CN113197619A - Thrombus taking support adapting to intracranial vascular structure - Google Patents

Thrombus taking support adapting to intracranial vascular structure Download PDF

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Publication number
CN113197619A
CN113197619A CN202110413766.2A CN202110413766A CN113197619A CN 113197619 A CN113197619 A CN 113197619A CN 202110413766 A CN202110413766 A CN 202110413766A CN 113197619 A CN113197619 A CN 113197619A
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China
Prior art keywords
stent
main body
thrombus
support
section
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CN202110413766.2A
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Chinese (zh)
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马家耀
常鑫岳
魏铭
李家林
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Tianjin University
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Tianjin University
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/22Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/22Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/22Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2217Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions single wire changing shape to a gripping configuration

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention discloses a thrombus removal stent adaptive to an intracranial vascular structure, which comprises a stent main body and a push rod, wherein the stent main body is provided with a stent main body; the stent main body is a tubular structure consisting of a plurality of ribs, the ribs are in a continuous sine wave structure in the axial direction, every two sine wave ribs with 90-degree phase difference form a mesh belt, the mesh belt comprises a plurality of stent meshes, and the plurality of mesh belts are circumferentially staggered to form the stent main body; the diameter of the bracket main body is uniformly reduced along the axial direction, and the whole bracket main body is conical; the stent main body can automatically expand after being crimped and restore to the original shape and size; the push rod is fixedly connected with one end, with the largest diameter, of the support main body.

Description

Thrombus taking support adapting to intracranial vascular structure
Technical Field
The invention relates to the technical field of medical instruments, in particular to a thrombus removal stent suitable for an intracranial vascular structure.
Background
Stroke, commonly known as "stroke," is the first killer of death and disability in adults, and has the characteristics of high morbidity, high disability rate, high mortality and high recurrence rate. Global Disease Burden studies (GBD) show that the overall life-long stroke risk in our country is 39.9%, which is the top Global, meaning that about 2 out of every 5 people in a Chinese life will suffer from stroke.
Stroke is classified into ischemic stroke (also called cerebral infarction) and hemorrhagic stroke (also called cerebral hemorrhage), wherein ischemic stroke accounts for about 87% of the total stroke. At present, two main treatment modes of cerebral arterial thrombosis are provided, one mode is drug thrombolysis which is the treatment means with the widest application at present, but the treatment effect of the drug thrombolysis on the recanalization of the blockage of the great vessel is poor, and the treatment time window is short;
the other is mechanical thrombus removal, which can overcome the defect of drug thrombolysis, accelerate the revascularization, obviously improve the prognosis of patients with large vessel occlusion, reduce disability and death rate and reduce complications.
The mechanical thrombus extraction process is a treatment method for enabling a thrombus extraction device to enter intracranial blood vessels through a blood vessel approach, capturing thrombus by utilizing a porous tubular structure of a thrombus extraction support and mechanically removing the thrombus from a human body, and recovering blood flow of the intracranial blood vessels, wherein the thrombus extraction support is an important medical consumable in the mechanical thrombus extraction process, and the effect of thrombus extraction operation is influenced to a great extent.
At present, the most widely used Solitaire and Trevo thrombus extraction stents have better thrombus extraction effects clinically, but the thrombus extraction stents are not suitable for being implanted into narrow blood vessels, and are difficult to meet the requirements of adaptation to the anatomical structures of the blood vessels, small damage to the cutting of the inner walls of the blood vessels, high thrombus extraction efficiency and high universality. Especially aiming at the characteristic that most of Chinese stroke patients are accompanied with angiostenosis focuses, the existing thrombus taking bracket in the market is difficult to achieve the clinical effects of rapid thrombus taking and small wound, and the defects of poor blood vessel adaptability, easy thrombus escape, difficult balance of structure flexibility and strong radial supporting force and the like exist, so that the thrombus taking effect is poor. According to the report of the quality control center of the diseases of the Chinese nervous system, the good prognosis rate of the Chinese embolectomy in 2018 is less than 60 percent.
Disclosure of Invention
The invention aims to overcome the defects in the prior art, provides the thrombus removal support adaptive to the intracranial vascular structure, solves the problem of difficult thrombus removal of a narrow blood vessel through the structural design of variable diameter, and improves the good prognosis rate of patients.
The purpose of the invention is realized by the following technical scheme:
a thrombus taking support adapting to an intracranial vascular structure comprises a support main body and a push rod; the stent main body is a tubular structure consisting of a plurality of ribs, the ribs are in a continuous sine wave structure in the axial direction, every two sine wave ribs with 90-degree phase difference form a mesh belt, the mesh belt comprises a plurality of stent meshes, and the plurality of mesh belts are circumferentially staggered to form the stent main body; the diameter of the bracket main body is uniformly reduced along the axial direction, and the whole bracket main body is conical; the stent main body can automatically expand after being crimped and restore to the original shape and size; the push rod is fixedly connected with one end, with the largest diameter, of the support main body.
Further, the support main part divide into changeover portion and working section, the changeover portion is connected support main part and push rod into an organic whole through the welding, and the working section is used for catching the thrombus, realizes the function of thrombectomy.
Furthermore, one end of the transition section is connected with the push rod, and the other end of the transition section is connected with the working section; the transition section and the working section are both tubular structures with oblique cutting sections.
Further, the mesh holes of the stent are gradually reduced along the diameter of the stent along the axial direction.
Furthermore, the stent main body is in an open and overlapped structure, concave-convex parts of circumferential edge ribs of the stent main body correspond to each other, and the circumferential edge ribs are overlapped in space.
Furthermore, an open loop link is arranged in the bracket main body; the ring-opening links are uniformly distributed in the circumferential direction and the axial direction of the support, and the protruding direction of the ring-opening links is consistent with the direction in which the diameter of the support main body is gradually reduced.
Further, a developing section is arranged at the welding position of the bracket main body and the pushing rod; the rib line of the bracket main body is circumferentially and uniformly provided with a developing section.
Compared with the prior art, the technical scheme of the invention has the following beneficial effects:
1. the variable diameter design of the thrombus taking support conforms to the anatomical structure of intracranial blood vessels aiming at the common cerebrovascular stenosis focus of Chinese people, improves the adaptability of the support to the lumen of the blood vessel, avoids the far end of the blood vessel from being greatly expanded after being implanted, reduces the resistance of instruments in the thrombus taking process, can structurally prevent thrombus from escaping in the thrombus taking process, and improves the thrombus taking efficiency.
2. The thrombus taking support adopts an open type and partial open-loop structural design, realizes the balance of the radial support force, the flexibility and the compliance of the support, ensures good radial support force, reduces the deformation of the blood vessel after the support is implanted to the greatest extent, and avoids the damage to the inner wall of the blood vessel.
3. This get and tie support's mesh diminishes along with the diameter gradually, can catch thrombus not of uniform size, has high commonality, and well nearly section heavy-calibre big mesh is fit for the terminal thrombus of carotid, and well distal section design that tapers gradually, little mesh of small-bore is fit for well artery m1, m2 section thrombus, can realize that the support of a specification model solves most and get and tie the problem. Meanwhile, thrombus can be covered at one time, the thrombus taking times are reduced, the operation time is shortened, the complication probability is reduced, and a better operation effect is achieved.
4. This thrombectomy support is evenly to setting up the development structure axially, can accurate sign support position in the blood vessel, judges the expansion condition of support, is favorable to the operation and the judgement in the doctor's operation.
Drawings
Fig. 1 is a schematic structural diagram of an embodiment of the present invention.
Fig. 2 is a schematic structural diagram of a working segment according to an embodiment of the present invention.
Fig. 3 is an expanded view of the structure of the embodiment of the present invention.
Fig. 4 is an expanded view of the structure of the embodiment of the present invention.
Reference numerals: 1-main body of stent, 2-pushing rod, 11-transition section, 12-working section, 21-near end of stent, 22-far end of stent, 31-rib wire, 32-mesh of stent, 33-open loop and 34-developing section.
Detailed Description
The invention is described in further detail below with reference to the figures and specific examples. It should be understood that the specific embodiments described herein are merely illustrative of the invention and are not intended to limit the invention.
In order to make the technical problems solved by the present invention, the adopted design schemes and the achieved technical effects clearer, the technical schemes of the present invention are further explained by the following specific embodiments with the accompanying drawings. For ease of description, the following terms "proximal" and "distal" are defined, where "proximal" refers to the portion of the stent body that is proximal to the push rod and "distal" refers to the portion of the stent body that is distal from the push rod.
With reference to fig. 1 and 2, an embolectomy stent suitable for an intracranial vascular structure comprises a stent body 1 and a push rod 2. The main body 1 of the bracket is a porous tubular structure, and adopts an even taper design, the diameter of the bracket is gradually reduced along the axial direction, and the whole bracket is conical. The main body 1 of the bracket comprises a transition section 11 and a working section 12, the transition section 11 is connected with the main body 1 of the bracket and the push rod 2 into a whole by welding, and the working section 12 is used for capturing thrombus and realizing the function of thrombus removal. In this embodiment, the proximal stent end 21 has the largest diameter, the radial dimension decreases uniformly from the proximal stent end 21 to the distal stent end 22, and the distal stent end 22 has the smallest diameter. According to the anatomical structure of cerebral vessels, the vessels at the end of cerebral arteries are gradually thinned, when stents with uniform diameters are expanded in the gradually narrowed vessels, the pressure on the vessel wall is not uniform due to the difference of the diameters of different parts of the vessels, the contact force and the generated deformation on the narrowed vessels are larger, harmful contact reaction can be generated, and the damage to the vessels is caused. The variable diameter support of this embodiment can adapt to narrow blood vessel focus, and the design of variable diameter has adapted to cerebral artery's anatomical feature, and implantation that can be better is to narrow blood vessel, reduces the inhomogeneity of the pressure that the vascular wall receives, improves the compliance to blood vessel, when reducing the vascular wall damage, improves and gets the thrombus effect.
Referring to fig. 2, 3 and 4, the stent body 1 has an open-type and overlapping-type structure, the stent is not closed in the circumferential direction, the uneven portions of the circumferential edge ribs 31 correspond to each other, and the circumferential edges of the stent overlap spatially. The open structure enables the stent to be more easily radially crimped, when the radial dimension of the stent is contracted, the overlapping part of the circumferential edge is increased, the overlapping rate is increased, so that the axial elongation of the stent is smaller when the stent is radially compressed, the positioning of the stent in a blood vessel is facilitated, and the expansion condition of the stent in the blood vessel can be estimated through the circumferential overlapping rate. The open-loop links 33 are uniformly distributed in the circumferential direction and the axial direction of the stent main body 1, the rib wires 31 at the joints of the adjacent stent meshes 32 are removed, the open-loop links 33 are replaced by sine wave-shaped open-loop links 33, and the protruding direction of the open-loop links 33 faces the distal end 22 of the stent and conforms to the withdrawing direction of the stent. The completely connected unit structure enables the surface of the stent to be smoother, enables the closed-loop stent to be easier to recover in the operation process, and can improve the radial supporting force of the stent. The open loop link 33 of the stent removes the joints of partial muscle wires 31, so that the stent has better flexibility and compliance to blood vessels, when the stent is implanted into a bent blood vessel, the stent has better adherence effect after being unfolded, and the stent thrombosis taking effect is improved. In this embodiment, the stent includes a plurality of open-loop links 33, the stent shown in fig. 3 includes 3 open-loop links 33, and the stent shown in fig. 4 includes 4 open-loop links 33, so that as the number of open-loop links 33 increases, the flexibility and compliance of the stent are enhanced, and better adherence is achieved; but the rigidity of the whole structure is deteriorated, the radial supporting force of the bracket is reduced, and certain influence is also caused on the recovery of the bracket.
With reference to fig. 3 and 4, the stent main body 1 includes stent meshes 32 formed by a plurality of rib wires 31, the rib wires 31 are in a continuously attenuated sine waveform in the axial direction, two sine wave rib wires 31 with a phase difference of 90 ° form an axial mesh zone including a plurality of stent meshes 32, and the plurality of axial mesh zones are circumferentially staggered to form the porous tubular stent main body 1. The number of stent meshes 32 arranged in the axial mesh zone depends on the axial size of the stent meshes 32 and the effective working length of the stent; the number of axial mesh bands depends on the circumferential size of the stent mesh 32 and the diameter of the stent. The stent main body 1 is made of nickel-titanium alloy material, is formed by laser engraving a tube, and is processed into a tubular structure containing stent meshes 32. During actual use, the stent is radially compressed into the microcatheter and is transported to a target blood vessel through the microcatheter, and the stent is automatically expanded after being released from the microcatheter, captures thrombus and gradually expands to be tightly attached to the blood vessel wall. In this embodiment, the stent working section 12 is circumferentially provided with 4 axial mesh zones, the mesh zones are axially provided with 8 stent meshes 32, and the mesh sizes are gradually reduced along with the diameter of the stent from the proximal stent end 21 to the distal stent end 22. The proximal end 21 of the stent is large-diameter and large-mesh and is suitable for capturing large thrombi, and the distal end 22 of the stent is small-diameter and small-mesh and conforms to the anatomical structure of blood vessels, so that endothelial injury is reduced to the maximum extent, and small thrombi are captured at the same time. The bracket meshes 32 with variable sizes of the thrombus taking bracket are used for capturing thrombus of different sizes, so that the capability of capturing thrombus of the bracket is enhanced, the thrombus can be prevented from being separated in the thrombus taking process to a certain extent, and the thrombus taking efficiency is improved. The design of the stent variable diameter and variable size stent mesh 32 ensures that a patient who cannot cover thrombus by using the traditional stent for one time and needs to carry out secondary thrombus extraction or repeated thrombus extraction only needs to receive one thrombus extraction operation, reduces the operation time and vascular injury complications and improves the good prognosis rate of the patient.
With reference to fig. 1, 3 and 4, the working section 12 of the stent is connected with the stent pushing rod 2 into a whole through the transition section 11. The support changeover portion 11 and the working section 12 are integrally formed, and the support changeover portion 11 and the push rod 2 are welded into a whole. The composition structure of the stent transition section 11 is similar to that of the working section 12, the stent transition section 11 is tubular with a beveled section, and the stent meshes 32 are obviously fusiform, so that the stent is conveniently compressed into a microcatheter. In order to facilitate the development and positioning in the operation process, the welding position of the bracket main body 1 and the push rod 2 and the two ends and the middle part of the rib line 31 of the bracket main body 1 are uniformly provided with the development sections 34, and the development sections 34 are uniformly distributed in the circumferential direction to achieve the maximum development effect. The developing section 34 is realized by welding a developing substance to the rib wire 31 at a determined position, and simultaneously avoids the influence of a developing structure on the performance of the bracket.
The present invention is not limited to the above-described embodiments. The foregoing description of the specific embodiments is intended to describe and illustrate the technical solutions of the present invention, and the above specific embodiments are merely illustrative and not restrictive. Those skilled in the art can make many changes and modifications to the invention without departing from the spirit and scope of the invention as defined in the appended claims.

Claims (7)

1. A thrombus taking support adapting to an intracranial vascular structure is characterized by comprising a support main body and a pushing rod; the stent main body is a tubular structure consisting of a plurality of ribs, the ribs are in a continuous sine wave structure in the axial direction, every two sine wave ribs with 90-degree phase difference form a mesh belt, the mesh belt comprises a plurality of stent meshes, and the plurality of mesh belts are circumferentially staggered to form the stent main body; the diameter of the bracket main body is uniformly reduced along the axial direction, and the whole bracket main body is conical; the stent main body can automatically expand after being crimped and restore to the original shape and size; the push rod is fixedly connected with one end, with the largest diameter, of the support main body.
2. The thrombus extraction stent adapting to intracranial vascular structures according to claim 1, wherein the stent main body is divided into a transition section and a working section, the transition section integrally connects the stent main body and the push rod through welding, and the working section is used for capturing thrombus and realizing thrombus extraction function.
3. The thrombus removal stent adapting to intracranial vascular structures according to claim 2, wherein one end of the transition section is connected with the push rod, and the other end of the transition section is connected with the working section; the transition section and the working section are both tubular structures with oblique cutting sections.
4. The embolectomy stent of claim 1, wherein the stent mesh axially decreases with the diameter of the stent.
5. The embolectomy stent of claim 1, wherein the stent body is in an open and overlapping structure, and the concave-convex parts of the circumferential edge lines of the stent body correspond, and the circumferential edge lines are overlapped in space.
6. The embolectomy stent adapting to intracranial vascular structures as recited in claim 1, wherein the stent body is provided with an open loop element therein; the ring-opening links are uniformly distributed in the circumferential direction and the axial direction of the support, and the protruding direction of the ring-opening links is consistent with the direction in which the diameter of the support main body is gradually reduced.
7. The thrombus removal stent adapting to intracranial vascular structures according to claim 1, wherein a developing section is arranged at the welding part of the stent main body and the pushing rod; the rib line of the bracket main body is circumferentially and uniformly provided with a developing section.
CN202110413766.2A 2021-04-16 2021-04-16 Thrombus taking support adapting to intracranial vascular structure Pending CN113197619A (en)

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN114191154A (en) * 2022-02-18 2022-03-18 天津市环湖医院 Integrated plug taking support with gradually-changed diameter
CN115153994A (en) * 2022-07-06 2022-10-11 深圳市金瑞凯利生物科技有限公司 Can post expand vascular support and system

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN2453962Y (en) * 2000-12-08 2001-10-17 杨大智 Engraved sinusoidal-wave tube net type coronary-artery carriage
US20150032144A1 (en) * 2013-07-25 2015-01-29 Covidien Lp Vascular devices and methods with distal protection
CN106137484A (en) * 2016-08-01 2016-11-23 江苏大学 A kind of self-expansion type conical blood vessel support
CN106580397A (en) * 2016-12-20 2017-04-26 北京久事神康医疗科技有限公司 Sectional thrombus extraction device and thrombus extraction method making use of thrombus extraction device
WO2019152328A1 (en) * 2018-01-30 2019-08-08 Wallaby Medical, Inc. Devices and methods for treating blocked blood vessels
CN111434314A (en) * 2019-01-15 2020-07-21 苏州博欣医疗科技有限公司 Can develop thrombectomy support and thrombus remove device of location
CN111938747A (en) * 2020-07-24 2020-11-17 上海璞慧医疗器械有限公司 A thrombus removal mechanism and conveying device

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN2453962Y (en) * 2000-12-08 2001-10-17 杨大智 Engraved sinusoidal-wave tube net type coronary-artery carriage
US20150032144A1 (en) * 2013-07-25 2015-01-29 Covidien Lp Vascular devices and methods with distal protection
CN106137484A (en) * 2016-08-01 2016-11-23 江苏大学 A kind of self-expansion type conical blood vessel support
CN106580397A (en) * 2016-12-20 2017-04-26 北京久事神康医疗科技有限公司 Sectional thrombus extraction device and thrombus extraction method making use of thrombus extraction device
WO2019152328A1 (en) * 2018-01-30 2019-08-08 Wallaby Medical, Inc. Devices and methods for treating blocked blood vessels
CN111434314A (en) * 2019-01-15 2020-07-21 苏州博欣医疗科技有限公司 Can develop thrombectomy support and thrombus remove device of location
CN111938747A (en) * 2020-07-24 2020-11-17 上海璞慧医疗器械有限公司 A thrombus removal mechanism and conveying device

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN114191154A (en) * 2022-02-18 2022-03-18 天津市环湖医院 Integrated plug taking support with gradually-changed diameter
CN115153994A (en) * 2022-07-06 2022-10-11 深圳市金瑞凯利生物科技有限公司 Can post expand vascular support and system

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