CN108836419B - Temporary plugging device for first-aid aorta and branch blood vessel thereof - Google Patents
Temporary plugging device for first-aid aorta and branch blood vessel thereof Download PDFInfo
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- CN108836419B CN108836419B CN201810688283.1A CN201810688283A CN108836419B CN 108836419 B CN108836419 B CN 108836419B CN 201810688283 A CN201810688283 A CN 201810688283A CN 108836419 B CN108836419 B CN 108836419B
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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
- A61B17/12027—Type of occlusion
- A61B17/1204—Type of occlusion temporary occlusion
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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
- A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
- A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
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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
- A61B17/12136—Balloons
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
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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
- A61B2017/12004—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for haemostasis, for prevention of bleeding
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/064—Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
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Abstract
The application discloses a temporary plugging device for an aorta for emergency and a branch vessel thereof, which comprises a balloon catheter, a guiding mechanism and a pressure measuring mechanism; a contrast medium channel is arranged in the balloon catheter, the front end of the balloon catheter is provided with a balloon, the tail end of the balloon catheter is provided with a control handle, and an air bag is arranged in an inner cavity of the control handle; the guide mechanism comprises a guide wire channel, a hard guide wire, a soft guide wire and a stay wire; an oval adjustable guide ring is arranged at the front end of the soft guide wire; the hard guide wire and the soft guide wire tail section are respectively provided with indication scales; the pressure measuring mechanism comprises two pressure conduction channels, a pressure measuring instrument and a display. The design of combining the soft guide wire with the hard guide wire of the guide mechanism and the design of the guide ring can effectively solve the problem of damage caused by the fact that the guide wire is wrongly inserted into a branch artery; according to the indication scale and the pressure measuring mechanism, the guiding depth and the guiding position of the balloon and the sealing effect of the balloon can be accurately determined, and further the guiding sealing efficiency and accuracy are effectively improved.
Description
Technical Field
The application belongs to the technical field of medical instruments, and particularly relates to a temporary plugging device for an aorta for emergency treatment and a branch vessel thereof.
Background
The guidewire is used to guide and support the catheter during interventional procedures. During treatment, medical personnel place the guidewire into the vessel from the predetermined incision and push the portion of the guidewire located outside the body so that the catheter reaches the predetermined lesion.
In general, to avoid rupture or arterial dissection by puncturing the vessel or intima, the end of the guidewire that enters the body is typically configured in a curved shape (e.g., a "J" head), and when it is desired to change the direction of advancement of the guidewire within the vessel, the medical personnel can twist the portion of the guidewire that is located outside the body to allow the curved structure at the end of the body to be advanced in a direction. In practical applications, in order to ensure that the guide wire has a correct path of entry, the insertion operation is performed under X-ray conditions. The guide wire and part of the vascular structure can be developed under the X-ray condition, and when encountering a vascular branch, medical staff can twist the external part of the guide wire according to the advancing direction as required, so that the guide wire enters the preset vascular branch.
However, in the emergency of the aorta or its branch vessels (where the branch vessels of the aorta refer to intercostal arteries, celiac dry arteries, superior and inferior mesenteric arteries, renal arteries, internal iliac arteries, etc.) and the rupture of the corresponding parenchymal target organs (e.g., spleen, liver, etc.), in order to temporarily block the blood flow of the ruptured aorta, branch vessels, and corresponding parenchymal target organs with an interventional instrument such as a balloon as soon as possible, medical staff has to rapidly introduce a guidewire from the lower limb artery into the proximal aorta without X-rays. Because the guide wire is required to support the catheter in addition to the guiding function, the guide wire cannot be too soft and needs to have relatively high hardness, under the condition of no X-ray, medical staff can only judge the depth and the position of the guide wire according to experience and hand feeling, and when the guide wire moves to the intersection of the aorta and the branch vessels, the guide wire is easy to enter the branch vessels by mistake, so that unnecessary mistaken damage to the branch vessels and target organs thereof can be caused, and precious rescuing time is delayed.
After the main artery and the branch blood vessels or the parenchymal target organs of the main artery rupture and bleed, the rescuing must take seconds, the patient can not go to and from the back, and the main artery can only be used for on-site emergency treatment outside the hospital, so that the bleeding can be controlled rapidly, and precious time is won for the back to the hospital. After the guide wire is in place, according to the existing intracavity technology, the guide tube is required to be exchanged, the superhard guide wire is exchanged, and finally the saccule is exchanged, so that in the process of exchanging various guide wire guide tubes, the tool pollution and in-vivo infection are easily caused under the non-sterile condition on the wound site, the operation efficiency is greatly reduced, the technical threshold is improved, and the effective hemostasis time is prolonged. Therefore, the balloon is also required to be integrated with the superhard guide wire on the annular guide wire without being guided by the annular guide wire by X-rays, and the balloon is rapidly placed by coaxial operation. Therefore, on the basis of the annular guide wire, a simple integrated coaxial embedded aortic temporary plugging device is also needed, and aortic balloon occlusion is rapidly completed.
In addition, when the balloon is inflated after reaching the designated position and cannot be visualized using an X-ray fluoroscopy, the effect of the existing occlusion device on blocking blood flow is difficult to observe in real time, and improvement of the occlusion device is also needed.
To sum up, when can't use X-ray perspective to develop to the outside first aid, guide wire import main artery degree of depth and position are difficult to control, cause vascular injury's technical problem easily to and traditional intracavity utensil exchange repeatedly, easy pollution and operation are complicated, are unfavorable for training and popularization's current situation, and a novel aortic shutoff device is under the condition that does not have image equipment such as X line to guide, can be quick, safe, effectual blocking aortic blood flow, reduces distal end hemorrhage, improves the rescue success rate.
Disclosure of Invention
Aiming at the technical problems that the depth and the position of a leading wire leading into a main artery are difficult to control and vascular injury is easy to cause when X-ray perspective development cannot be used for hospital external first aid, and the current situation that the traditional intracavity appliances are repeatedly exchanged, easy to pollute and complex to operate and are unfavorable for training and popularization, the application aims to provide a temporary plugging device capable of rapidly, safely and effectively blocking aortic blood flow under the condition that no X-ray imaging equipment is used for guiding, and meanwhile, the effect of balloon blocking can be judged immediately through the pressure change of the far end and the near end of a balloon.
The temporary plugging device for the first-aid aorta and the branch blood vessel comprises a balloon catheter, a guiding mechanism and a pressure measuring mechanism;
the balloon catheter is internally provided with a contrast medium channel, the contrast medium channel is filled with contrast medium, the front end of the balloon catheter is provided with a balloon surrounding the balloon catheter, the inner cavity of the balloon is communicated with the contrast medium channel, the tail end of the balloon catheter is provided with a control handle, the inner cavity of the control handle is communicated with the contrast medium channel, the inner cavity of the control handle is provided with an air bag, the air bag is externally connected with an air pipe, and the air pipe is provided with a valve;
the guide mechanism comprises a guide wire channel, a hard guide wire, a soft guide wire and a stay wire; the guide wire channel is arranged in the balloon catheter, and the hard guide wire passes through the guide wire channel; the soft guide wire passes through the hard guide wire, an oval guide ring is arranged at the front end of the soft guide wire, the short diameter of the guide ring is 0.5cm-3cm, the short diameter direction of the guide ring is perpendicular to the soft guide wire, a foldable hinge connecting rod is arranged in the guide ring along the short diameter, and a plurality of threading concave holes are formed in the soft guide wire at intervals; the stay wire sequentially passes through the threading concave holes along the soft guide wire, the front end of the stay wire is connected with the middle hinging part of the hinging connecting rod, and the tail end of the stay wire passes through the hard guide wire; the hard guide wire and the soft guide wire tail section are respectively provided with indication scales;
the pressure measuring mechanism comprises two pressure conduction channels, a pressure measuring instrument and a display; the two pressure conduction channels are arranged in the balloon catheter, pressure conduction liquid is filled in the pressure conduction channels, two ends of the two pressure conduction channels are respectively sealed through elastic membranes, and the elastic membranes at the front ends of the two pressure conduction channels are positioned on the outer wall of the balloon catheter and are respectively positioned at the proximal end and the distal end of the balloon; the elastic membranes at the rear ends of the two pressure conduction channels are positioned at the tail end of the balloon catheter and connected with the pressure measuring instrument, and the pressure measuring instrument is connected with the display.
In the application, the balloon catheter is used for delivering the balloon at the front end to the designated position of the aorta, and the balloon is arranged for extruding the contrast agent in the contrast agent channel from the control handle to the balloon at the front end, so that the balloon is filled to realize the function of temporarily blocking the aorta. The specific process of balloon filling and contraction is as follows, firstly, the end of the trachea is connected with common inflating and inhaling equipment (such as a trigger, a syringe, an ear washing ball and the like), the valve is opened to inflate, the balloon is filled with the contrast agent to flow into the balloon, the balloon is filled with the contrast agent, and blood flow can be blocked in a blood vessel; when the air bag is exhausted through a trigger and other devices, the air bag is contracted, so that the negative pressure state in the control handle is caused, contrast agent flows back into the control handle, the air bag is retracted, and blood flow is restored. In some preferred embodiments of the present application, the air tube end is integrally designed with a common inflation and suction device (such as a trigger, a syringe, an ear-washing ball, etc.), which is convenient to use, avoids the need to find an additional inflation and suction device that can be matched, and saves time.
The guiding mechanism is used for guiding and supporting the balloon catheter. The main differences of the guiding mechanism of the present application compared to the guidewires in existing vascular occlusion devices (mainly balloon catheters) include, but are not limited to: first, the device is integrated into a whole structure, guiding mechanism is in balloon pipe, when introducing balloon pipe to the aorta, balloon pipe and guiding mechanism send into through incision or puncture point simultaneously, then push soft seal wire makes its front end stretch out hard seal wire certain length, push hard seal wire makes its front end stretch out balloon pipe certain length again, the guide ring can be in the preceding detection guide, after reaching appointed position, continue to push hard seal wire makes its front end support to the guide ring, continue to push the balloon pipe and continue to introduce along the seal wire subassembly up to appointed position, the steerable always balloon pipe that contacts with the incision of whole process, compare in conventional guide wire of leading-in, after exchange catheter and superhard seal wire, it is more convenient quick to reintroduce balloon pipe, also can avoid incision secondary to open. The second, guiding mechanism is by hard seal wire with soft seal wire combines, wherein soft seal wire material is softer relatively, and its front end setting during the introduction the guide ring does not have sharp structure, and it is located the forefront of whole device, can effectively reduce the risk of damaging the blood vessel as the probe, moreover the short diameter of guide ring is limited to 0.5cm-3cm, when reaching the intersection of branch artery and aorta, because this short diameter is greater than the internal diameter of branch artery, the guide ring can not get into branch artery, perhaps block at branch artery entry and produce certain resistance for medical staff can judge whether mistake income branch artery according to the resistance feedback, thereby plays the effect of preventing mistake income branch artery and cause the damage. The hard guide wire material of the guide wire assembly is relatively hard, so that the guide and support functions of the balloon catheter can be realized, the smoothness of the soft guide wire passing through the guide wire assembly can be ensured, and the smoothness of the soft guide wire passing through the balloon catheter can be ensured. Thirdly, the setting of articulated connecting rod and acting as go-between in the guide ring can be effectively controlled the short diameter length (width) of guide ring, during concrete control, only need loosen or take up act as go-between can, take up when acting as go-between, the fifty percent discount is carried out after articulated connecting rod middle part atress, and then makes the guide ring both sides draw close, and the short diameter reduces, and when loosening act as go-between, the guide ring can freely open owing to self elasticity, and this design makes at any time can adjust according to the diameter of aorta and branch vessel when leading-in, improves the rate of leading-in.
The pressure measuring mechanism can measure the blood pressure at the near end and the far end of the balloon in real time through the design of the two pressure conduction channels and the pressure measuring instrument thereof, and is helpful for judging the blocking effect of the balloon, namely whether the aortic blood flow is completely or mostly blocked. The two pressure conduction channels are filled with pressure conduction liquid, are sealing channels and are not communicated with blood vessels and other channels, the pressure conduction liquid inside the two pressure conduction channels is not easy to block, the accuracy of data can be ensured, and the safety and reliability of the device are improved.
In addition, the indication scales respectively arranged on the hard guide wire and the soft guide wire tail section can indicate the lengths from the front ends of the hard guide wire and the soft guide wire to the corresponding positions, and according to the lengths of the balloon catheters, the lengths of the front ends of the soft guide wires extending out of the hard guide wire and the lengths of the front ends of the hard guide wires extending out of the balloon catheters can be determined. Of course, the indication scale can also directly indicate the length of the front end of the soft guide wire extending out of the hard guide wire and the length of the front end of the hard guide wire extending out of the balloon catheter. Through the two indication scales, the depth and the position of the hard guide wire, the soft guide wire and the balloon catheter entering the blood vessel can be accurately determined even under the condition of no X-ray, so that the efficiency and the accuracy of the introduction are effectively improved.
In some preferred embodiments of the present application, the contrast agent channel and the guide wire channel are coaxial, a tubular barrier is arranged between the contrast agent channel and the guide wire channel, the guide wire channel is positioned in the interior, and the cross section of the contrast agent channel is annular and positioned outside; the pressure conducting channel is located in the contrast channel or attached to the wall of the balloon catheter (the pressure conducting channel and the contrast channel are not separate from each other in the same lumen).
In some preferred embodiments of the present application, the rear ends of the hard guide wire and the soft guide wire are provided with adjusting knobs, which facilitate pushing and twisting of the hard guide wire and the soft guide wire.
Regarding the design of the guide ring, in some preferred embodiments of the present application, the guide ring may be inclined left and right with respect to the soft guide wire, and the inclination angle may be controlled to be 0-30 degrees, which has the advantage that when the guide ring enters into the bifurcation entrance by mistake, for example, a part of the front end of the guide ring enters into the bifurcation entrance, the soft guide wire may be rotated 180 degrees (of course, other angles may be rotated), and the guide ring rotates with the guide ring and then inclines in the opposite direction, so as to avoid re-entering into the bifurcation entrance.
Further, an indication mark corresponding to the inclination direction of the guide ring can be arranged on an adjusting knob arranged at the rear end of the soft guide wire. When the entering direction of the guide ring is wrong, medical staff twists the adjusting knob, so that the soft guide wire rotates, the angle of the guide ring at the front end can be adjusted, and the medical staff judges the inclination direction of the guide ring according to the indication mark of the adjusting knob, so that the operation of changing the advancing direction of the guide wire is easier to carry out.
In some preferred embodiments of the present application, the control handle is disposed obliquely, and an included angle formed by the control handle and a central axis of the balloon catheter is 30 degrees to 60 degrees. The control handle arranged obliquely can not prevent the guide mechanism from smoothly entering and exiting, so that the operation is more convenient.
In some preferred embodiments of the present application, the guide ring is made of a memory material.
In some preferred embodiments of the present application, the inner wall of the front end of the guide wire channel is provided with a first sealing ring which is matched with the hard guide wire.
In some preferred embodiments of the present application, a second sealing ring matched with the soft guide wire is arranged on the inner side wall of the front end of the hard guide wire, and the second sealing ring is of an elastic passive structure.
In some preferred embodiments of the application, the pressure-conducting liquid is normal saline.
In some preferred embodiments of the application, the pressure measuring instrument is a piezoelectric thin film sensor. The piezoelectric film sensor adopts a thin piezoelectric film, is light in weight and very flexible, and can work passively, so that the piezoelectric film sensor can be widely applied to medical sensors, and particularly when a fine signal needs to be detected. When the pressure sensor is actually assembled, the piezoelectric film of the piezoelectric film sensor can be contacted with the elastic film at the tail end of the pressure conduction channel, even the piezoelectric film can be made into a part of the elastic film, and further the slight deformation of the elastic film can be sensed and converted into an electric signal, so that the front-end blood pressure can be detected.
The pressure measuring instrument is connected with the tail end of the balloon catheter in a pluggable or snap-in mode, so that the balloon catheter can be disposable, and the matched pressure measuring instrument can be reused.
Preferably, the rear ends of the two pressure conduction channels can protrude to the outside of the balloon catheter, so that the pressure conduction channels are convenient to connect with a pressure measuring instrument.
The application has the beneficial effects that:
1. in the temporary plugging device for the first-aid aorta and the branch blood vessels thereof, the contrast medium channel and the pressure conduction channel are of sealing structures, the balloon can be rapidly inflated and released in a closed sterile environment, and the measurement of the blood pressure at the proximal end and the distal end of the balloon can also ensure better stability and accuracy, so that the temporary plugging effectiveness of the aorta is effectively monitored and improved.
2. The device is an integral structure, when the balloon catheter is guided into the aorta, the balloon catheter and the guiding mechanism are simultaneously fed through the incision or the puncture point, then the soft guide wire is pushed to enable the front end of the soft guide wire to stretch out and draw back to a certain length of the hard guide wire, the front end of the hard guide wire is pushed to extend out of the balloon catheter for a certain length, the guide ring can be used for detecting and guiding in the front, after the soft guide wire guide ring reaches a designated position, the hard guide wire is continuously pushed to enable the front end of the hard guide wire to abut against or cover the guide ring, and then the balloon catheter is continuously pushed to be continuously guided along the guide wire component until reaching the designated position.
3. The design of combining the soft guide wire and the hard guide wire in the guide mechanism and the design of the guide ring can effectively solve the problem of damage caused by the fact that the guide wire is wrongly inserted into a branch artery. The hard guide wire and the soft guide wire can be freely stretched, the front end of the soft guide wire and the guide ring can be ensured to have lower hardness during operation, no sharp structure exists, and meanwhile, the soft guide wire and the guide ring can be prevented from entering a branch artery.
4. The hard guide wire and the soft guide wire tail sections are provided with indication scales respectively, so that the depth and the position of the hard guide wire, the soft guide wire and the balloon catheter entering a blood vessel can be accurately determined during operation even under the condition of no X-ray, and further the efficiency and the accuracy of introduction are effectively improved. And the design of the stay wire and the hinged connecting rod can adjust the short diameter of the guide ring, and the guide ring can be adjusted at any time according to the diameters of the aorta and the branch vessels thereof during the guide, so that the guide rate is improved.
5. The pressure measuring mechanism can measure the blood pressure at the near end and the far end of the balloon in real time through the design of the two pressure conduction channels and the pressure measuring instrument thereof, thereby being beneficial to judging the blocking effect of the balloon. And the two pressure conduction channels are filled with pressure conduction liquid, are sealing channels and are not communicated with blood vessels and other channels, the pressure conduction liquid inside the two pressure conduction channels is not easy to block, the accuracy of data can be ensured, and the safety and reliability of the device are improved.
In summary, the temporary aortic and branch vessel plugging device for emergency treatment of the application can rapidly, safely and effectively block aortic blood flow even under the condition of no guidance of imaging equipment such as X rays and the like.
Drawings
FIG. 1 is a schematic view of an aortic and branch vessel temporary plugging device for emergency treatment according to the present application;
FIG. 2 is a cross-sectional view and a partially enlarged schematic illustration of a balloon catheter of the present application;
FIG. 3 is a schematic view of a guide mechanism of the present application;
FIG. 4 is a schematic view of a flexible guidewire of the present application;
FIG. 5 is a schematic view of a guide ring according to the present application;
FIG. 6 is a schematic view showing the inclination of the guide ring according to the present application.
Reference numerals
Balloon catheter 1, contrast medium channel 11, balloon 12, control handle 13, balloon 14, trachea 15, valve 16, syringe 17;
the guide mechanism 2, the guide wire channel 21, the hard guide wire 22, the soft guide wire 23, the stay wire 24, the guide ring 25, the hinged connecting rod 26, the threading concave hole 27 and the adjusting knob 28/29;
the pressure measuring device comprises a pressure measuring mechanism 3, a pressure conducting channel 31, a pressure measuring instrument 32, a display 33 and an elastic membrane 34.
Detailed Description
The application will be further illustrated with reference to specific examples. It should be understood that the following examples are illustrative of the present application and are not intended to limit the scope of the present application.
Example 1
Fig. 1 shows a temporary plugging device for an aorta for emergency treatment and a branch vessel thereof according to a preferred embodiment of the application, which comprises: a balloon catheter 1, a guiding mechanism 2 and a pressure measuring mechanism 3.
As shown in fig. 2, a contrast medium channel 11 is provided in the balloon catheter 1, and the contrast medium channel 11 is filled with a contrast medium. The front end of the balloon catheter 1 is provided with a balloon 12 surrounding the balloon catheter 1, and the inner cavity of the balloon 12 is communicated with the contrast medium channel 11. The tail end of the balloon catheter 1 is provided with a control handle 13, the inner cavity of the control handle 13 is communicated with the contrast medium channel 11, an air bag 14 is arranged in the inner cavity of the control handle 13, an air pipe 15 is externally connected with the air bag 14, a valve 16 is arranged on the air pipe 15, and the tail end of the air pipe 15 is connected with an injector 4 (a trigger, an ear-washing ball and other conventional appliances which can be used for air suction and inspiration can also be adopted).
As shown in fig. 2 and 3, the guide mechanism 2 includes a guidewire channel 21, a hard guidewire 22, a soft guidewire 23, and a pull wire 24. The guide wire channel 21 is arranged in the balloon catheter 1 and is coaxial with the contrast medium channel 11, a tubular barrier layer is arranged between the contrast medium channel 11 and the guide wire channel 21 to separate, wherein the guide wire channel 21 is positioned inside, and the cross section of the contrast medium channel 11 is annular and positioned outside. A hard guidewire 22 passes through the guidewire channel 21 and a soft guidewire 23 passes through the hard guidewire 22. As shown in FIG. 4, the front end of the soft guide wire 23 is provided with an elliptical guide ring 25, the short diameter of the guide ring 25 is 0.5cm-3cm, and the short diameter direction of the guide ring 25 is perpendicular to the soft guide wire 23. As shown in fig. 5, a hinge connecting rod 26 which can be folded in half is arranged in the guide ring 25 along the short diameter, and a plurality of threading concave holes 27 are arranged on the soft guide wire 23 at intervals. The pull wire 24 sequentially passes through a plurality of threading concave holes 27 along the soft guide wire 23, the front end is connected with the middle hinging part of the hinging connecting rod 26, and the tail end passes through the hard guide wire 22. The tail sections of the hard guide wire 22 and the soft guide wire 23 are also respectively provided with indication scales. The tail ends of the hard guide wire 22 and the soft guide wire 23 are also respectively provided with an adjusting knob 28/29.
The pressure measuring mechanism 3 comprises two pressure conducting channels 31, a pressure measuring instrument 32 and a display 33; the two pressure conduction channels 31 are arranged in the contrast medium channel 11, pressure conduction liquid is filled in the pressure conduction channels 31, two ends of the two pressure conduction channels 31 are respectively sealed through elastic membranes 34, and the elastic membranes 34 at the front ends of the two pressure conduction channels 31 are positioned on the outer wall of the balloon catheter 1 and are respectively positioned at the proximal end and the distal end of the balloon 12; the elastic membranes at the rear ends of the two pressure conduction channels 31 are positioned at the tail end of the balloon catheter 1 and are connected with a pressure measuring instrument 32, and the pressure measuring instrument 32 is connected with a display 33.
Preferably, regarding the design of the guide ring 25, as shown in fig. 6, the guide ring 25 may be inclined left and right with respect to the soft guide wire 23, and the inclination angle may be controlled to be 0-30 degrees, so that when the guide ring 25 enters into the bifurcation entrance by mistake, for example, a part of the front end enters into the bifurcation entrance, the soft guide wire 23 may be rotated 180 degrees (or may be rotated by other angles), and the guide ring 25 may be inclined in the opposite direction after being rotated, thereby avoiding re-entering into the bifurcation entrance. Preferably, an adjusting knob 29 at the rear end of the soft guide wire 23 is provided with an indication mark corresponding to the inclination direction of the guide ring 25. When the entering direction of the guide ring 25 is wrong, the medical staff twists the adjusting knob 29 to rotate the soft guide wire 23, and then the direction of the front guide ring 25 can be adjusted, and the medical staff judges the angle and the direction of the guide ring 25 according to the indication mark of the adjusting knob 29, so that the operation of changing the advancing direction of the guide wire is easier to carry out.
Preferably, the control handle 13 is obliquely arranged, and an included angle formed by the control handle 13 and the central axis of the balloon catheter 1 is 30-60 degrees. The control handle 13 arranged obliquely does not prevent the smooth in-out of the guiding mechanism 2, and is more convenient to operate.
Preferably, the guide ring 25 is a memory material. The elliptic shape can be restored when the device is extruded or pulled without external force.
Preferably, the inner wall of the front end of the guide wire channel 21 is provided with a first sealing ring which is matched with the hard guide wire 22.
Also preferably, the inner side wall of the front end of the hard guide wire 22 is provided with a second sealing ring matched with the soft guide wire 23, and the second sealing ring is of an elastic blunt structure, so that the soft guide wire 23 is prevented from being cut.
Preferably, the pressure transfer fluid is normal saline.
Preferably, the load cell 32 is a piezoelectric film sensor. The rear ends of the two pressure conduction channels 31 can protrude to the outside of the balloon catheter 1, so that the connection with the piezoelectric film sensor is facilitated.
In the above embodiment, the balloon catheter 1 is used for delivering the front balloon 12 to the designated aortic position, and the balloon 14 is arranged for extruding the contrast medium in the contrast medium channel 11 from the control handle 13 into the front balloon 12, so that the balloon 12 is inflated to temporarily seal the aortic. The specific process of filling and contracting the balloon 12 is as follows, the valve 16 is opened, the air bag 14 is inflated by using the injector 17, after the air bag 14 is filled, the contrast agent is caused to flow into the balloon 12, the balloon 12 is filled, and the blood flow can be blocked in the blood vessel; when the balloon 14 is exhausted by a trigger or the like, the balloon 14 is contracted, so that the negative pressure state in the control handle 13 is caused, the contrast medium flows back into the control handle 13, the balloon 12 is retracted, and the blood flow is restored.
The guiding mechanism 2 is then used to guide and support the balloon catheter 1. The main differences of the guiding mechanism 2 of the present application compared to the guidewires in existing vascular occlusion devices (mainly balloon catheter 1) include, but are not limited to: first, the device is integrated into a whole structure, guiding mechanism 2 is in balloon catheter 1, when introducing balloon catheter 1 to the aorta, balloon catheter 1 and guiding mechanism 2 are simultaneously fed through incision or puncture point, then push soft guide wire 23 makes its front end stretch out of hard guide wire 22 a certain length, push hard guide wire 22 makes its front end stretch out of balloon catheter 1 a certain length, guide ring 25 can detect the guide in the front, after reaching appointed position, continue pushing hard guide wire 22 makes its front end support to guide ring 25, continue pushing balloon catheter 1 and continue to introduce along the guide wire subassembly until appointed position, the whole process is controllable and is balloon catheter 1 all the time with incision contact, compared with conventional guide wire of leading in, after exchanging catheter and superhard guide wire 22, it is more convenient and quick to introduce balloon catheter 1 again, also can avoid incision secondary to open. The second, guiding mechanism 2 is combined by hard wire 22 and soft wire 23, wherein soft wire 23 material is softer relatively, and its leading-end setting's guide ring 25 does not have sharp structure when leading-in, and it is located the forefront of whole device, and as the risk of damaging the blood vessel can effectively be reduced to the probe, and the short diameter of guide ring 25 is limited to 0.5cm-3cm, when reaching the intersection of branch artery and aorta, because this short diameter is greater than the internal diameter of branch artery, therefore guide ring 25 can not get into branch artery, perhaps block at the branch artery entry and produce certain resistance, make medical staff can judge whether to go into branch artery by mistake according to the resistance feedback, thereby play the effect of preventing to go into branch artery by mistake and cause the damage. The hard guide wire 22 of the guide wire assembly is relatively hard, so that the function of guiding and supporting the balloon catheter 1 can be realized, and meanwhile, the smoothness of the soft guide wire 23 passing through the guide wire can be ensured, and the smoothness of the soft guide wire passing through the balloon catheter 1 can also be ensured. Thirdly, the arrangement of the hinged connecting rod 26 and the stay wire 24 in the guide ring 25 can effectively control the short diameter length (width) of the guide ring 25, and when the stay wire 24 is specifically controlled, only the stay wire 24 is required to be loosened or pulled, when the stay wire 24 is pulled, the middle part of the hinged connecting rod 26 is stressed and folded in half, so that two sides of the guide ring 25 are close, the short diameter is reduced, and when the stay wire 24 is loosened, the guide ring 25 can be opened freely due to self elasticity.
The pressure measuring mechanism 3 can measure the blood pressure at the proximal end and the distal end of the balloon 12 in real time through the design of the two pressure conduction channels 31 and the pressure measuring instrument 32 thereof, and is helpful for judging the blocking effect of the balloon 12, namely whether the aortic blood flow is completely or mostly blocked. The two pressure conduction channels 31 are filled with pressure conduction liquid, are sealing channels and are not communicated with blood vessels and other channels, the pressure conduction liquid inside the two pressure conduction channels is not easy to block, the accuracy of data can be ensured, and the safety and reliability of the device are improved.
In addition, the indication scales respectively arranged at the tail sections of the hard guide wire 22 and the soft guide wire 23 can indicate the lengths of the front ends of the hard guide wire 22 and the soft guide wire 23 to the corresponding positions, and according to the length of the balloon catheter 1, the length of the front end of the soft guide wire 23 extending out of the hard guide wire 22 and the length of the front end of the hard guide wire 22 extending out of the balloon catheter 1 can be determined. Of course, the indication scale can also directly indicate the length of the front end of the soft guide wire 23 extending out of the hard guide wire 22 and the length of the front end of the hard guide wire 22 extending out of the balloon catheter 1. The depth and the position of the hard guide wire 22, the soft guide wire 23 and the balloon catheter 1 entering the blood vessel can be accurately determined through the two indicating scales even under the condition of no X-ray, so that the efficiency and the accuracy of the introduction are effectively improved.
While the preferred embodiments of the present application have been illustrated and described, the present application is not limited to the embodiments, and various equivalent modifications and substitutions can be made by one skilled in the art without departing from the spirit of the present application, and these equivalent modifications and substitutions are intended to be included in the scope of the present application as defined in the appended claims.
Claims (8)
1. The temporary plugging device for the aorta for first aid and the branch blood vessel thereof is characterized by comprising a balloon catheter, a guiding mechanism and a pressure measuring mechanism;
the balloon catheter is internally provided with a contrast medium channel, the contrast medium channel is filled with contrast medium, the front end of the balloon catheter is provided with a balloon surrounding the balloon catheter, the inner cavity of the balloon is communicated with the contrast medium channel, the tail end of the balloon catheter is provided with a control handle, the inner cavity of the control handle is communicated with the contrast medium channel, the inner cavity of the control handle is provided with an air bag, the air bag is externally connected with an air pipe, and the air pipe is provided with a valve;
the guide mechanism comprises a guide wire channel, a hard guide wire, a soft guide wire and a stay wire; the guide wire channel is arranged in the balloon catheter, and the hard guide wire passes through the guide wire channel; the soft guide wire passes through the hard guide wire, an oval guide ring is arranged at the front end of the soft guide wire, the short diameter of the guide ring is 0.5cm-3cm, the short diameter direction of the guide ring is perpendicular to the soft guide wire, a foldable hinge connecting rod is arranged in the guide ring along the short diameter, and a plurality of threading concave holes are formed in the soft guide wire at intervals; the stay wire sequentially passes through the threading concave holes along the soft guide wire, the front end of the stay wire is connected with the middle hinging part of the hinging connecting rod, and the tail end of the stay wire passes through the hard guide wire; the hard guide wire and the soft guide wire tail section are respectively provided with indication scales;
the pressure measuring mechanism comprises two pressure conduction channels, a pressure measuring instrument and a display; the two pressure conduction channels are arranged in the balloon catheter, pressure conduction liquid is filled in the pressure conduction channels, two ends of the two pressure conduction channels are respectively sealed through elastic membranes, and the elastic membranes at the front ends of the two pressure conduction channels are positioned on the outer wall of the balloon catheter and are respectively positioned at the proximal end and the distal end of the balloon; the elastic membranes at the rear ends of the two pressure conduction channels are positioned at the tail end of the balloon catheter and are connected with the pressure measuring instrument, and the pressure measuring instrument is connected with the display;
the tail end of the air pipe is connected with a trigger, a syringe or an ear washing ball for inflating and inhaling;
the pressure conducting liquid is physiological saline.
2. The temporary plugging device for the aorta for emergency and the branch vessels thereof according to claim 1, wherein the contrast medium channel and the guide wire channel are coaxial, a tubular blocking layer is arranged between the contrast medium channel and the guide wire channel, the guide wire channel is arranged inside, and the cross section of the contrast medium channel is annular and arranged outside; the pressure conduction channel is located in the contrast channel or attached to the wall of the balloon catheter.
3. The temporary plugging device for the aorta for emergency and the branch vessels thereof according to claim 1, wherein the rear ends of the hard guide wire and the soft guide wire are provided with adjusting knobs.
4. The temporary plugging device for the aorta for emergency and the branch vessels thereof according to claim 1, wherein the control handle is obliquely arranged, and an included angle formed between the control handle and the central axis of the balloon catheter is 30-60 degrees.
5. The temporary plugging device for the aorta for emergency and the branch vessels thereof according to claim 1, wherein the guide ring is made of a memory material.
6. The temporary plugging device for the aorta for emergency and the branch vessels thereof according to claim 1, wherein the inner wall of the front end of the guide wire channel is provided with a first sealing ring matched with the hard guide wire.
7. The temporary plugging device for the aorta for emergency and the branch vessels thereof according to claim 1, wherein a second sealing ring matched with the soft guide wire is arranged on the inner side wall of the front end of the hard guide wire, and the second sealing ring is of an elastic blunt structure.
8. The temporary plugging device for the aorta for emergency and the branch vessels thereof according to claim 1, wherein the pressure measuring instrument is a piezoelectric film sensor.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810688283.1A CN108836419B (en) | 2018-06-28 | 2018-06-28 | Temporary plugging device for first-aid aorta and branch blood vessel thereof |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201810688283.1A CN108836419B (en) | 2018-06-28 | 2018-06-28 | Temporary plugging device for first-aid aorta and branch blood vessel thereof |
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| CN108836419A CN108836419A (en) | 2018-11-20 |
| CN108836419B true CN108836419B (en) | 2023-08-29 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN201810688283.1A Active CN108836419B (en) | 2018-06-28 | 2018-06-28 | Temporary plugging device for first-aid aorta and branch blood vessel thereof |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN110037754B (en) * | 2019-05-20 | 2023-11-24 | 中国医学科学院北京协和医院 | Intravascular biopsy device and biopsy system |
| CN111803171B (en) * | 2020-06-30 | 2021-08-24 | 重庆大学附属肿瘤医院 | Vascular surgery is with plugging device convenient to operation |
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| CN2275460Y (en) * | 1996-03-15 | 1998-03-04 | 钟汉权 | Three-cavity single saccule valve dilating catheter |
| CN2380244Y (en) * | 1999-07-30 | 2000-05-31 | 黄如川 | Ball-bag expansion therapeutic device for treating cardiochalasia disease |
| CN103055412A (en) * | 2013-01-25 | 2013-04-24 | 湖南埃普特医疗器械有限公司 | Balloon catheter for coronary artery balloon dilatation and preparation method of balloon catheter |
| CN205729956U (en) * | 2016-06-10 | 2016-11-30 | 韩新巍 | A kind of multi-functional compliant balloon conduit |
| CN205759114U (en) * | 2016-06-17 | 2016-12-07 | 韩宇 | Ultrasound guidance pulmonary stenosis Nephrolithotomy Percutaneous is with guiding conduit |
Family Cites Families (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7591813B2 (en) * | 2003-10-01 | 2009-09-22 | Micrus Endovascular Corporation | Long nose manipulatable catheter |
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2018
- 2018-06-28 CN CN201810688283.1A patent/CN108836419B/en active Active
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN2275460Y (en) * | 1996-03-15 | 1998-03-04 | 钟汉权 | Three-cavity single saccule valve dilating catheter |
| CN2380244Y (en) * | 1999-07-30 | 2000-05-31 | 黄如川 | Ball-bag expansion therapeutic device for treating cardiochalasia disease |
| CN103055412A (en) * | 2013-01-25 | 2013-04-24 | 湖南埃普特医疗器械有限公司 | Balloon catheter for coronary artery balloon dilatation and preparation method of balloon catheter |
| CN205729956U (en) * | 2016-06-10 | 2016-11-30 | 韩新巍 | A kind of multi-functional compliant balloon conduit |
| CN205759114U (en) * | 2016-06-17 | 2016-12-07 | 韩宇 | Ultrasound guidance pulmonary stenosis Nephrolithotomy Percutaneous is with guiding conduit |
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| CN108836419A (en) | 2018-11-20 |
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