CN111281484A - Filter screen assembly for removing pulmonary embolism thrombus and thrombus suction assembly - Google Patents
Filter screen assembly for removing pulmonary embolism thrombus and thrombus suction assembly Download PDFInfo
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- 208000007536 Thrombosis Diseases 0.000 title claims abstract description 186
- 208000010378 Pulmonary Embolism Diseases 0.000 title claims abstract description 35
- 238000002955 isolation Methods 0.000 claims abstract description 54
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- 238000013151 thrombectomy Methods 0.000 claims 6
- 229910003460 diamond Inorganic materials 0.000 claims 2
- 239000010432 diamond Substances 0.000 claims 2
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- 206010051055 Deep vein thrombosis Diseases 0.000 description 2
- 206010047249 Venous thrombosis Diseases 0.000 description 2
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- 230000023555 blood coagulation Effects 0.000 description 1
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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
- A61B17/22—Implements 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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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements 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
- A61B2017/22079—Implements 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 suction of debris
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Abstract
The invention relates to the technical field of medical instruments and discloses a filter screen assembly and a thrombus suction assembly for clearing pulmonary embolism and thrombus. This filter screen subassembly includes: the thrombus crushing filter screen, the first isolation filter screen and the second isolation filter screen can be elastically expanded in the radial direction and are coaxially arranged; the broken filter screen of thrombus set up in first keep apart the filter screen and between the filter screen is kept apart to the second. The thrombus aspiration assembly comprises: the thrombus suction tube, the thrombus output tube, the thrombus aspirator and the connecting seat with a hollow channel; the hollow channel is used for passing through the received filter screen assembly; the thrombus suction pipe is arranged at the front end of the connecting seat, the flexible sealing valve is arranged at an opening at the rear end of the connecting seat, the inner end of the thrombus output pipe is connected with the side face of the connecting seat, and the outer end of the thrombus output pipe is connected with the thrombus aspirator. The embodiment can effectively remove large thrombus of the pulmonary embolus, reduce the complexity of the operation and shorten the operation time.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a filter screen assembly and a thrombus suction assembly for clearing pulmonary embolism and thrombus.
Background
Acute Pulmonary Embolism (PE) is a common cardiovascular system disease in China, is a clinical and pathophysiological syndrome of pulmonary circulation disorder caused by the blockage of pulmonary artery by endogenous or exogenous emboli, is usually caused by the thrombus drop due to the deep venous thrombosis of lower limb, has high fatality rate, and seriously harms the health and the life quality of patients. Pulmonary thromboembolism is the most common type of acute pulmonary embolism PE, and deep vein thrombosis is the major source of thrombus that causes pulmonary thromboembolism.
Acute pulmonary embolism is a condition that the pulmonary circulation of acute development presents with disorder, and the most important is that patients present with symptoms of dyspnea, chest distress and even death. Clinical studies now show that the mortality rate of pulmonary embolism is high, and the main method for treating pulmonary embolism is surgical treatment, which is carried out in time after the disease occurs, so as to avoid the death of patients caused by recurrence.
The traditional operation mode for treating pulmonary embolism mainly comprises incision for thrombus removal and pulmonary artery intimal stripping, and the traditional operation mode has large wound. Intravascular therapy has now become an effective and important treatment for acute pulmonary embolism. At present, the common treatment modes mainly comprise treatment operation modes such as guide wire catheter thrombus breaking, thrombus suction, catheter thrombus dissolving and the like. When the existing apparatus is used alone to remove thrombus, the effect of removing massive pulmonary artery thrombus is not ideal, and when a plurality of operation modes are used, the operation is complex, the operation time is long, and the cost is high.
Disclosure of Invention
The invention aims to provide a filter screen assembly and a thrombus suction assembly for clearing thrombus of pulmonary embolism, which can effectively clear massive thrombus of the pulmonary embolism, reduce the complexity of the operation and shorten the operation time.
To solve the above technical problems, embodiments of the present invention provide a filter screen assembly for pulmonary embolism thrombus removal, comprising:
the thrombus crushing filter screen, the first isolation filter screen and the second isolation filter screen can be elastically expanded in the radial direction and are coaxially arranged; the broken filter screen of thrombus set up in first keep apart the filter screen and between the filter screen is kept apart to the second.
Embodiments of the present invention also provide a thrombus aspiration assembly for pulmonary embolism thrombus removal, comprising: the thrombus suction pipe, the thrombus output pipe, the thrombus aspirator and the connecting seat;
the inner end of the thrombus suction pipe is connected with the connecting seat, the thrombus suction pipe and the connecting seat form a channel, and the channel is used for penetrating the accommodated filter screen assembly;
and a flexible sealing valve is arranged at the opening of the channel of the connecting seat, the inner end of the thrombus output tube is connected with the side surface of the connecting seat, and the outer end of the thrombus output tube is connected with the thrombus aspirator.
The filter screen component comprises a thrombus crushing filter screen, a first isolation filter screen and a second isolation filter screen which can be elastically expanded in the radial direction and are coaxially arranged, the thrombus crushing filter screen is arranged between the first isolation filter screen and the second isolation rate screen, the filter screen component can be contained in a filter screen recovery pipe before use, and can be automatically expanded in the radial direction when the filter screen recovery pipe is withdrawn, so that effective thrombus crushing is realized in the process, a large pulmonary artery thrombus can be crushed, and the first isolation filter screen and the second isolation filter screen are respectively arranged at two ends of the thrombus crushing filter screen, so that the crushed large thrombus can be filtered and intercepted, and the crushed smaller thrombus is prevented from escaping to block a far-end blood vessel; simultaneously, the thrombus suction assembly that this embodiment provided can use with the filter screen subassembly cooperation, and the filter screen subassembly accessible thrombus suction assembly's that is in the accepting state passageway penetrates and is pushed to broken position of embolia to the thrombus suction that accessible thrombus suction tube, thrombus output tube and thrombus aspirator will break away goes out. On the basis that the filter screen subassembly of this embodiment can break the bold thrombus effectively, the cooperation thrombus suction subassembly is smoked, can improve the thrombus greatly and clear up the effect, consequently, the bold pulmonary artery thrombus can effectively be clear up to this embodiment, reduces the operation complexity, shortens the operation time.
In one embodiment, the first and second isolation filters are ellipsoidal; the thrombus crushing filter screen is in a lantern shape.
As an embodiment, the thrombus crushing filter screen, the first isolation filter screen and the second isolation filter screen are all woven by elastic thin metal wires.
In one embodiment, the meshes of the first and second separating screens are diamond-shaped or approximately diamond-shaped.
As an embodiment, developing points are arranged at two ends of the thrombus breaking filter screen, two ends of the first isolation filter screen and two ends of the second isolation filter screen.
As an embodiment, the screen assembly further comprises: a filter screen recovery device;
the filter screen recovery unit includes: a filter screen recovery pipe and a recovery pipe seat which are fixedly connected;
broken filter screen of thrombus, first isolation filter screen and second keep apart the filter screen all accomodate in the filter screen recovery tube.
As an embodiment, the outer end of the first isolation filter screen is provided with a tip soft head, the inner end of the second isolation filter screen is connected with a perfusion liner pipe, the other end of the perfusion liner pipe is provided with a perfusion pipe seat, and the side surface of the perfusion pipe seat is provided with a medicine injection connector.
As an embodiment, a plurality of diversion grooves which are parallel to the axis and are circumferentially distributed are arranged between two ends of the pouring liner tube, and a plurality of micropores communicated with the diversion grooves are arranged on the outer side surface of the front end of the pouring liner tube.
As an embodiment, a valve is arranged at the joint of the thrombus aspirator and the thrombus output tube.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly introduced below, it is understood that the drawings in the following description are only embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to the provided drawings without creative efforts.
FIG. 1 is a schematic diagram of a screen assembly according to an embodiment of the present disclosure;
FIG. 2 is a schematic diagram of an embodiment of an isolation filter;
FIG. 3 is a schematic diagram of a thrombus-breaking filter according to an embodiment;
FIG. 4 is a schematic view of an embodiment of a connection structure between an irrigation liner and an irrigation tube seat;
FIG. 5 is a schematic view of a portion of an embodiment of an irrigation liner;
FIG. 6 is a schematic view of a thrombus aspiration assembly provided in one embodiment;
fig. 7 is a schematic structural view of a flexible sealing valve according to an embodiment;
FIG. 8 is a schematic view of an embodiment of a filter screen assembly and a thrombus extraction assembly in use;
figure 9 is a schematic view of a retracted state of the screen assembly according to one embodiment.
In the figure: the thrombus crushing device comprises a filter screen assembly 1, a first isolation filter screen 11, a thrombus crushing filter screen 12, a first isolation filter screen 13, a developing point 14, a mesh hole 15, an arc-shaped part 16, a filter screen recycling pipe 17, a recycling pipe seat 18, a pouring liner pipe 21, a pouring pipe seat 22, a medicine injection joint 23, a tip soft head 24, a micropore 211, a diversion trench 212, a connecting pipe 31, a thrombus suction pipe 32, a flexible sealing valve 33, a thrombus output pipe 34, a valve 35, a thrombus aspirator 36, a puncture inner core 41 and an inner core connecting seat 42.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention more apparent, embodiments of the present invention will be described in detail below with reference to the accompanying drawings. However, it will be appreciated by those of ordinary skill in the art that numerous technical details are set forth in order to provide a better understanding of the present application in various embodiments of the present invention. However, the technical solutions claimed in the claims of the present application can be implemented without these technical details and with various changes and modifications based on the following embodiments.
The present embodiments provide a screen assembly for pulmonary embolism thrombus removal. As shown in fig. 1 to 3, the screen assembly 1 includes: the thrombus crushing filter screen 12, the first isolation filter screen 11 and the second isolation filter screen 13 are elastically expandable in the radial direction and are coaxially arranged; the thrombus breaking filter 12 is arranged between the first isolation filter 11 and the second isolation filter 13.
The filter screen subassembly of this embodiment can be accomodate in filter screen recovery unit before using, and in use is pushed to pulmonary embolism thrombus position department, makes bold thrombus fragment through the broken filter screen of thrombus to first isolation filter screen and second are kept apart the filter screen and are filtered the broken fritter thrombus that drops of interception respectively from the both sides of the broken filter screen of thrombus, prevent that the less thrombus escape after the breakage from blockking up distal end blood vessel. Therefore, the filter screen component of the embodiment is matched with other suitable pulmonary embolism and thrombus removing instruments for use, so that large pulmonary embolism and thrombus can be effectively removed, the complexity of the operation is reduced, and the operation time is shortened.
Optionally, broken filter screen 12 of thrombus is the lantern form, the broken filter screen 12 of thrombus of lantern form has the 16 structures of arc portion, can be in pulmonary artery bold thrombus department extrusion tear the thrombus and do not harm the blood vessel, and the broken filter screen 12 of thrombus of lantern form has stronger holding power performance, can be in bold thrombus department extrusion tear thrombus, the broken filter screen 12 of thrombus of lantern form simultaneously exerts the pulling force to the thrombus when opening, carry out mechanical stretching to the thrombus, thereby reach the broken purpose of thrombus in making bold pulmonary artery.
The first isolation filter screen 11 and the second isolation filter screen 13 are both in an ellipsoidal shape, so that broken thrombus can be better filtered and intercepted.
Optionally, the thrombus-breaking filter 12, the first isolation filter 11, and the second isolation filter 13 are all woven by elastic fine metal wires. The present embodiment is not limited to this, and the filter screen assembly may be manufactured by other processing techniques.
Optionally, in this embodiment, the meshes 15 of the first isolation filter screen 11 and the second isolation filter screen 13 are both rhombic or approximately rhombic and are regularly arranged on the first isolation filter screen 11 and the second isolation filter screen 13, so as to better filter and intercept the broken thrombus. In this embodiment, neither the mesh structures nor the arrangement of the first isolation filter 11 and the second isolation filter is specifically limited, and it should be understood that in some applications, the mesh structures may also be triangular or other mesh structures with good filtering performance.
Optionally, the two ends of the thrombus-breaking filter 12, the two ends of the first isolation filter 11, and the two ends of the second isolation filter 13 are provided with developing points 14. Therefore, the position of the massive thrombus can be better assisted and accurately positioned. The present embodiment is not particularly limited with respect to the number and the arrangement positions of the development sites 14, as long as it is advantageous to accurately locate the position of the thrombus.
Optionally, the screen assembly 1 may further comprise: a filter screen recovery device; the filter screen recovery unit includes: a filter screen recovery pipe and a recovery pipe seat which are fixedly connected; broken filter screen 12 of thrombus, first isolation filter screen 11 and second are kept apart filter screen 13 and are all accomodate in the filter screen recovery tube. The thrombus-breaking sieve 12, the first isolation sieve 11 and the second isolation sieve 13 are released and recovered in the following manner.
In some applications, as shown in fig. 4 to 5, the outer end of the first isolation filter screen 11 is provided with a tip soft head 24, the inner end of the second isolation filter screen 13 is connected to the perfusion liner 21, the other end of the perfusion liner 21 is provided with a perfusion tube seat 22, and the side surface of the perfusion tube seat 22 is provided with a drug injection joint 23. The soft tip 24 does not damage the blood vessel during the pushing of the filter assembly to the thrombus site, and facilitates the pushing of the filter assembly.
Optionally, a plurality of diversion grooves 212 are arranged between two ends of the pouring liner 21 and are parallel to the axis and distributed along the circumference, and a plurality of micropores 211 communicated with the diversion grooves are arranged on the outer side surface of the front end of the pouring liner 21. Pour into bushing pipe 21 and pour into tube socket 22 and not only can be used for propelling movement filter screen subassembly to thrombus position, can withdraw filter screen subassembly moreover to, still can pour into the thrombolysis medicine into through pouring into bushing pipe 23, prevent that the xenogenous invasion from causing the blood coagulation to produce the thrombus. The pushing and withdrawing device of the screen assembly is not particularly limited in this embodiment, and in some applications, other apparatuses may be used to push and withdraw the screen assembly.
The filter screen subassembly of this embodiment can cooperate other pulmonary embolism thrombus to clear up the apparatus and use, can take out at the pulmonary embolism thrombus in-process of clearing up and get rid of the pulmonary embolism thrombus to the thrombus that the filtration interception was broken prevents that it from escaping and blockking up distal end blood vessel, thereby can realize effectively clearing away of bold pulmonary artery thrombus, reduces the operation complexity, shortens operation time.
The present embodiment provides a thrombus suction assembly for pulmonary embolism thrombus removal, as shown in fig. 6, the thrombus suction assembly 3 includes: a thrombus suction pipe 32, a thrombus output pipe 34, a thrombus aspirator 36 and a connecting seat 31; the inner end of the thrombus suction tube 32 is connected with the connecting seat 31, and the thrombus suction tube 32 and the connecting seat 31 form a channel for penetrating the accommodated filter screen assembly as in the previous embodiment; a flexible sealing valve 33 is arranged at the opening of the channel of the connecting seat 31, the inner end of the thrombus output tube 34 is connected with the side surface of the connecting seat 31, and the outer end of the thrombus output tube 34 is connected with the thrombus aspirator 36. Optionally, a valve 35 is provided at the junction of the thrombus aspirator 36 and the thrombus output tube 34.
In this embodiment, a large gap is formed between the thrombus suction tube 32 and the screen recovery tube on which the screen assembly is mounted, and a guide gap is formed therebetween, and the thrombus output tube 34 communicates with the guide gap, so that the thrombus in the thrombus suction tube 32 can be sucked by the thrombus aspirator 36.
As shown in fig. 7, in the present embodiment, the flexible sealing valve 33 is made of a soft medical material, and the flexible sealing valve 33 has a closed sealing structure 331.
Alternatively, the thrombus output tube 34 may be detachably connected to the connection holder 31, but not limited thereto, and may be fixedly connected thereto.
With reference to the accompanying drawings, the method for using the filter screen assembly and the thrombus extraction assembly in a matching manner comprises the following steps:
in the acute pulmonary embolism removal thrombus operation treatment, an instrument intervention channel is established in a femoral vein vessel through a puncture needle, a guide wire, a catheter and a small-size puncture sheath. The catheter is introduced into the central pulmonary artery by an intravascular interventional channel technology, and then selective main pulmonary artery radiography, pulmonary artery detection and digital subtraction pulmonary artery radiography are carried out to determine the position of the pulmonary artery thrombus in the blood vessel. The replacement angiographic catheter is a guide wire (which is introduced and then withdrawn from the catheter). The catheter is replaced by the combination of the thrombus aspiration component, the puncture inner core 41, the inner core connecting seat 42 and the like shown in fig. 6, the puncture inner core 41 has a tip structure, the puncture inner core 41 is matched with the thrombus aspiration tube 32 to puncture a blood vessel easily, then the puncture inner core 41 is drawn out through the inner core connecting seat 42, and the thrombus aspiration component is reserved, wherein the puncture inner core 41 and the inner core connecting seat 42 do not belong to the thrombus aspiration component. Then, the filter screen assembly loaded in the filter screen recovery device is pushed to the proximal occlusion part of the pulmonary artery or the part with the maximum thrombus content, as shown in fig. 8, the filter screen assembly with the tip soft head 24 and the perfusion liner tube 21 is pushed to the part with the large thrombus content, the filter screen assembly is loaded in the filter screen recovery tube 17 in the pushing process, the filter screen assembly can be positioned by passing through the developing point 14 on the filter screen assembly 1 while pushing, and the pushing is stopped when the broken filter screen 12 of the thrombus in the filter screen assembly 1 is determined to be positioned at the position with the maximum thrombus content. The infusion tube holder 22 is then grasped and the infusion liner 21 is held against the screen recovery tube 17 by withdrawing the screen recovery tube through the recovery tube holder 18, releasing the screen assembly 1 so that the screen assembly is fully deployed and the thrombus-breaking screen 12 is fully inserted and broken into large pieces of thrombus. The thrombus delivery tube 34 is connected to the connection holder 31, and the thrombus in the thrombus suction tube 32 is sucked by the thrombus aspirator 36. Then, as shown in fig. 9, the recovery tube base 18 can be held, the perfusion tube base 22 is slowly pulled back, and the thrombus broken off by the screen assembly 1 is pulled into the thrombus suction tube 32 to continue suction until the screen assembly 1 is completely retracted into the screen recovery tube 17, at which time, a part of the thrombus is collected in the screen recovery tube, and is withdrawn out of the body together with the screen recovery tube 17 and the thrombus suction assembly to complete thrombus removal. In practice, the thrombus can be sucked from the thrombus suction tube 32 at any time by using the thrombus suction device 36, and the thrombus can be removed more completely.
The thrombus suction assembly of this embodiment uses with the filter screen subassembly cooperation, and the filter screen subassembly can break away massive thrombus (the thrombus of being difficult to take out through thrombus suction assembly alone) to can filter the thrombus that the interception was broken and prevent that it from escaping and blockking up distal end blood vessel, thereby can also retrieve most thrombus into in the filter screen recovery tube simultaneously and withdraw from extracorporeally, and thrombus suction assembly can in time aspirate away the partial thrombus that breaks away. Thereby effectively removing the massive pulmonary artery thrombus, reducing the complexity of the operation and shortening the operation time.
Although only the use of a screen assembly in conjunction with a thrombus extraction assembly is described herein, it should be understood that the screen assemblies disclosed in the embodiments of the present application may also be used in conjunction with other suitable pulmonary embolectomy devices.
It will be understood by those of ordinary skill in the art that the foregoing embodiments are specific examples for carrying out the invention, and that various changes in form and details may be made therein without departing from the spirit and scope of the invention in practice.
Claims (10)
1. A screen assembly for pulmonary emboli thrombectomy, comprising:
the thrombus crushing filter screen, the first isolation filter screen and the second isolation filter screen can be elastically expanded in the radial direction and are coaxially arranged; the broken filter screen of thrombus set up in first keep apart the filter screen and between the filter screen is kept apart to the second.
2. The screen assembly of claim 1, wherein the first and second isolation screens are each ellipsoidal; the thrombus crushing filter screen is in a lantern shape.
3. The screen assembly of claim 1, wherein the thrombus disruption screen, the first isolation screen, and the second isolation screen are woven from a thin, resilient wire.
4. The screen assembly for pulmonary embolism thrombectomy according to claim 1, wherein the mesh openings of said first and second isolation screens are diamond shaped or approximately diamond shaped.
5. The screen assembly for pulmonary embolism thrombus removal according to claim 1, wherein visualization points are provided at both ends of the thrombus-breaking screen, both ends of the first isolation screen, and both ends of the second isolation screen.
6. The screen assembly for pulmonary embolism thrombectomy according to claim 1, further comprising: a filter screen recovery device;
the filter screen recovery unit includes: a filter screen recovery pipe and a recovery pipe seat which are fixedly connected;
broken filter screen of thrombus, first isolation filter screen and second keep apart the filter screen all accomodate in the filter screen recovery tube.
7. The filter screen assembly for pulmonary embolism and thrombus removal as recited in any one of claims 1 to 6, wherein the outer end of said first isolation filter screen is provided with a sharp soft head, the inner end of said second isolation filter screen is connected with an infusion liner, the other end of said infusion liner is provided with an infusion tube seat, and the side surface of said infusion tube seat is provided with a drug injection connector.
8. The filter screen assembly for pulmonary embolism and thrombus removal of claim 7, wherein a plurality of guide grooves are arranged between two ends of the perfusion liner in parallel with the axis and distributed along the circumference, and a plurality of micropores communicated with the guide grooves are arranged on the outer side surface of the front end of the perfusion liner.
9. A thrombus aspiration assembly for pulmonary embolus thrombectomy, comprising: the thrombus suction pipe, the thrombus output pipe, the thrombus aspirator and the connecting seat;
the inner end of the thrombus suction tube is connected with the connecting seat, the thrombus suction tube and the connecting seat form a channel, and the channel is used for penetrating the accommodated filter screen assembly as claimed in any one of claims 1 to 8;
and a flexible sealing valve is arranged at the opening of the channel of the connecting seat, the inner end of the thrombus output tube is connected with the side surface of the connecting seat, and the outer end of the thrombus output tube is connected with the thrombus aspirator.
10. A thrombectomy assembly according to claim 9, wherein a valve is disposed at the connection between the thrombectomy device and the thrombus delivery tube.
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CN202010216583.7A CN111281484A (en) | 2020-03-25 | 2020-03-25 | Filter screen assembly for removing pulmonary embolism thrombus and thrombus suction assembly |
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CN202010216583.7A CN111281484A (en) | 2020-03-25 | 2020-03-25 | Filter screen assembly for removing pulmonary embolism thrombus and thrombus suction assembly |
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Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN115429381A (en) * | 2022-08-24 | 2022-12-06 | 玮铭医疗器械(上海)有限公司 | Thrombus aspiration catheter device |
WO2023015652A1 (en) * | 2021-08-09 | 2023-02-16 | 上海腾复医疗科技有限公司 | Thrombus removal device |
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