CN111803170A - Interventional medical instrument pusher and interventional medical instrument conveying system - Google Patents
Interventional medical instrument pusher and interventional medical instrument conveying system Download PDFInfo
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- CN111803170A CN111803170A CN201910297390.6A CN201910297390A CN111803170A CN 111803170 A CN111803170 A CN 111803170A CN 201910297390 A CN201910297390 A CN 201910297390A CN 111803170 A CN111803170 A CN 111803170A
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- cable
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- interventional medical
- push
- medical device
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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
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12027—Type of occlusion
- A61B17/12031—Type of occlusion complete occlusion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
- A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
- A61B17/12122—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder within the heart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12159—Solid plugs; being solid before insertion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
- A61B2017/00606—Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
- A61B2017/00623—Introducing or retrieving devices therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B2017/1205—Introduction devices
- A61B2017/12054—Details concerning the detachment of the occluding device from the introduction device
Abstract
The invention provides an interventional medical instrument pusher and an interventional medical instrument conveying system. The interventional medical instrument pusher comprises a pushing cable and a pushing handle which is slidably sleeved on the pushing cable; the pushing handle comprises a frame body and a locking piece arranged in the frame body, and the locking piece moves relative to the frame body to enable the pushing handle to lock or unlock the pushing cable. The interventional medical device delivery system comprises the interventional medical device pusher. The interventional medical instrument pusher and the interventional medical instrument conveying system can be conveniently pushed, the pushing speed is improved, and the operation time is saved.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to an interventional medical instrument pusher and an interventional medical instrument conveying system.
Background
Minimally invasive interventional procedures are becoming more and more popular in clinical applications, and the delivery system of intraluminal interventional medical devices (such as left atrial appendage occluders, vascular plugs, filters, etc.) usually comprises several parts, such as a conveyor, a dilator, a loader, a pusher, etc., wherein the conveyor comprises a delivery sheath and a sheath seat. The channel is built between the conveying sheath tube and the dilator, then the dilator is withdrawn, the interventional medical device is collected into the loader through the pusher, then the sheath tube seat and the loader are connected, and the interventional medical device is guided into the conveying sheath tube through the pusher until the interventional medical device is conveyed to the target position.
Existing pushers typically include a flexible wire cable having a distal end removably attached to the interventional medical device to be delivered, and a push handle secured to a proximal end of the wire cable. At the first arrival of propelling movement intervene medical instrument and have been more close to the most propelling movement in-process of target location, because the steel cable length between handle and the loader entry is longer, the loader entry is kept away from to the handle, the steel cable is flexible again, come the propelling movement cable through the handle and only can make the steel cable take place the bending, the unable effective transmission of propelling movement power, that is to say, the handle of current pusher is in fact inoperative at most propelling movement in-process, the operator can only hold the place that the steel cable is close to the loader entry with the hand and carry out the propelling movement. However, the diameter of the steel cable is small, the holding is inconvenient, and the steel cable pushing speed is limited, so that the operation time is prolonged, and the operation risk is increased.
Disclosure of Invention
The technical problem to be solved by the invention is to provide an interventional medical instrument pusher and an interventional medical instrument conveying system aiming at the defects of the prior art, which can facilitate pushing, improve the pushing speed and save the operation time.
In order to solve the technical problem, the invention firstly provides a pusher for an interventional medical instrument, which comprises a pushing cable and a pushing handle which is slidably sleeved on the pushing cable; the pushing handle comprises a frame body and a locking piece arranged in the frame body, and the locking piece moves relative to the frame body to enable the pushing handle to lock or unlock the pushing cable.
The invention also provides an interventional medical instrument conveying system which comprises a conveyor, a loader and an interventional medical instrument pusher, wherein the conveyor comprises a sheath tube, the loader comprises a loading tube connected to the proximal end of the sheath tube, and the interventional medical instrument pusher comprises a pushing cable and a pushing handle slidably sleeved on the pushing cable; the pushing handle comprises a frame body and a locking piece arranged in the frame body, and the locking piece moves relative to the frame body to enable the pushing handle to lock or unlock the pushing cable. The pushing cable in the interventional medical instrument pusher is movably arranged in the loading tube and the sheath tube in a penetrating mode.
In the interventional medical instrument pusher and the interventional medical instrument conveying system provided by the invention, the pushing handle comprises a frame body and a locking piece arranged in the frame body, and the locking piece moves relative to the frame body to lock or unlock the pushing cable; during the pushing of the interventional medical device, the operator is allowed to repeatedly perform: the pushing handle is used for locking the pushing cable, pushing the pushing cable by using the pushing handle, unlocking the pushing cable by using the pushing handle, sliding the pushing handle to a proper position on the pushing cable and locking the pushing cable by using the pushing handle again, so that the pushing handle can be always conveniently adjusted to a position which is suitable for being held by an operator and is convenient for the operator to push the pushing cable through the pushing handle relative to the pushing cable, and the pushing force of the pushing handle on the pushing cable can be effectively transmitted, therefore, the interventional medical instrument pusher and the interventional medical instrument conveying system can be conveniently pushed, the pushing speed is obviously improved, and the operation time is saved.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings needed to be used in the embodiments will be briefly described below, and it is obvious that the drawings in the following description are some embodiments of the present invention, and it is obvious for those skilled in the art to obtain other drawings based on these drawings without creative efforts.
Fig. 1 is a schematic structural diagram of an interventional medical device delivery system according to a first embodiment of the present invention, which includes a delivery device, a dilator, a loader, a hemostatic valve, and an interventional medical device pusher.
Fig. 2 is a perspective view of a push handle of the interventional medical device pusher of fig. 1.
Fig. 3 is a schematic perspective view of the push handle of fig. 2 from another perspective.
Fig. 4 is a cross-sectional view of the push handle of fig. 2.
FIG. 5 is a schematic view of the interventional medical device pusher of FIG. 1 in one use configuration.
Fig. 6 is a partial cross-sectional view of fig. 5.
FIG. 7 is a partial cross-sectional view of another use configuration of the interventional medical device pusher of FIG. 1.
FIG. 8 is a schematic view of another use configuration of the interventional medical device pusher of FIG. 7.
FIG. 9 is a schematic view of the dilator of FIG. 1 in combination with a delivery apparatus in a dilation assembly.
Fig. 10 is a schematic view of the transporter, loader, and hemostasis valve of fig. 1 after attachment.
Fig. 11 is a schematic view of a first embodiment of the present invention showing a use state of the interventional medical device delivery system.
FIG. 12 is a schematic end view of a push handle of an interventional medical device pusher of a second embodiment of a delivery system for interventional medical devices according to the present invention.
Fig. 13 is a cross-sectional view of fig. 12.
Fig. 14 is an exploded schematic view of fig. 13.
Fig. 15 is a schematic end view of the fastener of fig. 14.
Fig. 16 is a side view of the fastener of fig. 15.
FIG. 17 is a schematic view of a second embodiment of an interventional medical device pusher in accordance with the present invention in a deployed state.
Fig. 18 is a cross-sectional view of fig. 17.
FIG. 19 is a schematic view illustrating another use state of the pusher for an interventional medical device according to the second embodiment of the present invention.
Fig. 20 is a cross-sectional view of fig. 19.
Fig. 21 is a schematic structural diagram of an interventional medical device pusher according to a third embodiment of the present invention.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without any inventive step, are within the scope of the present invention.
Furthermore, the following description of the various embodiments refers to the accompanying drawings, which illustrate specific embodiments in which the invention may be practiced. Directional phrases used in this disclosure, such as "upper," "lower," "front," "rear," "left," "right," "inner," "outer," "side," and the like, refer only to the direction of the appended figures and, therefore, are used in order to better and more clearly illustrate and understand the present invention and are not intended to indicate or imply that the device or element so referred to must have a particular orientation, be constructed and operated in the particular orientation, and, therefore, should not be taken to be limiting of the present invention.
Orientation definition: for clarity of description, the end of the surgical procedure that is closer to the operator will be referred to hereinafter as the "proximal end" and the end that is further from the operator will be referred to hereinafter as the "distal end"; "axial" refers to a direction parallel to the line joining the center of the distal end and the center of the proximal end of the interventional medical device; "radial" refers to a direction perpendicular to the axial direction. The foregoing definitions are for convenience only and are not to be construed as limiting the present invention.
Referring to fig. 1, the present invention provides an interventional medical device delivery system 100, which includes a delivery device 20, a dilator 40, a loader 60, a hemostatic valve 70, and an interventional medical device pusher 80. The delivery device 20 includes a sheath 22 and a sheath holder 25 attached to the proximal end of the sheath 22. The dilator 40 comprises an expansion rod 42 and a connecting part 45 connected to the proximal end of the expansion rod 42, the expansion rod 42 is movably arranged in the sheath tube 22 in a penetrating way, and the connecting part 45 is detachably connected to the proximal end of the sheath tube seat 25. The loader 60 comprises a loading tube 62, a first connector 64 disposed at the distal end of the loading tube 62, and a second connector 66 disposed at the proximal end of the loading tube 62; the first connector 64 of the cartridge 60 is connected to the proximal end of the sheath hub 25 and the second connector 66 is connected to the hemostasis valve 70. The interventional medical device pusher 80 is used for pushing an interventional medical device and comprises a pushing cable 82 and a pushing handle 83 slidably sleeved on the pushing cable 82. The push cable 82 is preferably, but not limited to, a steel cable having flexibility. The pushing handle 83 includes a frame 85 and a locking member 87 disposed in the frame 85, and the locking member 87 moves relative to the frame 85 to enable the pushing handle 83 to lock the pushing cable 82 or unlock the pushing cable 82, so that the pushing handle 85 can be locked on the pushing cable 82 or can slide on the pushing cable 82. When the pushing handle 83 is locked at a proper position on the pushing cable 82, an operator can conveniently hold the pushing handle 83 to push the pushing cable 82; when the push handle 83 unlocks the push cable 82, the push handle 83 can be conveniently slid on the push cable 82 and adjusted to a proper position. The suitable positions are: during operation, the pushing handle 83 is suitable for the operator to hold and is convenient for the operator to push the position of the pushing cable 82 through the pushing handle 83. In the proper position, the push handle 83 is closer to the proximal end orifice of the loading tube 62, and the pushing force of the push handle 83 against the push cable 82 is effectively transmitted.
The interventional medical device pusher 80 of the present invention allows an operator to repeatedly perform, during pushing of an interventional medical device: the pushing handle 83 is used for locking the pushing cable 82, the pushing handle 83 is used for pushing the pushing cable 82, the pushing handle 83 is used for unlocking the pushing cable 82, the pushing handle 83 is used for sliding to a proper position on the pushing cable 82, and the pushing handle 83 is used for locking the pushing cable 82 again, so that the pushing handle 83 can be always conveniently adjusted to a position which is suitable for being held by an operator and is convenient for the operator to push the pushing cable 82 through the pushing handle 83, and the pushing force of the pushing handle 83 on the pushing cable 82 can be effectively transmitted, therefore, the interventional medical instrument pusher 80 can be conveniently pushed, the pushing speed is obviously improved, and the operation time is saved.
Referring to fig. 2-4, the frame 85 includes a base 850, the base 850 includes a rectangular base plate 8501, two supporting plates 8502 disposed on the base plate 8501 at intervals, and two end plates 8503, the two supporting plates 8502 are respectively protruded on two opposite sides of the base plate 8501, and the two end plates 8503 are respectively protruded on the other two opposite sides of the base plate 8501 and connected between the two supporting plates 8502. A pair of through holes 8504 are formed in the two end plates 8503, the pair of through holes 8504 are close to the upper surface of the base plate 8501, and the aperture of the through holes 8504 is slightly larger than the diameter of the push cable 82, so that the push cable 82 can be slidably inserted into the pair of through holes 8504, the push cable 82 can be slidably inserted between the two support plates 8502, and the push cable 82 is supported by the upper surface of the base plate 8501. The base plate 8501, the two support plates 8502, and the two end plates 8503 define an accommodating space 852, and the upper surface of the base plate 8501 is a surface of the base plate 8501 facing the accommodating space 852. Rolling and/or sliding the lock 87 moves the lock 87 relative to the base 8501 in a direction that is not parallel to the axial direction of the push cable 82 and closer to the base 8501 so that the push cable 82 is locked between the lock 87 and the base 8501, thereby causing the push handle 83 to lock the push cable 82.
In this embodiment, the base 850 is made of nylon, rubber, or plastic, and after the locking member 87 and the base plate 8501 lock the pushing cable 82, even if the pushing cable 82 receives pushing resistance, the pushing cable 82 and the pushing handle 83 still remain relatively still due to the static friction force existing in the pushing direction between the pushing cable 82, the locking member 87, and the base plate 8501, that is, the pushing handle 83 is fixed on the pushing cable 82.
The base 850 further includes a non-slip mat 854, the non-slip mat 854 is attached to the upper surface of the base plate 8501, the non-slip mat 854 can increase the static friction force between the non-slip mat 854 and the push cable 82, when the push cable 82 is locked, the non-slip mat 854 can increase the friction force, and further prevent the push cable 82 from sliding. Specifically, a receiving groove 8506 is formed in the substrate 8501, the anti-slip pad 854 is received in the receiving groove 8506, and an upper surface of the anti-slip pad 854 is flush with or slightly higher than an upper surface of the substrate 8501. The non-slip pad 854 may be a silicone pad or a rubber pad, etc.
In other embodiments, the upper surface of the substrate 8501 may be textured or grooved or roughened to increase the friction between the push cable 82 and the upper surface of the substrate 8501, so as to further stabilize the locking effect and effectively prevent the push cable 82 from sliding.
A pair of guide grooves 8507 are formed on the two support plates 8502. The pair of guide grooves 8507 extends from a side away from the base plate 8501 toward a side close to the base plate 8501 in a direction not parallel to the axial direction of the push cable 82. The locking member 87 includes a locking portion 872 located between the two supporting plates 8502, and a connecting shaft 874 protruding from the locking portion 872, wherein two ends of the connecting shaft 874 far away from the locking portion 872 are respectively fitted into the pair of guide grooves 8507, and the connecting shaft 874 can roll and/or slide in the pair of guide grooves 8507.
In this embodiment, the locking portion 872 is a cylindrical locking wheel. A limiting hook 8508 is arranged at the tail end of at least one guide groove 8507 close to the base plate 8501, and a latch meshed with the limiting hook 8508 is arranged on a connecting shaft 874 accommodated in the guide groove 8507. When the locking wheel rolls and/or slides to the end of the guide groove 8507 close to the base plate 8501, the latch of the connecting shaft 874 is clamped with the limit hook 8508, and the pushing cable 82 is locked between the locking wheel and the base plate 8501.
Specifically, in one embodiment, the guide slot 8507 is substantially arc-shaped, and the guide slot 8507 extends from the proximal end of the base plate 8501 to the distal end of the base plate 8501 obliquely with respect to the axial direction of the push cable 82, such that the height of the guide slot 8507 gradually decreases from the proximal end to the distal end on the support plate 8502, that is, the distal end of the guide slot 8507 is adjacent to the base plate 8501, the proximal end of the guide slot 8507 is far away from the base plate 8501, the limit hook 8508 is disposed at the distal end of the guide slot 8507, the connection shaft 874 moves along the proximal end of the guide slot 8507 to the distal end, such that the locking wheel gradually approaches the push cable 82 until the push cable 82 is locked, and at this time, the latch. Propelling movement during the propelling movement cable 82, latch and spacing hook 8508's joint can be balanced the moment of force is applied to the locking wheel to the static friction, prevents that the locking wheel reversal and loosen propelling movement cable 82.
In an embodiment, the outer circumferential surface of the locking wheel is wrapped with a non-slip pad 876, in this embodiment, the non-slip pad 876 is a silica gel ring, and the silica gel ring and the locking wheel are connected together in an interference fit manner. When the locking wheel locks the push cable 82, the anti-slip pad 876 can increase the static friction between the push cable 82 and the locking portion 872, thereby further preventing the push cable 82 from slipping.
In other embodiments, the outer surface of the locking portion 872 may be textured or grooved or roughened to increase the static friction between the pushing cable 82 and the outer surface of the locking portion 872, so as to further stabilize the locking effect and effectively prevent the pushing cable 82 from sliding.
In other embodiments, the guiding groove may also extend in a direction perpendicular to the axial direction of the push cable 82, that is, the guiding groove gradually approaches the base plate 8501 along the direction perpendicular to the axial direction of the push cable 82, that is, the direction perpendicular to the base plate 8501, the locking member 87 slides and/or rolls in the guiding groove until the locking member 87 presses the push cable 82 on the base plate 8501, and then the operator may press the locking member 87 with a finger to lock the push cable 82, and release the pressing of the locking member 87 by the finger releases the locking of the push cable 82, and the push handle 83 may slide on the push cable 82. In addition, an elastic hook can be arranged between the locking member 87 and the supporting plate 8502, so that the locking member 87 can be clamped on the supporting plate 8502 to lock the pushing cable 82; when the elastic hook is operated to release the clamping between the locking piece 87 and the support plate 8502, the locking of the pushing cable 82 is released, and the pushing handle 83 can slide on the pushing cable 82, so that the pushing handle 83 can be conveniently adjusted to a proper position on the pushing cable 82.
In other embodiments, the guide slot 8507 extends from the distal end of the base plate 8501 to the proximal end of the base plate 8501 obliquely with respect to the axial direction of the push cable 82 such that the height of the guide slot 8507 gradually decreases from the distal end to the proximal end on the support plate 8502, i.e., the proximal end of the guide slot 8507 is adjacent to the base plate 8501 and the distal end of the guide slot 8507 is distant from the base plate 8501. Spacing hook 8508 sets up in the near-end of guide slot 8507, and connecting axle 874 moves to the near-end from the distal end of guide slot 8507, makes locking portion 872 be close to push cable 82 gradually, until locking push cable 82, at this moment, the latch of connecting axle 874 and spacing hook 8508 joint.
Referring to fig. 5 and 6, when the pushing cable 82 is assembled with the pushing handle 83, the locking member 87 of the pushing handle 83 is rolled to the proximal end along the guiding groove 8507, so that the locking portion 872 is away from the base 8501; the distal end of the pushing cable 82 passes through the pair of through holes 8504 from the proximal end of the base 850, the pushing cable 82 and the locking member 87 are not in contact with each other, and no opposite acting force is applied, and the pushing handle 83 is slidably sleeved on the pushing cable 82, so that the pushing handle 83 can be conveniently slid to a position where an operator can conveniently hold the pushing cable.
Referring to fig. 7 and 8, when the pushing cable 82 needs to be pushed by the pushing handle 83, the locking member 87 rolls from the proximal end to the distal end along the guiding groove 8507, so that the anti-slip pad 876 on the locking member 87 approaches the pushing cable 82 until the latch of the connecting shaft 874 is engaged with the limit hook 8508. At this time, the pushing cable 82 is clamped between the anti-slip pad 876 of the locking member 87 and the anti-slip pad 854 on the substrate 8501, that is, the pushing cable 82 is locked, the pushing handle 83 is fixed to the pushing cable 82, and at this time, the holding handle 83 can push the pushing cable 82, so that the use is convenient.
Referring to fig. 9, during the operation, the dilator 40 is assembled into the delivery device 20 to form a dilator assembly, and specifically, the dilator rod 42 of the dilator 40 sequentially passes through the sheath seat 25 and the sheath 22 from the proximal end of the delivery device 20 until the connecting portion 45 of the dilator 40 is connected to the proximal end of the sheath seat 25. In this embodiment, the connection portion 45 is connected to the proximal end of the sheath tube seat 25 by a screw connection.
Referring to FIG. 10, after removing dilator 40 from carrier 20, loader 60 is mounted to the proximal end of carrier 20, specifically, the distal end of loading tube 62 is inserted into the proximal end of sheath seat 25, so that loading tube 62, sheath seat 25 and sheath 22 form a communicating channel. The first connector 64 of the shuttle 60 is attached to the sheath seat 25 to fixedly attach the shuttle 60 to the carrier 20. A hemostasis valve 70 is attached to the proximal end of the cartridge 60, and a three-way valve is provided on the hemostasis valve 70.
Referring to fig. 11, the following description of the operation of the interventional medical device delivery system 100 of the present invention will be made by taking the procedure of clinical delivery of a left atrial appendage closure device as an example:
connecting dilator 40 with delivery apparatus 20 forms the dilation assembly shown in FIG. 9; following the trajectory established by the guidewire (not shown), the stent assembly is advanced from the femoral vein vessel through the atrial septum to the left atrial appendage, and the dilator 40 is withdrawn, leaving the sheath 22 in vivo to establish a passageway from outside the body to inside the body;
connecting the hemostatic valve 70 and the loader 60 together, rolling the locking member 87 to the far end along the guide groove 8507 until the latch of the connecting shaft 874 of the locking member 87 is clamped on the limit hook 8508, locking the push cable 82, holding the push handle 83 to push the far end of the push cable 82 to sequentially pass through the hemostatic valve 70 and the loader 60, detachably connecting the far end of the push cable 82 and the near end of the left atrial appendage occluder together, and withdrawing the push cable 82 towards the near end to enable the left atrial appendage occluder to be accommodated in the loading tube 62 of the loader 60;
screwing the loading tube 62 and the sheath tube seat 25, namely inserting the distal end of the loading tube 62 from the proximal end of the sheath tube seat 25, and connecting the first connecting head 64 to the proximal end of the sheath tube seat 25 to obtain the interventional medical device conveying system loaded with the left atrial appendage occluder;
pushing the push cable 82 distally using a push handle 83 to deliver and deploy the left atrial appendage occluder to a predetermined position of the left atrial appendage; during this process, the operator repeatedly performs: the pushing cable 82 is pushed by using the pushing handle 83, the pushing cable 82 is unlocked by using the pushing handle 83, the pushing handle 83 is slid and adjusted to a proper position on the pushing cable 82, and the pushing cable 82 is locked by using the pushing handle 83 again, so that the pushing handle 83 can be always conveniently adjusted to a position which is suitable for being held by an operator and is convenient for the operator to push the pushing cable 82 through the pushing handle 83 relative to the pushing cable 82, the pushing force of the pushing handle 83 on the pushing cable 82 can be effectively transmitted, the operation is simple and reliable, and the pushing efficiency is high; specifically, the method comprises the following steps: the pushing handle 83 is held by a hand, the locking piece 87 is operated by a thumb, the locking piece 87 is rolled towards the near end, the locking of the pushing cable 82 is released, the pushing handle 83 is slid to a proper position, namely, a position convenient for an operator to hold by the hand, the locking piece 87 is operated by the thumb to roll to the far end along the guide groove 8507, the latch of the connecting shaft 874 of the locking piece 87 is clamped on the limiting hook 8508, the pushing cable 82 is locked, the pushing handle 83 is held to push the pushing cable 82 to slide towards the far end until the pushing handle 83 abuts against the near end of the loader 60; then, the locking of the pushing cable 82 is released, the pushing handle 83 is slid to the near end to a proper position, the pushing cable 82 is locked, the pushing handle 83 is held to push the pushing cable 82, and the reciprocating operation is carried out until the left atrial appendage occluder is delivered to a preset position; furthermore, whether the left atrial appendage occluder reaches a preset position or not can be evaluated by means of radiography, and the position of the left atrial appendage occluder is correspondingly adjusted to reach the preset position;
the connection between the left atrial appendage occluder and the push cable 82 is released, releasing the left atrial appendage occluder.
Referring to fig. 12 to 16, the second embodiment of the present invention provides an interventional medical device delivery system having a structure similar to that of the first embodiment, except that: the push handle 83a of the interventional medical device delivery system of the second embodiment is different in structure from the push handle 83 of the first embodiment. In the second embodiment, the pushing handle 83a includes a frame body and a locking member 835 disposed in the frame body, the frame body includes a base 830 and a rotating cover 837 rotatably connected to one end of the base 830, the locking member 835 is disposed between the base 830 and the rotating cover 837, the base 830 has a first axial through hole 8301 axially, the rotating cover 837 has a second axial through hole 8377 corresponding to the first axial through hole 8301, and the pushing cable 82 slidably inserts into the first axial through hole 8301 and the second axial through hole 8377. The locking member 835 includes a clamping head 8352 slidably disposed on the push cable 82, and the rotating cover 837 rotates relative to the base 830 to push the locking member 835 to move the locking member relative to the base 830, so that the clamping head 8352 elastically deforms to lock the push cable 82.
Specifically, the base 830 is a cylinder with an open proximal end and a closed distal end, and a cylindrical column 8302 is axially protruded from the inner surface of the distal end of the cylinder toward the proximal end, and the column 8302 extends to be adjacent to the proximal end surface of the cylinder. An annular connecting space 8303 is defined between the outer peripheral surface of the cylinder 8302 and the inner peripheral surface of the cylinder, and the connecting space 8303 is used for accommodating the rotating cover 837. The first axial through hole 8301 is axially opened at the middle of the cylinder 8302, and the first axial through hole 8301 includes a receiving hole 8304 near one end of the rotating cover 837 and a through hole 8305 communicating with the distal end of the receiving hole 8304. The inner diameter of the receiving hole 8304 is larger than the inner diameter of the through hole 8305, and the inner diameter of the through hole 8305 is slightly larger than the diameter of the push cable 82, so that the base 830 can be slidably sleeved on the push cable 82. An external thread 8306 is formed at the proximal end of the outer peripheral surface of the cylinder 8302, and a rotary cover 837 is screwed on the external thread 8306.
The locking member 835 further includes a sleeve 8354 slidably disposed on the pushing cable 82, the clamping head 8352 is connected to an end of the sleeve 8354 close to the rotating cover 837, and the sleeve 8354 is slidably received in the receiving hole 8304 of the cylinder 8302. When the sleeve 8354 of the locking member 835 is inserted into the receiving hole 8304, the clamping head 8352 stops at the proximal end port of the receiving hole 8304. The axial length of the sleeve 8354 is less than the axial length of the receiving bore 8304. The clamp head 8352 comprises at least two elastic clamp blocks 8355, a radial gap is arranged between adjacent elastic clamp blocks 8355, one end of each elastic clamp block 8355 close to the sleeve 8354 is provided with an inclined guide surface 8356, and the diameter of each guide surface 8356 is gradually reduced from the proximal end to the distal end. The proximal opening of the receiving hole 8304 is rounded or beveled to facilitate the guiding surface 8356 of the resilient clamp blocks 8355 being pressed into the receiving hole 8304 when the rotating cap 837 is rotated to push the clamp head 8352 to move distally, thereby elastically deforming and gathering the resilient clamp blocks 8355. In this embodiment, four resilient clamp blocks 8355 are provided on the clamp head 8352, four resilient clamp blocks 8355 are circumferentially arrayed on the proximal end of the sleeve 8354, and a guide surface 8356 is provided on one end of each clamp head 8352 facing the sleeve 8354.
The rotary cover 837 includes a circular cover plate 8371 and a connecting cylinder 8373 provided at a peripheral edge of the cover plate 8371, the connecting cylinder 8373 is rotatably received in the connecting space 8303, and an inner surface of a distal end of the connecting cylinder 8373 is provided with an internal thread 8375 corresponding to the external thread 8306 of the cylinder 8302. The second axial through hole 8377 is opened at the middle of the cover plate 8371, and the push cable 82 can slidably pass through the second axial through hole 8377. An operation rod 8378 is disposed on a proximal end surface of the cover plate 8371, and the rotating cover 837 can be driven to rotate relative to the base 830 by swinging the operation rod 8378.
When the pushing handle 83a is assembled, the sleeve 8354 of the locking member 835 is inserted into the receiving hole 8304 of the base 830 until the guiding surface 8356 of the elastic clamp block 8355 abuts against the proximal end opening of the receiving hole 8304; the rotating cover 837 is screwed onto the cylinder 8302, and in particular, the connecting cylinder 8373 of the rotating cover 837 is received in the connecting space 8303 of the base 830, so that the internal threads 8375 of the rotating cover 837 are screwed onto the external threads 8306 of the cylinder 8302 until the inner surface of the cover plate 8371 approaches the proximal end of the clamping head 8352 of the locking member 835. At this time, the first axial through hole 8301, the inner cavity of the sleeve 8354 and the second axial through hole 8377 of the cover plate 8371 are communicated and coaxial.
Referring to fig. 17 and 18, in the present embodiment, the rotating cover 837 is rotated counterclockwise by the operating rod 8378, so that the cover plate 8371 does not contact the proximal end of the elastic clamping block 8355, and the clamping head 8352 is in a natural state; the distal end of the push handle 83a is slidably received on the push cable 82 by passing the proximal end of the rotatable cap 837 of the push cable 82 through the second axial port 8377 of the cover plate 8371, the clamp head 8352, the sleeve 8354 and the first axial port 8301 of the base 830. At this time, the clamp head 8352 does not clamp the push steel cable 82, i.e. there is no relative force between the clamp head 8352 and the push steel cable 82, so that the push handle 83a can slide to a position where it can be conveniently held by the operator.
Referring to fig. 19 and 20, when the push cable 82 needs to be pushed by the push handle 83a, the push handle 83 slides to a suitable position on the push cable 82, the rotating cover 837 is rotated clockwise by the operating rod 8378, so that the cover plate 8371 abuts against the locking member 835, the locking member 835 moves far away from the base 830, the guide surface 8356 is pressed by the accommodating hole 8304, the elastic clamping blocks 8355 elastically deform and the radial gap is reduced, the elastic clamping blocks 8355 are gathered together to lock the push cable 82, the push handle 83a is integrally fixed with the push cable 82, and the push handle 83a is held to push the push cable 82, which is convenient and reliable.
The operation procedure of the interventional medical device delivery system provided by the second embodiment of the invention for delivering an interventional medical device, such as a left atrial appendage occluder, is similar to that of the first embodiment, but the specific operation steps of pushing the push cable 82 by using the push handle 83a, unlocking the push cable 82 by using the push handle 83a, sliding the push handle 83a, adjusting the push handle 83a to a proper position on the push cable 82, and locking the push cable 82 by using the push handle 83a again are different for the operator, specifically: the rotating cover 837 is rotated counterclockwise by the operating rod 8378, so that the chuck 8352 is restored to a natural state, the locking of the pushing cable 82 is released, the pushing handle 83 is slid to a proper position, then the rotating cover 837 is rotated clockwise by the operating rod 8378, so that the elastic clamping blocks 8355 are elastically deformed, the radial gap is reduced, the elastic clamping blocks 8355 are mutually gathered to lock the pushing cable 82, the pushing handle 83a is held to push the pushing cable 82 to slide towards the far end until the pushing handle 83a abuts against the near end of the loader 60; then, the locking of the push cable 82 is released, the push handle 83a is slid to a proper position towards the near end, the push cable 82 is locked, the push handle 83a is held to push the push cable 82, and the operation is repeated until the left atrial appendage occluder is delivered to a preset position. In the process, the pushing handle 83a can be always conveniently adjusted to a position suitable for being held by an operator and facilitating the operator to push the pushing cable 82 through the pushing handle 83a relative to the pushing cable 82, the pushing force of the pushing handle 83a on the pushing cable 82 can be effectively transmitted, the operation is simple and reliable, and the pushing efficiency is high.
Referring to fig. 21, a third embodiment of the present invention provides an interventional medical device delivery system having a similar structure to the second embodiment, except that: the structure of the locking piece 835a in the third embodiment is different from that of the locking piece 835 in the second embodiment. In this third embodiment, the distal end of the elastic clamp block 8355 of the locking piece 835a is provided with a stop surface 8358 abutting against the proximal end surface of the cylinder 8302, the proximal end of the elastic clamp block 8355 is provided with an inclined guide surface 8359, and the diameter of the guide surface 8359 is gradually reduced from the distal end to the proximal end. When the rotating cover 837 pushes against the clamping head 8352, the stopping surface 8358 prevents the clamping head 8352 from moving distally, so that the proximal end of the clamping head 8352 can only move proximally relative to the rotating cover 837, and the guiding surface 8359 at the proximal end of the elastic clamping block 8355 is pressed into the second axial through hole 8377, so that the elastic clamping blocks 8355 are elastically deformed and gathered together, and further, the guiding surface 8359 of the elastic clamping block 8355 is more easily pressed into the second axial through hole 8377 by rounding or chamfering the distal end opening of the second axial through hole 8377. When the push-type wire clip is used, the rotating cover 837 is rotated clockwise by the operating rod 8378, so that the locking piece 835a moves towards the near end relative to the rotating cover 837, the guide surface 8359 is pressed by the far end hole opening of the second axial through hole 8377, the elastic clamping blocks 8355 are elastically deformed, the radial gap is reduced, the elastic clamping blocks 8355 are mutually gathered to lock the push cable 82, and the push handle 83a is conveniently held to push the push cable 82 to slide; when the rotating cover 837 is rotated by the operating rod 8378 counterclockwise, the cover plate 8371 moves towards the proximal end away from the elastic clamping block 8355, the distal end opening of the second axial through hole 8377 releases the pressing of the guide surface 8359 on the elastic clamping block 8355, so that the locking piece 835a is elastically reset to release the locking of the push cable 82, and the push handle 83a can conveniently slide on the push cable 82.
The foregoing is illustrative of embodiments of the present invention, and it should be noted that modifications and adaptations to those skilled in the art may be made without departing from the principles of the embodiments of the present invention and are intended to be within the scope of the present invention.
Claims (12)
1. The pusher for the interventional medical instrument is characterized by comprising a pushing cable and a pushing handle which is slidably sleeved on the pushing cable; the pushing handle comprises a frame body and a locking piece arranged in the frame body, and the locking piece moves relative to the frame body to enable the pushing handle to lock or unlock the pushing cable.
2. The interventional medical device pusher of claim 1, wherein the frame comprises a base, the push cable is slidably disposed through the base, and a moving direction of the locking member relative to the base is not parallel to an axial direction of the push cable, such that the locking member is close to or away from the push cable to lock or unlock the push cable.
3. The interventional medical device pusher of claim 2, wherein the base comprises a base plate and two support plates disposed on the base plate in a spaced apart relationship, the push cable is slidably disposed between the two support plates, the locking member is connected between the two support plates, and rolling and/or sliding the locking member moves the locking member relative to the base plate in a direction non-parallel to an axial direction of the push cable and closer to the base plate such that the push cable is locked between the locking member and the base plate.
4. The interventional medical device pusher of claim 3, wherein the two support plates are provided with a pair of guide slots; the pair of guide grooves extend from a side away from the substrate toward a side close to the substrate in a direction not parallel to the axial direction of the push cable; the locking part comprises a locking part positioned between the two supporting plates and a connecting shaft convexly arranged on the locking part, and two end parts, far away from the locking part, of the connecting shaft are respectively arranged in the pair of guide grooves, so that the connecting shaft rolls and/or slides in the pair of guide grooves.
5. The interventional medical device pusher of claim 4, wherein the guide slot extends in a direction perpendicular to an axial direction of the push cable; or the guide groove extends obliquely with respect to the axial direction of the push cable toward the distal end or the proximal end of the substrate.
6. The interventional medical device pusher of claim 4, wherein the locking portion is a locking roller, and at least a portion of a surface of the locking roller and/or the base plate is provided with an anti-slip structure.
7. The interventional medical device pusher according to claim 4, wherein at least one of the guide grooves is provided with a limit hook at a distal end thereof adjacent to the base plate, and the connecting shaft is provided with a latch engaged with the limit hook; when the latch is clamped on the limiting hook, the push cable is locked between the locking part and the substrate.
8. The interventional medical device pusher of claim 2, wherein the frame further comprises a rotating cover screwed to one end of the base, the locking member is disposed between the base and the rotating cover, the locking member comprises a collet sleeved on the pushing cable, and the rotating cover rotates to push the locking member to move the locking member relative to the base in a direction perpendicular to an axial direction of the pushing cable, so that the collet is elastically deformed to lock the pushing cable.
9. The interventional medical device pusher of claim 8, wherein the base defines a first axial through hole, the rotating cover defines a second axial through hole corresponding to the first axial through hole, the pushing cable slidably penetrates the first axial through hole and the second axial through hole, the first axial through hole includes a receiving hole near one end of the rotating cover, the locking member further includes a sleeve slidably sleeved on the pushing cable, the collet is connected to one end of the sleeve near the rotating cover, and the sleeve is received in the receiving hole.
10. The interventional medical device pusher of claim 9, wherein the collet comprises at least two elastic clamping blocks, a radial gap is formed between adjacent elastic clamping blocks, an inclined guide surface is arranged at one end of each elastic clamping block close to the sleeve, the rotating cover rotates to push the locking member to move the locking member relative to the base, the guide surface is pressed by the accommodating hole to reduce the radial gap, and the elastic clamping blocks are gathered to lock the pushing cable.
11. The interventional medical device pusher of claim 9, wherein the collet comprises at least two elastic clamping blocks, a radial gap is formed between adjacent elastic clamping blocks, an inclined guide surface is arranged at one end of each elastic clamping block close to the rotating cover, the rotating cover rotates to push the locking member to enable the locking member to move relative to the rotating cover, the guide surface is pressed by the second axial through hole to reduce the radial gap, and the elastic clamping blocks are gathered to lock the pushing cable.
12. An interventional medical device conveying system, characterized by comprising a conveyor, a loader and the interventional medical device pusher as claimed in any one of claims 1 to 11, wherein the conveyor comprises a sheath, the loader comprises a loading tube connected to the proximal end of the sheath, and the pushing cable in the interventional medical device pusher is movably inserted into the loading tube and the sheath.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910297390.6A CN111803170A (en) | 2019-04-12 | 2019-04-12 | Interventional medical instrument pusher and interventional medical instrument conveying system |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201910297390.6A CN111803170A (en) | 2019-04-12 | 2019-04-12 | Interventional medical instrument pusher and interventional medical instrument conveying system |
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| CN111803170A true CN111803170A (en) | 2020-10-23 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN201910297390.6A Pending CN111803170A (en) | 2019-04-12 | 2019-04-12 | Interventional medical instrument pusher and interventional medical instrument conveying system |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN117224253A (en) * | 2023-11-10 | 2023-12-15 | 东南大学泰州生物医药与医疗器械研究院 | Interventional medical instrument pushing device |
-
2019
- 2019-04-12 CN CN201910297390.6A patent/CN111803170A/en active Pending
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN117224253A (en) * | 2023-11-10 | 2023-12-15 | 东南大学泰州生物医药与医疗器械研究院 | Interventional medical instrument pushing device |
| CN117224253B (en) * | 2023-11-10 | 2024-02-23 | 东南大学泰州生物医药与医疗器械研究院 | Interventional medical instrument pushing device |
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