CN112294397A - Thrombus removing system - Google Patents
Thrombus removing system Download PDFInfo
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- CN112294397A CN112294397A CN201910698856.3A CN201910698856A CN112294397A CN 112294397 A CN112294397 A CN 112294397A CN 201910698856 A CN201910698856 A CN 201910698856A CN 112294397 A CN112294397 A CN 112294397A
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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
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
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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
- A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
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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
- A61B17/32—Surgical cutting instruments
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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
- A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
- A61B2017/22035—Gripping instruments, e.g. forceps, for removing or smashing calculi for retrieving or repositioning foreign objects
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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
- A61B2017/22038—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 a guide wire
- A61B2017/22047—Means for immobilising the guide wire in the patient
- A61B2017/22048—Balloons
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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
- A61B2017/22051—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 an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
- A61B2017/22065—Functions of balloons
- A61B2017/22067—Blocking; Occlusion
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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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- 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
- A61B2017/22082—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 after introduction of a substance
- A61B2017/22084—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 after introduction of a substance stone- or thrombus-dissolving
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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
- A61B17/32—Surgical cutting instruments
- A61B2017/320004—Surgical cutting instruments abrasive
- A61B2017/320008—Scrapers
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Abstract
The invention relates to a thrombus removal system, which comprises a suction catheter, an occlusion device and a stirring device, wherein the suction catheter is provided with a suction channel and a guide wire channel; the stirring device comprises a first sheath pipe, a second sheath pipe sleeved outside the first sheath pipe in a sliding manner, and a stirring assembly arranged at the far end of the first sheath pipe. The invention can remove a large amount of thrombus in the inferior vena cava under the condition of ensuring relative safety, protect the vein valve and the vein wall, control the blood loss, has simple operation steps, shortens the operation time and lightens the hospitalization cost of patients.
Description
Technical Field
The invention belongs to the field of medical instruments, and particularly relates to a thrombus removal system.
Background
The existing treatment methods mainly comprise vascular incision embolectomy, catheter contact thrombolysis and percutaneous mechanical puncture embolectomy, wherein the incision embolectomy needs to be performed through dissection separation and blood vessel incision, such as femoral artery, femoral vein or brachial artery incision, and with the development of intracavity intervention technology and the innovation of materials, the open operation mode is gradually replaced by minimally invasive interventional intracavity treatment, namely catheter contact thrombolysis and percutaneous mechanical puncture embolectomy. Catheter contact thrombolysis is not beneficial to many patients because of the high risk of thrombolysis drug bleeding and the extreme severity of the surgical indications, and a large proportion of patients have catheter contact thrombolysis contraindications.
Based on the existing medical cognition, the deep venous thrombosis is often large in capacity, and the acute-phase thrombosis is soft and fragile in texture; arterial thrombosis often has small volume, and thrombus in an acute stage is soft in texture; old thrombi tend to adhere to the vessel wall. For old thrombus, the old thrombus is mainly scraped mechanically by the vessel wall or falls off by thrombolytic drugs at present.
For example, a thrombectomy catheter system, such as an X-sizer thrombectomy catheter system, in which a spiral cutter at the front end of the catheter is used to cut thrombus and blood clots are sucked out of the body, chinese patent CN204092102U discloses a novel peripheral vascular disease thrombus suction connector, which includes: the rotary tail seat comprises a pipe body, a rotary rod, a spiral rotary piece, an arc joint and a connecting tail seat, wherein the pipe body is in a hollow tubular shape, the upper end of the pipe body is movably connected with the arc joint through threads, a rectangular groove is formed in the middle upper portion of the pipe body, the rotary rod is inserted into the pipe body, and the spiral rotary piece is sleeved on the periphery of the rotary rod. However, the thrombus removal device has a complicated structure, high production cost, and cumbersome use, and when the thrombus on the vascular wall is detached by the rotation of the spiral cutter or the spiral rotary blade in the blood vessel, the vascular endothelium is easily damaged, and the thrombus removal sequelae are easily caused.
For another example, the Angiojet thrombus remover can spray a certain amount of thrombolytic agent into the thrombus at high pressure to break up the thrombus, increase the contact area with the thrombus, and perform thrombus suction (called chemical-physical coupling thrombus volume reduction), and is suitable for acute stage thrombus of iliac, femoral and popliteal veins. However, the patient often loses too much blood due to the overlong negative pressure time, and meanwhile, the red blood cell injury may be caused by the high-pressure rapid stirring, so that the hemolysis is caused, and the thrombus extraction sequelae are easy to occur.
Disclosure of Invention
The invention aims to provide a thrombus removal system capable of reducing thrombus extraction sequelae.
In order to solve the technical problems, the invention adopts the following technical scheme:
viewed from a product structure, the thrombus removal system comprises an suction catheter, wherein the suction catheter is provided with a suction channel for sucking thrombus and a guide wire channel for penetrating a guide wire, the suction channel extends along the axial direction of the suction catheter and penetrates through two ends of the suction catheter, and the guide wire channel is positioned at the distal end of the suction catheter;
the thrombus removal system also comprises a plugging device and a stirring device;
the occlusion device comprises an occlusion catheter and an occluder which is arranged at the distal end of the occlusion catheter and has an open state and a folded state; when the occluder is in an open state, the outer diameter of the occluder is more than or equal to the inner diameter of the blood vessel; when the occluder is in a folded state, the occluding device can pass through the suction passage;
the stirring device comprises a first sheath pipe, a second sheath pipe sleeved outside the first sheath pipe in a sliding manner, and a stirring assembly arranged at the far end of the first sheath pipe; the stirring assembly comprises a stirrer with an unfolding state and a folding state, when the stirrer is in the unfolding state, the stirrer is separated from the second sheath, and the outer diameter of the stirrer is less than or equal to the inner diameter of the blood vessel; when the stirrer is in a furled state, the stirring assembly is positioned in the second sheath tube, and the stirring device can penetrate through the suction channel.
The thrombus removal system comprises an aspiration catheter, wherein the aspiration catheter is provided with an aspiration channel for aspirating thrombus and a guide wire channel for penetrating a guide wire, the aspiration channel extends along the axial direction of the aspiration catheter and penetrates through two ends of the aspiration catheter, and the guide wire channel is positioned at the distal end of the aspiration catheter;
the thrombus removal system also comprises a plugging device and a stirring device;
the occlusion device comprises an occlusion catheter which passes through the suction channel and the far end of which extends out of the suction catheter, and an occluder which is arranged at the far end of the occlusion catheter and has an open state and a folded state; when the occluder is in an open state, the occluder is attached to the inner wall of the blood vessel; when the occluder is in a folded state, the occluding device can pass through the suction passage;
the stirring device comprises a first sheath pipe which passes through the suction channel and the far end of which extends out of the suction catheter, a second sheath pipe which is sleeved outside the first sheath pipe in a sliding way and penetrates through the suction channel, and a stirring assembly which is arranged at the far end of the first sheath pipe and is positioned between the far end of the suction catheter and the stopper; the stirring assembly comprises a stirrer with an unfolding state and a folding state, when the stirrer is in the unfolding state, the stirrer is separated from the second sheath tube, the stirrer is in contact with the inner wall of the blood vessel, and when the first sheath tube is dragged, the stirrer moves back and forth in the blood vessel; when the stirrer is in a furled state, the stirring assembly is positioned in the second sheath tube, and the stirring device can penetrate through the suction channel.
When the blood vessel blockage device is used, the upstream of the blood vessel is blocked through the blocking device so as to temporarily block blood flow, then the stirrer moves back and forth in the blood vessel by dragging the first sheath pipe back and forth, the stirrer scrapes the blood vessel wall back and forth and stirs thrombus in the blood vessel, and therefore the thrombus falls off from the blood vessel wall, is broken and is captured; and the thrombus is sucked by matching with a suction catheter, so that a large amount of deep vein thrombus and old thrombus can be quickly taken out, the vascular wall and vein valves are not damaged, and the thrombus taking sequelae are reduced.
Proximal end is defined herein as the side that is proximal to the medical practitioner when the thrombectomy system is in use; the distal end is defined on the side away from the medical personnel when the thrombectomy system is in use.
On the premise that the suction catheter has the thrombus removal function, the suction catheter can provide a passage for other thrombus removal equipment, so that doctors can conveniently select operation schemes aiming at different thrombi, and the thrombus removal system has wide adaptation diseases.
Of course, for some thrombotic conditions that can be treated by aspiration through an aspiration catheter alone, the practitioner may use only the aspiration catheter of the present invention without the use of an agitation device and an occlusion device.
Preferably, the suction catheter further comprises a filling channel extending along the axial direction of the suction catheter, and a balloon fixedly arranged at the distal end of the suction catheter and communicated with the filling channel, wherein the balloon has an open state and a folded state, and when the balloon is in the open state, the outer diameter of the balloon is larger than or equal to the inner diameter of the blood vessel. Through set up the sacculus on the suction catheter for thereby can carry out the shutoff to blood vessel low reaches when the sacculus is full and temporarily cut off the blood flow, avoid the thrombus to get into low reaches blood vessel and cause other positions thrombus.
Further preferably, the balloon is located between two outlets of the guide wire channel.
In the invention, the suction channel and the guide wire channel are separated and not communicated with each other, thereby avoiding the interference of the guide wire with other components. Furthermore, the filling channel, the suction channel and the guide wire channel are respectively separated and not communicated, and the filling channel and the guide wire channel are respectively positioned at two sides of the suction channel, so that the functions of the channels are definite and convenient to distinguish, and the space can be reserved for the suction cavity channel to the maximum extent, thereby improving the suction efficiency.
It is further preferred that the proximal end of the aspiration catheter is provided with a filling port in communication with the filling channel, an aspiration port in communication with the aspiration channel, and an interface for other devices in communication with the aspiration channel, such that other devices may be introduced into the blood vessel through the aspiration channel, including occlusion devices, agitation devices, and other devices as needed, such as thrombolytics, etc.
More preferably, the axis of the further device interface coincides with the axis of the suction channel, thereby facilitating access by further devices.
Preferably, the distal end surface of the suction catheter is a slope, so that the suction range and effect can be enlarged; the outlet of the guide wire channel is positioned at the far end of the inclined plane, so that the whole system can conveniently enter a lesion site along the guide wire.
Preferably, the occluder is a balloon which can be inflated by inflating or filling with a liquid.
Preferably, the stirrer is a mesh basket made of memory wires; when the stirrer is one, the stirrer can control the unfolding degree by the second sheath; when the stirrers are multiple, the stirrers are sequentially arranged along the axial direction of the first sheath pipe, and two adjacent stirrers are connected through the elastic piece, so that the two adjacent stirrers can be relatively close to or far away from the first sheath pipe along the axial direction of the first sheath pipe.
The memory wire herein may be a memory alloy such as nitinol.
In the invention, the net basket made of the memory wire can be formed by laser cutting and then heat setting through the nickel-titanium alloy whole tube. The setting of basket makes when making a round trip to pull the agitator, and the area of contact of agitator and vascular wall is little to it is little to the damage of vascular wall, and the agitator can carry out partial breakage and interception to the thrombus in the blood vessel and catch.
For the version in which the stirrer is one, it is prior art to control the extent of deployment of the stirrer by withdrawing the second sheath.
Withdraw to near-end through second sheath and realize the agitator from expanding the degree for the adherence degree and the pulling force of agitator can be adjusted as required when pulling the thrombus.
For the multiple schemes of the stirrer, the elastic part can be a thin-wall pipe, according to one embodiment, the elastic part is a spring, the spring referred to herein includes all parts which have spiral shapes similar to the spring and thus have elasticity, so that the processing is technically convenient, the elastic part can be connected to pass through complex lesion parts in the using process, and the flexibility of the diameters of the sheath pipe and the stirrer is improved.
Wherein, elastic component and first sheath pipe can be welding or integrative setting, preferably, elastic component with first sheath pipe integrative setting, through carrying out the elastic component that spiral cutting formed similar spring on one section of first sheath pipe promptly to make preparation convenient and the fastness good.
According to the invention, the stirrers are elastically connected by the elastic piece, so that certain buffering effect is achieved between the stirrers and the blood vessel when the first sheath tube is dragged back and forth.
Preferably, when the elastic part is in a static state, the distance between every two adjacent stirrers is 5-10 mm, so that the stirrers are improved to have good flexibility in the dragging process.
Further preferably, the projection of the stirrer on the plane perpendicular to the axis of the first sheath is petal-shaped, the number of petals can be set according to actual needs, and preferably set to 4-6 petals, so that the vertical projection planes of the two stirrers can form an effective blocking section.
Further preferably, projections of the plurality of stirrers on a plane perpendicular to the axis of the first sheath are staggered, so that an effective intercepting area for intercepting thrombus is increased.
The "plane perpendicular to the axis of said first sheath" defined herein is an axis defined by the first sheath shown in fig. 1 extending in a straight line, and the plane is perpendicular to the straight line axis.
Preferably, the stirrer is spherical, the spherical stirrer is not easy to scratch the vessel wall, the adherence is good, and old adherent thrombus is easy to remove.
Further preferably, the diameter of the stirrer is 9-14 mm, so that the stirrer can adapt to blood vessels with different inner diameters.
Preferably, first sheath run through the agitator, just the axis of first sheath, the central line coincidence of agitator to make agitating unit preparation convenient, convenient operation and to the damage of vascular wall little.
In the invention, the suction catheter, the plugging device and the stirring device are respectively and independently packaged, and the parts of each independent package can be sold integrally or separately, so that the suction catheter, the plugging device and the stirring device can be selectively used by medical personnel.
According to one embodiment, the thrombus removal system further comprises a guidewire. This product can be equipped with the seal wire and sell together, also can use the seal wire of other producers.
According to one embodiment, the thrombus removal system further comprises a thrombolytic tube. The product can be provided with the thrombolytic tubes for selling together, and the thrombolytic tubes of other manufacturers can also be used.
Due to the implementation of the technical scheme, compared with the prior art, the invention has the following advantages:
the invention can remove a large amount of thrombus in the inferior vena cava under the condition of ensuring relative safety, protect the vein valve and the vein wall, control the blood loss, has simple operation steps, shortens the operation time and lightens the hospitalization cost of patients.
Drawings
FIG. 1 is a schematic diagram of a thrombus removal system according to an embodiment;
FIG. 2 is a cross-sectional view taken along line A-A of FIG. 1;
FIG. 3 is a cross-sectional view taken along line B-B of FIG. 1;
FIG. 4 is a cross-sectional view taken along line C-C of FIG. 1;
FIG. 5 is a schematic view showing the superposition of the sectional view B-B and the sectional view C-C;
FIG. 6 is an enlarged view of a portion of FIG. 1 at position D;
FIG. 7 is an enlarged view of a portion of FIG. 1 at location E;
fig. 8 is a schematic structural view of the stirring device according to the first embodiment before deployment (the second sheath is retracted, but before the stirrer is opened);
fig. 9 is a schematic structural view of the stirring apparatus according to the first embodiment after development;
fig. 10 is a schematic structural view of the stirring device of the second embodiment after being unfolded;
fig. 11 is a schematic structural view of a stirring apparatus according to a second embodiment of the present invention before being expanded;
wherein, 1, a suction catheter; 2. a guide wire; 11. a suction channel; 12. a guidewire channel; 13. filling the channel; 14. a bevel; 15. filling the interface; 16. a suction interface; 17. other device interfaces; 18. a balloon; 31. plugging the catheter; 32. an occluder; 41. a first sheath tube; 42. a second sheath; 43. a stirrer; 44. a memory wire; 45. an elastic member.
Detailed Description
The present invention will be described in further detail with reference to specific examples. It is to be understood that these embodiments are provided to illustrate the basic principles, essential features and advantages of the present invention, and the present invention is not limited by the following embodiments.
As shown in FIG. 1, the thrombectomy system of the present invention comprises an aspiration catheter 1, a guide wire 2, an agitation device, and an occlusion device.
The suction catheter 1 has a suction channel 11 for sucking thrombus, a guide wire channel 12 for passing the guide wire 2, and an inflation channel 13. The suction channel 11 extends along the axial direction of the suction catheter 1 and penetrates both ends of the suction catheter 1, the guide wire channel 12 is located at the distal end of the suction catheter 1, and the filling channel 13 extends along the axial direction of the suction catheter 1.
The filling channel 13, the suction channel 11 and the guide wire channel 12 are respectively separated from each other and do not communicate, and the filling channel 13 and the guide wire channel 12 are respectively positioned at two sides of the suction channel 11, as shown in fig. 2.
The distal end face of the suction catheter 1 is a slope 14, as shown in fig. 7, the outlets of the distal ends of the suction channel 11 and the guide wire channel 12 are both opened on the slope 14, and the outlet of the guide wire channel 12 is located at the distal end of the slope 14, namely the tip position of the suction catheter 1.
As shown in fig. 1, the proximal end of the aspiration catheter 1 is provided with a filling port 15 communicated with the filling channel 13, an aspiration port 16 communicated with the aspiration channel 11, and an other device port 17 communicated with the aspiration channel 11, that is, the outlet of the proximal end of the filling channel 13 is communicated with the filling port 15, and the outlet of the proximal end of the aspiration channel 11 is communicated with the aspiration port 16 and the other device port 17, respectively. Preferably, the axis of the further device interface 17 coincides with the axis of the suction channel 11, so that the further device is accessible.
The distal end of the suction catheter 1 is fixedly provided with a balloon 18, and the balloon 18 is communicated with the distal outlet of the filling channel 13, so that the balloon 18 can be filled and released through the filling interface 15 and the filling channel 13, and the balloon 18 has an open state and a folded state. When the suction catheter 1 is implanted and recovered, the balloon 18 is in a folded state, so that the implantation and the recovery of the suction catheter 1 are facilitated; when in use, the balloon 18 is in an open state, the outer diameter of the balloon 18 is larger than or equal to the inner diameter of a blood vessel, and the outer diameter of the balloon 18 is preferably equal to or slightly larger than the inner diameter of the blood vessel, so that the blood vessel can be blocked, the blood flow can be temporarily blocked, and the loose free thrombus in the thrombus removal process can be prevented from drifting to other blood vessels.
In this embodiment, the balloon 18 is located between two outlets of the guide wire channel 12, as shown in fig. 1, i.e. the outlet of the proximal end of the guide wire channel 12 opens onto the wall of the suction catheter 1, which outlet is located at the front end of the balloon 18.
In this embodiment, the aspiration catheter 1 is a catheter with three lumens, although other catheters with multiple lumens may be used instead. The guidewire channel 12 of the aspiration catheter 1 may be passed over an OTW rapid exchange guidewire or a central push guidewire, fitting, but not limited to, a 0.014 "guidewire. The suction catheter 1 reserves other equipment passages while ensuring the capability of sucking thrombus, thereby being capable of dealing with various complicated thrombus.
As shown in fig. 1, the occlusion device comprises an occlusion catheter 31, an occluding device 32 arranged at the distal end of the occlusion catheter 31 and having an open state and a collapsed state, wherein the occluding device 32 is a balloon which can be inflated by inflating or filling a liquid.
When the occluder 32 is in an open state, the outer diameter of the occluder 32 is larger than or equal to the inner diameter of the blood vessel, preferably, the outer diameter of the occluder 32 is equal to or slightly larger than the inner diameter of the blood vessel, so that the occluder 32 is attached to the inner wall of the blood vessel, and when the occluder 32 is used, the occluder 32 is positioned at the far end of the suction catheter 1 and acts with the balloon 18 of the suction catheter 1 simultaneously, so that a closed space is formed in the blood vessel in a short time, and therefore, the stirring device can achieve good curative effect when dragging thrombus or thrombolysis. When the occluder 32 is in a collapsed state, the occluding device can pass through the suction channel 11.
The stirring device comprises a first sheath tube 41, a second sheath tube 42 which is sleeved outside the first sheath tube 41 in a sliding manner, and a stirring component which is arranged at the far end of the first sheath tube 41; the agitator assembly includes an agitator 43 having an expanded state and a collapsed state, the agitator 43 having an outer diameter in the expanded state that is less than or equal to the inner diameter of the blood vessel. In use, the stirring assembly and the first sheath 41 are folded in the second sheath 42, the stirring device enters the suction channel 11 from the interface of other equipment and enables the stirrer 43 to be positioned between the suction catheter 1 and the occluder 32, the second sheath 42 is retracted, the stirrer 43 is opened, and the stirrer 43 moves back and forth in the blood vessel by dragging the first sheath 41 back and forth.
The first implementation mode comprises the following steps:
as shown in fig. 8 and 9, only one stirrer 43 is formed by shaping several braided memory filaments 44, and can be retracted proximally through the second sheath tube 42 to achieve self-expansion, and when the first sheath tube 41 is dragged, the degree of adherence and the dragging force of the memory filaments 44 can be controlled by adjusting the opening degree of the stirrer 43 through the length of the retracted second sheath tube 42.
The first sheath 41 is inserted through the stirrer 43 and the axis of the first sheath 41 is aligned with the center line of the stirrer 43, and the stirrer 43 is fixed to the first sheath 41 by welding or other processes.
The shape of the baskets may be that commonly used in the art, such as spherical, fusiform, etc. The memory wire 44 may be made of a memory alloy such as nitinol.
The second embodiment:
the number of stirrers 43 is plural, and as shown in fig. 10 and 11, two stirrers 43 are provided, which are provided in this order along the axial direction of the first sheath 41. Adjacent two stirrers 43 are connected by an elastic member 45 so that adjacent two stirrers 43 can relatively move closer to or away from each other in the axial direction of first sheath 41.
As shown in fig. 6, the elastic member 45 is provided integrally with the first sheath 41, and the elastic member 45 like a spring is formed by spirally cutting a section of the first sheath 41.
When the elastic member 45 is in a static state (i.e. the elastic member 45 is not extended and is not compressed), the distance between two adjacent stirrers 43 is 5-10 mm.
As shown in fig. 3 and 4, the stirrer 43 has a petal-shaped projection on a plane perpendicular to the axis of the first sheath 41, and the number of petals can be set according to actual needs, preferably 4 to 6 petals, and in this embodiment, 5 petals.
As shown in fig. 5, projections of the plurality of stirrers 43 on a plane perpendicular to the axis of first sheath 41 are offset, that is, projections of memory wires 44 of the plurality of stirrers 43 on the plane are offset.
The first sheath 41 is inserted through the stirrer 43, and the axis of the first sheath 41 and the center line of the stirrer 43 are overlapped with each other, and the stirrer 43 is fixed to the first sheath 41 by welding or other processes.
The thrombus removal system also comprises a guide wire 2 and a thrombolytic tube, and the improvement of the guide wire 2 and the thrombolytic tube is not the key point of the protection of the invention, and the guide wire 2 and the thrombolytic tube in the prior art can be adopted.
Suction catheter 1, plugging device, agitating unit are independent packing respectively, when selling, can be equipped with the seal wire 2 and the thrombolysis pipe of independent packing, make things convenient for the whole set of use of medical personnel.
The thrombus removal system comprises the following use steps:
1. the guide wire 2 is threaded to the lesion.
2. The guide wire 2 is passed through the guide wire channel 12 so as to send the suction catheter 1 to the front end of the lesion part, and the blockage situation is observed by radiography.
3. The occluding device is accessed from the other device port, delivered through the aspiration channel 11 and passed through the lesion, the distal end of the blood vessel is occluded by inflating the occluding device 32 through the occluding catheter 31, and the proximal end of the blood vessel is occluded by inflating the balloon 18 through the inflation port 15 and the inflation channel 13, so that a short period of time of occlusion is formed between the occluding device 32 and the balloon 18.
4. The thrombolysis tube enters from other equipment interfaces and is conveyed to a lesion part in the closed space through the suction channel 11, thrombolysis is carried out on the thrombolysis tube in the characteristic space, and the thrombolysis tube is taken out after thrombolysis is finished.
5. The stirring device enters from other equipment interfaces, is conveyed to the lesion part in the closed space through the suction channel 11, and the second sheath tube 42 is withdrawn to open the stirrer 43.
6. The first sheath 41 is grasped and repeatedly pulled, and simultaneously, negative pressure is sucked through the suction port 16 via the suction channel 11.
7. After the insoluble thrombus is attached to the stirrer 43, the first sheath 41 is withdrawn, and the thrombus is extracted from the body.
8. After the stirrer 43 is completely removed, the aspiration catheter 1 is repeatedly aspirated to thereby extract the remaining thrombus.
9. After the thrombus is taken out, the occluder 32 and the saccule 18 are decompressed, the contrast observation is carried out again to observe the treatment effect, and if the thrombus is not completely taken out, the steps are repeated until the thrombus is completely sucked.
10. After the treatment is completed, the suction catheter 1 is withdrawn along the guide wire 2, and then the occluder 32 is withdrawn.
The steps are the processing steps for old thrombus which is difficult to process, and for some thrombus which is easier to process, the steps of thrombolysis, thrombolysis and the like can be correspondingly omitted.
The invention intervenes through the guide wire 2, and the blood vessel is blocked when the balloon 18 and the stopper 32 of the suction catheter 1 are full, thereby facilitating the operation of a doctor, simultaneously increasing the effect of placing the catheter for thrombolysis and preventing the thrombus from falling off and floating to the heart in the thrombus taking process. The use of a large scale aspiration catheter 1 in combination with the agitator 43 in the vein effectively removes large areas of acute and subacute thrombus in the inferior vena cava. Can dissolve the thrombus earlier when reply old thrombus of inferior vena cava, then draw to suction catheter 1 in through agitator 43, use this apparatus can remove a large amount of thrombus in the inferior vena cava under the circumstances of guaranteeing relative safety, protection venous valve and venous blood vessel wall, the amount of blood loss is controllable, and operating procedure is simple, shortens operating time, alleviates patient's cost of being in hospital.
As described above, the present invention has been explained fully in accordance with the gist of the present invention, but the present invention is not limited to the above-described examples and implementation methods. A practitioner of the related art can make various changes and implementations within a range allowed by the technical idea of the present invention.
Claims (18)
1. A thrombectomy system comprising an aspiration catheter (1), characterized in that: the suction catheter (1) is provided with a suction channel (11) for sucking thrombus and a guide wire channel (12) for penetrating a guide wire (2), the suction channel (11) extends along the axial direction of the suction catheter (1) and penetrates through two ends of the suction catheter (1), and the guide wire channel (12) is positioned at the distal end of the suction catheter (1);
the thrombus removal system also comprises a plugging device and a stirring device;
the occlusion device comprises an occlusion catheter (31) and an occluder (32) which is arranged at the distal end of the occlusion catheter (31) and has an open state and a folded state; when the occluder (32) is in an open state, the outer diameter of the occluder (32) is larger than or equal to the inner diameter of the blood vessel; when the occluder (32) is in a collapsed state, the occluding device can pass through the suction passage (11);
the stirring device comprises a first sheath pipe (41), a second sheath pipe (42) sleeved outside the first sheath pipe (41) in a sliding manner, and a stirring assembly arranged at the far end of the first sheath pipe (41); the stirring assembly comprises a stirrer (43) with an unfolded state and a folded state, when the stirrer (43) is in the unfolded state, the stirrer (43) is separated from the second sheath (42), and the outer diameter of the stirrer (43) is less than or equal to the inner diameter of a blood vessel; when the stirrer (43) is in a furled state, the stirring assembly is positioned in the second sheath tube (42), and the stirring device can pass through the suction channel (11).
2. A thrombectomy system comprising an aspiration catheter (1), characterized in that: the suction catheter (1) is provided with a suction channel (11) for sucking thrombus and a guide wire channel (12) for penetrating a guide wire (2), the suction channel (11) extends along the axial direction of the suction catheter (1) and penetrates through two ends of the suction catheter (1), and the guide wire channel (12) is positioned at the distal end of the suction catheter (1);
the thrombus removal system also comprises a plugging device and a stirring device;
the occlusion device comprises an occlusion catheter (31) which passes through the suction channel (11) and the far end of which extends out of the suction catheter (1), and an occlusion device (32) which is arranged at the far end of the occlusion catheter (31) and has an open state and a folded state; when the occluder (32) is in an open state, the occluder (32) is attached to the inner wall of the blood vessel; when the occluder (32) is in a collapsed state, the occluding device can pass through the suction passage (11);
the stirring device comprises a first sheath tube (41) which passes through the suction channel (11) and the far end of which extends out of the suction catheter (1), a second sheath tube (42) which is sleeved outside the first sheath tube (41) in a sliding way and penetrates through the suction channel (11), and a stirring component which is arranged at the far end of the first sheath tube (41) and is positioned between the far end of the suction catheter (1) and the stopper (32); the stirring assembly comprises a stirrer (43) with an unfolded state and a folded state, when the stirrer (43) is in the unfolded state, the stirrer (43) is separated from the second sheath (42), the stirrer (43) is in contact with the inner wall of the blood vessel, and when the first sheath (41) is dragged, the stirrer (43) moves back and forth in the blood vessel; when the stirrer (43) is in a furled state, the stirring assembly is positioned in the second sheath tube (42), and the stirring device can pass through the suction channel (11).
3. A thrombus removal system according to claim 1 or 2, wherein: the suction catheter (1) further comprises an filling channel (13) extending along the axial direction of the suction catheter (1), and a balloon (18) fixedly arranged at the distal end of the suction catheter (1) and communicated with the filling channel (13), wherein the balloon (18) has an open state and a folded state, and when the balloon (18) is in the open state, the outer diameter of the balloon (18) is larger than or equal to the inner diameter of a blood vessel.
4. A thrombus removal system according to claim 3, wherein: the balloon (18) is positioned between two outlets of the guide wire channel (12).
5. A thrombus removal system according to claim 3, wherein: the filling channel (13), the suction channel (11) and the guide wire channel (12) are respectively separated from each other, and the filling channel (13) and the guide wire channel (12) are respectively positioned at two sides of the suction channel (11).
6. A thrombus removal system according to claim 3, wherein: the near end of the suction catheter (1) is provided with a filling interface (15) communicated with the filling channel (13), a suction interface (16) communicated with the suction channel (11) and other equipment interfaces (17) communicated with the suction channel (11).
7. The thrombus removal system of claim 6, wherein: the axis of the other device interface (17) coincides with the axis of the suction channel (11).
8. A thrombus removal system according to claim 1 or 2, wherein: the distal end surface of the suction catheter (1) is a slope (14), and the outlet of the guide wire channel (12) is positioned at the distal end of the slope (14).
9. A thrombus removal system according to claim 1 or 2, wherein: the occluder (32) is a balloon.
10. A thrombus removal system according to claim 1 or 2, wherein: the stirrer (43) is a net basket made of memory wires (44); when one stirrer (43) is provided, the stirrer (43) can control the unfolding degree of the second sheath (42); when the stirrer (43) is a plurality of stirrers, the stirrers (43) are sequentially arranged along the axial direction of the first sheath (41), and two adjacent stirrers (43) are connected through an elastic piece (45) so that the two adjacent stirrers (43) can relatively approach or separate along the axial direction of the first sheath (41).
11. The thrombus removal system of claim 10, wherein: the elastic piece (45) is a spring, and the elastic piece (45) and the first sheath tube (41) are integrally arranged.
12. The thrombus removal system of claim 10, wherein: when the elastic piece (45) is in a static state, the distance between two adjacent stirrers (43) is 5-10 mm.
13. The thrombus removal system of claim 10, wherein: the projections of the stirrers (43) on a plane perpendicular to the axis of the first sheath (41) are in a petal shape, and the projections of the stirrers (43) on the plane perpendicular to the axis of the first sheath (41) are mutually staggered.
14. The thrombus removal system of claim 10, wherein: the stirrer (43) is spherical, and the diameter of the stirrer (43) is 9-14 mm.
15. The thrombus removal system of claim 10, wherein: the first sheath pipe (41) penetrates through the stirrer (43), and the axis of the first sheath pipe (41) and the central line of the stirrer (43) are coincident.
16. A thrombus removal system according to claim 1 or 2, wherein: the suction catheter (1), the plugging device and the stirring device are respectively and independently packaged.
17. A thrombus removal system according to claim 1 or 2, wherein: the thrombus removal system further comprises a guide wire (2).
18. A thrombus removal system according to claim 1 or 2, wherein: the thrombus removal system also includes a thrombolytic tube.
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CN117017419A (en) * | 2023-08-01 | 2023-11-10 | 上海心弘生命科学有限公司 | Thrombus aspiration catheter, device and system |
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CN117017419A (en) * | 2023-08-01 | 2023-11-10 | 上海心弘生命科学有限公司 | Thrombus aspiration catheter, device and system |
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