CN113262010A

CN113262010A - Conveying mechanism of aneurysm plugging device

Info

Publication number: CN113262010A
Application number: CN202110702152.6A
Authority: CN
Inventors: 胡天宙; 张捷捷; 刘振全; 孙冰; 贾晶
Original assignee: Shanghai Warm Sun Medical Instrument Co ltd
Current assignee: Shanghai Warm Sun Medical Instrument Co ltd
Priority date: 2021-06-24
Filing date: 2021-06-24
Publication date: 2021-08-17

Abstract

The invention is applicable to the technical field of medical instruments, and discloses a conveying mechanism of an aneurysm plugging device. In order to achieve the purpose, the invention provides a conveying mechanism of an aneurysm occlusion device, which comprises a sheath and a catheter movably arranged in the sheath; a first wire drawing and a second wire drawing which are movably arranged in the guide pipe; the first pull wire and the second pull wire are independently movable relative to the catheter and through the central bore of the occluding device; the far end of the first drawn wire is provided with a protruding part, and the second drawn wire and the protruding part can respectively penetrate through the middle hole in sequence to limit the plugging device, so that the plugging device is loaded into the sheath tube. The technical problem that the plugging device cannot be reloaded after being disconnected with the conveying mechanism is solved.

Description

Conveying mechanism of aneurysm plugging device

Technical Field

The invention relates to the technical field of medical instruments, in particular to a conveying mechanism of an aneurysm plugging device.

Background

Intracranial aneurysm refers to localized bulging and dilatation of the vessel wall of an artery due to the action of acquired pathological factors or congenital malformations. Intracranial aneurysm has a very high incidence rate of about 5%, and its course is often more secret, rupture bleeding is often more sudden, and the fatality rate or disability rate is also high. The lethality rate of the first rupture bleeding is 8% -45%, the lethality rate in one year is higher than 60%, and the lethality rate in 2 years is more than 85%. Therefore, it is globally emphasized that early diagnosis and treatment of intracranial aneurysms is of great clinical importance to improve patient survival and quality of life. A common treatment currently used for cerebral aneurysms is endovascular interventional embolization; the plugging device is mainly implanted into the aneurysm through the conveying mechanism, so that the purpose of treating the aneurysm by blocking the aneurysm is achieved.

The chinese utility model patent with publication number CN209450597U discloses a plugging device for intracranial aneurysm, which comprises a plugging device body, a developing mark, a conveying guide wire, a separation point, a conveying pipe and a separator, wherein the developing mark is respectively fixed at the far end and the near end of the plugging device body; the plugging device is formed by weaving 24-72 strands of nickel-titanium memory alloy wires into a net shape; after the plugging device is completely opened, the far end and the near end are respectively provided with a developing mark, and the developing marks are respectively bound to fix the nickel-titanium memory alloy wires at the far end and the near end of the plugging device; the delivery guide wire is positioned in the delivery pipe; a separation point is arranged between the proximal development marker of the plugging device and the distal end of the delivery guide wire; the proximal end of the delivery guidewire is connected with the separator. The device disconnects the plugging device through the separator but cannot be further recycled, and cannot be further adjusted when the plugging device is not in place or is not in place.

Disclosure of Invention

The invention aims to overcome the defects of the prior art and provides a conveying mechanism of an aneurysm plugging device, which is a device for limiting by a first wire drawing and a second wire drawing and aims to solve the technical problem that the plugging device cannot be reloaded after being disconnected from the conveying mechanism in the prior art.

In order to achieve the purpose, the invention provides a conveying mechanism of an aneurysm occlusion device, which comprises a sheath and a catheter movably arranged in the sheath; a first wire drawing and a second wire drawing which are movably arranged in the guide pipe; the first pull wire and the second pull wire are independently movable relative to the catheter and through the central bore of the occluding device; the far end of the first drawn wire is provided with a protruding part, and the second drawn wire and the protruding part can respectively penetrate through the middle hole in sequence to limit the plugging device, so that the plugging device is loaded into the sheath tube.

Preferably, the sum of the maximum diameter of the bulge and the diameter of the second drawn wire is larger than the diameter of the middle hole; the sum of the diameter of the portion of the first wire not including the boss and the diameter of the second wire is smaller than or equal to the diameter of the intermediate hole.

Preferably, a handle is connected to the proximal ends of the first and second wire drawing members, and a push rod for driving the first and second wire drawing members to move is arranged in the handle.

Preferably, an upper track is arranged in the handle, and an upper push rod for driving the second wire drawing to move is connected to the upper track; a lower rail is arranged in the handle, and a lower push rod for driving the first wire drawing to move is connected to the lower rail.

Preferably, the upper rail and the lower rail are parallel.

Preferably, one end of the upper push rod, which is far away from the plugging device, is connected with an upper spring, and one end of the lower push rod, which is far away from the plugging device, is connected with a lower spring; the length of the upper spring is greater than that of the lower spring.

Preferably, one side of the upper push rod is connected with a deflector rod; when the shifting lever moves away from the plugging device, the lower pushing rod can be pushed to move together.

Preferably, the section of the deflector rod is in a right triangle shape.

Preferably, a push button is connected to the upper push rod; the push button extends from the upper push rod to the outside of the handle; and the handle is provided with a track for the push button to move.

Preferably, the cross section of one end of the handle close to the plugging device is semi-elliptical.

Preferably, the push button is provided with push grooves which are bilaterally symmetrical.

Compared with the prior art, the conveying mechanism of the aneurysm occlusion device provided by the invention has the beneficial effects that:

1. the plugging device is limited by arranging the protruding part on the first wire drawing to be matched with the second wire drawing, so that the plugging device is conveniently reloaded. And the first wire drawing and the second wire drawing are depended on, so that the structure is simple and the cost is low.

2. Through set up driving lever and push button on last catch bar, only need to realize the motion of the first wire drawing of simultaneous control and second wire drawing through control push button.

3. The original states of the first wire drawing and the second wire drawing can be better controlled by arranging the upper spring and the lower spring, and the plugging device is convenient to load.

The features and advantages of the present invention will be described in detail by embodiments in conjunction with the accompanying drawings.

Drawings

Figure 1 is an enlarged view of the delivery mechanism of an aneurysm occlusion device without a handle according to an embodiment of the invention.

Fig. 2 is a structural diagram illustrating a loaded state of a delivery mechanism of an aneurysm occlusion device according to an embodiment of the present invention.

Fig. 3 is an enlarged schematic structural view at a position a of a delivery mechanism of an aneurysm occlusion device according to an embodiment of the present invention.

Fig. 4 is a schematic structural view of a limiting state of a delivery mechanism of an aneurysm occlusion device according to an embodiment of the present invention.

Figure 5 is an enlarged schematic structural view at B of a delivery mechanism of an aneurysm occlusion device according to an embodiment of the invention.

Figure 6 is a schematic illustration of a delivery mechanism of an aneurysm occlusion device in an intermediate release state according to an embodiment of the invention.

Figure 7 is an enlarged schematic view of the delivery mechanism of an aneurysm occlusion device at position C according to an embodiment of the invention.

Figure 8 is a schematic structural view of a delivery mechanism of an aneurysm occlusion device in a fully released state according to an embodiment of the present invention.

In the figure: 1. a plugging device; 31. first wire drawing; 311. a boss portion; 32. second wire drawing; 33. a conduit; 34. a sheath tube; 35. a handle; 351. pushing the button; 352. an upper push rod; 353. an upper spring; 354. a deflector rod; 355. pushing the rod downwards; 356. a lower spring; 357. an upper rail; 358. a lower rail; 359. pushing the groove.

Detailed Description

In order to make the objects, technical solutions and advantages of the present invention more apparent, the present invention is further described in detail below with reference to the accompanying drawings and examples. It should be understood, however, that the description herein of specific embodiments is only intended to illustrate the invention and not to limit the scope of the invention. Moreover, in the following description, descriptions of well-known structures and techniques are omitted so as to not unnecessarily obscure the concepts of the present invention.

In the description of the present invention, it should be noted that when an element is referred to as being "fixed" or "disposed" to another element, it can be directly on the other element or be indirectly on the other element. When an element is referred to as being "connected to" another element, it can be directly connected to the other element or be indirectly connected to the other element.

In the description of the present invention, it should be noted that the terms "center", "length", "width", "thickness", "upper", "lower", "front", "rear", "left", "right", "vertical", "horizontal", "top", "bottom", "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 in which the products of the present invention are conventionally placed when used, and are merely used for convenience of describing and simplifying the description, but do not indicate or imply that the device or element 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. Thus, a feature defined as "first" or "second" may explicitly or implicitly include one or more of that feature. In the description of the present invention, "a plurality" means two or more unless specifically defined otherwise. The meaning of "a number" is one or more unless specifically limited otherwise.

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.

Embodiments of the present disclosure will now be described in detail with reference to the accompanying drawings. As used herein, the term "clinician" refers to a doctor, surgeon, nurse, or any other care provider, and may include support personnel. The term "proximal" will refer to the portion of the device or component thereof that is closer to the clinician, and the term "distal" will refer to the portion of the device or component thereof that is further from the clinician.

The plugging device 1 used in the present invention also has a central hole through which the first wire 31 and the second wire 32 pass. The same function as the present invention can be achieved as long as the limit is achieved by the first wire drawing 31 and the second wire drawing 32 matching with the middle hole, and the function is understood to fall into the protection scope of the invention.

Specifically, the occlusion device 1 adopted by the invention comprises a reticular elastic shell and a far end gathering part formed by inward gathering of the near end of the reticular elastic shell and the far end of the reticular elastic shell. The near-end collecting part and the far-end collecting part are collected at the middle mark part and connected with the middle mark part. The middle mark part is provided with a middle hole. The plugging device is attached to the tumor cavity for plugging. The occluding device 1 includes a self-expanding configuration and a delivery configuration, and the outer diameter of the self-expanding configuration is larger than that of the delivery configuration. Under the self-expanding state, the diameter of the net-shaped elastic shell is larger than the diameter of the maximum position of the tumor cavity, and the outer diameter of the conveying state is smaller, so that the conveying of the plugging device is facilitated.

The first embodiment is as follows:

referring to fig. 1, 2 and 3, an embodiment of the present invention provides a delivery mechanism for an aneurysm occlusion device comprising a sheath 34 and a catheter 33 movably disposed within the sheath 34. A first wire 31 and a second wire 32 movably disposed within a conduit 33. The first wire 31 and the second wire 32 are individually movable relative to the catheter 33 and pass through the central bore of the occluding device 1. The distal end of the first drawn wire 31 is provided with a convex part 311, and the second drawn wire 32 and the convex part 311 can respectively penetrate through the middle hole in sequence to limit the plugging device 1, so that the plugging device 1 is loaded into the sheath 34. After the protrusion 311 of the first wire 31 passes through the central hole, the second wire 32 also passes through the central hole, and the protrusion 311 engages the second wire 32 against the central hole. When the clinician withdraws the first wire 31 and the second wire 32 proximally, the occlusion device 1 is driven to withdraw together and enter the sheath. The sheath is only a general term here, and it is within the scope of the invention that the sheath can be used to load the occluding device 1. The first and

second wires

31, 32 are axially flexible filaments and the conduit 33 is an axially flexible tube. The first wire 31, the second wire 32, the conduit 33 and the protrusion 311 may be made of memory metal, polymer, etc. The catheter 33 cannot pass through the middle hole and can form a limit at the proximal end, so that the plugging device 1 can smoothly enter the aneurysm.

Referring to fig. 2, in an alternative embodiment, the sum of the maximum diameter of the boss 311 and the diameter of the second wire 32 is greater than the diameter of the central hole. The sum of the diameter of the portion of the first wire 31 not including the boss 311 and the diameter of the second wire 32 is smaller than or equal to the diameter of the intermediate hole. So set up, simple structure makes first wire drawing 31 and second wire drawing 32 free from obstacles when passing in and out the centre bore alone, and is also more convenient when using.

The medical staff can realize the release and loading of the occlusion device 1 by directly controlling the connection state of the first wire drawing 31 and the second wire drawing 32 with the occlusion device 1.

Example two:

in order to facilitate the control of the first wire 31 and the second wire 32, the solution of the first embodiment is modified. The specific improvement scheme is as follows:

referring to fig. 2, in an alternative embodiment, a handle 35 is connected to the proximal ends of the first wire 31 and the second wire 32, and a push rod for moving the first wire 31 and the second wire 32 is disposed in the handle 35. By locating the proximal ends of the first 31 and second 32 wires within the handle 35, the proximal wires are not overly cluttered or even entangled with each other, interfering with use. The first wire drawing 31 and the second wire drawing 32 are controlled more conveniently by using the push rod, the problem that the wire drawing is inconvenient to operate due to over-fine wire drawing is solved, and the effect is better in the actual use process.

Further, referring to fig. 2, in an alternative embodiment, an upper rail 357 is provided in the handle 35, and an upper push rod 352 for moving the second wire 32 is connected to the upper rail 357. A lower rail 358 is provided in the handle 35, and a lower push rod 355 for moving the first wire 31 is connected to the lower rail 358. The upper rail 357 is parallel to the lower rail 358, so that the operation habit of medical personnel is better met, and the use is simpler. The upper rail 357 and the lower rail 358 are arranged to be more convenient to use and can run in a specific rail, and the drawn wires are prevented from being wound and knotted with each other.

Example three:

since the distal ends of the first wire 31 and the second wire 32 cannot clearly observe the positions of each other after entering the artery of the human body. However, in the actual loading process, the protrusion 311 of the first wire 31 must first pass through the middle hole of the plugging device 1, and then the second wire 32 can pass through the middle hole for limiting. Therefore, the scheme of the second embodiment is further optimized.

Referring to fig. 2, in an alternative embodiment, an upper spring 353 is connected to an end of the upper push rod 352 remote from the occluding device 1, and a lower spring 356 is connected to an end of the lower push rod 355 remote from the occluding device 1. The upper spring 353 has a length greater than the length of the lower spring 356. By length is meant that both the upper spring 353 and the lower spring 356 are in their natural condition (i.e., not under the force of the healthcare worker), with the distal end of the upper spring 353 being further from the healthcare worker relative to the distal end of the lower spring 356. Preferably, the two springs have the same elastic potential energy and the proximal fixation position is the same distance from the medical care provider.

Example four:

the separate control of the first wire 31 and the second wire 32 is too troublesome, and in order to simplify the operation process, the technical scheme is further optimized on the basis of the third embodiment.

Referring to FIG. 2, in an alternative embodiment, a toggle lever 354 is coupled to one side of the upper push rod 352. The rod 354 pushes the lower push rod 355 to move together when moving away from the plugging device 1. Medical personnel only need can control lower catch bar 355 through controlling upper catch bar 352, and the operation is simpler, and one-hand operation can, has also improved degree of automation simultaneously.

Referring to FIG. 2, in an alternative embodiment, the cross-section of the toggle 354 is a right triangle. The upper push rod 352 is detachably mounted on the upper rail 357. When the right-angle side and the bevel edge face the lower push rod 355, the shape and the stroke of the adjustment are different, and the shape and the stroke of the adjustment are more convenient.

Referring to fig. 2, in an alternative embodiment, a push button 351 is coupled to the upper push rod 352. The push button 351 extends out of the handle 35 from the upper push rod 352, so that the operation is more convenient and labor-saving, and the upper push rod 352 does not need to be pushed directly. The handle 35 is provided with a track for moving the push button 351.

Referring to fig. 2, in an alternative embodiment, the handle 35 has a semi-elliptical cross-section at the end near the occluding device 1, tapering from the proximal end to the distal end, and has two openings at the distal end for two pull wires to pass through. This arrangement allows the two wires to be drawn better into the conduit 33 and parallel in the conduit 33.

Referring to fig. 2, in an alternative embodiment, the push button 351 is provided with push grooves 359 symmetrical to each other. Medical personnel's finger can be according to promoting on recess 359, is difficult for taking off the hand, and better control dynamics prevents that horizontal push-and-pull is too easy, and leads to the wire drawing motion push-and-pull too fast, causes the damage to the artery.

During interventional therapy, the delivery mechanism and the occluding device are first advanced through the aneurysm site by angiography to push the catheter (now with the occluding device already loaded in the sheath, as shown in fig. 2) within sheath 34 into the microcatheter. Enters into the aneurysm along the inner cavity of the microcatheter, and after the plugging device 1 is separated from the restriction of the microcatheter, the plugging device is slowly unfolded in the aneurysm and gradually expands to a state of adapting to the aneurysm. The proper position is observed by the development mark of the plugging device.

If the position is proper, the occluding device 1 is released, and the specific releasing process is as follows. When the release of the occluding device 1 is not started, the upper push rod 352 and the lower push rod 355 are held on the respective rails only by the action of the springs. In this state, both the second wire 32 and the first wire 31 pass through the middle hole, and the most distal end of the second wire 32 is farther from the handle 35 with respect to the boss 311. The protrusion 311 and the second wire 32 cannot be simultaneously inserted through the central hole (as shown in fig. 4 and 5).

Then the push button 351 is slowly pushed to the proximal end, the upper push rod 352 slowly presses the upper spring 353, and the second wire 32 also moves to the proximal end along with the upper push rod 352 and penetrates out of the middle hole (as shown in fig. 6 and 7), and the shift rod 354 can just contact the lower push rod 355 or needs a certain movement to contact the lower push rod 355. Continuing to push the push button 351 proximally, the lever 354 moves the lower push rod 355 proximally, and the lower spring 356 is compressed. The boss 311 of the first wire 31 also gradually penetrates out of the center hole. At this point, the first wire 31 and the second wire 32 both enter the catheter 33, which is the process of fully releasing the occluding device (as shown in fig. 8).

If the closure device 1 is not suitable or the release position is incorrect, the loading is resumed. The conduit 33 of the handle 35 in the condition of figure 8 is directed towards the central hole. The push button 351 is slowly released and the first wire 31 and the second wire 32 are simultaneously moved distally. However, the boss 311 of the first wire 31 is closer to the central hole than the distal end of the second wire 32, so that the boss 311 of the first wire 31 first passes through the central hole, and the second wire 32 is about to pass through the central hole. When push button 351 is released, protrusion 311 moves forward a distance, and lever 354 disengages from lower push rod 355. The push button 351 is further released, the first wire 31 does not move, and the second wire 32 passes through the middle hole. In the process of withdrawing the handle 35, the convex part 311 is matched with the second wire drawing 32 for limiting and cannot penetrate out of the middle hole at the same time. The occluding device 1 is withdrawn together against the handle 35 and the occluding device 1 is compressed into the micro-catheter to complete loading (as shown in figure 2).

The above description is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the invention, and any modifications, equivalents or improvements made within the spirit and principle of the present invention should be included in the scope of the present invention.

Claims

1. A delivery mechanism for an aneurysm occlusion device comprising a sheath (34) and a catheter (33) movably disposed within the sheath (34); the method is characterized in that: a first wire (31) and a second wire (32) movably disposed within the conduit (33); the first wire (31) and the second wire (32) are separately movable relative to the catheter (33) and pass through the central hole of the occlusion device (1); the far end of the first drawn wire (31) is provided with a protruding part (311), the second drawn wire (32) and the protruding part (311) can respectively penetrate through the middle hole in sequence to limit the plugging device (1), and the plugging device (1) is loaded into the sheath tube (34).

2. The delivery mechanism for an aneurysm occlusion device of claim 1, wherein: the sum of the maximum diameter of the convex part (311) and the diameter of the second drawn wire (32) is larger than the diameter of the middle hole; the sum of the diameter of the portion of the first wire (31) not comprising the boss (311) and the diameter of the second wire (32) is less than or equal to the diameter of the intermediate hole.

3. The delivery mechanism of an aneurysm occlusion device according to claim 1 or 2, wherein: the near ends of the first wire drawing (31) and the second wire drawing (32) are connected with a handle (35), and a push rod for driving the first wire drawing (31) and the second wire drawing (32) to move is arranged in the handle (35).

4. The delivery mechanism for an aneurysm occlusion device of claim 3, wherein: an upper rail (357) is arranged in the handle (35), and an upper push rod (352) which drives the second screw rod (32) to move is connected to the upper rail (357); a lower rail (358) is arranged in the handle (35), and a lower push rod (355) which drives the first screw rod (31) to move is connected to the lower rail (358).

5. The delivery mechanism for an aneurysm occlusion device of claim 4, wherein: the upper rail (357) and the lower rail (358) are parallel.

6. The delivery mechanism for an aneurysm occlusion device of claim 4, wherein: an upper spring (353) is connected to one end, away from the plugging device (1), of the upper push rod (352), and a lower spring (356) is connected to one end, away from the plugging device (1), of the lower push rod (355); the length of the upper spring (353) is larger than that of the lower spring (356).

7. The delivery mechanism for an aneurysm occlusion device of claim 4, wherein: one side of the upper pushing rod (352) is connected with a shifting lever (354); when the shifting rod (354) moves away from the plugging device (1), the lower pushing rod (355) can be pushed to move together.

8. The delivery mechanism for an aneurysm occlusion device of claim 4, wherein: a push button (351) is connected to the upper push rod (352); the push button (351) extends from the upper push rod (352) to the outside of the handle (35); the handle (35) is provided with a track for the push button (351) to move.

9. The delivery mechanism for an aneurysm occlusion device of claim 3, wherein: the cross section of one end of the handle (35) close to the plugging device (1) is semi-elliptical.

10. The delivery mechanism for an aneurysm occlusion device of claim 8, wherein: push grooves (359) which are symmetrical left and right are arranged on the push button (351).