CN112386776A - Improved auxiliary catheter - Google Patents
Improved auxiliary catheter Download PDFInfo
- Publication number
- CN112386776A CN112386776A CN202010805238.7A CN202010805238A CN112386776A CN 112386776 A CN112386776 A CN 112386776A CN 202010805238 A CN202010805238 A CN 202010805238A CN 112386776 A CN112386776 A CN 112386776A
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- Prior art keywords
- catheter
- guide
- improved
- improved auxiliary
- guide catheter
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- 210000002321 radial artery Anatomy 0.000 claims abstract description 29
- 210000001105 femoral artery Anatomy 0.000 claims description 7
- 210000002302 brachial artery Anatomy 0.000 claims description 2
- 239000000463 material Substances 0.000 claims description 2
- 210000002559 ulnar artery Anatomy 0.000 claims description 2
- 230000001404 mediated effect Effects 0.000 claims 1
- 238000000034 method Methods 0.000 description 9
- 208000002193 Pain Diseases 0.000 description 8
- 210000004351 coronary vessel Anatomy 0.000 description 6
- 210000000245 forearm Anatomy 0.000 description 6
- 208000005392 Spasm Diseases 0.000 description 5
- 238000002560 therapeutic procedure Methods 0.000 description 5
- 230000008901 benefit Effects 0.000 description 4
- 238000002586 coronary angiography Methods 0.000 description 4
- 208000029078 coronary artery disease Diseases 0.000 description 4
- 230000008961 swelling Effects 0.000 description 4
- 208000031481 Pathologic Constriction Diseases 0.000 description 3
- 210000001367 artery Anatomy 0.000 description 3
- 239000003814 drug Substances 0.000 description 3
- 230000002526 effect on cardiovascular system Effects 0.000 description 3
- 230000008569 process Effects 0.000 description 3
- 208000037804 stenosis Diseases 0.000 description 3
- 230000036262 stenosis Effects 0.000 description 3
- 208000031226 Hyperlipidaemia Diseases 0.000 description 2
- 210000000709 aorta Anatomy 0.000 description 2
- 238000003745 diagnosis Methods 0.000 description 2
- 229940079593 drug Drugs 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 210000001035 gastrointestinal tract Anatomy 0.000 description 2
- 230000003902 lesion Effects 0.000 description 2
- 210000005000 reproductive tract Anatomy 0.000 description 2
- 210000002345 respiratory system Anatomy 0.000 description 2
- 230000002792 vascular Effects 0.000 description 2
- SGTNSNPWRIOYBX-UHFFFAOYSA-N 2-(3,4-dimethoxyphenyl)-5-{[2-(3,4-dimethoxyphenyl)ethyl](methyl)amino}-2-(propan-2-yl)pentanenitrile Chemical compound C1=C(OC)C(OC)=CC=C1CCN(C)CCCC(C#N)(C(C)C)C1=CC=C(OC)C(OC)=C1 SGTNSNPWRIOYBX-UHFFFAOYSA-N 0.000 description 1
- 208000004476 Acute Coronary Syndrome Diseases 0.000 description 1
- 206010002388 Angina unstable Diseases 0.000 description 1
- 206010003162 Arterial injury Diseases 0.000 description 1
- 206010018852 Haematoma Diseases 0.000 description 1
- 206010020772 Hypertension Diseases 0.000 description 1
- SNIOPGDIGTZGOP-UHFFFAOYSA-N Nitroglycerin Chemical compound [O-][N+](=O)OCC(O[N+]([O-])=O)CO[N+]([O-])=O SNIOPGDIGTZGOP-UHFFFAOYSA-N 0.000 description 1
- 239000000006 Nitroglycerin Substances 0.000 description 1
- 208000006735 Periostitis Diseases 0.000 description 1
- 208000007814 Unstable Angina Diseases 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 230000009471 action Effects 0.000 description 1
- 230000003143 atherosclerotic effect Effects 0.000 description 1
- 210000004204 blood vessel Anatomy 0.000 description 1
- 230000000747 cardiac effect Effects 0.000 description 1
- 230000008859 change Effects 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 206010012601 diabetes mellitus Diseases 0.000 description 1
- HSUGRBWQSSZJOP-RTWAWAEBSA-N diltiazem Chemical compound C1=CC(OC)=CC=C1[C@H]1[C@@H](OC(C)=O)C(=O)N(CCN(C)C)C2=CC=CC=C2S1 HSUGRBWQSSZJOP-RTWAWAEBSA-N 0.000 description 1
- 229960004166 diltiazem Drugs 0.000 description 1
- 210000002310 elbow joint Anatomy 0.000 description 1
- 229960003711 glyceryl trinitrate Drugs 0.000 description 1
- 238000001727 in vivo Methods 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 201000004332 intermediate coronary syndrome Diseases 0.000 description 1
- 238000013152 interventional procedure Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000013146 percutaneous coronary intervention Methods 0.000 description 1
- 210000003460 periosteum Anatomy 0.000 description 1
- 210000005259 peripheral blood Anatomy 0.000 description 1
- 239000011886 peripheral blood Substances 0.000 description 1
- 230000002093 peripheral effect Effects 0.000 description 1
- 230000002035 prolonged effect Effects 0.000 description 1
- 230000011514 reflex Effects 0.000 description 1
- 210000003291 sinus of valsalva Anatomy 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 208000011580 syndromic disease Diseases 0.000 description 1
- 230000001225 therapeutic effect Effects 0.000 description 1
- 210000001635 urinary tract Anatomy 0.000 description 1
- 229960001722 verapamil Drugs 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0043—Catheters; Hollow probes characterised by structural features
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0074—Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biophysics (AREA)
- Pulmonology (AREA)
- Engineering & Computer Science (AREA)
- Anesthesiology (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Hematology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Abstract
The invention relates to an improved auxiliary catheter which can be used for guiding by matching with a guide catheter, and is characterized in that: the improved accessory catheter includes: a body part and head ends respectively positioned at the front part of the body part; the body part extends into the inner cavity of the guide catheter, and the head end has a conical structure and extends outwards from the far end of the guide of the finger; the tail handle extends outwards from the proximal end of the guide catheter; the body has an open channel. The improved auxiliary catheter can assist in guiding the catheter to rapidly pass through a narrow section, and obviously shortens the intervention time; obviously reduces the complications of the radial artery.
Description
Technical Field
The invention relates to the technical field of medical treatment, in particular to an improved auxiliary catheter applied to treatment or diagnosis of cardiovascular, cerebrovascular, peripheral blood vessel, digestive tract, respiratory tract, urinary tract and reproductive tract, and particularly relates to a diagnosis or treatment process through radial artery, ulnar artery, brachial artery and femoral artery.
Background
In vivo, especially in human body, the vessels such as cardiovascular vessels, cerebrovascular vessels, peripheral vessels, respiratory tract, digestive tract, reproductive tract and the like are often locally narrow, and the catheter is difficult to pass through.
In 1989, the Canadian physician Campeau reported that coronary angiography of the first percutaneously punctured radial artery was found to significantly reduce the incidence of complications compared to the femoral artery approach. The change of the approach not only improves the safety of the operation, but also has great advantages that the patient can get out of bed immediately after the operation. In 2015, 567583 coronary artery interventional therapy patients are treated in China in a coronary artery interventional therapy mode, wherein 89.45% of patients are treated in a radial artery interventional therapy mode, and 91% of radial artery interventional path is displayed by military data.
In recent years, with the deep understanding of atherosclerotic coronary artery diseases and the mature of coronary artery interventional therapy instruments and techniques, percutaneous coronary artery intervention has become the main treatment means of coronary heart disease at present. Vascular complications at the puncture site operated via the radial approach are significantly reduced compared to the transfemoral approach, which is a great clinical advantage of transradial interventional Therapy (TRI).
However, due to the small tortuosity of the radial artery, the inner diameter of the radial artery of China is only 2.2-2.7 mm on average, and the anatomical characteristics or limitations of the radial artery, cardiovascular interventional doctors often encounter some practical operation difficulties in the process of completing percutaneous coronary intervention. The most common of them is radial artery spasm, the incidence rate is as high as 5-10%, the occurrence rate is often short in operation, and the prediction and avoidance are difficult.
Particularly, after coronary angiography is completed, the guide catheter is most easily replaced, so that the guide catheter cannot be sent forward, and the upper arm of a patient is severely painful. The solution once a similar situation occurs is as follows:
1. and (3) replacing an intervention path: the femoral artery is changed into the approach, the pain of the patient is obviously increased, the intervention time is prolonged, the treatment cost is increased, and the proportion of serious complications of the femoral artery is obviously increased compared with the proportion of serious complications of the radial artery
2. Injecting medicine through radial artery sheath: including anti-spasm drugs such as nitroglycerin, verapamil, and diltiazem, but this method has uncertain therapeutic effect, drug-related side effects, long waiting time, and spasm again when the guiding catheter is used again to move upwards
3. Guiding the catheter to rotate upwards: the guiding catheter is used for guiding the guide wire, the left and right pushing is performed lightly, the success rate of the method is low, the intimal injury of the radial artery is often caused, the anterior wall is often seriously hematoma, pain and vague reflex after the operation are frequently caused, the radial artery occlusion probability is increased, and the periosteum syndrome can be generated in serious cases.
4. The improved auxiliary catheter guiding method comprises the following steps: 0.014 guide wire is fed into the improved auxiliary catheter through the radial artery along the guide wire to the head end of the guide catheter, and is fed forwards after being gradually expanded, so that the method obviously increases the cost of patients and prolongs the interventional exposure time.
Disclosure of Invention
To overcome the disadvantages and shortcomings of the prior art, the present invention discloses an improved accessory catheter and a catheter having the same.
The present invention provides an improved accessory catheter, comprising: a body part and head ends respectively positioned at the front part of the body part; the body part extends into the inner cavity of the guide catheter, and the head end has a conical structure and extends outwards from the far end of the guide of the finger; the tail handle extends outwards from the proximal end of the guide catheter; the body has an open channel.
The improved guide catheter as above, wherein the rear part of the body has a tail handle.
The improved auxiliary conduit is characterized in that: wherein the body part and the handle are integrally formed.
4. An improved guide tube as set forth in any of claims 1-3, wherein said tip is softer than said body.
The improved secondary catheter as set forth above, wherein said tip and body have different thicknesses.
The improved secondary catheter as described above, wherein the tip and body are of different materials.
The improved secondary catheter as described above, wherein the tip and body are integrally formed.
The improved secondary catheter as described above, wherein the outer sidewall of the body and the inner sidewall of the guide catheter abut each other.
The improved guide catheter described above, wherein the tip has a protrusion, may facilitate synchronization of the tip with the guide catheter.
The improved secondary catheter as described above, wherein the tip of the tip has a spherical front portion.
The invention also provides the use of an improved auxiliary catheter as described above for the device of interventional treatment of radial, ulnar, brachial and femoral access.
Compared with the prior art, the invention has the advantages that: the improved auxiliary catheter can assist in guiding the catheter to rapidly pass through a narrow section, and obviously shortens the intervention time; significantly reducing complications of the radial artery; and does not alter the interventional approach (femoral artery puncture is not required); in addition, the improved auxiliary conduit of the invention is low in price; the rapid exchange is realized, the guide wires do not need to be completely withdrawn, and the coronary artery is prevented from being damaged by the guide catheter; when the lesion is complicated and a large-caliber guide catheter is needed, the lesion can pass through the radial artery route conventionally, femoral artery puncture is avoided, and radial artery injury is reduced.
The technical problems actually solved by the applicant in the present invention are: the head of the guide catheter is prevented from damaging the blood vessel wall during the advancement, and the guide catheter is difficult to be delivered to the coronary ostia site through a fine detour in the artery. The conical shape of the head end of the auxiliary catheter and the arrangement of the conical shape of the head end of the auxiliary catheter extending outwards from the far end of the guide catheter can prevent the head of the guide catheter from damaging the vascular wall in the conveying process, meanwhile, the auxiliary catheter and the side wall of the guide catheter are attached to form friction force between the auxiliary catheter and the guide catheter, so that the auxiliary catheter and the guide catheter are tightly combined and are sent into the artery as an assembly, and the auxiliary catheter can rapidly pass through the tiny tortuous parts of each artery under the guiding action of the conical structure of the head end of the auxiliary catheter.
The side walls of the auxiliary catheter and the guide catheter must be fitted to form an assembly in order to improve the operational stability.
The improved auxiliary catheter can assist in guiding the catheter to rapidly pass through a narrow section, and obviously shortens the intervention time; obviously reduces the complications of the radial artery.
Drawings
FIG. 1 is a first schematic view of an improved secondary catheter in accordance with the present invention;
FIG. 2 is a second schematic view of the improved secondary catheter of the present invention;
FIG. 3 is a schematic view of a caudal peduncle of the present invention
FIG. 4 is a schematic view of a radial artery access interventional procedure
FIG. 5 is a schematic view of a cardiac interventional device entering coronary arteries
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings of specific embodiments of the present invention. The technical features of the embodiments of the present invention may be combined with each other without contradiction.
The invention discloses a using method and a treatment effect of the improved auxiliary catheter and the catheter assembly through the following embodiments.
Example 1
Female, age 73, coronary heart disease, unstable angina, diabetes, hyperlipidemia, patient preoperative stress, coronary angiography through radial artery, suggesting severe stenosis of right crown 80%; conventionally keeping a J-shaped guide wire to the aortic sinus to form a U shape; the guiding catheter 2 is sent to the vicinity of the radial artery along the guide wire 3, the resistance is high, the forearm of the patient is severely painful, and the guiding catheter is withdrawn, so that the pain is relieved. Judging as radial artery spasm.
1. Inserting the auxiliary catheter 1 into the guide catheter 2 through the tail end (Y valve) of the guide catheter 2, wherein the length of the head end of the auxiliary catheter 1 exceeding the guide catheter 2 is 5 cm;
2. the assembled guide catheter 2, the auxiliary catheter 1 and the extension wire 3 are synchronously and integrally sent to reach the ascending aorta through the radial artery stenosis section;
3. fixing the guide wire 3, withdrawing the auxiliary catheter 1, and quickly withdrawing, wherein the guide catheter 2 and the J-shaped guide wire 3 are kept still;
4. the guide catheter 2 smoothly reaches the first opening of the right coronary to complete the coronary intervention operation;
5. after the guide catheter 2 and the radial artery sheath are removed smoothly, the puncture part is wrapped by conventional pressure, and the forearm has no swelling and obvious pain;
after 6.48 hours, there was no swelling and no obvious pain in the forearms.
Example 2
Male, age 58, coronary heart disease, acute coronary syndrome, hypertension, hyperlipidemia; coronary angiography is performed through the radial artery, and 90% of severe diffuse stenosis of the anterior descending branch and the middle section is prompted; the distal 90% of the right coronal mass is severely stenosed; patients are advised to bypass the bridge surgically and are considered to be rejected and require intervention.
After three days, coronary intervention treatment is carried out, the head end of the guide catheter 2 is sent to the position near the elbow joint of the radial artery along the guide wire 3 and meets obvious resistance, the forearm of a patient is severely painful, and the guide catheter 2 is withdrawn, so that the pain is relieved. Judging as radial artery spasm.
1. Inserting the auxiliary catheter 1 into the guide catheter 2 through the tail end (Y valve) of the guide catheter 2, wherein the head end of the auxiliary catheter 1 exceeds the guide catheter 2 by 10 cm;
2. the assembled guide catheter 2, the auxiliary catheter 1 and the extension wire 3 are synchronously and integrally sent to reach the ascending aorta through the radial artery resistance section;
3. fixing the guide wire 3, withdrawing the auxiliary catheter 1, stripping the auxiliary catheter 1 along the groove line, and quickly withdrawing, wherein the guide catheter 2 and the guide wire 3 are kept still;
4. the guide catheter 2 smoothly reaches the first opening of the left coronary to complete the coronary intervention operation;
5. after the guide catheter 2 and the radial artery sheath are removed smoothly, the puncture part is wrapped by conventional pressure, and the forearm has no swelling and obvious pain;
after 6.48 hours, there was no swelling and no obvious pain in the forearms.
It is obvious that the above embodiments are only a part of the embodiments of the present invention, and not all of them. Based on the embodiments of the present invention, those skilled in the art should also include various changes, modifications, substitutions and improvements without creative efforts to the embodiments.
Claims (10)
1. An improved auxiliary catheter which can be mediated by a guide catheter, characterized in that: the improved accessory catheter includes: a body part and head ends respectively positioned at the front part of the body part; the body part extends into the inner cavity of the guide catheter, and the head end has a conical structure and extends outwards from the far end of the guide of the finger; the tail handle extends outwards from the proximal end of the guide catheter; the body has an open channel.
2. The improved auxiliary conduit according to claim 1, wherein: the rear part of the body is provided with a tail handle.
3. The improved auxiliary conduit according to claim 2, wherein: the body part and the handle are integrally formed.
4. An improved auxiliary catheter as in any of claims 1-3, wherein: the head is softer than the body.
5. An improved auxiliary catheter as in any of claims 1-4, wherein: the head and body portions have different thicknesses.
6. An improved auxiliary catheter as in any of claims 1-4, wherein: the head and body portions are of different materials.
7. An improved auxiliary catheter as in any of claims 1-4, wherein: the head end and the body are integrally formed.
8. An improved auxiliary catheter as in any of claims 1-4, wherein: the outer side wall of the body part is attached to the inner side wall of the guide conduit.
9. An improved auxiliary catheter as in any of claims 1-4, wherein: the tip has a protrusion that may facilitate synchronization of the tip with the guide catheter.
10. Use of the improved accessory catheter of any one of claims 1-10 in an interventional device for use in any one of the radial, ulnar, brachial and femoral arteries.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2019107379454 | 2019-08-12 | ||
| CN201910737945 | 2019-08-12 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN112386776A true CN112386776A (en) | 2021-02-23 |
Family
ID=74603058
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202010805238.7A Pending CN112386776A (en) | 2019-08-12 | 2020-08-11 | Improved auxiliary catheter |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN112386776A (en) |
Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN206964705U (en) * | 2016-12-20 | 2018-02-06 | 首都医科大学附属北京友谊医院 | Guiding catheter auxiliary sleeve pipe is exchanged through seal wire |
| CN108853685A (en) * | 2017-05-08 | 2018-11-23 | 靳志涛 | Trans-radial interposing catheter assistor |
| CN109875615A (en) * | 2018-04-12 | 2019-06-14 | 中国医学科学院阜外医院 | A kind of subsidiary conduit |
-
2020
- 2020-08-11 CN CN202010805238.7A patent/CN112386776A/en active Pending
Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN206964705U (en) * | 2016-12-20 | 2018-02-06 | 首都医科大学附属北京友谊医院 | Guiding catheter auxiliary sleeve pipe is exchanged through seal wire |
| CN108853685A (en) * | 2017-05-08 | 2018-11-23 | 靳志涛 | Trans-radial interposing catheter assistor |
| CN109875615A (en) * | 2018-04-12 | 2019-06-14 | 中国医学科学院阜外医院 | A kind of subsidiary conduit |
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Application publication date: 20210223 |