CN101172051A - Device for crushing and taking out thrombus - Google Patents
Device for crushing and taking out thrombus Download PDFInfo
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- CN101172051A CN101172051A CNA200610123099XA CN200610123099A CN101172051A CN 101172051 A CN101172051 A CN 101172051A CN A200610123099X A CNA200610123099X A CN A200610123099XA CN 200610123099 A CN200610123099 A CN 200610123099A CN 101172051 A CN101172051 A CN 101172051A
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Abstract
The invention discloses a device for crushing and taking-off thrombus. The device comprises a conducting wire, a crossing mesh, a strainer, a draught device, a multi ball bag conduct pipe and a casing conduct pipe. A plurality of ball bags are arranged in series on the soft part of the far end of the multi ball bag conduct pipe; the crossing mesh and the strainer are sleeved through compression on the far end of the ball bag conduct pipe and covered on the ball bags, the ball bags are filled, the crossing mesh and the strainer are pulled off, and the thrombus or other emboli in the small blood vessel is crushed and taken off.
Description
Technical field
The present invention relates to be used to pulverize and take out in the blood vessel or the device of fresh thrombus, atheromatous plaque or other objects in other anatomic passageway.
Background technology
Along with the improvement of living standard, the cardiovascular and cerebrovascular disease sickness rate improves year by year, becomes one of human three big causes of death.Wherein the sickness rate of cerebrovascular disease, prevalence, mortality rate, disability rate and relapse rate are all high.Main result is as follows for China's EPDML investigation of cerebrovascular: sickness rate: 136~4,41/,100,000 population/years (163.2~1529.2 ten thousand/year), wherein, cerebral infarction accounts for 75% of apoplexy; Prevalence: 280~12,85/,100,000 populations (336~1529.2 ten thousand/year); Mortality rate: 59 ~ 2,81/,100,000 population/years (70.8~337.2 ten thousand/year) average 1,30/,100,000 people/years (1,560,000/year); Disability rate: 60-80%.It is greatly endangering human beings'health, is the key subjects that medical circle faces.In general, the main cause of adult morbidity in late period mostly is the inaccessible disease of atherosclerotic thrombosis.。
Its therapeutic purposes: treatment focuses on the perfusion that recovers or actively increase ischemic region; take thrombolytic or anticoagulant and cerebral protective agent, adjust blood pressure, it is hemorrhage to prevent that hyperpiesia from causing in the thrombolytic process; avoid hypopiesia hypoperfusion to occur again, increase the weight of ischemia symptom.
Increasing the dabbling way of brain mainly contains through tremulous pulse and intravenous thrombolysis Drug therapy and percutaneous intubate interventional therapy method.Clinical thrombolytic drug commonly used has urokinase, tissue plasminogen activator (TPA) etc. at present, and anticoagulant has heparin, warfarin etc.This method is crossed the concurrent cerebral hemorrhage of conference at therapeutic process Chinese medicine dosage, the too small purpose that does not reach thrombolytic of dosage, and have recanalization rate not high, and the shortcoming of thromboembolism treatment overlong time, thus therapeutic effect reduced.
The at present normal existing thrombosis taking-up/destruction conduit of the percutaneous intubate interventional therapy method induction type conduit of suction hose (as have), thrombosis trap-type conduit (conduit that has the thrombosis container for capturing as far-end), thrombosis breaking plant (distal end of catheter contains ultrasonic spy or laser head), above-mentioned apparatus far-end is surpassed or close thrombosis, thrombosis is caught, destroyed or melts, play the purpose of logical blood vessel again.Existing thrombosis trap-type conduit respectively has its pluses and minuses, because of it is flexible not enough, to better than thrombosis capture effect in the trunk, but the tortuous intracranial vessel of traveling is then entered difficulty, is difficult to carry out.
Summary of the invention
Shortcoming at prior art, the purpose of this invention is to provide a kind of device that is used to pulverize with removal of thromboses, be used at the blood vessel small artery, particularly removal of thromboses or other emboluses in heart or the crooked cerebrovascular, avoid angiemphraxis further to increase the weight of, reduce mortality rate, alleviate the degree that disables, improve the quality of living.
To achieve these goals, technical scheme of the present invention is: a kind of device that is used to pulverize with removal of thromboses, it comprises that seal wire, tubulose intersect twine, filter, traction apparatus, foley's tube and housing catheter.The far-end soft of foley's tube is beading sample and is arranged with a plurality of sacculus; The far-end and the filter of tubulose intersection twine link, near-end and traction apparatus link, tubulose intersection twine and filter are compressed the distal portions that is enclosed within foley's tube and cover sacculus, guidewire shaft is to passing foley's tube, and the proximal part of seal wire, traction apparatus and foley's tube is with housing catheter movably.
Described tubulose intersection twine 3 is stainless steel tube or the Ni-Ti alloys by thin-walled, Cu-Zn-Al compo pipe laser engraving forms, or by 3,4,6,8 or the more cross one another Ni-Ti alloy threadlets of helical form, the Cu-Zn-Al alloy threadlet, stainless steel filament, resilient macromolecule medical plastic or fiber filaments or the braiding of other filaments form, tubulose crossing net filament length about 2.0,2.5,3.0,3.5,4.0,4.5,5.0 centimetre do not wait, diameter is 3.0,3.5,4.0,4.5,5.0,6.0 millimeter does not wait, and can be divided into different model according to length and diameter.
Described filter is divided into two parts, nearly section part is a tubulose, end is a funnel-form, by 3,4,6,8 or the tinsel of many axially symmetric structures constitute skeleton, the skeleton outside is with the medical plastic thin film, and this thin film is provided with numerous apertures, and the diameter of this aperture is 100 to 500 microns, it can allow blood pass through, and can stop thrombosis again or the atheromatous plaque that comes off passes through.
Described filter also can be made of more intensive intersection twine, do not need thin film, end is funnel-form, the filter mesh is little than the mesh of tubulose intersection twine, filter part mesh short diagonal is the 100-500 micron, and long-diagonal is the 500-3000 micron, and the mesh of tubulose intersection twine is bigger, long-diagonal is the 1000-5000 micron, and short diagonal is the 500-3000 micron.When more intensive mesh also can allow blood pass through, prevention thrombosis or the atheromatous plaque that comes off passed through.
Described foley's tube contains the sacculus that 2-5 beading sample arranged, foley's tube contains the soft of a plurality of sacculus by far-end and has and necessarily tensile, flexiblely forms than far-end difference proximal part, single length of balloon is 5.0-10.0mm, and diameter is 2-5mm, and sacculus is spaced apart 5.0-10.0mm.In the time of balloon expandable, strut pressure and be attached to top intersection netware and filter.
Described many foley's tubes distal flexible part sidewall has a seal wire to pass through the hole apart from the far-end certain distance, seal wire is divided into two-chamber by the hole with distal part, wherein seal wire can be passed through in a chamber, another chamber with and catheter proximal end part and sacculus communicate and end at the distally sacculus, make far distance port that the outlet of one seal wire only be arranged, inject the sacculus that a plurality of beading samples of the full expansion of contrast agent are arranged through end interface, pressure is attached to tubulose on the sacculus and intersects the expansion of thereupon taking advantage of a situation of twine 3 and filter 2, thrombosis is squeezed broken and is entered space between the sacculus in tubulose crossover network cables 3 and the filter 2, makes broken thrombosis be positioned at tubulose crossover network cables and filter.
Described many foley's tubes also can be single lumen catheter, the distal end of catheter outlet attenuates, only can be by the soft part of micro-wire leading portion, the outlet that thick and stiff part is attenuated is blocked, the conduit handle of single lumen catheter end is provided with main aperture and side opening, and the side opening end can connect threeway, and the terminal inner chamber of main aperture is a funnel type, the funnel-form elastic tape of the built-in one band medium pore that is complementary with it, end put band medium pore nut.Seal wire can be by nut and the elastic tape that medium pore is arranged, can be in the time of tightening nuts to main aperture inner chamber extruding elastic tape, dwindle or close medium pore, with fixing and control seal wire, and closure ball ductus bursae two ends, inject contrast agent through side opening 11 then and fill the sacculus that a plurality of beading samples of expansion are arranged, pressure is attached to tubulose on the sacculus and intersects the expansion of thereupon taking advantage of a situation of twine 3 and filter 2, thrombosis is squeezed broken and is entered space between the sacculus in tubulose crossover network cables 3 and the filter 2, makes broken thrombosis be positioned at tubulose crossover network cables and filter.
Described traction apparatus is traction seal wire and connector, and connector is that the fine wire of 3,4 or 6 axially symmetric structures is formed, this traction seal wire parallel with foley's tube and by the connector fine wire of axially symmetric structure with intersect the near-end of twine and link.
Described housing catheter is the conduit of the big inner chamber of thin-walled.
Compared with prior art, the present invention can avoid angiemphraxis further to increase the weight of at removal of thromboses or other emboluses in small artery blood vessel (especially cerebrovascular), reduces mortality rate, alleviates the degree that disables, and improves the quality of living.
Description of drawings
The present invention is described in further detail below in conjunction with accompanying drawing.
Fig. 1 is for pulverizing and the removal of thromboses overall schematic, and many foley's tubes are single chamber, and filter is more intensive intersection twine.
Fig. 2 is for pulverizing and the removal of thromboses overall schematic, and foley's tube section far away soft is a two-chamber, and filter is a wire armature outside cover thin film.
Fig. 3 is with the filter of thin film, the sketch map of tubulose intersection twine, connecting piece and traction seal wire for the outside.
The sketch map of the filter that Fig. 4 makes for more intensive intersection twine, tubulose intersection twine, connecting piece and traction seal wire.
Fig. 5 is divided into many foley's tubes sketch map of two-chamber with distal part by the hole for seal wire.
Fig. 6 is single chamber many foley's tubes sketch map.
The specific embodiment
See also Fig. 1,2, the device of the embodiment of the invention one comprises: seal wire 1, filter 2, tubulose intersect twine 3, connector 4, traction seal wire 5, sacculus 6, many foley's tubes 7, seal wire by hole 8 and housing catheter 12.Seal wire 1 can pass thrombosis or the arteriosclerosis plaque that comes off or other embolus and arrive thrombosis far-end position enough far away; Many foley's tubes 7 are along seal wire follow-up, pass thrombosis and arrive the thrombosis far-end enough far away, and its proximal balloon should be positioned at the thrombosis near-end; Catch the tubulose intersection twine 3 that the thrombosis device comprises the filter 2 of far-end and is attached thereto, tubulose intersection twine 3 and filter 2 cover all sacculus 6, and be compressed and be enclosed within foley's tube 7 far-ends, and with in the foley's tube 7 insertion thrombosis, full sacculus 6, tubulose intersection twine 3 and filter 2 are expanded thereupon, thrombosis is compressed to gap between the sacculus, simultaneously by the chopping of tubulose intersection twine, find time sacculus 6 and pumpback foley's tube 7, remaining broken thrombosis are positioned at tubulose and intersect twine 3 and filter 2, the traction seal wire that pumpback links to each other with support, advance the epitheca conduit simultaneously, make tubulose intersection twine and the broken thrombosis of inner residue thereof be taken in housing catheter and take out.
See also Fig. 3,4, tubulose intersection twine is by the stainless steel tube or the Ni-Ti alloy of thin-walled, Cu-Zn-Al compo pipe laser engraving forms, or by 3,4,6,8 or the more cross one another Ni-Ti alloy threadlets of helical form, the Cu-Zn-Al alloy threadlet, stainless steel filament, resilient macromolecule medical plastic or fiber filaments or the braiding of other filaments form, crossing net filament length about 2.0,2.5,3.0,3.5,4.0,4.5,5.0 centimetre do not wait, diameter is 3.0,3.5,4.0,4.5,5.0,6.0 millimeter does not wait, and can be divided into different model according to length and diameter.Its near-end links to each other with the traction seal wire through connector, and far-end links to each other with filter, and traction seal wire and foley's tube are parallel.
Consult Fig. 3, filter 2 is divided into two parts, and nearly section part is a tubulose, and end is a funnel-form, tinsel by many axially symmetric structures constitutes skeleton, the skeleton outside is with thin film, and this thin film is provided with numerous apertures, and the diameter of this aperture is 100 to 500 microns, it can allow blood pass through, the atheromatous plaque that can stop thrombosis again or come off passes through, and filter 2 distal center have a hole, just can be by catheter end head and seal wire.Filter 2 length are 2.0,2.5,3.0cm does not wait, and it is identical that diameter and tubulose intersect twine 3, can be divided into different model according to length and diameter.
Consult Fig. 4, filter 2 also can be made of more intensive intersection twine, do not need thin film, nearly section is more intensive tubulose intersection twine, end is funnel-form, tubulose intersection twine is by the stainless steel tube or the Ni-Ti alloy of thin-walled, Cu-Zn-Al compo pipe laser engraving forms, or by 3,4,6,8 or the more cross one another Ni-Ti alloy threadlets of helical form, the Cu-Zn-Al alloy threadlet, stainless steel filament, resilient macromolecule medical plastic or fiber filaments or the braiding of other filaments form, crossing net filament length about 2.0,2.5,3.0 centimetre do not wait, diameter can be divided into different model according to length and diameter with to intersect twine consistent.The filter mesh is rhombus or the polygon being convenient to compress, it is little that the filter mesh intersects the mesh of netware, filter part mesh short diagonal is the 100-500 micron, long-diagonal is the 500-3000 micron, the mesh of intersection netware is bigger, long-diagonal is the 1000-5000 micron, and short diagonal is the 500-3000 micron.When more intensive mesh also can allow blood pass through, prevention thrombosis or the atheromatous plaque that comes off passed through.
See also Fig. 5, many foley's tubes 7 are by the soft of far-end and have necessarily tensile, flexible near section part than the far-end difference formed, conduit soft far-end contains the sacculus that 3-5 beading sample arranged, single length of balloon is 5.0-10.0mm, diameter is 2-5mm, sacculus is spaced apart 5.0-10.0m-m, distal flexible part sidewall has a micro-wire by hole 8 apart from far-end certain distance (5-30cm), seal wire by the hole with far away the part be two-chamber, wherein micro-wire can be passed through in a chamber, another chamber with and catheter tip and each sacculus communicate and end at the distally sacculus, make far distance port that the outlet of one micro-wire only be arranged, inject the sacculus that a plurality of beading samples of the full expansion of contrast agent are arranged through end interface, pressure is attached to tubulose on the sacculus and intersects the expansion of thereupon taking advantage of a situation of twine 3 and filter 2, and thrombosis is squeezed broken and enters space between the interior sacculus of tubulose crossover network cables 3 and filter 2, makes broken thrombosis be positioned at tubulose crossover network cables and filter.
See also Fig. 6, many foley's tubes 7 also can be single lumen catheter, distal end of catheter outlet 8 attenuates, only can be by the soft part of seal wire 1 leading portion, and the back thicker part divides diameter greater than outlet diameter, the outlet that is attenuated is blocked, the conduit handle of single lumen catheter end is provided with main aperture and side opening 11, and the side opening end can connect threeway, and the terminal inner chamber of main aperture is a funnel type, the funnel-form elastic tape 8 of the built-in one band medium pore 10 that is complementary with it, end put band medium pore nut 9.Seal wire can be by nut 9 and the elastic tape 8 that medium pore 10 is arranged, can be in the time of tightening nuts 9 to main aperture inner chamber extruding elastic tape 8, dwindle or close medium pore 10, with fixing and control seal wire 1, and closure ball ductus bursae two ends, inject contrast agent through side opening 11 then and fill the sacculus that a plurality of beading samples of expansion are arranged, pressure is attached to tubulose on the sacculus and intersects the expansion of thereupon taking advantage of a situation of twine 3 and filter 2, thrombosis is squeezed broken and is entered space between the sacculus in tubulose crossover network cables 3 and the filter 2, makes broken thrombosis be positioned at tubulose crossover network cables and filter.
Foley's tube and sacculus are that the medical high polymer plastic material is made, such as materials such as polyethylene, polrvinyl chloride, polyurethane, fluorine resin, polypropylene,
According to the present invention, can implement the method for a kind of treatment cerebrovascular acute ischemic cerebral infarction of thromboembolism because cerebrovascular thrombosis or embolus come off:
Adopt the Seldinger technology through femoral artery or other arteries intubate, housing catheter 12 is advanced to the artery-clogging at internal carotid artery or vertebral artery or other positions, carry out angiography, judge the thrombus obstruction situation, and with the close thrombosis position of housing catheter, seal wire 1 is sent into blood vessel and pass thrombosis through housing catheter again and arrive thrombosis far-end position enough far away and fixing, to press many foley's tubes 7 of having tubulose intersection twine 3 and filter 2 to follow up and pass thrombosis again and arrive the thrombosis far-end along seal wire, full a plurality of sacculus 6 are with expansion tubulose crossing net silk 3 and filter 2, thrombosis is squeezed the space between the broken sacculus that enters in the tubulose crossover network cables, make broken thrombosis be positioned at tubulose intersection twine 3 and filter 2, the sacculus 6 of finding time, and pumpback foley's tube 7, remaining broken thrombosis is positioned at intersection twine 3 and filter 2, pumpback with intersect the traction seal wire 5 that twine links to each other, advance housing catheter 12 simultaneously, making intersection twine 3 and the broken thrombosis of filter 2 inner residues be taken in housing catheter takes out, implemented to treat and have a small amount of thrombosis in the journey and drain in the blood vessel through intersecting the mesh of twine and filter, but the broken [that spill this moment can not cause the obstruction of intracranial trunk and cause serious consequence, and because in implementing therapeutic process, adopted small dose drug thrombolytic and heparinization, it can be with broken [dissolving.Inject the contrast agent radiography through the housing catheter remote port, observe thrombosis and remove and the revascularization situation.
Claims (9)
1. device that is used to pulverize with removal of thromboses, it comprises: seal wire, tubulose intersect twine, filter, traction apparatus, many foley's tubes and epitheca conduit; The far-end soft of foley's tube is beading sample and is arranged with a plurality of sacculus, and foley's tube section far away soft is a two-chamber, and wherein seal wire can be passed through in a chamber, and another chamber communicates with each sacculus and catheter tip; The far-end of tubulose intersection twine is connected with filter, tubulose intersection twine near-end is connected with traction apparatus, tubulose intersection twine and filter are compressed the distal portions that is attached to many foley's tubes and cover a plurality of sacculus, guidewire shaft is to passing many foley's tubes, and the proximal part of seal wire, traction apparatus and many foley's tubes is with the epitheca conduit movably.
2. the described device that is used to pulverize with removal of thromboses as claimed in claim 1, it is characterized in that tubulose intersection twine is formed by the metal tube engraving of thin-walled, or form by the many cross one another metals of helical form or fiber filaments or plastic mesh braiding, far-end links to each other with filter, both become an integral body of pulverizing and catching thrombosis, and near-end links to each other with traction apparatus.
3. the described device that is used to pulverize with removal of thromboses as claimed in claim 1 or 2, it is characterized in that, filter is divided into two parts, nearly section part is a tubulose, end is a funnel-form, it is rhombus or the polygon being convenient to compress that tubulose intersects twine and filter mesh, filter is that more intensive intersection twine is formed, the mesh of filter is less than the mesh of tubulose intersection twine, filter part mesh short diagonal is the 100-500 micron, and long-diagonal is the 500-3000 micron, and the mesh of tubulose intersection twine is bigger, long-diagonal is the 1000-5000 micron, and short diagonal is the 500-3000 micron.
4. the device that is used to pulverize with removal of thromboses as claimed in claim 1, it is characterized in that, filter is divided into two parts, and nearly section part is a tubulose, and end is a funnel-form, tinsel by many axially symmetric structures constitutes skeleton, the skeleton outside is with thin film, and this thin film is provided with numerous apertures, and the diameter of this aperture is 100 to 500 microns, it can allow blood pass through, and can stop thrombosis again or the atheromatous plaque that comes off passes through.
5. the device that is used to pulverize with removal of thromboses as claimed in claim 1, it is characterized in that, described traction apparatus is for intersecting the fine wire and the traction seal wire of the many axially symmetric structures that the near-end of twine is connected with tubulose, and it is parallel with many foley's tubes that this draws seal wire.
6. the device that is used to pulverize with removal of thromboses as claimed in claim 1, it is characterized in that, described many foley's tubes contain the soft of the sacculus that 3-5 beading sample arrange by far-end and have and necessarily tensile, flexiblely form than the proximal part of far-end difference, single length of balloon is 5.0-10.0mm, diameter is 2-5mm, and sacculus is spaced apart 5.0-10.0mm.
7. the device that is used to pulverize with removal of thromboses as claimed in claim 1, it is characterized in that, described many foley's tubes distal flexible duct wall has a micro-wire to pass through the hole apart from far-end 20-50cm place, seal wire is a two-chamber by the hole distal portions, wherein micro-wire can be passed through in a chamber, another chamber communicates with and each sacculus terminal with microtubular and ends at the distally sacculus, makes far distance port that the outlet of one micro-wire only be arranged.
8. the device that is used to pulverize with removal of thromboses as claimed in claim 1, it is characterized in that, many foley's tubes can be single lumen catheter, the distal end of catheter outlet attenuates, only can be by the soft part of seal wire leading portion, the back thicker part divides diameter greater than outlet diameter, the outlet that is attenuated is blocked, the conduit handle of single lumen catheter end is provided with main aperture and side opening, the side opening end can connect threeway, the terminal inner chamber of main aperture is a funnel type, and the funnel-form elastic tape of the built-in one band medium pore that is complementary with it, end put band medium pore nut.Seal wire can be by nut and the elastic tape that medium pore is arranged, can be in the time of tightening nuts to main aperture inner chamber extruding elastic tape, and dwindle or close medium pore, with fixing and control seal wire, and closure ball ductus bursae two ends.
9. the device that is used to pulverize with removal of thromboses as claimed in claim 1 is characterized in that described housing catheter is the conduit of the big inner chamber of thin-walled.
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CNA200610123099XA CN101172051A (en) | 2006-10-31 | 2006-10-31 | Device for crushing and taking out thrombus |
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