CN108143459A - Medical treatment isolation instrument - Google Patents
Medical treatment isolation instrument Download PDFInfo
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- CN108143459A CN108143459A CN201611093945.8A CN201611093945A CN108143459A CN 108143459 A CN108143459 A CN 108143459A CN 201611093945 A CN201611093945 A CN 201611093945A CN 108143459 A CN108143459 A CN 108143459A
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- instrument
- medical treatment
- dropbox
- distal
- fixed frame
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- 238000002955 isolation Methods 0.000 title claims abstract description 58
- 238000011282 treatment Methods 0.000 title claims abstract description 40
- 239000002184 metal Substances 0.000 claims abstract description 17
- 229910052751 metal Inorganic materials 0.000 claims abstract description 17
- 210000005240 left ventricle Anatomy 0.000 claims description 58
- 239000000463 material Substances 0.000 claims description 12
- 229910001000 nickel titanium Inorganic materials 0.000 claims description 11
- 238000005520 cutting process Methods 0.000 claims description 7
- 239000000203 mixture Substances 0.000 claims description 7
- 230000002861 ventricular Effects 0.000 description 27
- 238000000034 method Methods 0.000 description 12
- 238000010586 diagram Methods 0.000 description 11
- 239000008280 blood Substances 0.000 description 10
- 210000004369 blood Anatomy 0.000 description 10
- 230000000694 effects Effects 0.000 description 10
- 230000017531 blood circulation Effects 0.000 description 9
- 210000002216 heart Anatomy 0.000 description 7
- 230000001788 irregular Effects 0.000 description 7
- 210000000709 aorta Anatomy 0.000 description 6
- NJPPVKZQTLUDBO-UHFFFAOYSA-N novaluron Chemical compound C1=C(Cl)C(OC(F)(F)C(OC(F)(F)F)F)=CC=C1NC(=O)NC(=O)C1=C(F)C=CC=C1F NJPPVKZQTLUDBO-UHFFFAOYSA-N 0.000 description 6
- 238000003466 welding Methods 0.000 description 6
- 230000006870 function Effects 0.000 description 5
- HZEWFHLRYVTOIW-UHFFFAOYSA-N [Ti].[Ni] Chemical compound [Ti].[Ni] HZEWFHLRYVTOIW-UHFFFAOYSA-N 0.000 description 4
- 210000001367 artery Anatomy 0.000 description 4
- 238000011038 discontinuous diafiltration by volume reduction Methods 0.000 description 4
- 238000001356 surgical procedure Methods 0.000 description 4
- 210000003462 vein Anatomy 0.000 description 4
- 210000003484 anatomy Anatomy 0.000 description 3
- 238000002788 crimping Methods 0.000 description 3
- 230000007547 defect Effects 0.000 description 3
- 238000005516 engineering process Methods 0.000 description 3
- 210000001308 heart ventricle Anatomy 0.000 description 3
- 238000010438 heat treatment Methods 0.000 description 3
- 238000002513 implantation Methods 0.000 description 3
- 238000002844 melting Methods 0.000 description 3
- 230000008018 melting Effects 0.000 description 3
- HLXZNVUGXRDIFK-UHFFFAOYSA-N nickel titanium Chemical compound [Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni] HLXZNVUGXRDIFK-UHFFFAOYSA-N 0.000 description 3
- 238000004064 recycling Methods 0.000 description 3
- 238000002627 tracheal intubation Methods 0.000 description 3
- 230000002792 vascular Effects 0.000 description 3
- 206010019280 Heart failures Diseases 0.000 description 2
- 208000035478 Interatrial communication Diseases 0.000 description 2
- PXHVJJICTQNCMI-UHFFFAOYSA-N Nickel Chemical compound [Ni] PXHVJJICTQNCMI-UHFFFAOYSA-N 0.000 description 2
- 230000006978 adaptation Effects 0.000 description 2
- 208000013914 atrial heart septal defect Diseases 0.000 description 2
- 206010003664 atrial septal defect Diseases 0.000 description 2
- 210000002837 heart atrium Anatomy 0.000 description 2
- 230000003116 impacting effect Effects 0.000 description 2
- 210000004115 mitral valve Anatomy 0.000 description 2
- 210000005241 right ventricle Anatomy 0.000 description 2
- 230000006641 stabilisation Effects 0.000 description 2
- 238000011105 stabilization Methods 0.000 description 2
- 238000002560 therapeutic procedure Methods 0.000 description 2
- 206010002329 Aneurysm Diseases 0.000 description 1
- 201000000057 Coronary Stenosis Diseases 0.000 description 1
- 206010011089 Coronary artery stenosis Diseases 0.000 description 1
- 206010013012 Dilatation ventricular Diseases 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 229910045601 alloy Inorganic materials 0.000 description 1
- 239000000956 alloy Substances 0.000 description 1
- 210000000702 aorta abdominal Anatomy 0.000 description 1
- 206010003119 arrhythmia Diseases 0.000 description 1
- 230000006793 arrhythmia Effects 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 210000004204 blood vessel Anatomy 0.000 description 1
- 230000037237 body shape Effects 0.000 description 1
- 210000000988 bone and bone Anatomy 0.000 description 1
- 230000000747 cardiac effect Effects 0.000 description 1
- 239000003795 chemical substances by application Substances 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 230000008602 contraction Effects 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- 230000002526 effect on cardiovascular system Effects 0.000 description 1
- 230000002708 enhancing effect Effects 0.000 description 1
- 210000001105 femoral artery Anatomy 0.000 description 1
- ZZUFCTLCJUWOSV-UHFFFAOYSA-N furosemide Chemical compound C1=C(Cl)C(S(=O)(=O)N)=CC(C(O)=O)=C1NCC1=CC=CO1 ZZUFCTLCJUWOSV-UHFFFAOYSA-N 0.000 description 1
- PCHJSUWPFVWCPO-UHFFFAOYSA-N gold Chemical compound [Au] PCHJSUWPFVWCPO-UHFFFAOYSA-N 0.000 description 1
- 239000010931 gold Substances 0.000 description 1
- 229910052737 gold Inorganic materials 0.000 description 1
- 230000000004 hemodynamic effect Effects 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 210000005248 left atrial appendage Anatomy 0.000 description 1
- 210000004072 lung Anatomy 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 239000012528 membrane Substances 0.000 description 1
- 238000000465 moulding Methods 0.000 description 1
- 208000031225 myocardial ischemia Diseases 0.000 description 1
- 210000004165 myocardium Anatomy 0.000 description 1
- 239000002120 nanofilm Substances 0.000 description 1
- 229910052759 nickel Inorganic materials 0.000 description 1
- 210000003540 papillary muscle Anatomy 0.000 description 1
- 238000010079 rubber tapping Methods 0.000 description 1
- 238000007789 sealing Methods 0.000 description 1
- 229910001285 shape-memory alloy Inorganic materials 0.000 description 1
- 210000001519 tissue Anatomy 0.000 description 1
- 210000001835 viscera Anatomy 0.000 description 1
- 238000009941 weaving Methods 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
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
- A61B17/12122—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder within the heart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12168—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12168—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
- A61B17/12172—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure having a pre-set deployed three-dimensional shape
-
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B2017/1205—Introduction devices
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Molecular Biology (AREA)
- Vascular Medicine (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Reproductive Health (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Cardiology (AREA)
- Surgical Instruments (AREA)
Abstract
The present invention provides a kind of medical treatment isolation instrument, including elastically deformable main body and the flexible distal end being connected in main body.Main body includes：By the Dropbox that at least an one metal wire is formed, Dropbox has proximal end face and distal face, and the wire for forming proximal end face and distal face converges to the position that medical treatment completely cuts off the central axis of instrument respectively；The fixed frame being arranged in Dropbox, fixed frame are formed by supporting rod；Film is connect with Dropbox and fixed frame.Dropbox includes proximal sleeve and distal cannula, and the wire for forming proximal end face is collapsed by proximal sleeve, and the wire for forming distal face is collapsed by distal cannula, and proximal sleeve is connect with fixed frame, and distal cannula is connect with flexible distal end.
Description
Technical field
The present invention relates to medical instruments, and human body selected position is transmitted to using the method for intervention especially by microcatheter technology
Medical instrument.
Background technology
It is currently with tending to extensive therapy, conduit to carry out disease treatment using interventional method by microcatheter technology
A variety of materials, instrument and drug are placed in the internal organs (such as heart, lungs) of human body, artery and vein vascular etc. by interventional therapy method.
For example, by intubation intervention method by various plugging device (such as atrial septal defect (ASD) plugging device, left atrial appendage occlusion
Device) position that needs to block is placed in heart to treat corresponding illness.Such plugging device passes through the spiral shell between instrument and conveyer
Line connects so that instrument is transported to scheduled position under the push of conveyer by conduit, then releases and is threadedly coupled with disconnected
Open the connection between instrument and conveyer.For such instrument, the reliable and secure of instrument and conveyer can be realized by being threadedly coupled
Connection, while can realize controllable release.If the size selection of instrument is improper or when instrument expansion shape is bad, can be again
It is secondary that instrument is taken in conduit, it changes suitable instrument and reapposes, finally discharge.
For due to ischemic heart disease (such as coronary artery stenosis or blocking) and formed left ventricular enlargement (in left ventricle
Form aneurysm) lead to the patient of heart failure, intubation intervention method deployment instrument (such as CardioKinetix Inc companies can be passed through
The Parachute instruments of production) to left ventricle, completely cut off the part that left ventricle loses function, reduce the volume of left ventricle, improve every
The ability of secondary ventricular contraction output blood, improves degree of heart failure.The method completely intervened is by femoral artery puncture, is moved through bone
Arteries and veins, abdominal aorta, aorta pectoralis, aorta petal reach left ventricle and set up channel, instrument by the channel in conveyer
Push is placed into the scheduled position of left ventricle, instrument is then unfolded, then release the connection of conveyer and instrument, last release
Tool.
When being placed by intubation intervention method in heart, artery and vein vascular, left auricle of heart of these instruments to human body, due to
Heart, the artery and vein vascular of human body, the especially more complicated position of cardiac structure accurately reach predetermined position reality requiring instrument
Under the premise of existing proper function, it is also necessary to which instrument has good adaptation predetermined position anatomical structure, mechanical requirements and hemodynamic
Ability, and surrounding tissue cannot be influenced.Therefore, in the design of instrument, the simplicity for considering to operate, instrument are needed
Safety and validity.
Fig. 1-1 is position view of the Parachute instruments of the prior art in heart and left ventricle anatomical structure, figure
1-2 is from status diagram of the Parachute instruments in left ventricle in terms of bicuspid valve direction.Shown in figure right ventricle (RV) 1,
Papillary muscle 6 in atrium dextrum (RA) 2, left ventricle (LV) 7, atrium sinistrum (LA) 4, aorta 3, bicuspid valve 5 and left ventricle.
Parachute instruments 8 include support feet 9, film 10 and skeleton 11.
By taking Parachute instruments as an example, there are following defects for the prior art：
(1) skeleton 11 of the agent structure of instrument for elasticity, covers a floor height molecular film 10 on skeleton 11.When instrument 8
After being placed in left ventricle 7, since the anatomical structure of left ventricle is irregular, in the edge that instrument and left ventricle contact
It will appear more gap 12, as shown in Figs. 1-2.Blood can enter the left ventricle that needs completely cut off via these 12 gaps of seam, reduce left
The effect of ventricle volume reduction.
(2) instrument can not be recovered in delivery conduit again after deployment, even if instrument is not up to desired position or instrument
The shape of expansion is undesirable, can not also be adjusted again, therefore there are serious safety and validity problems for instrument.
(3) elastic skeleton of instrument can interact in heartbeat with heart wall, since the contact area of the two has
Limit, causes stress concentration in contact portion, conductive beam can be influenced when serious, leads to arrhythmia cordis.
(4) film 10 of instrument is softer, and supports its elastic skeleton 11 again very sparse relative to film, in the blood of ventricle
Serious deformation can occur for pressure, so as to influence normal blood flow direction and flow.
(5) structural instability of the support feet 9 of instrument as Figure 1-1, it is unstable to be easy to cause instrument deflection.
(6) design of instrument is difficult in adapt to irregular Left Ventricular Structure, and the adherence quality for leading to instrument is bad, significantly affects
Isolation effect, and instrument unbalance stress is be easy to cause, easy fracture simultaneously punctures left ventricle.
205198210 U of CN disclose a kind of Weaving type left ventricle volume reduction instrument, using the design of two-part, including master
Body and below the main body and coupled pedestal.Main body is woven into woven mesh structure, centre covering using nitinol alloy wire
There is polymeric membrane, shape is in inverted umbrella shape.Pedestal is woven into woven mesh structure for memory alloy wire, and shape is in caged.
It can be connected between main body and pedestal by metallic tube-shaped structure.
The major defect of above-mentioned instrument is：Main body is only made of the Dropbox woven, and support force is weak, in left auricle of heart high pressure
Blood flow is easily deformed when impacting, it is difficult to keep preset shape.This can cause blood flow to be difficult fully to be put out, and left ventricle is helped to fight
The function of blood weakens significantly.On the other hand, the anchor thorn of above-mentioned instrument is twisted by titanium-nickel wire, is not easy to be pierced into left ventricular wall, is led to device
Tool fixes unstable, easily displacement.Since anchor thorn is a part for Dropbox in itself, when Dropbox stress, anchor thorn can also be involved,
Influence the realization of the two function.Sheath that anchor that more titanium-nickel wires twist into thorn needs diameter to significantly increase is transported, and leads to blood vessel
Cross poly-injury.In addition, the impact of blood can so that position of the film in ventricle is elegant, it is unfavorable for putting out for blood.
104739460 A of CN disclose a kind of left ventricle capacity-reduction device, equally using two-piece design, including pedestal and
Main body.Base shape is in cage structure, and main body is integrally cut by laser molding, and setting in multi-layer net using Nitinol pipe
Meter, grid are closed loop structure design.The top of main body is additionally provided with the anchor thorn tilted upward, and when placing, anchor thorn can be pierced into
In the cardiac muscle of locular wall, play the role of being anchored left ventricle capacity-reduction device.The lower end of main body is connected with tubular structure, tubular structure with
Pedestal connects, and pedestal is woven into woven mesh structure by titanium-nickel wire, thermally treated discoid.
The major defect of above-mentioned instrument is：Consolidated by the body shape with enclosed construction of Nitinol pipe excision forming
It is fixed, it is unlikely to deform, it is difficult to adapt to irregular left ventricle anatomical structure, can not obtain and be bonded with the best of left ventricular wall.Therefore,
Gap is susceptible at the position that instrument edge is contacted with left ventricle, influences left ventricle volume reduction effect.
Invention content
The object of the present invention is to provide a kind of improved medical instruments, can be in the conjunction in the left ventricle of irregular structure
The right position place of putting provides effective positioning and fixes, and provides optimal seal in isolation position.Specifically：
(1) realize that instrument is bonded with the best of left ventricular wall, especially instrument edge and left ventricular wall is bonded, and is kept away
Exempt from or reduce gap, improve the effect of left ventricle volume reduction.
(2) the recyclable of instrument is realized so that instrument can be easily withdrawn in delivery conduit in any time of operation, is reduced
The generation of complication improves safety and validity, enhances the confidence of doctor, facilitate the operation of doctor.
(3) improve the situation that instrument is contacted with left ventricular wall, reduce stress concentration.Ensureing instrument fixed premise safely
Under, the effect to left ventricular wall is uniform mild, reduces conductive beam retardance problem caused by stress is concentrated.
(4) ensure that the face of instrument and contacting blood there are enough support forces, so as to which the flow direction for avoiding blood gets muddled.
(5) improve the stability of instrument supports foot, instrument is made to keep stablizing in left ventricle.
(6) integral strength of raising instrument and respectively mechanical behavior so that instrument stability increases, and durability improves, and subtracts
Less or avoid being broken.
The present invention provides a kind of medical treatment isolation instrument, including elastically deformable main body and the elasticity being connected in main body
Distally.Main body includes：By the Dropbox that at least an one metal wire is formed, Dropbox has proximal end face and a distal face, composition proximal end face and
The wire of distal face converges to the position of the central axis of medical treatment isolation instrument respectively；The fixed frame being arranged in Dropbox, Gu
Determine frame to be formed by supporting rod；Film is connect with Dropbox and fixed frame.Dropbox includes proximal sleeve and distal cannula, and composition is near
The wire of end face is collapsed by proximal sleeve, and the wire for forming distal face is collapsed by distal cannula, proximal sleeve and fixed frame
Connection, distal cannula are connect with flexible distal end.
Preferably, Dropbox is woven by 16 to 144 wires, and the material of wire is NiTi, the diameter of wire
For 0.02-0.8mm.
Preferably, one end of supporting rod converges to the proximal end of fixed frame, and the proximal end of fixed frame and the proximal sleeve of Dropbox are consolidated
Fixed connection, the other end of supporting rod are free ends, and the end structure of free end is into sharp shape.The proximal end of fixed frame forms spiral shell
Line.The distance between the end of free end and the central axis of medical treatment isolation instrument are than between the margin and center axis of Dropbox
Apart from big 1-5mm.
Preferably, at least one hole is formed on each supporting rod, the suture across hole connects film and fixed frame suture.
The distance between the edge of film and the central axis of medical treatment isolation instrument are smaller than the distance between the margin and center axis of Dropbox
1-5mm。
Preferably, fixed frame is formed after cutting by metal tube, and the material of metal tube is NiTi, outer diameter 0.3-5mm, wall thickness
For 0.05-0.5mm.
Preferably, for fixed frame with Dropbox in the shape of centrum, the angle between the male cone (strobilus masculinus) and central axis of centrum is 30
To 90 degree.
In one embodiment, the distal end of medical treatment isolation instrument is configured to spherical distal ends, is implanted in medical treatment isolation instrument
Afterwards, bulb distal end is hanging.Spherical distal ends are made of ball heads, flexible connector and connecting sleeve, connecting sleeve and Dropbox it is remote
Hold casing connection.Preferably, flexible connector and connecting sleeve are obtained by cutting metal tube.
In another embodiment, the distal end of medical treatment isolation instrument is configured to support feet, and support feet is by elastic support feet master
Body, support feet proximal sleeve and support feet distal cannula composition.Support feet is formed by a plurality of wire, and wire converges to support
The location mid-shaft at the both ends of foot main body is collapsed in proximal end by support feet proximal sleeve, is collapsed in distal end by support feet distal cannula.
Support feet distal cannula is located at the inside of support feet main body.The distal cannula of support feet proximal sleeve and Dropbox is aligned, in the two
Outer surface on put on connecting sleeve to achieve a fixed connection.Preferably, support feet is woven by 16 to 144 wires,
The material of wire be NiTi, a diameter of 0.02-0.8mm.Preferably, support feet main body is cylinder, dish type or prismatic.
Instrument according to the present invention can realize following technique effect：
(1) Dropbox, fixed frame and film form an elastic deformable body, which is an entirety, is connect with left ventricular wall
It touches, uniform and mild power is applied to left ventricular wall, be reduced or avoided that stress is concentrated and what is caused burst left ventricle and conductive beam
Retardance, and ensure that instrument is continually and steadily placed in left ventricle.When impacting instrument proximal end face from mitral blood flow, instrument
Shape keeping property is good, blood flow can be allowed to flow to aorta petal, Jin Erliu according to normal track under the premise of blood flow is completely cut off
To whole body.
(2) continuous edge and flexibility of Dropbox, edge and irregular left ventricular wall formed it is best be bonded, allow adaptation to a left side
The irregular shape of ventricle, farthest avoid Dropbox edge and its contact left ventricular wall between gap, so as to improve every
Exhausted effect.
(3) distal end of instrument is set for flexible adjustment, and doctor is facilitated, to the positioning of instrument and fixation, to permit in surgical procedure
Perhaps the distance of instrument and left ventricular wall is adjusted.The distal end of elasticity avoids puncturing left ventricular wall, reduces the damage to patient.
(4) design of instrument allows doctor in surgical procedure, can be according to the form and size of patient's left ventricle reality
Selected positioning area.When operation needs, can instrument be withdrawn into delivery pipe at any time, be conveniently operated, mitigate doctor because of positioning
The stress that surgical procedures is waited to generate.
Although the structure of instrument is described in detail so that left ventricle completely cuts off instrument as an example in specification, the present invention
Suitable for other types of medical treatment isolation instrument.
Description of the drawings
The present invention will be described in detail in conjunction with the following drawings.
Fig. 1-1 to Fig. 1-2 is that position of the Parachute instruments of the prior art in heart and left ventricle anatomical structure shows
It is intended to.
Fig. 2 is the structure diagram of the first embodiment of left ventricle isolation instrument according to the present invention.
Fig. 3 is the structure diagram of the Dropbox and fixed frame in first embodiment.
Fig. 4 is the front view of the fixed frame in first embodiment.
Fig. 5-1 to Fig. 5-2 is the structure diagram of the fixed frame in first embodiment.
Fig. 6 is the side view of the fixed frame in first embodiment.
Fig. 7 is the structure diagram of the bulb distal end in first embodiment.
Fig. 8 is the attachment structure schematic diagram of Dropbox in first embodiment, fixed frame and proximal sleeve.
Fig. 9 is the structure diagram of the second embodiment of left ventricle isolation instrument according to the present invention.
Figure 10 is the structure diagram of the support feet in second embodiment.
Figure 11 is the attachment structure schematic diagram of the Dropbox and support feet in second embodiment.
Figure 12-1 to Figure 12-2 is the first embodiment of left ventricle isolation instrument according to the present invention in heart and left ventricle
Position view in anatomical structure.
Figure 13-1 to Figure 13-6 is the mistake of the second embodiment implantation left ventricle of left ventricle isolation instrument according to the present invention
Journey schematic diagram.
Figure 14-1 to Figure 14-4 is the process schematic of left ventricle isolation instrument income delivery conduit according to the present invention.
Specific embodiment
Fig. 2 to Fig. 8 shows the left ventricle isolation instrument of first embodiment according to the present invention.As shown in Fig. 2, left ventricle
Completely cut off instrument and include Dropbox 101, fixed frame 102, film 103 and bulb distal end 104.Dropbox 101 is formed by a plurality of metal wire knitted,
Preset shape is shaped into for example, by modes such as heat treatments.Preferably, Dropbox is woven by 16 to 144 wires, gold
It is preferably titanium-nickel wire to belong to silk, and the diameter of wire is preferably 0.02-0.8mm.
Dropbox 101 and fixed frame 102 are shown in Fig. 3, in order to clearly express connection mode between the two, is moved in Fig. 3
In addition to the film 103 of isolation instrument and bulb distal end 104.Dropbox 101 can have two layers, including proximal end face 1014 and distal face
1013, the wire in two faces converges to the position of central axis.The wire of convergence is in distal end by the distal cannula of Dropbox
1012 collapse, and the modes such as can crimp by welding, melting or be interference fitted between wire and distal cannula 1012 and are fixedly connected.
Show that Dropbox 101 has the shape of substantially centrum, the included angle A between male cone (strobilus masculinus) and central axis 105 in Fig. 4
Preferably 30 to 90 degree.
Fixed frame 102 provides support for Dropbox 101, and isolation instrument is located in the suitable position of left ventricular wall.It is excellent
Selection of land, fixed frame 102 is by metal tube by cutting, being shaped into preset shape by way of heat treatment again.The material of metal tube
Material preferably NiTi is to provide elasticity, and the outer diameter of metal tube is preferably 0.3-5mm, and wall thickness is preferably 0.05-0.5mm.
Fig. 5-1 shows that fixed frame 102 is made of multiple supporting rods 1022, and one end of these supporting rods converges to fixed frame
Proximal end 1024, the other end is free end 1021.The end structure of free end 1021 is into sharp shape, for being pierced into left ventricle
Wall plays the role of fixed instrument.As shown in Fig. 5-2, at least one aperture 1023 is formed on each supporting rod 1022.
Fixed frame 102 has and 101 matched centrum shape of Dropbox.The centrum that fixed frame 102 is formed is shown in Fig. 6
Included angle B between male cone (strobilus masculinus) and central axis 105 is preferably again 30 to 90 degree.The end of free end 1021 is radially
Extend beyond the edge of Dropbox 101.Preferably, the distance between the end of free end 1021 and central axis 105 are than Dropbox 101
The big 1-5mm of the distance between margin and center axis.
Fig. 8 shows the connection structure between the proximal sleeve 1011 of Dropbox 101, fixed frame 102 and Dropbox.Proximal sleeve
1011st, the wire 1013 of composition Dropbox and the proximal end 1024 of fixed frame are real by welding, melting or be bonded in connection position 1014
Now it is fixedly connected.1025 can be also threaded in the proximal end 1024 of fixed frame with forming screw thread for the conveyer of delivery device
Connection, the screw thread 1025 can be formed by directly carrying out tapping to the endoporus of proximal end 1024, can also be by the way that nut is fixed
It is formed in the endoporus of proximal end 1024.
Fig. 7 is the schematic diagram of the bulb distal end in the left ventricle isolation instrument of first embodiment according to the present invention.Bulb
Distally 104 it is made of ball heads 1041, flexible connector 1042 and connecting sleeve 1043.Ball heads 1041 can pass through molten metal
(preferably niti material) obtains or by being machined.Ball heads 1041 and flexible connector 1042 are by welding or be bonded
It is fixedly connected.Flexible connector 1042 and connecting sleeve 1043 can by a metal tube (preferably nickel admire material) cutting and
Into.Connecting sleeve 1043 is fixedly connected with the distal cannula 1012 of Dropbox, such as welding, bonding or crimping.
Show that the left ventricle isolation instrument 100 of first embodiment is placed in the shape in left ventricle 7 in Figure 12-1 and Figure 12-2
State.The free end of fixed frame 102 is pierced into left ventricular wall to ensure the fixation of instrument, and the bulb distal end 104 of instrument is vacantly on a left side
In ventricle 7.
On the one hand, the edge of Dropbox 101 be by very thin metal wire knitted into continuous structure, since its own is good
Flexibility can well be covered on the irregular wall of left ventricle, apply uniform power to left ventricular wall, both avoid
Between there is undesirable gap.On the other hand, fixed frame 102 is formed by relatively thick cuts in metallic pipe and is placed in Dropbox
In 101, fixed frame 102 not only plays the role of supporting Dropbox 101, but also be pierced into left ventricular wall by the free end 1021 of supporting rod,
Ensure stabilization of the entire instrument in left ventricle, prevent from shifting.In addition, even if the spherical form of bulb distal end 104 ensures when it
Contact left ventricular wall will not puncture left ventricular wall, and the flexible connector 1042 of bulb distal end 104 can play the role of cushion effect.
Film 103 and the connection of both Dropbox 101 and fixed frame 102 can be fixed by suture.Film 103 is with entire Dropbox
101 and fixed frame 102 expansion and be unfolded.Film 103 plays the role of stopping that blood enters the left ventricle that needs obstruct, same to time limit
The free end 1021 of fixed frame processed is pierced into the depth of left ventricular wall, and plays sealing function in the edge of instrument.Preferably,
The distance between margin and center axis of film 103 is than the small 1-5mm of the distance between the margin and center axis of Dropbox 101.
Dropbox 101, fixed frame 102 and film 103 all have elasticity, therefore form an elastic entirety.102 He of fixed frame
Connection structure of the Dropbox 101 at proximal sleeve 1011 also allows entire isolation instrument other than ensureing the stable bond of the two
It is connected with conveyer, it is ensured that any time of the isolation instrument in operation repeats positioning and recycling.Fixed frame plays following work
With：
(1) fixed frame provides the support force of enhancing, after instrument is placed in left ventricle, can have to left ventricular wall stronger
Power, to ensure that enough strength is so that blood is put out from ventricle in the heartthrob period.
(2) free end of fixed frame has sharp shape, can be pierced into left ventricular wall, play the role of fixed instrument.
(3) aperture is provided on the supporting rod of fixed frame for fixing film, film is sewn to fixed frame using suture
On so that instrument implantation left ventricle caudacoria can preferably be unfolded, and ensure effective isolation blood flow.
(4) fixed frame can keep the shape of whole instrument, and the blood flow in left ventricle is avoided to impact the near of implement body
Excessive deformation is caused during end face, so as to ensure the normal route of instrument stabilization and blood flow.
Fig. 9 to Figure 11 shows left ventricle isolation instrument according to the second embodiment of the present invention, with identical attached in figure
Icon note represents the feature identical with first embodiment.As shown in figure 9, the left ventricle isolation instrument of second embodiment includes net
Disk 101, fixed frame 102, film 103 and support feet 201.The structure of Dropbox 101, fixed frame 102 and film 103 and first embodiment phase
Together, details are not described herein again.
Difference lies in the bulb distal ends substituted with support feet 201 in first embodiment for second embodiment and first embodiment
104.As shown in Figure 10, support feet 201 is by support feet main body 2013, support feet proximal sleeve 2011 and support feet distal cannula
2012 compositions.Support feet main body 2013 is elastic deformable body, can be deformed in stress.Similar with Dropbox, support feet also may be used
It is formed by a plurality of metal wire knitted, preset shape is shaped by modes such as heat treatments.Preferably, support feet is by 16 to 144
Wire forms, and the material of wire can be NiTi, and the diameter of wire is preferably 0.02-0.8mm.Although show in Figure 10
The support feet main body gone out is cylinder, but other shape is also feasible, such as dish type or prismatic.
The wire 2015 of composition support feet 201 converges to the location mid-shaft at both ends, in proximal end by support feet proximal sleeve
2011 collapse, and are collapsed in distal end by support feet distal cannula 2012.Preferably, support feet distal cannula 2012 is located at support feet master
The inside of body 2013.As shown in figure 11, the wire 2015 of convergence leads to support feet proximal sleeve 2011 at connection position 2014
The modes such as welding, melting or interference fit crimping are crossed to be fixedly connected.
The connection structure between Dropbox and support feet is also shown in Figure 11.Support feet proximal sleeve 2011 and Dropbox it is remote
End cap pipe 1012 is aligned, the connecting sleeve 300 on set on the outer surface of the two.The distal end of support feet proximal sleeve 2011, Dropbox
Between casing 1012 and connecting sleeve 300 be fixedly connected can by welding, it is be bonded or interference fit crimping realize.Support feet
201 is relatively soft, has elasticity, can stretch in stress.These characteristics allow to adjust the relative position of instrument, and
Cushioning effect is played to instrument, instrument is avoided to puncture left ventricular wall.
Figure 13-1 to Figure 13-6 completely cuts off the implantation process of instrument using the second embodiment of the present invention to be illustrated left ventricle.
As shown in Figure 13-1, channel is established with the cardiovascular interventional operation method of standard first, it will across aorta petal by aorta 3
Delivery conduit 500 is placed in left ventricle 7.Preferably, a diameter of 2-5mm of delivery conduit 500.As shown in Figure 13-2, using pushing away
It send device that left ventricle isolation instrument is pushed to the head end of delivery conduit 500, then first releases support feet 201.Then, as schemed
Shown in 13-3, withdraw delivery conduit 500 so that the Dropbox 101 of isolation instrument together with fixed frame 102 and film 103 slowly
Expansion, while the position of support feet 201 is adjusted, it is made to stick on left ventricular wall.As shown in Figure 13-4, continue to withdraw conveying and lead
Pipe 500, until Dropbox 101 is fully deployed, and make the edge and left ventricular wall of support feet 201 together with fixed frame 102 and film 103
Fully fitting.Isolation instrument 200 is in left ventricle 7 after recycling pusher and delivery conduit are shown in Figure 13-5 and Figure 13-6
State, in this case fixed frame 102 free end be pierced into left ventricular wall in.
The removal process of left ventricle isolation instrument according to the present invention is shown in Figure 14-1 to Figure 14-4.As Figure 14-1 institute
Show, push rod 501 is made to extend beyond the distal end of delivery conduit 500 first and make push rod 501 with completely cutting off the fixed frame of instrument
102 proximal threads connection, then applies axial force F to retract isolation instrument to push rod 501.Isolation is shown in Figure 14-2
Proximal end face 1014, fixed frame 102 and the film 103 of the Dropbox of instrument are deformed due to the effect of axial force F.As Figure 14-3 institute
Show, keep applying axial force F to push rod 501 so that proximal end face 1014, fixed frame 102 and the film 103 of Dropbox continue to deform
And partially into delivery conduit 500.At this point, the distal face 1013 of Dropbox also begins to deform, edge is gradually received
Hold together, until fully entering delivery conduit 500.Figure 14-4 shows that isolation instrument is whole and shrinks completely and enter delivery conduit 500
It is interior.In this way, the present invention allows for the complete recycling of isolation instrument any time in surgical procedure so that operation
It is simple controllable, mitigate the pressure of doctor.
According to the embodiment above, those skilled in the art will recognize that the other feature and advantage of the present invention.Cause
This, the present invention should not be restricted by the limitation specifically illustrated with description content, unless appended claims are indicated.
Claims (20)
1. a kind of medical treatment isolation instrument, including：
Elastically deformable main body, the main body include：
By the Dropbox that at least an one metal wire is formed, the Dropbox has proximal end face and distal face, forms the proximal end face and institute
The wire for stating distal face converges to the position that the medical treatment completely cuts off the central axis of instrument respectively；
The fixed frame being arranged in the Dropbox, the fixed frame are formed by supporting rod；
Film is connect with the Dropbox and the fixed frame；
The distal end of elasticity connects on the body,
Wherein, the Dropbox includes proximal sleeve and distal cannula, forms the wire of the proximal end face by the proximal sleeve
It collapses, the wire for forming the distal face is collapsed by the distal cannula, and the proximal sleeve is connect with the fixed frame, institute
Distal cannula is stated to connect with the distal end.
2. medical treatment isolation instrument as described in claim 1, which is characterized in that the Dropbox is woven by 16 to 144 wires
It forms, the material of wire is preferably NiTi, and the diameter of wire is preferably 0.02-0.8mm.
3. medical treatment isolation instrument as described in claim 1, which is characterized in that one end of the supporting rod converges to the fixation
The proximal end of frame, the proximal end of the fixed frame are fixedly connected with the proximal sleeve of the Dropbox, and the other end of the supporting rod is outstanding
Dead end, the end structure of the free end is into sharp shape.
4. medical treatment isolation instrument as claimed in claim 3, which is characterized in that the proximal end of the fixed frame forms screw thread.
5. medical treatment isolation instrument as claimed in claim 3, which is characterized in that the end of the free end completely cuts off with the medical treatment
The distance between central axis of instrument is than the big 1-5mm of the distance between the edge of the Dropbox and the central axis.
6. medical treatment isolation instrument as described in claim 1, which is characterized in that form at least one hole on each supporting rod, wear
The suture for crossing the hole connects the film and fixed frame suture.
7. medical treatment isolation instrument as described in claim 1, which is characterized in that the edge of the film completely cuts off instrument with the medical treatment
The distance between central axis than the small 1-5mm of the distance between the edge of the Dropbox and the central axis.
8. medical treatment isolation instrument as described in claim 1, which is characterized in that the fixed frame is formed after cutting by metal tube,
The material of the metal tube is preferably NiTi, and outer diameter is preferably 0.3-5mm, and wall thickness is preferably 0.05-0.5mm.
9. medical treatment isolation instrument as described in claim 1, which is characterized in that the fixed frame has matched with the Dropbox
Shape, preferably centrum, the angle between the male cone (strobilus masculinus) and central axis of the centrum are 30 to 90 degree.
10. medical treatment isolation instrument as described in claim 1, which is characterized in that the distal end is configured to spherical distal ends, described
After medical treatment isolation instrument is implanted, the bulb distal end is hanging.
11. medical treatment isolation instrument as claimed in claim 10, which is characterized in that the spherical distal ends are connected by ball heads, elasticity
Fitting and connecting sleeve composition, the connecting sleeve are connect with the distal cannula of the Dropbox.
12. medical treatment isolation instrument as claimed in claim 10, which is characterized in that the flexible connector and the connecting sleeve
It is obtained by cutting metal tube.
13. medical treatment isolation instrument as described in claim 1, which is characterized in that the distal end is configured to support feet, the support
Foot is made of support feet main body, support feet proximal sleeve and the support feet distal cannula of elasticity.
14. medical treatment isolation instrument as claimed in claim 13, which is characterized in that the support feet is formed by a plurality of wire,
The wire converges to the location mid-shaft at the both ends of the support feet main body, is received in proximal end by the support feet proximal sleeve
Hold together, collapsed in distal end by the support feet distal cannula.
15. medical treatment isolation instrument as claimed in claim 14, which is characterized in that the support feet distal cannula is located at the branch
The inside of spike main body.
16. medical treatment isolation instrument as claimed in claim 14, which is characterized in that the support feet proximal sleeve and the Dropbox
Distal cannula alignment, on the outer surface of the two on set connecting sleeve to achieve a fixed connection.
17. medical treatment isolation instrument as claimed in claim 13, which is characterized in that the support feet is by 16 to 144 wires
It weaves, the material of the wire is preferably NiTi, and diameter is preferably 0.02-0.8mm.
18. medical treatment isolation instrument as claimed in claim 13, which is characterized in that the support feet main body is cylinder, dish type
It is or prismatic.
19. the medical treatment isolation instrument as described in any one of claim 1-18, which is characterized in that the medical treatment isolation instrument exists
Along deform under the action of the axial force opposite with conveying direction and can recycle completely into for convey the medical treatment every
In the delivery conduit of exhausted instrument.
20. the medical treatment isolation instrument as described in any one of claim 1-18, which is characterized in that the medical treatment, which completely cuts off instrument, is
Left ventricle excluder.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201611093945.8A CN108143459A (en) | 2016-12-02 | 2016-12-02 | Medical treatment isolation instrument |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201611093945.8A CN108143459A (en) | 2016-12-02 | 2016-12-02 | Medical treatment isolation instrument |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN108143459A true CN108143459A (en) | 2018-06-12 |
Family
ID=62469298
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201611093945.8A Pending CN108143459A (en) | 2016-12-02 | 2016-12-02 | Medical treatment isolation instrument |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN108143459A (en) |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN109464173A (en) * | 2018-12-20 | 2019-03-15 | 先健科技(深圳)有限公司 | Plugging device |
| CN111513773A (en) * | 2020-03-30 | 2020-08-11 | 北京大学深圳研究生院 | Recoverable ventricular isolation device, recovery device and system |
| CN114504352A (en) * | 2022-03-09 | 2022-05-17 | 山东省千佛山医院 | Ventricular septum is perforated isolated with heart plug device and system |
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| JP2016028764A (en) * | 2015-11-04 | 2016-03-03 | カーディオキネティックス・インコーポレイテッドＣａｒｄｉｏｋｉｎｅｔｉｘ， Ｉｎｃ． | Retrievable cardiac devices |
| CN205198210U (en) * | 2015-11-18 | 2016-05-04 | 上海形状记忆合金材料有限公司 | Type left ventricle of weaving subtracts container tool |
| CN105662516A (en) * | 2016-03-03 | 2016-06-15 | 上海普实医疗器械科技有限公司 | Left aurcle plugging device |
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| CN104706444A (en) * | 2015-03-03 | 2015-06-17 | 上海形状记忆合金材料有限公司 | Volume reduction device for left ventricle |
| CN104958087A (en) * | 2015-07-28 | 2015-10-07 | 杭州德诺科技有限公司 | A left auricle occluding device |
| JP2016028764A (en) * | 2015-11-04 | 2016-03-03 | カーディオキネティックス・インコーポレイテッドＣａｒｄｉｏｋｉｎｅｔｉｘ， Ｉｎｃ． | Retrievable cardiac devices |
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Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN109464173A (en) * | 2018-12-20 | 2019-03-15 | 先健科技(深圳)有限公司 | Plugging device |
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| CN111513773A (en) * | 2020-03-30 | 2020-08-11 | 北京大学深圳研究生院 | Recoverable ventricular isolation device, recovery device and system |
| CN111513773B (en) * | 2020-03-30 | 2022-01-14 | 北京大学深圳研究生院 | Recoverable ventricular isolation device, recovery device and system |
| CN114504352A (en) * | 2022-03-09 | 2022-05-17 | 山东省千佛山医院 | Ventricular septum is perforated isolated with heart plug device and system |
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