a third specific embodiment:

based on the second embodiment, the optical fibers in the catheter are arranged concentrically around the lumen, using epoxy as a filler material, to provide efficient and reliable energy transmission. The intravascular optical coherence imaging optical fibers (9) and the acoustic sensing optical fibers (10) are arranged in a mirror image opposite mode along the central axis of the catheter head end tube (14), the two groups of thermal chromatography optical fibers (8) are arranged in a mirror image opposite mode along the catheter head end tube (14), the diameters of the imaging optical fibers (9) and the acoustic sensing optical fibers (10) are perpendicular to the diameters of the two groups of thermal chromatography optical fibers (8), and the rest of the space is concentrically arranged around the lumen by using laser-ablated optical fibers (11) to form the close-packed intelligent catheter.

The specific embodiment IV is as follows:

the laser intervention ablation operation composite intelligent catheter adopts a multi-layer structure all-fiber array arrangement design. The catheter comprises a catheter head end tube (7), an in-vivo catheter (6), a fixed seat (5), a catheter seat (4), a guide wire (3), an in-vitro catheter (2) and an optical fiber plug (1) which are connected. The circular aperture in the centremost part of the catheter is the guide wire aperture, allowing the catheter to flexibly pass through the guide wire.

Fifth embodiment:

based on the fourth embodiment, in operation, the guide wire (3) is inserted through the guide tube seat (4), the guide wire (3) guides and supports the in-vivo guide tube (6) to be pushed into the blood vessel, the in-vivo guide tube (6) and the guide tube head end tube (7) are slowly pushed into the blood vessel, the guide tube head end tube (7) moves to the vicinity of an ablation plaque, physiological saline flows out through the physiological saline injection opening (13), and damage of laser ablation to the blood vessel wall is reduced. The laser emits pulse laser to ablate the plaque through an optical fiber (11) ablated by the laser via an optical fiber plug (1), the morphology of the plaque is observed by adopting an optical coherence imaging optical fiber (9), and a proper ablation position is selected. In the ablation process, a thermal chromatography optical fiber (8) is adopted to measure the temperature field of ablation, the energy and the power of laser are adjusted in real time, the ablation effect is optimized, meanwhile, an acoustic sensing optical fiber (10) receives an acoustic signal of the ablation process, the type of plaque is judged in real time, and the energy and the pulse width of the ablation laser are adjusted for different types of plaque, so that the conformal precise ablation is achieved. The thermal chromatography optical fiber (8), the optical coherence imaging optical fiber (9) and the acoustic sensing optical fiber (10) are all used for transmitting signals from the optical fiber plug (1).

It will be understood that modifications and variations will be apparent to those skilled in the art from the foregoing description, and it is intended that all such modifications and variations be included within the scope of the following claims.

Claims (6)

1. A compound intelligent pipe for laser intervention ablation operation which characterized in that: including pipe head end pipe, internal pipe, fixing base, pipe seat, seal wire, external pipe, optic fibre and fiber plug, its characterized in that: the central part of the catheter head end tube is designed into a circular aperture, which allows the catheter to flexibly pass through the guide wire to reach a specific position of a lesion; annular holes are designed on the periphery of the circular aperture in the center of the catheter head end tube and serve as injection holes for physiological saline; the periphery of the catheter head end tube is sequentially arranged in an adjacent concentric circle array by a plurality of optical fibers used for optical coherence tomography, laser ablation, thermal chromatography and acoustic sensing; the outer side of the catheter wall is coated with a polyvinylpyrrolidone hydrophilic coating, so that the blood compatibility of the catheter is improved; a guide wire aperture and a physiological saline injection aperture are reserved at the lumen part of the catheter; the catheter fiber plug connects the optical fiber of intravascular optical coherence tomography to imaging equipment, the optical fiber of laser ablation is connected to an excimer laser, the thermal chromatography and acoustic sensing optical fiber is connected to a multiparameter optical fiber demodulation system, and the catheter is designed to be of an all-fiber array type with a multilayer structure, so that plaque in the blood vessel is imaged, ablated, thermally chromatographed and identified in real time.

2. The composite intelligent catheter of claim 1, wherein: the optical fibers used for optical coherence tomography, laser ablation, thermal chromatography and acoustic sensing are sequentially arranged in an array manner in adjacent concentric circles, and multi-mode physical field composite information of tissues in the blood vessel is collected, so that multi-azimuth multi-angle sectional images in the blood vessel can be obtained, and the laser ablation optical fibers accurately and rapidly act on pathological tissues in the blood vessel.

3. The composite intelligent catheter of claim 1, wherein: the hollow design in the catheter, the central part of the head end tube of the catheter is designed into a circular aperture, which allows the catheter to flexibly pass through the guide wire to reach the specific position of the lesion; the circular aperture periphery in the center of the catheter head end tube is provided with an annular aperture for injecting physiological saline, and the physiological saline is allowed to be injected. The composite intelligent catheter of claim 1, wherein: the polyvinylpyrrolidone hydrophilic coating is coated on the outer side of the catheter wall and is used for improving the biocompatibility of the catheter, reducing the friction force in the conveying process and improving the operability of the catheter.

4. The composite intelligent catheter of claim 2, wherein: the optical fiber used for optical coherence tomography, laser ablation, thermal chromatography and acoustic sensing is an intravascular optical coherence imaging optical fiber which is a microsphere type all-fiber lens single-mode optical fiber, so that intravascular high-resolution imaging is realized, and the treatment angle of the catheter is adjusted according to the intravascular image; the laser ablation optical fiber is 355nm wavelength optical fiber, and the laser light source with 355nm wavelength is used for ablating the atherosclerosis calcified plaque, and the short pulse duration is less than 10ns, so that the laser ablation optical fiber generally has higher peak power, and achieves deeper treatment depth and low treatment boundary error; the thermal chromatography optical fiber has the temperature measurement resolution superior to 0.1 ℃ and the temperature control precision of +0.5 ℃ and is used for acquiring the time-space information of the intravascular temperature field in the ablation process, so that the ablation safety is ensured; the acoustic sensing optical fiber is used for identifying plaque components under the ablation acoustic signal, and adjusting the energy and pulse width of laser ablation in real time to achieve the optimal treatment result; the diameter of the fiber core in the catheter is 50-125 mu m, the number of the optical fibers is 10-40, and the number of the optical fibers is adjusted according to specific clinical conditions to prepare the close-packed intelligent catheter with the diameter of 2mm.

5. A composite intelligent catheter according to claim 3, wherein: saline eliminates blood interference for optical coherence tomography and also helps to protect the vessel wall during laser ablation.

6. The control method for the composite intelligent catheter for the laser intervention ablation operation is characterized in that a guide wire (3) is inserted through a catheter seat (4), the guide wire (3) guides and supports the in-vivo catheter (6) to be pushed into a blood vessel, the in-vivo catheter (6) and a catheter head end tube (7) are slowly pushed into the blood vessel, the catheter head end tube (7) moves to the vicinity of an ablation plaque, physiological saline flows out through a physiological saline injection port (13), and the damage of laser ablation to the wall of the blood vessel is reduced; the laser emits pulse laser to ablate the plaque through an optical fiber (11) ablated by the laser via an optical fiber plug (1), the morphology of the plaque is observed by adopting an optical coherence imaging optical fiber (9), and a proper ablation position is selected; in the ablation process, a thermal chromatography optical fiber (8) is adopted to measure an ablation temperature field, the energy and the power of laser are adjusted in real time, the ablation effect is optimized, meanwhile, an acoustic sensing optical fiber (10) receives an acoustic signal in the ablation process, the type of plaque is judged in real time, and the energy and the pulse width of ablation laser are adjusted for different types of plaque, so that conformal accurate ablation is achieved; the thermal chromatography optical fiber (8), the optical coherence imaging optical fiber (9) and the acoustic sensing optical fiber (10) are all used for transmitting signals from the optical fiber plug (1).

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