CN102871727B - Multipolar radiofrequency ablation catheter which is applicable to being used in renal artery vessels - Google Patents

Multipolar radiofrequency ablation catheter which is applicable to being used in renal artery vessels Download PDF

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CN102871727B
CN102871727B CN201210423459.3A CN201210423459A CN102871727B CN 102871727 B CN102871727 B CN 102871727B CN 201210423459 A CN201210423459 A CN 201210423459A CN 102871727 B CN102871727 B CN 102871727B
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elbow
sub
ablation
catheter
renal artery
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CN102871727A (en
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陈平根
邹旭华
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陈平根
邹旭华
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Abstract

一种适用于肾动脉血管内的多极射频消融导管,包括导管消融工作端、主体段和手柄三部分,导管消融工作端采用运动副机构结构,运动副机构由多套单组前后拐肘运动副组成,每单组前后拐肘运动副上连接一套电极管和凸台式环电极组成一独立或联动的单组导管消融工作端,多个凸台式环电极均匀分布在血管四周并紧密贴附于肾动脉内壁以便标测消融。 A suitable within the renal artery multipolar radiofrequency catheter ablation, ablation catheter comprising a working end, a handle section and a three-part body, the ablation catheter working end using the sub-motion mechanism structure, the movement mechanism comprises front and rear sub-sets of a single set of motion of the elbow Vice composition before and after each set of electrodes connected to a single set of pipes and the ring-land electrodes constitute a single set of independent or linked ablation catheter working end on the elbow kinematic pair, a plurality of ring electrodes desktop projections uniformly distributed and closely attached perivascular in the inner wall of the renal artery for mapping and ablating. 本发明的导管操作简便,调节灵活,消融定位准确,实时监测调节消融温度和射频功率,减少治疗的并发症,降低手术的风险性。 Simple operation of the present invention, catheter, flexible adjustment, accurate positioning ablation, real-time monitoring and regulating the ablation temperature RF power, reducing the complications of treatment, reducing the risk of surgery.

Description

一种适用于肾动脉血管内的多极射频消融导管 A suitable within the renal artery multipolar radiofrequency ablation catheter

技术领域 FIELD

[0001] 本发明属于医疗器械技术领域,涉及一种适用于肾动脉血管内的多极射频消融导管。 [0001] The present invention belongs to the technical field of medical instruments, relates to a method for multi the renal artery radiofrequency catheter ablation.

背景技术 Background technique

[0002] 高血压具有发病例高,知晓率代,危害大的特点,美国心脏学会(American HeartAssociation,AHA)2008年发表科学声明,顽固性高血压定义为;经过生活方式改善,同时服用3种不同作用机制的降压药物(其中一种为利尿剂),或至少需要4种药物才能将收缩压和舒张压控制在目标水平(〈140/90mmHg)。 [0002] with a high incidence of hypertension cases, awareness generation characteristics of great harm, the American Heart Association (American HeartAssociation, AHA) scientific statement published in 2008, resistant hypertension is defined as; through lifestyle changes, while taking three kinds antihypertensive drugs with different mechanisms of action (one diuretic), or at least four drugs to control the systolic and diastolic pressures at a target level (<140 / 90mmHg). 目前关于顽固性高血压的发病率尚未精确统计,但多项临床研宄提示该类患者占高血压患者的20%-30%。 Currently on the incidence of resistant hypertension has not been precise statistics, but the number of such patients in clinical study based on prompt accounting for 20% -30% of patients with hypertension. 2007年中国心血管病报告指出,我国目前高血压患者至少有2亿人,其中有近5000万顽固性高血压患者。 2007 China cardiovascular disease report pointed out that China currently has at least 200 million people with hypertension, of which nearly 50 million patients with resistant hypertension. 经过对180例人体解剖,统计得出:肾动脉长度大约为30 _左右;男性肾动脉的平均管径为:左侧〇6±2.4臟,右侧〇6.7±2.6謹;女性的平均管径为:左侧〇4.2±2.4謹, 右侧(64. 6±2. 2mm。 After 180 cases of human anatomy, statistics obtained: Renal artery _ length is about 30; mean diameter of male renal artery: left dirty 〇6 ± 2.4, ± 2.6 〇6.7 wish right; the average diameter of the female is: ± 2.4 〇4.2 wish left, right (64. 6 ± 2 2mm.

[0003] 2009年世界著名的医学杂志《柳叶刀》发表了以澳大利亚医生Krum为首的研宄论文,证实了肾动脉内介入射频方法对治疗高血压是有效的。 [0003] In 2009 the world-renowned medical journal "The Lancet" published a study based on a doctor thesis Krum led by Australia, confirmed the renal artery interventional radiofrequency method is effective for the treatment of hypertension. 该项技术的始作俑者Mark Gelfand和Howard R. Levin因此荣获2011年度美国爱迪生发明银奖。 The initiator of the technology Mark Gelfand and Howard R. Levin invention therefore won the 2011 American Silver Edison.

[0004] 射频消融治疗仪主要包括射频消融发生器、治疗电极和中性电极板,射频消融发生器可产生持续或脉冲形式的高频率电磁波,由交变电场和磁场组成。 [0004] Radiofrequency Ablation apparatus includes radiofrequency ablation generator, the treatment electrode and the neutral electrode plate, radiofrequency ablation generator can be in the form of continuous or pulsed high frequency electromagnetic waves, electric and magnetic fields of alternating composition. 射频消融治疗的基本原理是对靶组织施以频率500KHZ左右的射频电流,使组织内的极性分子处于一种激励状态,发生高速震荡摩擦,而产生生物热,当局部温度超过45-50°C时,即可引起细胞内的蛋白质变性,脂质层溶解,细胞膜崩裂,细胞水分丧失,导致靶组织凝固性坏死, The basic principle of radiofrequency ablation of target tissue is subjected to the frequency of the RF current of about 500KHZ, the polarity of the molecules in the tissue in a state of energized state, high-speed vibration friction, bio-generated heat when the local temperature exceeds 45-50 ° C, the denaturation of proteins can cause intracellular lipid layer is dissolved, membrane cracking, loss of cellular water, resulting in the target tissue coagulation necrosis,

[0005] 国际申请W002010078175公开了进入肾动脉并对肾动脉交感神经进行热诱导处理的器械和方法。 [0005] International application discloses an apparatus and method W002010078175 into the renal artery and the renal arteries induced sympathetic heat treatment. 该器械采用多段式导管结构,通过回拉各控制线,向各弯曲区施加压缩和弯曲力,由此使加热元件朝向肾动脉的内壁移动。 The instrument uses a multi-stage conduit structure, by retracting control lines, compressive and bending forces applied to the respective curved area, whereby the heating element is moved toward the inner wall of the renal artery. 但是,该导管操作和结构都比较复杂。 However, the conduit structure and operation are relatively complex. 而且,该导管不能很好地适应不同内径的肾动脉,从而电极无法在不同内径的肾动脉中实现贴壁。 Further, the conduit is not well adapted to the renal artery different inner diameters, so that the electrode can not be achieved adherent renal artery of different internal diameters.

[0006]经导管去肾神经术(TranscatheterRenalDenervation,TRenD)或肾脏去交感神经术(RenalSympatheticDenervation,RSD)是世界上最新的一种非药物介入治疗高血压的方法。 [0006] Transcatheter renal nerve to surgery (TranscatheterRenalDenervation, TRenD) or renal sympathetic denervation surgery (RenalSympatheticDenervation, RSD) is the world's newest method of a non-pharmacological intervention to treat hypertension. 2011年9月24日在香港万豪酒店召开了亚太TRenD会议,Medtronics公司在会议上通过视频传输直播了世界上唯一的商用Symplicity消融导管并现场演示了3例手术。 September 24, 2011 held a meeting at the Asia-Pacific TRenD Marriott Hotel Hong Kong, Medtronics company at the meeting live in the world's only commercial Symplicity ablation catheter and a live demonstration of three cases of surgical video transmission. 但Symplicity消融导管及治疗方法存在以下不足;1)无法标测肾动脉交感神经支配点,需要随机消融6~8个点才能达到要求;2)无法标测消融状态,判断消融效果;3) 治疗时,消融点不均匀,可能对同一点重复消融,有血管穿孔的危险;4)过多消融点导致血管壁疤痕过多,有可能造成肾动脉狭窄。 However Symplicity ablation catheter and treatment of the following shortcomings; 1) Unable mapping point sympathetic innervation of the renal artery, requires random ablation points 6-8 to meet the requirements; 2) mapping and ablating not state determines the ablation effect; 3) Treatment , the ablation points evenly, this may be repeated on the same point ablation, there is the risk of vessel perforation; 4) excessive blood vessel wall ablation point lead to excessive scarring, may cause renal artery stenosis.

发明内容 SUMMARY

[0007] 本发明提供了一种操作简单、快速和安全的适用于肾动脉血管内的多极射频消融导管。 [0007] The present invention provides a simple, quick and safe to apply renal artery multipolar radiofrequency catheter ablation.

[0008] 本发明的适用于肾动脉血管内的多极射频消融导管,包括导管消融工作端1、主体段2、手柄3,导管消融工作端1为带有多极电极管的运动副机构;主体段2由外套管和内芯构成,外套管和内芯分别与运动副机构的两端连接;手柄3内置组合开关与内芯连接。 [0008] The renal artery is suitable for the present invention a plurality of radiofrequency catheter ablation, ablation catheter comprising a working end, the main body section 2, the handle 3, the working end of a catheter ablation motion mechanism with multiple sub-electrode tube; body section 2 is composed of the outer sleeve and the inner core, the outer sleeve and the inner core are respectively connected to both ends of the sub-motion mechanism; built-in handle combination switch 3 is connected to the inner core.

[0009] 所述的导管消融工作端1采用的运动副机构46由若干单组前后拐肘运动副47组成,每单组前后拐肘运动副47连接一套由电极管8和凸台式环电极10组成的一独立或联动的单组导管消融工作端。 [0009] The sub-motion mechanism of the working end of a catheter ablation adopted by the crank 46 back and forth a single set of a plurality of sub-47 composition toggle motion, back and forth movement of the elbow 47 is connected to each of the sub-set of a single set of electrodes by the tube 8 and the ring-land electrode 10 consisting of a single set of independent catheter ablation linkage or working end. 当操纵导管后部的扭转器30回抽内芯5,内芯上的示标环15与外套管上远端示标环14显影对齐时,运动副机构已扩张到每一系列导管规定的最小直径,继续通过扭转器30调节内芯上的示标环15在外套管的两示标环(13、14)间的相对位置,以适应各系列范围内的肾动脉内径,运动副机构扩张后呈纺缍体45,凸台式环电极10均匀分布在血管四周并紧密贴附于肾动脉内壁以便标测消融。 When shown on the scale on the ring 30 Withdrawing core 5, the inner core catheter manipulation rear torsion tube 15 and the distal end of the outer ring 14 shown marked development aligned, sub-motion mechanism has been expanded to a predetermined minimum in each series conduit after the diameter, continues through the twister 30 adjusts the relative position between the two rings shown marked (13, 14) shows marked on the core ring 15 of the outer sleeve, renal artery diameter to fit within the series of ranges, sub-motion expansion mechanism as a spindle body 45, the ring-land electrode 10 uniformly distributed in perivascular and closely adhered to the inner wall of the renal artery for mapping and ablating.

[0010] 所述的主体段2分为外套管4和内芯5,内芯5末端与前定位球7连接,前定位球7上设有前示标环12,外套管4的末端与后定位球6连接,后定位球6上设有后示标环11, 前后示标环(12、11)通过X光显影运动副机构在肾动脉内的位置。 Body section [0010] 2 into the outer sleeve 4 and the inner 5 core, the core 5 and the front end of the detent ball 7 is connected, 12, and the front end token ring shown overtube 4 is provided on the front positioning the ball 7 positioning the ball 6 is connected with the ring 11 is shown marked on the positioning of the ball 6, is shown before and after the token ring (12, 11) by X-ray image sub-mechanism moving the position within the renal arteries. 内芯5为实芯体或中空的管材结构,内芯的近端与扭转器30或标准鲁尔接头连接,在内芯上设有示标环15,内芯5通过扭转器30的推送向前或向后移动,控制运动副机构的扩张和收缩。 5 is a solid core or hollow core tube construction, the proximal end of the inner core 30 and the twister or a standard luer connector, provided on the inner ring 15 illustrates standard core, the inner core 5 by twisting 30 to push front or back, the sub-control expansion and contraction movement mechanism.

[0011]外套管4的近端与手柄3连接或与管座接头连接,外套管上设有近端示标环13 和远端示标环14,外套管由内层材料PTFE,中层金属编织网管,外层材料为PA和PEBAX 等热塑性材料,外表面涂有Hydrolene亲水涂层。 The proximal end of the handle [0011] 4 of the overtube 3 is connected to the connection or joint stem with a proximal end and a distal end 13 is shown illustrating the Token-Ring standard ring 14, outer sleeve inner layer material PTFE, the middle layer metal braided outer sleeve NM, PA and PEBAX outer layer material is a thermoplastic material, the outer coating layer is coated with a hydrophilic Hydrolene. 内芯可在外套管内移动。 The core may be moved within the outer sleeve.

[0012] 进一步所述运动副机构46由3-6单组前后拐肘运动副47组成。 [0012] Further movement of the mechanism 46 by a front sub-set of the elbow motion 3-6 single sub-47 composition. 呈纺缍状结构, 前拐肘9和后拐肘16形成单组前后拐肘运动副47,前拐肘与后拐肘采用中间内球头21 和中间外球头18配合成摆动连接,前拐肘9的一端前内球头22与前外球头20形成摆动连接,前外球头20与前定位球7采用焊接等方式固定连接,后拐肘16的一端后内球头17 与后外球头19形成摆动连接,后拐肘中间一段向内弯曲,后外球头19与后定位球6采用焊接等方式固定连接,后拐肘16为电极管8的内部支架,电极管弯曲一端装配有凸台式环电极10或凸台式半环形电极。 After the form spindle-like structure, prior to the elbow 9 and the elbow sub 47 the elbow moving back and forth 16 form a single group, the elbow using intermediate spherical head 21 and the intermediate outer ball head 18 is fitted into the pivot connection before the elbow and the rear, front the elbow inner front end 9 of the ball 22 pivot connected to the front outer ball head 20 is formed, the front outer ball head 20 and the front detent ball 7 using welding or the like fixedly connected to the rear end 16 of the inner ball head 17 after the elbow outer ball head 19 connected to wobble is formed, the intermediate section of the elbow is bent inwardly, the outer ball head 19 and the detent ball 6 is fixedly connected by welding, etc., after the elbow pipe 16 to an inner support electrode 8, the electrode end curved pipe equipped with a ring electrode 10-land-land or semi-annular electrode.

[0013] 所述的电极管8向内弯曲的一段为末直段28,在末直段上有台式环电极10或凸台式半环形电极,凸台式半环形电极保留与血管壁接触的一侧凸台,便于导管收缩时有较小的直径,凸台式环电极或凸台式半环形电极结构有利于充分接触血管内壁。 [0013] 8 inwardly bent section of the electrode tube end straight section 28, on the end of the straight section 10 or the side projecting semi-annular electrode desktop, a desktop semi-annular protrusion electrode and the vessel wall to retain the ring electrode in contact Desktop has a smaller diameter boss, to facilitate contraction of the conduit, the ring-land-land electrode or a semi-annular electrode structure facilitates full contact with the vascular wall. 凸台式环电极10与铜导线27连接,将焊好铜导线的消融电极装配在末直段28的凸台上,铜导线从远端孔中穿入电极管8,铜导线在电极管的内部并经由主体段2的空腔中穿过后从手柄3的尾部连出到电极接头29。 Ring-land electrode 1027 is connected to the copper wire, copper wire to weld the end of a linear ablation electrode fitted in the boss section 28, a copper wire electrode penetrates the tube from the distal end hole 8, inside the copper wire in the electrode tube after the body cavity and is connected via a section 2 through from the end of the handle 3 to the electrode tab 29. 凸台式环电极10内置有温度传感器,温度传感器采用热电隅或热敏电阻。 The ring electrode 10 built-land a temperature sensor, a temperature sensor using a thermistor or thermoelectric corner. 所述电极管8采用的材料为热塑性弹性体材料制成,热塑性弹性体材料包括Pebax、PA和聚亚氨酯中的一种或多种混合体。 8 the electrode material used is a tube made of a thermoplastic elastomer material, a thermoplastic elastomer material comprises a mixture of one or more Pebax, PA, and in the polyurethane.

[0014] 所述的单组前后拐肘运动副47的前拐肘9和后拐肘16上设有三个活动连接点(A,B,C),在连接点A处后拐肘16的后内球头17与后定位球6内固定的后外球头19配合并上下摆动连接,后外球头19的开槽尺寸限制了后拐肘的上下转动角度,并防止后拐肘左右偏摆;在连接点C处前拐肘9的前内球头22与前定位球7内固定的前外球头20配合并上下摆动连接,前外球头20的开槽尺寸限制了前拐肘的上下转动角度,并防止前拐肘左右偏摆;中间连接点B为前后拐肘的摆动连接点,中间外球头18与中间内球头21的配合并上下摆动连接,中间外球头18的开槽尺寸防止前拐肘左右偏摆。 [0014] The longitudinal movement of the elbow of the single sub-set of the elbow 47 of the front 9 and the elbow has three active connection points (A, B, C) 16, after the connection point A of the rear of the elbow 16 the ball head 17 and the ball 6 positioned within the fixed outer ball head 19 of the mating connector and swing up and down, the size of the outer ball head slot 19 limits the rotation of the vertical angle of the elbow, the elbow and the right and left deflection preventing ; at the connection point C before the elbow before the ball head 22 and the ball 9 is positioned before the front of the fixed outer ball head 20 is connected with the tilting and 7, the front outer slotted ball 20 limits the size of the front of the elbow upper and lower rotation angle, and to prevent the crank about the elbow deflection before; intermediate connection point B is the pivot connection point of before and after the elbow outer intermediate ball head 18 and the tilting connection with a mating ball head 21 in the intermediate and outer intermediate ball head 18 the front slot size to prevent deflection around the elbow.

[0015] 所述的运动副机构46设有限位保险功能,后外球头19上设有开槽,开槽的上限位面23、下限位面24限制了后拐肘上下摆动角度;前外球头20上设有开槽,开槽的上限位面25、下限位面26限制了前拐肘上下摆动角度。 [0015] The sub-motion mechanism 46 has a limit safety function is provided on the rear slotted outer ball head 19, slotted upper limiting surface 23, the lower limiting surface 24 limits the tilting angle of the elbow after; front outer with slotted, grooved ball head 20 upper limiting surface 25, the lower limiting surface 26 limits the tilting angle of the elbow before. 当运动副扩张到最大直径时,上限位面(23,25)限制前后拐肘(16,9)不能继续绕连接点(A,C)向后转动,防止运动副机构46的过度扩张,具有限位保护功能,运动副机构46的扩张程度根据肾动脉内径大小而定。 When moved to the maximum expanded diameter of the sub, upper limiting surface (23, 25) before and after the restriction the elbow (16,9) can not continue around the connection points (A, C) backward rotation, to prevent excessive movement of the sub-expansion mechanism 46, having limit protection, the degree of expansion of sports gear mechanism 46 depends on the size of the renal artery diameter. [0016] 所述的导管后部的手柄3,包括把手部分31、锁定内芯的组合开关32,手柄3前端与外套管4固定连接,手柄3前半部分装有锁定内芯的组合开关32,操作组合开关32可使手柄抱紧或松开内芯,手柄中空的内腔有内芯5和铜导线27通过,手柄尾部有标准件扭转器30和电极接头29,通过扭转器30的回抽调节内芯5的移动从而控制导管的开合。 [0016] The rear handle of the catheter 3, comprises a handle portion 31, locking the inner core 32 of the combination switch, connecting the handle 4 is fixed to the front end of the outer sleeve 3, the first part of the handle 3 with the lock combination switch 32 of the inner core, combination switch operation lever 32 can hold or release the inner core, the hollow interior of the handle 5 and the inner core 27 through the copper wire, the tail of the handle 30 and the torsion standard electrode tab 29, through the twister 30 Withdrawing adjusting the moving core 5 so as to control opening and closing of the catheter. 手柄3内置与电极管8内部连通的铜导线27,并从手柄3尾部连与电极接头29相连,电极接头29通过中间连接线43与射频消融发生器44连接,中间连接线43分出四根带不同颜色和编号的单电极接头,便于手术时对各电极依次顺序地消融。 Built copper wire handle 3 and the internal electrodes 27 communicating tube 8, and is connected to the handle 3 from the tail 29 is connected to the electrode tab, the electrode tab 29 by an intermediate connecting line 43 is connected to the radiofrequency ablation generator 44, an intermediate connecting line 43 drop four single electrode tab with different colors and numbered sequentially sequentially to each electrode during an ablation procedure convenience.

[0017] 所述的锁定内芯的组合开关32包括组合开关的上旋钮33、组合开关的下按钮36和弹簧38,按下组合开关32的上旋钮33,弹簧38压缩,同时组合开关的下按钮36移动并抱紧内芯5,使内芯5和外套管4不能相对移动,保持按住组合开关的上旋钮33同时旋转,上旋钮33绕下按钮的转轴37旋转,此时上旋钮的左卡位台34、右卡位台35卡进槽位并阻止上旋钮33弹回,保持手柄抱紧内芯的状态。 [0017] The lock core 32 includes a combination switch of the combination switch knob 33, the combination switch button 36 and the spring 38, the combination switch 32 on the press knob 33, a compression spring 38, while the combination switch hold button 36 and moving the core 5, the inner core 5 and the outer tube 4 can not move relative to, the holding down the knob 33 is rotated while the combination switch, the button knob 33 around the lower shaft 37 is rotated, the knob case left latching stage 34, the right card into a card slot table 35 and prevent the recoil knob 33, hold the handle hold the inner core. 当需要松开内芯5时,旋转组合开关的上旋钮33,上旋钮33绕下按钮的转轴37旋转,上旋钮的左卡位台34、右卡位台35退出槽位,弹簧38回弹,下按钮36弹回到一定位置,此时手柄松开内芯。 When the need to release the core 5 when the combination switch knob 33, the knob 33 on shaft 37 rotating about the down button, the left knob latching stage 34, the right latching slot exit station 35, the rebound spring 38 , the button 36 springs back to a predetermined position, then release the handle core.

[0018] 本发明的有益效果是: [0018] Advantageous effects of the present invention are:

[0019] 1、本发明的多极射频消融导管通过运动副机构的作用下扩张,以适应不同内径的肾动脉,凸台式环电极能均匀分布在血管四周并有利于紧密贴附于肾动脉内壁以便标测消融,使操作简便,调节灵活; [0019] 1, the present invention is a multi-electrode ablation catheter through the action of radiofrequency sub-motion mechanism is expandable to accommodate different inner diameters of the renal artery, the ring-land electrode can be evenly distributed in perivascular and facilitate closely adhered to the inner wall of the renal artery mapping and ablating in order to make easy and flexible adjustment operation;

[0020] 2、多极射频消融导管有多个电极分布在四周,一次放置导管后,多个电极依次顺序地对靶组织的交感神经支配点进行标测消融,减少操作次数,不要反复调整电极的位置,使整个手术操作时间短; [0020] 2, a multi-polar radiofrequency ablation catheter with a plurality of electrodes distributed around, after a placement of the catheter, the plurality of electrode are sequentially sympathetic innervation of the target tissue site mapping and ablating performed, reduce the number of operations, do not repeatedly adjusting electrode position, so that the whole operative time is short;

[0021] 3、精确标测靶组织的交感神经支配点,消融定位准确,减少盲目消融的弊端; [0021] 3, sympathetic innervation point accurately mapping the target tissue ablation accurate positioning and reduce the defects of blind ablation;

[0022] 4、内置温度传感器,实时监测消融温度,实时调整消融温度,射频功率和消融时间,减少血管损伤,操作可控性较强; [0022] 4, built-in temperature sensors, real-time monitoring the temperature of the ablation, real-time adjustment of the ablation temperature, RF power and ablation time, reduced vascular injury, strong controllability operation;

[0023] 5、由于精确标测消融,操作时间短,因此能够最大限度地减少治疗的并发症,降低手术的风险性; [0023] 5, since the accurate mapping and ablating operation time is short, it is possible to minimize the complications of treatment, reducing the risk of surgery;

附图说明 BRIEF DESCRIPTION

[0024] 图1是本发明实施例的整体结构示意图。 [0024] FIG. 1 is an overall schematic structural diagram of the embodiment of the present invention.

[0025] 图2是本发明实施例撑开后导管尖端的形态结构示意图。 [0025] FIG. 2 is a schematic view of the embodiment of the catheter tip morphology distraction embodiment of the present invention.

[0026] 图3是本发明实施例的运动副机构的三维工程示意图。 [0026] FIG. 3 is a schematic view of a three-dimensional movement mechanism engineering sub-embodiment of embodiment of the present invention.

[0027] 图4是本发明实施例的运动副机构的结构剖面示意图。 [0027] FIG. 4 is a schematic cross-sectional structure of the sub-motion mechanism embodiment of the present invention.

[0028] 图5是本发明单组前后拐肘运动副的工作原理示意图。 [0028] FIG. 5 is a schematic view of the working principle of the elbow before and after the movement of a single sub-set of the present invention.

[0029] 图6是本发明实施例后外球头限位示意图。 [0029] FIG. 6 is the embodiment of the invention the outer ball stopper FIG.

[0030] 图7是本发明实施例前外球头了限位示意图。 [0030] FIG. 7 is a front outer ball head according to the present embodiment of the invention the stopper FIG.

[0031] 图8是本发明实施例中间外球头与中间内球头配合运动的示意图。 [0031] FIG. 8 is an embodiment of the intermediate and outer intermediate ball ball embodiment of the present invention with a schematic view of movement.

[0032] 图9是本发明实施例后定位球的示意图。 [0032] FIG. 9 is a schematic view of the embodiment of the invention positioning the ball.

[0033] 图10是本发明实施例前定位球的示意图。 [0033] FIG. 10 is a schematic view of the embodiment prior to positioning the ball embodiment of the present invention.

[0034] 图11是本发明实施例后外球头的示意图。 [0034] FIG. 11 is a schematic view of the embodiment of the invention the outer ball head.

[0035] 图12是本发明实施例后拐肘的示意图。 [0035] FIG. 12 is a schematic view of the embodiment of the present invention is the elbow.

[0036] 图13是本发明实施例前外球头的示意图。 [0036] FIG. 13 is a schematic front outer ball head embodiment of the present invention embodiment.

[0037] 图14是本发明实施例电极管的示意图。 [0037] FIG. 14 is a schematic diagram of an electrode tube according to the present invention.

[0038] 图15是本发明实施例手柄的主视结构示意图。 [0038] FIG. 15 is a schematic front view of the handle structure of the embodiment of the present invention.

[0039] 图16是本发明实施例手柄的俯视结构示意图。 [0039] FIG. 16 is a schematic plan view of the handle of the configuration example embodiment of the present invention.

[0040] 图17是本发明实施例手柄的剖视结构示意图。 [0040] FIG. 17 is a schematic cross-sectional view of the handle structure of the embodiment of the present invention.

[0041]图18是本发明实施例未撑开的原始状态示意图。 [0041] FIG. 18 is a diagram showing the original state of the embodiment of the present invention is not softened.

[0042] 图19是本发明实施例导管扩张后适合于小直径的肾动脉示意图。 [0042] FIG. 19 is a rear dilatation catheter embodiment of the present invention is suitable embodiment of the renal arteries of a small diameter Fig.

[0043] 图20是本发明实施例导管扩张后适合于大直径的肾动脉示意图。 [0043] FIG 20 is a large diameter adapted to the renal artery dilatation catheter schematic rear Example embodiments of the present invention.

[0044] 图21是本发明实施例在RSD手术中的使用状态示意图。 [0044] FIG. 21 is a schematic embodiment in use state RSD surgery embodiment of the present invention.

[0045]附图标记:导管消融工作端1,主体段2,手柄3,外套管4,内芯5,后定位球6,前定位球7,电极管8,前拐肘9,凸台式环电极10,运动副上的后示标环11,运动副上的前示标环12,外套管的近端示标环13,外套管的远端示标环14,内芯示标环15,后拐肘16,后内球头17,中间外球头18,后外球头19,前外球头20,中间内球头21,前内球头22,后外球头上限位面23,后外球头下限位面24,前外球头上限位面25, 前外球头下限位面26,铜导线27,电极管的末直段28,电极接头29,扭转器30,把手部分31,锁定内芯的组合开关32,组合开关的上旋钮33,上旋钮的左卡位台34,上旋钮的右卡位台35,组合开关的下按钮36,下按钮的转轴37,弹簧38,收缩的导管39,导引导管及管座40,肾动脉41,纺缍体形态42,中间连接线43,射频消融发生器44,纺缍体形态45,运动副机构46,单组前后拐肘运动副47。 [0045] The reference numerals: the working end of the ablation catheter 1, the main body section 2, the handle 3, the outer sleeve 4, inner core 5, the positioning of the ball 6, the ball 7 before positioning, the electrode tubes 8, 9 prior to the elbow, ring-land electrode 10, the token ring shown on the kinematic pair 11, shown before the token ring 12, the proximal end of the outer sleeve 13 is illustrated token ring, the distal end of the outer sleeve 14 is shown marked on the moving sub-ring, the inner core 15 is shown token ring, after the elbow 16, the inner ball head 17, the intermediate outer ball head 18, the outer ball head 19, before the outer ball head 20, the intermediate ball 21, before the ball head 22, the stopper surface 23 outer ball head, after the outer ball head lower limiting surface 24, the front surface of the outer ball head of the stopper 25, the front outer ball head lower limiting surface 26, the copper wire 27, the end of the straight pipe section of the electrode 28, electrode tab 29, the twister 30, the handle portion 31 locking the inner core combination switch 32, the knob combination switch 33, the knob left latching stage 34, the bottom button and right detent knob station 35, the combination switch 36, the rotation shaft down button 37, spring 38, shrinkage conduit 39, stem 40 and the guiding catheter, the renal arteries 41, 42 spindle morphology, the intermediate connecting line 43, radiofrequency ablation generator 44, spindle morphology 45, sub-motion mechanism 46, before and after a single set of the elbow 47 deputy sports.

具体实施方式 Detailed ways

[0046] 实施例1 [0046] Example 1

[0047] -种适用于肾动脉血管内的多极射频消融导管(以下简称为导管),在经导管去肾交感神经消融手术(RSD或TRenD)时,通过股动脉穿刺和双肾动脉造影后可以知道肾动脉长度和内径,导管经由导引导管输送到肾动脉开口处,固定导引导管的位置后,将本发明的导管从导引导管送出到肾动脉内,导管自身的柔顺性会使其顺应导引导管的变形,然后操作导管后部手柄3上的组合开关32,使手柄松开内芯,并操纵手柄后的扭转器30回抽内芯5,在运动副机构的作用下导管展开,通过X光显影观察,当内芯上的示标环15与外套管4上的远端示标环14显影对齐时,运动副机构已扩张到每系列导管规定的最小直径, 如果需要可继续通过扭转器30调节内芯上的示标环15在外套管的两示标环(13,14)间的相对位置,并通过X光显影观察多个凸台式环电极10在血管内的贴壁状态和运 [0047] - for multi-species within a renal artery catheter radiofrequency ablation (hereinafter, referred to as a catheter), when the catheter to the renal sympathetic nerve ablation procedures (RSD or TREND), through the femoral artery and the renal arteriography can know the length and inner diameter of the renal artery, via a catheter delivery opening of the guiding catheter to the renal artery, the stationary guide catheter, the catheter of the present invention is transmitted from the guiding catheter into the renal artery, the catheter itself makes compliance and its response to the deformation of the guide catheter, the catheter is then operated combination switch on the rear handle 332, the handle release inner core 30 and the torsion Withdrawing core after the joystick 5, the conduit under the influence of the sub-motion mechanism expand, X-ray image observation, when the scale shown on the ring core 15 and the distal end 4 of the outer sleeve 14 of the developing token ring shown aligned sub-motion mechanism is expanded to a predetermined minimum diameter of the catheter each series, if necessary, continues through the twister 30 two adjusting rings diagram illustrating standard Token-ring on the core 15 of the outer sleeve relative position (13, 14), and the X-ray image was observed by a plurality of electrodes 10 affixed to the ring-land within the vessel wall Condition and operation 副机构46在肾动脉内的相对位置,导管扩张后多个凸台式环电极10均匀分布在血管四周并紧密贴附于肾动脉内壁,然后操作手柄上的组合开关32来锁定内芯与外套管相对位置, 导管消融工作端1的扩张外形保持稳定;打开射频消融发生器(Ablationandsensing unit,ASU)激发射频电流,标测靶组织相应的交感神经兴奋支配点,然后通过多个电极依次顺序地对各革E点进行消融,每个电极做一次能量释放,每次持续时间不超过2Min,释放能量大约6 - 8W左右,消融过程中电极温度控制在40-75°C范围内,逐步步进式地增加消融温度;由于电极温度受动脉血流带走部分热量等因素的影响,通过内置的温度传感器(热电隅或热敏电阻)实时监测靶组织的消融温度,从而实时调节射频功率,消融温度和消融时间;消融完后,将导管先缩小后推进5mm左右,并使导管整体旋转45° The relative position of the gear mechanism 46 within the renal artery, the dilatation catheter plurality of ring electrodes 10 projecting desktop perivascular uniformly distributed and closely adhered to the inner wall of the renal artery, and the combination switch on the operating handle 32 to lock the inner core and the outer sleeve relative position, an expandable catheter ablation working end shape stable; open radiofrequency ablation generator (Ablationandsensing unit, ASU) excitation RF current, corresponding sympathetic dominant point mapping the target tissue, and then sequentially through the plurality of electrodes sequentially on each point E leather ablation, each electrode to do a release of energy, does not exceed the duration of each 2min, the release energy of about 6 - about 8W, during the ablation electrode is controlled within a temperature range of 40-75 ° C, gradually stepping increasing the temperature of ablation; since the electrode temperature is influenced by the arterial blood flow and other factors take part of the heat, the temperature of the ablation by the built-in temperature sensor (thermistor or thermoelectric corner) real-time monitoring of the target tissue, thereby adjusting the RF power in real time, ablation temperature and ablation time; after ablation, advancing the catheter to about 5mm after reduction, and that the overall rotation of the catheter 45 ° 然后按以上所述的步骤实施第二组目标交感神经支配点的标测消融;对多个电极依次顺序地标测消融, 直到消融完目标神经支配点(大约6 - 8个),消融完毕后收缩并闭合导管,然后经由导引导管回收并撤出到体外。 And the step of mapping the above-described embodiment by a second group of sympathetic innervation target ablation site; a plurality of electrodes for mapping and ablating the sequential order, until the point of complete ablation of the target innervated - post (approximately 6 8), the ablation is completed shrinkage and closing the duct, then recovered and withdrawn from the body through the guide catheter. 因此经导管去肾交感神经消融手术,从而调节了肾交感神经活动来达到治疗顽固性高血压的目的。 Thus Transcatheter renal sympathetic ablation procedures to thereby adjust the renal sympathetic nerve activity to achieve the treatment of refractory hypertension.

[0048] 图1所示导管分为三部分:导管尖端为导管消融工作端1,主体段2由外套管4和内芯5构成,后部为手柄3。 Catheter shown in [0048] FIG. 1 is divided into three parts: an ablation catheter tip to the working end of the catheter 1, the main body section 2 is constituted by the outer sleeve 4 and the inner core 5, the rear portion of the handle 3.

[0049] 图2-14所示:导管撑开后呈纺缍状45,内芯5与外套管4之间的相对运动使运动副机构46动作控制导管的开合直径大小。 [0049] As shown in FIG. 2-14: After spindle-shaped as a conduit opening 45, relative movement between the inner core and the outer sleeve 45 so that movement of the sub operation control mechanism 46 opening and closing the conduit diameter. 凸台式环电极10和运动副机构46两端的X光示标环(11,12)材料为铂铱合金或铂钨合金,可通过X光显影观察导管在肾动脉血管内的位置。 X 46 is across-land electrode 10 and the ring light motion gear mechanism shown Token-Ring (11, 12) material is a platinum-iridium alloy or platinum-tungsten alloy, can be observed the developing position of the catheter within the renal artery by X-ray. 电极管8向内弯曲的一段为末直段28,在末直段上有台式环电极10或凸台式半环形电极,凸台式半环形电极保留与血管壁接触的一侧凸台,便于导管收缩时有较小的直径,凸台式环电极或凸台式半环形电极结构有利于充分接触血管内壁。 Electrode tube section 8 is inwardly bent end straight section 28, on the end of the straight section 10 or ring electrodes are desktop-land semi-annular electrode, projecting semi-annular electrode desktop retained with the vessel wall contacting a side station, to facilitate contraction of the conduit when smaller diameter, the ring-land-land electrodes or semi-annular electrode structure facilitates full contact with the vascular wall. 凸台式环电极10 与铜导线27连接,将焊好铜导线的消融电极装配在末直段28的凸台上,铜导线从远端孔中穿入电极管8,铜导线在电极管的内部并经由主体段2的空腔中穿过后从手柄3的尾部连出到电极接头29,通过中间连接线43连接到射频消融发生器44。 Ring-land electrode 1027 is connected to the copper wire, copper wire to weld the end of a linear ablation electrode fitted in the boss section 28, a copper wire electrode penetrates the tube from the distal end hole 8, inside the copper wire in the electrode tube after the body cavity and is connected via a section 2 through from the end of the handle 3 to the electrode tab 29, line 43 is connected to the radio frequency ablation generator 44 through the intermediate connector. 凸台式环电极10内置有温度传感器,温度传感器采用热电隅或热敏电阻。 The ring electrode 10 built-land a temperature sensor, a temperature sensor using a thermistor or thermoelectric corner. 所述电极管8采用的材料为热塑性弹性体材料制成,热塑性弹性体材料包括Pebax、PA和聚亚氨酯中的一种或多种混合体。 8 the electrode material used is a tube made of a thermoplastic elastomer material, a thermoplastic elastomer material comprises a mixture of one or more Pebax, PA, and in the polyurethane.

[0050] 主体段2分为外套管4和内芯5,内芯5末端与前定位球7连接,前定位球7上设有前示标环12,外套管4的末端与后定位球6连接,后定位球6上设有后示标环11,前示标环11、后示标环12通过X光显影运动副机构在肾动脉内的位置。 [0050] The body section 2 is divided into the outer sleeve 4 and the inner 5 core, the core 5 and the front end of the detent ball 7 is connected to token ring 12 is shown with the front, and the rear end of the outer sleeve 64 is positioned on the ball 7 before positioning the ball connection, the positioning ring 11 is provided with the standard shown, illustrating the front ring 11 standard, the standard ring 12 is shown in position within the renal artery by X-ray image motion ball gear mechanism 6. 内芯5为实芯体, 内芯的近端与扭转器30连接,在内芯的最远端为球形,在内芯上设有示标环15,内芯5 通过扭转器30的推送下向前或向后移动,控制运动副机构的扩张和收缩。 5 is a solid core of the core, the proximal end of the inner core 30 is connected with the torsion, the most distal end of the inner core is spherical, has shown marked on the ring 15 of the inner core, the inner core 5 is pushed through the twister 30 forward or backward, control expansion and contraction of the secondary body movement. 外套管4的近端与手柄3固定连接,外套管上设有近端示标环13和远端示标环14,外套管4由内层材料PTFE,中层金属编织网管,外层材料为PA和PEBAX等热塑性材料,外表面涂有Hydrolene 亲水涂层。 The handle proximal end of the overtube 3, 4 is fixedly connected with a proximal end and a distal end 13 is shown illustrating the Token-Ring standard ring 14, the outer sleeve 4 from the inner material PTFE, braid metal middle layer, the outer layer material to the outer sleeve PA and PEBAX thermoplastic material, the outer coating layer is coated with a hydrophilic Hydrolene. 内芯5可在外套管4内移动。 Core 5 can move within the outer sleeve 4. 运动副的材料为镍钛合金或不锈钢等,在轴向上具有足够的强度作为运动副的结构件,在横向上又具有一定的柔顺性,便于在血管内输送。 Motion of the material for the sub-like nitinol or stainless steel, having sufficient strength as a structural sub-element movement in the axial direction, in the transverse direction and has a certain flexibility to facilitate delivery within a vessel.

[0051] 其它实施例中:内芯为中空的管材结构,手柄3尾部处内芯与标准的鲁尔接头连接。 [0051] Other embodiments: the core is a hollow tube structure, the inner core and the handle 3 at the tail of the standard luer connection.

[0052] 其它实施例中:外套管4的近端简单地与管座接头连接,不与具有多功能的手柄3 连接。 [0052] Other embodiments: the proximal end of the outer sleeve 4 is simply connected to the header connector is not connected to the handle 3 having multifunctional.

[0053] 运动副机构46为3-6组单组前后拐肘运动副47组成,为了导管精确地适合于不同内径的肾动脉,将导管扩张后纺缍体的尺寸大小精确地细分为四个系列,第I系列的尺寸为:扩张后纺缍体的直径范围为彡O5. 0mm,纺缍体轴向长度16mm左右,I系列适用于内径(64.0mm-①5.Omm的肾动脉;第II系列的尺寸为:扩张后纺缍体的直径范围为< 06. 0_,纺缍体轴向长度16mm左右,II系列适用于内径®5. 0mm-06.Omm的肾动脉;第111系列的尺寸为:扩张后纺缍体的直径范围为<07.Omm,纺缍体轴向长度18mm左右,III系列适用于内径®6.0mm-07.Omm的肾动脉;第系列的尺寸为:扩张后纺缍体的直径范围为< (68. 0_,纺缍体轴向长度18 _ 左右,IV系列适用于内径®7. 0 Omm的肾动脉。 [0053] The sub-motion mechanism 46 back and forth motion of the elbow 3-6 group consisting of a single set of sub-47, adapted for the catheter to the renal artery precisely different inner diameters, the spindle dilatation catheter body size accurately subdivided into four series, series I, dimensions: diameter range spindle body after expansion of San O5 0mm, spindle about the axial length of the body 16mm, an inner diameter suitable for series I (64.0mm-①5.Omm renal arteries; section. II family size: diameter range spindle body after expansion of <06. 0_, spindle about the axial length of the body 16mm, an inner diameter suitable for series II ®5 0mm-06.Omm renal artery; 111 series. dimensions: diameter range of the spindle body is expandable <07.Omm, spindle about the axial length of the body 18mm, III series for ®6.0mm-07.Omm inner diameter of the renal artery; series of dimensions: after expansion diameter range for the spindle body <(68. 0_, spindle about the axial length of the body 18 _, IV series for the inner diameter of the renal artery ®7. 0 Omm's.

[0054] 每系列导管的展开过程,例如:1系列导管扩张后纺缍体的直径范围为彡(65.Omm,适用于内径®4. 0mm- (65.Omm的肾动脉;I系列的导管扩张,当内芯上的示标环15与外套管上的远端示标环14显影对齐时,运动副机构已扩张到此系列导管规定的最小直径为(64 _,导管适合于® 4mm的肾动脉,通过X光显影可观察到电极管8的末直段28保持水平,此时在中间连接点B处,中间外球头18和中间内球头21形成的角度0为180度(如图8),纺缍体的多个凸台式环电极10均匀分布在血管四周并紧密贴附于内径®4.0mm的肾动脉内壁。如果需要可继续通过扭转器30调节内芯上的示标环(15) 在外套管的两示标环(13,14)间的相对位置,以适用于内径®4.0mm-(65.Omm的肾动脉,在调节过程中同时通过X光显影观察多个凸台式环电极10在血管内的贴壁状态和运动副机构46在肾动脉内的相对位置,外套 [0054] Each series of the catheter during deployment, for example: a series of post-dilatation diameter in the range of San spindle body (65.Omm, applied to the inner diameter ®4 0mm- (65.Omm renal arteries; the I series conduit expansion, when the scale shown on the core ring 15 on the distal end of the outer sleeve 14 of the developing ring alignment mark shown, this movement of the sub-series expansion mechanism has a predetermined minimum diameter of the catheter (_ 64, the conduit adapted to ® 4mm renal artery can be observed by the X-ray image 28 to maintain the level of the end of the straight tube segment electrodes 8, in which case the connection point B in the middle, middle and outer ball head 18 within an angle formed by the intermediate ball 21 0 180 degrees (e.g. FIG. 8), a plurality of ring-land electrode spindle body 10 and evenly distributed in perivascular closely adhered to the inner wall of the renal artery of the inner diameter ®4.0mm. 30 shows marked adjusting ring on the inner core if necessary continue twister relative position (13, 14) (15) of the outer sleeve of the two token ring shown to apply to the inner diameter ®4.0mm- (65.Omm renal artery, while observing the X-ray image by a plurality of projections in the adjustment process desktop ring 10 and wall motion sub-state of the electrode means relative position within a blood vessel 46 within the renal artery, jacket 管上的两示标环间隔0. 5mm-l.Omm左右,即是内芯继续调整的距离,依拐肘角度设置而定,运动副机构直径继续扩张< 1.0mm,单边单组前后拐肘运动副需要继续扩张<0.5mm,因此只需微调内芯的位置,当内芯上的示标环15与外套管上的近端示标环13显影对齐时,导管扩张后的直径确定为(65.Omm,适用于内径(65.Omm的肾动脉,导管扩张后纺缍体上的多个凸台式环电极10均匀分布在血管四周并紧密贴附于肾动脉内壁以便标测消融。 Shows two rings on the tube marked interval of about 0. 5mm-l.Omm, that is, to continue to adjust the distance of the inner core, provided by the angle of the elbow may be, sub-motion mechanism continues to expand a diameter of <1.0mm, before and after the turn-sided single set elbow motion need continues to expand the sub <0.5mm, the inner core thus only fine adjustment position, when the proximal end of the scale shown in the diagram marked ring on the inner ring of the core 15 and the outer sleeve 13 of the developing aligned, the diameter of the dilatation catheter is determined (65.Omm, applied to the inner diameter (65.Omm renal artery, duct ectasia plurality of projections on the spindle body desktop ring electrodes 10 and uniformly distributed in perivascular closely adhered to the inner wall of the renal artery for mapping and ablating.

[0055] 运动副机构46由多套单组前后拐肘运动副47组成,呈纺缍状结构,前拐肘9和后拐肘16形成单组前后拐肘运动副47,前拐肘与后拐肘形成摆动连接,摆动连接采用中间内球头21和中间外球头18配合连接。 [0055] The motion gear mechanism 46 turn by the front and rear sets a single set of toggle kinematic pair 47 composed of, as a spindle-like structure, before and after the elbow 9 and the elbow sub 47 the elbow moving back and forth 16 form a single group, before the elbow and the rear the elbow pivot connection is formed, the intermediate pivot connection using a ball head 21 and the intermediate outer ball head 18 fit connection. 前拐肘9的一端前内球头22与前外球头20形成摆动连接,前外球头20与前定位球7采用焊接等方式固定连接,后拐肘16的一端后内球头17与后外球头19形成摆动连接,后拐肘中间一段向内弯曲角度,前外球头19、后外球头20与前定位球6、后定位球7采用焊接等方式固定连接,后拐肘16为电极管8的内部支架,电极管弯曲一端装配有凸台式环电极10或凸台式半环形电极。 The ball head 17 and the rear before the elbow ball 22 pivot connected to the front outer ball head 20 is formed within the front end 9, the front outer ball head 20 and the front detent ball 7 using welding or the like is fixedly connected, after the elbow end 16 after the formation of the outer ball head 19 connected to the wobble, the crank angle of the intermediate inwardly curved elbow section, the front outer ball head 19, the outer ball head 20 and front positioning the ball 6, the detent ball 7 is fixedly connected by welding, etc., after the elbow an inner support tube 16 to electrode 8, the electrode tube is bent end fitted with a ring electrode 10-land-land or semi-annular electrode.

[0056] 当外套管4的相对位置固定不动,内芯5向外伸出时,后拐肘16和前拐肘9的相对运动与上述的动作正好相反,使得直径缩小,因此内芯与外套管之间的相对运动及其运动副的作用能控制导管的开合直径大小。 [0056] When the relative position of the outer sleeve 4 is fixed, the inner core 5 outwardly when the elbow 16 and the front of the elbow 9 and a relative movement opposite the above-described operation, so that the diameter is reduced, and thus the inner core its effect relative movement between the movement of the sub overtube to control opening and closing of the catheter diameter.

[0057] 手柄3前半部分装有锁定内芯的组合开关32,组合开关组成包括组合开关的上旋钮33,组合开关的下按钮36和弹簧38。 [0057] The front half portion of the handle 3 with the lock core 32 within the combination switch, the combination switch consists of the combination switch knob 33, the button 36 and the spring 38 of the combination switch. 按下组合开关32的上旋钮33,弹簧38压缩,同时组合开关的下按钮36移动并抱紧内芯,使内芯和外套管不能相对移动保持按住组合开关的上旋钮33同时旋转,上旋钮33绕下按钮的转轴37旋转一角度,此时上旋钮的左右卡位台(34, 35)卡进槽位并阻止上旋钮(33)弹回,保持手柄抱紧内芯的状态。 Press the combination switch 33 on the knob 32, the compression spring 38, while the combination of the push-button switch 36 moves and hold the inner core, the inner core and the outer sleeve immovably hold the combination switch 33 while rotating the knob, the button knob 33 around the lower shaft 37 a rotation angle, this time around the knob latching stage (34, 35) into the card slot and prevents the knob (33) springs back, hold the handle hold the inner core. 当需要松开内芯5时,旋转组合开关的上旋钮33,上旋钮33绕下按钮的转轴37旋转,上旋钮的左右卡位台(34,35)退出槽位,弹簧38回弹伸长,下按钮36弹回到一定位置, 此时手柄松开内芯。 When the need to release the inner core 5, the combination switch knob 33, the knob 33 on shaft 37 rotating about the down button, the left knob latching units (34, 35) exit slots, elongated resilient spring 38 , the button 36 springs back to a predetermined position, then release the handle core.

[0058]图18-21 所不,多极射频消融导管在RSD(RenalSympatheticDenervation,RSD) 手术中的的过程状态示意图。 [0058] FIGS. 18-21 are not, a schematic view of a multi-polar radiofrequency catheter ablation procedure RSD (RenalSympatheticDenervation, RSD) surgery state. 在RSD手术过程中,通过操纵手柄上的扭转器30回抽或推送内芯,通过X光显影观察,当内芯上的示标环15与外套管4上的远端示标环14显影对齐时,运动副机构已扩张到每系列导管规定的最小直径(如图19),如果需要可继续通过扭转器30调节内芯上的示标环15在外套管的两示标环(13,14)间的相对位置,并通过X光显影观察多个凸台式环电极10在血管内的贴壁状态和运动副机构46在肾动脉内的相对位置,当内芯上的示标环15与外套管4上的近端示标环13显影对齐时,运动副机构扩张到每一系列导管规定的最大直径(如图20),导管扩张后多个凸台式环电极10均匀分布在血管四周并紧密贴附于肾动脉内壁,然后操作手柄上的组合开关32来锁定内芯与外套管相对位置,导管消融工作端1的扩张外形保持稳定;打开射频消融发生器(Ablation andsensingunit,ASU)激发射频电流, In RSD during surgery, or through the core 30 Withdrawing push twist on the joystick, X-ray image observation, as shown on the token ring on the distal end of the inner core and the outer sleeve 415 is shown aligned with the developing Token-Ring 14 when, sub-motion mechanism has been expanded to a predetermined minimum diameter of the catheter each series (FIG. 19), if necessary, to continue to adjust the two rings diagram illustrating standard Token-ring on the core 15 of the outer sleeve (30, 13, 14 by a torsion ) the relative position and the relative position of the X-ray image was observed by a plurality of walls 10 and the motion state of the sub-land mechanism ring electrodes within the vessel 46 within the renal artery, as shown on the token ring core 15 and the jacket when the ring 13 is shown marked on the proximal end of the developing aligned tube 4, sub-motion mechanism to expand to a predetermined maximum diameter of the conduit in each series (FIG. 20), a plurality of ring-land after dilatation electrode 10 uniformly distributed and closely perivascular It is attached to the inner wall of the renal artery, and the combination switch on the operating handle 32 to lock the inner core and the outer pipe relatively stable position, the working end of the expandable catheter ablation profile 1; open radiofrequency ablation generator (ablation andsensingunit, ASU) RF excitation current , 测祀组织相应的交感神经兴奋支配点,然后通过多个电极依次顺序地对各靶点进行消融。 Si respective measuring tissue sympathetic dominant point, followed sequentially by a respective plurality of target ablation electrodes. 图21中导引导管及其管座40用于输送本发明的导管到肾动脉内;本实施例的导管的手柄尾部的电极接头29通过中间连接线43的四根单电极接头分别连接到射频消融发生器(AblationandSensingUnit,ASU)上的四个电极接口上,同时使用ASU上的选择旋钮开关调到相应的位置,才可激发射频消融电流。 FIG guiding catheter 21 and the stem 40 for conveying the catheter of the invention into the renal artery; electrode tab of the handle end of a catheter according to the present embodiment is a single electrode 29 is connected to four connection lines 43 are connected through an intermediate to a radio frequency four ablation electrodes on the interface generator (AblationandSensingUnit, ASU), while using the selector knob switch on the ASU tuned to the respective positions before the excitation current radiofrequency ablation. 这样可以有控制地顺序地选择消融电极操作。 Such control can sequentially select the ablation electrode operation.

Claims (3)

1. 一种适用于肾动脉血管内多极射频消融导管,包括导管消融工作端(1),主体段(2),手柄(3),其特征在于:导管消融工作端(1)为带有多极电极管(8)的运动副机构(46), 运动副机构(46)扩张后呈纺缍体;所述运动副机构(46)由若干单组前后拐肘运动副(47) 组成,每单组前后拐肘运动副(47)为连接一套由电极管(8)和凸台式环形电极(10)组成的一独立或联动的单组导管消融工作端;所述单组前后拐肘运动副是由前后拐肘组成,后拐肘中间段向内弯曲,电极管(8)的内部支架是后拐肘(16),其电极管弯曲段配有凸台式环形电极(10);主体段(2)由外套管(4)和内芯(5)构成,所述的外套管(4)与运动副机构(46 )的近端连接,内芯(5 )与运动副机构(46 )的远端连接;手柄(3 )内置组合开关(32 ),与内芯(5)连接,所述组合开关由上旋钮(33),下按钮(36) A suitable RF multipole renal artery ablation catheter, an ablation catheter comprising a working end (1), the body section (2), a handle (3), characterized in that: the working end of the ablation catheter (1) having sub-motion mechanism multipole electrode tube (8) (46), sub-motion mechanism (46) after expansion as a spindle body; the sub-motion mechanism (46) before and after the elbow by a plurality of sub-motion a single set (47) consisting of, each single set of back and forth movement of the elbow sub (47) by a set of electrodes connected to the tube (8) and the ring-land electrode (10) a single set of ablation catheter working end of a linkage or independently thereof; before and after the single set of the elbow longitudinal movement of the elbow by the sub, the latter intermediate section the elbow is bent inwardly, electrode tube (8) inside the stent after the elbow (16), which electrode tube curved section with an annular projection desktop electrode (10); a body section (2) consists of an outer sleeve (4) and the inner core (5), said outer sleeve (4) and the sub-motion mechanism (46) connected to the proximal end of the inner core (5) and the sub-motion mechanism (46) connected to the distal end; a handle (3) a combination of built-in switch (32), the inner core (5), said combination switch (33), the button by the knob (36) 弹簧(38)组成;本导管用于肾动脉血管内标测与消融。 A spring (38) consisting of; the present endovascular renal artery catheter for mapping and ablation.
2. 如权利要求1所述的适用于肾动脉血管内多极射频消融导管,其特征在于:单组前后拐肘运动副(47)由前拐肘(9)和后拐肘(16)组成,前拐肘(9)的一端前内球头(22)与前外球头(20)形成摆动连接,前外球头(20)与前定位球(7)焊接,后拐肘中间一段向内弯曲角度,后拐肘(16)的一端后内球头(17)与后外球头(19)形成摆动连接,后外球头(19)与后定位球(6)焊接。 As claimed in claim 1 for multi-polar radiofrequency ablation catheter within the renal artery, comprising: a single set of longitudinal movement of the elbow sub (47) from the front the elbow (9), and after the elbow (16) composed of , the front end of the front the elbow (9) of the ball head (22) and the front outer ball head (20) forming pivot connection, the front outer ball head (20) and the front positioning the ball (7) welding, after the elbow middle section to the bending angle, the rear end of the crank elbow (16) of the ball head (17) and the rear outer ball head (19) swing link is formed, the outer ball head (19) and the detent ball (6) are welded.
3. 如权利要求1或2所述的适用于肾动脉血管内多极射频消融导管,其特征在于:所述运动副机构(46)由3-6组单组前后拐肘运动副(47)组成。 As claimed in claim 1 or claim 2 applies to multi-polar radiofrequency ablation catheter within the renal artery, which is characterized in that: said sub-motion mechanism (46) consists of 3-6 groups of single longitudinal movement of the elbow sub (47) composition.
CN201210423459.3A 2012-10-30 2012-10-30 Multipolar radiofrequency ablation catheter which is applicable to being used in renal artery vessels CN102871727B (en)

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CN105193498B (en) * 2015-09-18 2019-03-08 先健科技(深圳)有限公司 Ablation catheter apparatus

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1210021B1 (en) * 1999-03-19 2006-05-10 Atrionix, Inc. Atrial annulus ablation device
CN101495048A (en) * 2006-05-24 2009-07-29 艾姆西森有限公司 Vessel sealing device and methods
CN202069688U (en) * 2011-03-11 2011-12-14 北京天助畅运医疗技术股份有限公司 Radio frequency ablation electrode capable of treating resistant hypertension
CN102462532A (en) * 2011-10-25 2012-05-23 张石江 Conduit system with label testing and ablation functions in blood vessels
CN202859295U (en) * 2012-10-30 2013-04-10 陈平根 Multipolar radio frequency melting catheter suitable for renal artery blood vessels

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040082947A1 (en) * 2002-10-25 2004-04-29 The Regents Of The University Of Michigan Ablation catheters

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1210021B1 (en) * 1999-03-19 2006-05-10 Atrionix, Inc. Atrial annulus ablation device
CN101495048A (en) * 2006-05-24 2009-07-29 艾姆西森有限公司 Vessel sealing device and methods
CN202069688U (en) * 2011-03-11 2011-12-14 北京天助畅运医疗技术股份有限公司 Radio frequency ablation electrode capable of treating resistant hypertension
CN102462532A (en) * 2011-10-25 2012-05-23 张石江 Conduit system with label testing and ablation functions in blood vessels
CN202859295U (en) * 2012-10-30 2013-04-10 陈平根 Multipolar radio frequency melting catheter suitable for renal artery blood vessels

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