CN111097094A - Micro-catheter for microvascular nerve decompression - Google Patents
Micro-catheter for microvascular nerve decompression Download PDFInfo
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- CN111097094A CN111097094A CN201911238759.2A CN201911238759A CN111097094A CN 111097094 A CN111097094 A CN 111097094A CN 201911238759 A CN201911238759 A CN 201911238759A CN 111097094 A CN111097094 A CN 111097094A
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Images
Classifications
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- 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
- A61M25/10—Balloon 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
- A61M25/0043—Catheters; Hollow probes characterised by structural features
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- 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
- A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
- A61M2025/0042—Microcatheters, cannula or the like having outside diameters around 1 mm or less
-
- 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
- A61M25/0043—Catheters; Hollow probes characterised by structural features
- A61M2025/0057—Catheters delivering medicament other than through a conventional lumen, e.g. porous walls or hydrogel coatings
-
- 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
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/1063—Balloon catheters with special features or adapted for special applications having only one lumen used for guide wire and inflation, e.g. to minimise the diameter
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- 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
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/1079—Balloon catheters with special features or adapted for special applications having radio-opaque markers in the region of the balloon
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Hematology (AREA)
- Engineering & Computer Science (AREA)
- Anesthesiology (AREA)
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- General Health & Medical Sciences (AREA)
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- Child & Adolescent Psychology (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Materials For Medical Uses (AREA)
Abstract
The invention provides a micro catheter for microvascular nerve decompression, which comprises a storage bag (1), a release mechanism (4) connected with the storage bag (1) in a releasable way and a release switch (7) controlling the release mechanism in sequence from a far end to a near end in the length direction of the micro catheter, wherein a decompression pad (2) is arranged in the storage bag. When the micro catheter for the nerve decompression is used for the microvascular nerve decompression, the micro catheter has the excellent effects of no craniotomy, low risk, small micro wound, quick operation, short recovery time, retained nerve function, high long-term curative effect and the like.
Description
Technical Field
The invention relates to a medical instrument, in particular to a micro catheter for microvascular nerve decompression.
Background
Facial spasm, also known as facial spasm, is a functional disease of cranial nerves. In the onset of disease, the hemilateral muscle paroxysmal involuntary twitching is caused because nerves in the cranium memory area of a patient are compressed by blood vessels and are positioned at the branches of the anterior inferior cerebellar artery or the posterior inferior cerebellar artery.
Trigeminal neuralgia is the most common cranial nerve disease, which is mainly manifested by paroxysmal severe pain repeatedly attacking in a trigeminal region at one side, the domestic counted incidence rate is 52.2/10 ten thousand, women are slightly more than men, and the incidence rate is increased with the age of the middle-aged and the elderly. The disease is characterized by severe pain in trigeminal nerve distribution region, such as sudden incisional sensation and burning sensation which are difficult to endure. Often, washing the face, brushing teeth, and even walking can result in paroxysmal and intense pain. Pain takes seconds or minutes, and the pain occurs periodically and is intolerable.
Aiming at the two diseases, at present, the microvascular decompression is mainly used for treatment in medical treatment, during the operation, a small incision is made behind the sick lateral ear of a patient, a small hole is drilled from the skull to enter the cranium, and a responsible vessel for compressing the facial nerve is found at the root part of the facial nerve. Then, it is slowly pushed away from the root of facial nerve, and a spacer, such as polytetrafluoroethylene or dacron spacer, is placed between them to completely separate blood vessel and facial nerve, so that the blood vessel does not press nerve any more, and the operation is finished.
Microvascular decompression was first proposed in 1967 by professor Jannatta and has now become the standard treatment for trigeminal neuralgia. The advantage is that the local vascular compression can be relieved, the intact trigeminal nerve sensory conduction can be maintained, and the loss of facial sensation can not occur. The operation has obvious effect, can solve the problems once and for all, has the effective rate of over 95 percent, low recurrence rate and small side effect.
However, since the operation belongs to craniotomy, the risk is high, the doctor operates under a microscope, and the action must be gentle, otherwise the neurovascular is easily damaged. In addition, when the stained tissue is separated or the cotton pad is placed, peripheral microvasculature is often touched or nerves are often squeezed, which causes nerve injury or bleeding, thereby affecting the success rate and the recurrence rate of the operation.
To overcome the above problems, patent document 1 proposes a push rod device for delivering a cotton pad patch, which attempts to perform a microvascular decompression operation with a single instrument. However, the patient still needs general anesthesia and performs the craniotomy, which can reduce the nerve injury caused by the operation but still can not avoid the risk caused by the craniotomy.
In addition, in recent years, a surgical method for treating trigeminal neuralgia by percutaneous puncture of a balloon has been developed, and the operation is to paralyze nerve sensation by compressing a ganglion by the balloon, thereby reducing pain caused by vascular compression. Although the minimally invasive surgery is simple and convenient to operate and high in safety, the problems that the complete function of nerves cannot be reserved, the long-term curative effect is lower than that of a craniotomy and the like still exist.
Documents of the prior art
Patent document 1: CN205107771U
Disclosure of Invention
The mode of pressing the ganglion by the saccule in the prior art to treat trigeminal menstrual pain is to press the ganglion to be paralyzed and necrotized by the force spread by the saccule, and the pain can not be transferred due to the nerve paralysis and necrosis, so that the trigeminal neuralgia can be necessarily relieved, but the normal nerve function is damaged at the same time, and sequelae such as facial paralysis, facial paralysis and the like are frequently generated clinically.
In view of the above problems in the prior art, the present invention provides a micro-catheter for nerve decompression, which separates a blood vessel from a nerve by a balloon decompression pad without causing irreversible damage to the nerve, and thus, when performing decompression surgery using the micro-catheter, the micro-catheter not only has a small opening wound and reduces the risk of craniotomy, but also reduces the use of surgical instruments and the risk of nerve injury.
In order to solve the above problems, the present invention proposes the following specific solutions:
a micro catheter for microvascular nerve decompression characterized in that it comprises in order from the distal end to the proximal end in its length direction a reservoir bag having a decompression pad therein, a release mechanism releasably connected to the reservoir bag, and a release switch controlling the release mechanism.
In the above-described microcatheter for microvascular nerve decompression, preferably, the reservoir is made of a degradable polymer or polysaccharide, and has degradability and flexibility.
In the micro catheter for microvascular nerve decompression, the reservoir is preferably composed of a mixture of 1 or more selected from the group consisting of polylactic acid, cellulose, hyaluronic acid, alginic acid, gelatin and wood.
In the above-mentioned microcatheter for microvascular nerve decompression, preferably, the decompression pad is made of polytetrafluoroethylene, dacron, polyvinyl alcohol or nylon having bio-inertness.
In the micro catheter for microvascular nerve decompression, preferably, a joining portion for connecting to a release mechanism is provided at a trailing end of the reservoir.
In the micro catheter for microvascular nerve decompression, preferably, the head end of the reservoir and the tail end of the reservoir are provided with a visualization mark, respectively.
In the above-described microcatheter for microvascular nerve decompression, preferably, the visualization marker is ferroferric oxide, iron particles, barium sulfate, zirconium dioxide, tantalum metal, or platinum.
In the micro catheter for microvascular nerve decompression, preferably, the release mechanism is a magnetic release mechanism, an electrochemical release mechanism, a latch release mechanism, a screw release mechanism, or a liquid degradation mechanism.
Effects of the invention
Through the micro-catheter, the opening wound is small, the craniotomy risk is reduced, the use of surgical instruments is reduced, and the risk of nerve injury is reduced.
Drawings
Fig. 1 is a schematic view of a micro-catheter for microvascular nerve decompression in accordance with one embodiment of the present invention.
FIG. 2 is a schematic diagram showing neuralgia caused by the compression of responsible blood vessels due to pathological changes of trigeminal nerve.
Fig. 3 is a flowchart showing a decompression operation performed by using the micro catheter for microvascular nerve decompression of the present invention.
Fig. 4 is a flowchart showing a decompression operation performed by using the micro catheter for microvascular nerve decompression of the present invention.
Description of the reference numerals
1. Storing the bags; 2. a pressure reducing pad; 31. a head end of the reservoir; 32, a first step of removing the first layer; the tail end of the storage bag; 4. a release mechanism; 5. a metal guide wire; 6. a hose; 7. releasing the switch; 8; a large conduit; 9. the trigeminal nerve; 10. culprit blood vessel
Detailed Description
The present invention will be described in detail below with reference to the accompanying drawings. However, the present invention is not limited thereto.
Structure of microcatheter of the present invention
FIG. 1 is a schematic view of a microcatheter according to one embodiment of the invention. As shown in fig. 1, the microcatheter is provided with a reservoir (1), a release mechanism (4) detachably connected to the reservoir (1), and a release switch (7) for controlling the release mechanism (4) in this order from the distal end (end away from the operator) to the proximal end in the longitudinal direction.
The present inventors have conducted extensive studies in order to deliver a pressure-reducing pad to a target site, and have found that it is difficult and difficult to deliver a pressure-reducing pad using a catheter or the like, and therefore, the present inventors have achieved the above-mentioned object of the present invention by employing a degradable storage bag which can be easily delivered, and which can degrade itself to release a pressure-reducing pad after reaching a target site. The reservoir (1) used in the present invention has degradability and flexibility, and is preferably composed of a degradable polymer or polysaccharide, and for example, it is composed of 1 or a mixture of 1 or more selected from polylactic acid, cellulose, hyaluronic acid, alginic acid, gelatin and wood. The storage bag (1) is internally provided with a pressure reducing pad (2), the pressure reducing pad (2) is made of bio-inert Polytetrafluoroethylene (PTFE), terylene (Dacron), polyvinyl alcohol (PVA), Nylon (Nylon) and the like, and for example, a pressure reducing cotton pad can be adopted. When the pressure reducing pad is placed between nerves and blood vessels, the pressure reducing pad can play a role for a long time due to biological inertia, thereby preventing neuralgia caused by nerve compression by responsible blood vessels.
In the invention, the two ends of the storage bag (1) are respectively provided with a head end (31) of the storage bag and a tail end (32) of the storage bag, the tail end (32) of the storage bag can be provided with a combination part for connecting with a release mechanism, and in addition, the head end (31) and the tail end (32) of the storage bag can be respectively provided with a developing mark for an operator to confirm the position.
The developing mark may be a magnetic mark such as ferroferric oxide or iron particles. When a magnetic visualization marker is used at the trailing end (32) of the reservoir, the visualization marker can simultaneously serve as a binding site for effecting attachment to the detachment mechanism in conjunction with the magnetic catheter. The development mark may be a mark having no magnetism, such as barium sulfate, zirconium dioxide, tantalum metal, platinum, or the like. As described above, the developing marks are respectively arranged at the head end (31) and the tail end (32) of the storage bag, so that an operator can be helped to accurately arrange the pressure reduction pad at a target position, and the pressure reduction effect is improved.
When the storage bag (1) is conveyed to a target point through the releasing mechanism (4), the releasing mechanism (4) is separated from a combined part arranged at the tail end (32) of the storage bag by controlling the releasing switch (7), so that the storage bag (1) is placed at the target point, and after the storage bag (1) is degraded, the pressure reducing pad (2) stored in the storage bag is released to play a pressure reducing role. The release mechanism may be, for example, a magnetic release mechanism, an electrochemical release mechanism, a trip release mechanism, a screw release mechanism, or a liquid degradation mechanism.
As shown in fig. 1, the release mechanism (4) in the microcatheter of the present embodiment is connected to a release switch (7) via a metal guide wire (5) provided in a hose (6), and the operator controls the release mechanism (4) by closing the release switch (7) to place the reservoir (1) at a target position.
Procedure for operating the microcatheter of the invention
In the operation process, the operation is performed under general anesthesia, and the patient can adopt a supine position. The puncture needle-inserting point is 2.5 cm outside the affected side corner of mouth, and the other two reference points are the inner edge of the pupil and the front 3 cm of the horizontal external auditory canal of zygomatic arch on the same side. The foramen ovale was punctured with a 14 gauge needle under X-ray fluoroscopy guidance. The needle core is withdrawn when the needle tip reaches the foramen ovale of the skull base, and then the microcatheter of the present invention is slowly pushed into the region of the Mackel sac (Meckel cave) through the puncture needle.
In one embodiment, the puncture needle is removed from the patient's facial skin by puncturing the needle through the foramen ovale to the region of the Mach's sac, the microcatheter of the present invention is slowly pushed to the affected area, the storage sac is placed in the vascular compression nerve site with the help of X-rays through the visualization markers provided at the head and tail ends of the storage sac, the responsible vessel and the compressed nerve are isolated, after placement is completed, the release mechanism is controlled by the release switch, the storage sac and the microcatheter are separated, and the microcatheter is slowly withdrawn. According to the situation, the process is repeated to place the pressure reduction pad so as to achieve complete pressure reduction of the microvasculature. .
Examples
The present invention will be described in further detail below with reference to examples.
The microcatheter of this example was constructed as follows: the storage bag is made of cellulose, the decompression pad is made of medical grade pure polytetrafluoroethylene, the developing mark is magnetic ferroferric oxide and can also act on a combination part connected with the releasing mechanism, and the releasing mechanism realizes the combination and separation of the storage bag and the guide wire through the principle of magnetic adsorption.
An operator controls the release switch (7), the component with the magnet inside conducts the magnetic field to the front end of the guide wire through the near end of the guide wire, the component is combined with a magnetic combination part arranged at the tail end of the storage bag (the interior of the storage bag is provided with a pressure reduction pad), the storage bag is combined and then slowly pushed to an affected part, and then the release switch (7) is operated to separate the component with the magnet inside from the near end of the guide wire, so that the magnetic field at the front end of the guide wire disappears instantly, and the front end of the guide wire is separated from the storage bag. After the placement is finished, the reservoir bag is degraded in the environment filled with cerebrospinal fluid, the decompression pad is released, and then the decompression pad plays a role in permanently isolating responsible blood vessels from nerves, so that the purpose of nerve decompression is achieved.
See in particular fig. 2-4. FIG. 2 is a schematic view showing neuralgia caused by the compression of the trigeminal nerve (9) by the affected blood vessel (10) due to a lesion or the like. Fig. 3 is a flowchart showing a decompression operation performed by using the micro catheter for microvascular nerve decompression of the present invention. As shown in figure 3, after the micro catheter enters an affected part, the storage bag (1) is placed at a position where a blood vessel presses nerves through the developing marks arranged at the head end and the tail end of the storage bag to separate a responsible blood vessel (10) and the pressed trigeminal nerve (10), after the placement is finished, an operator controls the release mechanism (4) through the release switch (7), separates the storage bag from the micro catheter, and slowly extracts the micro catheter. If desired, the above procedure may be repeated to place multiple reservoirs to achieve complete depressurization of the microvasculature as shown in figure 4.
Claims (8)
1. A micro catheter for microvascular nerve decompression characterized in that it comprises in order from the distal end to the proximal end in its length direction a reservoir bag having a decompression pad therein, a release mechanism releasably connected to the reservoir bag, and a release switch controlling the release mechanism.
2. The microcatheter of claim 1, wherein said reservoir is comprised of a degradable polymer or polysaccharide and has degradability and flexibility.
3. The microcatheter of claim 2, wherein the reservoir is comprised of a mixture of 1 or more selected from the group consisting of polylactic acid, cellulose, hyaluronic acid, alginic acid, gelatin, and wood.
4. The microcatheter of claim 1, wherein the reduced pressure pad is comprised of biologically inert polytetrafluoroethylene, dacron, polyvinyl alcohol, or nylon.
5. The microcatheter of claim 1, wherein a binding site is provided at the trailing end of the reservoir for connection to a release mechanism.
6. The microcatheter of claim 1, wherein a visualization mark is provided at the head end of the reservoir and at the tail end of the reservoir, respectively.
7. The microcatheter of claim 6, wherein the visualization marker is ferroferric oxide, iron particles, barium sulfate, zirconium dioxide, tantalum metal, or platinum gold.
8. The microcatheter of claim 1, wherein said release mechanism is a magnetic release mechanism, an electrochemical release mechanism, a bayonet release mechanism, a screw release mechanism, or a liquid degradation mechanism.
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| WO2024141935A1 (en) * | 2022-12-27 | 2024-07-04 | Hadasit Medical Research Services And Development Ltd. | Spinal treatment apparatus and method |
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