CN109875615B - Auxiliary catheter - Google Patents
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- CN109875615B CN109875615B CN201910121894.2A CN201910121894A CN109875615B CN 109875615 B CN109875615 B CN 109875615B CN 201910121894 A CN201910121894 A CN 201910121894A CN 109875615 B CN109875615 B CN 109875615B
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Classifications
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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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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Abstract
The invention relates to an auxiliary catheter, which comprises a body part, a head end and a tail handle, wherein the head end and the tail handle are respectively positioned at two ends of the body part; the body part extends into the inner cavity of the guide catheter, and the outer side wall of the body part is mutually attached to the inner side wall of the guide catheter; the head end has a conical structure and extends outwards from the distal end of the guide catheter; the tail handle extends outwards from the proximal end of the guide catheter; a guide wire channel for guide wire to pass through is arranged in the auxiliary catheter; the outer side wall of the auxiliary catheter is provided with a first opening, and the guide wire can be pulled out from the first opening. The auxiliary catheter can assist in guiding the catheter to rapidly pass through a narrow section, and obviously shortens the intervention time; obviously reduces the complications of the radial artery.
Description
Technical Field
The invention relates to the technical field of medical treatment, in particular to an auxiliary catheter applied to treatment or diagnosis of cardiovascular, cerebrovascular, peripheral blood vessel, digestive tract, respiratory tract, urinary tract and reproductive tract, and particularly relates to a diagnosis or treatment process through radial artery, ulnar artery, brachial artery and femoral artery.
Background
In vivo, especially in human body, the vessels such as cardiovascular vessels, cerebrovascular vessels, peripheral vessels, respiratory tract, digestive tract, reproductive tract and the like are often locally narrow, and the catheter is difficult to pass through.
In recent years, with the deep understanding of atherosclerotic coronary artery diseases and the mature of coronary artery interventional therapy instruments and techniques, percutaneous coronary artery intervention has become the main treatment means of coronary heart disease at present. Vascular complications at the puncture site operated via the radial approach are significantly reduced compared to the transfemoral approach, which is a great clinical advantage of transradial interventional Therapy (TRI).
In 1989, the Canadian physician Campeau reported that coronary angiography of the first percutaneously punctured radial artery was found to significantly reduce the incidence of complications compared to the femoral artery approach. The change of the approach not only improves the safety of the operation, but also has great advantages that the patient can get out of bed immediately after the operation.
The netherlands physician Kiemeniji in 1992 and 1993 reported in succession that the first Percutaneous Transluminal Coronary Angioplasty (PTCA) and stenting was performed via the radial artery approach, leading interventional cardiology to a further stage of development.
In 2015, 567583 coronary artery interventional therapy patients are treated in China in a coronary artery interventional therapy mode, wherein 89.45% of patients are treated in a radial artery interventional therapy mode, and 91% of radial artery interventional path is displayed by military data.
However, due to the small tortuosity of the radial artery, the inner diameter of the radial artery of China is only 2.2-2.7 mm on average, and the anatomical characteristics or limitations of the radial artery, cardiovascular interventional doctors often encounter some practical operation difficulties in the process of completing percutaneous coronary intervention. The most common of them is radial artery spasm, the incidence rate is as high as 5-10%, the occurrence rate is often short in operation, and the prediction and avoidance are difficult.
Particularly, after coronary angiography is completed, the guide catheter is most easily replaced, so that the guide catheter cannot be sent forward, and the upper arm of a patient is severely painful. The solution once a similar situation occurs is as follows:
1. and (3) replacing an intervention path: the femoral artery is changed into the approach, the pain of the patient is obviously increased, the intervention time is prolonged, the treatment cost is increased, and the proportion of serious complications of the femoral artery is obviously increased compared with the proportion of serious complications of the radial artery
2. Injecting medicine through radial artery sheath: including anti-spasm drugs such as nitroglycerin, verapamil, and diltiazem, but this method has uncertain therapeutic effect, drug-related side effects, long waiting time, and spasm again when the guiding catheter is used again to move upwards
3. Guiding the catheter to rotate upwards: the guiding catheter is used for guiding the guide wire, the left and right pushing is performed lightly, the success rate of the method is low, the intimal injury of the radial artery is often caused, the anterior wall is often seriously hematoma, pain and vague reflex after the operation are frequently caused, the radial artery occlusion probability is increased, and the periosteum syndrome can be generated in serious cases.
4. Auxiliary catheter guiding method: 0.014 guide wire is sent into the auxiliary catheter through the radial artery along the guide wire to the head end of the guide catheter, and is sent forward after being gradually expanded, the method obviously increases the cost of the patient by about 5000 yuan, and the intervention exposure time is prolonged.
Disclosure of Invention
In order to overcome the defects and shortcomings in the prior art, the invention discloses an auxiliary catheter, a catheter assembly with the auxiliary catheter and a preparation method of the auxiliary catheter.
The invention is realized by the following technical scheme:
an accessory catheter comprising a body and a head end and a tail handle at either end of the body; the body part extends into the inner cavity of the guide catheter, and the outer side wall of the body part is mutually attached to the inner side wall of the guide catheter; the head end has a conical structure and extends outwards from the distal end of the guide catheter; the tail handle extends outwards from the proximal end of the guide catheter; a guide wire channel for guide wire to pass through is arranged in the auxiliary catheter; the outer side wall of the auxiliary catheter is provided with a first opening, and the guide wire can be pulled out from the first opening.
Further, the first opening extends from the tail handle to the middle position of the body; or, the first opening extends from the tail handle to the head end.
Further, the first opening is one of a linear first opening and an elongated first opening.
Further, the diameter of the head end is gradually reduced from one end close to the body part to one end far away from the body part; the head end is gradually deflected from one end close to the body part to one end far away from the body part to the direction far away from the axis of the body part.
Further, an inner tube is arranged in the inner cavity of the body, and the guide wire penetrates through the inner tube; the outer side wall of the inner pipe is connected with the inner side wall of the body part through a plurality of connecting walls; a second opening is formed in the outer side wall of the inner pipe; the guide wire is communicated with the inner cavity of the guide catheter through the first opening and the second opening.
A catheter assembly for treatment of an endovascular bifurcation lesion, comprising an auxiliary catheter extending into the guide catheter, a guide catheter extending into the auxiliary catheter, and a guide wire comprising a body, and a head end and a tail handle respectively located at two ends of the body; the body part extends into the inner cavity of the guide catheter, and the outer side wall of the body part is mutually attached to the inner side wall of the guide catheter; the head end has a conical structure and extends outwards from the distal end of the guide catheter; the tail handle extends outwards from the proximal end of the guide catheter; a guide wire channel for guide wire to pass through is arranged in the auxiliary catheter; a first opening is formed in the outer side wall of the auxiliary conduit; the guide wire comprises a core material and a coil, wherein the core material comprises a front end part and a rear end part.
Further, the core material is made of stainless steel materials and/or nickel-titanium alloy materials, and the coil is made of nickel-titanium alloy materials; the outer periphery of the rear end part is coated with an annular resin layer; the outer periphery of the front end part is coated with a silver-strontium alloy layer; the outer periphery of the coil is coated with a layered double hydroxide layer.
A method for preparing a catheter assembly for treatment of a bifurcation lesion in a blood vessel, the catheter assembly comprising an auxiliary catheter, a guide catheter and a guide wire, wherein the auxiliary catheter extends into the guide catheter, the guide wire extends into the auxiliary catheter, the auxiliary catheter comprises a body part, and a head end and a tail handle which are respectively positioned at two ends of the body part;
the body part extends into the inner cavity of the guide catheter, and the outer side wall of the body part is mutually attached to the inner side wall of the guide catheter;
the head end has a conical structure and extends outwards from the distal end of the guide catheter;
the tail handle extends outwards from the proximal end of the guide catheter;
a guide wire channel for guide wire to pass through is arranged in the auxiliary catheter;
a first opening is formed in the outer side wall of the auxiliary conduit; the guide wire comprises a core material and a coil, wherein the core material comprises a front end part and a rear end part;
the core material is made of stainless steel materials and/or nickel-titanium alloy materials, and the coil is made of nickel-titanium alloy materials;
the outer periphery of the rear end part is coated with an annular resin layer; the outer periphery of the front end part is coated with a silver-strontium alloy layer;
the outer periphery of the coil is coated with a layered double hydroxide layer;
the guide wire is prepared by the following steps:
s1, performing resin coating pretreatment on the rear end part;
s2, carrying out metal sputtering deposition pretreatment on the integrally formed front end part;
s3, carrying out layered double hydroxide layer coating pretreatment on the coil;
s4, connecting and fixing the front end part and the rear end part with each other by adopting welding flux through laser welding;
s5, winding the internal coil on the outer periphery of the front end part, welding one end of the internal coil and a first joint part with each other, and welding the other end of the internal coil and a third joint part with each other;
s6, winding the external coil outside the internal coil, welding one end of the external coil and the first joint part with each other, and welding the other end of the external coil and the second joint part with each other.
A method of using an auxiliary catheter for bifurcation treatment of any one of radial, ulnar, brachial and femoral arteries.
Compared with the prior art, the invention has the advantages that: the auxiliary catheter can assist in guiding the catheter to rapidly pass through a narrow section, and obviously shortens the intervention time; significantly reducing complications of the radial artery; and does not alter the interventional approach (femoral artery puncture is not required); in addition, the auxiliary conduit of the invention is low in price.
In addition, the guide wires do not need to be withdrawn completely, so that the coronary artery is prevented from being damaged by the guide catheter; when the lesion is complicated and a large-caliber guide catheter is needed, the lesion can pass through the radial artery route conventionally, femoral artery puncture is avoided, and radial artery injury is reduced. After the whole guide catheter, the auxiliary catheter and the guide wire pass through the artery to reach the designated position of the coronary artery opening, the auxiliary catheter can be removed from the guide catheter through gradually tearing off the tail handle of the handheld auxiliary catheter, and the guide wire still remains at the original position. The reason why the guide wire is not withdrawn simultaneously with the auxiliary catheter is to prevent the guide catheter port from damaging the coronary artery without the constraint of the guide wire, which is another important benefit of the present invention.
Drawings
FIG. 1 is a first schematic view of the secondary catheter of the present invention;
FIG. 2 is a second schematic view of the secondary catheter of the present invention;
FIG. 3 is a third schematic view of the secondary catheter of the present invention;
FIG. 4 is a schematic view of the caudal stem of the present invention;
FIG. 5 is a schematic cross-sectional view of a guidewire, an auxiliary catheter, and a guiding catheter according to the present invention;
FIG. 6 is a schematic view of a guidewire according to the present invention;
FIG. 7 is a first schematic weld of a guidewire of the present invention;
FIG. 8 is a second schematic weld of a guidewire of the present invention;
FIG. 9 is a schematic view of a coil of a guidewire according to the present invention;
fig. 10 is an enlarged partial view of a coil of a guidewire according to the present invention.
Description of reference numerals:
auxiliary catheter-1, guide catheter-2, guide wire-3, body-11, tip-12, tail-handle-13, first opening-15, inner tube-16, connecting wall-17, second opening-18, core-31, front end-311, stepped cylindrical boss-3111, rear end-312, hollow cylindrical boss-3121, coil-32, inner coil-321, outer coil-322, first junction-331, second junction-332, third junction-333, and solder-34.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings of specific embodiments of the present invention. The technical features of the embodiments of the present invention may be combined with each other without contradiction.
Referring to fig. 1-10, the embodiment of the present invention provides an auxiliary catheter, wherein the auxiliary catheter 1 comprises a body 11, and a head end 12 and a tail handle 13 respectively located at two ends of the body 11; the body 11 extends into the inner cavity of the guide catheter 2, and the outer side wall of the body 11 is attached to the inner side wall of the guide catheter 2; the tip 12 has a conical structure and extends outwardly from the distal end of the guide catheter 2; the tail handle 13 extends out from the proximal end of the guiding catheter 2; a guide wire channel for a guide wire 3 to pass through is arranged in the auxiliary catheter 1; a first opening 15 is arranged on the outer side wall of the auxiliary catheter 1, and the guide wire 3 can be pulled out from the first opening 15. The length of the guide catheter 1 is greater than the length of the guide catheter 2. Specifically, the length of the auxiliary catheter 1 is 0.5 to 50 cm longer than the length of the guide catheter 2, preferably, the length of the auxiliary catheter 1 is 1 to 25 cm longer than the length of the guide catheter 2, and more preferably, the length of the auxiliary catheter 1 is 3 to 20cm longer than the length of the guide catheter 2. The length of the auxiliary conduit 1 is 90-150 cm, and preferably, the length of the auxiliary conduit 1 is 100-125 cm.
In use, the auxiliary catheter 1 provided by the embodiment of the present invention is inserted into the lumen of the guiding catheter 2, and the guide wire 3 is inserted into the lumen of the auxiliary catheter 1 through the guide wire channel. In the operation, the guide wire 3, the auxiliary catheter 1 and the guide catheter 2 are conveyed to the focus part through the blood vessel of the human body by the manual operation of a doctor or the operation of controlling corresponding instruments. The invention defines the operation end of a doctor as a near end or a rear end, and defines the focus end of a patient as a far end or a front end. During delivery, the guide wire 3 is positioned in front of the guide catheter 2, the body 11 extends into the inner cavity of the guide catheter 2, and the outer side wall of the body 11 is attached to the inner side wall of the guide catheter 2; the tip 12 has a conical configuration and extends outwardly from the distal end of the guide catheter 2. Because the head end 12 has a conical structure, the damage to the vessel wall caused by the front end of the guide catheter 2 can be avoided, and the damage can be effectively reduced. Furthermore, a first opening 15 is provided on the outer side wall of the secondary duct 1. In some embodiments of the present invention, the first opening 15 extends from the tail handle 13 to a middle position of the body 11; alternatively, the first opening 15 extends from the tail handle 13 to the head end 12. The first opening 15 is either a linear first opening or an elongated first opening. After the guide catheter 2 reaches the target position, the auxiliary catheter 1 is separated from the guide wire 3 penetrating through the inside thereof through the first opening 15 by twisting and tearing the auxiliary catheter 1, so that the auxiliary catheter 1 can be easily withdrawn without affecting the treatment effect of the guide wire 3 and the auxiliary catheter 1 to be continued at the lesion site.
The diameter of the head end 12 gradually decreases from the end close to the body 11 to the end far away from the body 11; the head end 12 is gradually deflected from an end close to the body 11 to an end far from the body 11 in a direction far from the axis of the body 11. The head end 12 with the structure of gradually deflecting away from the axis can better adapt to the blood vessel in the human body, and has good operability and flexibility.
In some embodiments of the present invention, an inner tube 16 is disposed in the lumen of the body 11, and the guide wire 3 extends through the inner tube 16; the outer side wall of the inner pipe 16 is connected with the inner side wall of the body 11 through a plurality of connecting walls 17; a second opening 18 is arranged on the outer side wall of the inner pipe 16; the guide wire 3 is communicated with the inner cavity of the guide catheter 2 through the first opening 15 and the second opening 18. In the prior art, a catheter is delivered into a blood vessel of a patient under the guidance of a guide wire, and the movement and steering of the catheter in the blood vessel are difficult to control, so that the operation skill level of a doctor is high, and uncontrollable factors and unexpected events in the operation are high. In order to avoid the problems, the inner tube 16 is arranged, the diameter of the inner tube 16 is slightly larger than that of the guide wire 3, and the outer side wall of the body part 11 is attached to the inner side wall of the guide catheter 2, so that a doctor can easily control the feeding and steering of the guide catheter 2, the efficiency of the operation is improved, the difficulty of the operation is reduced, the safety is improved, and unnecessary vascular injury is avoided. After the use, the physician can separate the auxiliary catheter 1 and the guide wire 3 by rotating and stretching, namely, the first opening 15 and the second opening 18, and the operation is simple.
In some embodiments of the present invention, the guide wire 3 includes a core 31 and a coil 32, the core 31 includes a front end 311 and a rear end 312; the coil 32 is wound around the outer periphery of the tip portion 311. The rear end 312 has a cylindrical configuration; the front end 311 has a conical structure with a diameter gradually decreasing from an end close to the rear end 312 to an end far from the rear end 312. The front end 311 is provided with a stepped cylindrical boss 3111; the rear end 312 is provided with a hollow cylindrical boss 3121; after the stepped cylindrical boss 3111 is partially inserted into the hollow cylindrical boss 3121, the stepped cylindrical boss 3111 and the hollow cylindrical boss 3121 are fixedly connected to each other by laser welding using a solder 34.
The coil 32 comprises an inner coil 321 and an outer coil 322 which are coaxially arranged, and the outer coil 322 surrounds the outer part of the inner coil 321; one end of the external coil 322 is welded to the front end 311 via a first joint 331, and the other end is welded to the front end 311 via a second joint 332; one end of the internal coil 321 is welded to the front end portion 311 via a first joint 331, and the other end is welded to the front end portion 311 via a third joint 333; the diameter of the outer coil 322 is gradually increased from an end near the first joint portion 331 to an end near the second joint portion 332; the diameter of the inner coil 321 is gradually reduced from one end near the first joint part 331 to one end near the third joint part 333.
The core material 31 is made of stainless steel material and/or nickel-titanium alloy material, and the coil 32 is made of nickel-titanium alloy material; an annular resin layer is coated on the outer periphery of the rear end part 312; the outer periphery of the front end 311 is coated with a silver-strontium alloy layer; the outer periphery of the coil 32 is coated with a layered double hydroxide layer.
Specifically, the guide wire 33 is prepared by the following steps:
s1, performing resin coating pretreatment on the rear end part 312;
s2, carrying out metal sputtering deposition pretreatment on the integrally formed front end part 311;
s3, carrying out coating pretreatment on the coil 32 by using a layered double hydroxide layer;
s4, connecting and fixing the front end part 311 and the rear end part 312 with each other by adopting a welding flux 34 through laser welding;
s5. winding the internal coil 321 around the outer periphery of the front end 311, welding one end of the internal coil 321 and the first joint 331 to each other, and welding the other end of the internal coil 321 and the third joint 333 to each other;
s6. the external coil 322 is wound around the outside of the internal coil 321, one end of the external coil 322 and the first joint 331 are welded to each other, and the other end of the external coil 322 and the second joint 332 are welded to each other.
The guide wire 3 provided by the embodiment of the invention can pass through a bifurcation lesion part more easily; in addition, when complex bifurcation lesion is treated, the surface of the preformed guide wire is smooth, the internal stress and the structure of the guide wire are stable, and the preformed guide wire is not easy to break and scratch a blood vessel; in addition, the invention can improve the operation efficiency, reduce the time of the operator for manually shaping the guide wire repeatedly, shorten the operation time, reduce the branch occlusion and reduce the complications. Finally, the preformed guide wire can be further processed to meet the special requirements of various special branch lesions.
The flexibility and recovery of the tip 311 is enhanced by the inner and outer coils 321, 322, respectively, of gradually changing diameter, making it particularly suitable for treatment of bifurcation lesions. In addition, the preformed guide wire provided by the embodiment of the invention has higher flexibility, so that the operation is simple and convenient, and the possibility of mistakenly entering a blood vessel is greatly reduced. Because the front end 311 is relatively soft and low in rigidity, the double-layer design of the inner coil 321 and the outer coil 322 can prevent the front end 311 from being plastically deformed, so that the safety of the front end 311 is improved, the guide wire is prevented from being replaced in the operation process, the operation cost is reduced, and the operation efficiency is improved.
In some embodiments of the present invention, the core 31 is made of stainless steel and/or nitinol, and the coil 32 is made of nitinol. An annular resin layer is coated on the outer periphery of the rear end part 312; the outer periphery of the front end 311 is coated with a silver-strontium alloy layer; the outer periphery of the coil 32 is coated with a layered double hydroxide layer. The reason why the annular resin layer is coated on the outer periphery of the rear end portion 312 is that: the annular resin layer can improve the hydrophilicity and softness of the outer periphery of the rear end part 312, and the rear end part has good flexibility, elasticity and biocompatibility on the premise of not reducing rigidity and pushing torsion controllability, so that the friction with the surface of a blood vessel wall and the possibility of damaging the blood vessel wall are reduced. The reason why the silver-strontium alloy layer is coated on the outer periphery of the tip portion 311 is that: the nickel-titanium alloy material has good shape memory effect, but can release toxic free nickel ions after entering a human body, so that the biological safety of the preformed guide wire is reduced, and allergy and postoperative infection are easily caused. The reason why the outer peripheral edges of the coil 32, i.e., the inner coil 321 and the outer coil 322, are coated with the layered double hydroxide layer is that: first, free nickel ions reduce biocompatibility and safety of the coil 32 portion, and the layered double hydroxide has a unique anion exchange capacity and is excellent in biocompatibility, so that it can not only improve biocompatibility of the coil 32 portion but also be suitable for drug loading.
Specifically, the preformed guide wire is obtained through the following steps:
s1, performing resin coating pretreatment on the rear end part 312;
s2, carrying out metal sputtering deposition pretreatment on the integrally formed front end part 311;
s3, carrying out coating pretreatment on the coil 32 by using a layered double hydroxide layer;
s4, the front end part 311 and the rear end part 312 are fixedly connected with each other through welding fluxes 34, specifically, after the stepped cylindrical boss 3111 is partially inserted into the hollow cylindrical boss 3121, the welding fluxes 34 are used for performing laser welding along the externally exposed stepped cylindrical boss 3111 which is not inserted into the hollow cylindrical boss 3121, and the front end part 311 and the rear end part 12 are fixedly connected;
s5. winding the internal coil 21 around the outer periphery of the front end 311, welding one end of the internal coil 321 and the first joint 331 to each other, and welding the other end of the internal coil 321 and the third joint 33 to each other;
s6. the external coil 322 is wound around the outside of the internal coil 321, one end of the external coil 322 and the first joint 331 are welded to each other, and the other end of the external coil 322 and the second joint 332 are welded to each other.
In step S1, the rear end portion 312 is subjected to resin coating pretreatment by:
s1-1, soaking the rear end part 312 in 10-20 wt% hydrochloric acid aqueous solution at the temperature of 30-40 ℃ for 40-60 min;
s1-2, soaking the rear end part 312 treated in the step S1-1 in a sodium bicarbonate water solution with the concentration of 5-15 wt% at the temperature of 50-60 ℃ for 80-120 min;
s1-2, the rear end part 312 processed by the step S1-2 is taken out after being soaked in the flowing polyamide resin for 10min-20 min.
In step S2, the integrally formed leading end portion 311 is subjected to a metal sputter deposition pretreatment by:
s2-1, placing the integrally formed front end part 311 into a cylindrical sample table in a vacuum chamber of plasma alloying equipment, horizontally placing a silver-strontium alloy target containing 2-5% of silver by mass on the cylindrical sample table, and adjusting the distance between the silver-strontium alloy target and the integrally formed front end part 11 to be 20-40 cm;
s2-2, vacuumizing the air pressure of the vacuum chamber through an air outlet by using a vacuumizing device, and then introducing argon into the vacuum chamber through an air inlet, wherein the flow rate of the argon is controlled by a flow meter; when the air pressure in the vacuum chamber is stabilized at 10Pa-20Pa, a power supply is switched on, the voltage is slowly increased to 450V-500V, the temperature of the integrally formed front end part 311 is kept at 800-840 ℃ through the bombardment effect of argon plasma, at the moment, Si and Ag elements in the silver-strontium target material are deposited on the surface of the front end part 311 through the sputtering effect to be alloyed under the bombardment effect of the argon plasma, and a silver-strontium alloyed layer is formed, wherein the alloying time is 1.5h-2 h.
In step S3, the coil 32 is subjected to a layered double hydroxide coating pretreatment by:
s3-1, placing the coil 32 into a reaction kettle, and carrying out hydrothermal reaction on the coil and sodium hydroxide with the concentration of 4-6 wt% at the temperature of 80-100 ℃ for 6-8 h;
s3-2, soaking the coil 32 processed in the step S3-1 in 2-4 wt% hydrochloric acid aqueous solution at normal temperature for 180-250 min;
s3-3, soaking the coil 32 processed in the step S3-2 in a mixed aqueous solution of sodium polystyrene sulfonate and sodium chloride at the temperature of 80-90 ℃ for 40-60 min, wherein the concentrations of the sodium polystyrene sulfonate and the sodium chloride are 2-4 g/L and 6-12 g/L respectively.
The invention discloses the using method and the treatment effect of the auxiliary catheter 1 and the catheter assembly through the following embodiments.
Example 1
Female, age 75, coronary heart disease, diabetes, hypertension, coronary angiography via radial artery, suggesting severe stenosis of the right coronary 90%; conventional retention J-shaped guide wires to the aortic sinus; the guiding catheter 2 is sent to the vicinity of the radial artery along the guide wire 3, the resistance is high, the forearm of the patient is severely painful, and the guiding catheter is withdrawn, so that the pain is relieved. Judging as radial artery spasm.
1. Inserting the auxiliary catheter 1 into the guide catheter 2 through the tail end (Y valve) of the guide catheter 2, wherein the length of the head end of the auxiliary catheter 1 exceeding the guide catheter 2 is 5 cm;
2. the assembled guide catheter 2, the auxiliary catheter 1 and the extension wire 3 are synchronously and integrally sent to reach the ascending aorta through the radial artery stenosis section;
3. fixing the guide wire 3, withdrawing the auxiliary catheter 1, and quickly withdrawing, wherein the guide catheter 2 and the guide wire 3 are kept still;
4. the guide catheter 2 smoothly reaches the first opening of the right coronary to complete the coronary intervention operation;
5. after the guide catheter 2 and the radial artery sheath are removed smoothly, the puncture part is wrapped by conventional pressure, and the forearm has no swelling and obvious pain;
after 6.48 hours, there was no swelling and no obvious pain in the forearms.
Example 2
Male, age 38, coronary heart disease, angina pectoris, hypertension, hyperlipidemia; coronary angiography is performed through the radial artery, and 99% of severe anterior descending stenosis is suggested; distal 90% severe stenosis in the right coronal;
after three days, coronary intervention treatment is carried out, the guiding catheter 2 is sent to the position near the radial artery along the guiding wire 3 to be blocked, the forearm of a patient is severely painful, the guiding catheter 2 is withdrawn, and the pain is relieved. Judging as radial artery spasm.
1. Inserting the auxiliary catheter 1 into the guide catheter 2 through the tail end (Y valve) of the guide catheter 2, wherein the head end of the auxiliary catheter 1 exceeds the guide catheter 2 by 10 cm;
2. the assembled guide catheter 2, the auxiliary catheter 1 and the extension wire 3 are synchronously and integrally sent to reach the ascending aorta through the radial artery resistance section;
3. fixing the guide wire 3, withdrawing the auxiliary catheter 1, stripping the auxiliary catheter 1 along the groove line, and quickly withdrawing, wherein the guide catheter 2 and the guide wire 3 are kept still;
4. the guide catheter 2 smoothly reaches the first opening of the left coronary to complete the coronary intervention operation;
5. after the guide catheter 2 and the radial artery sheath are removed smoothly, the puncture part is wrapped by conventional pressure, and the forearm has no swelling and obvious pain;
after 6.48 hours, there was no swelling and no obvious pain in the forearms.
It is obvious that the above embodiments are only a part of the embodiments of the present invention, and not all of them. Based on the embodiments of the present invention, those skilled in the art should also include various changes, modifications, substitutions and improvements without creative efforts to the embodiments.
Claims (8)
1. An accessory catheter, comprising: the auxiliary catheter (1) comprises a body part (11), and a head end (12) and a tail handle (13) which are respectively positioned at two ends of the body part (11); the body part (11) extends into the inner cavity of the guide catheter (2), and the outer side wall of the body part (11) is attached to the inner side wall of the guide catheter (2); the head end (12) is of a conical structure, and the diameter of the head end (12) is gradually reduced from one end close to the body part (11) to one end far away from the body part (11); the head end (12) is gradually deflected from one end close to the body part (11) to one end far away from the body part (11) to the direction far away from the axis of the body part (11), and the head end (12) extends outwards from the distal end of the guide catheter (2); the tail handle (13) extends outwards from the proximal end of the guide catheter (2).
2. The secondary catheter of claim 1, wherein: a guide wire channel for a guide wire (3) to pass through is arranged in the auxiliary catheter (1); the outer side wall of the auxiliary catheter (1) is provided with a first opening (15), and the guide wire (3) can be pulled out of the first opening (15).
3. The secondary catheter of claim 2, wherein: the first opening (15) extends from the tail handle (13) to the middle position of the body (11); or, the first opening (15) extends from the tail handle (13) to the head end (12).
4. The secondary catheter of claim 2, wherein: the first opening (15) is either a linear first opening or a long-strip first opening.
5. The accessory catheter of any one of claims 2-3, wherein: an inner tube (16) is arranged in the inner cavity of the body part (11), and the guide wire (3) penetrates through the inner tube (16); the outer side wall of the inner pipe (16) is connected with the inner side wall of the body part (11) through a plurality of connecting walls (17); a second opening (18) is arranged on the outer side wall of the inner pipe (16); the guide wire (3) is communicated with the inner cavity of the guide catheter (2) through the first opening (15) and the second opening (18).
6. A catheter assembly for endovascular bifurcation lesion treatment, comprising an auxiliary catheter (1), a guiding catheter (2) and a guide wire (3), said auxiliary catheter (1) extending into said guiding catheter (2), said guide wire (3) extending into said auxiliary catheter (1), characterized in that: the auxiliary catheter (1) comprises a body part (11), and a head end (12) and a tail handle (13) which are respectively positioned at two ends of the body part (11); the body part (11) extends into the inner cavity of the guide catheter (2), and the outer side wall of the body part (11) is attached to the inner side wall of the guide catheter (2); the head end (12) is of a conical structure, and the diameter of the head end (12) is gradually reduced from one end close to the body part (11) to one end far away from the body part (11); the head end (12) is gradually deflected from one end close to the body part (11) to one end far away from the body part (11) to the direction far away from the axis of the body part (11), and the head end (12) extends outwards from the distal end of the guide catheter (2); the tail handle (13) extends outwards from the proximal end of the guide catheter (2); a guide wire channel for a guide wire (3) to pass through is arranged in the auxiliary catheter (1); a first opening (15) is arranged on the outer side wall of the auxiliary conduit (1); the guide wire (3) comprises a core material (31) and a coil (32), wherein the core material (31) comprises a front end part (311) and a rear end part (312).
7. The catheter assembly for endovascular bifurcation lesion treatment of claim 6, wherein: the core material (31) is made of stainless steel material and/or nickel-titanium alloy material, and the coil (32) is made of nickel-titanium alloy material; the outer periphery of the rear end part (312) is coated with an annular resin layer; the outer periphery of the front end part (311) is coated with a silver-strontium alloy layer; the outer periphery of the coil (32) is coated with a layered double hydroxide layer.
8. A method for preparing a catheter assembly for the treatment of an endovascular bifurcation lesion,
the catheter assembly comprises an auxiliary catheter (1), a guide catheter (2) and a guide wire (3), wherein the auxiliary catheter (1) extends into the guide catheter (2), the guide wire (3) extends into the auxiliary catheter (1), and the auxiliary catheter (1) comprises a body (11) and a head end (12) and a tail handle (13) which are respectively positioned at two ends of the body (11);
the body part (11) extends into the inner cavity of the guide catheter (2), and the outer side wall of the body part (11) is attached to the inner side wall of the guide catheter (2);
the head end (12) has a conical structure and extends outwards from the distal end of the guide catheter (2);
the diameter of the head end (12) is gradually reduced from one end close to the body part (11) to one end far away from the body part (11); the head end (12) is gradually deflected from one end close to the body part (11) to one end far away from the body part (11) to a direction far away from the axis of the body part (11);
the tail handle (13) extends outwards from the proximal end of the guide catheter (2);
a guide wire channel for a guide wire (3) to pass through is arranged in the auxiliary catheter (1);
a first opening (15) is arranged on the outer side wall of the auxiliary conduit (1); the guide wire (3) comprises a core material (31) and a coil (32), wherein the core material (31) comprises a front end part (311) and a rear end part (312), and the coil (32) comprises an inner coil (321) and an outer coil (322) which are coaxially arranged;
the core material (31) is made of stainless steel material and/or nickel-titanium alloy material, and the coil (32) is made of nickel-titanium alloy material;
the outer periphery of the rear end part (312) is coated with an annular resin layer; the outer periphery of the front end part (311) is coated with a silver-strontium alloy layer;
the outer periphery of the coil (32) is coated with a layered double hydroxide layer;
the guide wire (3) is prepared by the following steps:
s1, performing resin coating pretreatment on the rear end part (312);
s2, carrying out metal sputtering deposition pretreatment on the front end part (311);
s3, carrying out coating pretreatment on the coil (32) by using a layered double hydroxide layer;
s4, the front end part (311) and the rear end part (312) are connected and fixed with each other through welding materials (34) by laser;
s5, winding the internal coil (321) on the outer periphery of the front end part (311), welding one end of the internal coil (321) and a first joint part (331) with each other, and welding the other end of the internal coil (321) and a third joint part (333) with each other;
s6, winding the external coil (322) outside the internal coil (321), welding one end of the external coil (322) and a first joint part (331) with each other, and welding the other end of the external coil (322) and a second joint part (332) with each other.
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PCT/CN2019/000066 WO2019196520A1 (en) | 2018-04-12 | 2019-04-12 | Auxiliary catheter |
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CN201910121894.2A Active CN109875615B (en) | 2018-04-12 | 2019-02-18 | Auxiliary catheter |
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CN112386776A (en) * | 2019-08-12 | 2021-02-23 | 唐熠达 | Improved auxiliary catheter |
US20230019859A1 (en) * | 2019-12-09 | 2023-01-19 | The Cleveland Clinic Foundation | Apparatus and method for use of fluid flow device |
CN111135431B (en) * | 2020-01-17 | 2020-12-01 | 科塞尔医疗科技(苏州)有限公司 | Balloon catheter for anchoring guide wire and connector assembly |
CN112336964B (en) * | 2020-11-24 | 2021-06-04 | 郑州四环医药用品有限公司 | Catheter with antibacterial coating |
CN113559389A (en) * | 2021-07-26 | 2021-10-29 | 上海志心健康咨询事务所 | Dilating tube for coronary artery stent implantation operation |
CN113707272B (en) * | 2021-08-02 | 2024-02-02 | 复旦大学附属中山医院 | Model for evaluating suitable crowd for interventional therapy of radial artery access liver cancer and construction method |
CN116850430A (en) * | 2023-09-05 | 2023-10-10 | 易生科技(北京)有限公司 | Guide wire |
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DE69426071T2 (en) * | 1994-06-24 | 2001-05-10 | Schneider (Europe) Gmbh, Buelach | Medicinal device for the treatment of a part of a body vessel by means of ionizing radiation |
JP4677205B2 (en) * | 2003-07-17 | 2011-04-27 | テルモ株式会社 | Guide wire |
JP5221032B2 (en) * | 2006-12-11 | 2013-06-26 | 株式会社グツドマン | Insertion aid, catheter assembly and catheter set |
US7713215B2 (en) * | 2008-01-31 | 2010-05-11 | Shriver Edgar L | Steering, piercing, anchoring, distending extravascular guidewire |
CN201453804U (en) * | 2009-07-06 | 2010-05-12 | 成正辉 | Conveying and recovering duct of remote end protector inside blood vessel |
JP5164283B2 (en) * | 2010-06-25 | 2013-03-21 | 朝日インテック株式会社 | Balloon catheter |
CN202459771U (en) * | 2012-03-08 | 2012-10-03 | 王鑫 | Stomach tube auxiliary guide tube |
CN204521928U (en) * | 2015-02-05 | 2015-08-05 | 王先林 | A kind of stomach tube introducer |
CN205698858U (en) * | 2016-04-08 | 2016-11-23 | 上海庆之医疗科技有限公司 | Conduit |
CN206964705U (en) * | 2016-12-20 | 2018-02-06 | 首都医科大学附属北京友谊医院 | Guiding catheter auxiliary sleeve pipe is exchanged through seal wire |
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