CN113197663B - Lateral laser ablation catheter system - Google Patents
Lateral laser ablation catheter system Download PDFInfo
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- CN113197663B CN113197663B CN202110629835.3A CN202110629835A CN113197663B CN 113197663 B CN113197663 B CN 113197663B CN 202110629835 A CN202110629835 A CN 202110629835A CN 113197663 B CN113197663 B CN 113197663B
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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
- 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
- A61B18/24—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 with a catheter
- A61B18/245—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 with a catheter for removing obstructions in blood vessels or calculi
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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
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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
- A61B2018/00351—Heart
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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
- 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
- A61B2018/2205—Characteristics of fibres
Abstract
The application provides a lateral laser ablation catheter system, including being responsible for, laser ablation unit, formation of image unit and oppression unit. The pipe wall of the main pipe is provided with an ablation window. The laser ablation unit comprises a laser ablation engine, a laser ablation optical fiber and a lens assembly, wherein the laser ablation engine is used for emitting a laser ablation beam and conducting the laser ablation beam through the laser ablation optical fiber, the laser ablation optical fiber and the lens assembly are arranged in the main pipe, and the lens assembly is used for adjusting the laser ablation beam emitted from the laser ablation optical fiber so as to enable the laser ablation beam to be emitted from the ablation window. The imaging unit is connected with the main tube and is used for acquiring tissue image information corresponding to the lateral direction of the main tube. The compression unit is connected with the main tube and is used for enabling the ablation window to be attached to the tissue wall. The ablation operation of the vessel wall of the side direction of the catheter is carried out by matching with vessel wall imaging, so that the local calcified plaque of the vessel wall is convenient to treat, the target position is accurate, and the efficiency and the success rate of the operation are improved.
Description
Technical Field
The invention relates to the field of medical equipment, in particular to a lateral laser ablation catheter system.
Background
Plaque ablation is a cardiac intervention assisted treatment technique, which includes rotational atherectomy, orbital atherectomy, laser ablation, etc. of plaque in the coronary artery. Early excimer laser treatment equipment is huge, the operation is complicated, long-time preheating preparation is needed, clinical application is inconvenient, laser is continuously dispersed to the periphery of a blood vessel wall, the probability of coronary perforation is greatly improved, and the clinical application of the coronary perforation is limited. In recent years, novel excimer laser ablation equipment is successfully researched and developed, an ultraviolet light source is adopted, and a laser emission mode is changed into forward pulse emission, so that energy is more concentrated, and the safety of clinical application is improved. And is gradually applied to the interventional therapy of complex coronary artery disease. After the excimer laser is absorbed by the tissue, the carbon-carbon double bond of the tissue is broken, the molecular structure of the cell is damaged, the temperature in the cell is increased, the formation of water vapor is promoted, the cell is promoted to be broken, and simultaneously, bubbles can be generated at the front end of the catheter, so that the atherosclerotic plaque tissue in the blood vessel is further damaged.
The inventor researches and discovers that the existing plaque ablation system has the following defects:
the current excimer laser ablation technology mainly acts on plaque tissues at the front end of a catheter and cannot exert good ablation effect on side wall plaque (such as calcified plaque) causing stenosis of blood vessels.
Disclosure of Invention
The invention aims to provide a lateral laser ablation catheter system which can exert good ablation effect on a side wall plaque (such as a calcified plaque) causing stenosis of a blood vessel.
The embodiment of the invention is realized by the following steps:
the invention provides a lateral laser ablation catheter system, comprising:
the pipe wall of the main pipe is provided with an ablation window;
the laser ablation unit comprises a laser ablation engine, a laser ablation optical fiber and a lens assembly, wherein the laser ablation engine is used for emitting a laser ablation beam and conducting the laser ablation beam through the laser ablation optical fiber;
the imaging unit is connected with the main pipe and is used for acquiring lateral tissue image information corresponding to the main pipe;
and a compression unit connected with the main tube for attaching the ablation window to the tissue wall.
In an optional embodiment, the main tube is provided with a first channel and a second channel which are independent of each other, the laser ablation optical fiber and the lens assembly are arranged in the first channel in a penetrating manner, and the ablation window is communicated with the first channel; the imaging unit is disposed in the second channel.
In an alternative embodiment, the lens assembly comprises a lens body and a reflective film, the lens body has an incident surface and a reflective surface opposite to each other in the extending direction of the first channel, the reflective surface has an included angle with the incident surface, and the reflective film is connected with the reflective surface, and the reflective surface is used for enabling the laser ablation light beam to be emitted from the ablation window.
In an alternative embodiment, the entrance face is perpendicular to the axis of the laser ablated fiber; the reflecting surface and the axis of the laser ablation optical fiber form an included angle, the reflecting surface and the inner wall of the first channel jointly define a heat dissipation cavity, and a heat dissipation layer is filled in the heat dissipation cavity.
In an alternative embodiment, the lens body comprises a first portion and a second portion connected, the first portion is arranged in the first channel, the second portion is arranged in the ablation window, the side surface of the second portion far away from the first portion is an arc-shaped surface, and the arc-shaped surface and the peripheral wall of the main pipe are located on the same circumferential surface.
In an optional embodiment, the imaging unit comprises a protective tube, an OCT imaging optical fiber and an imaging lens, wherein an imaging window is arranged on the wall of the protective tube, the protective tube is arranged in the second channel in a penetrating manner, and the imaging window extends out of the far end of the second channel; the OCT imaging optical fiber is arranged in the protective tube in a penetrating way and is in rotating fit with the protective tube; the imaging lens is arranged in the protective tube and connected with the distal end of the OCT imaging optical fiber, and the imaging lens is used for reflecting the OCT imaging light beam so as to enable the OCT imaging light beam to be emitted out of the imaging window.
In an alternative embodiment, the distance between the midline of the ablation window in the direction of extension of the axis of the main tube and the midline of the imaging window in the direction of extension of the axis of the main tube is 0-4 mm.
In an alternative embodiment, the imaging unit further comprises a spring tube, the spring tube is simultaneously connected with the protective tube and the OCT imaging fiber, and is used for driving the OCT imaging fiber to rotate relative to the protective tube.
In an alternative embodiment, the main pipe is provided with a charging channel; the pressing unit comprises a bag body, the bag body is connected with the peripheral wall of the main pipe, and the pressurizing channel is communicated with the bag body.
In an alternative embodiment, the main tube is provided with a guidewire lumen for threading a guidewire.
The embodiment of the invention has the beneficial effects that:
in summary, the present embodiment provides a lateral laser ablation catheter system, which includes a main tube, a laser ablation unit, an imaging unit, and a compression unit. An erosion window is arranged on the main pipe and is positioned on the pipe wall of the main pipe. The laser ablation unit comprises a laser ablation engine, a laser ablation optical fiber and a lens assembly, wherein the laser ablation optical fiber and the lens assembly are arranged in the main pipe, after the laser ablation engine is started, a laser ablation light beam is transmitted to the lens assembly through the laser ablation optical fiber, the lens assembly can change the emergence angle of the laser ablation light beam, so that the laser ablation light beam is emitted from an ablation window, the ablation window is arranged on the pipe wall of the main pipe, the pipe wall of the main pipe corresponds to the pipe wall of a blood vessel, and the laser ablation light beam emitted from the ablation window can erode plaque on the pipe wall of the blood vessel, so that the purpose of lateral ablation is realized, the diseases such as angiostenosis and the like are effectively improved, and the recovery of a patient is facilitated.
Simultaneously, the cooperation imaging unit, at the laser ablation operation in-process, the image of vascular wall can in time be observed by medical personnel directly perceivedly, improves the security, avoids damaging healthy vascular wall, improves the security.
And because the design of the compression unit, before the laser ablation operation is carried out, after the imaging unit is matched to find the tissue to be ablated, the ablation window corresponds to the tissue to be ablated, the compression unit drives the main pipe to move, so that the ablation window is attached to the vascular wall, the laser ablation light beam emitted from the ablation window directly acts on the vascular wall, the ablation effect is improved, the laser ablation light beam is prevented from contacting with blood, the blood cannot be heated, the operation risk is reduced, and the operation safety is improved.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings needed to be used in the embodiments will be briefly described below, it should be understood that the following drawings only illustrate some embodiments of the present invention and therefore should not be considered as limiting the scope, and for those skilled in the art, other related drawings can be obtained according to the drawings without inventive efforts.
FIG. 1 is a schematic structural view of a lateral laser ablation catheter system in accordance with an embodiment of the present invention;
FIG. 2 is a schematic sectional view along the line A-A in FIG. 1;
FIG. 3 is a schematic sectional view along the direction B-B in FIG. 2;
fig. 4 is a partial structural schematic view of a lateral laser ablation catheter system in accordance with an embodiment of the present invention.
Icon:
001-distal end face; 002-proximal end face; 003-guide wire; 004-axial spacing; 100-main tube; 110-ablation window; 120-a first channel; 130-a second channel; 140-a third channel; 150-a pressurizing channel; 151-injection port; 152-a pressurizing port; 200-laser ablation unit; 210-a laser ablation engine; 211-laser ablation beam; 220-laser ablation of optical fibers; 230-a lens assembly; 231-a lens body; 2311-an incident plane; 2312-a reflective surface; 2313-an exit surface; 232-a reflective film; 240-heat dissipation layer; 300-an imaging unit; 310-an OCT engine; 311-OCT imaging beam; 320-a protective tube; 321-an imaging window; 330-OCT imaging fiber; 340-an imaging lens; 400-a compression unit; 500-connecting a joint; 600-spring tube.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are some, but not all, embodiments of the present invention. The components of embodiments of the present invention generally described and illustrated in the figures herein may be arranged and designed in a wide variety of different configurations.
Thus, the following detailed description of the embodiments of the present invention, presented in the figures, is not intended to limit the scope of the invention, as claimed, but is merely representative of selected embodiments of the invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
It should be noted that: like reference numbers and letters refer to like items in the following figures, and thus, once an item is defined in one figure, it need not be further defined and explained in subsequent figures.
In the description of the present invention, it should be noted that the terms "center", "upper", "lower", "left", "right", "vertical", "horizontal", "inner", "outer", etc. indicate orientations or positional relationships based on the orientations or positional relationships shown in the drawings or the orientations or positional relationships that the products of the present invention are conventionally placed in use, and are only used for convenience in describing the present invention and simplifying the description, but do not indicate or imply that the devices or elements referred to must have a specific orientation, be constructed and operated in a specific orientation, and thus, should not be construed as limiting the present invention. Furthermore, the terms "first," "second," "third," and the like are used solely to distinguish one from another and are not to be construed as indicating or implying relative importance.
Furthermore, the terms "horizontal", "vertical" and the like do not imply that the components are required to be absolutely horizontal or pendant, but rather may be slightly inclined. For example, "horizontal" merely means that the direction is more horizontal than "vertical" and does not mean that the structure must be perfectly horizontal, but may be slightly inclined.
In the description of the present invention, it should also be noted that, unless otherwise explicitly specified or limited, the terms "disposed," "mounted," "connected," and "connected" are to be construed broadly and may, for example, be fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meanings of the above terms in the present invention can be understood in specific cases to those skilled in the art.
At present, laser ablation can only perform laser ablation treatment on the tissue at the front end of a catheter, and cannot perform good ablation effect on the vascular wall corresponding to the side wall of the catheter, especially on the side wall plaque (such as calcified plaque) causing stenosis of the blood vessel.
In view of this, the designer has designed a side direction laser ablation catheter system, cooperates the vascular wall formation of image to carry out the ablation operation of the vascular wall of catheter side direction to be convenient for handle the local calcification plaque of vascular wall, and the target location is accurate, improves the efficiency and the success rate of operation.
Referring to fig. 1-4, in the present embodiment, the lateral laser ablation catheter system includes a main tube 100, a laser ablation unit 200, an imaging unit 300, and a compression unit 400. The main pipe 100 is provided with an erosion window 110 on the pipe wall. The laser ablation unit 200 includes a laser ablation engine 210, a laser ablation optical fiber 220, and a lens assembly 230, the laser ablation engine 210 is configured to emit a laser ablation beam 211 and transmit the laser ablation beam through the laser ablation optical fiber 220, the laser ablation optical fiber 220 and the lens assembly 230 are both disposed in the main pipe 100, and the lens assembly 230 is configured to adjust the laser ablation beam 211 emitted from the laser ablation optical fiber 220 so that the laser ablation beam 211 is emitted from the ablation window 110. The imaging unit 300 is connected to the main tube 100 for acquiring tissue image information corresponding to a lateral direction of the main tube 100. Compression unit 400 is coupled to main tube 100 for engaging ablation window 110 to the tissue wall.
In the lateral laser ablation catheter system provided in this embodiment, an ablation window 110 is disposed on the main tube 100, and the ablation window 110 is located on the tube wall of the main tube 100. The laser ablation unit 200 comprises a laser ablation engine 210, a laser ablation optical fiber 220 arranged in the main pipe 100 and a lens assembly 230, after the laser ablation engine 210 is started, the laser ablation light beam 211 is transmitted to the lens assembly 230 through the laser ablation optical fiber 220, the lens assembly 230 can change the exit angle of the laser ablation light beam 211, so that the laser ablation light beam 211 is emitted from the ablation window 110, because the ablation window 110 is arranged on the wall of the main pipe 100, the wall of the main pipe 100 corresponds to the wall of the blood vessel, the laser ablation light beam 211 emitted from the ablation window 110 can ablate plaque on the wall of the blood vessel, the purpose of lateral ablation is realized, the diseases such as stenosis of the blood vessel and the like are effectively improved, and the recovery of a patient is facilitated.
Simultaneously, cooperation imaging unit 300, at the laser ablation operation in-process, the image of vascular wall can in time be observed by medical personnel directly perceivedly, improves the security, avoids damaging healthy vascular wall, improves the security.
Moreover, due to the design of the pressing unit 400, before the laser ablation operation is performed, after the imaging unit 300 is matched to find the position of the tissue to be ablated, that is, the ablation window 110 corresponds to the tissue to be ablated, the pressing unit 400 drives the main tube 100 to move, so that the ablation window 110 is close to the tissue to be ablated on the blood vessel wall and is attached to the tissue to be ablated, and thus the laser ablation light beam 211 emitted from the ablation window 110 directly acts on the blood vessel wall, the ablation effect is improved, the laser ablation light beam 211 is prevented from directly contacting with blood, the laser ablation light beam 211 is not easy to directly heat the blood, the operation risk is reduced, and the operation safety is improved.
Referring to fig. 1 and 4, in the present embodiment, optionally, the main tube 100 is configured as a circular tube, that is, the outer profile of the cross section of the main tube 100 is circular. The main pipe 100 is provided therein with a first passage 120, a second passage 130, a third passage 140, and a pressurizing passage 150, which are independent of each other. The first channel 120 extends on the axis of the main tube 100, one end of the first channel 120, which is located on the proximal end surface 002 of the main tube 100, is open, one end of the first channel 120, which is located on the distal end surface 001 of the main tube 100, is a closed structure, the erosion window 110 is a through hole formed in the tube wall of the main tube 100, and the through hole penetrates through the tube wall of the main tube 100 along the radial direction of the circle where the cross section of the main tube 100 is located. The erosion window 110 is disposed proximate the distal end face 001 of the main tube 100, and the through hole communicates with the first passage 120. In other words, the axis of the through-hole is perpendicular to the extending direction of the first passage 120. Obviously, in other embodiments, the axis of the through hole may not be perpendicular to the first channel 120, but may be at an angle different from zero with respect to the first channel 120. In addition, the cross-sectional profile of the first channel 120 is configured to be semicircular, and the center of the circle where the cross-section of the first channel 120 is located coincides with the center of the circle where the cross-sectional outer profile of the main pipe 100 is located. The second channel 130 extends in the axial extension direction of the main pipe 100, the cross-sectional profile of the second channel 130 is circular, and both ends of the second channel 130 are open. One end of the third channel 140 is positioned on the distal end face 001 of the main tube 100, the other end of the third channel 140 is positioned on the tube wall of the main tube 100, and the third channel 140 is used for penetrating the guide wire 003. Both ends of the pressurizing passage 150 are located on the pipe wall of the main pipe 100, one end of the pressurizing passage 150 is provided with an injection port 151, the other end is provided with a pressurizing port 152, the pressurizing port 152 is communicated with the pressing unit 400, fluid is injected through the injection port 151, the fluid can enter the pressing unit 400 from the pressurizing port 152, the internal pressure of the pressing unit 400 is increased, and the pressing unit 400 is pressed on the main pipe 100.
It should be appreciated that the cross-sectional profiles of the second channel 130, the third channel 140, and the charging channel 150 may each be configured as a circle.
Furthermore, a connection adapter 500 is provided at the proximal end face 002 of the main tube 100 for connection with the laser ablation engine 210 and the OCT engine of the imaging unit 300.
In this embodiment, optionally, the laser ablation optical fiber 220 and the lens assembly 230 are both disposed in the first channel 120, and the lens assembly 230 is closer to the distal end of the first channel 120 than the laser ablation engine 210. The proximal end of the laser ablation fiber 220 exits the first channel 120 and passes through the connector 500 before being coupled to the laser ablation engine 210.
It should be understood that the cross-sectional profile of the first channel 120 is semicircular, the laser ablation optical fiber 220 is inserted into the first channel 120, the outer wall of the laser ablation optical fiber 220 is attached to the wall of the first channel 120, the position of the laser ablation optical fiber 220 is stable, the position of the laser ablation light beam 211 emitted from the lens assembly 230 is stable, and the accuracy of the ablation operation is improved.
Referring to fig. 2 and 3, in particular, the lens assembly 230 includes a lens body 231 and a reflective film 232, the lens body 231 is disposed in the first channel 120 and is located at the distal end side of the laser ablation fiber 220. The lens body 231 has an incident surface 2311, a reflecting surface 2312, and an exit surface 2313, the exit surface 2313 is provided at the ablation window 110, and the incident surface 2311 and the reflecting surface 2312 are arranged at intervals in the extending direction of the first passage 120. The incident surface 2311 is perpendicular to the extending direction of the first channel 120, the reflecting surface 2312 and the first channel 120 have an acute angle or an obtuse angle, that is, the reflecting surface 2312 and the incident surface 2311 have an included angle different from zero, and the distance between the reflecting surface 2312 and the ablation window 110 gradually increases in the direction from the distal end of the first channel 120 to the proximal end of the first channel 120. The exit surface 2313 is an arc surface, the exit surface 2313 and the outer peripheral wall of the main pipe 100 are located in the same cylindrical surface, in other words, the exit surface 2313 is arranged at a port of the ablation window 110 located on the outer peripheral wall of the main pipe 100, the exit surface 2313 is in smooth butt joint with the outer peripheral wall of the main pipe 100, a joint of the exit surface 2313 and the outer peripheral wall of the main pipe 100 is not provided with a concave or convex structure, the outer peripheral wall of the main pipe 100 and the exit surface 2313 form a cylindrical surface part, when the ablation window 110 is attached to a tissue, the exit surface 2313 is tightly attached to the tissue, a gap is not easily generated between the exit surface 2313 and the tissue, the laser ablation light beam 211 is directly acted on the tissue after being emitted from the exit surface 2313, the ablation effect is good, and the operation risk is low.
It will be appreciated that, since the circumferential wall of the main tube 100 has a thickness, the erosion window 110 is located at a distance from the port on the outer circumferential wall of the main tube 100 and the first channel 120, which is the thickness of the circumferential wall. Therefore, in order to facilitate the lens body 231 to better fit with the main tube 100, the exit surface 2313 and the peripheral wall are located on the same cylindrical surface, the lens body 231 includes a first portion and a second portion integrally formed, the first portion is disposed in the first channel 120, and the incident surface 2311 and the reflecting surface 2312 are located on the first portion. The second portion is embedded in the ablation window 110 and the exit face 2313 is located on the second portion.
It should be appreciated that a reflective film 232 is provided on the reflective surface 2312 for reflecting the laser ablation beam 211 to exit the exit surface 2313. The reflective film 232 may be provided as a total reflection film 232. In this embodiment, the material of the reflective film 232 is not particularly limited.
The distal end of the laser ablation fiber 220 is adhesively fixed to the incident surface 2311.
In addition, since the reflective surface 2312 is an inclined surface, the reflective surface 2312 and the tube wall forming the first channel 120 jointly define a heat dissipation chamber, the heat dissipation cavity is internally provided with the heat dissipation layer 240, the heat dissipation layer 240 can be made of a material with a high heat conduction coefficient, and the cooling of the reflective surface 2312 can be accelerated by the arrangement of the heat dissipation layer 240, so that the operation is facilitated.
In addition, the lens body 231 may be made of silicon dioxide or sapphire, and a dielectric film may be disposed at the exit face 2313 to increase the light transmittance of the exit face 2313 of the lens body 231 and reduce the reflection of the laser ablation beam 211 at the exit face 2313.
Alternatively, the laser ablation fiber 220 uses a multimode fiber. The Numerical Aperture (NA) of the fiber is set to 0.15-0.45 and the core diameter is set to 20-300 microns. The wavelength of the laser ablation beam 211 emitted by the laser ablation engine 210 is set between 300 nanometers and 420 nanometers. Alternatively, the laser ablation engine 210 is configured as a Nd: YAG triple harmonic laser with a wavelength of 355 nm and an energy flux per pulse exiting the lens body 231 of at least 50mJ/mm 2. The frequency of the pulses emitted by the lens body 231 is at least 10Hz, for example between 25Hz and 40 Hz.
It should be noted that the laser ablation engine 210 may also be an excimer laser with a wavelength of 308 nanometers. The energy flux per pulse exiting the lens body 231 is at least 30mJ/mm 2. The frequency of the pulses emitted by the lens body 231 is at least 10Hz, for example between 25Hz and 40 Hz.
Referring to fig. 1 and fig. 3, in the present embodiment, optionally, the imaging unit 300 includes an OCT engine 310, a protection tube 320, an OCT imaging fiber 330, and an imaging lens 340, wherein the OCT engine 310 is connected to the OCT imaging fiber 330 for emitting an imaging beam to the OCT imaging fiber 330. The wall of the protective tube 320 is provided with an annular imaging window 321, i.e. the imaging window 321 is in an annular structure around the axis of the protective tube 320, the protective tube 320 is arranged in the second channel 130 in a penetrating way, the imaging window 321 extends out of the distal end of the second channel 130, and the proximal end of the protective tube 320 does not protrude out of the proximal end of the main tube 100. The OCT imaging fiber 330 is inserted into the protecting tube 320 and is rotatably fitted with the protecting tube 320, and the proximal end of the OCT imaging fiber 330 extends out of the proximal end of the second channel 130, passes through the connection joint 500, and is connected to the OCT engine 310. An imaging lens 340 is disposed in the protective tube 320 and connected to the distal end of the OCT imaging fiber 330, and the imaging lens 340 is used for reflecting the OCT imaging beam 311 so that the OCT imaging beam 311 exits from the imaging window 321.
Optionally, the distal end surface of the protection tube 320 extends out of the distal end of the second channel 130, and the distal end surface of the protection tube 320 is provided with an arc-shaped surface, so as to reduce the probability that the distal end surface of the protection tube 320 damages the tissue. The outer wall of the protection pipe 320 is attached to the pipe wall forming the second channel 130, and the protection pipe 320 is fixed to the main pipe 100.
Further, the OCT imaging fiber 330 is inserted into the spring tube 600 and fixedly connected to the spring tube 600, and the spring tube 600 is inserted into the protection tube 320 and extends out of the proximal end surface 002 of the second channel 130, and is connected to the OCT engine 310 after passing through the connection joint 500. Meanwhile, a driving mechanism is arranged on the OCT engine 310 and connected with the spring tube 600 and used for driving the spring tube 600 to rotate around the axis of the spring tube, so that the OCT imaging optical fiber 330 and the imaging lens 340 are driven to rotate, the OCT imaging optical fiber 330 and the imaging lens 340 are used for completing the scanning of the periphery of the blood vessel wall, namely, when the spring tube 600 rotates for one circle, the OCT imaging light beam 311 emitted by the OCT imaging optical fiber 330 rotates for one circle, and the cross-sectional view of the blood vessel wall is obtained through scanning.
It should be understood that, since the imaging window 321 is disposed to protrude from the distal end surface 001 of the main tube 100, that is, the imaging window 321 is spaced from the ablation window 110 in the extending direction of the main tube 100, the OCT imaging beam 311 emitted from the imaging window 321 is not blocked by the main tube 100 and other components, and the OCT imaging beam 311 can scan and acquire the cross-sectional view of the blood vessel wall after rotating for one circle.
Furthermore, the distance between the center line of the ablation window 110 in the axial extension direction of the main tube 100 and the center line of the imaging window 321 in the axial extension direction of the main tube 100 is (0-4 mm), which may be referred to as an axial space 004, for example, the axial space 004 may be 1mm, 2mm, or 4mm, which not only prevents the OCT imaging beam 311 from being blocked, but also effectively utilizes the image scanned and acquired by the OCT imaging beam 311 to assist the laser ablation, meanwhile, the axial space 004 is set between (0-4 mm), which is reasonably set, so that it is convenient for the operator to compensate the distance by operation when performing the ablation, and the success rate of the operation is improved.
Optionally, the light incident surface of the imaging lens 340 is perpendicular to the axis of the second channel 130, and can be adhered to the distal end surface of the OCT imaging fiber 330 by glue. The light exiting surface of the imaging lens 340 is disposed as a slope having an acute angle or an obtuse angle with the axis of the second channel 130. A reflective film 232 may be disposed on the light exit surface.
Further, the distance between the light emergent surface and the axis of the main tube 100 is gradually increased in the direction from the distal end surface 001 to the proximal end surface 002 of the main tube 100, so that the light emergent surface can enable the OCT imaging beam 311 to propagate towards the side where the ablation window 110 is located after reflecting the OCT imaging beam 311, thereby firstly imaging the tissue on the side of the ablation window 110 and being beneficial to the operation.
In this embodiment, optionally, the pressing unit 400 includes a capsule body, the capsule body has a certain elastic deformation capability, the capsule body is provided with a pressurizing cavity, the capsule body is connected to the outer peripheral wall of the main pipe 100, and the pressurizing cavity is communicated with the pressurizing port 152 of the pressurizing channel 150. Utilize injection port 151 can be for the internal fluid such as injection liquid or gas of bag, make the bag inflation, pressure increase to drive the motion of being responsible for 100 through the bag, make ablation window 110 laminate on the vascular wall, improve the ablation effect, also improve the operation security.
The lateral laser ablation catheter system provided in this embodiment can be used to place the guidewire 003 into the blood vessel and reach the distal end of the target site. Then, the third channel 140 of the main tube 100 is sleeved outside the guide wire 003, so that the main tube 100 can enter the blood vessel along the guide wire 003 and reach the target position, and after the form of the tissue is confirmed by the imaging unit 300, the rotation angle of the main tube 100 is adjusted and the main tube 100 is pushed forward by an axial distance 004. Injecting liquid or gas into the capsule by using the injection port 151 for pressurizing, attaching the ablation window 110 on the main pipe 100 to the vessel wall by using the pressure of the capsule, then opening the laser ablation engine 210, and emitting a laser ablation beam 211 emitted by the laser ablation engine 210 from the ablation window 110 under the guidance of the laser ablation optical fiber 220 and the lens assembly 230, and acting on a target position to complete the laser ablation. Plaque on the vessel wall can be ablated, and the purpose of lateral ablation is realized, so that diseases such as angiostenosis are effectively improved, and the rehabilitation of patients is facilitated.
The above description is only a preferred embodiment of the present invention and is not intended to limit the present invention, and various modifications and changes may be made by those skilled in the art. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.
Claims (7)
1. A lateral laser ablation catheter system, comprising:
the pipe wall of the main pipe (100) is provided with an ablation window (110); the main pipe (100) is also provided with a first channel (120) and a second channel (130) which are independent of each other, and the ablation window (110) is communicated with the first channel (120);
a laser ablation unit (200), the laser ablation unit (200) comprising a laser ablation engine (210), a laser ablation optical fiber (220), and a lens assembly (230), the laser ablation engine (210) being configured to emit a laser ablation beam (211) and to be conducted through the laser ablation optical fiber (220), the laser ablation optical fiber (220) and the lens assembly (230) being disposed in the first channel (120), the lens assembly (230) being configured to condition the laser ablation beam (211) exiting from the laser ablation optical fiber (220) such that the laser ablation beam (211) exits from the ablation window (110);
an imaging unit (300), the imaging unit (300) being connected to the main tube (100) and being arranged in the second channel (130) for acquiring tissue image information corresponding to a lateral direction of the main tube (100); the imaging unit (300) comprises a protective tube (320), an OCT imaging optical fiber (330), an imaging lens (340) and a spring tube; an imaging window (321) is arranged on the pipe wall of the protection pipe (320), the protection pipe (320) is arranged in the second channel (130) in a penetrating mode, the imaging window (321) extends out of the far end of the second channel (130), and a distance is formed between the imaging window and the ablation window in the extending direction of the main pipe; the OCT imaging optical fiber (330) is arranged in the protective tube (320) in a penetrating way and is matched with the protective tube (320) in a rotating way; the imaging lens (340) is arranged in the protective tube (320) and connected with the distal end of the OCT imaging optical fiber (330), and the imaging lens (340) is used for reflecting the OCT imaging beam (311) so as to enable the OCT imaging beam (311) to be emitted out of the imaging window (321); the spring tube (600) is connected with the protective tube (320) and the OCT imaging optical fiber (330) at the same time, and is used for driving the OCT imaging optical fiber (330) to rotate relative to the protective tube (320);
and a compression unit (400), the compression unit (400) being connected to the main tube (100) for attaching the ablation window (110) to a tissue wall.
2. The lateral laser ablation catheter system of claim 1, wherein:
the lens assembly (230) comprises a lens body (231) and a reflecting film (232), wherein the lens body (231) is provided with an incident surface (2311) and a reflecting surface (2312) which are opposite in the extending direction of the first channel (120), the reflecting surface (2312) is provided with an included angle with the incident surface (2311), the reflecting film (232) is connected with the reflecting surface (2312), and the reflecting surface (2312) is used for enabling the laser ablation light beam (211) to be emitted out of the ablation window (110).
3. The lateral laser ablation catheter system of claim 2, wherein:
the incident surface (2311) is perpendicular to an axis of the laser ablation fiber (220); the reflecting surface (2312) and the axis of the laser ablation optical fiber (220) form an included angle, the reflecting surface (2312) and the inner wall of the first channel (120) jointly define a heat dissipation cavity, and a heat dissipation layer (240) is filled in the heat dissipation cavity.
4. The lateral laser ablation catheter system of claim 2, wherein:
the lens body (231) comprises a first part and a second part which are connected, the first part is arranged in the first channel (120), the second part is arranged in the ablation window (110), the side surface of the second part, which is far away from the first part, is an arc-shaped surface, and the arc-shaped surface and the peripheral wall of the main pipe (100) are positioned on the same circumferential surface.
5. The lateral laser ablation catheter system of claim 1, wherein:
the distance between the midline of the ablation window (110) in the direction of extension of the axis of the main tube (100) and the midline of the imaging window (321) in the direction of extension of the axis of the main tube (100) is 0-4 mm.
6. The lateral laser ablation catheter system of claim 1, wherein:
the main pipe (100) is provided with a pressurizing channel (150); the compression unit (400) comprises a capsule body, the capsule body is connected with the outer peripheral wall of the main pipe (100), and the pressurizing channel (150) is communicated with the capsule body.
7. The lateral laser ablation catheter system of claim 1, wherein:
the main pipe (100) is provided with a guide wire (003) cavity for the guide wire (003) to penetrate.
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| CN111035451A (en) * | 2018-10-11 | 2020-04-21 | 庞兴学 | Laser catheter |
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| US20050251116A1 (en) * | 2004-05-05 | 2005-11-10 | Minnow Medical, Llc | Imaging and eccentric atherosclerotic material laser remodeling and/or ablation catheter |
| WO2013009977A1 (en) * | 2011-07-12 | 2013-01-17 | David Lambert | Device for reducing renal sympathetic nerve activity |
| US20150112188A1 (en) * | 2013-09-20 | 2015-04-23 | Volcano Corporation | Systems and methods for monitoring endoluminal valve formation |
| CN107920858A (en) * | 2015-05-25 | 2018-04-17 | 拉兹凯瑟私人有限公司 | The method of conduit system and ablation tissue |
| CN110051432A (en) * | 2019-05-27 | 2019-07-26 | 北京航空航天大学 | A method of laser thrombolysis in the blood vessel is realized under optical coherence tomography guidance |
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| WO2015159296A1 (en) * | 2014-04-17 | 2015-10-22 | Digma Medical Ltd. | Methods and systems for blocking neural activity in an organ of a subject, preferably in the small intestine or the duodenum |
| CN111035451A (en) * | 2018-10-11 | 2020-04-21 | 庞兴学 | Laser catheter |
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