CN113180820A - Radial laser ablation catheter - Google Patents
Radial laser ablation catheter Download PDFInfo
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- CN113180820A CN113180820A CN202110482148.3A CN202110482148A CN113180820A CN 113180820 A CN113180820 A CN 113180820A CN 202110482148 A CN202110482148 A CN 202110482148A CN 113180820 A CN113180820 A CN 113180820A
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
- A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00345—Vascular system
- A61B2018/00404—Blood vessels other than those in or around the heart
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Abstract
The invention relates to a radial laser ablation catheter. It comprises a catheter main body, a transmission piece and an optical element; the delivery member is disposed inside the catheter body along the catheter body axis; the transmission piece is used for transmitting laser; the optical element is arranged at the end part of the catheter body and is connected with the tail end of the transmission piece; the optical element is used for changing the direction of the laser transmitted by the transmission member so as to enable the laser to be emitted towards the direction of the blood vessel wall. The radial laser ablation catheter shown in the application can be used for ablation and removal of unstable plaque of a blood vessel wall, and a blood flow channel in the blood vessel is widened. Greatly reducing the possibility of vascular restenosis and reducing the recurrence of coronary heart disease. The invention has simple structure, good compatibility with the original structure and strong practicability. Can be used in combination with other medical treatment means for treatment, and is especially suitable for medical scenes of intravascular ablation operations such as coronary heart disease.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a radial laser ablation catheter.
Background
With the development of medical science and technology, in the treatment of coronary heart disease, there are a plurality of methods for eliminating diseased tissue plaques. Which comprises the following steps:
(1) radiofrequency ablation. The radio frequency ablation is a method for necrotizing the pathological tissue by using the heat effect of radio frequency current, the working temperature of the radio frequency ablation is controlled to be 37-55 ℃, and the temperature can enable the pathological tissue to be coagulated and necrotized. Radio frequency ablation, however, is not capable of liquefying and removing the diseased tissue.
(2) Cardiac stenting therapy. A heart stent is a medical device commonly used in cardiac interventional surgery. The heart stent has the function of dredging artery vessels. When the blood vessel is blocked by the blood vessel plaque and the thrombus, the blood vessel is expanded by using the heart stent, so that the effect of recovering the blood flow is achieved. However, after the heart stent is implanted, anticoagulant drugs need to be taken for a long time, and restenosis of blood vessels, namely recurrence of coronary heart disease, is easily caused.
(3) Laser ablation. Laser ablation is performed by extending a laser transmission catheter into a blood vessel to act on a tissue target, so that the purpose of ablating pathological tissues is achieved. However, laser ablation can only enlarge the blood flow channel and can not completely cure unstable plaque, and a heart stent needs to be used together at the moment. Similarly, coronary heart disease is likely to recur because cardiac stents are likely to cause vascular restenosis.
Therefore, how to eliminate unstable plaque of the blood vessel wall is an urgent problem to be solved in cardiovascular surgery.
Disclosure of Invention
Based on this, it is necessary to provide a radial laser ablation catheter aiming at the problem of how to eliminate unstable plaque of the vessel wall.
A radial laser ablation catheter comprising: a catheter body, a transmission member and an optical element;
the delivery member is disposed inside the catheter body along the catheter body axis; the transmission piece is used for transmitting laser;
the optical element is arranged at the end part of the catheter main body and comprises an inlet section, a turning section and an emitting section which are sequentially connected;
the entrance section is connected with the tail end of the transmission piece;
the direction changing section is used for changing the laser direction;
the exit surface of the exit section faces the vessel wall.
In one embodiment, the direction-changing section comprises at least one reflecting surface and/or at least one refractive layer.
In one embodiment, the direction changing section comprises a first coupling surface connected with the entrance section and a second coupling surface connected with the exit section;
the first coupling surface and the second coupling surface are non-parallel, and the reflecting surface and/or the refraction layer are formed between the first coupling surface and the second coupling surface;
the emergent surface is parallel to the second coupling surface;
the included angle between the emergent surface and the radial line of the catheter main body is 90 +/-10 degrees.
In one embodiment, the second coupling surface coincides with the exit surface.
In one embodiment, the direction changing section comprises a reflecting surface, and an included angle between the reflecting surface and the axial direction of the catheter main body is 45 +/-5 degrees.
In one embodiment, the optical element is a waveguide lens having at least one reflective surface that redirects the laser light.
In one embodiment, the end of the waveguide lens remote from the catheter body is provided with the reflective surface, which is non-perpendicular and non-parallel to the direction of laser light incident on the waveguide lens.
In one embodiment, the angle between the reflective surface and the axial direction of the catheter body is 45 °.
In one embodiment, the waveguide lens is a ring waveguide lens; the diameter of the waveguide lens is 1/3-1/2 of the diameter of a blood vessel.
In one embodiment, the contact surface of the waveguide lens and the catheter body forms an included angle of 90 ± 3 ° with the axial direction of the catheter body.
In one embodiment, the number of the optical elements is at least one, and one optical element is connected with at least one transmission piece.
Above-mentioned radial laser ablation catheter, through optical element's setting, will change the direction of laser emission originally for laser can launch towards the direction of vascular wall, melts and clears away to the unstable plaque on the vascular wall. By adopting the radial laser ablation catheter, the blood flow channel in the blood vessel can be dredged. Compared with the added vascular stent, the cost is lower, and the side effect is smaller. After the unstable plaque of the vascular wall is eliminated, the possibility of vascular restenosis can be greatly reduced, and the recurrence of coronary heart disease is reduced.
In addition, the invention has simple structure, good compatibility with the original structure and strong practicability. Can be used in combination with other medical treatment means for treatment, and is especially suitable for medical scenes of intravascular ablation operations such as coronary heart disease.
In summary, the invention includes at least one of the following beneficial technical effects:
1. the radial laser ablation catheter provided by the invention has a good ablation effect on thrombus and plaque of a blood vessel wall. Compared with the traditional axial laser, the laser emitted by the radial laser ablation catheter can ablate plaque and thrombus with larger aperture, so that the channel for blood to flow in the blood vessel is enlarged.
2. After the radial laser ablation catheter provided by the invention is used, the use of a blood vessel stent can be avoided, and the situations of injury and restenosis of blood vessels are effectively prevented.
3. The invention uses less power density than the axial laser ablation catheters of the related art. The adoption of smaller power density can reduce the damage to the vessel wall and even the tissue cells and relieve the pain of patients.
Drawings
Fig. 1 is a schematic structural view of a radial laser ablation catheter provided in accordance with an embodiment of the present application;
FIG. 2 is an enlarged partial schematic view at A of FIG. 1;
FIG. 3 is a cross-sectional view of an optical element provided in an embodiment of the present application (with arrows indicating laser directions);
FIG. 4 is a cross-sectional view of an optical element provided in another embodiment of the present application (with arrows indicating laser direction)
Fig. 5 is a schematic view of a radial laser ablation catheter in operation (with the arrows indicating the laser direction) according to an embodiment of the present application.
Reference numerals: 1. a catheter body; 11. a laser coupling tip; 12. a tail pipe; 13. a working section; 131. a through hole; 132. a guide channel; 2. an optical element; 21. entering a section; 22. a turning section; 23. an ejection section; 24. a reflective surface; 25. a connecting surface; 26. an exit surface; 27. a first coupling surface; 28. a second coupling surface; 3. a metal guide wire.
Detailed Description
In order to make the aforementioned objects, features and advantages of the present invention comprehensible, embodiments accompanied with figures are described in detail below. In the following description, numerous specific details are set forth in order to provide a thorough understanding of the present invention. This invention may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein.
In the description of the present invention, it is to be understood that the terms "central," "longitudinal," "lateral," "length," "width," "thickness," "upper," "lower," "front," "rear," "left," "right," "vertical," "horizontal," "top," "bottom," "inner," "outer," "clockwise," "counterclockwise," "axial," "radial," "circumferential," and the like are used in the orientations and positional relationships indicated in the drawings for convenience in describing the invention and to simplify the description, and are not intended to indicate or imply that the referenced device or element must have a particular orientation, be constructed and operated in a particular orientation, and are not to be considered limiting of the invention.
Furthermore, the terms "first", "second" and "first" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defined as "first" or "second" may explicitly or implicitly include at least one such feature. In the description of the present invention, "a plurality" means at least two, e.g., two, three, etc., unless specifically limited otherwise.
In the present invention, unless otherwise expressly stated or limited, the terms "mounted," "connected," "secured," and the like are to be construed broadly and can, for example, be fixedly connected, detachably connected, or integrally formed; can be mechanically or electrically connected; they may be directly connected or indirectly connected through intervening media, or they may be connected internally or in any other suitable relationship, unless expressly stated otherwise. The specific meanings of the above terms in the present invention can be understood by those skilled in the art according to specific situations.
In the present invention, unless otherwise expressly stated or limited, the first feature "on" or "under" the second feature may be directly contacting the first and second features or indirectly contacting the first and second features through an intermediate. Also, a first feature "on," "over," and "above" a second feature may be directly or diagonally above the second feature, or may simply indicate that the first feature is at a higher level than the second feature. A first feature being "under," "below," and "beneath" a second feature may be directly under or obliquely under the first feature, or may simply mean that the first feature is at a lesser elevation than the second feature.
It will be understood that when an element is referred to as being "secured to" or "disposed on" another element, it can be directly on the other element or intervening elements may also be present. When an element is referred to as being "connected" to another element, it can be directly connected to the other element or intervening elements may also be present. The terms "vertical," "horizontal," "upper," "lower," "left," "right," and the like as used herein are for illustrative purposes only and do not denote a unique embodiment.
Referring to fig. 1 and 2, fig. 1 is a schematic structural diagram of a radial laser ablation catheter in an embodiment of the invention. Fig. 2 is a partially enlarged schematic view at a in fig. 1. The invention provides a radial laser ablation catheter, which comprises a catheter main body 1, a transmission piece and an optical element 2. Wherein the catheter body 1 can be connected to a laser generating device. The catheter main body 1 is internally provided with a transmission member for transmitting laser. The optical element 2 is arranged at one end of the catheter main body 1 far away from the laser generating device, and the optical element 2 is connected with the tail end of the transmission piece so as to change the direction of the laser transmitted by the transmission piece and enable the laser to be emitted towards the direction of the blood vessel wall. The direction of laser is changed into towards the vascular wall direction by towards the vascular axial, and the laser of emitting towards the vascular wall direction can be ablated to the unstable plaque on vascular wall surface to enlarge the blood flow passageway.
The laser generating device can be a fiber laser, and can also be other devices capable of realizing the same function.
As shown in fig. 1, the catheter body 1 includes a laser coupling tip 11, a tail tube 12 and a working section 13 connected in sequence, and the catheter body 1 is coupled to the laser generator through the laser coupling tip 11. One end of the tail pipe 12 is connected with the laser coupling end head 11, and the other end of the tail pipe 12 is connected with the working section 13. The tail pipe 12 and the working section 13 are shaped by thermal shrinkage of a plastic sheath. The tail pipe 12 can be made of PTFE, PU, PVC or pebax. Since the tail tube 12 needs to be held by a doctor and needs to maintain a certain bending rigidity and toughness, the diameter of the tail tube 12 is slightly larger than the working section 13, for example, the tail tube 12 with a diameter of 3-5mm may be selected.
Since the working section 13 needs to be extended into the blood vessel and to travel smoothly in the blood vessel. Thus, the outer surface of the working section 13 is smooth, and the working section 13 is constructed of a non-biotoxic material. For example, the material is made of any material such as FEP, pebax, PET or PC, and can also be made of other nontoxic materials. The diameter of the working section 13 may be 1-2 mm. In operation, the working portion 13 needs to extend from the wrist of the patient, along the blood vessel, and to the heart. Therefore, the length of the working section 13 is not less than 1.2 m. The length of the working section 13 is preferably 1.3-1.5m in order to reduce material waste.
Since the working section 13 needs to be moved in the axial direction of the blood vessel, the working section 13 has a guide passage 132 in order to facilitate the movement of the working section 13 to the target position, as shown in fig. 2. The guide passage 132 is provided in the radial middle of the working section 13, and the guide passage 132 extends in the same direction as the axial direction of the working section 13. In addition, to facilitate movement of the working section 13 to the target location, the radial laser ablation catheter may further include a metal guidewire 3. The metal guide wire 3 is used to guide the working section 13. In some embodiments, the working section 13 is located near the tail pipe 12, and a through hole 131 for the metal guide wire 3 to pass through may be formed in a side wall thereof. The through-hole 131 communicates with the guide passage 132. The working section 13 may be sleeved on the metal guide wire 3, that is, the metal guide wire 3 may sequentially pass through the through hole 131 and the guide channel 132. When the working section 13 of the radial laser ablation catheter is inserted into a human body, the working section 13 of the radial laser ablation catheter needs to be extended into the working section 13 of the radial laser ablation catheter along the direction of the metal guide wire 3 inserted into the human body in the previous step in the operation, so that the working section 13 can be inserted into the human body.
In some embodiments, a transmission member (not shown) may be optionally used as a fiber optic bundle to facilitate transmission of the laser light. The optical fiber bundle may be formed by spirally winding a plurality of optical fibers. The fiber optic bundle is disposed in a wall of the conductor main tube. The number of the optical fiber bundles may be plural. The optical fiber bundles are spirally wound around the tail pipe 12 of the conductor main pipe, and the optical fiber bundles may be arranged in parallel at intervals or may be wound around the working section 13. Here, in order to increase the supporting force and toughness of the tail pipe 12, the tail pipe 12 is further provided with a mandrel. The core rod can be a stainless steel core rod or a core rod made of other materials. The fiber bundle in the tailpipe 12 is wrapped around the surface of the core rod to facilitate the surgeon's handling of the tailpipe 12. The winding may be a spiral winding.
As shown in fig. 3-5, in order to realize the above-mentioned optical element 2, the direction of the laser light transmitted by the transmission member is changed so that the laser light is emitted in the direction of the blood vessel wall. It should be noted here that the "direction toward the blood vessel wall" means a direction in which the laser light is emitted from the optical element 2 in a radial direction of the catheter main body 1, or in a direction close to the radial direction of the catheter main body 1. Further, "approximately radial to the catheter body 1" is to be understood as meaning that the angle between the exit direction of the optical element 2 and the radial to the catheter body 1 is 0-10 °. That is, the emission angle deviation amount of the laser light does not exceed ± 10 ° of the radial line. Preferably, the exit direction of the optical element 2 coincides radially with the catheter body 1. In this case, laser ablation is more effective and less can be irradiated to non-indeterminate plaques, i.e., non-targeted tissue, thereby reducing damage to healthy tissue.
In some embodiments, as shown in fig. 3 and 4, the optical element 2 may include an entrance section 21, a direction changing section 22, and an exit section 23 connected in sequence.
Wherein the direction of the laser movement is unchanged in the entry section 21, as shown in fig. 4. I.e. the laser moves in the original direction of the laser emitted from the end of the fiber bundle. After the laser moves from the entering section 21 to the turning section 22, the turning section 22 changes the moving direction of the laser in modes of reflection and/or refraction and the like. I.e. the redirecting section 21 comprises at least one reflecting surface 24 and/or at least one refractive layer. After the laser light passes through the direction-changing section 21, at least one reflection and/or refraction occurs to change the moving direction of the laser light. The deflecting section 21 comprises a first coupling surface 27 connected to the entry section 21 and a second coupling surface 28 connected to the exit section 23. The first coupling surface 27 is the end surface closest to where the reflecting surface 24 or refractive layer of the entrance section 21 joins the entrance section 21. The second coupling surface 28 is an end surface closest to the connection between the reflection surface 24 or the refraction layer of the emission section 23 and the emission section 23, and the end surface is parallel to the emission surface 26. The aforementioned reflecting surface 24 and/or refractive layer is formed between the first coupling surface 27 and the second coupling surface 28. In some embodiments, the first coupling surface 27 is perpendicular, or approximately perpendicular, to the second coupling surface 28. For example, the angle between the first coupling surface 27 and the second coupling surface 28 is 90 ° ± 10 °. For example, as shown in fig. 3, the direction changing section 22 has a reflecting surface 24, and the reflecting surface 24 is not perpendicular to and not parallel to the original moving direction of the laser. The laser light moves to the first coupling surface 27 and is then reflected at the reflecting surface 24 to change the laser light direction. When the direction-changing section 22 has only one reflecting surface 24, the angle between the reflecting surface 24 and the direction in which the laser beam enters the section 21 may be 45 °. I.e. the angle of incidence of the laser light at the reflecting surface 24 is 45 deg., in which case the angle of reflection is also 45 deg.. At this time, the second coupling surface 28 and the exit surface 26 are perpendicular to the radial direction of the catheter body 1. When the laser light passes through the reflecting surface 24, the direction of the laser light can be changed from the direction along the axial direction of the catheter main body 1 to the direction along the radial direction of the catheter main body 1. Furthermore, referring back to fig. 3, the second coupling surface 28 may coincide with the exit surface 26, i.e. the laser light is reflected at the reflection surface 24 and then exits from the second coupling surface 28 (i.e. the exit surface 26). In this way, the ejection section 23 can be omitted and the resulting outer surface of the optical element 2 can be relatively smooth, facilitating smooth travel of the radial laser ablation catheter within the blood vessel.
The number of the reflecting surfaces 24 may be two or more. The angle of the reflecting surface 24 is adjusted so that the direction of laser light emission changes to the target direction after the laser light is reflected twice or more.
For another example, the direction-changing section 22 is formed by connecting at least one substance with a different refractive index from the entering section 21, and the first coupling surface 27 is non-perpendicular and non-parallel to the moving direction of the laser light in the entering section 21. When the laser moves from the entering section 21 to the turning section 22, the laser enters different media at a certain angle at the first coupling surface 27, and the refractive indexes of the two media are different, so that a refraction phenomenon occurs, and the moving direction of the laser changes. In this case, the radial direction of the exit surface 26 and the catheter main body 1 may be different, that is, at the exit surface 26, a refraction may be performed once so that the laser light finally emitted from the exit surface 26 is emitted in the radial direction or a direction close to the radial direction of the blood vessel.
For another example, the direction-changing section 22 is formed by connecting at least one substance with a different refractive index from the entering section 21, and the first coupling surface 25 is non-perpendicular and non-parallel to the moving direction of the laser light in the entering section 21. The deflecting section 22 is furthermore provided with a reflecting surface 24. When the laser moves from the entering section 21 to the direction changing section 22, the laser is firstly refracted, so that the angle of the laser changes to a certain extent. The laser light is reflected as it moves to the reflective surface 24 to reflect the direction of travel of the laser light to the appropriate location.
After the laser is turned in any one of the above manners or the like, the laser enters the emitting section 23 from the turning section 22, and is emitted to the blood vessel wall from one end of the emitting section 23 far away from the turning section 22, or is directly emitted to the blood vessel wall from the turning section 22. After passing through the optical element 2, the direction of movement of the laser light changes from the axial direction along the catheter main body 1 to the direction toward the blood vessel wall.
The number of the optical elements 2 may be one or more, or may be plural. For example, in some embodiments, the number of the optical elements 2 is one, and the optical elements are simultaneously connected to a plurality of transmission members and simultaneously change the direction of the laser light transmitted through the plurality of transmission members. For another example, in some embodiments, the number of the optical elements 2 is multiple and is the same as the number of the transmission members, and the two are in one-to-one correspondence. At this time, the optical elements 2 may be disposed at intervals along the circumferential direction of the catheter body 1.
In some embodiments, as shown in fig. 2-5, the optical element 2 may be a waveguide lens, or other materials with high transmittance and that do not release toxic substances at high temperature. For example, in some embodiments, the waveguide lens is made of high purity quartz with high ultraviolet transmittance. It is to be explained here that in laser ablation processes, the laser light typically used is 308nm or 355nm ultraviolet light. Further, the above-mentioned "high ultraviolet transmittance" preferably means not less than 90% of ultraviolet transmittance. In addition, the "high purity quartz" referred to above may be silica having a content of 99% or more.
In the case of using a waveguide lens, the optical element 2 changes the laser beam traveling direction by reflection. In some embodiments, as shown in fig. 2-4, the number of waveguide lenses is one, and the waveguide lens may be a ring waveguide lens. The waveguide lens and the catheter body 1 can be connected by glue. The glue is non-toxic, stable in chemical property, transparent and uniform in texture. The axial direction of the waveguide lens coincides with the axial direction of the catheter body 1, or the deviation angle of both does not exceed 3 °. Namely, the angle of the end face at the joint of the transmission piece and the waveguide lens is ensured to be 90 degrees +/-3 degrees, so that the situation that the deviation of the laser emergent angle is large due to the angle deviation of the bonding part is reduced. The annular waveguide lens is provided with a channel which penetrates along the axial direction of the annular waveguide lens, the channel is arranged to facilitate the metal guide wire 3 to pass through, and the width of the channel is slightly wider than the diameter of the metal guide wire 3.
As shown in fig. 3-5, the end surface of the waveguide lens facing away from the catheter body 1 is beveled and the outer wall of the bevel is coated with a dense coating. The inclined surface serves as a reflecting surface 24. When the laser light strikes the coating, the light path is reflected. The coating can be a metal coating, such as aluminum, silver or titanium coating, or other nontoxic and chemically stable metal material.
As shown in fig. 4, in the waveguide lens, a surface connected to the catheter main body 1 is referred to as a connection surface 25. The surface with the reflective coating is denoted as the reflective surface 24. The surface from which the laser light is emitted is an emission surface 26. The section of the reflecting surface 24 cut along the radial direction of the catheter main body 1 near the end of the connecting surface 25 is the first coupling surface 27. The section of the end of the reflecting surface 24 close to the exit surface 26, cut along the axial direction of the catheter body 1, is the second coupling surface 28 (if a radial laser ablation catheter as shown in fig. 3 is used, the second coupling surface 28 coincides with the reflecting surface 24). Corresponding to the foregoing, i.e. the connection face 25 to the first coupling face 27 of the waveguide lens, is the aforementioned entry section 21. The first coupling surface 27 to the second coupling surface 28 are the aforementioned direction-changing sections 22. The second coupling surface 28 to the exit surface 26 are the exit section 23 (if the second coupling surface 28 and the reflection surface 24 overlap as shown in fig. 3, the length of the exit section 23 is 0).
Since the laser light is converted from the axial direction to the radial direction along the catheter main body 1, the unstable plaque elimination effect on the blood vessel wall and the elimination efficiency are high. Therefore, in some embodiments, the incident angle formed by the reflecting surface 24 and the laser light is preferably 45 °, and the corresponding reflecting angle is also 45 °. In order to avoid the deviation of the laser beam direction due to the change of the propagation medium of the laser beam when the laser beam is emitted from the emission surface 26 of the waveguide lens, the angle between the emission surface and the laser beam emission direction is 90 °, that is, the emission surface is perpendicular to the laser beam emission direction.
Furthermore, in other embodiments, the waveguide lens has two or more reflective surfaces 24, and the laser light sequentially passes through different reflective surfaces 24 to form successive reflections. After the laser light is reflected from the last reflecting surface 24, the emission direction thereof is the target direction. I.e. the laser light, after being emitted from the emitting section 23, moves along the radial direction of the catheter body 1 or approximately along the radial direction of the catheter body 1.
In order to facilitate the waveguide lens to move in the blood vessel, the diameter of the waveguide lens is 1/3-1/2 of the diameter of the blood vessel. If the diameter of the waveguide lens is too large, the vessel wall is easily damaged, and the resistance during travel is large. If the diameter of the waveguide lens is too small, the ablation effect is not good. It should be noted that the diameter of the waveguide lens referred to herein is the outer diameter of the widest part of the waveguide lens.
In addition, in some embodiments, the number of the waveguide lenses is plural, and corresponds to the number of the transmission members one by one. At this time, the adjacent waveguide lenses may be bonded by glue. The waveguide lens group formed after bonding can form a ring-shaped optical element 2. At this time, the farthest distance of the ring-shaped optical element 2 in the radial direction of the catheter body 1 is taken as the diameter of the ring-shaped optical element 2. The diameter is 1/3-1/2 of the diameter of the blood vessel.
Also, in some embodiments, a mounting member may be mounted to the end of the catheter body 1. The mounting member is provided with a plurality of mounting channels, and each mounting channel can be used for mounting one waveguide lens so as to realize the mounting of the waveguide lens. The mounting means may be adhesive or other fixed attachment means. The mounting piece can be made of any material such as FEP, pebax, PET or PC. At this time, the farthest distance of the mount in the radial direction of the catheter main body 1 is taken as the diameter of the annular optical element 2. Similarly, the diameter is 1/3-1/2 of the diameter of the blood vessel.
The working process of the radial laser ablation catheter shown in the application is as follows:
the radial artery of the hand is punctured and the sheath is left. The metal guide wire 3 is extended according to the perspective picture on the computer, and the contrast catheter is extended along the metal guide wire 3. Contrast agent is injected through the contrast catheter to visualize the lesion. The contrast catheter is then withdrawn and the usual axial excitation catheter is again extended along the metal guide wire 3. The common axial laser catheter is firstly used for ablating lesion plaques and thrombus, so that a blood flow channel is recovered, and the blood vessel is not completely blocked any more. The common laser catheter is then withdrawn. Extending along the metal guide wire 3 into the radial laser ablation catheter. So that the end of the working section 13 is located at the target position.
And (3) opening the laser generating device, connecting the laser generating device with the laser coupling end head 11, and transmitting the laser to the laser coupling end head 11. The laser beam passes through the tail tube 12 and the working section 13 in order along the extending direction of the optical fiber bundle, i.e., the axial direction of the catheter body 1, and reaches the optical element 2. At the optical element 2, i.e. at the waveguide lens, the laser light direction changes. The laser beam is emitted from the connecting surface 25 into the entrance section 21, and then moves to the reflecting surface 24 for reflection. The reflected laser light is redirected to be emitted in a radial direction of the catheter body 1 to ablate unstable plaque on the vessel wall. During ablation, the blood flow channel again enlarges, or even returns to normal levels. At this point, the radial laser ablation catheter can be withdrawn, the metal guide wire 3 withdrawn, and the wound is dressed.
In the laser ablation process, compared with the common axial ablation laser used in the prior art, the laser power can be effectively reduced. Since the thickness of the ablation layer of the blood vessel wall is smaller than the ablation thickness in the axial direction of the blood vessel, the laser power can be reduced when using a radial laser ablation catheter. The laser power density is reduced by matching with accelerating the advancing speed of the end part of the laser tube or adopting a back-and-forth moving ablation mode, so that the effect of reducing the damage is achieved. When the laser ablation operation is carried out, the laser power of the radial laser ablation catheter is reduced to about 30-40% of that of the axial laser ablation catheter in the related art. In addition, the patient does not need to install a vascular stent, and the medical cost is reduced.
The technical features of the embodiments described above may be arbitrarily combined, and for the sake of brevity, all possible combinations of the technical features in the embodiments described above are not described, but should be considered as being within the scope of the present specification as long as there is no contradiction between the combinations of the technical features.
The above-mentioned embodiments only express several embodiments of the present invention, and the description thereof is more specific and detailed, but not construed as limiting the scope of the invention. It should be noted that, for a person skilled in the art, several variations and modifications can be made without departing from the inventive concept, which falls within the scope of the present invention. Therefore, the protection scope of the present patent shall be subject to the appended claims.
Claims (10)
1. A radial laser ablation catheter, comprising: a catheter body, a transmission member and an optical element;
the delivery member is disposed inside the catheter body along the catheter body axis; the transmission piece is used for transmitting laser;
the optical element is arranged at the end part of the catheter main body and comprises an inlet section, a turning section and an emitting section which are sequentially connected;
the entrance section is connected with the tail end of the transmission piece;
the direction changing section is used for changing the laser direction;
the exit surface of the exit section faces the vessel wall.
2. The radial laser ablation catheter of claim 1, wherein the redirecting segment comprises at least one reflective surface and/or at least one refractive layer.
3. The radial laser ablation catheter of claim 2, wherein the redirecting section comprises a first coupling surface connected to the entry section and a second coupling surface connected to the exit section;
the first coupling surface and the second coupling surface are non-parallel, and the reflecting surface and/or the refraction layer are formed between the first coupling surface and the second coupling surface;
the emergent surface is parallel to the second coupling surface;
the included angle between the emergent surface and the radial line of the catheter main body is 90 +/-10 degrees.
4. The radial laser ablation catheter of claim 3, wherein the second coupling surface coincides with the exit surface.
5. The radial laser ablation catheter of claim 2, wherein the redirecting section comprises a reflecting surface, and the angle between the reflecting surface and the axial direction of the catheter body is 45 ± 5 °.
6. The radial laser ablation catheter of claim 1, wherein the optical element is a waveguide lens having at least one reflective surface that redirects laser light.
7. The radial laser ablation catheter of claim 6, wherein the end of the waveguide lens distal from the catheter body is provided with the reflective surface that is non-perpendicular and non-parallel to the direction of laser light incident on the waveguide lens.
8. The radial laser ablation catheter of claim 7, wherein the angle between the reflective surface and the axial direction of the catheter body is 45 °.
9. The radial laser ablation catheter of claim 7, wherein the waveguide lens is an annular waveguide lens; the diameter of the waveguide lens is 1/3-1/2 of the diameter of a blood vessel.
10. The radial laser ablation catheter of claim 6, wherein the angle between the contact surface of the waveguide lens with the catheter body and the axial direction of the catheter body is 90 ± 3 °.
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| CN202110482148.3A CN113180820A (en) | 2021-04-30 | 2021-04-30 | Radial laser ablation catheter |
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| CN202110482148.3A CN113180820A (en) | 2021-04-30 | 2021-04-30 | Radial laser ablation catheter |
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Address after: 510700 room 302-2, Keng Garden Shopping Mall, West 351 Xiangxue Avenue, Luogang, Huangpu District, Guangzhou City, Guangdong Province Applicant after: Guangdong Diguang Medical Technology Co.,Ltd. Address before: 510700 room 302-2, Keng Garden Shopping Mall, West 351 Xiangxue Avenue, Luogang, Huangpu District, Guangzhou City, Guangdong Province Applicant before: Guangzhou Diguang Medical Technology Co.,Ltd. |
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Application publication date: 20210730 |