CN106333766A - Positioning device for in-situ windowing of endovascular stent-graft - Google Patents

Positioning device for in-situ windowing of endovascular stent-graft Download PDF

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CN106333766A
CN106333766A CN 201610677521 CN201610677521A CN106333766A CN 106333766 A CN106333766 A CN 106333766A CN 201610677521 CN201610677521 CN 201610677521 CN 201610677521 A CN201610677521 A CN 201610677521A CN 106333766 A CN106333766 A CN 106333766A
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hole
magnetic member
magnetic
end
guide wire
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CN 201610677521
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CN106333766B (en )
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董红霖
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董红霖
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Abstract

The invention relates to a positioning device for in-situ windowing of an endovascular stent-graft. The positioning device comprises a push piece, a conveying sheath and a guiding wire, wherein a first through hole is formed in the push piece, a first magnetic piece is arranged at the first end of the push piece, and a guiding wire hole communicated with the first through hole is formed in the first magnetic piece; a second through hole is formed in the conveying sheath, a second magnetic piece is arranged at the first end of the conveying sheath, a third through hole communicated with the second through hole is formed in the second magnetic piece, and the first magnetic piece is connected with the second magnetic piece in a magnetic attracting manner; and the guiding wire is used for conveying the first magnetic piece and the second magnetic piece. The positioning device provided by the invention has the benefits as follows: after folding of the magnetic pieces, windowing is achieved through guided laser burning punching or a puncture needle method, the step of windowing is simplified, operating difficulty and risks are lowered, the operation time is saved, equipment customization is avoided, and moreover, the operation cost is lowered.

Description

一种血管覆膜支架原位开窗定位装置 An intravascular stent-graft in situ fenestration positioning means

技术领域 FIELD

[0001]本发明涉及医疗器械技术领域,尤其涉及一种血管覆膜支架原位开窗定位装置,特别涉及一种主动脉等大中动脉血管覆膜支架原位开窗定位装置。 [0001] The present invention relates to the technical field of medical devices, and particularly to an intravascular stent-graft fenestration in-situ locating apparatus, particularly to an aortic stent graft and medium-sized arteries in situ fenestration positioning means.

背景技术 Background technique

[0002]随着老龄化社会的到来及吸烟、高血压等疾病的高发,主动脉瘤样扩张或夹层病变的发生越来越多,以往必须开胸或开腹手术,但近来覆膜支架开窗技术应用,并得到血管外科及介入学界的广泛认可,覆膜支架植入术是目前治疗大中动脉非常重要的手段,尽管费用昂贵,但在临床上仍有广泛的应用。 [0002] With the high incidence of the arrival of the aging society and smoking, hypertension and other diseases, aortic aneurysm or dissection lesions occur more and more in the past must thoracotomy or laparotomy, but recently opened stent graft window technology, and it is widely recognized vascular surgery and interventional academia, covered stent implantation is the treatment of medium and large arteries very important tool, despite the high cost, but in clinical practice is still widely used. 每年世界范围内有近100万例的使用,但在复杂病变,如涉及覆盖段的重要分支动脉的保留方面,却面临困境,这类病例在世界范围内都成为难点,一种选择是开放手术,病人面临并发症高,死亡率高的风险;另外的选择是保留分支血管的支架开窗技术的微创介入治疗,避免了开刀的风险;目前国际上采用了以下两种开窗技术,但其应用均因为技术问题和时限问题等受到了极大的限制,使其不能广泛推广。 Each year around the world use nearly one million cases, but in complex lesions, such as those involving retention of important branch artery of the overlay, but facing difficulties such cases in the world have become difficulty, one option is to open surgery patients face high complications and high mortality risk; another option is to retain the branch minimally invasive vascular stent fenestration technology therapy, avoids the risk of surgery; currently the use of two window technology, but its application was because of technical problems and issues such as the time limit has been extremely limited, it can not be widely promoted. 本发明将使得开窗技术简化的同时,有利于开窗技术的广泛推广应用。 The present invention is simplified at the same time such that windowing technique, widely applied in favor of windowing techniques.

[0003]目前,涉及保留分支动脉的技术一个是针对病人的专门定制的支架,出厂时设计制作好带有分支动脉支架的覆膜支架,周期长,大概需要三个月左右,且操作难度大,实用性差;另一种为将覆膜支架在术前做开窗,需要紧密结合术前的CT显像,不能出现误差,而且,在开窗后需要将覆膜支架重新送回支架导引鞘内,由于增加了标记金属圈等,导致回納困难,用力回送后损伤支架可能,进而进入人体发生支架断折和意外释放可能,发生灾难性后果,同时开窗后在术中操作需要良好的立体观察,极有可能发生对合不良,进而发生分支血管闭塞狭窄及根本不能对合等,近期远期效果不良,必要时使病人面临开腹开胸等危险手术。 [0003] Currently, a technique to retain a branch arteries are specially tailored for the patient's stent, the factory design with good branch artery stent stent graft, long period, probably need about three months, and the operation is difficult , practical difference; the other is a stent graft fenestration done preoperatively, requires tight binding preoperative CT imaging, an error can not occur, and, after the stent graft fenestration is necessary to re-back guide bracket intrathecal, due to increased mark metal ring, leading to difficulties back satisfied, after returning force may damage the bracket, and then enter the body and accidental release occurred bracket Duanzhe possible catastrophic consequences, while the rear window in good operation requires surgery the stereoscopic viewing, it is highly likely to close bad, and thus the occurrence of stenosis and occlusion of branch vessels simply can not fit, etc., the recent adverse long-term effects, so that the patient is facing dangerous abdominal thoracic surgery when necessary.

发明内容 SUMMARY

[0004]本发明提供了一种血管覆膜支架原位开窗定位装置,经磁吸件对合后引导激光烧灼打孔或穿刺针方法实现了在体内开窗,极大简化了开窗步骤,减低了对技术的要求及经验的依赖性,降低了手术难度和风险,节约了手术时间,避免了设备定制,同时降低了手术费用,减低个人负担及社会负担。 [0004] The present invention provides a vascular stent-graft in situ fenestration positioning means, the magnetic members after engagement of the guide needle punching, or laser ablation method enables windowing in the body, greatly simplifies the step of windowing reduce the dependence on technology and experience requirements, reducing the difficulty and risks of surgery, surgery to save time and avoid the custom equipment, while reducing operation costs, reduce the burden of personal and social burden. 开窗技术的程序化,使其成为仅仅是一个操作,而不是一个难点,这将使此项开窗技术有利于在世界范围内推广使用。 Programming window technology, making it just one operation, rather than a difficulty that will make this window in favor of promoting the use of technology in the world.

[0005]本发明所采用的技术方案为: [0005] The technical proposal of the present invention are:

[0006] —种血管覆膜支架原位开窗定位装置,包括: [0006] - seed vessel stent-graft fenestration in-situ locating apparatus, comprising:

[0007]推送件,所述推送件上设有第一通孔,所述推送件的第一端设有第一磁吸件,所述第一磁吸件上设有与所述第一通孔连通的导丝孔; [0007] The push member, the push member is provided with a first through hole, a first end of the push member is provided with a first magnetic member, provided with the first through the first magnetic member guide wire bore hole communicating;

[0008]输送鞘,所述输送鞘上设有第二通孔,所述输送鞘的第一端设有第二磁吸件,所述第二磁吸件上设有与所述第二通孔连通的第三通孔,所述第一磁吸件和所述第二磁吸件磁吸连接; [0008] The delivery sheath, the delivery sheath is provided with a second through hole, a first end of the delivery sheath is provided with a second magnetic member, it is provided with the second through the upper second magnetic member the third hole communicating through holes, said first magnetic member and said second magnetic element magnetically connected;

[0009] 和用于输送所述第一磁吸件和所述第二磁吸件的导丝。 [0009] and for delivering said first magnetic member and said second magnetic member of the guidewire.

[0010]进一步的,所述第一磁吸件的侧壁上设有所述导丝孔和凹槽,所述第一磁吸件上还设有第四通孔,所述凹槽和所述导丝孔分别与所述第四通孔连通。 [0010] Further, the sidewalls of the first magnetic member is provided on the guide wire openings and grooves, said first magnetic member is also provided with a fourth through-hole, the groove and the said guide wire bore in communication with the fourth through holes, respectively.

[0011]进一步的,所述凹槽和所述导丝孔关于所述第一磁吸件的中心轴对称设置。 [0011] Further, the recess and the guide wire aperture about said first central axis symmetrically disposed magnetic member.

[0012]进一步的,所述推送件的第一端设有凹陷,所述第一磁吸件可拆卸固定在所述凹陷内,且所述导丝孔与所述第一通孔连通; [0012] Further, the push member is provided with a first end of the recess, the first magnetic member is removably secured within the recess, and the guide wire aperture communicating with the first through hole;

[0013]所述推送件的第二端设有手柄。 [0013] The second end of the push member provided with a handle.

[0014] 进一步的,所述手柄上设有第五通孔,所述第五通孔与所述第一通孔连通,所述导丝孔的轴线、所述第一通孔的轴线和所述第五通孔的轴线相互重合。 [0014] Further, the fifth through hole provided on the handle, the fifth through hole communicates with the first through hole, the axis of the guide wire hole, the first through hole and the axis of the said fifth axial through-holes coincide with each other.

[0015]进一步的,所述手柄为六棱柱形。 [0015] Further, the handle is a hexagonal prism.

[0016]进一步的,所述第二磁吸件的一端与所述输送鞘可拆卸固定连接,且所述第二通孔的轴线、和所述第三通孔的轴线相互重合。 [0016] Further, one end of the second magnetic member is detachably secured to the delivery sheath is connected, and the axis of the second through-hole, and the axis of the third through-hole coincide with each other.

[0017] 进一步的,所述导丝包括第一导丝、第二导丝和第三导丝; [0017] Further, the guidewire comprises a first guidewire, the second godet and third godet;

[0018]所述第一导丝的第一端依次穿过所述导丝孔、所述第四通孔和所述凹槽,所述第一导丝的第二端依次穿过所述第一通孔和所述第五通孔; [0018] The first end of the first guidewire passes through the guide wire hole, the fourth through hole and said groove, a second end of the first guidewire passes through the first a fifth through hole and the through hole;

[0019]所述第二导丝的第一端穿过所述第三通孔,所述第二导丝的第二端穿过所述第二通孔; [0019] The second end of a first guidewire through the third through hole, a second end of the second guidewire through the second through hole;

[0020]所述第三导丝用于穿过位于所述第一磁吸件和所述第二磁吸件之间覆膜支架的薄膜,并达到目的血管。 [0020] for the third guidewire through the film positioned between the first stent graft member and said second magnetic magnetic member, and achieve the object blood vessel.

[0021]进一步的,所述输送鞘的第一端弯曲成圆弧形,所述输送鞘的第二端的弧度为α,90°^α<180° ; [0021] Further, a first end of the delivery sheath curved in an arc shape, the delivery sheath to a second end of the arc α, 90 ° ^ α <180 °;

[0022]所述输送鞘的第二端设有止血阀。 [0022] The second end of the delivery sheath is provided with hemostasis valve.

[0023]进一步的,所述推送件的材质为镍钛合金; [0023] Further, the push member is made of nickel-titanium alloy;

[0024]所述输送鞘的材质为聚四氟乙烯; [0024] The delivery sheath is made of polytetrafluoroethylene;

[0025]所述第一磁吸件的材质为铁或磁铁; Material [0025] The first magnetic member is of iron or a magnet;

[0026]所述第二磁吸件的材质为磁铁或铁。 [0026] The material of the second magnetic member is a magnet or an iron.

[0027]本发明的有益效果: [0027] Advantageous effects of the invention:

[0028] 1、本发明采用简单的体内对合技术,将覆膜支架送入人体后,将此装置放置在血管的开口处,并通过磁吸方式将覆膜支架定位在目的分支血管的开口处,在导入穿刺针或激光后将覆膜支架开窗,后续的操作包括置入导丝进入目的血管、球囊扩张并在其内放置小支架至目的血管,从而使血流顺利进入目的血管保证了脏器供血。 [0028] 1, the present invention is a simple bonding technique of in vivo, the stent graft into the human body, this device is placed at the opening of the vessel, and by the firmness of the stent-graft is positioned in the opening of a branch vessel purpose at, or in the introduction of the puncture needle after the stent graft fenestration laser, the subsequent operations comprising the guidewire into the blood vessel into the object, a small balloon and the stent to a target vessel is placed therein, so that the blood flow smoothly into the vascular object to ensure that the blood supply to the organ.

[0029]本装置采用简单易行的方法,经磁吸件对合后引导激光烧灼打孔或穿刺针方法实现了在体内开窗,极大简化了开窗步骤,减低了对技术的要求及经验的依赖性,降低了手术难度和风险,节约了手术时间,避免了设备定制,同时降低了手术费用,减低个人负担及社会负担。 [0029] The present method by using a simple apparatus, the magnetic member after the engagement of the guide needle punching, or laser ablation method enables windowing in the body, greatly simplifies the windowing step, reducing the requirements for technical and experience dependence, reducing the difficulty and risks of surgery, surgery to save time and avoid the custom equipment, while reducing operation costs, reduce the burden of personal and social burden. 开窗技术的程序化,使其成为仅仅是一个操作,而不是一个难点,这将使此项开窗技术有利于在世界范围内推广使用。 Programming window technology, making it just one operation, rather than a difficulty that will make this window in favor of promoting the use of technology in the world.

[0030] 2、第一磁吸件的可拆卸固定在凹陷内,增加了第一磁吸件与推送件之间的摩擦力,使得两者结合更牢固,避免了在术中因两者的意外分离造成的医疗事故,且第一磁吸件的进入方式操作方便,便于和第二磁吸件磁吸连接。 [0030] 2, the first magnetic member is removably secured within the recess, increases the friction between the first magnetic member and the push member, so that both bind more firmly against the result both of Surgery medical malpractice due to accidental separation and easy access to a first embodiment of the magnetic member to operate, easy and the second magnetic element magnetically connected.

[0031] 3、第一磁吸件的结构设计,方便进入血管,符合动脉内径,同时方便取出起指引作用的第一导丝,且第一导丝仍可留在分支动脉中,便于定位;当开窗后,自窗口进入目的动脉的第三导丝在拔除定位磁铁装置的时候,由于第一磁吸件上的凹槽设计,第三导丝可自凹槽滑出,方便进行下一步操作。 [0031] 3, the first magnetic member design, easy access to the blood vessel, compliance artery diameter, while easily taken out from a first guidewire guidance function, and the first guide wire may remain in the branch artery, facilitate positioning; when the window, since the window object into the artery at the time of plucking the third guidewire positioning magnet assembly, since the groove design on the first magnetic member, the third recess from slipping out of the guide wire can facilitate the next step operating.

[0032] 4、第一磁吸件上设有第四通孔,第二磁吸件上设有第三通孔,使得第一磁吸件和第二磁吸件在磁吸的过程中,在两磁吸件的接触面上不会产生位移偏差,从而保证了第四通孔的轴线和第三通孔的轴线相互重合,便于激光光纤或穿刺针灼穿或刺穿位于第一磁吸件和第二磁吸件之间覆膜支架的薄膜,从而实现开窗的目的。 [0032] 4, a first magnetic member provided on the fourth through hole, a third through hole provided with a second magnetic member, so that the first magnetic member and the second magnetic member in a magnetic process, a the contact surfaces of two magnetic member displacement deviation does not occur, thus ensuring the axis of the third through hole and a fourth through-holes coincide with each other, to facilitate the laser fiber or burning through or piercing needle is located in the first magnetic film between the stent graft and the second magnetic member, thereby achieving the purpose of windowing.

附图说明 BRIEF DESCRIPTION

[0033]图1是本发明推送件一实施例的结构示意图; [0033] FIG. 1 is a schematic structural diagram of an embodiment of the present invention, a push member;

[0034]图2是本发明第一磁吸件一实施例的结构不意图; [0034] FIG 2 is a first magnetic member of the present invention according to an embodiment of the structure is not intended;

[0035]图3是本发明输送鞘一实施例的结构示意图; [0035] FIG. 3 is a schematic structural diagram of a delivery sheath of the present invention according to an embodiment;

[0036]图4是本发明第二磁吸件一实施例的结构示意图; [0036] FIG. 4 is a block diagram of a second embodiment of a magnetic element according to the present embodiment of the invention;

[0037]图5是本发明一实施例的第一状态结构示意图; [0037] FIG. 5 is a schematic view of a state of a first embodiment of the present invention;

[0038]图6是本发明一实施例的第二状态结构示意图; [0038] FIG. 6 is a schematic structural diagram of a second state of the embodiment of the present invention;

[0039]图7是本发明一实施例的第三状态结构示意图; [0039] FIG. 7 is a schematic structural diagram of a third state of the embodiment of the present invention;

[0040]图8是本发明一实施例的第四状态结构示意图。 [0040] FIG. 8 is a schematic view of a fourth state of the embodiment of the present invention.

[0041] 其中:1.推送件、101.第一通孔、102.凹陷、103.手柄、104.第五通孔、2.第一磁吸件、21.导丝孔、22.凹槽、23.第四通孔、3.输送鞘、31.第二通孔、32.止血阀、4.第二磁吸件、41.第三通孔、5.第一导丝、6.第二导丝、7.第三导丝、8.激光光纤、9.肾动脉、10.腹主动脉瘤、11.覆膜支架。 [0041] wherein: a push member, a first through hole 101, the recess 102, handle 103, fifth through hole 104, a first magnetic member 2, a guide wire hole 21, the recess 22...... , 23 fourth through holes, 3. delivery sheath, 31. The second through-hole 32. hemostatic valve 4. The second magnetic member 41. The third through hole 5. The first guidewire 6 of two guidewire, 7. third godet, 8. laser fiber, 9 renal artery 10. abdominal aortic aneurysm, 11 of the stent graft.

具体实施方式 detailed description

[0042]为使本发明的目的、技术方案和优点更加清楚,下面将结合本发明的附图,给出具体实施例的描述,但不作为对本发明的任何限定。 [0042] To make the objectives, technical solutions, and advantages of the present invention will become apparent in conjunction with the accompanying drawings of the present invention will now be given a description of specific embodiments, but not as any limitation of the present invention.

[0043]参见图1至图5,一种血管覆膜支架原位开窗定位装置,包括:推送件I,推送件I上设有第一通孔101,推送件I的第一端设有第一磁吸件2,第一磁吸件2上设有与第一通孔101连通的导丝孔21,推送件I的第二端设有手柄103;输送鞘3,输送鞘3上设有第二通孔31,输送鞘3的第一端设有第二磁吸件4,第二磁吸件4上设有与第二通孔31连通的第三通孔41,第一磁吸件2和第二磁吸件4磁吸连接,输送鞘3的第二端设有止血阀32;和用于输送第一磁吸件2和第二磁吸件4的导丝。 [0043] Referring to FIG. 1 to FIG. 5, an intravascular stent-graft fenestration in-situ locating apparatus, comprising: a push member I, I push member provided with a first through hole 101, a first end of a push member is provided with I the first magnetic member 2, a first magnetic member provided with a guide wire hole communicating with the through hole 101 on the first 221, the second end of the push member I is provided with a handle 103; delivery sheath 3, is provided on the delivery sheath 3 a second through hole 31, a first end of the delivery sheath 43 is provided with a second magnetic member, the third through hole communicating with the second through hole 3141 is provided on the second magnetic member 4, a first magnetic 2 and the second magnetic member magnetically connecting member 4, a second end of the delivery sheath 3 is provided with hemostasis valve 32; and a guidewire for delivering a first magnetic member 2 and the second magnetic member 4. 其中,第一磁吸件2的材质为铁或磁铁;第二磁吸件4的材质为磁铁或铁。 Wherein the first magnetic member 2 is made of iron or a magnet; a second magnetic member 4 is made of a magnet or iron.

[0044]通过上述血管覆膜支架原位开窗定位装置的结构设计,将覆膜支架11送入人体后,将此装置放置在血管的开口处,并通过磁吸方式将覆膜支架11定位在目的分支血管的开口处,在导入穿刺针或激光后将覆膜支架11开窗,后续的操作包括置入导丝5进入目的血管、球囊扩张并在其内放置小支架至目的血管,从而使血流顺利进入目的血管保证了脏器供血。 [0044] By the above-described vessel stent in situ fenestration positioning apparatus design, after the stent graft 11 into the body, this device is placed at the opening of the vessel, and by the firmness of the stent-graft 11 is positioned purposes at the opening of a branch vessel, the puncture needle or laser after the introduction of the stent graft fenestration 11, the subsequent operations comprising the guidewire 5 inserted into the vascular object, the small balloon and the stent to a target vessel disposed therein, so that the blood flow smoothly into the blood vessel to ensure that the purpose of organ blood supply.

[0045] 参见图1和图2,一种较佳的实施方式中,第一磁吸件2上设有第四通孔23,第一磁吸件2的侧壁上设有凹槽22和导丝孔21,凹槽22和导丝孔21分别与第四通孔23连通,凹槽22和导丝孔21关于第一磁吸件2的中心轴对称设置。 [0045] Referring to Figures 1 and 2, a preferred embodiment, the fourth through hole 23 is provided on the first magnetic member 2, a first magnetic member provided with a groove 22 on the side wall 2 and guide wire bore 21, groove 22 and the guide wire bore 21 are in communication with the fourth hole 23, groove 22 and the guide wire bore 21 about the center axis of the first magnetic member 2 arranged symmetrically. 其中,第一磁吸件2为空心圆柱,第一磁吸件2的长度为3mm,外径为3mm,内径为1.5mm,壁厚为0.75mm;凹槽22的宽度为1.0mm;导丝孔21的孔径为1.0mm,方便进入血管,符合动脉内径,同时方便取出起指引作用的第一导丝5,且第一导丝5仍可留在分支动脉中,便于定位;当开窗后,自窗口进入目的动脉的第三导丝7在拔除定位磁铁装置的时候,由于第一磁吸件2上的凹槽22设计,第三导丝7可自凹槽22滑出,方便进行下一步操作。 Wherein the first magnetic member 2 is a hollow cylinder, the length of the first magnetic member 2 is 3mm, an outer diameter of 3mm, an inside diameter of 1.5mm, a wall thickness of 0.75mm; width of the grooves 22 is 1.0mm; guidewire 21 is a pore diameter 1.0mm, easy access to the blood vessel, compliance artery diameter, and easily removed from a first guidewire acting guide 5, 5 and the first guide wire may remain in the branch artery, to facilitate positioning; when the window from the window into the third object of the artery guidewire positioning magnet 7 when the removal device, since the recess 22 is designed on the first magnetic member 2, third godet 7 can slide out from the groove 22, to facilitate the step operation.

[0046] 推送件I的第一端设有凹陷102,第一磁吸件2可拆卸固定在凹陷102内,且导丝孔21与第一通孔101连通。 [0046] I push member is provided with a first end of the recess 102, a first magnetic member 2 is detachably secured within the recess 102 and the through hole 21 communicates with the first guide wire bore 101. 手柄103上设有第五通孔104,第五通孔104与第一通孔101连通,导丝孔21的轴线、第一通孔101的轴线和第五通孔104的轴线相互重合。 Provided with a handle 103 on the fifth through hole 104, fifth through hole 104 communicates with the first through-hole 101, the axis of the guide wire hole 21, and the fifth axis of the through hole 104 of the first through-hole 101 coincide with each other. 第一磁吸件2的可拆卸固定在凹陷102内,增加了第一磁吸件2与推送件I之间的摩擦力,使得两者结合更牢固,避免了在术中因两者的意外分离造成的医疗事故,且第一磁吸件2的进入方式操作方便,便于和第二磁吸件4磁吸连接。 The first magnetic member 2 is detachably secured in the recess 102, increasing the frictional force between the first magnetic member 2 and the push member I, so that both bind more firmly, to avoid accidental both intraoperatively medical accident caused by separation, and the first magnetic element into the convenient operation of embodiment 2, and 4 to facilitate the second magnetic element magnetically connected. 其中,推送件I为空心圆柱杆,外径为3.0mm,内径为1.0mm,长度为1020〜150cm;凹陷102的弧度与第一磁吸件2的侧壁的弧度相匹配,且第一磁吸件2黏贴在凹陷102内;旋转手柄103为六棱柱形,长为20mm,直径为10mm,六棱柱形增大了用于旋转手柄的旋转件与旋转手柄的摩擦力,在调整推送件I的方向时,防止了旋转手柄的旋转件与旋转手柄相对滑动,从而能够方便调整并把控推送件I的方向;推送件I采用镍钛合金材质,与第一磁吸件2不产生磁吸作用,避免了推送件I与第一磁吸件2因磁力而相互作用。 Wherein the push rod member I is a hollow cylinder, an outer diameter of 3.0mm, an inner diameter of 1.0mm, a length of 1020~150cm; sidewall curvature and the curvature of the first magnetic member 2 of the recess 102 matches the first magnet and 2 stuck on the suction member 102 within the recess; rotation handle 103 is hexagonal prism, length 20mm, diameter 10mm, hexagonal prism with increased friction rotating member for rotating the rotation handle of the handle, the adjustment of the push member when the direction I, the rotary slide member prevents relative rotation of the handle and the rotation of the handle, it is possible to easily adjust and control the direction of the push member I; I thruster nickel titanium alloy material, the first magnetic member 2 does not generate a magnetic suction effect, to avoid pushing member I and the first magnetic member 2 due to the interaction of the magnetic force.

[0047]参见图3和图4,一种较佳的实施方式中,第二磁吸件4的一端与输送鞘3可拆卸固定连接,优选地,第二磁吸件4黏贴在输送鞘3的第一端上;当第二磁吸件4与第一磁吸件2的磁吸连接时,第二通孔31的轴线、第四通孔23的轴线和第三通孔41的轴线相互重合。 [0047] Referring to FIGS. 3 and 4, a preferred embodiment, one end of the second magnetic member delivery sheath 3 is detachably fixed connection 4, preferably, the second magnetic member pasted on delivery sheath 4 the first end 3; 4 when the second magnetic member connected to the magnetic attraction of first magnetic member 2, the axis of the second through-hole 31, the fourth through-hole axis and the third axis 41 through the hole 23 coincide with each other. 其中,第二磁吸件4为空心圆柱,第二磁吸件4的长度为1mm,外径为3mm,内径为1.5mm,壁厚为0.75mm;输送鞘3采用聚四氟乙烯材质,利用聚四氟乙烯材质的特性,将输送鞘3的第二端的端部弯曲成圆弧形,输送鞘3的第二端的弧度为α,90°<α<180°,优选地弧度为90°,且输送鞘3的第二端为长100〜150cm,宽5F的长鞘,5F为5*0..33mm;输送鞘3的第一端为长1030〜140cm的长鞘,且输送鞘3第一端的端部设有止血阀32。 Wherein the second magnetic member 4 is a hollow cylinder, the length of the second magnetic member 4 of 1mm, an outer diameter of 3mm, an inside diameter of 1.5mm, a wall thickness of 0.75mm; PTFE material delivery sheath 3, using end of the second end of the material properties of polytetrafluoroethylene, the delivery sheath 3 is curved in an arc shape, a second end of the delivery sheath 3 radian as α, 90 ° <α <180 °, preferably arc of 90 °, 3 and the second end of the delivery sheath is long 100~150cm, long sheath width. 5F, 5F is 5 * 0..33mm; delivery sheath 3 is a first end of a long 1030~140cm long sheath, and the first delivery sheath 3 One end of the end portion of the hemostatic valve 32 is provided.

[0048]通过上述第一磁吸件2和第二磁吸件4的空心结构设计,使得第一磁吸件2和第二磁吸件4在磁吸的过程中,在两磁吸件的接触面上不会产生位移偏差,从而保证了第四通孔23的轴线和第三通孔41的轴线相互重合,便于激光光纤8或穿刺针灼穿或刺穿位于第一磁吸件2和第二磁吸件4之间覆膜支架11的薄膜,从而实现开窗的目的。 [0048] By the above-described first magnetic member 2 and the hollow design of the second magnetic member 4, such that the first magnetic member 2 and the second magnetic member 4 in the process of magnetic attraction, the two magnetic members contact surface displacement deviation does not occur, thus ensuring the axial axis of the fourth through hole 23 and third through holes 41 coincide with each other, to facilitate the laser fiber 8 or burning through or piercing needle is located in the first magnetic member 2 and stent-graft film 11 between the second magnetic member 4, thereby achieving the purpose of windowing.

[0049] —种较佳的实施方式中,导丝包括第一导丝5、第二导丝6和第三导丝7;第一导丝5的第一端依次穿过导丝孔21、第四通孔23和凹槽22,第一导丝5的第二端依次穿过第一通孔101和第五通孔104;第二导丝6的第一端穿过第三通孔41,第二导丝6的第二端穿过第二通孔31;第三导丝7用于穿过位于第一磁吸件2和第二磁吸件4之间覆膜支架11的薄膜,并达到目的血管。 [0049] - species preferred embodiment, the guidewire comprising a first wire 5, the second godet and third godet 7 6; 5 a first end of a first guidewire 21 passes through the guide wire orifice, a fourth through hole 23 and recess 22, a second end 5 of the first guidewire passes through the first through hole 101 and the fifth through holes 104; a first end of a second guidewire through the third through-hole 416 of the , a second end of the second guide wire 6 through the second through hole 31; a third guidewire through the thin film 7 for the first magnetic member 2 and the second magnetic member 4 between the stent graft 11, and achieve the purpose of blood vessels.

[0050] 本发明的工作原理如下: [0050] The working principle of the present invention is as follows:

[0051]血管造影的影像通过数字化处理,把不需要的组织影像删除掉,只保留血管影像,这种技术叫做数字减影技术,即Digital subtract1n ang1graphy,简称DSA。 Imaging [0051] angiography by digital processing, the unwanted tissue image removed, leaving only vascular imaging, this technique is called digital subtraction technique, namely Digital subtract1n ang1graphy, referred to as DSA. 其特点是图像清晰,分辨率高,对观察血管病变,血管狭窄的定位测量,诊断及介入治疗提供了真实的立体图像,为各种介入治疗提供了必备条件。 Characterized by the image is clear, high resolution observation of vascular disease, vascular stenosis positioning measurements, to provide diagnostic and interventional treatment true stereoscopic image, for a variety of conditions provide the necessary intervention. DSA是动脉瘤最有价值的检查方法。 DSA is the most valuable aneurysm screening method.

[0052]参见图5至图8,以肾动脉9的腹主动脉瘤10为例,借助DSA设备操作并控制本实施例的血管覆膜支架11原位开窗定位装置在手术过程中的应用,具体使用方法如下: [0052] Referring to FIG. 5 to FIG. 8, 9 renal artery of abdominal aortic aneurysm 10 as an example, and controls the operation of the device by means of DSA vessel stent of the present application embodiment a stent in situ fenestration positioning means 11 during surgery embodiment specific methods are as follows:

[0053] 1、将左侧肱动脉切开,将第一导丝5送入,沿肱动脉、腋动脉、锁骨下动脉、主动脉弓、降主动脉等到达腹主动脉,并将导丝5置入左(或右)肾动脉9; [0053] 1, the left brachial artery incision, the wire 5 fed into the first guide, along the brachial artery, axillary artery, artery, aortic arch, descending aorta subclavian like reach the abdominal aorta, and the guide wire 5 opposite into the left (or right) renal artery 9;

[0054] 2、将第一导丝5的第一端依次穿过导丝孔21、第四通孔23和凹槽22,沿第一导丝5将第一磁吸件2送入肱动脉,并用推送件I沿第一导丝5将第一磁吸件2推送至左(或右)肾动脉9,旋转手柄103,调整第一磁吸件2的方向,将第一磁吸件2的任意一端对准左(或右)肾动脉9开口的主动脉方向,也就是覆膜支架11方向,并且保证第一磁吸件2和第二磁吸件4能够磁吸配合,将推送件I固定; [0054] 2, a first end of the first guide wire 5 passes through the guide wire bore 21, a fourth groove 22 and the through hole 23, along a first guidewire 5 into the first magnetic member 2 brachial artery and with a push member along a first guidewire I 5 of the first magnetic member 2 is pushed to the left (or right) renal artery 9, the rotation handle 103, the adjustment direction of the first magnetic member 2, the first magnetic member 2 aligned with either end of the left (or right) renal arteries aorta direction of the opening 9, i.e. the direction of stent-graft 11, and ensure that the first magnetic member 2 and the second magnetic element capable of magnetically with 4, push member I fixed;

[0055] 3、再将股动脉切开,送入覆膜支架11,到达目的血管后释放,通过覆膜支架11将第一磁吸件2压入左(或右)肾动脉9内;再经过覆膜支架11的髂动脉分支将第二导丝6送入,第二导丝6的第一端穿过第二通孔31和第三通孔41,并通过第二导丝6的作用将输送鞘3的第二端拉直,便于输送鞘3在血管内移动,沿第二导丝6将输送鞘3和第二磁吸件4送至左(或右)肾动脉9附近,撤出第二导丝6,从而消除了第二导丝6对输送鞘3的拉直作用力,输送鞘3的第二端在其自身弹力的作用下弯曲,从而使得第二磁吸件4的第三通孔41与第一磁吸件2的第四通孔23相对,通过旋转输送鞘3使得第二磁吸件4逐渐靠近第一磁吸件2并磁吸连接,此时将激光光纤8或穿刺针经输送鞘3的第一端输送至输送鞘3的第二端,灼穿或刺穿位于第一磁吸件2和第二磁吸件4之间覆膜支架11的薄膜(即为开窗),撤 [0055] 3, then cut the femoral artery, into the stent-graft 11, the object reaches the release vessel, the stent graft 11 through the first magnetic member 2 is pressed into the 9 left (or right) renal artery; then after iliac artery stent graft 11 into the second guide wire 6, a first end of a second guidewire through the second through hole 31 and third through holes 416 and by the action of the second godet 6 the second end of the delivery sheath 3 straightening facilitate delivery sheath 3 is moved within the blood vessel, the guide wire 6 in the second delivery sheath 3 and the second magnetic members 4 to the left (or right) 9 near the renal arteries, withdrawal a second guide wire 6, thereby eliminating the straightening force of the second pair of conveying the guide wire 6 of the sheath 3, the second end of the delivery sheath 3 is bent under the action of its own elastic force, so that the second magnetic element 4 4123 third through hole and the fourth through hole opposite the first magnetic member 2, by the rotation of delivery sheath 3 such that the second magnetic member 4 gradually approach the first magnetic member 2 and magnetically connected, at which time the laser fiber 8 or the first end of the delivery sheath through the puncture needle 3 is conveyed to a second end of the delivery sheath 3, burning through or piercing stent graft 11 is located between the film 4 and the first magnetic element a second magnetic member 2 ( is the window), withdrawal 出激光光纤8或穿刺针,送入第三导丝7并通过被灼穿或刺穿的薄膜,第三导丝7经覆膜支架11达到左(或右)肾动脉9,固定后,依次撤除推送件1、第一磁吸件2、输送鞘3和第二磁吸件4,再送入球囊用于扩张开窗处,扩大窗口直径,再将一个小支架送达开窗处,释放后,大动脉血流即可顺小支架进入肾动脉9,开窗完成。 After the laser fiber or needle 8, 7 and the guide wire is fed through the third film is burning through or pierced, the guide wire 7 via the third stent-graft 11 reaches the left (or right) renal artery 9, a fixed, successively removal push member 1, a first magnetic member 2, a second delivery sheath 3 and the magnetic member 4, and then into the balloon used to expand the window, the window enlarged diameter, and then a small window at the stent delivery, release after, aortic blood flow to shun the small bracket into the renal artery 9, the window is complete. 手术过程中可以通过设置在输送鞘3上的止血阀32进行止血,以防血管破裂、大出血等意外事故的发生。 The procedure can be provided by the hemostasis valve of the hemostatic delivery sheath 332 to prevent rupture of blood vessels, bleeding and other accidents.

[0056]本发明不局限于上述最佳实施方式,本领域技术人员在本发明的启示下都可得出其他各种形式的产品,但不论在其形状或结构上作任何变化,凡是具有与本申请相同或相近似的技术方案,均落在本发明的保护范围之内。 [0056] The present invention is not limited to the preferred embodiments, those skilled in the art can obtain other forms of product in light of the present invention, but irrespective of any changes in its shape or structure, all having this application is substantially identical or similar technical solutions, all fall within the scope of the present invention.

Claims (10)

  1. 1.一种血管覆膜支架原位开窗定位装置,其特征在于,包括: 推送件(I),所述推送件(I)上设有第一通孔(101),所述推送件(I)的第一端设有第一磁吸件(2),所述第一磁吸件(2)上设有与所述第一通孔(101)连通的导丝孔(21); 输送鞘(3),所述输送鞘(3)上设有第二通孔(31),所述输送鞘(3)的第一端设有第二磁吸件(4),所述第二磁吸件(4)上设有与所述第二通孔(31)连通的第三通孔(41),所述第一磁吸件(2)和所述第二磁吸件(4)磁吸连接; 和用于输送所述第一磁吸件(2)和所述第二磁吸件(4)的导丝。 A vessel stent-graft in situ fenestration positioning means, characterized by comprising: a first through hole (101) on the push member (the I), the push member (the I), the push member ( I) a first end of the guide wire is provided with holes (21) and the first through hole (101) communicating on the first magnetic member (2), said first magnetic member (2); transport a sheath (3), the delivery sheath is provided with a second through hole (31) (3), said delivery sheath (3) is provided with a first end (4), the second magnetic second magnetic member absorbing member is provided (4) a third through hole (41) and the second through hole (31) communicating said first magnetic member (2) and said second magnetic member (4) magnetic suction connection; and means for conveying said first magnetic member (2) and said second magnetic member (4) of the guidewire.
  2. 2.根据权利要求1所述的一种血管覆膜支架原位开窗定位装置,其特征在于,所述第一磁吸件的侧壁上设有所述导丝孔(21)和凹槽(22),所述第一磁吸件(2)上还设有第四通孔(23),所述凹槽(22)和所述导丝孔(21)分别与所述第四通孔(23)连通。 A vessel stent-graft in situ according to claim 1, said window positioning device, characterized in that, the guide wire is provided with said hole (21) and a recess on a sidewall of the first magnetic member (22), said first magnetic member (2) is further provided with a fourth through hole (23), the groove (22) and said guide wire bore (21) respectively with said fourth through hole (23) in communication.
  3. 3.根据权利要求2所述的一种血管覆膜支架原位开窗定位装置,其特征在于,所述凹槽(22)和所述导丝孔(21)关于所述第一磁吸件(2)的中心轴对称设置。 According to an intravascular stent-graft as claimed in claim 2 in situ fenestration positioning means, characterized in that the groove (22) and said guide wire bore (21) with respect to the first magnetic member (2) symmetrically disposed central axis.
  4. 4.根据权利要求2所述的一种血管覆膜支架原位开窗定位装置,其特征在于,所述推送件(I)的第一端设有凹陷(102),所述第一磁吸件(2)可拆卸固定在所述凹陷(102)内,且所述导丝孔(21)与所述第一通孔(101)连通; 所述推送件(I)的第二端设有手柄(103)。 According to an intravascular stent-graft as claimed in claim 2 in situ fenestration positioning apparatus, wherein the push member (I) of the recess is provided with a first end (102), said first magnetic (2) is detachably secured in the recess (102), and said guide wire bore (21) in communication with the first through hole (101); the push member (I) has a second end a handle (103).
  5. 5.根据权利要求4所述的一种血管覆膜支架原位开窗定位装置,其特征在于,所述手柄(103)上设有第五通孔(104),所述第五通孔(104)与所述第一通孔(101)连通,所述导丝孔(21)的轴线、所述第一通孔(101)的轴线和所述第五通孔(104)的轴线相互重合。 A vessel stent-graft in situ according to claim 4, wherein the window positioning means, characterized in that a fifth through hole (104) on the handle (103), the fifth through hole ( 104) in communication with the first through hole (101), the axis of the guide wire bore (21), the axis of the first through hole (101) and said fifth through hole (104) coincide with each other .
  6. 6.根据权利要求5所述的一种血管覆膜支架原位开窗定位装置,其特征在于,所述手柄(103)为六棱柱形。 A vessel stent-graft in situ as claimed in claim 5 fenestration positioning means, wherein the handle (103) is a hexagonal prism.
  7. 7.根据权利要求5所述的一种血管覆膜支架原位开窗定位装置,其特征在于,所述第二磁吸件(4)的一端与所述输送鞘(3)可拆卸固定连接,且所述第二通孔(31)的轴线、和所述第三通孔(41)的轴线相互重合。 The in situ an intravascular stent-graft as claimed in claim 5, wherein the fenestration positioning device, wherein one end of said second magnetic member (4) and the delivery sheath (3) is detachably fixed connection , and the axis of the second through hole (31), and the axis of the third through hole (41) coincide with each other.
  8. 8.根据权利要求7所述的一种血管覆膜支架原位开窗定位装置,其特征在于,所述导丝包括第一导丝(5)、第二导丝(6)和第三导丝(7); 所述第一导丝(5)的第一端依次穿过所述导丝孔(21)、所述第四通孔(23)和所述凹槽(22),所述第一导丝(5)的第二端依次穿过所述第一通孔(101)和所述第五通孔(104); 所述第二导丝(6)的第一端穿过所述第三通孔(41),所述第二导丝(6)的第二端穿过所述第二通孔(31); 所述第三导丝(7)用于穿过位于所述第一磁吸件(2)和所述第二磁吸件(4)之间覆膜支架的薄膜,并达到目的血管。 According to an intravascular stent-graft as claimed in claim 7 in situ fenestration positioning means, wherein said guide wire comprises a first guidewire (5), a second guide wire (6) and the third guide wire (7); a first end of the first guide wire (5) passes through said guide wire bore (21), the fourth through hole (23) and said recess (22), said a first end of a second guidewire (5) passes through the first through hole (101) and said fifth through hole (104); a first end of the second guide wire (6) through the said third through hole (41), a second end of the second guide wire (6) passes through the second through-hole (31); said third wire (7) located to pass through the stent-graft films (4) a first magnetic member (2) and said second magnetic member, and to achieve a blood vessel.
  9. 9.根据权利要求1〜8任意一项所述的一种血管覆膜支架原位开窗定位装置,其特征在于,所述输送鞘(3)的第一端弯曲成圆弧形,所述输送鞘(3)的第二端的弧度为α,90°<α<180。 According to claim any one of claims 1~8 an intravascular stent graft fenestration positioning means situ claim, wherein said delivery sheath (3) is curved in an arc-shaped first end, said the second end of the arc delivery sheath (3) is α, 90 ° <α <180. ; 所述输送鞘(3)的第二端设有止血阀(32)。 ; The delivery sheath (3) is provided with a second end of the hemostasis valve (32).
  10. 10.根据权利要求1〜8任意一项所述的一种血管覆膜支架原位开窗定位装置,其特征在于, 所述推送件(I)的材质为镍钛合金;所述输送鞘(3)的材质为聚四氟乙烯;所述第一磁吸件(2)的材质为铁或磁铁;所述第二磁吸件(4)的材质为磁铁或铁。 An intravascular stent-graft in situ according to any one of claims 1~8 fenestration positioning means, characterized in that the material of the push member (I) is a nickel-titanium alloy; said delivery sheath ( 3) is made of polytetrafluoroethylene; the first magnetic member (2) is made of iron or a magnet; magnetic material of the second member (4) is a magnet or an iron.
CN 201610677521 2016-08-16 2016-08-16 An intravascular stent-graft in situ fenestration positioning means CN106333766B (en)

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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040143286A1 (en) * 2003-01-17 2004-07-22 Johnson Eric G. Catheter with disruptable guidewire channel
US7066924B1 (en) * 1997-11-12 2006-06-27 Stereotaxis, Inc. Method of and apparatus for navigating medical devices in body lumens by a guide wire with a magnetic tip
WO2016094430A1 (en) * 2014-12-09 2016-06-16 Baylor College Of Medicine Magnetic assisted in-situ tubular stentgraft fenestration

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7066924B1 (en) * 1997-11-12 2006-06-27 Stereotaxis, Inc. Method of and apparatus for navigating medical devices in body lumens by a guide wire with a magnetic tip
US20040143286A1 (en) * 2003-01-17 2004-07-22 Johnson Eric G. Catheter with disruptable guidewire channel
WO2016094430A1 (en) * 2014-12-09 2016-06-16 Baylor College Of Medicine Magnetic assisted in-situ tubular stentgraft fenestration

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