CN105188605B - Percutaneous transluminal angio plasty device with integrated embolism filter - Google Patents

Abstract

A kind of percutaneous transluminal angio plasty device, it is included in the embolism filter that the opening position in the distal side of Angioplasty balloons is attached to conduit shaft.Therefore the filter can be in the downstream of the blocking, and can be properly positioned the embolic particles that may be discharged into blood flow when that can carry out angioplasty procedures with capture.The embolism filter can be as not deployed, to help to guide described device to operative site and be extracted out from operative site against the conductor string under normal circumstances.However, once the Angioplasty balloons can be placed appropriately, operationally the device associated with the embolism filter can be activated, and be positioned screen pack across the inner chamber of the blood vessel with deploying the filter.

Description

Percutaneous transluminal angio plasty device with integrated embolism filter

The cross reference of related application

It is described this application claims the priority for the U.S. Provisional Application No. 13/838,523 submitted on March 15th, 2013 The full content of U.S. Provisional Application is incorporated by reference herein.

Invention field

Implementation as described herein relates generally to surgery device, and relate more specifically to percutaneous endoluminal vascular into Shape art device.

Background technology

Vescular bed provides oxygen-rich blood steady flow to organ.In the blood vessel of illness, blocking can be formed, this can reduce flow direction The blood of organ, and cause unfavorable clinical symptoms, until and including death.Ill blood vessel may include from early stage thrombus to A series of materials of late period calcified plaque.

Angioplasty can be described as being performed by doctor with open be blocked blood vessel and recover blood flow based on conduit Operation.Can for example open entry site in the groin, arm or hand of patient, and can under fluorescope guiding by seal wire and Conduit is advanced into the position of blocking.The conduit of the ballonet with its neighbouring distal end can be promoted under fluorescope guiding, directly It is located to air bag in narrow zone.Air bag then can be inflated and be evacuated it is one or many, with the narrow zone of expansion artery.

Angioplasty can discharge embolic particles from narrow location toward downstream.These embolic particles can cause unfavorable face Bed result.Have shown that it is favourable to capture these embolic particles to prevent that them from following blood flow downstream to march to capillary bed (for example, Baim D S, Wahr D, George B etc., Randomized trial of a distal embolic protection device during percutaneous intervention of saphenous vein aorto- Coronary bypass grafts, Circulation 2002；105:1285-90).

In addition to balloon angioplasty, it is possible to use support and use mechanical rotary-cut art (atherectomy) and thrombus Resection (thrombectomy) device treats stenosis.These devices also can be easily by embolic particles from narrow location toward downstream Release.

For capturing the system available now of these embolic particles mainly by filter system or occlusion balloons system group Into both of which is based on seal wire.Generally, the filter mounting for being configured to support filter membrane is arranged on filter seal wire At distal end.Filter mounting can move between advanced position and expanded position, and support abuts described in retracted position Seal wire, for insertion of the seal wire in patient's body and retraction, and filter medium crosses over substantially whole blood in expanded position Enlargement of pipe.In use, the filter seal wire of prior art is inserted by the main tube cavity of angioplasty catheter, and is pushed into To " touch-down zone " in narrow distal side.Filter seal wire is then operated to filter mounting of the expansion with filter medium, described Filter medium is attached and is configured to any embolism that capture is discharged by angioplasty procedures.

The filter or air bag with usually used seal wire can be more than using simplicity and using diameter be present in these systems Seal wire passes through the shortcomings that fine and close lesion correlation.Also be present pliability and stability problem in these embolisms protection seal wire so that protected The angioplasty procedures of shield are relative in many cases to be more difficult to.In the case of saphenous vein graft, problem is more particularly to master Arterial ostium lesion, wherein seal wire may fall short of to provide support；Or distal vein graft lesion and arteria renalis lesion, its It is middle that enough filter touch-down zones may be not present.The latter is probably a problem, because currently available filtration system is being treated There can be considerably long distance between air bag and distal end filter.This distance may be not only in distal vein graft lesion It is a problem, and is also a problem in arteriarctia, there may be side branch immediately after narrow in arteriarctia, it is all Such as autologous coronary artery.In such situation, filter can only usually may deploy in the distal side of side branch, thus Shi Ce branches It is not protected for embolic particles.

Accordingly, there exist the needs to the improved percutaneous transluminal angio plasty device with integrated embolism filter.

The content of the invention

It should be appreciated that this general introduction is not the comprehensive review to the disclosure.Originally be summarized as it is exemplary and nonrestrictive, And both it is not intended to identify the key or important element of the disclosure, is also not intended to describe its scope.The sole purpose of this general introduction exists In some concepts for explaining the simultaneously illustration disclosure, as to preamble following complete and being described in detail comprehensively.

In general, the disclosure includes a kind of percutaneous transluminal angio plasty device with integrated embolism filter.Cause It can be integrated for filter with the conduit of angioplasty equipment, so any need to self-contained unit is inserted in blood vessel can be eliminated Will.In addition, the appropriate placement of Angioplasty balloons can ensure that the appropriate placement of embolism filter.

More specifically, the disclosure includes a kind of leading with elongated shaft, nearside and distal end, the longitudinal axis and filter Pipe.Filter include coaxially be fixedly mounted on the distal portion of conduit shaft the first ring, be coaxially slidably mounted On the distal portion of conduit shaft and be configured to towards the first ring or away from the first ring movement the second ring and in the first ring The support extended between the second ring.Support also includes multiple first longitudinal direction connecting elements, each first longitudinal direction connecting elements tool There are the first end for being attached to the first ring and the second end towards the extension of the second ring；Multiple second longitudinal direction connecting elements, each second is vertical There is the first end for being attached to the second ring and the second end towards the extension of the first ring to connecting elements.First longitudinal direction connecting elements and Each also include in two longitudinal connecting components：Form bifurcated on its second end, each bifurcated includes the first branch and the Two branches；With for the branch on each in multiple first longitudinal direction connecting elements to be connected into multiple second longitudinal direction connecting elements In relative one on branch device.The filter also includes being at least connected with to the film of support.

The further feature and advantage of the example implementations of the disclosure will illustrate in the following description, and will partly It is clear that or can be understood by the practice of this kind of example implementations from description.Can be by means of appended power The feature and advantage of this kind of implementation are realized and obtained in the instrument specifically noted and combination during profit requires.These and other Feature will become to be more fully apparent from from the following description and the appended claims, or can by be such as set forth below this The practice of class example implementations is understood.

Brief description of the drawings

It is incorporated to this specification and forms the brief description of the drawings various aspects of the part of this specification, and together with description one Act the principle for being used for explaining described method and system.

Fig. 1 shows the side view of the one side of the angioplasty equipment with integrated embolism filter.

Fig. 2A shows the section view of the proximal end of the angioplasty equipment with integrated embolism filter shown in Fig. 1 Figure；And Fig. 2 B show the sectional view of the distal end of the device shown in Fig. 1.

Fig. 3 shows the schematic diagram of the one side of the filter mounting of the angioplasty equipment shown in Fig. 1, shows to be in The filter mounting of not deployed position.

Fig. 4 shows the schematic diagram of Fig. 3 filter mounting, shows the filter mounting being in the deployed.

Fig. 5 shows the schematic diagram of the other side of the filter mounting of Fig. 1 angioplasty equipment, shows in not The filter mounting of expanded position.

Fig. 6 shows the schematic diagram of Fig. 5 filter mounting, shows the filter mounting being in the deployed.

Fig. 7 shows the schematic diagram of the 3rd aspect of the filter mounting of Fig. 1 angioplasty equipment, shows in not The filter mounting of expanded position.

Fig. 8 shows the schematic diagram of Fig. 7 filter mounting, shows the filter mounting being in the deployed.

Fig. 9 shows there is narrow blood vessel.

Figure 10 shows that Fig. 9's has narrow blood vessel, wherein Fig. 1 angioplasty equipment is located.

Figure 11 shows Figure 10 blood vessel and angioplasty equipment, wherein integrated embolism filter has been expanded.

Figure 12 shows Figure 10 blood vessel and angioplasty equipment, wherein Angioplasty balloons and integrated embolism filter Deploy.

Figure 13 shows the blood vessel and angioplasty equipment of Figure 10 after narrow treatment, wherein at Angioplasty balloons In its not deployed position and embolism filter is still in its expanded position.

Figure 14 shows the blood vessel and angioplasty equipment of Figure 10 after narrow treatment, wherein Angioplasty balloons and Embolism filter is both at not deployed position, is that withdrawing device is prepared from blood vessel.

Figure 15 shows the other side for including the filter mounting of waveform framework.

Figure 16 shows the one side of the attachment of waveform framework.

Figure 17 shows the side view of the other side of the angioplasty equipment with integrated embolism filter, wherein controlling Treat the distal side that device is located at filter.

Embodiment

Can retouching by reference to described in detail below, embodiment, schema and claim and before and after them State and more easily understand the present invention.However, before the disclosure and description present apparatus, system and/or method, it should be appreciated that unless Explanation in addition, otherwise the invention is not restricted to disclosed specific device, system and/or method, thus it is of course possible to change.Should also Understand, term as used herein and is not intended to be any limitation as merely for the purpose of description particular aspects.

The teaching that can be realized of currently known best aspect of the following invention description as the present invention is provided.Therefore, Those skilled in the relevant art, which will recognize and appreciate that, to make many changes to various aspects of the invention described herein, And still obtain beneficial outcomes described herein.It also will be appreciated that some in desired beneficial effect as described herein can With by selecting some in feature as described herein, and obtained without using other features.Therefore, the practitioner of this area It will be recognized that to the present invention carry out it is many improvement and modification be possible, and be possibly even desirable in some cases and And it is a part of the present invention.Therefore, be described below as explanation the principles described herein and provide and do not exist Among it is limited.

The various aspects of one or more implementations of the present invention are described referring now to accompanying drawing.It should be understood that accompanying drawing is one The diagram of individual or multiple implementations and schematically show, and do not limit the disclosure.Although in addition, by being considered as to one or Multiple effective ratios of implementation provide each accompanying drawing, but these accompanying drawings are not necessarily to all realization sides covered Formula is all drawn to scale.Therefore, accompanying drawing represents exemplary ratios, but should not be made from accompanying drawing on any required ratio Infer.

In the following description, it is proposed that many details, well understood to provide to described herein.It is however, right For those skilled in the art, it becomes clear that the disclosure can be implemented without these details.In other cases, In order to avoid unnecessarily obscuring the various aspects of disclosed implementation, percutaneous transluminal angio plasty dress is not described in detail Put the well-known aspect with embolism filter.

As used in specification and the claim, in addition to the other clear stipulaties of context, otherwise odd number shape Formula "one", " one kind " and " described " include plural referents.Scope can be expressed as from " about " particular value herein And/or to " about " another particular value.When such a range is expressed, on the other hand include from this particular value and/ Or to another particular value.Similarly, when value " about " is expressed as into approximation by using antecedent, it will be appreciated that this Particular value forms on the other hand.It is to be further understood that the end points of each scope is to have relative to another end points Meaning, and independently of another end points.

" optional " or " optionally " mean that the event that then describes or situation can occur or can not occur, and describe to wrap Include situation that wherein described event or situation occur and wherein its nonevent situation.

Through the described and claimed of this specification, the version of word " including (comprise) " and the word As " including (comprising) " and " including (comprises) " mean " to include but is not limited to " and be not intended to exclude for example its Its additive, component, integer or step." exemplary " means " ... example " and is not intended to reception and registration preferably or preferable aspect Instruction." such as " is not used with restrictive, sense, but for illustrative purposes.

Referring now to accompanying drawing, wherein through the same numeral instruction identity element of each view, Fig. 1 is shown according to the present invention's The one side of angioplasty catheter 10 with integrated embolism filter.Angiopoiesis with integrated embolism filter Art conduit 10 includes slender conduit 12, and the slender conduit 12 has shaft 14, and the shaft 14 is with proximal end 16 and far Side end 18.As used herein, " nearside " refers to the part of the doctor near execution operation of described device, and " distal side " refers to The part farthest from the doctor for performing operation of described device.Angioplasty therapy device 20 can be close to conduit shaft 14 The opening position of distal end 18 is mounted to conduit 12.Angioplasty therapy device includes, such as and be not limited to, it may expand Air bag, expandable stent, rotary-cut art and thrombectomy device etc..Embolism filter 30 can be in angioplasty therapy device 20 Distal side and at the distal end 18 of conduit 12 or the opening position of nearside is mounted to conduit shaft 14.As shown in figure 17, It is also contemplated that embolism filter 30 can be mounted to conduit shaft 14 in the opening position of the nearside of therapeutic system 20.Other Or in the embodiment substituted, filter 30 can be positioned so that towards or away from therapeutic system.Those skilled in the art will also To be recognized according to the disclosure, angioplasty catheter is configurable to, such as and be not limited to, it is overall to exchange (over-the- Wire) conduit, rapid-exchange catheter etc..Merely for it is disclosed it is clear for the sake of, this specification describes overall exchanging pipe form.

Referring now to Fig. 2, conduit shaft 14 can limit three tube chambers：Main tube cavity 32, Angioplasty balloons expansion tube cavity 34 and embolism filter actuator wire tube chamber 36.Main tube cavity 32 can extend to distal end from the proximal end 16 of conduit shaft 14 18.Main tube cavity 32 optionally provides service aisle and is configured to receive the seal wire passed through, for promoting conduit 12 Distal end 18 through patient vascular system to therapentic part.As used herein, term " therapentic part " refers to patient vessel The position of system internal congestion, and when conduit 12 is regarded as being located at or is positioned at the therapentic part, it will be understood that it is meant that described Conduit is positioned such that angioplasty therapy device 20 in obstruction.

Balloon expansion lumen 34 can extend from the proximal hole 38 at the proximal end 16 of conduit 12 and pass through conductor string Body 14 is to the distal hole 40 in angioplasty therapy device 20.Similarly, actuator wire tube chamber 36 can be from conduit 12 Proximal hole 44 at proximal end 16 extends and through conduit shaft 14 in the remote of the distal side of angioplasty therapy device 20 Side port 46.

Unless otherwise indicated, otherwise following public all aspects share preceding feature, and the difference master of various aspects It is the design of embolism filter.Therefore, when open various aspects, it will be appreciated that unless otherwise indicated, otherwise each aspect All include preceding feature, and the description will transfer to concentrate on the design and operation of embolism filter.

The aspect of the disclosure shown in reference picture 3 and Fig. 4, embolism filter 30 include filter membrane 50 (Figure 12) and are used for The Collapsible rack 52 of the filter membrane is supported, the filter membrane 50 leads to will optionally be dimensioned so as to permission blood Cross but capture the hole of the particle more than normal blood particle.For clarity, when showing support 52, accompanying drawing omits Filter membrane 50, it should be appreciated that all embolism filters disclosed herein all include the filter membrane supported by the support. It is contemplated that support 52 may include proximal ring 56 and distal loop 54.In one aspect, two rings can be positioned in angioplasty Between the distal end of therapeutic system 20 and the distal end 18 of conduit shaft.In another aspect, distal loop 54 can be fixed Appropriate location on conduit shaft 14, and proximal ring 56 can be slidably mounted to conduit shaft, in nearside and Moved axially in distal direction.

Each in multiple first column sections 60 has the end 64 of first end 62 and second.The of each first column sections 60 One end 62 can be attached to distal loop 54, and each first column sections can extend in a proximal direction.

In other respects, each in corresponding multiple second column sections 70 has the end 74 of first end 72 and second. This, the first end 72 of each second column sections 70 can be attached to proximal ring 56, and each second column sections also can be in nearside Side upwardly extends.

In terms of other, multiple second column sections 70 can be substituted with the waveform ring structure 55 as shown in Figure 15-16. In terms of this, waveform ring 55 shrinks radially inward as the relative distance between distal loop and proximal ring increases, and And expanded as the relative distance between distal loop and proximal ring is reduced.

In terms of other, the second end 64 of each first column sections 60 is attached to the of corresponding second column sections 70 Two ends 74.Here, each connected the first column sections 60 and the second column sections 70 collectively constitute pillar 80.Such as art technology Personnel from discussion above by what is understood, and multiple pillars 80 can surround proximal ring and distal loop is circumferentially spaced and connected near Side ring and distal loop, to form support 52.In operation and as shown in Figure 3, when proximal ring 56 and distal loop 54 are adjacent each other When near, each pillar 80 is configurable to turn back to itself.In addition, when proximal ring 56, distally ring 54 shifts to nearside When, pillar 80 is configurable to open in a manner of similar umbrella.Filter membrane 50 can be supported in the first column sections 60 so that when When support 52 is opened, as shown in Figure 4, the filter membrane can deploy similar to the mode of umbrella cover.

It is contemplated that each pillar may also include at least one " weakness area ", i.e. pillar is configurable to physically be weaker than Most of position of pillar so as to control pillar bend place position region.It will be appreciated by those skilled in the art that can At least one weakness area is formed any of in many ways.In one aspect, can be in the one or both sides shape of pillar Into groove.In another aspect, at least one in the upper and lower surface of pillar is formed indentation.In another side Face, at least one weakness area can be formed by material that can be weaker than forming the material of pillar remainder in structure.At other Aspect, at least one weakness area may include mechanical hinge.In terms of other and as shown in Figure 15, the top of waveform ring 55 End includes weakness area.In terms of other, at least two in these methods can be combined to form at least one weakness area, example Such as, both recessings on the width of pillar, and indentation is formed in depth.In addition, at least one weakness area may include multiple one The physical layout of type, such as single weakness area may include multiple grooves or multiple indentations.In operation, at least one weakness Area is configurable to make post bends in response to the power of the longitudinal axis into the predetermined angular of that part relative to pillar.

In operation, proximal ring 56 can be led to toward and away from distal loop 54 with opening and closing the movement of embolism filter 30 The operation of actuator wire 84 is crossed to complete.In one aspect, the proximal end 86 of actuator wire 84 can be extended out actuator wire tube chamber 36 Proximal hole 44, controlled in order to by the doctor for performing operation.Here, actuator wire 84 can extend across actuator wire tube chamber 36 and can Gone out by the distal hole 46 of actuator wire tube chamber.In another aspect, the distal end 88 of actuator wire 84 can be attached to nearside Ring 56.

It will be understood by those skilled in the art that there are various ways to can be used for arrangement filter mounting 52 and actuator wire herein 84, to allow to open and close embolism filter 30 by the proximal end 86 of mobile actuator wire.In a first aspect, can be Normally closed or not deployed position form filter mounting 52.In operation, the proximal end 86 of actuator wire 84 is pulled to make closely Side ring 56 proximally slide to open filter mounting 52 by direction.Filter mounting can be configured so that release in actuator wire 84 On tension force and/or distad promote actuator wire 84 filter mounting 52 can be allowed to be folded into not deployed position.

In the another aspect of the disclosure shown in Fig. 5 and Fig. 6, filter mounting 152 may include can be relative to conductor string The proximal ring 156 that body 114 is fixed and the distal loop 154 that can be slidably positioned along conductor string on nearside and distal direction. In another aspect, the distal hole 146 of actuator wire tube chamber 136 can be located at the distal side of proximal ring 156.Here, actuator wire (does not show Go out) actuator wire tube chamber is can extend across, it can be gone out by distal hole 146, and attach to distal loop 154.Can be normal The position of closure forms filter mounting 152.In operation, actuator wire 184 is promoted to make distal loop 154 away from proximal ring Shifted in 156 distal direction, to deploy filter mounting 152.Filter mounting can be configured so that release in actuator wire Power on 184 and/or distad promote actuator wire 184 that filter mounting 152 can be made to recover its not deployed position.

In the another aspect of the disclosure shown in Fig. 7 and Fig. 8, proximal ring 254 can fix relative to conduit shaft 214, And distal loop 256 can be slidably positioned on nearside and distal direction along conductor string.In another aspect, actuator wire The distal hole 246 of tube chamber 236 can distally located ring 256 distal side.Here, actuator wire 284 can extend across actuator wire tube chamber 236, it can be gone out by distal hole 246, and attach to distal loop 256.Filter can be formed in normally closed position Support 252.In operation, actuator wire 284 is pulled to make distal loop 256 in a distal direction and be shifted away from proximal ring 156, To deploy filter mounting 252.Filter mounting can be configured so that power of the release on actuator wire 284 can allow filter Support 252 recovers its not deployed position.

Fig. 3 and Fig. 4 are referred again to, the other side of filter mounting can be identical with the first embodiment 52 in structure, Except filter mounting can be formed in normal opening or expanded position.Here, it is contemplated that proximal end 86 to actuator wire 84 Applying distally directed power (that is, promoting actuator wire) can keep in its distal position by proximal ring 56 and therefore will can filter Device support 52 keeps being in its not deployed position.When release is applied to the power of actuator wire 84, filter mounting 52 can be allowed to expand The normal expanded positions of Zhang Zhiqi, so as to expand filter membrane 50., can be again to actuator wire 84 after intervention procedures completion Proximal end 86 apply distally directed power so that proximal ring 56 towards distal loop 54 movement and pleated filter support 52.

Fig. 5 and Fig. 6 are referred again to, the 5th aspect can be identical with the 3rd aspect in structure, except can normally beat The position opened forms filter mounting 152.Here, it is contemplated that can be by distal loop 154 normally towards the distal end portion of conduit shaft 114 Portion 18 shifts.In operation, distal loop 154 can be made to nearside towards fixed proximal ring by pulling the distal end 188 of actuator wire 184 156 movements, so as to which the tension force that pleated filter support 152 is discharged on actuator wire 184 can allow filter mounting 152 to expand simultaneously To its expanded position.

Those will apply to actuator wire power be configured to axial compressive force in terms of, the skilled addressee will appreciate that It is that can be used to be configured to line harder in the embodiment of axial tensile force than at those will apply to the power of actuator wire, so as to Prevent the rugosity of actuator wire.

In the disclosure, and especially for actuator wire, term " silk " is intended to include, such as and is not limited to, metal Silk, polymer filament etc..For polymer filament, polymer used may include, such as and be not limited to, nylon, polypropylene etc. Deng.

At above-mentioned aspect, filter membrane 50 can be formed by least one in fabric, polymer and silk screen.In another side Face, filter membrane 50 include hole, and in another aspect, and hole can be dimensioned to allow blood by but not allowing Embolic particles pass through.It is contemplated that arriving, filter membrane 50 may be mounted to that the top or inside of framework.

At foregoing aspect, filter membrane 50 is configurable to cover the outer surface of outermost column sections, i.e. the first column sections 60th, 160 and 260.Optionally, filter membrane 50 can be further constructed to extend beyond the remote of the first column sections 60,160 and 260 Side end or the second end 64,164 and 264, wherein its can be attached to the circumference of distal loop 54,156,256.In those distal sides Ring 54 can be by fixed aspect, and filter membrane 50 is optionally configured to extend beyond the distal end of distal loop, and can be Opening position between the distal loop 54 and distal end 18 of conduit shaft is attached to the circumference of conduit shaft 14.

It is contemplated that arriving, the filter membrane 50 in each disclosed embodiment is attached to the first column sections 60,160 With 260 inner surface, rather than outer surface.

It is contemplated that arriving, internal or the second column sections 70,170,270 are also configurable to when deploying filter mounting, phase It is concave for blood flow.Other or extra in terms of, filter membrane 50 can be attached to the second column sections 70,170,270 Inner surface or outer surface.When filter membrane 50 is attached to the surface of the second column sections 70,170,270, filter membrane 50 can be optional Ground extends beyond distal side or the second end 74,174,274 of these the second column sections, and be attached to proximal ring 56,154, 254 circumference.It is contemplated that arriving, if filter membrane 50 can be attached to the outer surface of the second column sections 70, and proximal ring 56 can Fixed, then the filter membrane is configurable to extend beyond the distal end of proximal ring and can be in proximal ring 56 and distal side Opening position between ring 54 is attached to conduit shaft 14.

In all aforementioned circumstances, filter mounting all includes retainer ring and removable ring, can be by the way that ring is moved away from To complete the rise of filter, and the folding of filter can be completed by the way that ring is moved together." moving away from " and " move Move together " it is used as relative terms so that in order to allow ring " moving away from " or " moving together ", it is only necessary to one in two rings It is individual to be moved relative to another.

Similarly, rise and the process of pleated filter can be considered as observed by the visual angle of conduit So that removable ring can be made to be moved towards or away from retainer ring.

In all aforementioned circumstances, it is to be understood that active applying power is with shift(ing) ring and release force to allow ring automatic The mobile step for both including moving come " causing " removable ring by " control " actuator wire.Therefore, it is as described herein just In both often expansion and normal not deployed filter mounting embodiment, actuator wire can be by " control " with " causing " removable ring Mobile, no matter the form of the power on actuator wire is taken to the form of actuator wire applying power or discharged in the control.

It is contemplated that arrive, doctor is allowed directly to grasp the proximal end of actuator wire with it, not as can be by control device in conductor string It is associated with the proximal end of actuator wire at the proximal end of body.Control device may include, such as and be not limited to, control-rod, Slider, rotary shaft etc., to promote the movement of silk.One example of such mechanical arrangement is in U.S. Patent Publication No.US It is described in 2010/0106182 [0079]-[0090] section and Figure 29-33, the disclosure is incorporated by reference herein.

It can show the above-mentioned angioplasty equipment with integrated embolism filter in blood vessel is treated in Fig. 9-13 The purposes of narrow aspect.In fig.9, blood vessel 500 can have the branch vessel 502 from its bifurcated.Blood vessel 500 can have narrow 504.The direction that blood vessel 500 is passed through by the instruction blood stream of arrow 506.As the preparation process in intervention procedures, seal wire 508 by Doctor inserts.

Figure 10 is shown with Angioplasty balloons 20 and bolt in its not deployed position and adjacent pipes shaft 14 Fill in the conduit 12 of filter 30.The distal end 18 of conduit shaft 14 is pushed into along seal wire 506, until the blood vessel that is evacuated into Shape art air bag 20 is present in narrow.When conduit 12 is positioned such that Angioplasty balloons 20 can be located at narrow interior, lead Pipe is referred to alternatively as being in its " target site " place.When conduit is in target site, the portion occupied by embolism filter 30 of blood vessel 500 Divide and be referred to alternatively as " touch-down zone " 510.

In fig. 11, embolism filter 30 is expanded by pulling actuator wire 84.In fig. 12, Angioplasty balloons 20 can be inflated and be evacuated and inflate again if desired, optionally repeatedly, to force narrow opening.In crushing shape During narrow patch, embolic particles 510 are released and are brought into the nearside of the opening of embolism filter 30 by blood flow End, herein they captured by filter membrane 50.

In fig. 13, originally narrow region can be what is opened, and Angioplasty balloons 20 can be evacuated.Embolism Filter 30 stays open, and is appointed with what capture discharged when Angioplasty balloons 20 are evacuated and are pulled away from the wall of blood vessel 500 What embolism.

In fig. 14, embolism filter 30 can be closure, so as to which the embolism of capture is enclosed in filter.Now may be used Extract conduit 12 out from blood vessel 500.

The one side of each disclosed embolism filter can so be done：Because pillar is folded back in their own, Filter mounting in not deployed position can be shorter than the filter branch of other known and/or commercially available embolism filters Frame.Shorter length can allow shorter touch-down zone, then filter can be allowed to be placed from angioplasty therapy device Closer to.A result for providing shorter touch-down zone can be that reduced branch vessel will be with angioplasty therapy device and embolism The possibility that narrow blood vessel between filter intersects, so as to reduce embolism machine captured around filter and in blood flow Meeting.

Therefore, foregoing implementation provides different required features.For example, the disclosure allows embolism filter to put Put very close to for treating narrow device.This has the effect in " touch-down zone " that minimizes filter, and also allows Side branch is protected, as shown in Figure 22-25.

Therefore the present invention can embody in other specific forms in the case of without departing from its spirit or substantive characteristics.Institute The each side of description is considered as only being illustrative rather than in every respect restricted.Therefore the scope of the present invention is by appended power Profit is required rather than indicated by described above.All changes in the implication and scope of the equivalent of the claim are all It will be contained in the range of claim.

Claims (12)

1. a kind of percutaneous transluminal angio plasty device, it includes：

Conduit (12), the conduit have shaft (14), proximal end (16) and distal end (18) and the longitudinal axis；

Angioplasty therapy device (20), it is installed to the conduit in the opening position close to the distal end (18) (12)；With

Filter (30), its opening position at the distal end (18) place or its nearside are installed to the conduit (12) simultaneously And including Collapsible rack (52) and filter membrane (50), the filter membrane includes the multiple holes being disposed therein, described to roll over Folded support (52) includes：

First ring, first ring are coaxially fixedly mounted on the distal portion of the shaft (14)；

Second ring, second ring are coaxially slidably mounted on the distal portion of the shaft (14) and are configured to court Moved to away from first ring；

Characterized in that, the Collapsible rack (52) also includes：

Multiple first column sections (60), each first column sections in the multiple first column sections, which have, is couple to described first The first end (62) of ring (54) and the second end (64) towards second ring (56) extension, wherein the multiple first Post portion (60) is circumferentially spaced around first ring (54)；With

Waveform ring structure (55), it has first group of top for being couple to second ring (56) and is couple to the multiple the Second group of top of the second end (64) of one column sections (60).

2. percutaneous transluminal angio plasty device as claimed in claim 1, wherein second ring (56) is led relative to described The longitudinal axis of pipe is located at the distal side of first ring (54).

3. percutaneous transluminal angio plasty device as claimed in claim 1, wherein second ring (56) is led relative to described The longitudinal axis of pipe is located at the nearside of first ring (54).

4. percutaneous transluminal angio plasty device as claimed in claim 1, wherein the angioplasty therapy device (20) It is located at the nearside of the filter (30) relative to the longitudinal axis of the conduit.

5. percutaneous transluminal angio plasty device as claimed in claim 1, wherein the angioplasty therapy device (20) It is located at the distal side of the filter (30) relative to the longitudinal axis of the conduit.

6. percutaneous transluminal angio plasty device as claimed in claim 1, wherein the angioplasty therapy device includes Angioplasty balloons.

7. percutaneous transluminal angio plasty device as claimed in claim 1, wherein the angioplasty therapy device includes Expandable stent.

8. percutaneous transluminal angio plasty device as claimed in claim 1, wherein the angioplasty therapy device includes Thrombectomy device.

9. percutaneous transluminal angio plasty device as claimed in claim 1, wherein the angioplasty therapy device includes Atherectomy devices.

10. percutaneous transluminal angio plasty device as claimed in claim 1, wherein the conduit (12) also includes leading from described The proximal end (16) of pipe (12) extends to the actuator wire tube chamber (36) of distal port (46), and described device also includes having The actuator wire (84) of proximal end (86) and distal end (88), at least a portion of the actuator wire (84) extend through described Actuator wire tube chamber (36) and gone out by the distal port (46), the distal end of the actuator wire is couple to described second Ring (56),

Wherein, when the filter (30) is in folding position, pull the proximal ends (86) of the actuator wire (84) on To the second ring (56) applying power on the y direction of the conduit (12) so that second ring (56) is away from described first Ring (54) is mobile；

Wherein, the selectivity of remote first ring (54) of second ring (56), which moves, causes the multiple second column sections (70) the second end (64) of the multiple first column sections (60) is promoted radially to deploy, so that the filter (30) selects Expanded towards expanded position to selecting property；

Wherein, the conduit (12) also includes balloon expansion lumen (34), and the balloon expansion lumen (34) is from the conduit (12) proximal end (16) extends and through conduit shaft (14) in the angioplasty therapy device (20) Distal side air bag inflation port (40)；And

Wherein, the conduit also includes the main tube cavity (32) being disposed therein, and the main tube cavity prolongs from the proximal end (16) Reach the distal end (18) of the conduit (12).

11. percutaneous transluminal angio plasty device as claimed in claim 1, wherein the filter membrane (50) include it is following in It is at least one：Polymer, fabric and silk screen.

12. percutaneous transluminal angio plasty device as claimed in claim 1, wherein the filter membrane (50) be arranged on it is described On the outer surface of multiple first column sections.