CN113425373A

CN113425373A - Blood vessel thrombus taking device

Info

Publication number: CN113425373A
Application number: CN202110875886.4A
Authority: CN
Inventors: 左斌
Original assignee: Jiangsu Pupeng Medical Technology Co ltd
Current assignee: Jiangsu Pupeng Medical Technology Co ltd
Priority date: 2021-07-30
Filing date: 2021-07-30
Publication date: 2021-09-24

Abstract

The invention provides a blood vessel thrombus taking device which comprises an aspiration catheter for aspirating thrombus, a thrombus taking device for breaking the thrombus and an occlusion structure for occluding the blood vessel of the area where the thrombus is located through self expansion. When the thrombus taking device provided by the invention is used for thrombus taking operation, the plugging structure can be firstly stretched into the area where thrombus is located, then the plugging structure is expanded, the blood vessel where the thrombus is located is plugged, and the flow of blood at the position where the thrombus is located is temporarily slowed or cut off. Then the thrombus can be removed through the thrombus remover and the suction catheter. At this time, since the blood flow at the thrombus site is slow or stopped, it is possible to effectively reduce the amount of blood sucked and prevent a patient from losing much blood when the suction catheter sucks the thrombus.

Description

Blood vessel thrombus taking device

Technical Field

The invention relates to the field of medical instruments, in particular to the field of interventional medical instruments, and particularly relates to a blood vessel thrombus removal device.

Background

Venous Thromboembolism (VTE) includes two forms of Pulmonary Thromboembolism (PE) and Deep Venous Thrombosis (DVT). And PE and DVT have the same predisposition, more than 95% of emboli originate in the lower limbs, and PE and DVT are two clinical manifestations of VTE at different parts and different stages.

Deep Vein Thrombosis (DVT) refers to the abnormal clotting of blood within the deep venous lumen, blocking the venous lumen, causing venous reflux obstruction, resulting in varying degrees of deep vein insufficiency. Thrombosis of the lower limbs and inferior vena cava is the most common, especially the iliac-femoral vein thrombosis. If the patients cannot be treated timely and effectively, the lower limb bruising and swelling and pigmentation can be caused, serious patients can cause femoral bruising and limb ischemic necrosis, partial or all labor force of the patients is lost, more than 50 percent of patients leave deep vein insufficiency of the lower limb to affect the life quality for a long time, even cause pulmonary embolism to cause death, and the traditional Chinese medicine becomes a common disease with great harm to human health at present.

Pulmonary thromboembolism (PE) refers to a disease caused by a thrombus from the venous system or right heart blocking a pulmonary artery or its branches, and is the most common type of pulmonary embolism with pulmonary circulation (including right heart) and respiratory dysfunction as the main clinical manifestations and pathophysiological features.

For the treatment of venous thromboembolism, three forms are currently involved: (1) and (3) medicine anticoagulation treatment: the anticoagulant therapy can effectively prevent the reformation and recurrence of thrombus. Commonly used anticoagulant drugs include plain heparin, low molecular heparin, warfarin, and the like. (2) Catheter thrombolysis: at present, the deep venous thrombosis of the lower limb mainly takes catheter thrombolysis. Thrombolytic drugs include urokinase, streptokinase, recombinant tissue plasminogen activator, and the like. Is suitable for patients in acute stage without thrombolytic contraindication and severe lower limb deep vein thrombosis and pulmonary embolism. (3) And (3) surgical embolectomy: the operation thrombus taking is suitable for patients with serious deep vein thrombosis of lower limbs such as iliac vein thrombosis and femoral bruise, and the operation needs to be careful to handle iliac vein compression.

When the thrombus is taken out in the operation, in the prior art, some methods adopt mechanical thrombus ablation in the venous cavity, namely thrombus negative pressure suction or thrombus crushing devices are adopted for taking the thrombus.

When the negative pressure suction is adopted to extract thrombus, the thrombus can be sucked into the catheter one time or a plurality of times through simple operation, so that the blood at the pathological change part can circulate. Generally, thrombus at a lesion position cannot be completely removed at one time, and a doctor needs to perform catheter suction for many times, so that the amount of thrombus sucked every time is reduced with the increase of the suction times, but the amount of blood sucked is increased. And because the bending degree of the human blood vessel is different, the complete alignment of the suction catheter and the thrombus at the pathological change part can not be ensured in the suction process of a doctor, so that the condition of accidentally and purely sucking blood can be generated, and the excessive blood loss of a patient can be caused. However, if the size of the suction catheter is reduced to reduce the blood loss of the patient, the suction effect of the thrombus is weakened, the suction frequency is increased, and the injury to the patient is not avoided. Particularly for the suction of the pulmonary thrombus, because the thrombus suction position is close to the blood vessel branch, the thrombus is easy to displace in the process or slide into the right branch from the left branch, and the subsequent suction difficulty is directly increased.

Disclosure of Invention

The invention provides a blood vessel thrombus removal device which can effectively reduce the blood extraction amount in the process of thrombus removal in operation.

The invention provides a blood vessel thrombus taking device which comprises an aspiration catheter for aspirating thrombus, a thrombus taking device for breaking the thrombus and an occlusion structure for occluding the blood vessel of the area where the thrombus is located through self expansion.

Further, the occlusion structure comprises at least one of a proximal occlusion structure for occluding a side of the thrombus facing a surgical access port and a distal occlusion structure for occluding a side of the thrombus facing away from the surgical access port.

Further, the blood vessel thrombus removal device also comprises an occlusion control part which is connected with the occlusion structure and controls the expansion of the occlusion structure.

Further, the plugging structure comprises a near-end plugging structure for plugging the thrombus towards one side of the surgical intervention port, the near-end plugging structure is arranged on the outer side wall of the suction catheter, the plugging control part comprises a near-end plugging control part, and the near-end plugging control part is connected with the near-end plugging structure and controls the expansion of the near-end plugging structure.

Further, the proximal end plugging structure is a proximal end balloon, the proximal end plugging control portion for controlling the proximal end plugging structure is a proximal end filling catheter communicated with the proximal end balloon, the proximal end balloon of the proximal end plugging structure is arranged on the outer side wall of the suction catheter, a pipeline is formed in the wall of the suction catheter, the proximal end filling catheter is arranged in the pipeline and is communicated with the proximal end balloon of the proximal end plugging structure after penetrating through the wall of the suction catheter, or the proximal end filling catheter corresponding to the proximal end balloon of the proximal end plugging structure is communicated with the proximal end balloon of the proximal end plugging structure from outside the suction catheter.

Furthermore, the proximal end plugging structure is a proximal end self-expanding support and a flexible membrane covering the proximal end self-expanding support, the proximal end plugging control portion for controlling the proximal end plugging structure comprises a proximal end sheath tube, the proximal end self-expanding support is arranged on the outer side wall of the suction catheter, the proximal end sheath tube is movably sleeved outside the suction catheter along the axial direction of the suction catheter, and when the proximal end self-expanding support is not expanded, the proximal end self-expanding support is clamped between the proximal end sheath tube and the suction catheter.

Further, the proximal end blocking structure is a proximal end self-expandable polymer elastic structure, the proximal end blocking control portion for controlling the proximal end blocking structure includes a proximal end outer sheath tube, the proximal end outer sheath tube is movably sleeved outside the suction catheter along the axial direction of the suction catheter, and when the proximal end self-expandable polymer elastic structure is not expanded, the proximal end self-expandable polymer elastic structure is clamped between the proximal end outer sheath tube and the suction catheter.

Furthermore, the occlusion structure comprises a far-end occlusion structure for occluding one side of the thrombus far away from the surgical intervention port, the occlusion control part comprises a far-end occlusion control part, the far-end occlusion control part controls the expansion of the far-end occlusion structure, the far-end occlusion control part passes through the lumen of the suction catheter to be connected with the far-end occlusion structure, and when a thrombus removal operation is performed, a suction space is formed between the far-end occlusion structure and the end part of the suction catheter.

Furthermore, the distal end occlusion structure is a distal balloon, the distal end occlusion control part for controlling the distal end occlusion structure is a distal filling catheter communicated with the distal balloon, and the distal filling catheter is connected with the distal balloon of the distal end occlusion structure after passing through the lumen of the suction catheter.

Furthermore, the distal end plugging structure is a distal end self-expanding support and a flexible membrane covering the distal end self-expanding support, the distal end plugging control portion for controlling the distal end plugging structure comprises a distal end sheath tube and a support rod, the distal end self-expanding support is arranged on the support rod, the distal end sheath tube is movably sleeved outside the support rod along the length direction of the support rod, and when the distal end self-expanding support is not expanded, the distal end self-expanding support is clamped between the distal end sheath tube and the support rod.

Furthermore, the distal end plugging structure is a distal end self-expanding polymer elastic structure, the distal end plugging control portion for controlling the distal end plugging structure comprises a distal end sheath tube and a support rod, the distal end self-expanding polymer elastic structure is arranged outside the support rod, the distal end sheath tube is sleeved outside the suction catheter in a movable manner along the axial direction of the suction catheter, and when the distal end self-expanding polymer elastic structure is not expanded, the distal end self-expanding polymer elastic structure is clamped between the distal end sheath tube and the support rod.

Further, the embolectomy device comprises a hollow grid structure, a conveying rod and a first outer sheath tube, wherein the first outer sheath tube is used for pressing, holding and containing the hollow grid structure, the hollow grid structure is connected with the conveying rod, the first outer sheath tube is movably sleeved outside the conveying rod along the axial direction of the conveying rod, the termination position of the first outer sheath tube, moving towards the direction of the hollow grid structure, in the axial direction of the conveying rod at least partially coincides with the hollow grid structure, when the first outer sheath tube is sleeved outside the hollow grid structure, the first outer sheath tube presses, holding and the hollow grid structure is radially expanded after external constraint is released.

Further, get and tie ware including cutting piece, protection net, conveying pole and first sheath pipe, the cutting piece with the conveying pole links to each other, the protection net set up in outside the cutting piece, first sheath pipe is followed the axially movable cover of conveying pole is located outside the conveying pole first sheath pipe box is located when on the protection net, first sheath pipe is right the cutting piece is acceptd, and right the protection net is pressed and is held, the protection net radially expands after the outside constraint releases.

Further, the bolt taking device comprises an umbrella-shaped net bag, a plurality of connecting rods, a conveying rod and a first outer sheath pipe, one end of each connecting rod is connected with the umbrella-shaped net bag, the other end of each connecting rod is connected with the conveying rod, the two connecting rods are arranged between the connecting rods, an arc-shaped portion is formed on the edge of the umbrella-shaped net bag, the first outer sheath pipe is arranged outside the conveying rod, the conveying rod is movably sleeved with the first outer sheath pipe, the first outer sheath pipe is arranged on the umbrella-shaped net bag, the umbrella-shaped net bag is pressed and held, and the umbrella-shaped net bag is radially expanded after being bound and released outside.

Further, the vascular embolectomy device includes a first interception portion disposed on a side of the distal occlusion structure distal to the suction catheter.

Further, the vascular embolectomy device further comprises a second intercepting part which is arranged at the end part of the suction catheter.

Further, the proximal balloon is composed of a plurality of sub-balloons, the sub-balloons are sequentially distributed on the outer side wall of the suction catheter along the circumferential direction of the suction catheter, and each sub-balloon is respectively communicated with one filling catheter.

Further, the proximal balloon is an asymmetric balloon.

Furthermore, the blood vessel embolectomy device also comprises a traction wire for controlling the orientation of the end part of the suction catheter, and a traction wire lumen for the traction wire to penetrate is formed in the wall of the suction catheter.

In summary, in the invention, when the thrombus removal operation is performed, the occlusion structure can be firstly extended into the area where the thrombus is located, and then the occlusion control portion is used for controlling the occlusion structure, so that the occlusion structure is expanded, the blood vessel where the thrombus is located is then occluded, and the flow of blood at the position where the thrombus is located is temporarily slowed or blocked. Then the thrombus can be removed through the thrombus remover and the suction catheter. At this time, since the blood flow at the thrombus site is slow or stopped, it is possible to effectively reduce the amount of blood sucked and prevent a patient from losing much blood when the suction catheter sucks the thrombus. Furthermore, the thrombus blocking device can block broken thrombus and prevent the position of the thrombus from being transferred along with the blood flow after the thrombus is broken.

Further, through the improvement of the related structures of the occlusion control part and the thrombus extractor, the thrombus 91 can be cleaned more thoroughly.

Further, through the improvement of the structure of the near-end balloon, the near-end balloon can be eccentrically inflated according to the trend of a blood vessel, so that the suction catheter can better suck thrombus.

Furthermore, through the arrangement of the first interception net and/or the second interception net, the broken thrombus can be better prevented from escaping outwards.

The foregoing description is only an overview of the technical solutions of the present invention, and in order to make the technical means of the present invention more clearly understood, the present invention may be implemented in accordance with the content of the description, and in order to make the above and other objects, features, and advantages of the present invention more clearly understood, the following preferred embodiments are described in detail with reference to the accompanying drawings.

Drawings

Fig. 1 is a schematic structural view of a vascular thrombus removal device according to a first embodiment of the present invention.

Fig. 2 is a schematic structural view of the proximal end blocking structure of fig. 1.

Figure 3 is a schematic view of the suction catheter of figure 2.

Fig. 4 is a schematic structural view of the distal occluding structure of fig. 1.

Fig. 5 is a schematic structural view of the embolectomy device in fig. 1.

Fig. 6 to 12 are schematic structural views showing steps in surgical embolectomy performed by using the vascular embolectomy device provided by the first embodiment of the invention.

Fig. 13 is a schematic structural view of a vascular thrombus removal device according to a second embodiment of the present invention.

Figure 14 is a schematic view of the proximal occluding structure of figure 13.

Fig. 15 is a schematic structural view of an embolectomy device of a blood vessel embolectomy device according to a third embodiment of the invention.

FIG. 16 is a schematic view showing the thrombus removal operation using the blood vessel thrombus removal device in FIG. 15.

Fig. 17 is a schematic structural view of an embolectomy device of a vascular embolectomy device according to a fourth embodiment of the invention.

Fig. 18 is a schematic structural view of a blood vessel embolectomy device according to a fifth embodiment of the invention.

Fig. 19 is a schematic structural view of a vascular embolectomy device provided by a sixth embodiment of the invention.

Fig. 20 is a schematic structural view of a vascular embolectomy device provided in a seventh embodiment of the present invention.

Figure 21 is a cross-sectional view of the suction catheter of figure 20.

Fig. 22 is a schematic cross-sectional view illustrating an aspiration catheter of a vascular embolization device according to an eighth embodiment of the present invention.

Figure 23 is a schematic view of a proximal occluding structure provided by an eighth embodiment of the invention as expanded uniformly.

FIG. 24 is a schematic view of an eighth embodiment of the present invention showing the proximal occluding structure eccentrically expanded.

Detailed Description

Fig. 1 is a schematic structural view of a vascular thrombus removal device according to a first embodiment of the present invention, fig. 2 is a schematic structural view of a proximal occlusion structure in fig. 1, fig. 3 is a schematic structural view of a suction catheter in fig. 2, fig. 4 is a schematic structural view of a distal occlusion structure in fig. 1, and fig. 5 is a schematic structural view of a thrombus removal device in fig. 1. As shown in fig. 1 to 5, a blood vessel thrombectomy device according to a first embodiment of the present invention includes an aspiration catheter 10 for aspirating a thrombus 91, a thrombectomy device 20 for fragmenting the thrombus 91, and an occlusion structure 30 for occluding a blood vessel 92 in an area where the thrombus 91 is located by self-expansion.

In this embodiment, when the thrombus removal operation is performed by the blood vessel thrombus removal device of this embodiment, the occlusion structure 30 may be first inserted into the area where the thrombus 91 is located, and then the occlusion structure 30 may be expanded to further occlude the blood vessel 92 at the position where the thrombus 91 is located, thereby temporarily slowing or blocking the flow of blood at the position where the thrombus 91 is located. The embolectomy operation can then be performed through the embolectomy device 20 and the aspiration catheter 10. At this time, since the blood flow at the site of the thrombus 91 is slow or stopped, it is possible to effectively reduce the amount of blood to be suctioned and prevent a patient from losing much blood when the suction catheter 10 suctions the thrombus 91. Furthermore, the thrombus 91 can be blocked, and the position of the thrombus 91 can be prevented from being shifted along with the blood flow after the thrombus 91 is broken.

Further, in the present embodiment, the occluding structure 30 comprises a proximal occluding structure 31 for occluding a side of the thrombus 91 facing the surgical access port (e.g., the left side in fig. 1) and/or a distal occluding structure 32 for occluding a side of the thrombus 91 facing away from the surgical access port (e.g., the right side in fig. 1). That is, when performing the embolectomy, the proximal end occlusion structure 31 may be used to occlude the blood vessel 92 from the thrombus 91 toward the surgical access port; the distal occluding structure 32 can also be used to occlude the blood vessel 92 from the side of the thrombus 91 remote from the surgical access port; the vessel 92 may also be occluded from both sides of the thrombus 91 using both the proximal occluding structure 31 and the distal occluding structure 32. Further, in order to facilitate positioning of the blocking structure 30, a development point is also provided within the blocking structure 30.

Further, in order to facilitate control of the occluding structure 30, the blood vessel embolectomy device further includes an occlusion control unit that controls expansion and contraction of the occluding structure 30. More specifically, the occlusion control portion includes a proximal occlusion control portion 41 (see fig. 3) that controls the proximal occluding structure 31, and a distal occlusion control portion 42 (see fig. 1) that controls the distal occluding structure 32.

In this embodiment, the occlusion structure 30 may be a balloon, and hereinafter, for convenience of distinction, the balloon corresponding to the proximal occlusion structure 31 is referred to as a proximal balloon, and the balloon corresponding to the distal occlusion structure 32 is referred to as a distal balloon. The occlusion control part 40 may be a filling catheter, and likewise, hereinafter, the filling catheter corresponding to the proximal occlusion control part 41 is referred to as a proximal filling catheter, and the filling catheter corresponding to the distal occlusion control part 41 is referred to as a distal filling catheter.

Referring to fig. 2, in the present embodiment, the thrombus remover 20 is disposed in the lumen of the suction catheter 10, and the thrombus remover 20 penetrates the lumen of the suction catheter 10 to reach the position of the thrombus 91 and break the thrombus 91. The proximal blocking structure 31 is provided on the outer sidewall of the suction catheter 10 to avoid blocking of the suction catheter 10.

Further, a proximal occlusion control part 41 controlling the proximal occlusion control structure 31 may be connected to the proximal occlusion structure 31 from outside the aspiration catheter 10, or inside the wall of the aspiration catheter 10, to control the proximal occlusion structure 31. The proximal occlusion structure 31 can simultaneously occlude the blood vessel 92 and support the aspiration catheter 10 to increase the coaxiality of the aspiration catheter 10 and the blood vessel 92.

The distal occluding structure 32 may be independent of the aspiration catheter 10, i.e. during an embolectomy procedure, an aspiration space is formed between the distal occluding structure 32 and the end of the aspiration catheter 10. To effect connection of the distal occluding structure 32 to the corresponding distal occluding control portion 42, the distal occluding control portion 42 corresponding to the distal occluding structure 32 may be connected to the distal occluding structure 32 through the inner lumen of the aspiration catheter 10. Further, a conical guiding head is provided at the end of the distal end occlusion structure 32 remote from the suction catheter 10.

In this embodiment, the occlusion structure 30 includes a proximal occlusion structure 31, and the proximal occlusion structure 31 may be a proximal balloon (see fig. 2), and correspondingly, the proximal occlusion control part 41 may be a proximal inflation catheter communicating with the proximal balloon, and the inflation and deflation of the proximal balloon may be controlled by the proximal inflation catheter.

As shown in fig. 2 and 3, a proximal balloon as the proximal occlusion structure 31 is disposed on the outer sidewall of the suction catheter 10, and a proximal filling catheter corresponding to the proximal occlusion structure 31 is disposed in the wall of the suction catheter 10 and is communicated with the proximal balloon through the wall of the suction catheter 10. In this case, to facilitate the placement of the proximal filling catheter, a tube 12 for the placement of the proximal filling catheter is also provided on the wall of the aspiration catheter 10.

As shown in fig. 1 and 4, a distal filling catheter corresponding to the distal occluding structure 32 is connected to the distal occluding structure 32 after passing through the lumen of the aspiration catheter 10.

That is, when the proximal occlusion structure 31 and the distal occlusion structure 32 exist simultaneously, they are connected to the corresponding proximal filling catheter and distal filling catheter, respectively, and the proximal occlusion structure 31 and the distal occlusion structure 32 can be controlled by the corresponding proximal filling catheter and distal filling catheter, respectively.

In this embodiment, the material of the proximal balloon and the distal balloon may be medical polymers, such as nylon, pebax (polyether block polyamide), TPU (Thermoplastic polyurethane elastomer rubber), and the like. It has a good compliance, and when in use, the proximal balloon and the distal balloon can be expanded to 7-30F as required to closely fit the inner wall of the vein 92 of various sizes. In order to enable the occlusion structure 30 to enter the blood vessel 92 more smoothly, the proximal balloon and the distal balloon may be folded and pressed to 7-9F by a pressing machine in advance.

The suction catheter 10 may include an outer layer (not shown), an inner layer (not shown), and an intermediate layer (not shown) sandwiched between the outer and inner layers. The outer layer of the suction catheter 10 may be Pebax, PI (Polyimide), etc., the inner layer may be PTFE (polytetrafluoroethylene), PI, etc., the middle layer may be a metal braid or spring coil, and the material may be stainless steel, nylon, etc., which has good bending rigidity and compression and deformation resistance, and can adapt to blood vessels 92 with different bending degrees. The proximal filling catheter described above in relation to the proximal occluding structure 31 may be disposed within the intermediate layer of the aspiration catheter 10.

Fig. 5 is a schematic structural view of the embolectomy device in fig. 1. As shown in fig. 5, the embolectomy device 20 includes a hollow lattice structure 21, a delivery rod 22, and a first sheath 23 for holding and accommodating the hollow lattice structure 21. The hollow grid structure 21 is connected with the conveying rod 22, the first outer sheath 23 can be sleeved outside the conveying rod 22 along the axial direction of the conveying rod 22, in the direction along the length of the conveying rod 22, the diameter of the middle part of the hollow grid structure 21 is larger than the diameters of the two ends, the termination position of the first outer sheath 23 moving towards the direction of the hollow grid structure 21 in the length direction of the conveying rod 22 is partially overlapped with the hollow grid structure 21 at least, preferably, the first outer sheath 23 crosses the middle part of the hollow grid structure 21, when the hollow grid structure 21 is sleeved with the first outer sheath 23, the first outer sheath 23 presses and holds the hollow grid structure 21, the first outer sheath 23 is withdrawn, and the hollow grid structure 21 can be radially expanded after external pressure is released.

The cells on the hollow cell structure 21 may be S-shaped, spiral, triangular, etc. When the first sheath 23 moves onto the hollow grid structure 21, the first sheath 23 may apply pressure to the hollow grid structure 21 to shrink the hollow grid structure 21, and as the first sheath 23 continues to move along the conveying rod 22 in the direction of the hollow grid structure 21, it may accommodate the hollow grid structure 21 in the first sheath 23.

In this embodiment, the hollow mesh structure 21 may be arranged coaxially with the suction catheter 10 or off-axis. The conveying rod 22 can drive the hollow grid structure 21 to rotate around the self axis or reciprocate along the self length direction. When the thrombus 91 is to be broken, the thrombus 91 may be cut with the mesh, the thrombus 91 may be scraped off from the inner wall of the blood vessel 92, the thrombus 91 may be stored in the hollow mesh structure 21, and the thrombus 91 may be taken out of the body together with the thrombus extractor 20 through the aspiration catheter 10.

In this embodiment, the first outer sheath 23 may also be formed by an outer layer (not shown), an inner layer (not shown) and an intermediate layer (not shown) sandwiched between the outer layer and the inner layer, the outer layer may be made of Pebax, PI, etc., the inner layer may be made of PTFE, PI, etc., the intermediate layer may be a woven layer made of stainless steel, nylon, etc., and the mesh member has good tensile and compressive properties, can be pressed and held to accommodate the crushed portion, and has a small expansion of the tube body. One end of the outer sheath close to the hollow grid structure 21 can also be provided with a developing point, and the material of the developing point can be platinum-iridium alloy, tungsten powder and the like. The material of the delivery rod 22 may be a polymer, such as Pebax, PI, PTFE, etc., to provide good stretch and compression resistance, and to allow for pushing and bending within the vessel 92.

Fig. 6 to 12 are schematic structural views showing steps in surgical embolectomy performed by using the vascular embolectomy device provided by the first embodiment of the invention. As shown in fig. 6 to 12, when performing the embolectomy, the guidewire pathway is completed in the blood vessel 92, and then the distal end occlusion structure 32 in an unexpanded state is inserted, so that the distal end occlusion structure 32 passes through the thrombus 91 to reach a position where the thrombus 91 is located far from the surgical access port and is as close as possible to the position of the thrombus 91. During which time it can be located by the visualization point on the distal occluding structure 32.

The aspiration catheter 10 is then advanced under the guidance of the dilator into the blood vessel 92, near or into the thrombus 91. The aspiration catheter 10 may be sleeved outside the distal occlusion control portion 42 of the distal occlusion structure 32 as the aspiration catheter 10 is advanced into the blood vessel 92.

As the suction catheter 10 enters the blood vessel 92, the proximal occluding structure 31 in an unexpanded state is also brought into the blood vessel 92, and the proximal occluding structure 31 and the distal occluding structure 32 are expanded by the proximal occluding control portion 41 and the distal occluding control portion 42 corresponding to the proximal occluding structure 31 and the distal occluding structure 32, respectively, to occlude the blood vessel 92. The size of the dilation may be set according to the size of the blood vessel 92 in which it is located. In this embodiment, the filling pressure of the balloon may be specifically adjusted.

It should be noted that the proximal occluding structure 31 and the distal occluding structure 32 may be used alternatively or simultaneously as desired. Preferably, when a larger suction pressure is used, the proximal blocking structure 31 and the distal blocking structure 32 can be used together to limit the suction range of the suction catheter 10, so as to effectively control the amount of blood sucked and prevent excessive blood loss of the patient.

The thrombectomy device 20 is pressed into the first sheath 23, extended into the blood vessel 92 through the aspiration catheter 10 to reach the thrombus 91, and then the first sheath 23 is withdrawn to expand the hollow lattice structure. The positioning can be performed by the development of the development spot on the first sheath 23 and the hollow mesh structure 21 itself. Moving the hollow lattice structure 21 back and forth or rotating it breaks up the thrombus 91 and separates the thrombus 91 from the wall of the blood vessel 92. The separated thrombus 91 is hooked to the outside of the hollow lattice structure 21 or stored in the hollow lattice structure 21. The delivery rod 22 is withdrawn and the hollow lattice structure 21 is withdrawn from the suction catheter 10.

After the thrombus extractor 20 is withdrawn, the area of the thrombus 91 can be aspirated through the aspiration catheter 10 so that the remaining thrombus 91 is aspirated out of the body through the aspiration catheter 10.

It should be explained that the sequence of the steps of breaking the thrombus 91 by the thrombus remover 20 and aspirating the thrombus 91 by the aspiration catheter 10 can be adjusted according to actual needs. That is, the aspiration may be performed first, and then the operation of crushing and scraping the thrombus 91 may be performed to remove the residual thrombus 91 (see fig. 11 and 12). For example, when thrombus 91 is embolised, the thrombus 91 is generally intact and concentrated, and may be removed by aspiration and scraping. The operation of crushing and scraping the thrombus 91 may be performed first, and then the aspiration may be performed (see fig. 9 and 10). For example, in deep vein thrombosis, the thrombus 91 is generally distributed over a longer range, and the whole thrombus may be scraped first and then aspirated by a catheter.

Fig. 13 is a schematic structural view of a vascular thrombus removal device according to a second embodiment of the present invention, and fig. 14 is a schematic structural view of the proximal occlusion structure 30 in fig. 13. In fig. 14, the left side is a side view of the proximal occluding structure 31 and the right side is a front view as seen from the end face of the suction catheter 10. As shown in fig. 13 and 14, the vascular embolectomy device according to the second embodiment of the present invention is substantially the same as the first embodiment, except that in this embodiment, the occlusion structure 30 may be a self-expanding stent and a flexible membrane covering the self-expanding stent. For the sake of convenience of distinction, the self-expanding stent corresponding to the proximal occluding structure 31 will be referred to as a proximal self-expanding stent, and the self-expanding stent corresponding to the distal occluding structure 32 will be referred to as a distal self-expanding stent.

Accordingly, the proximal occlusion control portion 41 for controlling the proximal occlusion structure 31 may include a proximal sheath, the proximal self-expandable stent is disposed on the suction catheter 10, the proximal sheath is movably sleeved outside the suction catheter 10 along the axial direction of the suction catheter 10, the proximal self-expandable stent is sandwiched between the proximal sheath and the suction catheter 10 when the proximal self-expandable stent is not expanded, the proximal sheath applies pressure to the proximal self-expandable stent, and the proximal self-expandable stent is expandable outward after the external pressure is released.

In this embodiment, the proximal self-expanding stent may be made of a biocompatible metal material, such as a shape memory alloy, such as nitinol. It may be a crimped mesh woven from the above-mentioned materials. The flexible membrane can be made of a high polymer material with biocompatibility, small pores and low permeability.

When the stent is used, the proximal self-expanding stent is sent to a preset position, then the proximal sheath tube is slid to expose the proximal self-expanding stent, the proximal self-expanding stent returns to a curled state at the temperature in the body, namely, the proximal self-expanding stent begins to expand outwards and abuts against the inner wall of the blood vessel 92, and the flexible membrane on the proximal self-expanding stent is utilized to complete the occlusion of the blood vessel 92. By controlling the sliding distance of the proximal sheath, the degree of deployment of the proximal self-expanding stent can be controlled to accommodate vessels 92 of different sizes. After use, the proximal outer sheath can be slid in the opposite direction to re-accommodate the proximal self-expanding stent between the proximal outer sheath and the aspiration catheter 10.

It is understood that the distal occlusion control portion 42 corresponding to the distal occlusion structure 32 may include a support rod (not shown) and a distal sheath, the distal self-expandable stent is disposed on the support rod, the distal sheath is movably sleeved outside the support rod along the length direction of the support rod, and the distal self-expandable stent is clamped between the distal sheath and the support rod when the distal self-expandable stent is not expanded. In this case, the support rod may be independent of the aspiration catheter 10, and in use, the distal occlusion control portion 42 corresponding to the distal occlusion structure 32 is connected to the distal occlusion structure 32 after passing through the lumen of the aspiration catheter 10. The material of the distal self-expanding stent and the flexible membrane disposed thereon may refer to the proximal self-expanding stent and the flexible membrane disposed thereon, and will not be described herein again.

As a variation of this embodiment, in another embodiment, the blocking structure 30 may be a self-expanding polymeric elastic structure. More specifically, the self-expanding polymeric structure is referred to as a distal self-expanding polymeric structure, corresponding to the distal occluding structure; corresponding to the proximal end blocking structure, the self-expanding polymeric structure is referred to as a proximal self-expanding polymeric structure. The self-expanding polymer elastic structure can be a polymer material with biocompatibility, small pores and low permeability. In the proximal occlusion control unit 41 corresponding to the proximal occlusion structure 31, the proximal self-expandable polymer elastic structure is disposed on the aspiration catheter 10, and when the proximal self-expandable polymer elastic structure is not expanded, the proximal self-expandable polymer elastic structure is sandwiched between the proximal sheath tube and the aspiration catheter 10, and the proximal self-expandable polymer elastic structure is deformed by pushing and pulling the proximal sheath tube until the proximal self-expandable polymer elastic structure is completely attached to the inner wall of the blood vessel 92, thereby completing occlusion of the blood vessel 92.

In the distal occlusion control portion 42 corresponding to the distal occlusion structure 32, the distal self-expandable polymer elastic structure is disposed on the support rod, and when the self-expandable polymer elastic structure is not expanded, the self-expandable polymer elastic structure is sandwiched between the distal sheath and the suction catheter 10. The deformation of the distal self-expanding polymer elastic structure is realized by pushing and pulling the distal sheath tube until the distal self-expanding polymer elastic structure is completely attached to the inner wall of the blood vessel 92, so that the occlusion of the blood vessel 92 is completed.

It should be noted that the proximal blocking structure 31 and the distal blocking structure 32 are not necessarily limited to the same structure, and may be combined in various ways in the above embodiments. That is, the proximal blocking structure 31 and the distal blocking structure 32 may be selected to have different structures.

Fig. 15 is a schematic structural view of an embolectomy device of a blood vessel embolectomy device according to a third embodiment of the invention, and fig. 16 is a schematic view of the blood vessel embolectomy device in fig. 15 during a surgical embolectomy procedure. As shown in fig. 15 to 16, the blood vessel embolectomy device provided by the third embodiment of the present invention is substantially the same as the above embodiments, except that in this embodiment, the embolectomy device 20 includes a cutting blade 23, a protective mesh 24, a delivery rod 22 and a first sheath 21. The cutting blade 23 is connected with the conveying rod 22, and the protective net 24 is covered outside the cutting blade 23. The first sheath 21 is movably sleeved outside the conveying rod 22 along the axial direction of the conveying rod 22, when the first sheath 21 is sleeved on the protection net 24, the first sheath 21 accommodates the cutting blade 23 and grips the protection net 24, and the protection net expands outwards after external constraint is released.

When the thrombus 91 is hard, the thrombus 91 can be cut by the rotation of the cutting blade 22, and the blood vessel 92 can be protected by the protective net 24. Further, in the lower limb venous vessel 92, the protective net 24 can hold open the venous valve to prevent damage to the valve when the thrombus 91 is crushed and scraped, and the protective net 24 can scrape the thrombus 91 adhering to the wall of the vessel 92. Preferably, the power source for driving the protection net 24 and the cutting blade 22 may be an external motor, and the whole thrombus 91 is decomposed by spiral stirring and pulverization.

Fig. 17 is a schematic structural view of an embolectomy device of a vascular embolectomy device according to a fourth embodiment of the invention. As shown in fig. 17, the thrombus removal device provided by the fourth embodiment of the present invention may be the same as the above embodiments, except that in this embodiment, the thrombus removal device 20 includes an umbrella-shaped string bag 25, a plurality of connecting rods 26, a delivery rod 22, and a first sheath 21 (not shown in fig. 17). The link 226 has one end connected to the umbrella net bag 25 and the other end connected to the feed rod 22, and an arc portion 251 is formed on the edge of the umbrella net bag 25 between the two links 26. The first outer sheath tube 21 is movably sleeved outside the conveying rod 22 along the axial direction of the conveying rod 22, when the first outer sheath tube 21 is sleeved on the umbrella-shaped net bag 25, the umbrella-shaped net bag 25 is pressed and held, and the umbrella-shaped net bag 25 radially expands after external constraint is released.

In this embodiment, the connecting rod 26 and the umbrella-shaped string bag 25 are arranged, so that the connecting rod 26 has a guiding function when the umbrella-shaped string bag 25 is pressed and held. The umbrella-shaped string bag 25 can be more easily gripped by the first outer sheath 23 to reduce the tube diameter of the first outer sheath 23. Further, the provision of the arc portion 251 can perform the function of scraping and breaking the thrombus 91. After the thrombus 91 is broken, the umbrella net bag 25 can more easily accommodate the broken thrombus 91, and the broken thrombus 91 can be more easily taken out through the umbrella net bag 25.

It should be noted that in the above embodiments, various embodiments of the blocking structure 30 and the embolectomy device 20 are provided, and any combination thereof may be used.

Fig. 18 is a schematic structural view of a blood vessel embolectomy device according to a fifth embodiment of the invention. As shown in fig. 18, the blood vessel embolectomy device provided by the fifth embodiment of the invention is basically the same as the previous embodiments, except that in this embodiment, the blood vessel embolectomy device further comprises a first interception part 51, the first interception part 51 is arranged on the side of the distal occlusion structure 32 far away from the suction catheter 10, and through the arrangement of the first interception part 51, the broken thrombus 91 can be prevented from escaping from the gap between the distal occlusion structure 32 and the blood vessel 92 while ensuring the blood to pass. Preferably, the first interception portion 51 may have an umbrella shape, the opening of which is directed to the side of the distal blocking structure 32.

Fig. 19 is a schematic structural view of a vascular embolectomy device provided by a sixth embodiment of the invention. As shown in fig. 19, the vascular embolectomy device provided by the sixth embodiment of the present invention is substantially the same as that of the above-described embodiments, except that in this embodiment, the vascular embolectomy device may further include a second intercepting part 52, and the second intercepting part 52 is disposed at the end of the aspiration catheter 10. The second blocking portion 52 can prevent the broken thrombus 91 from escaping toward the surgical access opening.

Fig. 20 is a schematic structural view of a vascular embolization device according to a seventh embodiment of the present invention, and fig. 21 is a schematic sectional structural view of the suction catheter in fig. 20. A seventh embodiment of the present invention provides a vascular embolectomy device which is substantially the same as the above-described embodiments, except that in this embodiment, in order to achieve controlled bending of the aspiration catheter 10, the vascular embolectomy device further comprises a pull wire (not shown) which controls the orientation of the end of the aspiration catheter 10. A pull wire lumen 11 for the pull wire to pass through is also formed in the wall of the suction catheter 10. Fig. 21 shows the configuration when the suction catheter 10 is provided with a traction wire on both sides. The number of the pull wires may be set according to the control requirement, and accordingly, the number of the pull wire lumens 11 may be set according to the number of the pull wires.

Fig. 22 is a schematic sectional view showing a suction catheter in a vascular embolization device according to an eighth embodiment of the present invention, fig. 23 is a schematic sectional view showing a uniformly expanded proximal occlusion structure 30 according to an eighth embodiment of the present invention, and fig. 24 is a schematic sectional view showing an eccentrically expanded proximal occlusion structure 30 according to an eighth embodiment of the present invention. The proximal occlusion structure 31 of the thrombus removal device according to the eighth embodiment of the present invention is a proximal balloon, and the remaining structure is substantially the same as that of the above embodiments, except that in this embodiment, the proximal balloon may be composed of a plurality of sub-balloons 311, and the plurality of sub-balloons 311 are sequentially arranged on the outer sidewall of the suction catheter 10 in the circumferential direction of the suction catheter 10. Each sub-balloon 311 is in communication with a respective proximal filling catheter, i.e. the degree of filling of the respective sub-balloon 311 can be controlled by a single proximal filling catheter to vary the eccentricity of the aspiration catheter 10 within the proximal balloon.

Further, in other embodiments, the proximal balloon may be an asymmetric balloon that, when inflated, offsets the aspiration catheter 20 from the axis of the blood vessel 92 to better aspirate the blood vessel.

In the thrombus removal operation of the pulmonary thrombus 91, the route of the blood vessel 92 reaching the pulmonary artery is relatively tortuous, and it is difficult to ensure the coaxiality of the suction catheter 10 and the blood vessel 92 with respect to the group of the thrombus 91 concentrated in the middle of the blood vessel 92 in the process of sucking the thrombus 91 by the suction catheter 10, and the bending angle of the suction catheter 10 is limited with respect to the thrombus 91 adhering to the side of the blood vessel 92, and it is difficult to maintain a stable direction in the blood vessel 92 and align the thrombus 91 with a lesion site, so that the suction effect is limited, and in such a case, the number of times of suction is increased, and an empty suction condition is easily caused, and the patient loses much blood.

Divide into a plurality of sub-sacs 311 through nearly end sacculus to respectively control each sub-sac 311's filling degree, the eccentric expansion of near end sacculus makes suction catheter 10 and blood vessel 92 be certain angle slope, makes suction catheter 10 aim at thrombus 91 then, prevents that the empty phenomenon of inhaling from taking place, reinforcing suction effect.

To sum up, in the present invention, when performing the embolectomy, the occlusion structure 30 may be inserted into the area where the thrombus 91 is located, and then the occlusion control unit 40 controls the occlusion structure 30 to expand the occlusion structure 30, thereby occluding the blood vessel 92 at the position of the thrombus 91 and temporarily slowing or blocking the flow of blood at the position of the thrombus 91. The embolectomy operation can then be performed through the embolectomy device 20 and the aspiration catheter 10. At this time, since the blood flow at the site of the thrombus 91 is slow or stopped, it is possible to effectively reduce the amount of blood to be suctioned and prevent a patient from losing much blood when the suction catheter 10 suctions the thrombus 91. Furthermore, the thrombus 91 can be blocked, and the position of the thrombus 91 can be prevented from being shifted along with the blood flow after the thrombus 91 is broken.

Further, the thrombus 91 can be cleaned more thoroughly by improving the occlusion control part and the related structure of the thrombus remover 20.

Further, through the improvement of the structure of the balloon 31, the balloon 31 can be eccentrically inflated according to the trend of the blood vessel 92, so that the aspiration catheter 10 can better aspirate the thrombus 91.

Further, the broken thrombus 91 can be better prevented from escaping outwards by the arrangement of the first blocking net 51 and/or the second blocking net 52.

Although the present invention has been described with reference to a preferred embodiment, it should be understood that various changes, substitutions and alterations can be made herein without departing from the spirit and scope of the invention as defined by the appended claims.

Claims

1. A blood vessel thrombectomy device, which is characterized in that: comprises an aspiration catheter for aspirating thrombus, a thrombus extractor for breaking the thrombus and an occlusion structure for occluding the blood vessel of the area where the thrombus is positioned by self-expansion.

2. The vessel embolectomy device of claim 1, wherein: the occlusion structure comprises at least one of a near-end occlusion structure used for occluding one side of the thrombus facing the surgical access opening and a far-end occlusion structure used for occluding one side of the thrombus far away from the surgical access opening.

3. The vessel embolectomy device of claim 1, wherein: the blood vessel thrombus removal device also comprises an occlusion control part which is connected with the occlusion structure and controls the expansion of the occlusion structure.

4. The vessel embolectomy device of claim 3, wherein: the occlusion structure comprises a near-end occlusion structure used for occluding the thrombus towards one side of the surgical intervention port, the near-end occlusion structure is arranged on the outer side wall of the suction catheter, the occlusion control part comprises a near-end occlusion control part, and the near-end occlusion control part is connected with the near-end occlusion structure and controls the expansion of the near-end occlusion structure.

5. The vessel embolectomy device of claim 4, wherein: the near-end plugging structure is a near-end balloon, the near-end plugging control part for controlling the near-end plugging structure is a near-end filling catheter communicated with the near-end balloon, the near-end balloon of the near-end plugging structure is arranged on the outer side wall of the suction catheter, a pipeline is formed in the wall of the suction catheter, the near-end filling catheter is arranged in the pipeline and is communicated with the near-end balloon of the near-end plugging structure after penetrating through the wall of the suction catheter, or the near-end filling catheter corresponding to the near-end balloon of the near-end plugging structure is communicated with the near-end balloon of the near-end plugging structure from the outside of the suction catheter.

6. The vessel embolectomy device of claim 4, wherein: the near-end plugging structure is a near-end self-expansion support and a flexible membrane covering the near-end self-expansion support, the near-end plugging control part for controlling the near-end plugging structure comprises a near-end sheath tube, the near-end self-expansion support is arranged on the outer side wall of the suction catheter, the near-end sheath tube is sleeved outside the suction catheter in a movable mode along the axial direction of the suction catheter, and when the near-end self-expansion support is not expanded, the near-end self-expansion support is clamped between the near-end sheath tube and the suction catheter.

7. The vessel embolectomy device of claim 4, wherein: the proximal end plugging structure is a proximal end self-expansion high polymer elastic structure, the proximal end plugging control part for controlling the proximal end plugging structure comprises a proximal end outer sheath tube, the proximal end outer sheath tube is movably sleeved outside the suction catheter along the axial direction of the suction catheter, and when the proximal end self-expansion high polymer elastic structure is not expanded, the proximal end self-expansion high polymer elastic structure is clamped between the proximal end outer sheath tube and the suction catheter.

8. The vessel embolectomy device of claim 3, wherein: the plugging structure comprises a far-end plugging structure used for plugging thrombus far away from one side of the surgical intervention port, the plugging control part comprises a far-end plugging control part, the far-end plugging control part controls the expansion of the far-end plugging structure, the far-end plugging control part penetrates through a lumen of the suction catheter and is connected with the far-end plugging structure, and when a thrombus removal operation is carried out, a suction space is formed between the far-end plugging structure and the end part of the suction catheter.

9. The vessel embolectomy device of claim 8, wherein: the far-end plugging structure is a far-end balloon, the far-end plugging control part for controlling the far-end plugging structure is a far-end filling catheter communicated with the far-end balloon, and the far-end filling catheter is connected with the far-end balloon of the far-end plugging structure after penetrating through the lumen of the suction catheter.

10. The vessel embolectomy device of claim 8, wherein: the far-end plugging structure is a far-end self-expansion support and a flexible membrane covering the far-end self-expansion support, the far-end plugging control part for controlling the far-end plugging structure comprises a far-end sheath tube and a support rod, the far-end self-expansion support is arranged on the support rod, the far-end sheath tube is movably sleeved outside the support rod along the length direction of the support rod, and when the far-end self-expansion support is not expanded, the far-end self-expansion support is clamped between the far-end sheath tube and the support rod.

11. The vessel embolectomy device of claim 8, wherein: the far-end plugging structure is a far-end self-expansion high-molecular elastic structure, the far-end plugging control part for controlling the far-end plugging structure comprises a far-end outer sheath tube and a support rod, the far-end self-expansion high-molecular elastic structure is arranged outside the support rod, the far-end outer sheath tube is sleeved outside the suction catheter in a movable mode along the axial direction of the suction catheter, and when the far-end self-expansion high-molecular elastic structure is not expanded, the far-end self-expansion high-molecular elastic structure is clamped between the far-end outer sheath tube and the support rod.

12. The vessel embolectomy device of claim 1, wherein: the thrombus remover comprises a hollow grid structure, a conveying rod and a first outer sheath tube, wherein the first outer sheath tube is used for pressing, holding and containing the hollow grid structure, the hollow grid structure is connected with the conveying rod, the first outer sheath tube is movably sleeved outside the conveying rod along the axial direction of the conveying rod, the end position of the first outer sheath tube, which moves towards the direction of the hollow grid structure in the axial direction of the conveying rod, at least partially coincides with the hollow grid structure, when the first outer sheath tube is sleeved outside the hollow grid structure, the first outer sheath tube presses and holds the hollow grid structure, and the hollow grid structure radially expands after external constraint is released.

13. The vessel embolectomy device of claim 1, wherein: get and tie ware including cutting piece, protection net, conveying pole and first sheath pipe, the cutting piece with the conveying pole links to each other, the protection net set up in outside the cutting piece, first sheath pipe is followed the axially movable cover of conveying pole is located outside the conveying pole first sheath pipe box is located when the protection is online, first sheath pipe is right the cutting piece is acceptd, and right the protection net is pressed and is held, the protection net radially expands after the outside constraint releases.

14. The vessel embolectomy device of claim 1, wherein: get the bolt ware and include umbelliform string bag, a plurality of connecting rod, conveying pole and first sheath pipe, the one end of connecting rod with umbelliform string bag links to each other, the other end with the conveying pole links to each other two between the connecting rod, be formed with arc portion on the edge of umbelliform string bag, first sheath pipe is followed the axially movable cover of conveying pole is located outside the conveying pole first sheath pipe box is located when on the umbelliform string bag, it is right the umbelliform string bag is pressed and is held, the radial expansion of umbelliform string bag constraint after externally releasing.

15. The vessel embolectomy device of claim 2 or 8, wherein: the vascular embolectomy device comprises a first interception part which is arranged on one side of the distal occlusion structure, which is far away from the suction catheter.

16. The vessel embolectomy device of claim 1, wherein: the vascular thrombus removal device further comprises a second intercepting part which is arranged at the end part of the suction catheter.

17. The vessel embolectomy device of claim 4, wherein: the near-end balloon is composed of a plurality of sub-balloons, the sub-balloons are sequentially distributed on the outer side wall of the suction catheter along the circumferential direction of the suction catheter, and each sub-balloon is respectively communicated with one filling catheter.

18. The vessel embolectomy device of claim 4, wherein: the proximal balloon is an asymmetric balloon.

19. The vessel embolectomy device of claim 1, wherein: the thrombus removal device for the blood vessel further comprises a traction wire for controlling the orientation of the end part of the suction catheter, and a traction wire tube cavity for the traction wire to penetrate through is formed in the tube wall of the suction catheter.