CN112472210A - Thrombus crushing and collecting mechanism of thrombus capturing and removing catheter device - Google Patents
Thrombus crushing and collecting mechanism of thrombus capturing and removing catheter device Download PDFInfo
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- CN112472210A CN112472210A CN202011480376.9A CN202011480376A CN112472210A CN 112472210 A CN112472210 A CN 112472210A CN 202011480376 A CN202011480376 A CN 202011480376A CN 112472210 A CN112472210 A CN 112472210A
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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
- A61B2017/22079—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with suction of debris
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Abstract
The invention discloses a thrombus crushing and collecting mechanism of a thrombus capturing and removing catheter device, and belongs to the field of blood vessel interventional medical instruments. The suction device comprises a three-way suction connector, a suction inner pipe, a two-way outer pipe connector and an outer pipe, wherein the far end of the three-way suction connector is hermetically connected with the near end of the suction inner pipe, the far end of the two-way outer pipe connector is hermetically connected with the near end of the outer pipe, the inner pipe is inserted into the outer pipe, and the suction device further comprises a self-expansion basket support, a tip cap, a guide wire guide pipe and a separator. The separator is arranged at the far end of the catheter device, so that thrombus is cracked and guided into the suction catheter, and the risk of blocking a suction opening by the thrombus is reduced; the self-expansion basket support arranged near the suction opening can scrape wall-attached thrombus and improve the thrombus extraction rate; the self-expanding basket support can collect thrombus, prevent the thrombus from escaping to the far end and reduce the incidence of operation complications.
Description
Technical Field
The invention relates to a thrombus crushing and collecting mechanism of a thrombus capturing and removing catheter device, and belongs to the technical field of blood vessel interventional medical instruments.
Background
Deep Venous Thrombosis (DVT) is a disease caused by abnormal clotting of blood within a deep vein. DVT causes increased venous pressure, impeded blood return, lower limb swelling, pain and dysfunction, and if not effectively treated in the acute phase, thrombosis, venous obstruction, loss of valve function, venous return and venous hypertension, post-thrombotic syndrome (PTS), endangers limb survival. Meanwhile, the thrombus is at risk of falling off, and the fallen thrombus reaches pulmonary artery along with blood flow impact to cause pulmonary thromboembolism (PE), which has high lethality and disability rate and threatens life safety. The PTE and DVT are collectively called Venous Thromboembolism (VTE), and both have the same predisposition factor and are two manifestations of VTE at different sites and different stages.
With the development of technology, in recent years, mechanical thrombus removal (PMT) devices have appeared, which are a group of instruments for removing acute and subacute thrombus formation in blood vessels, and the devices adopt dissolving, crushing, suction modes and the like to remove thrombus in blood vessels and restore blood circulation and valve functions. PMT is microtrauma intracavity thrombus clearing device, can clear away the thrombus fast, resumes blood flow, saves valve function, and clinical effect has obtained expert's recognition, becomes the focus of research in recent years. Such as a thrombus removal catheter disclosed in patent CN201780075702.8, an auxiliary jet aspiration thrombus removal catheter disclosed in patent CN201880031836.4 and a method for using the same, and a mechanical thrombus removal device such as a rotational atherectomy device disclosed in patent CN 200880105037.3.
Still further interventional techniques include advancing a suction catheter into the thromboembolism in order to remove it by aspiration (i.e., negative pressure). While generally safe, only relatively soft thromboembolisms are effective. In addition, thrombus often has adhesion to the vessel wall, which is difficult to remove by aspiration, and the smaller aspiration catheter distal tip aspiration opening is less likely to locate and capture the mural thrombus in large diameter vessels, which can result in the patient not aspirating thrombus but only blood during negative pressure aspiration, resulting in excessive patient blood loss.
Accordingly, a thrombus fragment collecting mechanism of a thrombus capture and removal catheter device is proposed, which can significantly improve patient safety and thrombus aspiration effect.
Disclosure of Invention
The technical problem to be solved by the invention is as follows: provided is a thrombus fragment collecting mechanism of a thrombus capturing and removing catheter device, which can significantly improve patient safety and thrombus aspiration effect.
The technical problem to be solved by the invention is realized by adopting the following technical scheme:
a thrombus crushing and collecting mechanism of a thrombus capturing and removing catheter device comprises an inner suction pipe, a self-expanding basket support and a separator;
the self-expansion basket support is a basket structure which is made of metal with shape memory effect and has a near-end opening and a far-end contraction, a hollow tip cap is arranged at the far-end part of the self-expansion basket support, and the near-end opening of the self-expansion basket support is connected with the far end of the suction inner tube through a plurality of guide wires;
the separator is composed of a control wire and a ring arranged at the far end of the control wire, the separator is inserted into the suction inner tube, and the ring of the separator is positioned near the far end of the suction inner tube.
A thrombus capturing and removing catheter device comprises a three-way suction connector, a suction inner tube, a two-way outer tube connector and an outer tube, wherein the far end of the three-way suction connector is hermetically connected with the near end of the suction inner tube, the far end of the two-way outer tube connector is hermetically connected with the near end of the outer tube, the inner tube is inserted into the outer tube, and the thrombus capturing and removing catheter device also comprises a self-expanding basket support, a tip cap, a guide wire guide tube and a separator;
the self-expansion basket support is a basket structure which is made of metal with shape memory effect and has a near-end opening and a far-end contraction, a hollow tip cap is arranged at the far-end part of the self-expansion basket support, and the near-end opening of the self-expansion basket support is connected with the far end of the suction inner tube through a plurality of guide wires;
the separator is composed of a control metal wire and a ring arranged at the far end of the control metal wire, the ring of the separator is sleeved at the far end of the guide wire guide tube, the separator and the guide wire guide tube are inserted into the suction inner tube together, the far end of the guide wire guide tube penetrates through the tip cap, and the ring of the separator is positioned near the far end of the suction inner tube.
As a preferred example, the proximal end faces of the three-way suction connector and the two-way outer tube connector are both provided with silica gel hemostatic sealing valves, and the suction inner tube is inserted into the outer tube through the silica gel hemostatic sealing valve at the proximal end of the two-way outer tube connector in a sealing manner.
As a preferred example, the surface of the self-expanding basket stent is wholly or partially coated with a film.
As a preferred example, the central axis of the ring is at an acute angle to the control wire.
As a preferred example, the outer side of the proximal end of the tip cap is provided with a stepped groove portion having the same inner diameter as the outer tube.
The invention has the beneficial effects that:
(1) the separator is arranged at the far end of the catheter device, so that thrombus is cracked and guided into the suction catheter, and the risk of blocking a suction opening by the thrombus is reduced;
(2) the self-expansion basket support arranged near the suction opening can scrape wall-attached thrombus and improve the thrombus extraction rate;
(3) the self-expanding basket support can collect thrombus, prevent the thrombus from escaping to the far end and reduce the incidence of operation complications.
Drawings
FIG. 1 is a schematic overall structure of the present invention;
FIG. 2 is a schematic view of the proximal end of the present invention;
FIG. 3 is a schematic view of the distal end configuration of the present invention;
FIG. 4 is a schematic view of a planar open self-expanding basket support structure;
FIG. 5 is a schematic view of a self-expanding basket support structure with acute angled openings;
FIG. 6 is a schematic view of a planar open conical self-expanding basket support structure;
FIG. 7 is a schematic view of a tapered self-expanding basket support structure with an inclined opening;
FIG. 8 is a schematic view of a self-expanding basket support securing structure;
FIG. 9 is a schematic view of the distal end of the separator;
FIG. 10 is a cross-sectional structural view of the distal end of the present invention;
FIG. 11 is a schematic structural diagram of the remote initial state of the present invention;
FIG. 12 is a schematic view of the distal end of the present invention passing through a thrombus site;
FIG. 13 is a schematic structural view of a released self-expanding basket support and separator of the present invention;
FIG. 14 is a schematic structural view illustrating the movement of the self-expandable basket stent toward the direction of thrombus according to the present invention;
FIG. 15 is a schematic view of the thrombus disruption, collection and aspiration device of the present invention;
fig. 16 is a schematic view of the structure of the present invention for removing a human body.
In the figure: the device comprises a three-way suction connector 1, a suction inner tube 2, a two-way outer tube connector 3, an outer tube 4, a self-expanding basket support 5, a guide wire 501, a tip cap 6, a step groove 601, a guide wire guide tube 7, a separator 8, a control metal wire 801, a ring 802, a silica gel hemostatic sealing valve 9, a guide wire 10, thrombus 11 and a blood vessel 12.
Detailed Description
In order to make the technical means, the original characteristics, the achieved purpose and the efficacy of the invention easy to understand, the invention is further described with reference to the specific drawings.
For ease of description, the following description uses the terms "proximal" and "distal", where proximal refers to the end closer to the operator and distal refers to the end further from the operator.
Examples
As shown in figures 1-2, the thrombus capturing and removing catheter device using the thrombus fragmentation collecting mechanism comprises a three-way suction connector 1, a suction inner tube 2, a two-way outer tube connector 3 and an outer tube 4, wherein the distal end of the three-way suction connector 1 is hermetically connected with the proximal end of the suction inner tube 2, the distal end of the two-way outer tube connector 3 is hermetically connected with the proximal end of the outer tube 4, the inner tube 2 is inserted into the outer tube 4, the proximal end faces of the three-way suction connector 1 and the two-way outer tube connector 3 are respectively provided with a silica gel hemostatic sealing valve 9, the suction inner tube 2 is hermetically inserted into the outer tube 4 through the silica gel hemostatic sealing valve 9 at the proximal end of the two-way outer tube connector 3, and the thrombus capturing and removing catheter device further comprises a.
Wherein, the three-way suction connector 1 and the two-way outer tube connector 3 are both provided with inner cavities which can be respectively communicated with the suction inner tube 2 and the suction outer tube 4, and one side end surfaces of the three-way suction connector 1 and the two-way outer tube connector 3 are both provided with silica gel hemostatic sealing valves 9, so that the suction inner tube 2 can coaxially enter the inner part of the outer tube 4 through the silica gel hemostatic sealing valves 9 to keep the end surface sealed.
A third luer (proximal hub) on the three-way suction connector 1 can be connected to an external negative pressure suction device to provide negative pressure inside the suction inner tube 2. The guide wire guide tube 7 and the separator 8 can enter the interior of the suction inner tube 2 through the silica gel hemostatic sealing valve 9 to keep the end face of the suction inner tube 2 sealed, the guide wire guide tube 7 is provided with a cavity, and the guide wire 10 can reach a lesion part through the guide wire guide tube 7.
As shown in fig. 3-8, the self-expandable basket support 5 is a basket structure made of metal with shape memory effect and having a proximal opening and a distal contraction, the distal end of the self-expandable basket support 5 is provided with a hollow tip cap 6, and the proximal opening of the self-expandable basket support 5 is connected with the distal end of the suction inner tube 2 through a plurality of guide wires 501; the surface of the self-expanding basket stent 5 is wholly or partially coated with a film.
Wherein, the self-expanding basket support 5 is made into an imitated conical basket structure by weaving nickel-titanium alloy wires or laser cutting of nickel-titanium alloy tubes. The self-expanding basket stent 5 is primarily held by a guide wire 501 and a tip cap 6 at the distal end of the basket. The self-expanding basket stent 5 comprises a narrow neck portion which narrows at the proximal end, a cone portion with a certain taper and a cylindrical extension portion with a proximal opening, and at least 2 guide wires 501 are arranged at the opening of the cylindrical extension portion and fixed with the suction inner tube 2. The self-expanding basket stent 5 is connected with a hollow tip cap 6 by injection molding, melting or bonding, and the distal tip of the tip cap 6 is of a conical or spherical structure with a certain taper, so that the guide can be carried out in the blood vessel 12.
The basket opening of the self-expanding basket support 5 may be a planar opening as shown in fig. 4; or may be an acute angled opening as shown in fig. 5; alternatively, as shown in fig. 6, the metallic basket structure of the self-expandable basket support 5 may comprise a tapered neck portion and a tapered cone portion, the tapered neck portion being tapered at the proximal end; the tapered basket openings may be flat as shown in fig. 6 or they may be angled as shown in fig. 7.
The inner cavity of the tip cap 6 is coaxially arranged on the guide wire guide tube 7, and the tip cap 6 can freely move back and forth along the axis of the guide wire guide tube 7. One end of the guide wire 501 of the self-expanding basket support 5 is fixedly connected with the outer surface of the suction inner tube 2 near the distal tip opening by injection molding, thermal welding, bonding and the like, and the distal tip opening of the suction inner tube 2 is positioned near the basket opening of the self-expanding basket support 5.
The tip cap 6 is provided with a stepped recess portion 601 having the same inner diameter as the outer tube 4 at the outer side of the proximal end thereof.
The metal net basket structure 52 is wholly or partially attached to a membrane made of polymer or composite material such as ePTFE, TPU, PU, etc.
As shown in fig. 9-10, the separator 8 is composed of a control wire 801 and a ring 802 provided at the distal end of the control wire 801, the ring 802 of the separator 8 is fitted over the distal end of the guide wire guide tube 7, the separator 8 and the guide wire guide tube 7 are inserted together into the suction inner tube 2, the distal end of the guide wire guide tube 7 passes through the tip cap 6, and the ring 802 of the separator 8 is located near the distal end of the suction inner tube 2. The central axis of the ring 802 forms an acute angle with the control wire 801.
Wherein the ring 802 of the separator 8 is coaxially mounted on the guide wire guide tube 7 and the separator 8 is capable of reciprocating along the axis. The separator 8 and the guide wire guide tube 7 are arranged in the inner cavity of the suction inner tube 2, and the suction inner tube 2 is coaxially arranged in the inner cavity of the outer tube 4;
the separator 8 is mainly composed of a thin filament-shaped metal wire straight section control metal wire 801 and a circular ring 802 wound by one end of the far side of the metal wire, and the included angle between the central axis of the circular ring 802 and the control metal wire 801 is an acute angle.
The operation process comprises the following steps:
as shown in fig. 11, in the initial state of the catheter apparatus, the self-expandable basket support 5 is pressed into the lumen of the outer tube 4, and the proximal end of the tip cap 6 is fitted to the distal tip opening of the outer tube 4 through the stepped recessed portion 601 thereon. The distal tip of the separator 8 is withdrawn into the lumen of the aspiration inner tube 2. The suction inner tube 2 is positioned within the lumen of the outer tube 4 and the guide wire guide tube 7 is positioned within the lumen of the suction inner tube 2.
As shown in fig. 12, during the procedure, a blood vessel 12 is punctured and a guidewire 10 (otherwise purchased) is introduced to completely traverse the lesion (thrombus 11) site. The catheter device extends the whole catheter device in an initial state 1-2cm through a diseased thrombus 11 under the guidance of a guide wire 10, and then an outer tube 4 is withdrawn backwards to keep other components still.
After the outer tube 4 is withdrawn back for a certain distance, the self-expandable basket stent 5 is changed from the state of being pressed in the tube to the state of being opened by radial self expansion and clings to the wall of the blood vessel 12, and simultaneously, the self-expandable basket stent 5 radially self expands to cause the axial contraction thereof, thereby causing the tip cap 6 to be withdrawn along the axial movement of the guide wire guide tube 7.
As shown in FIGS. 14 to 15, when the whole catheter device is slowly moved toward the thrombus 11, the inclined mesh openings of the self-expandable basket stent 5 scrape the thrombus 11 in the blood vessel 12 and the thrombus 11 on the wall of the blood vessel 12 and guide them to the basket intermediate position along the basket tapered surface, and the distal end opening of the aspiration inner tube 2 is now located at the basket intermediate position, so that the thrombus 11 tissue collected by the basket is always located near the distal end aspiration opening of the aspiration inner tube 2.
At this time, the external negative pressure aspiration device is opened to aspirate the thrombus 11 into the aspiration inner tube 2. Meanwhile, the separator 8 at the suction opening of the suction inner tube 2 reciprocates back and forth at a certain frequency and distance in the axial direction of the guide wire guide tube 7 near the suction opening, extrudes, breaks and separates the large thrombus 11 blocked at the suction opening into small thrombus 11, and pushes the small thrombus into the suction inner tube 2, so that the large thrombus is more easily sucked by the suction inner tube 2 under negative pressure and is conveyed to the outside of the body through the outlet end of the three-way suction connector 1.
After the thrombus 11 is completely aspirated, the outer tube 4 is held fixed, the aspiration inner tube 2 and the self-expandable basket stent 5 attached thereto are withdrawn into the lumen of the outer tube 4 by pulling the proximal end portion of the aspiration inner tube 2, and all the devices are withdrawn together from the body, as shown in fig. 16.
The foregoing illustrates and describes the principles, general features, and advantages of the present invention. It will be understood by those skilled in the art that the present invention is not limited to the embodiments described above, and that various changes and modifications may be made without departing from the spirit and scope of the invention as defined in the appended claims. The scope of the invention is defined by the appended claims and equivalents thereof.
Claims (4)
1. A thrombus crushing and collecting mechanism of a thrombus capturing and removing catheter device is characterized by comprising an inner suction pipe (2), a self-expanding basket support (5) and a separator (8);
the self-expansion basket support (5) is of a basket structure which is made of metal with shape memory effect and has a proximal opening and a distal contraction, a hollow tip cap (6) is arranged at the distal end of the self-expansion basket support (5), and the proximal opening of the self-expansion basket support (5) is connected with the distal end of the suction inner tube (2) through a plurality of guide wires (501);
the separator (8) is composed of a control wire (801) and a circular ring (802) arranged at the far end of the control wire (801), the separator (8) is inserted into the suction inner tube (2), and the circular ring (802) of the separator (8) is positioned near the far end of the suction inner tube (2).
2. The thrombus-fragmentation collection mechanism of a thrombus capture and removal catheter device according to claim 1, wherein the surface of the self-expanding basket stent (5) is entirely or partially covered with a membrane.
3. The thrombus-fragmentation collection mechanism of a thrombus capture and removal catheter device according to claim 1 wherein the central axis of the ring (802) is at an acute angle to the control wire (801).
4. The thrombus-breaking collection mechanism of a thrombus capture and removal catheter device according to claim 1, wherein a step recess portion (601) is provided outside the proximal end of the tip cap (6).
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202011480376.9A CN112472210A (en) | 2020-12-15 | 2020-12-15 | Thrombus crushing and collecting mechanism of thrombus capturing and removing catheter device |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202011480376.9A CN112472210A (en) | 2020-12-15 | 2020-12-15 | Thrombus crushing and collecting mechanism of thrombus capturing and removing catheter device |
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| CN112472210A true CN112472210A (en) | 2021-03-12 |
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| CN202011480376.9A Pending CN112472210A (en) | 2020-12-15 | 2020-12-15 | Thrombus crushing and collecting mechanism of thrombus capturing and removing catheter device |
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| CN113907839A (en) * | 2021-11-24 | 2022-01-11 | 西安交通大学医学院第二附属医院 | Support thrombectomy device with thrombus capture component |
| CN114209392A (en) * | 2021-11-26 | 2022-03-22 | 上海玮琅医疗科技有限公司 | Double-guide-wire thrombus cutting and thrombus capturing bracket assembly |
| CN114469261A (en) * | 2022-02-11 | 2022-05-13 | 科塞尔医疗科技（苏州）有限公司 | Mechanical thrombus suction device |
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| CN115177321A (en) * | 2022-06-14 | 2022-10-14 | 上海腾复医疗科技有限公司 | Multifunctional thrombus clearing device |
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| CN118058799A (en) * | 2024-02-22 | 2024-05-24 | 上海融脉医疗科技有限公司 | Double-net-disc deep venous thrombosis excision system capable of being released in segmented mode |
| CN118058799B (en) * | 2024-02-22 | 2024-07-26 | 上海融脉医疗科技有限公司 | Double-net-disc deep venous thrombosis excision system capable of being released in segmented mode |
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