CN108362192B - Aortic arch tangent angle measuring ruler and measuring method - Google Patents

Abstract

The invention provides an aortic arch tangent angle measuring ruler and a measuring method. The measuring ruler is provided with a protractor and a positioning ruler; the protractor is provided with a bottom edge indicator line, and a zero-degree indicator line perpendicular to the bottom edge indicator line and passing through the midpoint of the bottom edge, and the arc edge of the protractor is provided. There is a subdivision scale line on the inner side and a scale value. The scale value corresponding to the zero-degree indicator line is "0", and the clockwise and counterclockwise scale values on both sides of "0" are used to indicate 0°-90°; The positioning ruler is provided with a long axis indicator line, and the midpoint of the long axis of the long axis indicator line and the midpoint of the bottom edge of the bottom edge indicator line are hinged by a hinge shaft. The measuring method is to use the measuring ruler to measure the tangential angle of the aortic arch. The invention solves the problems of poor operation effect and many complications caused by the unrealistic DSA projection angle in the current thoracic aortic endovascular repair, and can realize the individualized measurement of the projection angle of the aortic arch.

Description

Aortic arch tangent angle measuring ruler and measuring method

technical field

The invention relates to the technical field of medical equipment and clinical parameter measurement, in particular to an aortic arch tangential angle measuring ruler and a measuring method.

Background technique

At present, thoracic aortic repair (TEVAR) is widely used in the treatment of thoracic aortic dilated diseases (including thoracic aortic aneurysm, aortic dissection, and thoracic aortic pseudoaneurysm). important surgical procedures.

In thoracic aortic endovascular repair, most of the tubes of the DSA machine are required to be vertically projected on the aortic arch to maximize the expansion of the aortic arch on the two-dimensional image, so as to accurately measure the distance of the landing zone of the lesion and the stent. precise positioning. The empirical projection angle (45° left anterior oblique) was used during the previous surgery. Our study on the anatomical parameters of aortic dilatation disease in China found that the tangential angle of the aortic arch (that is, the optimal projection angle of aortic arch DSA angiography) in most patients was greater than 45°, and a retrospective study also found that more than 95% of the stents were released at this angle. In all cases, the positioning was not ideal, resulting in catastrophic consequences such as insufficient proximal anchoring zone or incorrect coverage of the branch arteries above the arch.

Patent document CN103892799A, published on 2014.07.02, discloses an aortic blood vessel measurement probe, a device and a method for measuring aortic diameter. The aortic blood vessel measurement device includes an aortic blood vessel measurement probe and a signal processing module that are electrically connected to each other. The aortic blood vessel measurement probe includes a flexible substrate and a detector array (sensor array) disposed thereon, the detector array includes MXN ultra-wideband radio wave detectors, these ultra-wideband radio wave detectors ( Ultra-wideband sensors) contact the object to be measured to make the flexible substrate adapt to the deformation of the object to be measured. The ultra-wideband radio wave detector emits radio waves from the object to be measured, and when the radio waves hit the tissue interface of the aortic vessel wall of the object to be measured, the ultra-wideband radio wave detector receives the echo signal and processes it by the signal Module analysis to define the diameter of the aorta.

Patent document CN106580327A, published on 2017.04.26, discloses an angle gauge for measuring the angle of the aortic sinus, which includes a bottom dial, a rotating needle, and a rotating rod; wherein the rotating needle is vertically connected to the rotating rod and is arranged on the rotating rod The bottom of the rotating rod can be rotated with the rotating rod; the bottom of the rotating rod is vertically arranged on the dial, and the rotating rod can be rotated to drive the rotating needle to rotate on the dial to mark the angle to be measured; further, a card is set on the rotating rod Bit structure to fix the rotating rod after it has been rotated to a specific position. Further, the rotating needle also has a marking structure. The invention can conveniently measure the angle of the aortic sinus, and use the rotating needle to mark the structure to mark the starting position of cutting, which saves the operation time.

However, the DSA of the aortic arch in clinical thoracic endovascular repair still adopts the empirical projection angle, that is, the left anterior oblique angle of 45°. There is also no measuring device that can individually measure the projection angle of the aortic arch, accurately locate the release point of the proximal stent, and reduce complications.

SUMMARY OF THE INVENTION

The purpose of the present invention is to provide a measuring ruler for the tangential angle of the aortic arch in view of the deficiencies in the prior art.

Another object of the present invention is to provide a method for measuring the tangential angle of the aortic arch.

For realizing above-mentioned first purpose, the technical scheme that the present invention takes is:

An aortic arch tangent angle measuring ruler, which is provided with a protractor and a positioning ruler; The zero-degree indicator line passing through the midpoint of the bottom edge, the inner position of the arc edge of the protractor is provided with a subdivision scale line, and the protractor is also provided with a scale value for indicating the angle, and corresponds to the zero-degree indicator line The scale value is "0"; the positioning ruler is provided with a long axis indicator line, and the long axis midpoint of the long axis indicator line and the bottom edge midpoint of the bottom edge indicator line are hinged by the hinge shaft. The protractor and the positioning ruler can rotate relative to each other.

Preferably, the clockwise and counterclockwise scale values on both sides of the scale value "0" are "10", "20", "30", "40", "50", "60", "70", " 80", "90".

Preferably, a thick sub-scale line is further provided between the bottom edge indicator line and the zero-degree indicator line, and the angle between adjacent thick sub-scale lines is 10°.

Preferably, the scale value is set between the coarse scale line and the subdivision scale line.

Preferably, the protractor is provided with concentric circle indicating lines.

More preferably, the number of the concentric circle indicator lines is one, which is located at the inner end point of the subdivision scale line.

More preferably, the number of described concentric circle indicator lines is three, the outermost concentric circle indicator line is located at the inner end point of the subdivision scale line, the middle concentric circle indicator line is located at the outer end point of the thick subdivision scale line, and the innermost The concentric circles indicate where the line is located near the midpoint of the bottom edge.

Preferably, the angle between adjacent subdivision scale lines is 1°.

Preferably, both the protractor and the positioning ruler are made of transparent materials.

For realizing the above-mentioned second purpose, the technical scheme that the present invention takes is:

A method for measuring the tangential angle of the aortic arch, using the aortic arch tangent angle measuring ruler to measure, specifically comprising the following steps:

a) Place the described aortic arch tangent angle measuring ruler on the aortic arch site, make the bottom edge indicator line of the protractor connect the endpoints on both sides of the aortic arch, and the plane where the protractor is located is parallel to the plane where the aortic arch is located, where the zero-degree indicator line of the protractor points to The direction is the projection direction of the C-arm;

b) Rotate the positioning ruler so that the long-axis indicator line of the positioning ruler is in the direction of the longitudinal axis of the cross section of the human body. At this moment, the angle between the long-axis indicator line of the positioning ruler and the zero-degree indicator line of the protractor is the tangent to the aortic arch. bit angle.

The advantages of the present invention are:

1. Based on long-term clinical experience and systematic research and analysis, the inventor of the present application realized that the tangential angle of the aortic arch in most patients is greater than 45°, and the current thoracic aortic endovascular repair uses an empirical projection angle (left anterior). 45°), which is an important reason for poor surgical results and serious complications. Based on this, a method for measuring the tangential angle of the aortic arch and a measuring ruler for the tangential angle of the aortic arch have been invented, which realizes the personalized measurement of the projection angle of the aortic arch. , accurately locate the release point of the proximal end of the stent, so as to obtain a more satisfactory surgical effect and reduce the occurrence of complications;

2. The shape of the aortic arch tangent angle measuring ruler of the present invention, as well as the design of each indicator line and scale value, provide the operator with a benchmark for measurement and reading during operation, which is convenient for accurate and rapid identification, and has a good user experience;

3. The aortic arch tangent angle measuring ruler of the present invention only includes a protractor and a positioning ruler, and has a simple structure, is easy to use, and has a low manufacturing cost;

4. The present invention provides a method for measuring the tangential angle of the aortic arch, which will realize the clinical individualized measurement of the projection angle of the aortic arch, and significantly improve the effect of thoracic aortic endovascular repair;

5. The method for measuring the tangential angle of the aortic arch of the present invention can also be popularized and used without a workstation. For example, the patient may bring a film from another hospital to see a doctor. We can use the method of the present invention and use a ruler and a protractor. The optimal projection angle of the case was measured; in addition, the reconstruction of the radiology department generally does not provide the projection angle images that the clinician cares about during the operation, and the images seen in the clinic are the screenshots and the original transverse position of the three-dimensional reconstruction of the radiology department image, so the method of the present invention can be used by clinicians to measure the optimal projection angle under the existing resources.

Description of drawings

1 is a schematic structural diagram of the tangential angle measuring ruler of the aortic arch in Example 1.

Figures 2-4 are schematic diagrams of the method of using the aortic arch tangent angle measuring ruler of the present invention. 2 and 3 are schematic diagrams drawn, and FIG. 4 is a schematic diagram under the CT cross-sectional image of the aortic arch.

FIG. 5 is a schematic diagram of measuring the tangential angle of the aortic arch for a special case where the aortic arch is curved.

FIG. 6 is a schematic diagram of measuring the tangential angle of the aortic arch when the true lumen of the descending aorta is located medial or lateral in the case of aortic dissection.

7 is a schematic structural diagram of the tangential angle measuring ruler of the aortic arch in Example 2.

Detailed ways

The specific embodiments provided by the present invention will be described in detail below with reference to the accompanying drawings.

The reference numerals and components involved in the drawings are as follows:

1. Protractor 11. Bottom line

12. The midpoint of the bottom edge 13. The zero-degree indicator line

14. Coarse tick marks 15. Subdivision tick marks

16. Scale value 17. Concentric circle indicator line

2. Positioning ruler 21. Long axis indicator line

3. Articulating shaft 4. Aortic arch

Example 1

Please refer to FIG. 1 . FIG. 1 is a schematic structural diagram of the tangential angle measuring ruler of the aortic arch according to the first embodiment. The aortic arch tangential angle measuring ruler is provided with a protractor 1 and a positioning ruler 2 . The protractor 1 is a semicircle with an indicator mark on one side. Specifically: the protractor 1 is provided with a bottom edge indicator line 11 near the edge of the bottom edge, and the bottom edge indicator line 11 is the same as the one. The bottom edge of the protractor 1 is parallel, and the midpoint of the bottom edge indicating line 11 is the bottom edge midpoint 12; a zero-degree indicating line 13 is provided in the direction perpendicular to the bottom edge indicating line 11 and passing through the bottom edge midpoint 12 ; There is also a thick sub-scale line 14 between the described bottom edge indicator line 11 and the zero-degree indicator line 13, and the angle between the adjacent thick sub-scale lines 14 is 10 °; the arc edge of the protractor 1 is close to The inner position is provided with subdivision tick marks 15, and the angle between the adjacent subdivision tick marks 15 is 1 °; The scale value 16 corresponds to the thick sub-scale line 14, the zero-degree indicator line 13 and the bottom edge indicator line 11, wherein the scale value corresponding to the zero-degree indicator line 13 is "0", and the two sides of the scale value "0" are clockwise And the scale values in the counterclockwise direction are "10", "20", "30", "40", "50", "60", "70", "80", "90"; the protractor 1 There are also three concentric circle indicating lines 17, the outermost concentric circle indicating line 17 is located at the inner end point of the subdivision scale line 15, the middle concentric circle indicating line 17 is located at the outer end point of the thick dividing line 14, the innermost The concentric circle indicating line 17 is located near the midpoint 12 of the bottom edge; the concentric circle indicating line 17 is all centered on the center point 12 of the bottom edge. The positioning ruler 2 is provided with a long-axis indicator line 21, the long-axis indicator line 21 is parallel to the long side of the positioning ruler 2, and the midpoint of the long-axis indicator line 21 is the long-axis midpoint. The center point of the long axis just overlaps the center point of the positioning ruler 2. The positions of the midpoint of the long axis and the midpoint of the bottom edge 12 are hinged with a hinge shaft 3, so that the protractor 1 and the positioning ruler 2 can rotate 360° along the hinge shaft 3 at will. The length of the positioning ruler 2 is less than or equal to the length of the base of the protractor 1 .

Referring to Fig. 2-4, Fig. 2-4 is a schematic diagram of the method of using the aortic arch tangential angle measuring ruler of the present invention, and the specific method of measuring the aortic arch tangential angle using the aortic arch tangential angle measuring ruler of the present invention is described by taking a patient with type B dissection as an example. Steps. (1) Referring to Figures 2 and 4, first select the CT cross-sectional image of the aortic arch, place the bottom edge of the protractor 1 on the aortic arch 4, and make the bottom edge of the protractor 1 indicate line 11 to connect the two end points of the aortic arch 4, and the protractor The plane where 1 is located is substantially parallel to the plane where the aortic arch 4 is located. The direction pointed by the zero-degree indicating line 13 of the protractor 1 is the projection direction of the C-arm. (2) Referring to Figures 3 and 4, rotate the positioning ruler 2 so that the long axis indicator line 21 of the positioning ruler 2 is in the direction of the longitudinal axis of the cross section of the human body, and now the long axis indicator line 21 of the positioning ruler 2 and the protractor The included angle between the zero-degree indicating lines 13 of 1 is the tangential angle of the aortic arch of the patient, that is, the optimal projection angle of the aortic arch DSA angiography. However, in clinical cases, the aortic arch is curved in some cases, such as the case in Figure 5, then the A-line (that is, the location of the bottom edge indicator line) is not a conventional position, and should be done as shown in Figure 5. marked location. As shown in Figure 6, for the case of aortic dissection, if the true lumen of the descending aorta is located inside the patient, the tangent to the medial edge is made; if the true lumen of the descending aorta is located outside the patient, the lateral edge is made. Tangent.

It should be noted that, based on long-term clinical experience and systematic research, the inventors of the present application have recognized that the tangential angle of the aortic arch in most patients is greater than 45 degrees, and the current thoracic aortic endovascular repair uses an empirical projection angle. (45° left anterior inclination), which is an important cause of poor surgical effect and serious complications. Based on this, the method for measuring the tangential angle of the aortic arch and the measuring ruler for the tangential angle of the aortic arch of the present invention are invented, which realizes the personalized measurement of the aortic arch. The projection angle can precisely locate the release point of the proximal end of the stent, so as to obtain a more satisfactory surgical effect and reduce the occurrence of complications. The protractor 1 is not limited to a semicircle, but this shape can meet the measurement range requirements, and the shape is more convenient for intraoperative operation. The zero-degree indicator line 13 is used to indicate the projection direction of the C-arm during the measurement process. Through the scale values on both sides of the zero-degree indicator line 13, the optimal projection angle for DSA angiography of the aortic arch can be read. The zero-degree indicator line 13 is two The scale values on the side are "10", "20", "30", "40", "50", "60", "70", "80", "90", which is also for the convenience of direct reading. Described protractor 1 is provided with both coarse subscale marks 14 and subdivision scale marks 15, and described scale value 16 is located between the thick subscale scale marks 14 and the subdivision scale marks 15, and a concentric circle indicator line is provided. 17, both of which are beneficial to distinguish and identify the angle value in a more complex background. The long-axis indicator line 21 is used to indicate the longitudinal axis direction of the cross-section of the human body, thereby judging the value of the optimal projection angle of the aortic arch DSA angiography. Therefore, the positioning ruler 2 is not limited to a rectangle. The midpoint of the long axis on the axis indicator line 21 does not necessarily overlap with the central point of the positioning ruler 2, however, the above design can ensure that the entire device is more balanced and coordinated, easy to operate and read accurately. The length of the described positioning ruler 2 is preferably equal to the length of the base of the protractor 1, so that the long-axis indicator line 21 can directly overlap with the subdivision scale lines, the thick scale marks, and the scale values on the protractor 1, so as to be accurate. reading. The hinge shaft 3 may be a screw, a rivet or the like, as long as the protractor 1 and the positioning ruler 2 can be flexibly rotated.

In terms of manufacturing process, the protractor 1 is preferably made of colorless and transparent plexiglass, and the transparent material can ensure that the aortic arch behind the protractor 1 can be clearly observed through the protractor 1 . The positioning ruler 2 is preferably made of light yellow transparent plexiglass, which does not block the field of vision and is easy to distinguish from the protractor 1 . The corners of the protractor 1 and the positioning ruler 2 are preferably rounded to avoid touching the damaged tissue.

Example 2

Please refer to FIG. 7 . FIG. 7 is a schematic structural diagram of the tangential angle measuring ruler of the aortic arch according to the second embodiment. The described aortic arch tangential angle measuring ruler is basically the same as the aortic arch tangential angle measuring ruler described in Example 1, the only difference is that the protractor 1 is only provided with a concentric circle indicating line 17, and the concentric The circular indicator line 17 is located at the inner end point of the subdivision scale line 15 .

In this embodiment, the purpose of disposing the concentric circle indicator lines 17 on the protractor 1 is to facilitate accurate reading, however, it is not necessary and can be omitted, and similarly, the number thereof can also be increased.

The above are only the preferred embodiments of the present invention. It should be pointed out that for those skilled in the art, without departing from the method of the present invention, several improvements and supplements can be made, and these improvements and supplements should also be regarded as It is the protection scope of the present invention.

Claims (8)

1. a method for measuring aortic arch tangent position angle, it is characterized in that, use aortic arch tangent position angle measuring ruler to measure; The aortic arch tangent angle measuring ruler is provided with a protractor and a positioning ruler; one side of the protractor is provided with a bottom edge indicator line at a position near the edge of the bottom edge, and is provided with a bottom edge indicator line that is perpendicular to the bottom edge and passes through. The zero-degree indicator line passing through the midpoint of the bottom edge, the inner position of the arc edge of the protractor is provided with a subdivision scale line, and the protractor is also provided with a scale value for indicating the angle, and corresponds to the zero-degree indicator line. The scale value is "0"; the positioning ruler is provided with a long axis indicator line, and the long axis midpoint of the long axis indicator line and the bottom edge midpoint of the bottom edge indicator line are hinged by the hinge shaft, so that The protractor and the positioning ruler can rotate relative to each other; the protractor and the positioning ruler are both made of transparent materials; The method for measuring the tangential angle of the aortic arch specifically includes the following steps: a) Place the described aortic arch tangent angle measuring ruler on the aortic arch site, make the bottom edge indicator line of the protractor connect the endpoints on both sides of the aortic arch, and the plane where the protractor is located is parallel to the plane where the aortic arch is located, where the zero-degree indicator line of the protractor points to The direction is the projection direction of the C-arm; b) Rotate the positioning ruler so that the long-axis indicator line of the positioning ruler is in the direction of the longitudinal axis of the cross section of the human body. At this moment, the angle between the long-axis indicator line of the positioning ruler and the zero-degree indicator line of the protractor is the tangent to the aortic arch. bit angle. 2. aortic arch tangent position angle measurement method according to claim 1, is characterized in that, the scale numerical value of scale numerical value " 0 " both sides clockwise and counterclockwise are successively " 10 ", " 20 ", " 30 ", "40", "50", "60", "70", "80", "90". 3. aortic arch tangent position angle measurement method according to claim 1, is characterized in that, between described bottom edge indicator line and zero degree indicator line, is also provided with thick division mark, between adjacent thick division mark. The angle is 10°. 4 . The method for measuring the tangent position angle of the aortic arch according to claim 3 , wherein the scale value is set between the coarse scale line and the subdivision scale line. 5 . 5 . The method for measuring the tangential angle of the aortic arch according to claim 3 , wherein the protractor is provided with concentric circle indicator lines. 6 . 6 . The method for measuring the tangent position angle of the aortic arch according to claim 5 , wherein the number of the concentric circle indicator lines is one, which is located at the inner end point of the subdivision scale line. 7 . 7. aortic arch tangent position angle measuring method according to claim 5, is characterized in that, described concentric circle indicator line quantity is three, and outermost concentric circle indicator line is positioned at the inner end point of subdivision scale line, and the middle The concentric circle indicator line is located at the outer end of the thick division line, and the innermost concentric circle indicator line is located near the midpoint of the bottom edge. 8 . The method for measuring the tangent line angle of the aortic arch according to claim 1 , wherein the angle between adjacent subdivision scale lines is 1°. 9 .

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