CN106955140B - Thrombus taking support and thrombus taking device - Google Patents
Thrombus taking support and thrombus taking device Download PDFInfo
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- CN106955140B CN106955140B CN201710322315.1A CN201710322315A CN106955140B CN 106955140 B CN106955140 B CN 106955140B CN 201710322315 A CN201710322315 A CN 201710322315A CN 106955140 B CN106955140 B CN 106955140B
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00743—Type of operation; Specification of treatment sites
- A61B2017/00778—Operations on blood vessels
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
- A61B2017/2212—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
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Abstract
The invention relates to the technical field of medical equipment, in particular to a thrombus taking support and a thrombus taking device with the thrombus taking support, wherein the thrombus taking support adopts the design that big and small meshes of a first closed loop net unit and a second closed loop net unit are alternately arranged in an effective working section, wherein small meshes have higher radial supporting force, can rapidly anchor a vascular wall and embed thrombus, increase the stability of thrombus capture, reduce the possibility of thrombus escape, and the radial supporting force of large meshes is weaker, so that the excessive stimulation to the vascular wall is reduced, and the vasospasm is avoided; secondly, due to the conical barrel structural design of the proximal end region of the thrombus taking support, thrombus displacement in the retraction of the distal end region can be effectively compensated; finally, the first closed loop net unit and the second closed loop net unit of the distal end area of the thrombus taking support are composed of sine wave rods, so that the flexibility and the adherence of the support body are effectively improved.
Description
Technical Field
The invention relates to the technical field of medical equipment, in particular to a thrombus taking-out bracket and a thrombus taking-out device with the thrombus taking-out bracket.
Background
The cerebral apoplexy is a group of acute cerebrovascular diseases which take cerebral ischemia and hemorrhagic injury symptoms as main clinical manifestations, and seriously endangers the life health and the quality of life of the masses because of the characteristics of high morbidity, high mortality, high disability rate, high recurrence rate, high economic burden and the like. At present, the incidence rate of cerebral apoplexy in China is rising at 8.7% per year, and the number of cerebral apoplexy deaths per year in China exceeds that of tumors and cardiovascular diseases, so that the cerebral apoplexy is the 1 st cause of death.
The stroke is divided into two kinds of ischemic stroke and hemorrhagic stroke, wherein the ischemic stroke accounts for 70 to 80 percent. Among patients suffering from ischemic stroke, the intracranial large vessel occlusion caused by various reasons has the most serious consequences, and has been a treatment difficulty, and the current treatment methods comprise intravenous drug thrombolysis, arterial drug thrombolysis, intravascular mechanical thrombolysis, combination of the methods and the like. Arterial and venous thrombolysis is a conventional method for treating acute ischemic stroke, but the method has high requirements on treatment time window, strict requirements on patients to arrive at a hospital to receive relevant treatment within 3-4.5 hours from the onset of the disease, has various limitations on medicaments, and has low vascular recanalization rate for acute ischemic stroke caused by the most serious large vascular occlusion.
Arterial mechanical thrombolysis devices have gained widespread attention because of the following advantages: rapid recanalization, lower bleeding rates and prolonged time window in stroke. Has satisfactory clinical effect on acute ischemic stroke vascular recanalization caused by large vessel occlusion. The U.S. food and drug administration (Food and Drug Administration, FDA) approved Merci retrievals (2004) and Penumbra Stroke Systems (2008) as the first generation mechanical thrombolysis devices.
However, with respect to the mechanical thrombolysis device, there are still problems in the process of thrombolysis: if the working part of the current thrombus taking device is not designed with a design for effectively preventing thrombus from falling off, the thrombus is easy to fall off in the thrombus taking process; the flexibility of the thrombus taking device is relatively poor, and the thrombus taking device cannot be well attached to a blood vessel which is complicated and bent in the cranium, so that thrombus is easy to fall off and cerebral vascular spasm is easy to occur; the thrombus taking device is only designed with a single developing point, and can not judge the release and expansion conditions of the stent in the operation process, thereby being not beneficial to the operation of doctors in the operation process.
Disclosure of Invention
The invention aims to provide a thrombus taking bracket, which solves the problems that the radial supporting force is small when thrombus is caught in the prior art and the thrombus is easy to fall off when the bracket body is retracted through the staggered design of small meshes and big meshes of a far-end area.
It is still another object of the present invention to provide a thrombus removal device having the above-described thrombus removal stent.
To achieve the purpose, the invention adopts the following technical scheme:
the utility model provides a thrombus taking support, includes along its vertical axis circumference self-expanding's support body, the support body is including the distal end region that connects gradually and the proximal end region that is connected with the push rod, the distal end region includes first closed loop net unit and second closed loop net unit, and a plurality of first closed loop net unit and a plurality of second closed loop net unit connect and form the sleeve structure, the proximal end region is cone structure, the mesh of first closed loop net unit is less than the mesh of second closed loop net unit.
Preferably, a plurality of said first closed loop network elements and a plurality of said second closed loop network elements are connected to form a clockwise or counterclockwise spiral sleeve structure.
Preferably, the single first closed loop network unit and the single second closed loop network unit are arranged at intervals along the spiral line direction of the spiral sleeve structure.
Preferably, the single-row first closed-loop network units and the double-row second closed-loop network units are arranged at intervals along the axis direction of the spiral sleeve structure.
Preferably, the double-row first closed-loop net units and the single-row second closed-loop net units are arranged at intervals along the axis direction of the spiral sleeve structure.
Preferably, the single-row first closed-loop network units and the single-row second closed-loop network units are arranged at intervals along the circumferential direction of the spiral sleeve structure.
Preferably, the double-row first closed-loop network units and the single-row second closed-loop network units are arranged at intervals along the circumferential direction of the spiral sleeve structure.
Preferably, the first closed loop network unit comprises two parallel sine long-wave rods and two parallel sine short-wave rods respectively connected to the head end and the tail end of the sine long-wave rods, and the two sine long-wave rods and the two sine short-wave rods enclose a quadrilateral structure; the second closed loop network unit comprises two parallel sine long wave rods, a connecting wave rod connected to one end of the sine long wave rods along the length direction and two parallel sine short wave rods connected to two ends of the sine long wave rods and the connecting wave rods respectively, and the two sine long wave rods, the two sine short wave rods and the two connecting wave rods enclose to form a hexagonal-like structure.
Preferably, the proximal end region is of an oblique conical cylinder structure, and the shortest side line from the top to the bottom of the oblique conical cylinder structure coincides with the extension line of the pushing rod, so that the gradient is formed, and the pipe diameter of the proximal end region is prevented from being reduced when the proximal end region is retracted.
The thrombus taking-out device comprises any one of the above thrombus taking-out brackets, wherein the proximal end region of the thrombus taking-out bracket is connected with a pushing rod through a binding point, a microcatheter capable of pressing the thrombus taking-out bracket into the pushing rod is sleeved outside the pushing rod, and the microcatheter is connected with an introducing sheath through a microcatheter connecting piece; and developing structures are also distributed on the thrombus taking support.
The invention has the beneficial effects that:
the thrombus taking support provided by the invention has the advantages that firstly, the design that the big meshes and the small meshes of the first closed-loop net unit and the second closed-loop net unit are alternately arranged is adopted in the effective working section, wherein the small meshes have higher radial supporting force and can rapidly anchor the vascular wall and embed thrombus, the thrombus capturing stability is improved, the possibility of thrombus escaping is reduced, the radial supporting force of the big meshes is weaker, the excessive stimulation to the vascular wall is reduced, and the vasospasm is avoided; secondly, due to the conical barrel structural design of the proximal end region, thrombus displacement of the distal end region during withdrawal can be effectively compensated; and finally, the first closed loop net unit and the second closed loop net unit are both composed of sine wave rods, so that the flexibility and the adherence of the bracket body are effectively improved.
Drawings
Fig. 1 is a schematic structural view of a thrombus taking stand according to a first embodiment of the present invention;
fig. 2 is a schematic structural diagram of a thrombus taking support according to a first embodiment of the present invention;
fig. 3 is a schematic structural diagram of a second closed loop network unit according to a first embodiment of the present invention;
fig. 4 is a schematic structural diagram of a thrombus taking stand according to a second embodiment of the present invention;
fig. 5 is a schematic structural diagram of a thrombus taking support according to a second embodiment of the present invention;
fig. 6 is a schematic structural view of a thrombus taking stand according to a third embodiment of the present invention;
fig. 7 is a schematic structural diagram II of a thrombus taking stand according to a third embodiment of the present invention;
FIG. 8 is a schematic view of a thrombus removal device according to the present invention;
fig. 9 is a schematic diagram showing a structure of a thrombus removal device according to the present invention.
In the figure:
100-a bracket body; 110-distal region; 120-proximal region; 111-a first closed loop network element; 112-a second closed loop network element; 113-sine long wave bar; 114-sine short wave rod; 115-connecting a wave rod;
200-pushing a rod; 400-introducing a sheath; 500-microcatheters; 600-binding point.
Detailed Description
In order to make the technical problems solved, the technical scheme adopted and the technical effects achieved by the invention more clear, the technical scheme of the invention is further described below by a specific embodiment in combination with the attached drawings. For ease of description, the following description uses the terms "proximal" and "distal," where "proximal" refers to an end proximal to the operative end and distal refers to an end distal to the operative end.
Example 1
The invention provides a thrombus taking stent, which is shown in fig. 1 to 3, and comprises a stent body 100 which is self-expanding along the circumferential direction of the longitudinal axis of the stent body, wherein the stent body 100 comprises a distal end area 110 and a proximal end area 120 which are connected with a pushing rod 200 in sequence, wherein the distal end area 110 is an effective working section of the stent body 100, the distal end area 110 comprises a first closed loop net unit 111 and a second closed loop net unit 112, a plurality of the first closed loop net units 111 and a plurality of the second closed loop net units 112 are connected to form a sleeve structure, and preferably, a plurality of the first closed loop net units 111 and a plurality of the second closed loop net units 112 are connected to form a clockwise or anticlockwise spiral sleeve structure.
In this embodiment, referring to fig. 2, the single first closed loop network element 111 is arranged at intervals from the single second closed loop network element 112 along the spiral direction of the spiral sleeve structure.
The mesh of the first closed loop net unit 111 is smaller than the mesh of the second closed loop net unit 112, and thus, the radial supporting force of the first closed loop net unit 111 is greater than the radial supporting force of the second closed loop net unit 112. After the stent body 100 reaches the lesion site, the stent body 100 is pushed out from the micro catheter, the first closed loop net unit 111 has higher radial supporting force, can rapidly anchor the vessel wall and embed thrombus, increases the stability of capturing thrombus, reduces the possibility of thrombus escaping, and the second closed loop net unit 112 has weaker radial supporting force so as to reduce excessive stimulation to the vessel wall and avoid vasospasm.
The structure of the closed loop network unit may be a common mesh-shaped closed structure, and the mesh shape may be a circular shape, a diamond shape, a hexagonal shape, or the like, and in order to further increase the flexibility and the adherence of the overall spiral structure of the stent body 100 in a specific implementation, referring to fig. 2 and 3, the first closed loop network unit 111 includes two parallel sine long-wave rods 113 and two parallel sine short-wave rods 114 respectively connected to the head end and the tail end of the sine long-wave rods 113, and the two sine long-wave rods 113 and the two sine short-wave rods 114 enclose a quadrilateral structure; the second closed loop network unit 112 includes two parallel sine wave bars 113, a connection wave bar 115 connected to one end of the sine wave bars 113 in the length direction, and two parallel sine wave bars 114 connected to both ends of the sine wave bars 113 and the connection wave bars 115, respectively, and the two sine wave bars 113, the two sine wave bars 114, and the two connection wave bars 115 enclose a hexagonal-like structure. The structural design of the first closed loop net unit 111 and the second closed loop net unit 112 effectively improves the flexibility of the stent body 100, can reduce the stimulation to blood vessels and reduces the spasm of cerebral blood vessels.
In addition, in order to prevent the proximal end region 120 from being affected by the withdrawal force during the withdrawal process, the overall tube diameter of the stent body 100 becomes smaller or kinked, the proximal end region 120 is designed to be a conical tube structure, preferably, the proximal end region 120 is an oblique conical tube structure, and the shortest side line from the vertex to the bottom edge of the oblique conical tube structure coincides with the extension line of the pushing rod, so as to form a gradient to prevent the tube diameter of the proximal end region 120 from becoming smaller during the withdrawal process. The slope design of the inclined conical cylinder structure can effectively prevent the withdrawal force from being transmitted to the circumferential direction of the whole bracket body 100, thereby avoiding the phenomenon that thrombus is easy to fall off in the withdrawal process. Meanwhile, the shortest side line from the top to the bottom of the inclined conical cylinder structure coincides with the extension line of the pushing rod, and the traction force of the bracket body 100 is concentrated on the extension line where the pushing rod is located, so that the pipe diameter of the bracket body 100 is ensured to be unchanged.
The bracket body 100 can be made of nickel-titanium material or polymer material, specifically can be made by cutting nickel-titanium pipe by laser, can be made by cutting nickel-titanium plate by laser and then curling and heat setting, and can be further made by braiding nickel-titanium wire; or may be machined using a plastic material having elasticity.
Example two
Fig. 4 to 5 show a second embodiment, wherein the same or corresponding parts as in the first embodiment are given the same reference numerals as in the first embodiment. For simplicity, only the points of distinction between the second embodiment and the first embodiment will be described. The difference is that the arrangement of the first closed loop network unit 111 is different from the arrangement of the second closed loop network unit 112.
In this embodiment, along the axis direction of the spiral sleeve structure, the single-row first closed-loop network unit 111 and the double-row second closed-loop network unit 112 are arranged at intervals; alternatively, the double-row first closed-loop network unit 111 and the single-row second closed-loop network unit 112 are arranged at intervals.
Example III
Fig. 6 and 7 show a third embodiment, wherein the same or corresponding parts as in the first embodiment are given the same reference numerals as in the first embodiment. For simplicity, only the points of distinction of the third embodiment from the first embodiment will be described. The difference is that the arrangement of the first closed loop network unit 111 is different from the arrangement of the second closed loop network unit 112.
In this embodiment, along the circumferential direction of the spiral sleeve structure, the single-row first closed-loop network units 111 and the single-row second closed-loop network units 112 are arranged at intervals; alternatively, the double-row first closed-loop network unit 111 is arranged at a distance from the single-row second closed-loop network unit 112.
Example IV
As shown in fig. 8 and 9, the present invention further provides a thrombus removing device, which includes the fully developed thrombus removing stent according to any one of the above embodiments, wherein the proximal end region 120 of the thrombus removing stent is connected to the push rod 200 through the binding point 600, and a microcatheter 500 capable of pressing the thrombus removing stent into the push rod 200 is sleeved outside the push rod 200, and the microcatheter 500 is connected to the introducing sheath 400 through a microcatheter connector. The bracket body 100 is bound on the push rod 200, the binding point 600 is fixed by a binding spring wound by a binding developing ring or a developing wire, and the fixing mode can be welding, riveting or pressing and holding. The stent body 100 is also provided with a developing structure for observing whether thrombus is caught or not and whether the thrombus falls off or not in the retracting process in real time during thrombus taking, so as to guide specific thrombus taking microscopic operation, and enable thrombus taking to be more accurate. The structure and working principle of the thrombus taking support are as shown in the above embodiments, and are not described herein.
In preparation for thrombus removal, the stent body 100 is first pre-compressed into the introducer sheath 400, which is connected to the microcatheter connector through the introducer sheath 400, pushing the push rod 200, the stent body 100 can smoothly enter the lumen of the microcatheter 500, and then the stent body 100 is delivered to the thrombus location determined by contrast or other diagnostic means through the microcatheter 500, so that the stent body 100 is released at the vascular lesion site to form the lumen and the push-pull action can be accurately aligned through the push rod 200, thereby switching between the compressed state and the released state.
In interventional therapy, the microcatheter 500 is delivered to the lesion and the microcatheter 500 is secured across the thrombus. The stent body 100 is pushed to the position of the thrombus determined by contrast or other diagnostic means by the push rod 200, the microcatheter 500 is retracted to release the stent body 100 at the distal end, the stent body 100 is sprung open at the distal end to anchor the vessel wall, then the push rod 200 is slowly pushed forward, the microcatheter 500 is retracted under the reaction force, the tension of the microcatheter 500 is released, and the process is repeated for a plurality of times until the stent body 100 is completely released.
Due to the combined action of the elasticity of the shape memory material and the release method, the thrombus taking stent can be completely embedded into thrombus. After waiting a certain time, the pushing rod 200 is pulled back, the thrombus is captured by the thrombus removing bracket is withdrawn until the thrombus removing bracket and the microcatheter 500 are withdrawn together to the outside of the body, and the whole thrombus removing process is completed. The stent body 100 as a whole is press-held into the introduction sheath 400 and then introduced into the micro-catheter 500, that is, the stent body 100 is delivered to the lesion through the micro-catheter 500.
It is to be understood that the above examples of the present invention are provided for clarity of illustration only and are not limiting of the embodiments of the present invention. Other variations or modifications of the above teachings will be apparent to those of ordinary skill in the art. It is not necessary here nor is it exhaustive of all embodiments. Any modification, equivalent replacement, improvement, etc. which come within the spirit and principles of the invention are desired to be protected by the following claims.
Claims (3)
1. A thrombus taking stent, which is characterized by comprising a stent body which is self-expanding along the circumferential direction of a longitudinal axis of the stent body, wherein the stent body comprises a distal end area and a proximal end area which are connected in sequence, the distal end area is connected with a pushing rod, and the distal end area comprises a first closed loop net unit and a second closed loop net unit;
the first closed-loop network units and the second closed-loop network units are connected to form a clockwise or anticlockwise spiral sleeve structure;
the mesh openings of the first closed loop network element are smaller than the mesh openings of the second closed loop network element;
the first closed loop network unit comprises two parallel sine long-wave rods and two parallel sine short-wave rods which are respectively connected with the head end and the tail end of the sine long-wave rods, and the two sine long-wave rods and the two sine short-wave rods are enclosed to form a quadrilateral structure; the second closed loop network unit comprises two parallel sine long wave rods, a connecting wave rod connected to one end of the sine long wave rods along the length direction and two parallel sine short wave rods connected to the sine long wave rods and the two ends of the connecting wave rods respectively, and the two sine long wave rods, the two sine short wave rods and the two connecting wave rods are enclosed to form a hexagonal-like structure;
the proximal end area is of an oblique conical cylinder type structure;
the single first closed-loop net unit and the single second closed-loop net unit are distributed at intervals along the spiral line direction of the spiral sleeve structure; or alternatively, the process may be performed,
along the axis direction of the spiral sleeve structure, the single-row first closed-loop net units and the double-row second closed-loop net units are arranged at intervals; or alternatively, the process may be performed,
along the axis direction of the spiral sleeve structure, the double-row first closed-loop net units and the single-row second closed-loop net units are arranged at intervals; or alternatively, the process may be performed,
along the circumferential direction of the spiral sleeve structure, the single-row first closed-loop network units and the single-row second closed-loop network units are arranged at intervals; or alternatively, the process may be performed,
along the circumferential direction of the spiral sleeve structure, the double-row first closed-loop net units and the single-row second closed-loop net units are arranged at intervals.
2. The thrombolytic stent of claim 1, wherein the shortest edge line from the apex to the base of said beveled conical barrel structure coincides with the extension line of the pusher rod.
3. A thrombus taking-out device, characterized by comprising the thrombus taking-out bracket as claimed in any one of claims 1-2, wherein the proximal end of the thrombus taking-out bracket is connected with a pushing rod through a binding point, a microcatheter capable of pressing the thrombus taking-out bracket into the pushing rod is sleeved outside the pushing rod, and the microcatheter is connected with an introducing sheath through a microcatheter connecting piece; and developing structures are also distributed on the thrombus taking support.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201710322315.1A CN106955140B (en) | 2017-05-09 | 2017-05-09 | Thrombus taking support and thrombus taking device |
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| CN201710322315.1A CN106955140B (en) | 2017-05-09 | 2017-05-09 | Thrombus taking support and thrombus taking device |
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| CN106955140A CN106955140A (en) | 2017-07-18 |
| CN106955140B true CN106955140B (en) | 2023-07-25 |
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| CN109965940B (en) * | 2017-12-28 | 2022-05-10 | 先健科技(深圳)有限公司 | Thrombus taking device |
| CN108158630B (en) * | 2018-02-26 | 2024-06-07 | 上海加奇生物科技苏州有限公司 | Intravascular thrombus catcher |
| CN108433781B (en) * | 2018-03-30 | 2023-03-21 | 刘振生 | Intracranial blood vessel clamping type thrombus taking device |
| CN109480958B (en) * | 2018-12-03 | 2023-12-01 | 魏铭 | Multi-adaptability multi-tube-diameter thrombus taking device capable of preventing excessive cutting |
| CN111434314B (en) * | 2019-01-15 | 2023-08-08 | 苏州博欣医疗科技有限公司 | But thrombus support and thrombus extraction device of taking out of development location |
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| WO2022100734A1 (en) * | 2020-11-16 | 2022-05-19 | 杭州德诺脑神经医疗科技有限公司 | Thrombus-taking stent, thrombus-taking device and thrombus-taking system |
| CN112890915A (en) * | 2020-12-30 | 2021-06-04 | 上海融脉医疗科技有限公司 | Intravascular multi-segment embolectomy support and conveying device thereof |
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