CN108236478B - Left auricle plugging device, pusher and left auricle plugging system - Google Patents
Left auricle plugging device, pusher and left auricle plugging system Download PDFInfo
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- CN108236478B CN108236478B CN201611218381.6A CN201611218381A CN108236478B CN 108236478 B CN108236478 B CN 108236478B CN 201611218381 A CN201611218381 A CN 201611218381A CN 108236478 B CN108236478 B CN 108236478B
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- 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
- A61B17/12027—Type of occlusion
- A61B17/12031—Type of occlusion complete occlusion
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- 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
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- 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
- A61B17/1214—Coils or wires
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- 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
- A61B17/1214—Coils or wires
- A61B17/12145—Coils or wires having a pre-set deployed three-dimensional shape
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- 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
- A61B17/1214—Coils or wires
- A61B17/1215—Coils or wires comprising additional materials, e.g. thrombogenic, having filaments, having fibers, being coated
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—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
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- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—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
- A61B2017/12054—Details concerning the detachment of the occluding device from the introduction device
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Abstract
The invention provides a left auricle occluder, a pusher and a left auricle occluder system, when the left auricle occluder is not released, a hook structure of the left auricle occluder is accommodated in a containing hole of the left auricle occluder or the containing hole of the pusher, and an external thread structure of the pusher is meshed with an internal thread structure of the left auricle occluder, so that the left auricle occluder can be folded, and then the left auricle occluder is sheathed, and the problem that the left auricle occluder is too long in a sheath tube can be avoided. Upon release, the first portion is released, since the second portion with the anchoring structure is not released, at which point the positioning can be repeated until a suitable fixation position is reached, and then the second portion is released to secure the left atrial appendage occluder in place. Therefore, the left atrial appendage occluder, the pusher and the left atrial appendage occlusion system provided by the invention can better realize the insertion or release of the left atrial appendage occluder.
Description
Technical Field
The invention relates to the technical field of implantable medical devices, in particular to a left auricle occluder, a pusher and a left auricle occluder system.
Background
Atrial fibrillation (atrial fibrillation) is the most common sustained arrhythmia in clinic, and the incidence rate of atrial fibrillation in the common population is 0.5-1.3%. The atrial fibrillation is mainly used for promoting thrombosis and causing complications such as cerebral apoplexy, peripheral vascular embolism and the like after thrombus falls off, and the disability rate and the lethality rate are obviously increased. Stroke is the most common and most harmful complication of atrial fibrillation, with about 1500 million people worldwide per year suffering from stroke, with 20-25% of them being attributed to atrial fibrillation. Research shows that 60% of patients with rheumatic heart disease atrial fibrillation have cardiogenic thrombi from the left atrial appendage, and more than 90% of patients with non-valvular ward fibrillation have thrombi formed in the left atrial appendage. Therefore, the intervention of the left atrial appendage to prevent the thromboembolism of patients with atrial fibrillation, especially the stroke, has important theoretical basis and clinical significance.
Anticoagulant therapy is currently the standard method of preventing atrial fibrillation stroke complications, but there are certain limitations to anticoagulant therapy. Therefore, the method has important significance for preventing atrial fibrillation and stroke by adopting more effective and safe measures. Currently, medical intervention treatment is mostly adopted to block the left atrial appendage.
At present, left atrial appendage occluders are of a wide variety. The functions to be generally realized are mainly: (1) the shape of the left auricle part is irregular, so that the left auricle plugging device is required to be capable of completely plugging the left auricle part, and thrombus formed at the left auricle part due to atrial fibrillation is eliminated; (2) the left auricle has different structural shapes and depths and multiple cavities, and the left auricle occluder is suitable for the anatomical structure of the left auricle; (3) the device has certain adjustability, and can be repeatedly positioned, released and recovered; (4) prevention of displacement, anchoring stability, etc.
The most representative of the existing left atrial appendage occluders is a cage-shaped occlusion type left atrial appendage occluder. A typical caged occlusive left atrial appendage occluder includes a proximal ring structure, a distal ring structure, and a cage structure connecting the proximal ring structure and the distal ring structure, the cage structure having an anchoring structure thereon. However, the proximal ring structure and the distal ring structure are two-segment rods, and when the proximal ring structure and the distal ring structure are straightened and then sheathed, the cage-shaped occlusion type left atrial appendage occluder is too long in the sheath tube. As shown in fig. 1, when the cage-shaped occlusion type left atrial appendage occluder a is placed in the sheath b, the cage-shaped occlusion type left atrial appendage occluder a is elongated, which causes the cage-shaped occlusion type left atrial appendage occluder a to be too long in the sheath. Upon release, the distal ring structure is preferentially released, followed by release of the cage structure and the anchoring structure thereon, and then release of the proximal ring structure. The cage structure and the anchoring structure thereon are difficult to adjust for repositioning due to the preferential release of the distal loop structure, i.e., repositioning is difficult to achieve; also in repeated positioning, the muscle fiber tissue is easily damaged. Meanwhile, the performance that the shape of the left auricle can be properly adjusted according to different shapes is not provided.
Therefore, how to better realize the sheathing or releasing of the left atrial appendage occluder becomes a technical problem to be solved by the technical personnel in the field.
Disclosure of Invention
The invention aims to provide a left atrial appendage occluder, a pusher and a left atrial appendage occlusion system so as to better realize the insertion or release of the left atrial appendage occluder.
In view of the above, the present invention provides a left atrial appendage occluder, comprising: a proximal ring structure, a distal ring structure, and a cage structure connecting the proximal ring structure and the distal ring structure; wherein the distal ring structure has a drag hook structure; the proximal end annular structure is provided with an internal thread structure, and the proximal end annular structure is also provided with a containing space which is used for containing the drag hook structure.
Optionally, in the left atrial appendage occluder, the drag hook structure includes a cross rod and a vertical rod connected with the cross rod, an included angle between the cross rod and the vertical rod is an acute angle.
Optionally, in the left atrial appendage occluder, the number of the drag hook structures is two, and the two drag hook structures are located at two ends of the distal end annular structure with the same diameter.
Optionally, in the left atrial appendage occluder, the storage space is two storage holes, and two storage holes are used for respectively accommodating two drag hook structures.
Optionally, in the left atrial appendage occluder, the accommodating space is an accommodating groove, the number of the accommodating grooves is at least one, and the accommodating groove is used for accommodating the retractor structure.
Optionally, in the left atrial appendage occluder, the cage structure comprises a first portion connected to the proximal ring structure and a second portion connected to the first portion and the distal ring structure, respectively, the second portion having an anchoring structure thereon.
The invention also provides a left atrial appendage occluder, comprising: a proximal ring structure, a distal ring structure, and a cage structure connecting the proximal ring structure and the distal ring structure; wherein the distal ring structure has an internal thread structure; the proximal ring structure has a hook structure.
Optionally, in the left atrial appendage occluder, the drag hook structure includes a cross rod and a vertical rod connected with the cross rod, an included angle between the cross rod and the vertical rod is an acute angle.
Optionally, in the left atrial appendage occluder, the number of the drag hook structures is two, and the two drag hook structures are located at two ends of the same diameter of the proximal end annular structure.
Optionally, in the left atrial appendage occluder, the cage structure comprises a first portion connected to the proximal ring structure and a second portion connected to the first portion and the distal ring structure, respectively, the second portion having an anchoring structure thereon.
The invention also provides a pusher for pushing the left atrial appendage occluder, which comprises a pushing rod, wherein the distal end of the pushing rod is provided with an external thread structure, and the external thread structure is matched with the internal thread structure.
Optionally, in the pusher, the distal end of the pushing rod is further provided with a blocking portion, the blocking portion is closer to the distal end of the pushing rod relative to the external thread structure, and the blocking portion is used for blocking the draw hook structure accommodated in the accommodating space from being separated from the accommodating space.
The invention also provides a pusher for pushing the left atrial appendage occluder, which comprises a first pushing rod and a second pushing rod, wherein the first pushing rod is positioned in the second pushing rod; the far end of the first pushing rod is provided with an external thread structure, and the external thread structure is matched with the internal thread structure; and a storage space is arranged at the far end of the second pushing rod and is used for accommodating the drag hook structure.
Optionally, in the pusher, a diameter of the first pusher rod is smaller than an inner diameter of the proximal annular structure.
Optionally, in the pusher, the accommodating space is two accommodating holes, and the two accommodating holes are used for accommodating the two hook structures respectively.
Optionally, in the pusher, the accommodating space is an accommodating groove, the number of the accommodating grooves is at least one, and the accommodating groove is used for accommodating the hook structure.
The present invention also provides a left atrial appendage occlusion system, comprising: according to the left auricle occluder and the pusher, the external thread structure of the pusher is matched with the internal thread structure of the left auricle occluder; when the left atrial appendage occluder is not completely released, the draw hook structure is accommodated in the accommodating space, the external thread structure of the pusher is meshed with the internal thread structure of the left atrial appendage occluder, and the second part is positioned in the first part; when the left atrial appendage occluder is released, the first portion is released prior to the second portion.
Optionally, in the left atrial appendage occlusion system, the left atrial appendage occlusion system further includes a sheath tube, and the sheath tube is used for accommodating the pusher and the left atrial appendage occlusion device.
The present invention also provides a left atrial appendage occlusion system, comprising: according to the left auricle occluder and the pusher, the external thread structure of the pusher is matched with the internal thread structure of the left auricle occluder, and the accommodating hole of the pusher is used for accommodating the hook structure of the left auricle occluder; when the left atrial appendage occluder is not completely released, the draw hook structure is accommodated in the accommodating space, the external thread structure of the pusher is meshed with the internal thread structure of the left atrial appendage occluder, and the second part is positioned in the first part; when the left atrial appendage occluder is released, the first portion is released prior to the second portion.
Optionally, in the left atrial appendage occlusion system, the left atrial appendage occlusion system further includes a sheath tube, and the sheath tube is used for accommodating the pusher and the left atrial appendage occlusion device.
In the left auricle occluder, the pusher and the left auricle occluder system provided by the invention, when the left auricle occluder is not released, the hook structure of the left auricle occluder is accommodated in the accommodating space of the left auricle occluder or the accommodating space of the pusher, and the external thread structure of the pusher is meshed with the internal thread structure of the left auricle occluder, so that the left auricle occluder can be folded, and then the left auricle occluder is sheathed, so that the problem that the left auricle occluder is too long in a sheath tube can be avoided. Upon release, the first portion is released, since the second portion with the anchoring structure is not released, at which point the positioning can be repeated until a suitable fixation position is reached, and then the second portion is released to secure the left atrial appendage occluder in place. Therefore, the left atrial appendage occluder, the pusher and the left atrial appendage occlusion system provided by the invention can better realize the insertion or release of the left atrial appendage occluder.
Drawings
FIG. 1 is a schematic view of a prior art caged occlusive left atrial appendage occluder in a sheath;
fig. 2 is a schematic perspective view of a left atrial appendage occluder in accordance with a first embodiment of the present invention;
figure 3 is a schematic cross-sectional view of a left atrial appendage occluder in accordance with a first embodiment of the present invention;
fig. 4 is a schematic structural diagram of a pusher according to a first embodiment of the present invention;
fig. 5 is a schematic view of the connection state of the left atrial appendage occluder and the pusher according to the first embodiment of the present invention;
figure 6 is a schematic structural diagram of a left atrial appendage occlusion system in accordance with a first embodiment of the present invention;
figure 7 is a schematic diagram of the release process of the left atrial appendage occluder of the first embodiment of the present invention;
figure 8 is a schematic view of the left atrial appendage occluder in a first embodiment of the present invention in an out of position configuration after release of the first portion;
figure 9 is a schematic illustration of a reasonable position of the left atrial appendage occluder of the first embodiment of the present invention after release of the first portion;
figure 10 is a schematic diagram of the release process of the left atrial appendage occluder of the first embodiment of the present invention;
figure 11 is a schematic diagram of the release process of the left atrial appendage occluder of the first embodiment of the present invention;
figure 12 is a schematic perspective view of a left atrial appendage occluder in accordance with a second embodiment of the present invention;
figure 13 is a schematic cross-sectional view of a left atrial appendage occluder in accordance with a second embodiment of the present invention;
fig. 14 is a schematic structural diagram of a pusher according to a second embodiment of the present invention;
fig. 15 is a schematic view of the connection state of the left atrial appendage occluder and the pusher according to the second embodiment of the present invention;
figure 16 is a schematic structural view of a left atrial appendage occlusion system in accordance with a second embodiment of the present invention;
figure 17 is a schematic diagram of the release process of the left atrial appendage occluder of the second embodiment of the present invention;
figure 18 is a schematic diagram of the release process of the left atrial appendage occluder in the second embodiment of the present invention.
Detailed Description
The left atrial appendage occluder, pusher, and left atrial appendage occlusion system of the present invention are further described in detail below with reference to the drawings and the embodiments. Advantages and features of the present invention will become apparent from the following description and from the claims. It is to be noted that the drawings are in a very simplified form and are not to precise scale, which is merely for the purpose of facilitating and distinctly claiming the embodiments of the present invention. In particular, the drawings are intended to show different emphasis points and are often in different proportions.
In this document, "proximal" and "distal" are relative orientations, relative positions, directions of elements or actions with respect to each other from the perspective of a physician using the medical device, although "proximal" and "distal" are not limiting, but "proximal" generally refers to the end of the medical device that is closer to the physician during normal operation, and "distal" generally refers to the end that is first introduced into the patient.
[ EXAMPLES one ]
Referring to fig. 2 and fig. 3, fig. 2 is a schematic perspective view of a left atrial appendage occluder in accordance with a first embodiment of the present invention; fig. 3 is a schematic cross-sectional view of a left atrial appendage occluder in accordance with a first embodiment of the present invention. As shown in fig. 2 and 3, in the present embodiment, the left atrial appendage occluder 1 includes: a proximal ring structure 10, a distal ring structure 11 and a cage structure 12 connecting the proximal ring structure 10 and the distal ring structure 11; wherein, the proximal end of the distal ring structure 11 has a hook structure 110; the proximal ring structure 10 has an internal thread structure 100, and the proximal ring structure 10 further has a receiving space 101 thereon, wherein the receiving space 101 can accommodate the hook structure 110. In the embodiment of the present application, the specific structure of the receiving space 101 is a receiving hole, and in other embodiments of the present application, the specific structure of the receiving space 101 may also be a receiving groove, which only has a space capable of receiving the hook structure 110.
Further, the retractor structure 110 includes a cross bar 110a and a vertical bar 110b connected to the cross bar 110a, and an included angle between the cross bar 110a and the vertical bar 110b is an acute angle. Thereby making the hook structure 110 itself elastic and facilitating the detachment of the hook structure 110 from the receiving hole 101.
With continued reference to fig. 2 and 3, in the embodiment of the present application, the number of the hook structures 110 is two, and two hook structures 110 are located at two ends of the distal ring structure 11 with the same diameter. Correspondingly, the number of the receiving holes 101 is two, and two of the hook structures 110 can be respectively received in the two receiving holes 101. That is, the two receiving holes 101 are also located at both ends of the proximal ring structure 10 having the same diameter. In addition, when the specific structure of the receiving space 101 is a receiving groove, the number of the receiving grooves is at least one. Further, it may be an elongated slot structure to accommodate two of the hook structures 110.
In the present embodiment, the cage structure 12 comprises a first portion 120 connected to the proximal ring structure 10 and a second portion 121 connected to the first portion 120 and the distal ring structure 11, respectively, the second portion 121 having an anchoring structure 122 thereon. The left atrial appendage occluder 1 can be stably fixed on the inner cavity wall of the left atrial appendage by the anchoring structure 122. Further, the cage-like structure 12 may be composed of a connecting member such as a ring-shaped connecting member and a Y-shaped connecting rod, as long as the stable cage-like structure 12 can be formed, which is not limited in the embodiment of the present application.
Next, please refer to fig. 4, which is a schematic structural diagram of a pusher according to a first embodiment of the present invention. As shown in fig. 4, the pusher 2 comprises a pushing rod 20, and the distal end of the pushing rod 20 is provided with an external thread structure 21, and the external thread structure 21 is matched with an internal thread structure 100 (of the left atrial appendage occluder 1). Preferably, the distal end of the pushing rod 20 is further provided with a blocking portion 22, the blocking portion 22 is closer to the distal end of the pushing rod 20 than the external thread structure 21, and the blocking portion 22 can block the hook structure 110 accommodated in the accommodating hole 101 (of the left atrial appendage occluder 1) from being separated from the accommodating hole 101. Preferably, the pusher 2 may be made of a metal material or a polymer material.
Specifically, please refer to fig. 5, which is a schematic diagram illustrating a connection state between the left atrial appendage occluder and the pusher according to the first embodiment of the present invention. As shown in fig. 5, the hook structure 110 of the distal ring structure 11 is received in the receiving hole 101 of the proximal ring structure 10, and the external thread structure 21 of the pushing rod 20 is engaged with the internal thread structure 100 of the proximal ring structure 10. Further, the blocking portion 22 blocks the hook structure 110, and prevents the hook structure 110 from being separated from the receiving hole 101. At this time, the second portion 121 of the left atrial appendage occluder is located in the first portion 120, and the left atrial appendage occluder is in a collapsed state and has a shorter length.
Accordingly, the present embodiment further provides a left atrial appendage occlusion system, and specifically, please refer to fig. 6, which is a schematic structural diagram of the left atrial appendage occlusion system according to the first embodiment of the present invention. As shown in fig. 6, the left atrial appendage occlusion system includes: the left atrial appendage occluder comprises a left atrial appendage occluder 1, a pusher 2 and a sheath 3, wherein an external thread structure 21 of the pusher 2 is matched with an internal thread structure 100 of the left atrial appendage occluder 1, and the sheath 3 can contain the pusher 2 and the left atrial appendage occluder 1.
With continued reference to fig. 6, when the left atrial appendage occluder is not released, the hook structure 110 (of the left atrial appendage occluder 1) is accommodated in the accommodating hole 101, the external thread structure 21 of the pusher 2 is engaged with the internal thread structure 100 of the left atrial appendage occluder 1, and the blocking portion 22 blocks the hook structure 110 to prevent the hook structure 110 from being disengaged from the accommodating hole 101.
Next, please refer to fig. 7, which is a schematic diagram illustrating a release process of the left atrial appendage occluder according to the first embodiment of the present invention. As shown in fig. 7, when releasing the left atrial appendage occluder 1, the first portion 120 of the left atrial appendage occluder 1 is first released, and the first portion 120 is released by pushing the left atrial appendage occluder 1 such that the first portion 120 exposes the sheath 3, and at this time, the external thread structure 21 of the pusher 2 remains engaged with the internal thread structure 100 of the left atrial appendage occluder 1, and the stopper 22 blocks the hook structure 110. The first part 120 has no anchoring structure, and after release, the left atrial appendage occluder 1 cannot be fixed on the inner cavity wall of the left atrial appendage, and at this time, if the release position is found to be improper, the adjustment can be conveniently performed, as shown in fig. 8 and 9. When the first portion is released, as shown in fig. 8, and the position is found to be inappropriate, adjustments can be made to reach a preferred position (as shown in fig. 9).
After the first part is released and adjusted to a suitable position, the second part can be released, the pusher 2 moves towards the proximal end relative to the left atrial appendage occluder 1 by partially unscrewing the external thread structure and the internal thread structure, so that the blocking part no longer blocks the hook structure, and the included angle between the cross rod 110a and the vertical rod 110b is restored to an acute angle from a right angle due to the elasticity of the hook structure, so that the hook structure automatically breaks away from the accommodating hole, and the second part is released. As shown in fig. 10, the cage-like structures 12 are all separated from the sheath 3, and only the proximal ring-like structure is connected to the pusher 2 (and a part of the external thread structure and the internal thread structure are still engaged) and is located in the sheath 3.
Finally, the entire left atrial appendage occluder 1 is released, wherein the left atrial appendage occluder 1 is separated from the pusher 2 by completely unscrewing the external thread structure and the internal thread structure, so that the release of the left atrial appendage occluder 1 is achieved. As shown in fig. 11, the entire left atrial appendage occluder 1 is now detached from the sheath 3 (fixed to the inner lumen wall of the left atrial appendage).
In summary, in the left atrial appendage occluder, the pusher and the left atrial appendage occlusion system provided by the embodiment, when the left atrial appendage occluder is not released, the drag hook structure of the left atrial appendage occluder is accommodated in the accommodating hole of the left atrial appendage occluder, the external thread structure of the pusher is in a meshing state with the internal thread structure of the left atrial appendage occluder, so that the left atrial appendage occluder can be folded, and then the left atrial appendage occluder is sheathed, so that the problem that the left atrial appendage occluder is too long in a sheath tube can be avoided. Upon release, the first portion is released, since the second portion with the anchoring structure is not released, at which point the positioning can be repeated until a suitable fixation position is reached, and then the second portion is released to secure the left atrial appendage occluder in place. Therefore, the left atrial appendage occluder, the pusher and the left atrial appendage occlusion system provided by the embodiment can better realize the sheathing entry or release of the left atrial appendage occluder. The multifunctional operation table is simple in structure, convenient to operate, capable of greatly reducing operation time of an operation, excellent in function, high in reliability and capable of effectively preventing thrombus.
[ example two ]
Referring to fig. 12 and 13, fig. 12 is a schematic perspective view of a left atrial appendage occluder in a second embodiment of the present invention; fig. 13 is a schematic cross-sectional view of a left atrial appendage occluder in a second embodiment of the present invention. As shown in fig. 12 and 13, in the present embodiment, the left atrial appendage occluder 4 includes: a proximal ring structure 40, a distal ring structure 41, and a cage structure 42 connecting the proximal ring structure 40 and the distal ring structure 41; wherein the distal ring structure 41 has an internal thread structure 410; the proximal end of the proximal ring structure 40 has a hook structure 400.
Further, the retractor structure 400 includes a cross bar 400a and a vertical bar 400b connected to the cross bar 400a, and an included angle between the cross bar 400a and the vertical bar 400b is an acute angle, so that the retractor structure 400 itself has elasticity. Preferably, the number of the pulling hook structures 400 is two, and two pulling hook structures 400 are located at two ends of the proximal annular structure 40 with the same diameter.
In the present embodiment, the cage structure 42 includes a first portion 420 connected to the proximal ring structure 40 and a second portion 421 connected to the first portion 420 and the distal ring structure 41, respectively, and the second portion 421 has an anchoring structure 422 thereon. The left atrial appendage occluder 4 can be stably fixed on the inner cavity wall of the left atrial appendage through the anchoring structure 422. Further, the cage-shaped structure 42 may be composed of a connecting member such as a ring-shaped connecting member and a Y-shaped connecting rod, as long as the stable cage-shaped structure 42 can be formed, which is not limited in the embodiment of the present application.
Next, please refer to fig. 14, which is a schematic structural diagram of a pusher according to a second embodiment of the present invention. As shown in fig. 14, the pusher 5 includes a first pushing rod 50 and a second pushing rod 51, and the first pushing rod 50 is located in the second pushing rod 51; wherein the distal end of the first push rod 50 is provided with an external thread structure 52, and the external thread structure 52 is matched with the internal thread structure 410 (of the left atrial appendage occluder 4); the distal end of the second pushing rod 51 is provided with a receiving space 53, and the receiving space 53 can accommodate the hook structure 400 (of the left atrial appendage occluder 4). Preferably, the pusher 5 may be made of a metal material or a polymer material. In the embodiment of the present application, the specific structure of the receiving space 53 is a receiving hole, and in other embodiments of the present application, the specific structure of the receiving space 53 may also be a receiving groove, which only has a space capable of receiving the hook structure 400.
In the present embodiment, the diameter of the first push rod 51 is smaller than the inner diameter of the proximal ring structure 40 (of the left atrial appendage occluder 4). Thus, the first push rod 51 can easily pass through the proximal ring structure 40 and engage with the distal ring structure 41.
Further, the number of the receiving holes 53 (on the second pushing rod 51) is two, and the two hook structures 400 (of the left atrial appendage occluder 4) can be respectively accommodated in the two receiving holes 53. That is, the two receiving holes 53 are located at both ends of the second push rod 51 having the same diameter. In addition, when the specific structure of the receiving space 53 is a receiving groove, the number of the receiving grooves is at least one. Further, it may be an elongated slot structure to accommodate two of the hook structures 400.
Specifically, please refer to fig. 15, which is a schematic diagram illustrating a connection state between the left atrial appendage occluder and the pusher according to the second embodiment of the present invention. As shown in fig. 15, the hook structure 400 of the proximal ring structure (of the left atrial appendage occluder) is received in the receiving hole 53 of the second push rod 51 (of the pusher), and the external thread structure 52 of the first push rod 50 is engaged with the internal thread structure 410 of the distal ring structure (of the left atrial appendage occluder). Further, the first pushing rod 50 blocks the hook structure 400, and prevents the hook structure 400 from being separated from the receiving hole 53. At this time, the second part 421 of the left atrial appendage occluder is located in the first part 420, and the left atrial appendage occluder is in a folded state and has a shorter length.
Accordingly, the present embodiment further provides a left atrial appendage occlusion system, and specifically, please refer to fig. 16, which is a schematic structural diagram of a left atrial appendage occlusion system according to a second embodiment of the present invention. As shown in fig. 6, the left atrial appendage occlusion system includes: left atrial appendage occluder 4, pusher 5 and sheath 6, wherein, the external screw thread structure 52 of pusher 5 with the internal screw thread structure 410 of left atrial appendage occluder 4 matches, the hole 53 of accomodating of pusher 5 can hold the drag hook structure 400 of left atrial appendage occluder 4, sheath 6 can hold pusher 4 reaches left atrial appendage occluder 5.
With continued reference to figure 16, figure 16 shows the release of the first part 420 of the left atrial appendage occluder 4. Likewise, release of the first portion 420 is achieved by pushing the left atrial appendage occluder 4 such that the first portion 420 exposes the sheath 6. The first part 420 has no anchoring structure, and after release, the left atrial appendage occluder 4 cannot be fixed on the inner cavity wall of the left atrial appendage, and at this time, if the released position is found to be improper, adjustment can be conveniently carried out. At this time, the hook structure 400 on the proximal end annular structure (4 of the left atrial appendage occluder) is still accommodated in the accommodating hole 53 on the second push rod 51 (of the pusher 5), the external thread structure 52 on the first push rod 50 is still engaged with the internal thread structure 410 on the distal end annular structure (of the left atrial appendage occluder 4), and the first push rod 50 still blocks the hook structure 400.
When the first portion 420 is released and adjusted to the proper position, the second portion 421 can then be released, where the second portion 421 can be released by completely unscrewing the male thread structure 52 and the female thread structure 410, while the first push rod 50 still blocks the hook structure 400. At this point, the cage structures 42 are all detached from the sheath 6, and only the proximal ring structure is connected to the pusher 5 and is located within the sheath 6, as shown in fig. 17.
Finally, the entire left atrial appendage occluder 4 is released, and the first push rod 50 is pulled out, so that the first push rod 50 cannot block the hook structure 400, the left atrial appendage occluder 4 is separated from the pusher 5, and the release of the left atrial appendage occluder 4 is realized. As shown in fig. 18, the entire left atrial appendage occluder 4 is now detached from the sheath 6 (fixed to the inner lumen wall of the left atrial appendage).
In summary, in the left auricle occluder, pusher and left auricle occlusion system provided by this embodiment, when the left auricle occluder is not released, the drag hook structure of the left auricle occluder is accommodated in the accommodating hole of the pusher, the external thread structure of the pusher is in the engagement state with the internal thread structure of the left auricle occluder, so that the left auricle occluder can be folded, and then the left auricle occluder is sheathed, so that the problem that the left auricle occluder is too long in the sheath tube can be avoided. Upon release, the first portion is released, since the second portion with the anchoring structure is not released, at which point the positioning can be repeated until a suitable fixation position is reached, and then the second portion is released to secure the left atrial appendage occluder in place. Therefore, the left atrial appendage occluder, the pusher and the left atrial appendage occlusion system provided by the embodiment can better realize the sheathing entry or release of the left atrial appendage occluder. The multifunctional operation table is simple in structure, convenient to operate, capable of greatly reducing operation time of an operation, excellent in function, high in reliability and capable of effectively preventing thrombus.
The above description is only for the purpose of describing the preferred embodiments of the present invention, and is not intended to limit the scope of the present invention, and any variations and modifications made by those skilled in the art based on the above disclosure are within the scope of the appended claims.
Claims (12)
1. A pusher used for pushing a left auricle occluder,
the left atrial appendage occluder comprises: a proximal ring structure, a distal ring structure, and a cage structure connecting the proximal ring structure and the distal ring structure; wherein the distal ring structure has a drag hook structure; the proximal end annular structure is provided with an internal thread structure, and is also provided with a receiving space for accommodating the drag hook structure;
the pusher comprises a pushing rod, the distal end of the pushing rod is provided with an external thread structure, and the external thread structure is matched with the internal thread structure; the far end of push rod still is provided with the stop part, the stop part for the external screw thread structure is closer to the far end of push rod, the stop part is used for blockking the drag hook structure that holds in accomodating space from break away from in the accomodating space.
2. A left atrial appendage occlusion system, comprising: a left atrial appendage occluder and a pusher;
the left atrial appendage occluder comprises: a proximal ring structure, a distal ring structure, and a cage structure connecting the proximal ring structure and the distal ring structure; wherein the distal ring structure has a drag hook structure; the proximal end annular structure is provided with an internal thread structure, and is also provided with a receiving space for accommodating the drag hook structure;
the pusher comprises a pushing rod, the distal end of the pushing rod is provided with an external thread structure, and the external thread structure is matched with the internal thread structure; the far end of push rod still is provided with the stop part, the stop part for the external screw thread structure is closer to the far end of push rod, the stop part is used for blockking the drag hook structure that holds in accomodating space from break away from in the accomodating space.
3. The left atrial appendage occlusion system of claim 2, wherein the retractor structure comprises a cross bar and a vertical bar connected to the cross bar, wherein an angle between the cross bar and the vertical bar is an acute angle.
4. The left atrial appendage occlusion system of claim 3, wherein the number of the drag hook structures is two, the two drag hook structures being located at opposite ends of the distal loop structure having the same diameter.
5. The left atrial appendage occlusion system of claim 4, wherein the receiving space is two receiving holes, and wherein the two receiving holes are configured to receive two of the retractor structures, respectively.
6. The left atrial appendage occlusion system of claim 4, wherein the receiving space is at least one receiving slot for receiving the retractor structure.
7. A left atrial appendage occlusion system as in any one of claims 2-6, wherein the cage structure comprises a first portion connected to the proximal ring structure and a second portion connected to the first portion and the distal ring structure, respectively, the second portion having an anchoring structure thereon.
8. A left atrial appendage occlusion system, comprising: a left atrial appendage occluder and pusher of claim 1, the left atrial appendage occluder comprising: a proximal ring structure, a distal ring structure, and a cage structure connecting the proximal ring structure and the distal ring structure; wherein the cage structure comprises a first portion connected to the proximal ring structure and a second portion connected to the first portion and the distal ring structure, respectively, the second portion having an anchoring structure thereon; the distal end annular structure is provided with a drag hook structure; the proximal end annular structure is provided with an internal thread structure, the proximal end annular structure is also provided with a containing space, the containing space is used for containing the drag hook structure, the drag hook structure comprises a cross rod and a vertical rod connected with the cross rod, an included angle between the cross rod and the vertical rod is an acute angle, and the external thread structure of the pusher is matched with the internal thread structure of the left auricle blocker; when the left atrial appendage occluder is not completely released, the draw hook structure is accommodated in the accommodating space, the external thread structure of the pusher is meshed with the internal thread structure of the left atrial appendage occluder, and the second part is positioned in the first part; when the left atrial appendage occluder is released, the first portion is released prior to the second portion.
9. The left atrial appendage occlusion system of claim 8, wherein the number of the drag hook structures is two, the two drag hook structures being located at opposite ends of the distal loop structure having the same diameter.
10. The left atrial appendage occlusion system of claim 9, wherein the receiving space is two receiving holes, and wherein the two receiving holes are configured to receive two of the retractor structures, respectively.
11. The left atrial appendage occlusion system of claim 9, wherein the receiving space is at least one receiving slot configured to receive the retractor structure.
12. The left atrial appendage occlusion system of claim 8, further comprising a sheath for housing the pusher and the left atrial appendage occlusion device.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201611218381.6A CN108236478B (en) | 2016-12-26 | 2016-12-26 | Left auricle plugging device, pusher and left auricle plugging system |
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| CN201611218381.6A CN108236478B (en) | 2016-12-26 | 2016-12-26 | Left auricle plugging device, pusher and left auricle plugging system |
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| CN108236478B true CN108236478B (en) | 2020-07-14 |
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| CN110960279B (en) * | 2018-09-29 | 2023-06-16 | 上海佐心医疗科技有限公司 | Left auricle plugging device and left auricle plugging system |
| CN113440200A (en) * | 2020-03-24 | 2021-09-28 | 上海佐心医疗科技有限公司 | Support for blocking body cavity and left auricle blocking device |
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