CN105078569A - Sympathetic nerve mapping and ablating device and system - Google Patents
Sympathetic nerve mapping and ablating device and system Download PDFInfo
- Publication number
- CN105078569A CN105078569A CN201410220552.3A CN201410220552A CN105078569A CN 105078569 A CN105078569 A CN 105078569A CN 201410220552 A CN201410220552 A CN 201410220552A CN 105078569 A CN105078569 A CN 105078569A
- Authority
- CN
- China
- Prior art keywords
- mapping
- pipe
- guide catheter
- melt
- melts
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
Landscapes
- Surgical Instruments (AREA)
Abstract
The invention provides a sympathetic nerve mapping and ablating device and a mapping and ablating system. The device comprises a guide catheter, a mapping and ablating tube and a handle part, wherein the guide catheter is a hollow tube formed with openings in two ends, and the guide catheter is sleeved outside the mapping and ablating tube; the front section of the mapping and ablating tube is of a spiral structure which can extend out of the opening in the front end of the guide catheter; a plurality of electrodes for mapping and ablating sympathetic nerves are distributed on the surface of the front section of the mapping and ablating tube, and each electrode is provided with a mapping lead and an ablating lead which are respectively connected to a detector and an energy generator; and the handle part is connected to the guide catheter, and the handle is provided with a part by which the mapping and ablating tube is controlled to extend out of or retreat back from the guide catheter from the opening in the front end of the guide catheter. By virtue of the device disclosed by the invention, sympathetic nerve innervation points can be precisely mapped and ablated from vascular adventitia during an operation, so as to detect and ablate disease-related sympathetic nerves in a targeted mode and to avoid vascular injury and complication caused by treatment to the greatest extent.
Description
Technical field
The present invention relates to a kind of medical apparatus and instruments, be specifically related to a kind of sympathetic nerve mapping ablating device and system.
Background technology
Hypertension is a kind of global public disease, and not only sickness rate is high, and endangers huge, and it is the Major Risk Factors of apoplexy, coronary heart disease, heart failure, vascular disease and renal failure, also day by day causes the public to the worry of health problem.Particularly, intractable hypertension is a kind of malignant disease that fatality rate is high under treating without active drug, and its needs of patients takes the antihypertensive drugs of multiple different mechanism of action to control systolic pressure and diastolic pressure simultaneously, not only add the financial burden of patient to a certain extent, also add the untoward reaction of medicine to a certain extent, the treatment therefore for hypertension, particularly intractable hypertension needs a kind of brand-new therapeutic modality simultaneously.
Medical research is verified, a lot of disease senesis of disease can be summed up as that human body is orthosympathetic is overexcited, such as, kidney regulates mainly through sympathetic nerve Autonomous Control and netted postganglionic neuron, sympathetic nerve is circulated by kidney, the urinary function of kidney and the endocrine function of kidney regulate the rotation of water and eletrolytes, thus play important regulating action to blood pressure.Along with sympathetic nerve and hypertensive relation are approved gradually, sympathetic nerve is removed art and is therefore also regarded as treating the effective method of hypertensive one.But, this screening and blindly melt and remove orthosympathetic operation method and often cause patient with operation to be associated with more serious bowel dysfunction, postural hypotension and the complication such as bladder function and sexual disorder clinically, was eliminated completely from the fifties in last century.
Along with the development of Minimally Invasive Surgery technology, sympathetic nerve is gone to treat hypertension through intubation intervention kidney, since two thousand nine in a kind of new mechanotherapy method that world's medical domain rises, this method has overturned in the past all hypertension therapeutic tradition, and the safety of its treatment and effectiveness are by multiple clinical research confirmation.Apparatus (the Simplicity of current Medtronic Inc.
tM) be uniquely obtain FDA approval commercial product and be applied to clinical treatment, its treatment principle is inserted in the renal artery of left and right through femoral artery by ablation catheter to discharge radio-frequency (RF) energy, usually ablation catheter head need be close on renal artery inner membrance, release radio-frequency (RF) energy melts 6 ~ 8 points, with the SNE in high temperature renal artery blood vessel wall, reach reduction sympathetic excitability, reduce the secretion of kidney catecholamine and increase the object of renal hemodynamic, thus treat some sympathetic nerve and be overexcited diseases related, these diseases also comprise diabetes except hypertension, renal failure, arrhythmia and sleep disorder etc.
Interventional therapy method in above-mentioned Renal vascular, avoid the wound of open surgery, but current clinical treatment outcome still can not be satisfied the demand, main existence two shortcomings: 1. existing apparatus does not carry out mapping to the sympathetic nervous system of renal periarterial, thus which cannot confirm/effect of which spot ablations is better, or more suit the medicine to the illness, therefore it adopts melting of multiple spot hauling type, generally carry out multiple spot at Ink vessel transfusing to melt (6 ~ 8 points), wish whereby to cover effective site, but it is more that the point-like of renal artery inner membrance can be caused to damage; 2. the ablating electrode of existing apparatus melts at Endovascular, radio-frequency (RF) energy has to pass through blood vessel wall and arrives adventitia, could SNE on ablation vessels wall and tunica adventitia, therefore larger energy must be adopted, but larger or excessive radio-frequency (RF) energy can cause blood vessel injury, particularly blood vessel internal membrane damage is heavier, and post-operative complication is difficult to avoid, very large on therapeutic effect impact.Based on above feature and problem, this Therapeutic Method is since carrying out, also the report of some complication relevant to treatment and contraindication is had, as renal artery inner membrance multiple spot melts hypertension recurrence caused by rear formation cicatricial renal artery stenosis, ablation catheter in single-point energy too high caused renal artery perforation, dissecting aneurysm of renal artery etc., in addition this method can not be applied to the patient of contrast medium sensitivity and have arterial thrombosis to lower limb, patient that ventral aorta has obvious atheromatous plaque or renal artery congenital malformation.
So, explore more scientific less invasive techniques and realize melting target is orthosympathetic, the side effect for the treatment of and complication are dropped to minimum, the clinical treatment of relevant disease and application are had very important significance.
Summary of the invention
The invention provides a kind of sympathetic nerve mapping ablating device, accurately mapping and melting can be carried out from tremulous pulse tunica adventitia to sympathetic innervation point in operation, accomplish to put more accurately to melt, not only be beneficial to raising therapeutic effect, and the complication that can blood vessel injury avoided to greatest extent and cause because of ablation.
The present invention also provides a kind of sympathetic nerve mapping ablation system, its electrode can realize mapping and ablation functionality simultaneously, and this system possesses multiple electrode simultaneously, multiple electrode is simultaneously in place, thus location difficulty when not only avoid single electrode multi-pass operation, also avoid the displacement changed caused by electrode; This system utilizes the detector pair sympathetic nerve relevant to disease to detect, and melts targetedly needing the sympathetic nerve melted according to testing result, also judges ablation effect by mapping after ablation, convenient in actual applications.
A kind of sympathetic nerve mapping ablating device provided by the invention, comprise guide catheter, mapping melt pipe and handle portion,
Described guide catheter is the hollow pipe of both ends open, and it is sheathed on described mapping and melts outside pipe;
The leading portion that described mapping melts pipe can stretch out from the head end opening of described guide catheter and structure in the shape of a spiral, before described mapping melts pipe, section surface is laid with multiple electrode that can carry out mapping to sympathetic nerve and melt, and each electrode all has the mapping wire of connection detector and power generator respectively and melts wire;
Described handle portion is connected with described guide catheter, and it has and can control described mapping and melt pipe and stretch out from the head end opening of described guide catheter or return the parts of described guide catheter.
According to sympathetic nerve mapping ablating device provided by the present invention, described mapping melts pipe to be made up of medical macromolecular materials, its both ends open and be shaped as helicoidal structure in advance, melt in pipe in described mapping and be equipped with seal wire, it is substantially linearly that described seal wire can make described mapping melt pipe, further, when described mapping melt pipe stretch out from the head end opening of described guide catheter time, its extension can be drawn to small part and structure in the shape of a spiral because described seal wire melts pipe tail end from described mapping.
Further, the material of described seal wire is medical metal material or medical alloy material.
The present invention also provides a kind of sympathetic nerve mapping ablation system, comprise above-mentioned arbitrary described sympathetic nerve mapping ablating device, detector and power generator, wherein, described mapping multiple electrodes of melting pipe by mapping wire with melt wire and be connected with described detector and described power generator respectively.
The present invention also provides a kind of method using above-mentioned arbitrary device or system to carry out tremulous pulse sympathetic nerve mapping and melt, and comprises the steps:
1) head end of described guide catheter is utilized to isolate arteries;
2) utilize the described parts of described handle portion to make described mapping melt pipe stretch out from the head end opening of described guide catheter or return described guide catheter, thus multiple spot or single-point mapping are carried out to tremulous pulse sympathetic nerve and melts.
The enforcement of the present invention program, at least has following advantage:
1, mapping ablating device of the present invention changes the method for carrying out interventional therapy in traditional intravascular, it is carried out mapping by tunica adventitia to sympathetic innervation point and melts, thus can realize detecting targetedly and melting the sympathetic nerve relevant to disease by transferring to tunica adventitia compared with macro-energy without the need to intravascular inside, required energy Ratios carries out melting little from inner membrance, therefore little to the damage of blood vessel, the complication that can blood vessel injury avoided to greatest extent and cause because of ablation.
2, mapping ablating device of the present invention has multiple electrode that simultaneously can realize mapping function and ablation functionality, it can carry out mapping respectively or simultaneously to orthosympathetic multiple site and melt, not only required site is fewer than existing multiple spot hauling type ablation method, ascendingly progressively can also increase ablation energy, thus realize accurately location and the carrying out of appropriate energy and melt, the precision melted and efficiency all increase; In addition, ablation effect can also be judged by the mapping function of electrode after ablation, be conducive to avoiding melting the defects such as incomplete, thus improve the curative effect for the treatment of.
3, mapping ablating device of the present invention can guarantee that under the guiding of mapping result the site of carrying out melting is the position of SNE domination, by the process of selectivity denervation, avoids blindly melting brought all drawbacks; In addition it adopts less energy repeatedly repeatedly to melt, thus avoids the blood vessel injury caused because ablation energy is large.
4, present system structure is simple, easy to operate, it can control the state that described mapping melts pipe as required, thus realize single-point or multiple spot mapping and melt, clinical application range is extensive, as can be applicable in the routine operation such as abdominal part, Urology Surgery and open surgery, particularly it can realize without the need to larger operative incision, therefore can be applicable to Minimally Invasive Surgery.
Accompanying drawing explanation
Fig. 1 is the structural representation of the sympathetic nerve mapping ablation system of the embodiment of the present invention 1;
Fig. 2 is the sectional view of the sympathetic nerve mapping ablating device of the embodiment of the present invention 1;
Fig. 3 is the structural representation of the head end of the sympathetic nerve mapping ablating device of the embodiment of the present invention 1;
Fig. 4 is the sectional view of the head end of the sympathetic nerve mapping ablating device of the embodiment of the present invention 1;
Fig. 5 is the sympathetic nerve mapping ablating device front view in a state of use of the embodiment of the present invention 1;
Fig. 6 is the sympathetic nerve mapping ablating device left view in a state of use of the embodiment of the present invention 1.
Detailed description of the invention
For making the object, technical solutions and advantages of the present invention clearly, below in conjunction with the embodiment of the present invention, the technical scheme in the embodiment of the present invention is clearly and completely described, obviously, described embodiment is the present invention's part embodiment, instead of whole embodiments.Based on the embodiment in the present invention, those of ordinary skill in the art, not making the every other embodiment obtained under creative work prerequisite, belong to the scope of protection of the invention.
Sympathetic nerve mapping ablating device of the present invention, comprise guide catheter, mapping melt pipe and handle portion, guide catheter is the hollow pipe of both ends open, and it is sheathed on mapping and melts outside pipe; The leading portion that mapping melts pipe can stretch out from the head end opening of guide catheter and structure in the shape of a spiral, before mapping melts pipe, section surface is laid with multiple electrode that can carry out mapping to sympathetic nerve and melt, and each electrode all has the mapping wire of connection detector and power generator respectively and melts wire; Handle portion is connected with guide catheter, and it has and can control mapping and melt pipe and stretch out from the head end opening of guide catheter or return the parts of guide catheter.
In the present invention, " mapping " refers to and detects one or more physiology's clinical indices orthosympathetic, can judge whether to need the sympathetic nerve to mapping site to melt by testing result; " melt " to refer to and utilize energy to damage and remove site to be ablated, be i.e. the sympathetic nerve in mapping site that is positive of mapping result; " head end " refer to use sympathetic nerve mapping ablating device time in a forward direction foremost, " leading portion "/" front end " refers to one section/one end near guide catheter head end, " back segment "/" tail end " refer to one section/one end away from guide catheter head end.
Further, sympathetic nerve mapping ablating device of the present invention can carry out the mapping of single-point or multiple spot to sympathetic nerve and melt.Particularly, when mapping melt manage that from the beginning end opening stretches out guide catheter time, the extension that mapping melts pipe forms the helicoidal structure being distributed with multiple electrode, thus carries out multiple spot mapping to sympathetic nerve and melt; When mapping melt manage that from the beginning end opening stretches out guide catheter time, the head end electrode that mapping melts pipe is exposed from guide catheter by head end opening, thus carries out single-point mapping to sympathetic nerve and melt.
The head end of guide catheter should have to be beneficial to and enters operative incision and be beneficial to the shape of soft tissue being separated sympathetic peripheral, and such as it can be flat.Head end can be little as much as possible, and guide catheter should have certain length, applies in order to being used in Minimally Invasive Surgery.Guide catheter can be made up of macromolecular material or metal material, such as polyether block amide, polyimides, thermoplastic poly propylhomoserin, rustless steel, aluminium alloy, titanium alloy etc.
Mapping melts pipe should produce deformation, it both can be substantially linearly, thus be placed in guide catheter, it can also structure in the shape of a spiral, thus realize being formed arteries being wound around, such as it can be made up of memorial alloy, also can be made up of the medical macromolecular materials being shaped as helicoidal structure in advance.In the embodiment of the invention, mapping melts pipe to be made up of medical macromolecular materials, its both ends open and be shaped as helicoidal structure in advance, melt in pipe in mapping and be equipped with seal wire, it is substantially linearly that seal wire can make mapping melt pipe, further, when mapping melt pipe stretch out from the head end opening of guide catheter time, its extension can be drawn to small part and structure in the shape of a spiral because seal wire melts pipe tail end from mapping.
Making the medical macromolecular materials that mapping melts pipe and should have elasticity, such as, can be polrvinyl chloride, natural rubber, polyethylene, polyamide, polypropylene, polystyrene, silicone rubber, polyester, politef, polymethyl methacrylate and polyurethane etc.; Be wherein politef preferably.Further, the spiral internal diameter melting the helicoidal structure that pipe is formed by mapping can be equal to or less than the external diameter of target blood, is preferably less than, thus forms tight, stable contact to target blood.
Seal wire should have certain rigidity and elasticity, and it should resist the elasticity that mapping melts pipe, thus it is substantially linearly and be placed in guide catheter to make mapping moulding in advance melt pipe.When mapping melt pipe stretch out from the head end opening of guide catheter time, melt after pipe tail end is drawn to small part seal wire from mapping, mapping melts pipe can form helicoidal structure under natural resiliency effect, thus is formed target blood and be wound around; And when mapping with after having melted, again seal wire being inserted into mapping melts in pipe, thus the screw diameter that mapping melts pipe is expanded, to remove the winding to target blood, and again substantially linearly and be arranged in guide catheter.The material of seal wire can be medical metal material or medical alloy material, such as rustless steel, cobalt-base alloys, titanium-base alloy etc.
Electrode by discharging electricity irritation thus carrying out mapping to sympathetic nerve, also should can discharge radio-frequency (RF) energy thus melt sympathetic nerve.When mapping melt pipe from the head end opening of guide catheter stretch out and in the shape of a spiral structure time, the region being laid with multiple electrode at least should be positioned at the internal ring of helicoidal structure.Such as, electrode can in the form of a ring and spacer sleeve is located at mapping melts on pipe.
Electrode can be made up of metal material, such as platinum, platinumiridio, gold, silver etc.The number of the present invention to electrode is not particularly limited, as long as its number does not affect preparation and the use of apparatus of the present invention, the number of electrode can be such as 2 ~ 8.Further, each electrode can have independently numbers, and it can be corresponding with the numbering on detector and power generator, thus is accurately detected by the sympathetic nerve that detector and power generator control on corresponding electrode pair relevant position and melted.Power generator can be radio-frequency signal generator.
Handle portion should have the shape being beneficial to operator and gripping, and it can be manufactured by macromolecular material, such as polyformaldehyde, acrylonitrile-butadiene-styrene copolymer, Merlon, polyamide, polymethyl methacrylate etc.Handle portion can control mapping melt pipe stretch out from the head end opening of guide catheter or return guide catheter parts can according to this area general knowledge carry out routine arrange, such as it can be push-pull mechanism, be specifically as follows and be arranged on handle portion tail end and melt with mapping the push-pull bar that pipe tail end is connected, by to promote or the push-pull bar that stretches can make mapping melt pipe to move vertically, or cavity can be offered on the surface in handle portion and arrange and mapping melts the push rod that pipe is fixedly connected with at cavity; It can also be catch mechanism, specifically can melt pipe to mapping in above-mentioned cavity setting and form the parts held, such as, can melt on pipe in mapping and arrange lobe, and arrange the depressed part mated with this lobe on the components; It can also be stop mechanism, specifically can arrange at above-mentioned cavity and form to above-mentioned lobe the block etc. stopped.
Device of the present invention can be used for sympathetic nerve, especially mapping carried out to renal artery sympathetic nerve and melt, it melts pipe by the mapping of structure in the shape of a spiral and realizes arterial vascular winding, thus in surgery Minimally Invasive Surgery and open surgery, accurately mapping and melting can be carried out from tremulous pulse tunica adventitia to sympathetic innervation point, and without the need to inner by transferring to the adventitia of blood vessel wall compared with macro-energy by arteries, therefore blood vessel internal membrane damage can be avoided to greatest extent.Multiple electrodes that apparatus of the present invention are arranged are corresponding with energy measuring device generator with detector respectively to be connected, therefore, it is possible to accurately detect respectively or simultaneously the multiple sites on sympathetic nerve and melt, thus avoid and blindly melt brought drawback and injury.In addition, because this device has mapping function concurrently, less energy therefore can be adopted repeatedly repeatedly to melt, thus avoid the blood vessel injury and other complication that cause because ablation energy is large.
In the embodiment of the invention, handle portion can comprise taper knob and promotion part, taper knob offers through hole and is communicated with the tail end of guide catheter, and the back segment that mapping melts pipe enters in through hole through the tail end of guide catheter, and the seal wire that mapping melts in pipe stretches out from through hole tail end; Be provided with the first cavity be communicated with through hole on the surface at taper knob, promotion part is arranged in the first cavity, and it can control mapping and melt pipe and move vertically, thus stretches out from the head end opening of guide catheter or return guide catheter.Wherein, through hole can be axially extending bore, and promotion part can be above-mentioned push rod, catch mechanism or stop mechanism.
Further, promotion part can comprise the moving part and drive division that mutually form engagement, and at least part of of drive division stretches out from the first cavity; Moving part is set in mapping and melts outside pipe, and it can drive mapping to melt pipe to move vertically under the driving of drive division.Such as, chute can be set at moving part inner surface and make moving part two ends form end face, melt pipe is provided with in the mapping between the end face of moving part two ends and one or morely can form with the end face at described moving part two ends the lobe contacted, lobe can move vertically in chute.
This promotion part, by rotating (rotation) drive division, moving part is moved vertically, and when moving part moves axially, its two ends end face is formed with lobe and contacts, thus make mapping melt pipe to move axially, and then make mapping melt pipe to stretch out from the head end opening of guide catheter or return guide catheter thereupon.The present invention does not make considered critical to engagement, engagement only need meet can make moving part move axially by rotary driving part, engagement can be the engagement between tooth, such as intermeshing tooth is set respectively on the surface of moving part and drive division, engagement also can be the engagement between screw thread, such as moving part can be arranged to there is externally threaded hollow tubular structure, drive division is arranged to the female circulus of tool, drive division can be set in outside moving part, and to be mated with externally threaded by female thread thus when rotating drive portion, moving part moved vertically.This promotion part can make device of the present invention carry out mapping easily and melt associative operation.
In the embodiment of the invention, handle portion can also be provided with and can control mapping and melt the direction controlling portion that pipe rotates vertically, and be also provided with the second cavity be communicated with through hole on the surface at taper knob, direction controlling portion is arranged in the second cavity.Such as, direction controlling portion can comprise fixed part and rotation section, it is polygonal through hole that rotation section has cross sectional shape, it is set in mapping and melts outside pipe, mapping melts pipe at least to be had subregion and can match with the through hole of rotation section, with make mapping melt pipe stretch out preset length from the head end opening of guide catheter time, mapping melts pipe and still can be driven by rotation section and rotate vertically; At least part of of rotation section stretches out from the second cavity, and taper knob offers radial screw, and fixed part to be screwed onto in radial screw and to be butted on moving part.
Further, polygon can be regular polygon, and such as square, regular hexagon, octagon etc., be regular hexagon preferably.By mapping being melted tube portion, to be set to cross section be polygon to this direction control part, and by arranging the rotation section matched with it, thus make mapping melt pipe freely to move axially, be conducive to controlling mapping melt pipe stretching out in the shape of a spiral structure time spiral towards.
Can also offer form on the surface at taper knob, form exposes mapping and melts pipe.Form may be used for melting to mapping the length that pipe stretches out guide catheter and measures, thus is more easy to the practical operation of operator.
In the present invention, first cavity, the second cavity and the setting position of form on taper knob surface do not have considered critical, such as the first cavity can be arranged on the rear end of taper knob, and the second cavity can be arranged on the front end of taper knob, and form can be arranged between the first cavity and the second cavity.Further, the first cavity, can be interconnected between the second cavity and form, also can be separated from one another.
Sympathetic nerve mapping ablation system of the present invention, comprise above-mentioned arbitrary sympathetic nerve mapping ablating device, detector and power generator, wherein, mapping multiple electrodes of melting pipe by mapping wire with melt wire and be connected with detector and power generator respectively.
When using the device of the present embodiment or system carry out tremulous pulse sympathetic nerve mapping and melt, the head end of guide catheter first can be utilized to isolate arteries; Next utilizes the above-mentioned parts of handle portion to make mapping melt pipe to stretch out from the head end opening of guide catheter or return guide catheter, thus carries out multiple spot or single-point mapping to tremulous pulse sympathetic nerve and melt.
Further, the drive division of promotion part can be manipulated, make mapping melt pipe and stretch out from the head end opening of guide catheter; Melt pipe tail end from mapping to be subsequently drawn to small part seal wire and the mapping of stretching out from the head end opening of guide catheter to be melted manage structure in the shape of a spiral, target artery is formed and is wound around; Again by each electrode release electricity irritation and by electricity irritation communicating information to detector, monitor one or more physiology's clinical indices at each electrode stimulating position simultaneously, and electrode corresponding to the position of being positive by physiology's clinical indices is given off energy, and melts positive position.Further, can the fixed part of steer direction control part and rotation section, make mapping melt pipe head for target arteries, tighten up fixed part subsequently.
Further, after ablation, electricity irritation can be discharged by the electrode that positive position is corresponding, monitor one or more physiology's clinical indices at corresponding positive position simultaneously, and released energy by the electrode that positive position is corresponding, positive position is melted, until one or more physiology's clinical indices at positive position are negative.
In the method for the invention, physiology's clinical indices comprises one or more in blood pressure, heart rate.After each electrode is in place, nerve stimulation is carried out respectively from each electrode release electricity irritation (as electric pulse), and the physiology such as monitor heart rate, blood pressure clinical indices, when not causing obvious physiological reaction to the nerve stimulation in a certain position (site), this position is defined as negative position; When causing heart rate and/or blood pressure to rise to the nerve stimulation at a certain position, this position is defined as positive position; Subsequently, the electrode release ablation energy corresponding by positive position melts, thus damages the teleneuron at this position; Again carry out mapping after ablation, as positive reaction disappears, illustrate that this position is melted successfully, as positive reaction still exists, then again melt with identical energy or increase energy, mapping again after melting, until positive reaction disappears; After implementing aforesaid operations to all sites, re-start mapping, if each position is negative position, then melt successfully, treatment terminates; As still there is positive position, repeating aforesaid operations, until the positive reaction of all sites disappears, terminating treatment.
Embodiment 1
As depicted in figs. 1 and 2, the sympathetic nerve mapping ablating device of the present embodiment, comprises guide catheter 1, mapping melts pipe 2 and handle portion 3.
Composition graphs 3 and Fig. 4 simultaneously, guide catheter 1 is the hollow pipe of both ends open, and it is sheathed on mapping and melts outside pipe 2, and guide catheter 1 has the head end 11 in flat, and the front end of head end 11 tilts, and guide catheter 1 has certain length.
With further reference to Fig. 5 and Fig. 6, mapping melts pipe 2 to be made up of politef, its both ends open and be shaped as helicoidal structure (under relaxed state) in advance, melt in pipe 2 in mapping and be equipped with seal wire 21, it is substantially linearly that seal wire 21 can make mapping melt pipe 2, further, when mapping melt pipe 2 stretch out from the head end opening of guide catheter 1 time, its extension can be drawn to small part and structure in the shape of a spiral because seal wire melts pipe 2 tail end from mapping.Further, the spiral internal diameter of this helicoidal structure can be less than the external diameter of target blood, thus forms tight, stable contact to target blood.
Seal wire 21 is made up of rustless steel, and it is substantially linearly and be placed in guide catheter 1 that it can make mapping moulding in advance melt pipe 2.When mapping melt pipe 2 stretch out from the head end opening of guide catheter 1 time, melt after pipe 2 tail end is drawn to small part seal wire 21 from mapping, mapping melts pipe 2 can form helicoidal structure under natural resiliency effect, thus is formed target blood and be wound around; And when mapping with after having melted, again seal wire 21 being inserted into mapping melts pipe 2, thus the screw diameter that mapping melts pipe 2 is expanded, to remove the winding to target blood, and again substantially linearly and be arranged in guide catheter 1.
Before mapping melts pipe 2, section surface is laid with the electrode 22 that 8 energy carry out mapping to sympathetic nerve and melt, and each electrode 22 all has the mapping wire of connection detector 4 and power generator 5 respectively and melts wire 221, electrode 22 in the form of a ring and spacer sleeve is located at mapping melts on pipe 2.
Handle portion 3 comprises taper knob 31 and promotion part, and taper knob 31 offers through hole and is communicated with the tail end of guide catheter 1, and the back segment that mapping melts pipe 2 enters in through hole through the tail end of guide catheter 1, and the seal wire 21 that mapping melts in pipe 2 stretches out from through hole tail end; Be provided with the first cavity 311 be communicated with through hole on the surface at taper knob 31, promotion part is arranged in the first cavity 311.
Promotion part comprises the moving part 32 and drive division 33 that mutually form engagement, wherein moving part 32 is for having externally threaded hollow pipe, drive division 33 is the female ring of tool, when drive division 33 is set on moving part 32, female thread and external screw thread match, thus when rotating drive portion 33, moving part 32 being moved vertically, at least part of of drive division 33 stretches out from the first cavity 311, thus the practical operation of handled easily person; The mapping that is set in moving part 32 melts outside pipe 2, and it can drive mapping to melt pipe 2 to move vertically under the driving of drive division 31.
Further, moving part 32 inner surface is provided with chute 321, moving part 32 two ends have end face 322, and melt in the mapping between moving part 32 two ends end face 322 and pipe 2 is provided with an energy forms with the end face 322 at moving part 32 two ends the lobe 23 contacted, lobe 23 can move vertically in chute 321.This promotion part, by rotating drive portion 33, moving part 32 is moved vertically, and when moving part 32 moves axially, its two ends end face 322 is formed with lobe 23 and contacts, thus make mapping melt pipe 2 to move axially, and then make mapping melt pipe 2 to stretch out from the head end opening of guide catheter 1 or return guide catheter thereupon.
As shown in Figure 1, the sympathetic nerve mapping ablation system of the present embodiment, comprise above-mentioned sympathetic nerve mapping ablating device, detector 4 and power generator 5, wherein, multiple electrodes 22 that mapping melts pipe 2 by mapping wire with melt wire 221 and be connected with detector 4 and power generator 5 respectively.
Further, each electrode 22 can have independently numbers, and be corresponding with the numbering on detector 4 and power generator 5, thus accurately detect by the sympathetic nerve that detector 4 and power generator 5 control corresponding electrode 22 pairs of corresponding sites and melt.
The device of the present embodiment or system is used to carry out tremulous pulse sympathetic nerve, such as to renal artery sympathetic nerve mapping with melt, comprise the steps:
11, the head end 11 of guide catheter 1 is utilized to isolate arteries (renal artery blood vessel);
12, utilize the promotion part of handle portion to make mapping melt pipe 2 stretch out from the head end opening of guide catheter 1 or return guide catheter 1, thus multiple spot or single-point mapping are carried out to tremulous pulse sympathetic nerve and melts; It specifically comprises:
121, manipulate the drive division 33 of promotion part, make mapping melt pipe 2 and stretch out from the head end opening of guide catheter 1;
122, melt pipe 2 tail end from mapping to be drawn to small part seal wire 21 and to make the mapping of stretching out from the head end opening of guide catheter 1 melt pipe 2 structure in the shape of a spiral, target artery is formed and is wound around;
123, discharge electricity irritation by each electrode 22, monitor each electrode 22 stimulates one or more physiology's clinical indices caused simultaneously;
Electrode corresponding to the position 124, physiology's clinical indices being positive by power generator 5 gives off energy, to melt positive position;
125, discharge electricity irritation by the electrode 22 that positive position is corresponding, monitor corresponding positive position stimulates one or more physiology's clinical indices caused simultaneously, and wherein, physiology's clinical indices comprises blood pressure and heart rate;
126, released energy by the electrode 22 that positive position is corresponding, positive position is melted, until positive position stimulates one or more physiology's clinical indices caused to be negative.
Mapping ablating device/the system of the present embodiment changes the method for carrying out interventional therapy in traditional intravascular, it is by carrying out mapping at tunica adventitia to sympathetic innervation point and melt, thus can realize detecting targetedly and melting the sympathetic nerve relevant to disease, the complication therefore can avoided blood vessel injury to greatest extent and cause because of ablation by transferring to tunica adventitia compared with macro-energy without the need to intravascular inside; And, by arranging multiple electrode 22 that can realize mapping function and ablation functionality simultaneously, not only can carry out mapping respectively or simultaneously to orthosympathetic multiple site and melt, accurately can also melt site to mapping to position, can guarantee that under the guiding of mapping result the site of carrying out melting is the position of SNE domination, by the process of selectivity denervation, thus avoid blindly melting brought all drawbacks.This device/system can be applicable in the routine operation such as abdominal part, Urology Surgery and open surgery, and particularly it can realize without the need to larger operative incision, can be applied to Minimally Invasive Surgery preferably.
Embodiment 2
As shown in Figure 2, the present embodiment, on the basis of embodiment 1, arranges further and can control mapping and melt the direction controlling portion that pipe 2 rotates vertically in the first cavity 311 of taper knob 31.Particularly, direction controlling portion can comprise fixed part 34 and rotation section 35, rotation section 35 is in T shape and to have cross sectional shape be orthohexagonal through hole, it is set in mapping and melts outside pipe 2, and end is connected with the tail end of guide catheter 1, mapping melts pipe 2 at least to be had subregion and can match with the through hole of rotation section 35, with make mapping melt pipe 2 stretch out preset length from the head end opening of guide catheter 1 time, mapping melts pipe 2 and still can be driven by rotation section 35 and rotate vertically; The head end of rotation section 35 stretches out from the first cavity 311, thus the practical operation of convenient operation person; Taper knob 31 offers radial screw, and fixed part 34 to be screwed onto in radial screw and to be butted on moving part 35.The mapping that can control this direction control part melt pipe 2 stretching out in the shape of a spiral structure time spiral towards.
In the present embodiment, direction controlling portion is arranged on the front end of promotion part, and the form part of non-setting direction control part and promotion part (namely in the first cavity 311) can be formed between direction controlling portion and promotion part, the mapping that exposes form melts pipe 2, it can be used for melting to mapping the length that pipe 2 stretches out guide catheter 1 and observes and measure, thus is more easy to the practical operation of operator.
When using the device of the present embodiment or system carry out tremulous pulse sympathetic nerve mapping and melt, pipe 2 is melted from the step 121 of embodiment 1 (i.e. after) after the head end opening of guide catheter 1 stretches out in mapping, can direction of operating control part (namely, unclamp fixed part 34 and rotate rotation section 35), mapping is made to melt pipe 2 head for target arteries, and after winding is formed to target artery, tighten up fixed part 34, thus accurately locate.
Last it is noted that above each embodiment is only in order to illustrate technical scheme of the present invention, be not intended to limit; Although with reference to foregoing embodiments to invention has been detailed description, those of ordinary skill in the art is to be understood that: it still can be modified to the technical scheme described in foregoing embodiments, or carries out equivalent replacement to wherein some or all of technical characteristic; And these amendments or replacement, do not make the essence of appropriate technical solution depart from the scope of various embodiments of the present invention technical scheme.
Claims (10)
1. a sympathetic nerve mapping ablating device, is characterized in that, comprise guide catheter, mapping melt pipe and handle portion,
Described guide catheter is the hollow pipe of both ends open, and it is sheathed on described mapping and melts outside pipe;
The leading portion that described mapping melts pipe can stretch out from the head end opening of described guide catheter and structure in the shape of a spiral, before described mapping melts pipe, section surface is laid with multiple electrode that can carry out mapping to sympathetic nerve and melt, and each electrode all has the mapping wire of connection detector and power generator respectively and melts wire;
Described handle portion is connected with described guide catheter, and it has and can control described mapping and melt pipe and stretch out from the head end opening of described guide catheter or return the parts of described guide catheter.
2. sympathetic nerve mapping ablating device according to claim 1, it is characterized in that, described mapping melts pipe to be made up of medical macromolecular materials, its both ends open and be shaped as helicoidal structure in advance, melt in pipe in described mapping and be equipped with seal wire, it is substantially linearly that described seal wire can make described mapping melt pipe, and, when described mapping melt pipe stretch out from the head end opening of described guide catheter time, its extension can be drawn to small part and structure in the shape of a spiral because described seal wire melts pipe tail end from described mapping.
3. sympathetic nerve mapping ablating device according to claim 1, is characterized in that, the material of described seal wire is medical metal material or medical alloy material.
4., according to the arbitrary described sympathetic nerve mapping ablating device of claims 1 to 3, it is characterized in that, described handle portion comprises taper knob and promotion part,
Described taper knob offers through hole and is communicated with the tail end of described guide catheter, and the back segment that described mapping melts pipe enters in described through hole through the tail end of described guide catheter, and the seal wire that described mapping melts in pipe stretches out from described through hole tail end;
The first cavity be communicated with described through hole is provided with on the surface at described taper knob, described promotion part is arranged in described first cavity, it can control described mapping and melt pipe and move vertically, thus stretches out from the head end opening of described guide catheter or return described guide catheter.
5. sympathetic nerve mapping ablating device according to claim 4, is characterized in that, described promotion part comprises the moving part and drive division that mutually form engagement, and at least part of of described drive division stretches out from described first cavity;
Described moving part is set in described mapping and melts outside pipe, and it can drive described mapping to melt pipe to move vertically under the driving of described drive division.
6. the sympathetic nerve mapping ablating device according to claim 4 or 5, it is characterized in that, described handle portion is also provided with and can controls described mapping and melt the direction controlling portion that pipe rotates vertically, also be provided with the second cavity be communicated with described through hole on the surface at described taper knob, described direction controlling portion is arranged in described second cavity.
7. sympathetic nerve mapping ablating device according to claim 6, is characterized in that, described direction controlling portion comprises fixed part and rotation section,
It is polygonal through hole that described rotation section has cross sectional shape, it is set in described mapping and melts outside pipe, described mapping melts pipe at least to be had subregion and can match with the through hole of described rotation section, with make described mapping melt pipe stretch out preset length from the head end opening of described guide catheter time, described mapping melts pipe and still can be driven by described rotation section and rotate vertically; At least part of of described rotation section stretches out from described second cavity,
Described taper knob offers radial screw, and described fixed part to be screwed onto in described radial screw and to be butted on described moving part.
8. according to the arbitrary described sympathetic nerve mapping ablating device of claim 1 to 7, it is characterized in that, when described mapping melt pipe from the head end opening of described guide catheter stretch out and in the shape of a spiral structure time, the region being laid with multiple electrode is at least positioned at the internal ring of helicoidal structure.
9. sympathetic nerve mapping ablating device according to claim 8, is characterized in that, described electrode in the form of a ring and spacer sleeve is located at described mapping melts on pipe.
10. a sympathetic nerve mapping ablation system, it is characterized in that, comprise claim 1-9 arbitrary described sympathetic nerve mapping ablating device, detector and power generator, wherein, described mapping multiple electrodes of melting pipe by mapping wire with melt wire and be connected with described detector and described power generator respectively.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201410220552.3A CN105078569B (en) | 2014-05-22 | 2014-05-22 | Sympathetic nerve mapping ablating device and system |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201410220552.3A CN105078569B (en) | 2014-05-22 | 2014-05-22 | Sympathetic nerve mapping ablating device and system |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN105078569A true CN105078569A (en) | 2015-11-25 |
| CN105078569B CN105078569B (en) | 2017-11-10 |
Family
ID=54560532
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201410220552.3A Expired - Fee Related CN105078569B (en) | 2014-05-22 | 2014-05-22 | Sympathetic nerve mapping ablating device and system |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN105078569B (en) |
Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2018006383A1 (en) * | 2016-07-07 | 2018-01-11 | 四川锦江电子科技有限公司 | Inter-electrode discharge ablation apparatus |
| CN108523990A (en) * | 2018-01-30 | 2018-09-14 | 张丽娜 | A kind of microwave ablation therapeutic equipment for treating fibroid |
| CN109805926A (en) * | 2019-03-19 | 2019-05-28 | 苏州润迈德医疗科技有限公司 | Signal measurement apparatus for Intracoronary ECG |
| CN113116512A (en) * | 2019-12-31 | 2021-07-16 | 上海微创电生理医疗科技股份有限公司 | Ablation electrode assembly and ablation catheter |
| CN113995508A (en) * | 2021-11-05 | 2022-02-01 | 杭州佳量医疗科技有限公司 | Medical optical fiber guiding structure and guiding method |
Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20050070887A1 (en) * | 2003-09-26 | 2005-03-31 | Scimed Life Systems, Inc. | Medical probes for creating and diagnosing circumferential lesions within or around the ostium of a vessel |
| WO2008157399A1 (en) * | 2007-06-14 | 2008-12-24 | Hansen Medical, Inc. | System and method for determining electrode-tissue contact |
| US20130184549A1 (en) * | 2004-11-04 | 2013-07-18 | Boston Scientific Scimed, Inc. | Preshaped ablation catheter for ablating pulmonary vein ostia within the heart |
| US20130197507A1 (en) * | 2009-06-30 | 2013-08-01 | Boston Scientific Scimed, Inc. | Map and ablate open irrigated hybrid catheter |
| US20130237985A1 (en) * | 2009-07-29 | 2013-09-12 | Boston Scientific Scimed, Inc. | Mapping probe assembly with skived tube body frame |
| CN103417290A (en) * | 2012-05-14 | 2013-12-04 | 韦伯斯特生物官能(以色列)有限公司 | Catheter with helical end section for vessel ablation |
| CN103584853A (en) * | 2012-08-17 | 2014-02-19 | 麦德托尼克消融前沿有限公司 | Method of manufacturing mapping catheters with monophasic action potential |
| CN104039257A (en) * | 2012-01-10 | 2014-09-10 | 波士顿科学医学有限公司 | Electrophysiology system |
-
2014
- 2014-05-22 CN CN201410220552.3A patent/CN105078569B/en not_active Expired - Fee Related
Patent Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20050070887A1 (en) * | 2003-09-26 | 2005-03-31 | Scimed Life Systems, Inc. | Medical probes for creating and diagnosing circumferential lesions within or around the ostium of a vessel |
| US20130184549A1 (en) * | 2004-11-04 | 2013-07-18 | Boston Scientific Scimed, Inc. | Preshaped ablation catheter for ablating pulmonary vein ostia within the heart |
| WO2008157399A1 (en) * | 2007-06-14 | 2008-12-24 | Hansen Medical, Inc. | System and method for determining electrode-tissue contact |
| US20130197507A1 (en) * | 2009-06-30 | 2013-08-01 | Boston Scientific Scimed, Inc. | Map and ablate open irrigated hybrid catheter |
| US20130237985A1 (en) * | 2009-07-29 | 2013-09-12 | Boston Scientific Scimed, Inc. | Mapping probe assembly with skived tube body frame |
| CN104039257A (en) * | 2012-01-10 | 2014-09-10 | 波士顿科学医学有限公司 | Electrophysiology system |
| CN103417290A (en) * | 2012-05-14 | 2013-12-04 | 韦伯斯特生物官能(以色列)有限公司 | Catheter with helical end section for vessel ablation |
| CN103584853A (en) * | 2012-08-17 | 2014-02-19 | 麦德托尼克消融前沿有限公司 | Method of manufacturing mapping catheters with monophasic action potential |
Cited By (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2018006383A1 (en) * | 2016-07-07 | 2018-01-11 | 四川锦江电子科技有限公司 | Inter-electrode discharge ablation apparatus |
| CN108523990A (en) * | 2018-01-30 | 2018-09-14 | 张丽娜 | A kind of microwave ablation therapeutic equipment for treating fibroid |
| CN108523990B (en) * | 2018-01-30 | 2020-08-07 | 青岛大学附属医院 | Microwave ablation therapeutic apparatus for treating hysteromyoma |
| CN109805926A (en) * | 2019-03-19 | 2019-05-28 | 苏州润迈德医疗科技有限公司 | Signal measurement apparatus for Intracoronary ECG |
| CN113116512A (en) * | 2019-12-31 | 2021-07-16 | 上海微创电生理医疗科技股份有限公司 | Ablation electrode assembly and ablation catheter |
| CN113116512B (en) * | 2019-12-31 | 2022-12-16 | 上海微创电生理医疗科技股份有限公司 | Ablation electrode assembly and ablation catheter |
| CN113995508A (en) * | 2021-11-05 | 2022-02-01 | 杭州佳量医疗科技有限公司 | Medical optical fiber guiding structure and guiding method |
Also Published As
| Publication number | Publication date |
|---|---|
| CN105078569B (en) | 2017-11-10 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| US10842559B2 (en) | System and method for locating and identifying the functional nerves innervating the wall of arteries and catheters for same | |
| AU2016362114B2 (en) | System and method for mapping functional nerves innervating wall of arteries,3-D mapping and catheters for same | |
| JP6148314B2 (en) | Catheter apparatus having a multi-electrode array for renal neuromodulation and related systems and methods | |
| CN103271766B (en) | A kind of for mapping and melt the device being positioned at the kidney nerve that renal artery distributes | |
| US9439598B2 (en) | Mapping and ablation of nerves within arteries and tissues | |
| JP6134382B2 (en) | Multi-electrode catheter assembly and related systems and methods for renal neuromodulation therapy | |
| CN105078569A (en) | Sympathetic nerve mapping and ablating device and system | |
| TW201221165A (en) | Catheter apparatuses having expandable mesh structures for renal neuromodulation and associated systems and methods | |
| JP2017506105A (en) | Bidirectional deployment of neuromodulation devices and related systems and methods | |
| CN204169925U (en) | A kind of electrophysiologicalcatheter catheter | |
| CN105615990A (en) | Electrophysiology catheter | |
| WO2024006466A1 (en) | Systems and methods of denervation around subclavian arteries |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| C06 | Publication | ||
| PB01 | Publication | ||
| C10 | Entry into substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| GR01 | Patent grant | ||
| GR01 | Patent grant | ||
| CF01 | Termination of patent right due to non-payment of annual fee |
Granted publication date: 20171110 Termination date: 20190522 |
|
| CF01 | Termination of patent right due to non-payment of annual fee |