CN107049421B - Full-development thrombus taking support and thrombus taking device - Google Patents
Full-development thrombus taking support and thrombus taking device Download PDFInfo
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- CN107049421B CN107049421B CN201710322317.0A CN201710322317A CN107049421B CN 107049421 B CN107049421 B CN 107049421B CN 201710322317 A CN201710322317 A CN 201710322317A CN 107049421 B CN107049421 B CN 107049421B
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- 208000007536 Thrombosis Diseases 0.000 title claims abstract description 115
- 238000011161 development Methods 0.000 title claims abstract description 46
- 238000000034 method Methods 0.000 claims abstract description 16
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- 210000004204 blood vessel Anatomy 0.000 claims abstract description 9
- 239000000463 material Substances 0.000 claims abstract description 6
- 230000002537 thrombolytic effect Effects 0.000 claims description 18
- 239000003146 anticoagulant agent Substances 0.000 claims description 10
- 238000003825 pressing Methods 0.000 claims description 4
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Classifications
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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
-
- 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
-
- 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
- A61B2017/00831—Material properties
- A61B2017/00867—Material properties shape memory effect
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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
- A61B2017/00831—Material properties
- A61B2017/00902—Material properties transparent or translucent
- A61B2017/00915—Material properties transparent or translucent for radioactive radiation
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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
Abstract
The invention relates to the technical field of medical instruments, in particular to a full-development thrombus taking support and a thrombus taking device with the same, comprising a support body which is self-expanded along the circumferential direction of a longitudinal axis of the support body, wherein a certain number of development structures penetrate through the whole structure of the support body, the development structures are made of non-perspective ray materials, the forms of the thrombus taking support and thrombus can be more clearly identified in the thrombus taking process, the effective thrombus taking length of the thrombus taking support can be accurately identified, whether the thrombus taking support is completely released and expanded is judged, the contact condition of the thrombus taking support and thrombus is intuitively reflected, and whether a lesion blood vessel has in-situ stenosis is further judged, so that the operation and judgment of doctors are facilitated, and the thrombus taking success rate is effectively improved.
Description
Technical Field
The invention relates to the technical field of medical equipment, in particular to a full-development 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 first 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 most thrombus taking devices are designed with only a single developing point, the contact condition of the thrombus taking device and thrombus can not be clearly observed in the thrombus taking process, and the position and the form of the thrombus can not be clearly determined, so that the thrombus capturing rate is low.
Disclosure of Invention
The invention aims to provide a full-development thrombus taking support, which solves the problems that the contact condition of a thrombus taking device and thrombus cannot be clearly observed and the position and the form of the thrombus cannot be clearly observed in the thrombus taking process and improves the thrombus capturing rate by integrally arranging a certain number of development mark points on the thrombus taking support.
Another object of the present invention is to provide a thrombus removal device having the above fully developed thrombus removal stent.
To achieve the purpose, the invention adopts the following technical scheme:
the full-development thrombus taking support comprises a support body which is self-expanded along the circumferential direction of a longitudinal axis of the support body, a certain number of development structures in different forms or in the same form penetrate through the whole structure of the support body, the development structures are made of non-perspective ray materials, and the morphology of the support body and thrombus can be displayed in the thrombus taking process.
Preferably, the stent body comprises a distal end area, a middle area and a proximal end area which are connected with the pushing rod in sequence, wherein the distal end area, the middle area and the proximal end area are provided with a certain number of developing structures in different forms or in the same form.
Preferably, the developing structure comprises developing points, and the developing points are made into a ring shape and wound on the bracket body; or, the inner part or the outer part of the bracket body is embedded in a sheet shape or a tubular shape; alternatively, the developing point fixing portion is provided in advance on the holder body.
Preferably, the distal region includes a first closed loop network unit, the intermediate region includes a plurality of second closed loop network units, the proximal region includes a plurality of third closed loop network units, and the first closed loop network unit, the second closed loop network unit, and the third closed loop network unit sequentially connected in a set spiral form from the distal region to the proximal region have a counterclockwise or clockwise spiral structure.
Preferably, the developing points are arranged according to a spiral line of the spiral structure; or, according to the axial arrangement of the bracket body; or, the support body is circumferentially arranged.
Preferably, the effective working length of the bracket body can be equally divided by the arrangement distance of the developing points.
Preferably, the developing structure includes a developing dot and a developing belt.
Preferably, the developing point is provided on a holder body at a distal end of the distal end region, and the holder body is integrally provided with the developing belt, which is provided parallel to the holder body or wound on the holder body.
Preferably, the thickness of the development structure is 0.02-0.1mm, preferably 0.03-0.08mm.
The thrombus taking-out device comprises the full-development thrombus taking-out bracket, 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.
The invention has the beneficial effects that:
the invention provides a full-development thrombus taking support, which comprises a support body which is self-expanded along the circumferential direction of a longitudinal axis of the support body, wherein a certain number of development structures penetrate through the whole structure of the support body, the development structures are made of non-perspective ray materials, the forms of the thrombus taking support and thrombus can be more clearly defined in the thrombus taking process, the effective thrombus taking length of the thrombus taking support can be accurately marked, whether the thrombus taking support is completely released and expanded is judged, the contact condition of the thrombus taking support and the thrombus is intuitively reflected, and whether a lesion blood vessel has in-situ stenosis is further judged, so that the operation and judgment of doctors are facilitated, and the thrombus taking success rate is effectively improved.
Drawings
FIG. 1 is a schematic plan view of a fully developed thrombolytic stent according to an embodiment of the present invention;
fig. 2 is a schematic diagram of a spiral structure of a fully developed thrombus-removing stent according to a first embodiment of the present invention;
fig. 3 is a schematic diagram of a spiral structure of a fully developed thrombus-removing stent according to a first embodiment of the present invention;
fig. 4 is a schematic diagram III of a spiral structure of a fully developed thrombus-removing stent according to an embodiment of the present invention;
fig. 5 is a schematic diagram of a spiral structure of a fully developed thrombus-removing stent according to a second embodiment of the present invention;
fig. 6 is a schematic partial structural view of a fully developed thrombus-removing stent according to a second embodiment of the present invention;
fig. 7 is a schematic structural view of a developing point fixing part of the full-developing thrombus taking-out bracket provided by the 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; 101-a developing point fixing portion; 110-distal region; 111-a first closed loop network element; 120-middle region; 121-a second closed loop network element; 130-proximal region; 131-a third closed loop network element; 141-development point; 142-developing belt; 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 full-development thrombus taking support, which is shown in fig. 1-4 and 7, and comprises a support body 100 which is self-expanded along the circumferential direction of the longitudinal axis of the support body, wherein a certain number of development structures penetrate through the whole structure of the support body 100, the development structures are made of non-perspective ray materials, the form of the thrombus taking support and thrombus can be more clearly identified in the thrombus taking process, the effective thrombus taking length of the thrombus taking support can be accurately identified, whether the thrombus taking support is completely released and expanded is judged, the contact condition of the thrombus taking support and thrombus is intuitively reflected, and whether a lesion blood vessel has in-situ stenosis is further judged, so that the operation and judgment of doctors are facilitated, and the thrombus taking success rate is effectively improved.
Specifically, the stent body 100 includes a distal region 110, a middle region 120, and a proximal region 130 connected to the push rod 200, which are sequentially connected. The distal region 110 is provided with visualization structures to facilitate viewing of the actual position of the distal-most end of the thrombolytic stent to the vessel; the developing structure is arranged in the middle area 120, so that the contact condition of the blood vessel and thrombus can be clearly judged; the proximal region 130 is provided with a visualization structure that can indicate the effective working area of the thrombolytic stent.
The distal region 110 includes a plurality of first closed loop net units 111, the plurality of first closed loop net units 111 are connected to each other to form a sleeve structure, the intermediate region 120 includes a plurality of second closed loop net units 121, the plurality of second closed loop net units 121 are connected to each other to form a sleeve structure, the proximal region 130 includes a plurality of third closed loop net units 131, and the plurality of third closed loop net units 131 are connected to each other to form a cone structure. The first closed-loop network unit 111, the second closed-loop network unit 121, and the third closed-loop network unit 131 are each formed by enclosing a plurality of waverods into a polygonal structure, and the intersection point of the connected waverods located at the outermost side of the distal end region 110 is a wavehead. The first closed loop net unit 111, the second closed loop net unit 121, and the third closed loop net unit 131, which are sequentially connected in a set spiral manner, are in a counterclockwise or clockwise spiral configuration from the distal end region 110 to the proximal end region 130.
In this embodiment, the developing structure is a developing point 141, and the developing point 141 may be formed in a ring shape and wound on the waver rod itself; or can be made into a sheet or a tube and embedded inside or outside the wave rod; the development point fixing portion 101 may also be provided on the waver in advance, see fig. 7.
The number of developing points in each area may be set according to the number of wave heads, and may be equal to or less than the number of wave heads; the number of developing points may be set according to the length of the holder body 100. Referring to fig. 1, the developing point 141 may be disposed in a spiral line of a spiral structure, and preferably, in a proximal end region, the developing point 141 is disposed at a slope of a cone structure; alternatively, referring to fig. 2, the developing points 141 may also be disposed in the circumferential direction of the holder body 100; alternatively, referring to fig. 3, the developing point 141 may be further disposed in the axial direction of the holder body 100. Preferably, the effective working length of the stent body 100 can be divided by combining the circumferential arrangement and the axial arrangement of the developing points 141 (the distal end region 110 and the middle region 120 are the main body of the stent body 100, and are the effective working length of the thrombus taking), the effective working length of the stent body 100 can be divided into N parts by using the arrangement of the developing points 141, N is greater than or equal to 2, the specific value of N can be determined according to the specific length of the stent body 100, see fig. 4, the developing points 141 divide the effective working length of the stent body 100 into two parts, the length from the developing point region of the distal end region 110 to the developing point region of the middle region 120 is L1, the length from the developing point region of the middle region 120 to the developing point region of the proximal end region 130 is L2, and then L1 is about equal to L2, and when the thrombus taking stent is released into a blood vessel, the length of the blood vessel and thrombus can be clearly identified.
The thickness of the developing structure is 0.02-0.1mm, preferably 0.03-0.08mm, and the thickness arrangement can ensure that the length of blood vessels and thrombus can be clearly marked during thrombus taking, save non-perspective ray materials for manufacturing the developing structure to the greatest extent, and achieve the aim of saving cost.
Further, the first closed loop network unit 111 and the third closed loop network unit 131 are smaller in mesh than the second closed loop network unit 121. Through the small mesh design of the first closed loop net unit 111 of the distal end region 110, when the distal end region 110 catches thrombus in the release process, a larger radial supporting force is generated, when the stent body 100 is retracted, the thrombus is dragged, the thrombus is not easy to fall off in the retraction process, and the thrombus taking failure caused by the displacement of the thrombus in the retraction of the second closed loop net unit 121 of the middle region 120 of the stent body 100 is effectively compensated. The large mesh design of the second closed loop mesh unit 121 of the middle region 120 allows the stent body 100 to be effectively embedded into the thrombus when the thrombus is opened in the middle, so that the thrombus is not easy to be chopped or cut into small blocks, and the thrombus is convenient to be completely taken out. By the small mesh design of the third closed loop mesh unit 131 of the proximal region 130, the second closed loop mesh unit 121 of the intermediate region 120 is effectively compensated for during retraction, avoiding displacement of the thrombus during retraction. The small mesh design of the distal region 110 and the proximal region 130 limits the anterior and posterior sides of the thrombus, and allows smooth removal of the thrombus in cooperation with the intermediate region 120.
Example two
Fig. 5 and 6 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 developing structure includes a developing dot 141 and a developing belt 142.
Referring to fig. 5, the developing point 141 is disposed on the outermost wave rod of the distal end region 110, in addition, a developing belt 142 is disposed on the whole wave rod, the developing belt 142 is parallel to the wave rod or wound on the wave rod, and the developing belt 142 disposed on the wave rod is connected with the developing point 141; alternatively, referring to fig. 6, the developing point 141 is disposed at the wave head of the distal end region 110, a fixing seat is disposed at the wave head, the developing belt 142 is wound on the whole wave rod by a single strand or a plurality of strands, and the developing belt 142 is not connected to the wave head developing point 141.
Example III
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 of the above embodiments, wherein the proximal end 130 of the thrombus removing stent is connected to the push rod 200 through the binding point 600, and a micro catheter 500 capable of pressing the thrombus removing stent into the push rod 200 is sleeved outside the push rod 200, and the micro catheter 500 is connected to the introducing sheath 400 through a micro catheter 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 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 distally, 1/3-1/4 of the whole stent body 100 is released, the stent body 100 is sprung open distally 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 be withdrawn from 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.
The development structures distributed on the bracket body 100 are used for observing whether thrombus is caught and withdrawn in real time during thrombus taking or not, so as to guide specific thrombus taking microscopic operation, and enable thrombus taking to be more accurate.
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 (9)
1. The full-development thrombus taking support is characterized by comprising a support body which is self-expanded along the circumferential direction of a longitudinal axis of the support body, wherein a certain number of development structures in different forms or in the same form penetrate through the whole structure of the support body, the development structures are made of non-perspective ray materials, and the morphology of the support body and thrombus can be displayed in the thrombus taking process;
the support body comprises a distal end area, a middle area and a proximal end area which are sequentially connected, wherein the distal end area, the middle area and the proximal end area are respectively provided with a certain number of development structures in different forms or the same form;
the remote area is provided with a developing structure which is convenient for observing the actual position of the most remote end of the fully developed thrombus taking support to a blood vessel, the middle area is provided with the developing structure which can clearly judge the contact condition of the blood vessel and thrombus, and the near area is provided with the developing structure which can indicate the effective working area of the fully developed thrombus taking support.
2. The full-development thrombolytic stent of claim 1, wherein said development structure comprises development points, said development points being formed in a ring-like shape wound on the stent body; or, the inner part or the outer part of the bracket body is embedded in a sheet shape or a tubular shape; alternatively, the developing point fixing portion is provided in advance on the holder body.
3. The fully developed thrombolytic stent of claim 2, wherein the distal region comprises a first closed loop network element, the intermediate region comprises a plurality of second closed loop network elements, the proximal region comprises a plurality of third closed loop network elements, and the first, second and third closed loop network elements are sequentially connected in a set spiral from the distal region to the proximal region in a counter-clockwise or clockwise spiral configuration.
4. A full-development thrombolytic stent according to claim 3 wherein said development points are arranged in accordance with a helix of said helix; or, according to the axial arrangement of the bracket body; or, the support body is circumferentially arranged.
5. The full-development thrombolytic stent of claim 4, wherein the effective working length of said stent body can be equally divided by the distance of arrangement of said development points.
6. The full-development thrombolytic stent of claim 1, wherein said development structure comprises a development spot and a development zone.
7. The full-development thrombolytic stent according to claim 6, wherein said development point is provided on a stent body at a distal end of said distal end region, and further, said stent body is integrally provided with said development belt, said development belt being provided parallel to said stent body or wound around said stent body.
8. The full-development thrombolytic stent of any of claims 1-7, wherein said development structure has a thickness of 0.02-0.1mm.
9. A thrombus taking-out device, which is characterized by comprising the full-development thrombus taking-out bracket as claimed in any one of claims 1-8, wherein the proximal end region of the full-development 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.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710322317.0A CN107049421B (en) | 2017-05-09 | 2017-05-09 | Full-development thrombus taking support and thrombus taking device |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710322317.0A CN107049421B (en) | 2017-05-09 | 2017-05-09 | Full-development thrombus taking support and thrombus taking device |
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| CN107049421A CN107049421A (en) | 2017-08-18 |
| CN107049421B true CN107049421B (en) | 2023-11-17 |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN108245223A (en) * | 2018-01-22 | 2018-07-06 | 翎秀生物科技（上海）有限公司 | Take bolt stent |
| CN108670353A (en) * | 2018-04-09 | 2018-10-19 | 宋朝阳 | A kind of tandem takes bolt holder and thrombus withdrawing device |
| CN109692027A (en) * | 2018-12-03 | 2019-04-30 | 北京泰杰伟业科技有限公司 | A kind of whole course visible takes thrombus device |
| 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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