CN116712133A - Method for removing obstruction in inner lumen of human body and ultrasonic intervention removing instrument - Google Patents

Method for removing obstruction in inner lumen of human body and ultrasonic intervention removing instrument Download PDF

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Publication number
CN116712133A
CN116712133A CN202310470135.3A CN202310470135A CN116712133A CN 116712133 A CN116712133 A CN 116712133A CN 202310470135 A CN202310470135 A CN 202310470135A CN 116712133 A CN116712133 A CN 116712133A
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China
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ultrasonic
guide wire
lumen
target
blockage
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Inventor
王成勇
吴茂忠
姚光
赖建华
林健源
刘涛
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Guangdong University of Technology
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Guangdong University of Technology
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Priority to CN202310470135.3A priority Critical patent/CN116712133A/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A61B2017/22014—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A61B2017/22014—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire
    • A61B2017/22015—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire with details of the transmission member
    • A61B2017/22017—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire with details of the transmission member the ultrasonic transmitting members being fibres
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B2017/22027—Features of transducers
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
    • Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
    • Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
    • Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change

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  • Health & Medical Sciences (AREA)
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  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Mechanical Engineering (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
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Abstract

The application provides a method for removing a blockage in a lumen of a human body and an ultrasonic intervention removing instrument, wherein the removing method comprises the steps of obtaining parameter information of a blockage part in a target lumen of the human body; selecting a guide wire with proper length and diameter according to the parameter information; placing the catheter into the lumen and advancing the catheter to the target lumen plug site; placing the end of the guide wire into the guide pipe, and pushing the guide wire to the target cavity plug part to expose the end of the guide pipe; connecting the tail end of the guide wire with an ultrasonic generating device; setting ultrasonic parameters according to the parameter information; the ultrasonic wave generating device is started, ultrasonic energy is conducted to the blockage part of the target cavity through the guide wire, and the blockage of the target cavity is removed. The ultrasonic wave generating device is positioned outside the body, vibration energy excited by an external ultrasonic transducer system is transmitted to focus tissues, namely, the blockage parts, along the curved human body lumen through the slender guide wire, and the focus tissues are used as loads to absorb the energy to generate property change and physical damage, so that the purpose of ablation and removal is achieved.

Description

Method for removing obstruction in inner lumen of human body and ultrasonic intervention removing instrument
Technical Field
The application relates to the technical field of medical treatment, in particular to a method for removing a blockage in a lumen of a human body and an ultrasonic intervention removing instrument.
Background
Intravascular plaque is a lipid substance deposited on the wall of a blood vessel to cause vascular stenosis, and if the plaque is ruptured, secondary thrombus is caused, myocardial infarction, cerebral thrombosis and the like are generally easy to cause, while thrombus is blood coagulation, plaque is fat metabolism disorder, and thrombus is more serious. After the occurrence of vascular plaque or thrombus, a series of adverse effects such as myocardial ischemia, cerebral ischemia and the like can be caused, so that the human health is greatly endangered.
Urinary calculus refers to calculus of urinary system, which is a common urinary system disease and can cause renal colic, ureteral obstruction, renal insufficiency and uremia.
At present, aiming at vascular diseases such as vascular plaque, thrombus and the like, a plurality of treatment methods are provided, such as drug treatment, surgical incision treatment, guide wire and catheter intervention treatment and the like. The existing vascular plaque or thrombus removing methods are easy to cause damage to blood vessels and the like in the treatment process, and a series of complications are caused. For urinary system calculus, the treatment methods include drug calculus removal, extracorporeal shock wave calculus breaking, operation treatment and the like. However, the side effects of the medicine for removing urinary calculus can cause muscle and joint pain and also can cause kidney injury; the extracorporeal shock wave lithotripsy is inaccurate in positioning and low in efficiency, peripheral tissues can be damaged, and the surgical treatment has great harm to human bodies.
Ultrasound is widely used in medical surgery due to its unique properties, high frequency low energy ultrasound can be used for various ultrasound tests, and low frequency high energy can be used for various treatments. At present, an ultrasonic therapeutic apparatus used in a human body is provided with an ultrasonic transducer at the head end of the apparatus, and the ultrasonic transducer is influenced by the diameter of a tube cavity, has small volume and low energy.
Disclosure of Invention
In order to overcome the problems in the related art, the application provides a method for removing the blockage in the inner lumen of a human body and an ultrasonic intervention removing instrument, which are used for transmitting vibration energy excited by an external ultrasonic transducer system to focal tissues, namely the blockage, along a curved human body lumen through an elongated guide wire, wherein the focal tissues are used as loads to absorb the energy to change the properties and physically destroy, so that the purpose of ablation and removal is achieved.
One of the purposes of the application is to provide a method for removing the blockage of the inner lumen of a human body, which comprises the following steps:
acquiring parameter information of a target cavity plug part in a human body;
selecting a guide wire with proper length and diameter according to the parameter information;
placing the catheter into the lumen and advancing the catheter to the target lumen plug site;
placing the end of the guide wire into the guide pipe, and pushing the guide wire to the target cavity plug part to expose the end of the guide pipe;
connecting the tail end of the guide wire with an ultrasonic generating device;
setting ultrasonic parameters according to the parameter information;
the ultrasonic wave generating device is started, ultrasonic energy is conducted to the blockage part of the target cavity through the guide wire, and the blockage of the target cavity is removed.
In a preferred technical scheme of the application, the ultrasonic parameters comprise ultrasonic frequency, ultrasonic amplitude and ultrasonic power;
the range of the ultrasonic frequency is 20-50kHz;
the range of the ultrasonic amplitude is 1-30 mu m;
the range of the ultrasonic power is 1-30W.
In a preferred technical scheme of the application, the length of the guide wire is 10-200cm, and the diameter is 0.1-2mm.
In a preferred technical scheme of the application, the guide wire is a titanium alloy guide wire or a stainless steel guide wire.
In a preferred embodiment of the present application, it is determined whether a thrombus filter is to be placed downstream of the target lumen occlusion site prior to activating the ultrasound generating means.
In a preferred technical scheme of the application, the obtaining the parameter information of the target cavity blockage part in the human body comprises the following steps:
type, position, size, shape, and physicochemical properties of the target lumen plug;
the type of the target cavity obstruction is one of thrombus, plaque and calculus.
In a preferred technical solution of the present application, if the target cavity obstruction is a thrombus, the removing the target cavity obstruction includes:
slowly pushing the guide wire to enable the end of the guide wire to slowly penetrate through the target thrombus to form an ablation channel;
withdrawing the flexible guide wire, increasing ultrasonic power and ultrasonic amplitude, and simultaneously inputting physiological saline into the catheter;
the end of the guide wire is put in place again, the guide wire is pushed slowly, and the thrombus is removed completely step by step.
In a preferred embodiment of the present application, if the target lumen occlusion is a plaque, the removing the target lumen occlusion includes:
pushing the guide wire to enable the head end of the guide wire to be in direct contact with the fibrous cap and the calcified layer of the plaque, and cracking the hard fibrous cap and the calcified layer through ultrasonic action;
drawing the lysed chips out of the body through a catheter;
reducing ultrasonic power and ultrasonic amplitude;
slowly pushing the guide wire to gradually remove the lipid core of the plaque.
In a preferred technical solution of the present application, if the target cavity obstruction is a stone, the removing the target cavity obstruction includes:
pushing the guide wire to enable the head end of the guide wire to be in direct contact with the stone, and enabling cracks to be generated and cracked in the stone through ultrasonic action;
the lysed chips are pumped out of the body through a catheter.
It is a second object of the present application to provide an ultrasonic interventional cleaning device comprising ：
The ultrasonic generator is used for converting the electric energy into a high-frequency alternating current electric signal;
the ultrasonic transducer is connected with the ultrasonic generator and used for converting the high-frequency alternating current signal into ultrasonic vibration energy;
the tail end of the guide wire is connected with an amplitude transformer of the ultrasonic transducer and is used for transmitting ultrasonic vibration energy;
a catheter for placement into the body to form a guidewire channel.
In a preferred technical scheme of the application, the catheter further comprises a suction assembly, wherein the suction assembly is connected with the outer end of the catheter and is used for sucking cracked fragments in the lumen.
In the preferred technical scheme of the application, the device further comprises an injection component, wherein the injection component is connected with the outer end of the catheter and is used for injecting normal saline into the lumen.
In a preferred technical scheme of the application, the guide wire is a titanium alloy guide wire or a stainless steel guide wire.
The beneficial effects of the application are as follows:
vibration energy excited by an in-vitro ultrasonic transducer system is transmitted to focus tissues, namely, the blockage, along a curved human body lumen through an elongated guide wire, and the focus tissues are used as loads to absorb the energy so as to change properties and physically destroy, thereby achieving the purpose of ablation and removal;
the ultrasonic transducer is in vitro, the size of the transducer of the traditional ultrasonic interventional instrument is broken through the limit of the diameter of the lumen, the blockage in the lumen of the human body can be cleared by using higher-power ultrasonic, and the ultrasonic transmission is efficient and has low loss;
in the interventional process and the cleaning process of the instrument, the guide wire is isolated from the lumen through the catheter, the lumen is not damaged, physiological saline can be injected through the catheter, and ablated fragments can be sucked out of the body through the catheter.
Drawings
FIG. 1 is a flow chart of a method of clearing a lumen of a human body.
Fig. 2 is a schematic structural view of an ultrasonic interventional cleaning instrument.
Fig. 3 is a schematic illustration of ultrasonic removal of vascular thrombi.
Fig. 4 is a schematic representation of the removal of vascular atherosclerotic plaques.
Figure 5 is a schematic illustration of the cleavage of urinary stones.
Reference numerals:
1-an ultrasonic generator; 2-a back cover plate of the transducer; a 3-transducer; 4-an amplitude transformer; 5-a guidewire; 6-a catheter; 7-blood vessel; 8-physiological saline; 9-cavitation jet field; 10-thrombosis; 11-atherosclerotic plaque; 12-kidney; 13-ureter; 14-calculus; 15-cracking.
Detailed Description
Preferred embodiments of the present application will be described in more detail below with reference to the accompanying drawings. While the preferred embodiments of the present application are shown in the drawings, it should be understood that the present application may be embodied in various forms and should not be limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the application to those skilled in the art.
The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the application. As used in this specification and the appended claims, the singular forms "a," "an," and "the" are intended to include the plural forms as well, unless the context clearly indicates otherwise. It should also be understood that the term "and/or" as used herein refers to and encompasses any or all possible combinations of one or more of the associated listed items.
It should be understood that although the terms "first," "second," "third," etc. may be used herein to describe various information, these information should not be limited by these terms. These terms are only used to distinguish one type of information from another. For example, the first information may also be referred to as information, and similarly, the information may also be referred to as first information, without departing from the scope of the application. Thus, a feature defining "a first" or "a second" may explicitly or implicitly include one or more such feature. In the description of the present application, the meaning of "a plurality" is two or more, unless explicitly defined otherwise.
At present, aiming at vascular diseases such as vascular plaque, thrombus and the like, a plurality of treatment methods are provided, such as drug treatment, surgical incision treatment, guide wire and catheter intervention treatment and the like. The existing vascular plaque or thrombus removing methods are easy to cause damage to blood vessels and the like in the treatment process, and a series of complications are caused. For urinary system calculus, the treatment methods include drug calculus removal, extracorporeal shock wave calculus breaking, operation treatment and the like. However, the side effects of the medicine for removing urinary calculus can cause muscle and joint pain and also can cause kidney injury; the extracorporeal shock wave lithotripsy is inaccurate in positioning and low in efficiency, peripheral tissues can be damaged, and the surgical treatment has great harm to human bodies.
Ultrasound is widely used in medical surgery due to its unique properties, high frequency low energy ultrasound can be used for various ultrasound tests, and low frequency high energy can be used for various treatments. At present, an ultrasonic therapeutic apparatus used in a human body is provided with an ultrasonic transducer at the head end of the apparatus, and the ultrasonic transducer is influenced by the diameter of a tube cavity, has small volume and low energy.
Example 1
In view of the above problems, the present embodiment provides a method for removing a blockage in a lumen of a human body, which transmits vibration energy excited by an external ultrasonic transducer 3 system to a focal tissue, i.e. a blockage, along a curved lumen of the human body through an elongated guide wire 5, and the focal tissue absorbs the energy as a load to change its properties and physically destroy, thereby achieving the purpose of ablation and removal.
As shown in fig. 1, a method for removing a blockage in a lumen of a human body comprises the following steps:
101, acquiring parameter information of a target cavity plug part in a human body;
in practical application, the thrombus 10 of the target blood vessel 7 is detected by detection means such as angiography, intravascular ultrasound (IVUS) or Optical Coherence Tomography (OCT), so as to obtain the parameter information of the blockage part of the target cavity in the human body;
the obtaining of the parameter information of the target cavity obstruction part in the human body comprises the following steps:
type, position, size, shape, and physicochemical properties of the target lumen plug;
the types of target lumen plugs include, but are not limited to, soft, hard, and soft-hard composite tissue such as thrombus 10, atherosclerotic plaque 11, and urinary system stones 14.
102 selecting a guide wire 5 with proper length and diameter according to the parameter information;
the length of the guide wire 5 is 10-200cm, and the diameter is 0.1-2mm.
103, placing the catheter 6 into a lumen and pushing the catheter to a target cavity blockage part by means of ultrasonic angiography, optical Coherence Tomography (OCT) and the like;
104, placing the head end of the guide wire 5 into the guide tube 6 and pushing the guide wire 5 to the target cavity blockage part so that the head end of the guide wire 5 is exposed out of the head end of the guide tube 6;
105 connecting the tail end of the guide wire 5 with an ultrasonic generating device;
106, setting ultrasonic parameters according to the parameter information;
the ultrasonic parameters comprise ultrasonic frequency, ultrasonic amplitude and ultrasonic power;
the value range of the ultrasonic frequency is 20-50kHz low-frequency ultrasonic;
the range of the ultrasonic amplitude is 1-30 mu m;
the range of the ultrasonic power is 1-30W.
107, inputting physiological saline 8 into the lumen of the guide tube 6, starting the ultrasonic generating device, and conducting ultrasonic energy to the target cavity blockage part through the guide wire 5 to remove the target cavity blockage;
the cleaning method comprises the steps that cavitation jet flow of liquid around the blockage in the pipe cavity caused by high-frequency vibration of the head end of the guide wire 5 causes the soft blockage to be ablated, and the hard blockage is cracked caused by mechanical impact when the head end of the guide wire 5 is in high-frequency vibration and is in direct contact with the blockage.
For example, in practical applications, the ultrasonic power and ultrasonic amplitude are appropriately selected according to the type and size of the obstruction. The guide wire 5 can be bent according to the shape of the lumen and can efficiently conduct ultrasonic vibration from outside the body to inside the body in a bent state with low loss, and the diameter and length of the guide wire 5 can be appropriately selected according to the diameter and length of the lumen. The catheter 6 can avoid direct contact between the guide wire 5 and the lumen wall (such as the lumen wall of the blood vessel 7 and the lumen wall of the urinary system), avoid damaging the lumen, and realize the flushing and sucking functions by connecting a suction pump or a physiological saline bag outside the body.
In the preferred embodiment of the present application, it is determined whether a thrombus filter is to be disposed downstream of the target lumen occlusion site according to actual requirements before the ultrasonic wave generating device is started.
Illustratively, in practice, cavitation jets of liquid around the blockage in the lumen caused by high frequency vibrations at the head end of the guidewire 5 cause ablation of the soft blockage, and the ablated debris, if exceeding the size of human absorbable particles, may be drawn out of the body by the suction action of the catheter 6. The hard blockage is cracked due to direct contact impact with the blockage when the head end of the guide wire 5 vibrates at high frequency, and the cracked large stones 14 can be taken out of the body by adopting an umbrella-shaped filter (namely a thrombus filter) and the like.
In a preferred embodiment of the application, the guide wire 5 includes, but is not limited to, a titanium alloy guide wire 5 (e.g., TC4 titanium alloy guide wire), a stainless steel guide wire, which has flexibility to deliver ultrasonic energy along a curved body lumen to focal tissue, i.e., to an occlusion.
The method transmits vibration energy excited by an in-vitro ultrasonic transducer 3 system to focus tissues, namely the blockage, along the curved human body lumen through the slender guide wire 5, and the focus tissues absorb the energy as a load to generate property change and physical damage so as to achieve the purpose of ablation and removal.
The ultrasonic generating device is located outside the body, the limit of the size of the transducer 3 of the traditional ultrasonic interventional instrument on the diameter of the lumen is broken through, the blockage in the lumen of the human body can be cleared by using the ultrasonic with higher power, and the ultrasonic transmission is efficient and low in loss.
In the method, during the interventional process and the cleaning process of the instrument, the guide wire 5 is isolated from the lumen through the catheter 6, so that the lumen is not damaged, and meanwhile, physiological saline 8 can be injected through the catheter 6, and ablated fragments can be sucked outside the body through the catheter 6.
Example one
As shown in fig. 3, an example is to remove thrombus 10 by the method of example 1.
The method comprises the following specific steps:
the thrombus 10 of the target blood vessel 7 is detected by a detection means such as angiography, intravascular ultrasound (IVUS), or Optical Coherence Tomography (OCT).
The ultrasonic generator 1 is regulated to output proper ultrasonic parameters according to the conditions of the position, the size, the shape, the physicochemical properties and the like of the thrombus 10 of the target blood vessel 7 obtained by detection, and meanwhile, the flexible guide wire 5 with proper length and diameter is selected according to the obtained lumen information of the blood vessel 7.
Before ultrasonic cleaning treatment, a guide wire is pushed to the target thrombus 10 through a curved blood vessel 7 by means of ultrasonic angiography or Optical Coherence Tomography (OCT) and the like, then the catheter 6 is pushed to the target thrombus 10 under the guidance of the guide wire, the position of the catheter 6 in the blood vessel 7 is kept still, and the guide wire is taken out.
The guidewire 5 is placed into the lumen of the catheter 6 and advanced to the target thrombus 10 and the guidewire 5 tip is exposed at the catheter 6 tip.
Physiological saline 8 is input into the lumen of the catheter 6, the ultrasonic generator 1 is started, the ultrasonic generator 1 generates high-frequency alternating current signals to excite the transducer 3 to generate longitudinal vibration, the transducer 3 conducts ultrasonic energy into the bent blood vessel 7 through the guide wire 5 and reaches the vicinity of the thrombus 10 after gathering energy, longitudinal vibration of the head end of the flexible guide wire 5 occurs, tiny bubbles (cavitation nuclei) in surrounding liquid vibrate and grow under the action of an ultrasonic field and continuously gather acoustic field energy, when the energy reaches a certain threshold value, the cavitation bubbles rapidly collapse and close to form an ultrasonic cavitation jet field 9, at the moment, microjet and shock waves generated by cavitation collapse continuously ablate the surrounding thrombus 10, and the head end of the guide wire 5 slowly pushes the guide wire 5 to slowly penetrate through the target thrombus 10 to form an ablation channel.
The guide wire 5 is withdrawn, the ultrasonic power and the ultrasonic amplitude are increased, the amount of the physiological saline 8 which is input into the catheter 6 is properly increased, the operation is repeated, the size of the target thrombus 10 is observed through means such as angiography or Optical Coherence Tomography (OCT), and finally the target thrombus 10 is completely ablated.
Example two
As shown in fig. 4, example two uses the method of example 1 to remove atherosclerotic plaque 11 from blood vessel 7.
The method comprises the following specific steps:
similarly, the target atherosclerotic plaque 11 is detected by various detection means, and the position, size, shape, physicochemical properties, and the like of the target vascular 7 atherosclerotic plaque 11 obtained by the detection are determined.
The ultrasound generator 1 is adjusted to output the appropriate ultrasound parameters while the flexible guidewire 5 of the appropriate length and diameter size is selected based on the obtained lumen information of the vessel 7, and as part of the procedure and method is similar to example one, it will not be repeated here.
The difference is that the removal method is different from that of soft thrombus 10, since the atherosclerotic plaque 11 has a large lipid core in the middle, and necrotic cells and outer fibrous caps and calcified layers are a soft and hard composite material. The hard fibrous cap and fibrous cap need to be removed first, but cannot be removed even if it can be removed by ultrasonic cavitation jet, but is too inefficient, by using high ultrasonic power and amplitude to bring the tip of the guide wire 5 into direct contact with the fibrous cap and calcified layer of the atherosclerotic plaque 11, the longitudinal vibration of the tip of the guide wire 5 produces a mechanical impact effect which breaks the hard fibrous cap and calcified layer, and the cavitation jet field 9 produced by the tip of the guide wire 5 also separates the broken fibrous cap and calcified layer and pumps the debris out of the body in cooperation with the suction function of the catheter 6. After hard fibrous caps and calcified layers are removed by angiography or Optical Coherence Tomography (OCT), the middle lipid macrocore is softer, the ultrasonic power and ultrasonic amplitude can be reduced, and the ultrasonic cavitation jet is utilized to gradually remove the lipid macrocore.
Example three
As shown in fig. 5, example three uses the method of example 1 to remove urinary calculus 14.
The method comprises the following specific steps:
similarly, the target calculus 14 at the kidney 12 is detected by various detection means, and various property parameters of the target calculus 14 are obtained.
Since the urinary system stone 14 is a calcium oxalate stone 14 or a calcium phosphate stone 14, and the texture is hard, the fibrous cap and calcified layer of the atherosclerotic plaque 11 in example two are similar, and under high ultrasonic power and ultrasonic amplitude, the inside of the stone 14 is required to be cracked 15 and cracked by the mechanical effect generated by the longitudinal vibration of the head end of the guide wire 5, small pieces of stone 14 after cracking can be output to the outside of the body through the ureter 13, and large pieces of stone 14 can be taken out together with a filter.
Example 2
This embodiment only describes the differences from embodiment 1, and the remaining technical features are the same as those of the above-described embodiment. Further, as shown in fig. 2, an ultrasonic interventional removal device is provided to achieve the method of removing a lumen plug in a human body in accordance with embodiment 1.
As shown in FIG. 2, the ultrasonic interventional cleaning device comprises ：
An ultrasonic generator 1 for converting electric energy into a high-frequency alternating current signal, the ultrasonic generator comprising a controller for setting ultrasonic parameters;
an ultrasonic transducer 3 connected to the ultrasonic generator 1 for converting the high-frequency alternating current signal into ultrasonic vibration energy;
the tail end of the guide wire 5 is connected with the amplitude transformer 4 of the ultrasonic transducer 3 and is used for transmitting ultrasonic vibration energy;
a catheter 6 for insertion into the body to form a guide wire 5 passageway.
In this embodiment, the ultrasonic interventional cleaning device further comprises a suction assembly, illustratively a suction pump, connected to the outer end of the catheter 6 for drawing away the lysed debris in the lumen.
In this embodiment, the ultrasonic interventional cleaning device further comprises an injection assembly connected to the outer end of the catheter 6 for injecting normal saline 8 into the lumen, and the injection assembly is illustratively a normal saline bag.
In a preferred embodiment of the present application, the guide wire 5 is a titanium alloy guide wire 5 or a stainless steel guide wire 5, which has flexibility to transmit ultrasonic energy to a lesion tissue, i.e. an occlusion, along a curved lumen of a human body.
When the ultrasonic energy collection device is used, the ultrasonic generator 1 generates high-frequency alternating current signals matched with the ultrasonic transducer 3, the ultrasonic transducer 3 is driven to generate longitudinal vibration, the amplitude transformer 4 of the ultrasonic transducer 3 is rigidly connected with the guide wire 5, ultrasonic energy is conducted into the bent human body lumen through the guide wire 5 and directly acts on a blockage, and therefore the blockage is removed. The cleaning method comprises the steps that cavitation jet flow of liquid around the blockage in the pipe cavity caused by high-frequency vibration of the head end of the guide wire 5 causes the soft blockage to be ablated, and the hard blockage is cracked caused by mechanical impact when the head end of the guide wire 5 is in high-frequency vibration and is in direct contact with the blockage.
The relative arrangement of the components and steps, numerical expressions and numerical values set forth in these embodiments do not limit the scope of the present application unless it is specifically stated otherwise. Meanwhile, it should be understood that the sizes of the respective parts shown in the drawings are not drawn in actual scale for convenience of description. Techniques, methods, and apparatus known to one of ordinary skill in the relevant art may not be discussed in detail, but are intended to be part of the specification where appropriate. In all examples shown and discussed herein, any specific values should be construed as merely illustrative, and not a limitation. Thus, other examples of the exemplary embodiments may have different values. It should be noted that: like reference numerals and letters denote like items in the following figures, and thus once an item is defined in one figure, no further discussion thereof is necessary in subsequent figures. In the description of the present application, it should be understood that the azimuth or positional relationships indicated by the azimuth terms such as "front, rear, upper, lower, left, right", "horizontal direction, vertical, horizontal", and "top, bottom", etc., are generally based on the azimuth or positional relationships shown in the drawings, merely to facilitate description of the present application and simplify the description, and these azimuth terms do not indicate and imply that the apparatus or elements referred to must have a specific azimuth or be constructed and operated in a specific azimuth, and thus should not be construed as limiting the scope of protection of the present application; the orientation word "inner and outer" refers to inner and outer relative to the contour of the respective component itself.
Spatially relative terms, such as "above … …," "above … …," "upper surface at … …," "above," and the like, may be used herein for ease of description to describe one device or feature's spatial location relative to another device or feature as illustrated in the figures. It will be understood that the spatially relative terms are intended to encompass different orientations in use or operation in addition to the orientation depicted in the figures. For example, if the device in the figures is turned over, elements described as "above" or "over" other devices or structures would then be oriented "below" or "beneath" the other devices or structures. Thus, the exemplary term "above … …" may include both orientations of "above … …" and "below … …". The device may also be positioned in other different ways (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly.
In addition, the terms "first", "second", etc. are used to define the components, and are only for convenience of distinguishing the corresponding components, and the terms have no special meaning unless otherwise stated, and therefore should not be construed as limiting the scope of the present application.
The above description is only of the preferred embodiments of the present application and is not intended to limit the present application, but various modifications and variations can be made to the present application by those skilled in the art. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present application should be included in the protection scope of the present application.

Claims (10)

1. A method for removing a blockage in a lumen of a human body, comprising the steps of:
acquiring parameter information of a target cavity plug part in a human body;
selecting a guide wire with proper length and diameter according to the parameter information;
placing the catheter into the lumen and advancing the catheter to the target lumen plug site;
placing the end of the guide wire into the guide pipe, and pushing the guide wire to the target cavity plug part to expose the end of the guide pipe;
connecting the tail end of the guide wire with an ultrasonic generating device;
setting ultrasonic parameters according to the parameter information;
the ultrasonic wave generating device is started, ultrasonic energy is conducted to the blockage part of the target cavity through the guide wire, and the blockage of the target cavity is removed.
2. The method of claim 1, wherein the ultrasonic parameters include ultrasonic frequency, ultrasonic amplitude, ultrasonic power;
the range of the ultrasonic frequency is 20-50kHz;
the range of the ultrasonic amplitude is 1-30 mu m;
the range of the ultrasonic power is 1-30W.
3. The method for removing a blockage in a lumen of a human body according to claim 1, wherein the length of the guide wire is 10-200cm and the diameter is 0.1-2mm.
4. The method of claim 1, wherein the guide wire is a titanium alloy guide wire or a stainless steel guide wire.
5. The method of claim 1, wherein prior to activating the ultrasound generating device, determining whether a thrombus filter is to be placed downstream of the target lumen occlusion site.
6. The method for removing a blockage in a lumen of a human body according to claim 1, wherein the acquiring parameter information of a blockage site in the lumen of the human body comprises:
type, position, size, shape, and physicochemical properties of the target lumen plug;
the type of the target cavity obstruction is one of thrombus, plaque and calculus.
7. The method of claim 6, wherein if the target lumen occlusion is a thrombus, the removing the target lumen occlusion comprises:
slowly pushing the guide wire to enable the end of the guide wire to slowly penetrate through the target thrombus to form an ablation channel;
withdrawing the flexible guide wire, increasing ultrasonic power and ultrasonic amplitude, and simultaneously inputting physiological saline into the catheter;
the end of the guide wire is put in place again, the guide wire is pushed slowly, and the thrombus is removed completely step by step.
8. The method of claim 6, wherein if the target lumen occlusion is a plaque, said removing the target lumen occlusion comprises:
pushing the guide wire to enable the head end of the guide wire to be in direct contact with the fibrous cap and the calcified layer of the plaque, and cracking the hard fibrous cap and the calcified layer through ultrasonic action;
drawing the lysed chips out of the body through a catheter;
reducing ultrasonic power and ultrasonic amplitude;
slowly pushing the guide wire to gradually remove the lipid core of the plaque.
9. The method of claim 6, wherein if the target lumen occlusion is a stone, the removing the target lumen occlusion comprises:
pushing the guide wire to enable the head end of the guide wire to be in direct contact with the stone, and enabling cracks to be generated and cracked in the stone through ultrasonic action;
the lysed chips are pumped out of the body through a catheter.
10. An ultrasonic interventional cleaning device, comprising ：
The ultrasonic generator is used for converting the electric energy into a high-frequency alternating current electric signal;
the ultrasonic transducer is connected with the ultrasonic generator and used for converting the high-frequency alternating current signal into ultrasonic vibration energy;
the tail end of the guide wire is connected with an amplitude transformer of the ultrasonic transducer and is used for transmitting ultrasonic vibration energy;
a catheter for placement into the body to form a guidewire channel.
CN202310470135.3A 2023-04-27 2023-04-27 Method for removing obstruction in inner lumen of human body and ultrasonic intervention removing instrument Pending CN116712133A (en)

Priority Applications (1)

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CN202310470135.3A CN116712133A (en) 2023-04-27 2023-04-27 Method for removing obstruction in inner lumen of human body and ultrasonic intervention removing instrument

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN202310470135.3A CN116712133A (en) 2023-04-27 2023-04-27 Method for removing obstruction in inner lumen of human body and ultrasonic intervention removing instrument

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CN116712133A true CN116712133A (en) 2023-09-08

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