CN107753092B - Intra-cavity intima stripping device - Google Patents
Intra-cavity intima stripping device Download PDFInfo
- Publication number
- CN107753092B CN107753092B CN201711234081.1A CN201711234081A CN107753092B CN 107753092 B CN107753092 B CN 107753092B CN 201711234081 A CN201711234081 A CN 201711234081A CN 107753092 B CN107753092 B CN 107753092B
- Authority
- CN
- China
- Prior art keywords
- tube
- endoluminal
- spike
- thorn
- wall
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Active
Links
- 208000031481 Pathologic Constriction Diseases 0.000 claims abstract description 7
- 230000036262 stenosis Effects 0.000 claims abstract description 7
- 208000037804 stenosis Diseases 0.000 claims abstract description 7
- 238000011084 recovery Methods 0.000 claims description 30
- 239000003550 marker Substances 0.000 claims description 3
- 210000002472 endoplasmic reticulum Anatomy 0.000 claims 1
- 210000004204 blood vessel Anatomy 0.000 abstract description 15
- 208000037803 restenosis Diseases 0.000 abstract description 4
- 239000012528 membrane Substances 0.000 description 19
- 238000010276 construction Methods 0.000 description 6
- 239000011229 interlayer Substances 0.000 description 6
- 210000001105 femoral artery Anatomy 0.000 description 3
- 230000000149 penetrating effect Effects 0.000 description 3
- 239000007779 soft material Substances 0.000 description 3
- 230000009286 beneficial effect Effects 0.000 description 2
- 230000002792 vascular Effects 0.000 description 2
- 208000005189 Embolism Diseases 0.000 description 1
- 230000032683 aging Effects 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 230000010339 dilation Effects 0.000 description 1
- 238000002224 dissection Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 206010020718 hyperplasia Diseases 0.000 description 1
- 238000002513 implantation Methods 0.000 description 1
- 230000003902 lesion Effects 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000002601 radiography Methods 0.000 description 1
- 230000000087 stabilizing effect Effects 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 210000004026 tunica intima Anatomy 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320758—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B17/32002—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes with continuously rotating, oscillating or reciprocating cutting instruments
- A61B2017/320032—Details of the rotating or oscillating shaft, e.g. using a flexible shaft
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B2017/320741—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions for stripping the intima or the internal plaque from a blood vessel, e.g. for endarterectomy
Abstract
The invention discloses an endoluminal intima stripping device, comprising: a first tube having a first end provided with a peeling head capable of peeling the inner film from the inner wall of the cavity; a second tube having a first end extending into and out of the second end of the first tube, movably engaged with the first tube and reciprocally rotatable; an outlet disposed on an outer wall of the first end of the second tube; one end of the channel is communicated with the outlet, and the other end of the channel extends towards the direction of the inner wall of the second pipe and penetrates through the inner wall of the second pipe; the thorn is movably arranged in the channel and comprises a main thorn end; the driving piece is movably sleeved in the second pipe and can drive the main thorn end of the thorn to extend out of the outlet. When the invention is used for operation, the incision of blood vessels is not needed, the operation wound is small (minimally invasive), and the artificial stenosis caused by the incision and suture can be avoided. Can strip the whole intima of the blood vessel to reduce the incidence rate of restenosis.
Description
Technical Field
The present invention relates to surgical instruments, and in particular to endoluminal endocardial removal devices.
Background
Due to the improvement of living standard, the incidence of arteriosclerotic occlusive lesions, such as common superficial femoral artery intimal plaque, has increased year by year due to the arrival of aging society. In operation, the inner membrane is peeled off from the middle membrane by an inner membrane precutting instrument, and the inner membrane is resected together with the plaque by an inner membrane resecting instrument after reaching a preset resecting position. The existing endomembrane precutting instrument and endomembrane excision instrument are used for surgical operation, the inner cavity of a blood vessel needs to be cut, an operation wound is large, artificial stenosis caused by cutting and suturing is easy to cause, and the traditional stripping ring has great uncertainty in the treatment of the distal end of an inner membrane. If the endoluminal techniques such as balloon dilation and stent implantation are adopted, the possibility of continued intimal hyperplasia and restenosis exists. The newly developed internal rotating cutter in the blood vessel cavity has the defects of complex operation, time consuming and the like.
For this reason, it is desirable to seek a solution to at least alleviate the above problems.
Disclosure of Invention
The invention aims to solve the technical problem of providing a device for stripping endoluminal membranes, which is used for continuous operations of minimally invasive, endoluminal pre-cutting and endoluminal excision.
In order to solve the technical problems, the invention adopts the following technical scheme.
An endoluminal peeling device comprising:
a first tube having a first end provided with a peeling head capable of peeling the inner film from the inner wall of the cavity;
a second tube having a first end extending into and out of the second end of the first tube, movably engaged with the first tube and reciprocally rotatable;
an outlet disposed on an outer wall of the first end of the second tube;
one end of the channel is communicated with the outlet, and the other end of the channel extends towards the direction of the inner wall of the second pipe and penetrates through the inner wall of the second pipe;
the thorn is movably arranged in the channel and comprises a main thorn end;
the driving piece is movably sleeved in the second pipe and can drive the main thorn end of the thorn to extend out of the outlet.
The driving piece rotates in the second pipe to drive the main thorn end of the thorn to extend out of the outlet.
The end face of the thorn opposite to the main thorn end is provided with a poking bearing part, and the position of the driving piece corresponding to the poking bearing part is provided with a convex poking part; or the end of the thorn opposite to the main thorn end is movably connected with the driving piece through a first rotating shaft.
The driving piece moves in the second pipe along the axial direction of the second pipe towards the first end direction of the second pipe to drive the main thorn end of the thorn to extend out of the outlet.
The end face of the thorn opposite to the main thorn end is provided with a pushing and receiving part, and the position of the driving piece corresponding to the pushing and receiving part is provided with a pushing part.
The pushing part can extend into the channel; alternatively, the pushing part is formed with a wedge structure pushing the pushing receiving part.
The thorn has barbs extending in a direction opposite to the direction in which the main thorn end extends, and the end of the thorn opposite the main thorn end is restrained within the passageway when the main thorn end extends beyond the outlet.
The second end face of the first pipe is provided with an annular groove surrounding an inner hole of the first pipe, and a hard ring, a soft ring and a hardness adjusting pipe which extend into the groove from the second end of the first pipe and are arranged at intervals are movably sleeved in the groove.
The hardness adjusting tube is movably connected with the first tube through a thread pair and can rotate in the groove in a reciprocating manner.
The device also comprises a circular elastic recovery piece and a tightening wire, wherein the circular elastic recovery piece and the tightening wire circumferentially encircle the outer wall of the first end of the first pipe, one end of the recovery piece is fixed with the first pipe, the other end of the recovery piece extends towards the end face direction of the first end of the first pipe and can be tightened and closed by the tightening wire, and two free ends of the tightening wire extend towards the second end direction of the first pipe.
The recovery knob is movably connected to the first tube and can rotate reciprocally, two free ends of the tightening wire are connected with the recovery knob, the recovery knob is rotated, and the tightening wire is wound on the recovery knob.
The device further comprises a marking ring arranged on the outer wall of the first end of the second pipe and used for positioning the first end of the second pipe at the beginning end of the narrow cavity.
The invention has the following beneficial technical effects.
Taking the treatment of superficial femoral artery plaque as an example, when the invention is used for operation, the femoral artery is punctured, a vascular sheath with proper size is placed, a guide wire is operated to pass through a narrow section of a blood vessel, the initial end position of the narrow section is observed and positioned in a radiography manner, the first ends of a first tube and a second tube are introduced in an exchange manner, and 2 per close vascular staplers are preset for standby. Then the second tube is pushed in, the driving piece is manually operated, the main thorn end of the driving thorn extends out of the outlet and pierces into the plaque, and then the second tube is slightly rotated along the direction pointed by the main thorn end, so that the plaque is torn off the blood vessel wall, and an artificial interlayer is formed. The second tube is then advanced, and the dissection head is advanced between the intima and the vessel wall under the guidance of the roadmap, and the intima, along with plaque, is dissected intact from the vessel wall. And then the first ends of the first tube and the second tube are withdrawn simultaneously, and the perclose suture instrument is immediately tightened to suture the puncture point when the blood vessel is withdrawn. Therefore, when the invention is used for operation, the inner cavity of the blood vessel is not required to be cut, the operation wound is small (minimally invasive), the artificial stenosis caused by cutting and suturing can be avoided, the integrally-stripped inner membrane of the blood vessel is proliferated, and the occurrence rate of restenosis can be greatly reduced. Meanwhile, the continuous operation of endomembrane precutting and endomembrane excision is finished at one time, and the operation time can be shortened. The operation of the invention is simple and the cost is low.
Drawings
Fig. 1 is a schematic structural view of an endoluminal peeling apparatus of the present invention.
Fig. 2 is a schematic structural view of the second tube of the present invention.
Fig. 3 is an axial partial cross-sectional view of the first end of the second tube presented in fig. 2.
Fig. 4 is a cross-sectional view taken along A-A of fig. 2.
Fig. 5 is a cross-sectional view taken along the line B-B of fig. 2 (which is a schematic view of a structure of the connection of the spike and the driving member of the present invention).
FIG. 6 is a schematic view of a structure of the thorn of the present invention.
Fig. 7 is a view of fig. 6 in the direction C.
FIG. 8 is a schematic view of another structure of the connection of the spike and the driving member of the present invention.
FIG. 9 is a schematic view of another construction of the spike of the present invention.
Fig. 10 is a view in the direction D of fig. 9.
Fig. 11 is a view in the direction E of fig. 9.
Fig. 12 is an axial partial cross-sectional view of the second end of the second tube presented in fig. 2.
FIG. 13 is a schematic view of a ratchet mechanism according to the present invention.
Fig. 14 is a schematic view showing another structure of the second tube of the present invention.
Fig. 15 is an axial partial cross-sectional view of the first end of the second tube presented in fig. 14.
Fig. 16 is a cross-sectional view taken along the direction F-F of fig. 14.
Fig. 17 is a sectional view taken along G-G in fig. 15.
Fig. 18 is a partial schematic view of the drive member toward the first end of the second tube.
Fig. 19 is a view along the H direction of fig. 18.
FIG. 20 is a schematic view of yet another construction of the spike of the present invention.
Fig. 21 is a view of fig. 20 in the I-direction.
Fig. 22 is a schematic structural view of the pushing portion shown in fig. 18 and 19 when it enters the channel to push the thorn.
Fig. 23 is a schematic view of another partial structure of the driving member toward the first end of the second tube.
Fig. 24 is a view in the J direction of fig. 23.
Fig. 25 is a schematic structural view of the pushing portion shown in fig. 23 and 24 when it enters the channel to push the thorn.
FIG. 26 is another axial partial cross-sectional view of the first end of the second tube presented in FIG. 14.
Fig. 27 is an axial partial cross-sectional view of the second end of the second tube presented in fig. 14.
Fig. 28 is a schematic structural view of the pushing mechanism of the present invention (the push rod connector is not shown).
Fig. 29 is a schematic view of still another construction of the second tube of the present invention.
Fig. 30 is an axial partial cross-sectional view of the first end of the second tube presented in fig. 29.
Fig. 31 is a cross-sectional view taken along the direction K-K of fig. 29.
Fig. 32 is a cross-sectional view taken along L-L in fig. 29.
Fig. 33 is a cross-sectional view of another configuration of fig. 29 taken along the direction L-L (the spike and driver connection configuration of this figure differs from that presented in fig. 32).
Fig. 34 is an axial partial cross-sectional view of the second end of the second tube presented in fig. 29.
Fig. 35 is a schematic structural view of a first tube according to the present invention.
Fig. 36 is an axial partial cross-sectional view of the first end of the first tube presented in fig. 35.
Fig. 37 is an axial partial cross-sectional view of the second end of the first tube presented in fig. 35.
Fig. 38 is a schematic view showing a state in which the recovery member of the present invention is in a state to be tightened.
Fig. 39 is a schematic view showing a state in which the recovery member of the present invention is in a tightened state.
Detailed Description
So that the manner in which the features and functions of the present invention can be understood in detail, a more particular description of the invention, briefly summarized above, may be had by reference to embodiments, some of which are illustrated in the appended drawings.
Unless specifically stated otherwise, the terms "first," second, "" third, "" fourth, "etc. herein do not denote a order, nor the importance of the terms" a, "" an, "or" the like.
Fig. 1 illustrates an embodiment of one of many endoluminal peeling devices in accordance with the present invention. Referring also to fig. 2-5, the endoluminal peeling device comprises a first tube 1, a second tube 2, an outlet 21, a channel 24, a spike 3, and a driver 4.
Referring also to fig. 35 and 36, the first end of the first tube 1 is a peeling head 11 capable of peeling the inner film from the inner wall of the cavity. The inner wall of the peeling head 11 is preferably wedge-shaped to facilitate peeling of the inner film from the inner wall of the cavity. The first tube 1 is preferably made of a soft material. The first tube 1 is preferably of cylindrical construction.
Referring also to fig. 2-5, the first end of the second tube 2 extends into the second end of the first tube 1 and can extend from the first end of the first tube 1. The second tube 2 is movably engaged with the first tube 1 and can be reciprocally rotated. In the embodiment shown in fig. 2-5, the second tube 2 is preferably of cylindrical construction.
To facilitate introduction of the second tube 2 in the lumen, the first end of the second tube 2 is provided with a guiding tip 23 having a conical shape.
The outlet 21 is provided in the outer wall of the first end of the second tube 2.
Referring also to fig. 5, the passage 24 has one end communicating with the outlet 21 and the other end extending in the direction of the inner wall of the second tube 2 and penetrating the inner wall of the second tube 2.
Referring also to fig. 6 and 7, spike 3 is movably disposed within channel 24 and includes a main spike end 31. Preferably, the main spike 31 is pointed.
The driving member 4 is movably sleeved in the second tube 2, and can drive the main thorn end 31 of the thorn 3 to extend out of the outlet 21. The driving member 4 is preferably cylindrical.
In the embodiment presented in fig. 2-5, the driver 4 rotates within the second tube 2 to drive the main spike end 31 of the spike 3 out of the outlet 21.
Referring to fig. 5-7, the end surface of the thorn 3 opposite to the main thorn end 31 is provided with a poking receiving part 32, and the position of the driving piece 4 corresponding to the poking receiving part 32 is provided with a convex poking part 41. The toggle receiver 32 may be a concave recess in the corresponding end face. When the driving member 4 rotates in the second tube 2, the poking part 41 abuts against the poking bearing part 32 to push the thorn 3 to move along the channel 24 towards the outlet 21, finally the main thorn end 31 extends out of the outlet 21 and pierces into the inner membrane, and then the second tube 2 is slightly rotated along the direction pointed by the main thorn end 31 to tear the inner membrane away from the blood vessel wall, so as to form an artificial interlayer.
Fig. 8 shows another embodiment of the structure of the connection of the thorn 3 according to the invention with the driving member 4. In fig. 8, the end of the thorn 3 opposite the main thorn end 31 is movably connected to the driving member 4 by means of a first shaft 6. Referring also to fig. 9-11, fig. 9 is another structural embodiment of the spike of the present invention, fig. 10 is a view along direction D of fig. 9, and fig. 11 is a view along direction E of fig. 9. The end of the thorn 3 opposite the main thorn end 31 is provided with a first through-hole 34, the side facing the driving member 4 of which is provided with a groove 35, the bottom surface of which preferably corresponds to the outer wall of the corresponding position of the driving member 4. For facilitating the movable connection with the thorn 3 shown in fig. 9-11, for example, a groove extending circumferentially along the outer wall may be provided in the outer wall near an end face of the driving member 4, the distance between the groove and the end face being adapted to the width of the groove 35 or smaller than the width of the groove 35, and a second through hole (not shown) penetrating the end face and the groove may then be provided, the first shaft 6 being movably fitted in the first through hole 34 and the second through hole, so that the end of the thorn 3 opposite to the main thorn end 31 is movably connected with the driving member 4 via the first shaft 6. When the driving member 4 rotates in the second tube 2, the main spike end 31 is positioned in the channel, the spike 3 rotates around the first rotating shaft 6, and under the pushing of the first rotating shaft 6, the spike 3 moves along the channel 24 towards the outlet 21, finally the main spike end 31 extends out of the outlet 21 and penetrates into the inner membrane, and then the second tube 2 is slightly rotated along the direction pointed by the main spike end 31, so that the inner membrane is torn away from the blood vessel wall, and an artificial interlayer is formed.
Referring to fig. 12, fig. 12 is an axial partial cross-sectional view of the second end of the second tube presented in fig. 2. A ratchet mechanism 8 is provided between the drive member 4 and the second tube 2.
Referring also to fig. 13, the ratchet mechanism 8 includes a pawl 81 movably coupled to the inner wall of the second tube 2 and a ratchet 82 fitted over the driver 4.
In order to facilitate the rotation of the driving member 4, a knob connecting portion 22 is formed at the second end of the second tube 2, and the driving member knob 7 is sleeved and fixed on the driving member 4, movably connected with the knob connecting portion 22 and capable of reciprocally rotating around the axis thereof. In the case of the knob connecting portion 22, the pawl 81 is preferably movably connected to the inner wall of the knob connecting portion 22, and the ratchet 82 is preferably sleeved on the driving member 4.
Fig. 14 is an embodiment of another construction of the second tube of the present invention. Fig. 15 is an axial partial cross-sectional view of the first end of the second tube presented in fig. 14. Fig. 16 is a cross-sectional view taken along the direction F-F of fig. 14. Fig. 17 is a sectional view taken along G-G in fig. 15. The driving member 4 is capable of moving the main spike end 31 of the driving spike 3 in the second tube 2 in the axial direction of the second tube 2 towards the first end of the second tube 2 and out of the outlet 21.
Referring also to fig. 18-21, the end surface of the thorn 3 opposite to the main thorn end 31 is provided with a pushing and receiving part 36, and the position of the driving member 4 corresponding to the pushing and receiving part 36 is provided with a pushing part b. In the embodiment shown in fig. 15, 17, 18 and 19, the pushing portion b is cylindrical and can extend into the channel 24, and in this configuration, the pushing portion b is preferably made of a soft material. Referring to fig. 22, when the driving member 4 moves in the second tube 2 along the axial direction of the second tube 2 toward the first end of the second tube 2, the pushing portion b extends into the channel 24, abuts against the pushing receiving portion 36, and pushes the spike 3 to move along the channel 24 toward the outlet 21, and finally the main spike end 31 extends out of the outlet 21 and pierces into the inner membrane, and then the second tube 2 is slightly rotated along the direction pointed by the main spike end 31, so that the inner membrane is torn away from the blood vessel wall, thereby forming an artificial interlayer.
Referring to fig. 23 and 24, fig. 23 and 24 present an alternative embodiment of the structure in which the driver is oriented toward the first end of the second tube. This embodiment differs from the embodiment presented in fig. 18, 19 in that the pushing part b is formed with a wedge-shaped structure b1 pushing the pushing reception part 36. Referring to fig. 25 and 26, when the driving member 4 moves in the second tube 2 along the axial direction of the second tube 2 toward the first end of the second tube 2, the wedge-shaped structure b1 abuts against the pushing receiving portion 36 to push the thorn 3 along the channel 24 toward the outlet 21, and finally the main thorn end 31 extends out of the outlet 21 and pierces into the intima, and then the second tube 2 is slightly rotated along the direction pointed by the main thorn end 31 to tear the intima away from the blood vessel wall, thereby forming an artificial interlayer.
Referring also to fig. 27, 28, in some embodiments, the present invention further comprises a pushing mechanism 9 disposed between the second tube 2 and the driving member 4, the pushing mechanism 9 comprising a push rod connector a fixed to the second tube 2 and a push rod 91; the push rod 91 is a lever, and the point at which one end of the push rod 91 is movably connected with the push rod connecting piece a is a fulcrum of the lever; the two ends of the push rod 91 are movably connected with the driving piece 4. For example, the first end of the push rod 91 is movably connected through the second rotating shaft 92 and can rotate around the second rotating shaft 92 towards the first end or the second end direction of the second pipe 2, a kidney-shaped hole 94 extending along the length direction of the push rod 91 is formed between two ends of the push rod 91, a protruding portion 93 is arranged on the outer wall of the driving member 4, and the protruding portion 93 is movably installed in the kidney-shaped hole 94 in a penetrating mode. Pushing the push rod 91, the push rod 91 rotates around the second rotation shaft 92 towards the first end direction of the second pipe 2, and the protruding portion 93 moves along the kidney-shaped hole 94 towards the second rotation shaft 92, so that the driving member 4 is pushed to move towards the first end direction of the second pipe 2. Preferably, the protrusion 93 has a cylindrical shape.
Referring to fig. 28, two push rods 91 are connected to the second end of the push rod 91 through a connecting rod 95 to form a door structure, which is beneficial to balance force applied to the driving member 4 during pushing.
Referring to fig. 6, 9, 20, in some embodiments, the spike 3 has barbs 33 extending in a direction opposite to the direction in which the main spike end 31 extends, and when the main spike end 31 extends beyond the outlet 21, the end of the spike 3 opposite the main spike end 31 is constrained within the channel 24 so that the barbs 33 catch the inner membrane when pierced, preventing the main spike end 31 from falling off the inner membrane, and facilitating tearing of the inner membrane away from the vessel wall. For example, with this configuration, during surgery, the second tube 2 can be rotated in the direction indicated by the barbs 33 to more reliably tear the intima away from the vessel wall.
Fig. 29 is a further embodiment of the second tube of the present invention. Referring also to fig. 30-34, this embodiment differs from the embodiment presented in fig. 2 in that: still be provided with spacing portion 25, the one end of spacing portion 25 is connected with the first end inner wall of second pipe 2, and the other end extends to the second end direction of second pipe 2, has between spacing portion 25 outer wall and the inner wall of second pipe 2 and is cylindric clearance, and driving piece 4 is located this clearance, can rotate around this spacing portion 25. Otherwise, the embodiment presented in fig. 2 is identical.
The stopper 25 is preferably integrally formed with the second tube 2, for example, a circular groove surrounding the inner hole of the second tube 2 is provided at the second end face thereof, and a portion between the groove and the inner hole of the second tube 2 forms the stopper 25. The limiting portion 25 is preferably cylindrical.
In the embodiment shown in fig. 14, a limiting portion 25 is further provided, one end of the limiting portion 25 is connected to the inner wall of the first end of the second tube 2, the other end extends in the second end direction of the second tube 2, a cylindrical gap is formed between the outer wall of the limiting portion 25 and the inner wall of the second tube 2, and the driving member 4 is located in the gap and can reciprocate along the axial direction of the limiting portion 25, so that the limiting portion 25 plays a role in stabilizing structure and limiting guide.
It will be appreciated that the second tube 2 of the embodiment shown in fig. 14 may also be constructed as the second tube 2 of the embodiment shown in fig. 2, i.e. without the stop 25.
Referring to fig. 35 and 36, for example, when the first tube 1 is made of a soft material, the second end face of the first tube 1 has a ring-shaped groove 12 surrounding its inner hole, and a hard ring c, a soft ring d (i.e., one hard ring c, one soft ring d, another hard ring c, one soft ring d, and so on) and a hardness adjusting tube e extending from the second end of the first tube 1 and fitted into the groove 12 are movably fitted into the groove 12. The hardness adjusting tube e is preferably of a cylindrical structure. During operation, the first tube 1 is pushed into the inner cavity of the blood vessel, the hardness adjusting tube e is driven to move towards the first end direction of the first tube 1 according to the blood vessel running path under the guidance of a road map, so that the hard ring c and the soft ring d are tightly pressed, and the part of the first tube 1 close to the stripping head 11 is hard; when the hardness adjustment tube e is driven to move in the second end direction of the first tube 1, the hardness of the portion of the first tube 1 near the peeling head 11 becomes soft. Thereby realizing at least that the hardness and the softness of the part of the first pipe 1 close to the stripping head 11 are adjustable.
Referring to fig. 37, the hardness adjusting tube e is movably connected to the first tube 1 by a screw pair 13 so as to be reciprocally rotatable in the groove 12. In order to facilitate the adjustment of the hardness of the portion of the first tube 1 adjacent to the peeling head 11, the end of the hardness adjustment tube e which is not sleeved in the groove 12 is provided with a hardness adjustment knob f. The hardness adjusting knob f is provided with an inlet and outlet f1 communicated with the inner hole of the first pipe 1 for the second pipe 2 to enter and exit.
Referring to fig. 35 to 39, the present invention further comprises a recovery member i having elasticity and having a ring shape and circumferentially surrounding the outer wall of the first end of the first tube 1, one end of the recovery member i being fixed to the first tube 1, the other end of the recovery member i extending in the direction of the end face of the first end of the first tube 1 and being capable of being tightened and closed by the tightening wire h, and two free ends of the tightening wire h extending in the direction of the second end of the first tube. Wherein, the arrow in fig. 39 indicates the moving direction of the take-up wire h when the recovery member i is taken up. In operation, the intima is torn off the vessel wall to form an artificial interlayer, the second tube 2 is fixed, the first tube 1 is pushed forward, and the proliferated intima is completely peeled off and contained in the first tube 1. Then, the tightening wire h is pulled in the direction of the second end of the first tube 1, the end of the recovery member i extending in the direction of the first end face of the first tube 1 is tightened by the tightening wire h, and the recovery member i is pulled tightly, thereby smoothly cutting the end of the inner membrane and completely accommodating the peeled inner membrane and plaque in the first tube 1. Therefore, the structure of the recovery piece i and the tightening wire h is adopted, the remote uncontrollable property caused by the traditional stripping ring is improved, the integrally-stripped and contained vascular intima is increased, the occurrence rate of restenosis can be greatly reduced, and the risk of embolism caused by falling of the intima in operation can be avoided. Meanwhile, continuous operations of endomembrane precutting, endomembrane excision and recovery are completed at one time, and the operation time can be shortened.
In some embodiments, the present invention further comprises a recovery knob g movably connected to the first tube 1 and capable of reciprocally rotating, two free ends of the tightening wire h are connected to the recovery knob g, the recovery knob g is rotated, and the tightening wire is wound around the recovery knob g to facilitate tightening of the recovery member i.
In order to facilitate the positioning of the first end of the second tube 2 extending to the beginning of the intra-luminal stenosis, the present invention further comprises a marker ring 5 provided to the outer wall of the first end of the second tube 2 for positioning the first end of the second tube 2 at the beginning of the intra-luminal stenosis. During advancement of the second tube 2, advancement of the second tube 2 is stopped when the marker ring 5 is at the beginning of the stenosis to locate the position where the first end of the second tube 2 is advanced.
The specific features described in the above embodiments may be combined in any suitable manner without contradiction. In order to avoid unnecessary repetition, the invention is not described in any detail with respect to the various possible combinations.
The present invention has been described in detail with reference to the embodiments thereof, which are intended to be illustrative rather than restrictive, and variations and modifications are within the scope of the present invention without departing from the general inventive concept.
Claims (12)
1. An endoluminal peeling apparatus comprising:
a first tube having a first end provided with a peeling head capable of peeling the inner film from the inner wall of the cavity;
a second tube having a first end extending into and capable of extending from the second end of the first tube,
which is movably matched with the first pipe and can rotate reciprocally;
an outlet disposed on an outer wall of the first end of the second tube;
one end of the channel is communicated with the outlet, and the other end of the channel extends towards the direction of the inner wall of the second pipe and penetrates through the inner wall of the second pipe;
the thorn is movably arranged in the channel and comprises a main thorn end;
the driving piece is movably sleeved in the second pipe and can drive the main thorn end of the thorn to extend out of the outlet.
2. The endoluminal peeling apparatus of claim 1 wherein rotation of the drive member within the second tube drives the main spike end of the spike out of the outlet.
3. The endoluminal peeling apparatus of claim 2 wherein the end face of the spike opposite the main spike end has a toggle receiver and the drive member has a raised toggle portion in a position corresponding to the toggle receiver; or the end of the thorn opposite to the main thorn end is movably connected with the driving piece through a first rotating shaft.
4. The endoluminal peeling apparatus of claim 1 wherein movement of the driver member within the second tube in the direction of the second tube axis toward the first end of the second tube drives the main spike end of the spike out of the outlet.
5. The endoluminal peeling apparatus of claim 4 wherein the end surface of the spike opposite the main spike end has a push receiver and the drive member has a push at a position corresponding to the push receiver.
6. The endoluminal endoplasmic reticulum peeling apparatus of claim 5 wherein said pusher is extendable into said channel; alternatively, the pushing part is formed with a wedge structure pushing the pushing receiving part.
7. The endoluminal peeling device of claim 1 wherein the spike has barbs extending in a direction opposite to the direction in which the main spike end extends and wherein the end of the spike opposite the main spike end is constrained within the channel when the main spike end extends out of the outlet.
8. The endoluminal peeling apparatus of any of claims 1 to 7 wherein the second end surface of the first tube has an annular recess surrounding the bore thereof, the recess being removably fitted with spaced apart hard rings, soft rings and hardness adjusting tubes extending from the second end of the first tube into and fitting within the recess.
9. The endoluminal peeling apparatus of claim 8 wherein the hardness adjustment tube is movably coupled to the first tube by a threaded pair for reciprocal rotation within the groove.
10. The endoluminal peeling apparatus of any of claims 1 to 7 further comprising a recovery member having elasticity in the form of a ring circumferentially surrounding the outer wall of the first end of the first tube, one end of the recovery member being fixed to the first tube, the other end of the recovery member extending in the direction of the first end face of the first tube and being capable of being tightened closed by a tightening wire, the two free ends of the tightening wire extending in the direction of the second end of the first tube.
11. The endoluminal peeling apparatus of claim 10 further comprising a recovery knob movably coupled to the first tube and reciprocally rotatable, the two free ends of the cinch wire being coupled to the recovery knob, rotating the recovery knob, the cinch wire being wound around the recovery knob.
12. The endoluminal peeling apparatus of any of claims 1-7 further comprising a marker ring disposed on an outer wall of the first end of the second tube for positioning the first end of the second tube at the beginning of an endoluminal stenosis.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201711234081.1A CN107753092B (en) | 2017-11-30 | 2017-11-30 | Intra-cavity intima stripping device |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201711234081.1A CN107753092B (en) | 2017-11-30 | 2017-11-30 | Intra-cavity intima stripping device |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN107753092A CN107753092A (en) | 2018-03-06 |
| CN107753092B true CN107753092B (en) | 2024-01-19 |
Family
ID=61276336
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201711234081.1A Active CN107753092B (en) | 2017-11-30 | 2017-11-30 | Intra-cavity intima stripping device |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN107753092B (en) |
Families Citing this family (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN112020336A (en) * | 2018-04-19 | 2020-12-01 | 巴德股份有限公司 | Catheter for active sectioning/scoring and related methods |
Citations (28)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP0117519A1 (en) * | 1983-02-23 | 1984-09-05 | Johannes Dipl.-Ing. Theermann | Catheter |
| JPH0295359A (en) * | 1988-09-30 | 1990-04-06 | Samuel Shiber | Mechanical atheroma removing apparatus |
| EP0533321A2 (en) * | 1991-07-22 | 1993-03-24 | Dow Corning Wright Corporation | Expanding atherectomy device |
| US5356418A (en) * | 1992-10-28 | 1994-10-18 | Shturman Cardiology Systems, Inc. | Apparatus and method for rotational atherectomy |
| US6015420A (en) * | 1997-03-06 | 2000-01-18 | Scimed Life Systems, Inc. | Atherectomy device for reducing damage to vessels and/or in-vivo stents |
| JP2000175923A (en) * | 1998-12-15 | 2000-06-27 | Asahi Intecc Co Ltd | Foreign matter removing device |
| JP2001029349A (en) * | 1999-07-23 | 2001-02-06 | Asahi Optical Co Ltd | Biopsy forceps with needle for endoscope |
| CN101410063A (en) * | 2006-02-03 | 2009-04-15 | 詹姆斯·E·科尔曼 | Wound closure devices |
| WO2009054968A1 (en) * | 2007-10-22 | 2009-04-30 | Atheromed, Inc. | Atherectomy devices and methods |
| CN101451682A (en) * | 2007-12-06 | 2009-06-10 | 富士迈半导体精密工业（上海）有限公司 | Ring lighting device |
| CN102014773A (en) * | 2008-04-23 | 2011-04-13 | 阿维格公司 | Catheter system and method for boring through blocked vascular passages |
| CN102186427A (en) * | 2008-09-22 | 2011-09-14 | 浩特斯博尔技术公司 | Flow restoration systems and methods for use |
| CN202821511U (en) * | 2012-05-07 | 2013-03-27 | 王涛 | Thrombus breaking and taking device |
| CN103200886A (en) * | 2010-10-28 | 2013-07-10 | 科维蒂恩有限合伙公司 | Material removal device and method of use |
| CN103654912A (en) * | 2012-09-19 | 2014-03-26 | 上海理工大学 | Closed recycling type thrombus cutting device capable of performing circular cutting |
| CN104487127A (en) * | 2012-05-24 | 2015-04-01 | 波士顿科学西美德公司 | Subintimal re-entry catheter with an expandable structure |
| CN104540462A (en) * | 2012-06-14 | 2015-04-22 | 萨诺库里斯公司 | Medical device, assembly and method for creating a channel in soft tissue |
| CN104968285A (en) * | 2013-01-07 | 2015-10-07 | 塔尔雅格医疗有限公司 | Expandable atherectomy device |
| CN105120778A (en) * | 2013-03-14 | 2015-12-02 | 心血管系统股份有限公司 | Devices, systems and methods for a piloting tip bushing for rotational atherectomy |
| WO2016027492A1 (en) * | 2014-08-21 | 2016-02-25 | テルモ株式会社 | Method for stripping blood vessel and device for stripping blood vessel |
| WO2016027491A1 (en) * | 2014-08-21 | 2016-02-25 | テルモ株式会社 | Method for stripping blood vessel and device for stripping blood vessel |
| CN106963516A (en) * | 2017-03-23 | 2017-07-21 | 杭州唯强医疗科技有限公司 | Intracavitary orthotopic fenestration sting device |
| CN106963457A (en) * | 2017-04-06 | 2017-07-21 | 山东省肿瘤防治研究院 | A kind of laparoscope punctures sheath |
| CN106974694A (en) * | 2017-05-02 | 2017-07-25 | 陈安富 | Medicine equipment actuating station and PCI system, application method |
| JP2017153605A (en) * | 2016-02-29 | 2017-09-07 | テルモ株式会社 | Peeling device and peeling system |
| CN107280728A (en) * | 2017-08-04 | 2017-10-24 | 李莉 | A kind of thrombus remover for preventing blood vessel from damaging |
| CN107374700A (en) * | 2017-08-28 | 2017-11-24 | 北京赛铂医药科技有限公司 | A kind of segmented thrombus is broken to take device |
| CN209499843U (en) * | 2017-11-30 | 2019-10-18 | 彭翼 | Intracavitary Endarterectomy device |
Family Cites Families (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20040172051A1 (en) * | 2003-02-28 | 2004-09-02 | Sundaram Ravikumar | Method and apparatus for tubal occlusion |
| EP1924315B1 (en) * | 2005-09-12 | 2019-12-04 | Bridgepoint Medical, Inc. | Endovascular devices |
| US8361094B2 (en) * | 2006-06-30 | 2013-01-29 | Atheromed, Inc. | Atherectomy devices and methods |
| US8007506B2 (en) * | 2006-06-30 | 2011-08-30 | Atheromed, Inc. | Atherectomy devices and methods |
| US8070762B2 (en) * | 2007-10-22 | 2011-12-06 | Atheromed Inc. | Atherectomy devices and methods |
| WO2009117158A2 (en) * | 2008-03-21 | 2009-09-24 | Innovasc Llc | Device and method for opening blood vessels by pre-angioplasty serration and dilatation of aetherosclerotic plaque |
| TWM377203U (en) * | 2009-09-16 | 2010-04-01 | Profession Entpr Co Ltd | Structure of blood collection needle |
| US10130384B2 (en) * | 2014-09-23 | 2018-11-20 | CARDINAL HEALTH SWITZERLAND 515 GmbH | Catheter systems and methods for re-entry in body vessels with chronic total occlusion |
| US20160089228A1 (en) * | 2014-09-25 | 2016-03-31 | Contego Medical, Llc | Temporary embolic protection device and methods thereof |
| US10617546B2 (en) * | 2015-02-27 | 2020-04-14 | F.G.P. S.R.L. | Manually operated rotative locking device for orthopedic orthoses or braces |
-
2017
- 2017-11-30 CN CN201711234081.1A patent/CN107753092B/en active Active
Patent Citations (28)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP0117519A1 (en) * | 1983-02-23 | 1984-09-05 | Johannes Dipl.-Ing. Theermann | Catheter |
| JPH0295359A (en) * | 1988-09-30 | 1990-04-06 | Samuel Shiber | Mechanical atheroma removing apparatus |
| EP0533321A2 (en) * | 1991-07-22 | 1993-03-24 | Dow Corning Wright Corporation | Expanding atherectomy device |
| US5356418A (en) * | 1992-10-28 | 1994-10-18 | Shturman Cardiology Systems, Inc. | Apparatus and method for rotational atherectomy |
| US6015420A (en) * | 1997-03-06 | 2000-01-18 | Scimed Life Systems, Inc. | Atherectomy device for reducing damage to vessels and/or in-vivo stents |
| JP2000175923A (en) * | 1998-12-15 | 2000-06-27 | Asahi Intecc Co Ltd | Foreign matter removing device |
| JP2001029349A (en) * | 1999-07-23 | 2001-02-06 | Asahi Optical Co Ltd | Biopsy forceps with needle for endoscope |
| CN101410063A (en) * | 2006-02-03 | 2009-04-15 | 詹姆斯·E·科尔曼 | Wound closure devices |
| WO2009054968A1 (en) * | 2007-10-22 | 2009-04-30 | Atheromed, Inc. | Atherectomy devices and methods |
| CN101451682A (en) * | 2007-12-06 | 2009-06-10 | 富士迈半导体精密工业（上海）有限公司 | Ring lighting device |
| CN102014773A (en) * | 2008-04-23 | 2011-04-13 | 阿维格公司 | Catheter system and method for boring through blocked vascular passages |
| CN102186427A (en) * | 2008-09-22 | 2011-09-14 | 浩特斯博尔技术公司 | Flow restoration systems and methods for use |
| CN103200886A (en) * | 2010-10-28 | 2013-07-10 | 科维蒂恩有限合伙公司 | Material removal device and method of use |
| CN202821511U (en) * | 2012-05-07 | 2013-03-27 | 王涛 | Thrombus breaking and taking device |
| CN104487127A (en) * | 2012-05-24 | 2015-04-01 | 波士顿科学西美德公司 | Subintimal re-entry catheter with an expandable structure |
| CN104540462A (en) * | 2012-06-14 | 2015-04-22 | 萨诺库里斯公司 | Medical device, assembly and method for creating a channel in soft tissue |
| CN103654912A (en) * | 2012-09-19 | 2014-03-26 | 上海理工大学 | Closed recycling type thrombus cutting device capable of performing circular cutting |
| CN104968285A (en) * | 2013-01-07 | 2015-10-07 | 塔尔雅格医疗有限公司 | Expandable atherectomy device |
| CN105120778A (en) * | 2013-03-14 | 2015-12-02 | 心血管系统股份有限公司 | Devices, systems and methods for a piloting tip bushing for rotational atherectomy |
| WO2016027492A1 (en) * | 2014-08-21 | 2016-02-25 | テルモ株式会社 | Method for stripping blood vessel and device for stripping blood vessel |
| WO2016027491A1 (en) * | 2014-08-21 | 2016-02-25 | テルモ株式会社 | Method for stripping blood vessel and device for stripping blood vessel |
| JP2017153605A (en) * | 2016-02-29 | 2017-09-07 | テルモ株式会社 | Peeling device and peeling system |
| CN106963516A (en) * | 2017-03-23 | 2017-07-21 | 杭州唯强医疗科技有限公司 | Intracavitary orthotopic fenestration sting device |
| CN106963457A (en) * | 2017-04-06 | 2017-07-21 | 山东省肿瘤防治研究院 | A kind of laparoscope punctures sheath |
| CN106974694A (en) * | 2017-05-02 | 2017-07-25 | 陈安富 | Medicine equipment actuating station and PCI system, application method |
| CN107280728A (en) * | 2017-08-04 | 2017-10-24 | 李莉 | A kind of thrombus remover for preventing blood vessel from damaging |
| CN107374700A (en) * | 2017-08-28 | 2017-11-24 | 北京赛铂医药科技有限公司 | A kind of segmented thrombus is broken to take device |
| CN209499843U (en) * | 2017-11-30 | 2019-10-18 | 彭翼 | Intracavitary Endarterectomy device |
Also Published As
| Publication number | Publication date |
|---|---|
| CN107753092A (en) | 2018-03-06 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| US10143463B2 (en) | Snared suture trimmer | |
| US9750494B2 (en) | Suture trimmer | |
| US8911457B2 (en) | Method of using knot pusher and suture cutter instrument | |
| US6248119B1 (en) | Device and method for endoscopic vascular surgery | |
| US5383886A (en) | Methods and instruments for performing medical procedures percutaneously without a trocar | |
| US7390328B2 (en) | Device and method for suturing of internal puncture sites | |
| US6942684B2 (en) | Method and apparatus for positioning an anchor member | |
| US20160015389A1 (en) | Methods and systems for advancing and anchoring suture in tissue | |
| US8491613B2 (en) | Aortic dissection septal cutting tool | |
| JP2012520158A (en) | Vascular access and closure device | |
| US9387039B2 (en) | Aortic dissection septal cutting tool | |
| US11696752B2 (en) | Systems and methods for all-inside suture fixation for implant attachment and soft tissue repair | |
| EP2478846A2 (en) | Wound closure device using t-shaped tag | |
| CN107753092B (en) | Intra-cavity intima stripping device | |
| US20160317174A1 (en) | Aortic dissection septal cutting tool | |
| WO1996041574A2 (en) | Surgical system and method for the reattachment of soft tissue to bone | |
| US7322999B2 (en) | Tissue punch and method for creating an anastomosis for locating a bypass graft | |
| JP2007244408A (en) | Living tissue resection assisting tool | |
| CN113842183A (en) | Digestive tract closing device and control method | |
| JP2010148546A (en) | Suturing implement for endoscope |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| PB01 | Publication | ||
| PB01 | Publication | ||
| SE01 | Entry into force of request for substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
| GR01 | Patent grant | ||
| GR01 | Patent grant |