CN110584742A - 脉管栓塞捕获装置 - Google Patents

脉管栓塞捕获装置 Download PDF

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CN110584742A
CN110584742A CN201910510533.7A CN201910510533A CN110584742A CN 110584742 A CN110584742 A CN 110584742A CN 201910510533 A CN201910510533 A CN 201910510533A CN 110584742 A CN110584742 A CN 110584742A
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elongate member
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J.罗伦佐
K.约翰森
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DePuy Synthes Products Inc
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    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • AHUMAN NECESSITIES
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    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
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    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
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    • A61B17/22031Gripping instruments, e.g. forceps, for removing or smashing calculi
    • A61B2017/22034Gripping instruments, e.g. forceps, for removing or smashing calculi for gripping the obstruction or the tissue part from inside
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22038Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22051Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22094Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for crossing total occlusions, i.e. piercing
    • AHUMAN NECESSITIES
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    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2212Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34Trocars; Puncturing needles
    • A61B17/3417Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
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Abstract

本发明题为“脉管栓塞捕获装置”。本发明提供了一种用于捕获脉管中的栓塞的装置,该装置可包括第一细长构件、可膨胀元件、可倒置元件、以及定位在可膨胀元件和可倒置元件之间的间隙,该间隙的尺寸设定成跨栓塞布置。可膨胀元件和可倒置元件可定位在第一细长构件的远侧端部附近。可膨胀元件可从塌缩递送构型膨胀至膨胀构型。可倒置元件可从塌缩递送构型膨胀至膨胀构型,并且可倒置元件可从膨胀构型倒置成倒置构型,从而形成凹坑。凹坑可包封间隙的至少一部分,并且可由此捕获间隙中的栓塞。

Description

脉管栓塞捕获装置
技术领域
本发明整体涉及可用于移除患者体内血管中的栓塞的医疗装置和方法,并且更具体地涉及用于捕获脑动脉中的栓塞的装置。
背景技术
与通常由常规技术处理的血管相比,使用常规技术难以接近神经血管,因为目标血管直径较小,相对于插入部位而言在远端,并且是高度曲折的。即使美国每年有超过600,000次急性缺血性中风,但在不到<1%的病例中使用凝块取回装置来治疗患者。其原因是常规技术的轮廓太大、缺乏导航曲折血管的可递送性、或者在递送至目标部位时不能有效地移除凝块。
由于主动脉弓形(尤其是在具有2型或3型主动脉弓的患者中),与身体其它部位的类似尺寸的血管相比,血管部分具有尖锐、频繁弯曲和神经血管的脆弱性,因此导航血管接近脑动脉可能是困难的。
一旦将装置递送至治疗部位,栓塞(例如凝块、错位装置、迁移装置、大型栓塞等)可能难以分离,尤其是在患者被导管插入之前经过了数小时的情况下。栓塞与血管壁之间的脉冲血压和纤维蛋白形成能够将栓塞强力地粘附到血管壁。一旦分离,栓塞的未被捕获和取回的任何部分可在血流方向上被夹带。如果游离栓塞部分在大脑脉管中的其它地方存在,则可致使影响新领域的局部缺血性中风。
因此,需要一种脉管栓塞捕获装置,该装置能够捕获脑动脉内的栓塞,以便从患者中安全地取回。
发明内容
本文公开了可满足上述需要的本发明的各种示例性装置,这些装置通常可包括可膨胀元件、可倒置元件、定位在可膨胀元件和可倒置元件之间的间隙,以及用于将元件递送至栓塞部位的细长构件。这样,这些装置通过将栓塞包封在通过使该倒置元件倒置形成的凹坑内来允许捕获位于间隙中的栓塞。
在一个示例中,用于捕获脉管中的栓塞的装置可包括第一细长构件、可膨胀元件、可倒置元件和间隙。可膨胀元件和可倒置元件可定位在第一细长构件的远侧端部附近,其间的间隙的尺寸设定成跨栓塞布置。可膨胀元件可从塌缩递送构型膨胀至膨胀构型。可倒置元件可从塌缩递送构型膨胀至膨胀构型,并且可倒置元件可从膨胀构型倒置成倒置构型,从而形成凹坑。凹坑可包封间隙的至少一部分,并且可由此捕获位于间隙中的栓塞。
可膨胀元件可定位在可倒置元件的远侧。间隙可定位在连结可膨胀元件和第一细长构件的第一连结部和连结可倒置元件和细长构件的第二连结部之间。
该装置可包括芯线,该芯线具有定位在芯线的远侧端部附近的远侧线圈。芯线可相对于第一细长构件移动,使得移动使可膨胀元件膨胀。可膨胀元件的膨胀尺寸或膨胀的半径可由芯线相对于第一细长构件的移动来控制。
该装置可包括第二细长构件,该第二细长构件可相对于第一细长构件移动,使得移动使可倒置元件膨胀。使第一细长构件相对于第二细长构件移动也可使可倒置元件倒置。使可倒置元件倒置可使得间隙的至少一部分由通过使可倒置元件倒置形成的凹坑包封。
可膨胀元件和可倒置元件可各自对脉管的壁是可膨胀的。
该装置的另一个示例可包括定位在可膨胀元件和可倒置元件之间的凝块接合元件。可膨胀元件、可倒置元件和凝块接合元件可各自设置在第一细长构件的远侧端部附近。凝块接合元件可具有塌缩递送构型并且可自膨胀至膨胀展开构型。在膨胀构型中,凝块接合元件的一部分可接合凝块,然后在凝块接合元件移动时,凝块接合元件可在凝块夹紧构型中夹紧凝块。
当可倒置元件处于倒置构型时,凝块接合元件的至少一部分可被可倒置元件包封。
可膨胀元件可定位在可倒置元件的远侧,并且凝块接合元件可定位在可倒置元件的远侧和可膨胀元件的近侧。
又如,用栓塞捕获装置(其具有芯线、可膨胀元件、可倒置元件、和定位在可膨胀元件和可倒置元件之间的间隙)捕获栓塞的方法可包括以下步骤:提供栓塞捕获装置,跨栓塞布置间隙,将可膨胀元件从塌缩递送构型膨胀至膨胀构型,将可倒置元件从塌缩递送构型膨胀至膨胀构型,将可倒置元件从膨胀构型倒置成倒置构型以形成凹坑,由凹坑包封间隙的至少一部分,以及在凹坑中捕获栓塞。
该方法还可包括在由凹坑和可膨胀元件的表面形成的腔体内包封栓塞。
所提供的装置可具有芯线、第一细长构件和第二细长构件。在该示例中,该方法还可包括以下步骤:使芯线相对于第一细长构件移动以使得可膨胀元件膨胀,使第一细长构件相对于第二细长构件移动以使得可倒置元件膨胀,使第一细长构件相对于第二细长构件移动以使得可倒置元件倒置,使第一细长构件相对于第二细长构件移动以使得包封间隙的至少一部分,以及使第一细长构件相对于第二细长构件移动以使得在凹坑中捕获栓塞。
所提供的装置可具有凝块接合元件。在该示例中,该方法可包括以下步骤:将凝块接合元件从塌缩递送构型膨胀至膨胀构型,从而接合栓塞,以及将凝块接合元件从膨胀构型移动至凝块夹紧构型,从而夹紧栓塞。
附图说明
将参考下面的描述并结合附图进一步讨论本发明的上述及其它方面,
在这些附图中,相同的编号指示各种图中相同的结构元件和特征。附图未必按比例绘制,相反,将重点放在示出本发明的原理。附图仅以举例方式而非限制方式描绘了本发明装置的一种或多种具体实施。
图1a和图1b为本发明的示例性栓塞捕获装置的横截面侧视图;
图2a至图2e示出了本发明的示例性栓塞捕获装置的构型;
图3a至图3f示出了本发明的栓塞捕获装置的使用的方法;
图4a和图4b为本发明的示例性栓塞捕获装置的横截面侧视图;
图5a至图5e示出了本发明的示例性栓塞捕获装置的构型;
图6a至图6f示出了本发明的栓塞捕获装置的使用的方法;
图7a至图7e示出了本发明的栓塞捕获装置的使用的方法;
图8a为根据本发明的示例性制造的栓塞捕获装置的一部分的图像;并且
图8b为图8a的放大图像。
具体实施方式
栓塞捕获装置110的一个示例,如图1a和图1b中所示可具有第一细长构件115、可膨胀元件112、可倒置元件113、以及定位在可膨胀元件112和可倒置元件113之间的间隙125。如图所示,可膨胀元件112可沿着第一细长构件115定位在可倒置元件113的远侧,并且间隙125的尺寸可设定成跨栓塞布置。设想了未示出的其它几何形状。例如,可膨胀元件112可定位在可倒置元件113的近侧,其中间隙125定位在可膨胀元件112和可倒置元件113之间。
如图所示,第一细长构件可为具有贯穿其中的管腔的内管115、近侧端部和远侧端部。内管115可连接到可膨胀元件112和可倒置元件113。例如,内管115可在连结部119处连结到可膨胀元件112的近侧端部,内管115可在连结部120处连结到可倒置元件113的远侧端部,并且到内管115的连结部119,120在可膨胀元件112和可倒置元件113之间限定间隙125。
栓塞捕获装置110可包括另外的细长构件,诸如外管114和芯线116。如图1a所示,芯线116、内管115和外管114可与定位在管轴线处的芯线116同心,并且内管115可定位在外管114的内部。
芯线116可连接到远侧线圈111和可膨胀元件112。例如,芯线116可在远侧线圈111的远侧端部和近侧端部上的两个连结部117处连结到远侧线圈111,并且芯线116可在可膨胀元件112的远侧端部上的连结部118处连结到可膨胀元件112。
外管114可连接到可倒置元件113。例如,外管114可在连结部121处连接到可倒置元件113的近侧端部。
如图1a和图1b中所示,可膨胀元件112和可倒置元件113可处于塌缩递送构型。如图1b所示,装置110可包封在导管103中,诸如尺寸设定成跨栓塞布置的微导管。例如,导管103的尺寸可被设定成刺穿闭塞凝块或其它栓塞。
图2a至图2e示出了栓塞捕获装置110的构型。图2a示出了回缩以暴露可膨胀元件112的导管103。图2b示出了可膨胀元件112,该可膨胀元件从塌缩递送构型膨胀至膨胀构型。如图2b所示,可膨胀元件112的膨胀可通过相对于内管115朝近侧拉动芯线116来实现。在例示的示例中,可膨胀元件112可在远侧连结部118处连结到芯线116并且在近侧连结部119处连结到内管115。在这种构型中,朝近侧将芯线116相对于内管115拉动可使得可膨胀元件112被纵向压缩。纵向压缩可致使可膨胀元件112径向膨胀。
可膨胀元件112可具有柔性结构,诸如当纵向压缩或在纵向应变下塌缩时能够径向膨胀的网片。在此类示例中,可膨胀元件112的半径可通过内管115相对于芯线116的纵向移动来控制。在某些应用中,膨胀半径可因此延伸到脉管的壁。图2b还示出了回缩以暴露可倒置元件113的导管103。
图2c示出了从塌缩递送构型膨胀成膨胀构型的可倒置元件113。图2c还示出了相对于外管114朝近侧拉动的内管115。在例示的示例中,可倒置元件113可在远侧连结部120处连结到内管115并且在近侧连结部121处连结到外管114。在这种构型中,将内管115相对于外管114拉动可使得可倒置元件113被纵向压缩。纵向压缩可致使可倒置元件113径向膨胀。
图2c还示出了保持膨胀构型的可膨胀元件112。在例示的例证中,这可通过芯线116随着内管115朝近侧拉动时而连同内管115一起朝近侧被拉动来实现。同时拉动可保持可膨胀元件112的远侧连结部和近侧连结部118,119之间的间隔,这些连结部分别将可膨胀元件112连接至芯线116和内管115。
图2d示出了从膨胀构型倒置成倒置构型的可倒置元件113。如图所示,倒置构型可包括形成凹坑122的凹表面。可倒置元件113的倒置可通过继续将内管115相对于外管114朝近侧拉动来实现。将内管115相对于外管114拉动可使得可倒置元件113进一步被纵向压缩。如图2c所示并且如上所述,纵向压缩可使得可倒置元件113膨胀,然而一旦可倒置元件113已达到最大膨胀,进一步的纵向压缩可使得可倒置元件113在其自身上倒置或折叠,如图2d所示。在倒置期间,间隙125的至少一部分可被拉动到凹坑122中,变成由可倒置元件113包封。
图2d示出了间隙125,该间隙具有由可膨胀元件112和内管115之间的连结部119与可倒置元件113和内管115之间的连结部120之间的距离限定的长度。凹坑122的形成可使得可倒置元件113和内管115之间的连结部120推进到凹坑122中,并且可膨胀元件112朝凹坑122的开口推进。
图2e示出了完全包封在可倒置元件113的凹坑122中的间隙125和抵靠凹坑122的开口平接的可膨胀元件112。凹坑122和可膨胀元件112的相邻表面可形成腔体。
设想了未示出的栓塞捕获装置的其它构型。例如,可倒置元件可定位在近侧元件的远侧。在这种构型中,可倒置元件可在远侧连结部处连结到芯线并且在近侧连结部处连结到内管。可膨胀元件可在远侧连结部处连结到内管并且在近侧连结部处连结到外管。芯线、内管和外管可为操作者可移动的细长构件。在这种构型中,使外管相对于内管移动可将可膨胀元件膨胀,并且内管相对于芯线的移动可使可倒置元件膨胀和倒置。可倒置元件可倒置以形成具有朝近侧取向的开口的凹坑。腔体可形成在由可膨胀元件的相邻表面限定的可倒置元件的凹坑内。在该构型中使用装置的一种示例性方法可包括:跨栓塞定位间隙,朝远侧推动外管以将可膨胀元件膨胀,朝远侧推动内管和外管以使可倒置元件膨胀和倒置并包封栓塞,朝远侧移动微导管以包封装置,以及连同装置和其中包含的栓塞从患者身上提取微导管。
通过未示出的装置将可膨胀元件112膨胀。例如,可膨胀元件112可为自膨胀的。在此类示例中,可膨胀元件112可在递送期间被外管114或其它装置约束,然后一旦装置被定位成捕获栓塞,就允许该膨胀元件膨胀。
图3a至图3f示出了使用栓塞捕获装置110捕获栓塞12的方法,诸如图1a、1b和图2a至2e中描绘的示例性装置。
图3a示出了脉管10内的装置110,该脉管10包含栓塞12,诸如闭塞凝块。如图所示,装置110可被容纳在导管103内。装置110的远侧端部通过栓塞12递送,并且可被定位成使得间隙125跨栓塞12布置。
图3b示出了回缩以暴露可膨胀元件112的导管103。如图所示,可回缩导管103以暴露间隙125,使得其穿过栓塞12和可倒置元件113的一部分定位。
图3c示出了从塌缩构型膨胀至膨胀构型的可膨胀元件112,该可膨胀元件通过使芯线116相对于内管115移动而膨胀。
图3d示出了径向向外膨胀到脉管10的壁的可膨胀元件112。在该构型中,可膨胀元件可因此防止栓塞12的远侧移动。图3d示出了处于膨胀构型的可倒置元件113,其通过使内管115相对于外管114移动而膨胀。如图所示,可倒置元件113可膨胀至脉管10的壁并因此可防止栓塞12的近侧移动。
图3e示出了倒置构型的可倒置元件113和通过使内管115相对于外管114移动而移动到凹坑122中的栓塞12。如图所示,可膨胀元件112可朝近侧朝凹坑122的开口移动,将栓塞12推入凹坑122中并作用以防止凝块12的分离部分在血流中进一步向下通过脉管10。
图3f示出容纳在腔体内的栓塞12,该腔体由凹坑122以及可膨胀元件112的相邻表面形成。现在于腔体内捕获的栓塞12可通过朝近侧拉动细长构件而从脉管10移除。可通过若干方式移除栓塞12。装置110可被重新引入导管103中并被拉回而包封在其中。另选地,细长构件可在导管103外部朝近侧移动。在任一情况下,导管103可用于抽吸以确保最大限度地取回所有栓塞12颗粒。此外,可不必抽吸,因为可膨胀元件112和可倒置元件113的组合可确保整个栓塞12捕获。
图4a和图4b示出了示例性栓塞捕获装置110,其包括凝块接合元件123。凝块接合元件123可为本领域技术人员已知的任何凝块或栓塞捕获/支架回收器。例如,参见以引用方式并入本文的美国专利申请62/536,005。
如图4a所示,示例性栓塞捕获装置110包括相对于图1a所述的元件,这些元件包括远侧线圈111、可膨胀元件112、可倒置元件113、外管114、内管115、芯线116和连结部117,118,119,120,121。如图4a所示,凝块接合元件123可定位在可膨胀元件112和可倒置元件113之间的内管115上。凝块接合元件123可定位在间隙125内,以有利于在间隙125内捕获凝块或其它栓塞(诸如斑块)12。
图4a和图4b示出了各自处于塌缩递送构型的可膨胀元件112、凝块接合元件123和可倒置元件113。如图4b所示,装置110可被包封在导管103中,诸如尺寸设定成跨栓塞12布置的微导管。例如,导管103的尺寸可被设定成刺穿闭塞凝块或大型栓塞。
图5a至图5e示出了栓塞捕获装置110的构型。图5a示出了回缩以暴露可膨胀元件112的导管103和凝块接合元件123。凝块接合元件123可从塌缩递送构型自膨胀至膨胀构型,这意味着当不受导管103或其它装置约束时,凝块接合元件123可膨胀至膨胀构型。
图5b示出了可膨胀元件112通过使芯线116相对于内管115拉动而从塌缩递送构型膨胀至膨胀构型,并且图5b示出了回缩以暴露可倒置元件113的导管103。
图5c示出了通过使内管115相对于外管114朝近侧拉动而从塌缩递送构型膨胀至膨胀构型的可倒置元件113,并且图5c示出了保持膨胀构型的可膨胀元件112。
图5d示出了从膨胀构型倒置成倒置构型的可倒置元件113,形成围绕凝块接合元件123的凹坑122。图5d示出了推进到凹坑122中的间隙125和朝凹坑122的开口推进的可膨胀元件112。
图5e示出了完全包封在可倒置元件113的凹坑122中的间隙125和抵靠凹坑122的开口平接的可膨胀元件112。凹坑122和可膨胀元件112的相邻表面形成腔体。
图6a至图6f示出了使用栓塞捕获装置110捕获栓塞12的方法,诸如图4a、4b和图5a至5e中描绘的示例性装置。
图6a示出了容纳在导管103内的脉管10内的装置110,脉管10包含栓塞12,诸如闭塞凝块。装置110可被定位成使得凝块接合元件123和间隙125跨栓塞12布置。
图6b示出了回缩以暴露可膨胀元件112的导管103和凝块接合元件123。在其中栓塞12为凝块的示例性应用中,凝块接合元件123可在凝块12内自膨胀以接合凝块12。
图6c示出了从塌缩构型膨胀至膨胀构型膨胀的可膨胀元件112,该可膨胀元件通过使芯线116相对于内管115移动而膨胀。
图6d示出了径向向外延伸到脉管10的壁的可膨胀元件112。这样的构型可因此防止栓塞12的远侧移动。图6d示出了处于膨胀构型的可倒置元件113,其通过使内管115相对于外管114移动而膨胀。可倒置元件113可膨胀至脉管10的壁并因此可防止栓塞12的近侧移动。朝近侧拉动内管115以使可倒置元件113膨胀可使得可膨胀元件112和凝块接合元件123朝近侧移动。当凝块接合元件123朝近侧移动时,凝块接合元件123可在从膨胀构型移动至凝块夹紧构型时夹紧栓塞12,从而可由此有助于朝近侧分离和拉动栓塞12。如图所示,可膨胀元件112可防止远侧移动超过未被凝块接合元件123拉动的栓塞12的任何部分的可膨胀元件112。
图6e示出了倒置成倒置构型的可倒置元件113和通过使内管115相对于外管114移动而移动到凹坑122中的栓塞12。凝块接合元件123可朝近侧拉动栓塞12,而可膨胀元件112可防止栓塞12的远侧移动。
图6f示出容纳在腔体内的栓塞12,该腔体由凹坑122以及可膨胀元件112的相邻表面形成。现在于腔体内捕获的栓塞12可通过朝近侧拉动细长构件而从脉管10移除。
图7a至图7e示出了在从血管10移除闭塞凝块12的上下文下使用栓塞捕获装置110的方法。图7a示出了穿过血管10内的凝块12的微导管103中的装置110。如图所示,微导管103可通过导向导管或中间导管104递送至治疗部位附近。图7b示出了回缩以暴露可膨胀元件112和可倒置元件113的导管103,凝块12定位在可膨胀元件112和可倒置元件113之间。图7c示出了各自处于膨胀构型的可膨胀元件112和可倒置元件113,其中凝块12定位在可膨胀元件112和可倒置元件113之间的间隙125中。图7d示出了处于倒置构型的可倒置元件113,并且凝块12被移动到倒置元件的凹坑122中。图7e示出了被捕获在腔体内的凝块12,该腔体由倒置元件的凹坑122以及可膨胀元件112的表面形成。
图8a和图8b是表示示例性制造的栓塞捕获装置110的一部分的几何形状(以彼此的相对比例)的附图。图8b为图8a中绘制的装置110的近视图。
本文所包含的描述是本发明的实施方案的示例,并且不旨在以任何方式限制本发明的范围。如本文所述,本发明设想了栓塞捕获装置的多种变型和修改,包括膨胀元件、倒置元件和凝块接合元件的各种相对定位,利用细长构件诸如芯线或同心管的各种构型,将大量材料中的任一种用于每个元件或构件,并入额外元件或构件,利用自膨胀元件,或通过例如移动构件控制元件的膨胀。这些修改将对本领域中的普通技术人员将是显而易见的,并且旨在处于以下权利要求的范围内。

Claims (20)

1.一种用于捕获脉管中的栓塞的装置,包括:
第一细长构件,所述第一细长构件包括穿过其的管腔、近侧端部和远侧端部;
可膨胀元件,所述可膨胀元件定位在所述第一细长构件的所述远侧端部附近,所述可膨胀元件能够在塌缩递送构型和膨胀构型之间膨胀;
可倒置元件,所述可倒置元件定位在所述第一细长构件的所述远侧端部附近,所述可倒置元件能够在塌缩递送构型和膨胀构型之间膨胀,所述可倒置元件能够在所述膨胀构型和倒置构型之间倒置,所述倒置构型形成凹坑;以及
间隙,所述间隙定位在所述可膨胀元件和所述可倒置元件之间,所述间隙的尺寸设定成跨所述栓塞布置。
2.根据权利要求1所述的装置,其中所述可膨胀元件沿着所述第一细长构件定位在所述可倒置元件的远侧。
3.根据权利要求1所述的装置,其中所述间隙定位在连结所述可膨胀元件和所述第一细长构件的第一连结部和连结所述可倒置元件和所述第一细长构件的第二连结部之间。
4.根据权利要求1所述的装置,还包括芯线和远侧线圈,所述芯线包括远侧端部和近侧端部,并且所述远侧线圈定位在所述芯线的所述远侧端部附近。
5.根据权利要求1所述的装置,还包括芯线,所述芯线包括远侧端部和近侧端部,其中所述芯线相对于所述第一细长构件的移动使所述可膨胀元件膨胀。
6.根据权利要求5所述的装置,其中所述可膨胀元件包括直径,所述直径通过所述芯线相对于所述第一细长构件的移动可膨胀和可收缩。
7.根据权利要求1所述的装置,还包括第二细长构件,所述第二细长构件包括远侧端部和近侧端部,其中所述第一细长构件相对于所述第二细长构件的第一移动使所述可倒置元件膨胀。
8.根据权利要求7所述的装置,其中所述第一细长构件相对于所述第二细长构件的第二移动使所述可倒置元件倒置。
9.根据权利要求8所述的装置,其中所述第二移动使得所述间隙的至少一部分被所述凹坑包封。
10.根据权利要求1所述的装置,其中所述可膨胀元件可膨胀至脉管的壁,并且所述可倒置元件可膨胀至所述脉管的壁。
11.一种用于捕获脉管中的凝块的装置,包括:
第一细长构件,所述第一细长构件包括近侧端部和远侧端部;
可膨胀元件,所述可膨胀元件定位在所述第一细长构件的所述远侧端部附近,所述可膨胀元件能够在塌缩递送构型和膨胀构型之间膨胀;
可倒置元件,所述可倒置元件定位在所述第一细长构件的所述远侧端部附近,所述可倒置元件能够在塌缩递送构型和膨胀构型之间膨胀,所述可倒置元件能够在所述膨胀构型和倒置构型之间倒置;以及
凝块接合元件,所述凝块接合元件定位在所述可膨胀元件和所述可倒置元件之间。
12.根据权利要求11所述的装置,其中所述凝块接合元件为定位在所述第一细长构件上的可膨胀结构,所述可膨胀结构包括塌缩递送构型和膨胀构型,其中所述凝块接合元件从所述塌缩递送构型自膨胀至所述膨胀构型。
13.根据权利要求12所述的装置,其中所述凝块接合元件的至少一部分以所述膨胀构型接合所述凝块,并且在从所述膨胀构型到凝块夹紧构型的移动中夹紧所述凝块。
14.根据权利要求13所述的装置,其中当所述可倒置元件处于所述倒置构型时,所述凝块接合元件的至少一部分被所述可倒置元件包封。
15.根据权利要求11所述的装置,还包括芯线和第二细长构件,
其中所述芯线相对于所述第一细长构件的移动使所述可膨胀元件膨胀,
其中所述第一细长构件相对于所述第二细长构件的第一移动使所述可倒置元件膨胀,并且
其中所述第一细长构件相对于所述第二细长构件的第二移动使所述可倒置元件倒置。
16.根据权利要求11所述的装置,其中所述可膨胀元件定位在所述可倒置元件的远侧,并且所述凝块接合元件定位在所述可倒置元件的远侧和所述可膨胀元件的近侧。
17.一种从脉管捕获栓塞的方法,包括以下步骤:
提供栓塞捕获装置,其中所述栓塞捕获装置包括芯线、可膨胀元件、可倒置元件、以及定位在所述可膨胀元件和所述可倒置元件之间的间隙;
跨所述栓塞布置所述间隙;
使用至少所述芯线将所述可膨胀元件从塌缩递送构型膨胀至膨胀构型;
将所述可倒置元件从塌缩递送构型膨胀至膨胀构型;
将所述可倒置元件从所述膨胀构型倒置成倒置构型以形成凹坑;
由所述凹坑包封所述间隙的至少一部分;以及
在所述凹坑中捕获所述栓塞。
18.根据权利要求17所述的方法,还包括在由所述凹坑和所述可膨胀元件的表面形成的腔体内包封所述栓塞。
19.根据权利要求17所述的方法,其中所述栓塞捕获装置还包括芯线、第一细长构件和第二细长构件,所述方法还包括以下步骤:
使所述芯线相对于所述第一细长元件移动,以使得所述可膨胀元件膨胀;
使所述第一细长构件相对于所述第二细长构件移动,以使得所述可倒置元件膨胀;
使所述第一细长构件相对于所述第二细长构件移动,以使得所述可倒置元件倒置;
使所述第一细长构件相对于所述第二细长构件移动,以使得包封所述间隙的所述至少一部分;以及
使所述第一细长构件相对于所述第二细长构件移动,以使得在所述凹坑中捕获所述栓塞。
20.根据权利要求17所述的方法,其中所述栓塞捕获装置还包括凝块接合元件,所述方法还包括以下步骤:
将所述凝块接合元件从塌缩递送构型膨胀至膨胀构型,从而接合所述栓塞;以及
将所述凝块接合元件从所述膨胀构型移动至凝块夹紧构型,从而夹紧所述栓塞。
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