CN114130493B - Medical cutting assembly and volume reducing catheter system - Google Patents
Medical cutting assembly and volume reducing catheter system Download PDFInfo
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- CN114130493B CN114130493B CN202010918066.4A CN202010918066A CN114130493B CN 114130493 B CN114130493 B CN 114130493B CN 202010918066 A CN202010918066 A CN 202010918066A CN 114130493 B CN114130493 B CN 114130493B
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- 238000005520 cutting process Methods 0.000 title claims abstract description 102
- 238000011038 discontinuous diafiltration by volume reduction Methods 0.000 claims description 15
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- 208000000575 Arteriosclerosis Obliterans Diseases 0.000 description 5
- 208000030831 Peripheral arterial occlusive disease Diseases 0.000 description 5
- 238000002399 angioplasty Methods 0.000 description 5
- 210000003141 lower extremity Anatomy 0.000 description 5
- 230000008569 process Effects 0.000 description 5
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Classifications
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B02—CRUSHING, PULVERISING, OR DISINTEGRATING; PREPARATORY TREATMENT OF GRAIN FOR MILLING
- B02C—CRUSHING, PULVERISING, OR DISINTEGRATING IN GENERAL; MILLING GRAIN
- B02C18/00—Disintegrating by knives or other cutting or tearing members which chop material into fragments
- B02C18/06—Disintegrating by knives or other cutting or tearing members which chop material into fragments with rotating knives
- B02C18/14—Disintegrating by knives or other cutting or tearing members which chop material into fragments with rotating knives within horizontal containers
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B02—CRUSHING, PULVERISING, OR DISINTEGRATING; PREPARATORY TREATMENT OF GRAIN FOR MILLING
- B02C—CRUSHING, PULVERISING, OR DISINTEGRATING IN GENERAL; MILLING GRAIN
- B02C18/00—Disintegrating by knives or other cutting or tearing members which chop material into fragments
- B02C18/06—Disintegrating by knives or other cutting or tearing members which chop material into fragments with rotating knives
- B02C18/16—Details
- B02C18/18—Knives; Mountings thereof
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B02—CRUSHING, PULVERISING, OR DISINTEGRATING; PREPARATORY TREATMENT OF GRAIN FOR MILLING
- B02C—CRUSHING, PULVERISING, OR DISINTEGRATING IN GENERAL; MILLING GRAIN
- B02C18/00—Disintegrating by knives or other cutting or tearing members which chop material into fragments
- B02C18/06—Disintegrating by knives or other cutting or tearing members which chop material into fragments with rotating knives
- B02C18/16—Details
- B02C18/22—Feed or discharge means
- B02C18/2216—Discharge means
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B02—CRUSHING, PULVERISING, OR DISINTEGRATING; PREPARATORY TREATMENT OF GRAIN FOR MILLING
- B02C—CRUSHING, PULVERISING, OR DISINTEGRATING IN GENERAL; MILLING GRAIN
- B02C18/00—Disintegrating by knives or other cutting or tearing members which chop material into fragments
- B02C18/06—Disintegrating by knives or other cutting or tearing members which chop material into fragments with rotating knives
- B02C18/16—Details
- B02C18/22—Feed or discharge means
- B02C18/2225—Feed means
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B02—CRUSHING, PULVERISING, OR DISINTEGRATING; PREPARATORY TREATMENT OF GRAIN FOR MILLING
- B02C—CRUSHING, PULVERISING, OR DISINTEGRATING IN GENERAL; MILLING GRAIN
- B02C23/00—Auxiliary methods or auxiliary devices or accessories specially adapted for crushing or disintegrating not provided for in preceding groups or not specially adapted to apparatus covered by a single preceding group
- B02C23/04—Safety devices
Abstract
The invention discloses a medical cutting assembly and a volume-reducing catheter system, wherein the medical cutting assembly comprises a cutter head and a limiting piece connected with the cutter head, the cutter head comprises a conveying part, the limiting piece comprises a decomposing part, and the decomposing part penetrates through the conveying part when the cutter head and the limiting piece rotate relatively. The volume-reducing catheter system comprises the medical cutting assembly and a transmission shaft for driving the cutter head to rotate, and the distal end of the transmission shaft penetrates through the limiting piece and is connected with the cutter head. According to the invention, the conveying part can convey the redundant tissues cut by the cutter head to the near end from the far end, the decomposing part is arranged on the limiting part, when the cutter head and the limiting part relatively rotate, the decomposing part penetrates through the conveying part, and the high-speed rotating decomposing part further cuts and decomposes the cut tissues in the conveying part into tissues with smaller volumes, so that the decomposition is more sufficient, the subsequent conveying of the redundant tissues is more facilitated, and the overall improvement of the working efficiency is realized.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to a medical cutting assembly and a volume-reducing catheter system.
Background
Lower limb arteriosclerosis obliterans (arteriosclerosis obliterans, ASO) are common and frequently occurring diseases of middle-aged and elderly people, and are also important manifestations of atherosclerosis in lower limbs.
The current treatment methods for the arteriosclerosis obliterans of the lower limbs mainly comprise drug treatment, surgical operation, intracavity treatment, compound operation, autologous peripheral blood stem cell transplantation, gene drug treatment and the like. The intracavity treatment of the lower limb arteriosclerosis obliterans has the advantages of minimally invasive, safe, effective, quick recovery and the like, and has become the first choice for the treatment of the lower limb arteriosclerosis obliterans. Current methods of endoluminal treatment include conventional percutaneous transluminal angioplasty (percutaneous transluminal angioplasty, PTA) and emerging endoluminal volume reduction. Pure PTA has obvious limitations, and pure expansion treatment is carried out on a narrow section, so that redundant tissues cannot be removed, and the stretching of the blood vessel wall is unavoidable, so that air pressure injury and interlayer are easily generated, and the restenosis state is easily caused by rebound after operation. PTA is often used in combination with an endovascular volume reduction procedure, wherein plaque is resected by an intracavitary mechanical atherectomy procedure in the endovascular volume reduction procedure, and good therapeutic effect can be achieved by matching with PTA. However, after the existing intracavity volume reduction operation is used for cutting off the redundant tissues, the cut redundant tissues are not treated, the cut redundant tissues are carried out while being kept in the original state, the decomposition of the redundant tissues is not thorough enough, the transportation process of the redundant tissues is not smooth, and the overall working efficiency is low.
Disclosure of Invention
Therefore, the invention provides a medical cutting assembly and a corresponding volume-reducing catheter system, which are used for solving the problems that the existing intracavity volume-reducing device is not thorough enough in decomposing redundant tissues, so that the transportation process is not smooth and the overall working efficiency is low.
The technical scheme adopted by the invention is as follows:
the utility model provides a medical cutting assembly, include the tool bit and with the locating part that the tool bit rotates to be connected, the tool bit includes the conveying part, the locating part includes the decomposition portion, the tool bit with when the locating part relative rotation, the decomposition portion passes the conveying part.
In one embodiment, the cutter head comprises a cutting part, the cutting part comprises a plurality of blades extending from a proximal end to a distal end, the conveying part comprises a conveying groove between two adjacent blades, at least one blade is provided with a through groove, the through groove is communicated with the conveying groove adjacent to the blade, and the decomposing part passes through the conveying groove for a plurality of times when the cutter head rotates relative to the limiting piece.
In one embodiment, the number of the decomposition parts is one or more, and in the process of rotating the cutter head, at least one part of at least one decomposition part is always positioned in one through groove so as to axially limit the cutter head.
In one embodiment, the plurality of the decomposing parts are arranged, and at least two decomposing parts are arranged at intervals along the circumferential direction or the axial direction of the limiting piece.
In one embodiment, the blade extends helically from the proximal end to the distal end, and the helix angle of the flutes decreases progressively from the distal end to the proximal end.
In one embodiment, the medical cutting assembly further comprises a sleeve connected to the limiter, the sleeve is sleeved outside the cutter head and the limiter, and the sleeve axially covers at least the decomposition portion.
In one embodiment, the sleeve is provided with a plurality of decomposing grooves, and when the cutter head rotates relative to the limiting piece, the decomposing grooves are communicated with the conveying part at least at a certain moment.
In one embodiment, the decomposing part is located at the middle part of the limiting part, and a part of the limiting part is at least sleeved outside the proximal end of the cutter head.
In one embodiment, the axial width of the decomposition portion is smaller than the axial width of the through groove, and the axial position of the proximal end of the decomposition portion relative to the proximal end of the through groove is adjustable.
The volume-reducing catheter system further comprises a transmission shaft for driving the cutter head to rotate, and the distal end of the transmission shaft penetrates through the limiting piece and is connected with the cutter head.
The embodiment of the invention has the beneficial effects that:
the medical cutting assembly comprises a cutter head and a limiting piece connected with the cutter head, wherein the cutter head comprises a cutting part and a conveying part, the limiting piece comprises a decomposing part, and the decomposing part penetrates through the conveying part when the cutter head and the limiting piece rotate relatively. The conveying part can convey the redundant tissues cut by the cutter head to the near end from the far end, the limiting piece is provided with the decomposing part, when the cutter head and the limiting piece rotate relatively, the decomposing part penetrates through the conveying part, and the high-speed rotating decomposing part further cuts and decomposes the cut tissues in the conveying part into tissues with smaller volumes, so that the follow-up conveying out of the cut tissues is facilitated. The volume-reducing catheter system of the invention utilizes the medical cutting assembly of the invention to realize the cutting and decomposition of target tissues in a body and the transportation to the outside of the body, the cutting is sufficient and is more beneficial to the transportation, and the improvement of the working efficiency on the whole is realized.
Drawings
FIG. 1 is an overall schematic of a medical cutting assembly of example 1;
FIG. 2 is an exploded view of the medical cutting assembly of example 1;
FIG. 3 is a schematic view of the structure of the cutter head in embodiment 1;
FIG. 4 is a schematic view of the structure of the stopper in embodiment 1;
FIG. 5 is a schematic cross-sectional view of the distal end of the volume reduction catheter system of example 1;
FIG. 6 is a schematic view showing the structure of a limiting member of the medical cutting assembly of embodiment 2;
FIG. 7 is an exploded view of the medical cutting assembly of example 3;
FIG. 8 is a schematic view showing the installation of a cutter head and a stopper in the medical cutting assembly of example 3;
FIG. 9 is a schematic view showing the structure of a stopper of the medical cutting assembly of embodiment 3;
FIG. 10 is a schematic view of the structure of the distal end of the volume reduction catheter system of example 5;
fig. 11 is a schematic view showing the structure of the distal end of the volume reduction catheter system in example 6.
Detailed Description
In order that the invention may be readily understood, a more complete description of the invention will be rendered by reference to the appended drawings. Preferred embodiments of the present invention are shown in the drawings. This invention may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will be thorough and complete.
In the description of the present invention, if an orientation description such as "upper", "lower", "front", "rear", "left", "right", etc. is referred to, it is merely for convenience of description and simplification of the description, and does not indicate or imply that the apparatus or element referred to must have a specific orientation, be configured and operated in a specific orientation, and thus should not be construed as limiting the invention. If a feature is referred to as being "disposed," "secured" or "connected" to another feature, it can be directly disposed, secured or connected to the other feature or intervening features may also be disposed, secured or connected to the other feature.
In the description of the embodiments of the present invention, if "several" is referred to, it means more than one, if "multiple" is referred to, it is understood that the number is not included if "greater than", "less than", "exceeding", and it is understood that the number is included if "above", "below", "within" is referred to. If reference is made to "first", "second" it is to be understood as being used for distinguishing technical features and not as indicating or implying relative importance or implicitly indicating the number of technical features indicated or implicitly indicating the precedence of the technical features indicated.
In addition, unless defined otherwise, technical and scientific terms used in the embodiments of the present invention have the same meaning as commonly understood by one of ordinary skill in the art. The terminology used herein in the description of the invention is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. The term "and/or" as used herein includes any and all combinations of one or more of the associated listed items.
In the field of interventional medical devices, the end of a medical device implanted in a human or animal body closer to an operator is generally referred to as a "proximal end", the end farther from the operator is generally referred to as a "distal end", and the "proximal end" and the "distal end" of any component of the medical device are defined according to this principle. "axial" generally refers to the longitudinal direction of a medical device when delivered, and "radial" generally refers to the direction of the medical device perpendicular to its "axial" direction, and defines the "axial" and "radial" directions of any component of the medical device in accordance with this principle.
Example 1
Embodiment 1 provides a medical cutting assembly and corresponding reduced volume catheter system, wherein fig. 1-4 correspond to medical cutting assembly 10 and fig. 5 correspond to reduced volume catheter system 11.
Referring to fig. 1 to 2, fig. 1 is an overall schematic view of the medical cutting assembly of example 1, and fig. 2 is an exploded schematic view of the medical cutting assembly of example 1. In this embodiment, the medical cutting assembly 10 includes a coaxially mounted cutter head 101, a stop 102, and a cannula 103. The cutter head 101 is used as a main working component for cutting and conveying redundant tissues, the limiting piece 102 is rotationally connected with the cutter head 101, the limiting piece 102 can axially limit the cutter head 101, in the embodiment, the distal end of the limiting piece 102 is clamped with the proximal end of the cutter head 101 and can relatively rotate, and in addition, the limiting piece 102 can further decompose tissues conveyed by the cutter head 101. The sleeve 103 is sleeved on the proximal end of the cutter head 101, so that on one hand, the proximal end of the cutter head 101 is prevented from rotating to cut normal blood vessel walls or normal tissues, and on the other hand, the radial displacement of the cutter head 101 is limited, namely, the cutter head 101 is radially limited.
The sleeve 103 is sleeved outside the cutter head 101, so that the radial displacement of the cutter head 101 is limited, and meanwhile, when the cutter head 101 cuts and captures narrow tissues in a blood vessel at the distal end of the cutter head 101, the cut tissues can be transported from the distal end of the medical cutting assembly 10 to the proximal end along the conveying groove 1012, and the sleeve 103 can prevent the cut tissues from directly leaving the conveying groove 1012 of the cutter head 101 in the radial direction. That is, the cannula 103 cooperates with the cutter head 101 to move the captured stenotic tissue along the delivery slot 1012 toward the proximal end of the medical cutting assembly 10 for cutting and carrying out of the tissue by the instrument, and in particular, the cannula 103 covers the proximal portion of the cutter head 101 and the distal portion of the stop 102.
In another embodiment, the medical cutting assembly 10 does not include a cannula 103, and the medical cutting assembly 10 is still capable of cutting and disrupting tissue.
In another embodiment, the proximal end of the blade 101 of the medical cutting assembly 10 may be deployed within a sheath for working to collect the severed tissue with the sheath.
Referring to fig. 3 and 4 together, fig. 3 is a schematic structural view of the cutter head 101 in embodiment 1, and fig. 4 is a schematic structural view of the stopper 102 in embodiment 1. Specifically, the proximal end of the cutter head 101 is rotatably connected to the distal end of the stopper 102, and the cutter head 101 is restrained from axial movement toward the distal end by the stopper 102. In actual operation, the limiting member 102 is relatively fixed, and the cutter head 101 performs a rotary motion about its own rotary shaft 110 to achieve a rotary cutting function. The surface of the cutter head 101 is provided with at least two cutting edges 1011, and the cutting edges 1011 extend from the distal end to the proximal end of the cutter head 101 and are spirally distributed. The tool bit 101 drives the blade 1011 to rotate so as to cut redundant tissue in the blood vessel, in fact, the working position of the blade 1011 for cutting is a distal end portion of the blade 1011, and a sleeve 103 is sleeved on the proximal end portion of the blade 1011 to limit radial displacement of the blade 1011 and protect the blood vessel or tissue on the proximal end portion of the blade 1011 from being cut by the proximal end portion of the blade 1011. A conveying groove 1012 extending spirally in the axial direction is provided between two adjacent blade edges 1011. As the cutter head 101 rotates about its own pivot axis 110, the tissue being cut moves along the transport slot 1012 between the cutting edges 1011, gradually approaching the proximal end of the medical cutting assembly 10 in an axial direction. To obtain a larger cutting area, the exposed portion of the distal end of the cutter head 101 has a maximum outer diameter equal to the outer diameter of the cannula 103.
The conveying groove 1012 is a spiral groove, and the included angle between the tangent 130 of any point 121 on the groove bottom center line 120 of the conveying groove 1012 and the rotating shaft 110 of the cutter head 101 is the spiral angle of the conveying groove 1012. In fig. 3, the projection of the rotation axis 110 on a plane parallel to the rotation axis 110 through the tangent line 130 is the projection line 111, and the angle α between the tangent line 130 and the projection line 111 is the helix angle. Due to the helix angle, the transport groove 1012 imparts an axial force component to the captured tissue as the cutter head 101 rotates, thereby causing the captured tissue to displace axially. Allowing the cutter head 101 to not only cut stenotic tissue in a blood vessel, but also to spiral the cut tissue along the delivery slot 1012 toward the proximal end of the medical cutting assembly 10 to a predetermined location.
In another embodiment, the helix angle of the flutes 1012 decreases progressively from the distal end of the cutter head 101 to the proximal end thereof for better delivery, and accordingly, as the flutes 1012 are defined by adjacent blades 1011, the helix angle of the blades 1011 also varies as the helix angle of the flutes 1012 varies. For the whole cutter head 101, a larger helix angle is arranged at the distal end part of the cutter edge 1011, which is beneficial to cutting and capturing tissues and has higher cutting efficiency; as the flutes 1012 extend proximally, the helix angle of the flutes 1012 gradually decreases, facilitating the delivery of captured tissue to the proximal end of the blade 1011.
In another embodiment, the plurality of blades 1011 extend straight along the axis, and the conveying groove 1012 between two adjacent blades 1011 is a straight groove extending along the axis and parallel to the rotating axis 110. Since the distal end of the cutter head 101 cuts the surplus tissue, the cut tissue gradually enters the distal end of the conveying groove 1012, and as the tissue in the groove of the conveying groove 1012 gradually increases, the cut tissue is pushed gradually and moves along the groove toward the proximal end of the conveying groove 1012, so that the conveying groove 1012 is provided in a spiral shape in embodiment 1, which is just a shape selection for providing the conveying groove 1012 with good conveying ability, the specific shape of the conveying groove 1012 may not be limited.
In embodiment 1, the proximal end of the cutter head 101 is provided with a plurality of through grooves 1013, each through groove 1013 penetrating the blade 1011 where it is located in the circumferential direction and communicating with the conveying groove 1012 adjacent to the blade 1011. As shown in fig. 4, a plurality of decomposition parts 1021 are provided at positions near the distal end of the stopper 102, the decomposition parts 1021 are provided in a boss shape, the decomposition parts 1021 protrude inward from the inner wall of the stopper 102, and the plurality of decomposition parts 1021 are distributed at intervals in the circumferential direction of the stopper 102. When the tool bit 101 rotates, the decomposition parts 1021 alternately enter the through grooves 1013 and the conveying grooves 1012, the decomposition parts 1021 collide with the tissue in the conveying grooves 1012 and decompose the tissue into a smaller volume of tissue, and in the embodiment, the decomposition parts 1021 simultaneously move and respectively alternately pass through the through grooves 1013 and the corresponding conveying grooves 1012, so that the machining efficiency is high.
In another embodiment, the decomposition portion 1021 is provided in other shapes, including being provided in a blade shape, a zigzag shape, etc., that is, the specific shape of the decomposition portion 1021 in the medical cutting assembly 10 according to the corresponding embodiment of the present application may not be limited.
In addition, the breaking part 1021 is engaged with the through groove 1013 to form an engagement structure, and the axial limit of the cutter head 101 is realized without affecting the rotation of the cutter head 101. That is, during rotation of the cutter head 101, if there is no other structure to axially limit the cutter head 101, at least a portion of the at least one breaking portion 1021 is always located in one through slot 1013 to maintain the axial limit of the cutter head 101.
In another embodiment, the decomposing part 1021 only plays a role in decomposing, the limiting piece 102 is additionally provided with a limiting block, the proximal end of the cutter head 101 is also additionally provided with a positioning slot, the limiting block is clamped with the positioning slot to realize axial limiting of the cutter head 101, when the cutter head 101 and the limiting piece 102 relatively rotate, the limiting block does not need to be engaged with the conveying slot 1012, but the limiting block is always clamped with the positioning slot, and the decomposing part 1021 can be completely separated from the through slot 1013.
In another embodiment, when the vertical distances from the outer surfaces of the plurality of blades 1011 to the rotation shaft 110 on the cutter head 101 are different (i.e., the heights of the blades 1011 are different), the corresponding through grooves 1013 may be circumferentially provided in one or more, and the corresponding breaking portions 1021 may be circumferentially provided in one or more, at a certain axial position of the cutter head 101. When the cutter head 101 and the limit groove 102 are rotated relative to each other, the decomposition part 1021 passes through the through groove 1013 in the circumferential direction without being blocked, and in general, the through groove 1013 may be provided for each blade 1011, and in a special case, that is, in a case where only a part of the blades 1011 are provided with the through groove 1013, it is necessary to satisfy: the distance from the bottom surface of the decomposition part 1021 to the rotation shaft 110 is greater than the distance from the outer surface of the blade 1011, in which the through groove 1013 is not provided, to the rotation shaft 110, so that the decomposition part 1021 can pass through the through groove 1013 in a circumferential direction without being blocked, and does not collide with the blade 1011, in which the through groove 1013 is not provided.
When the number of the through grooves 1013 is one and the number of the corresponding resolvers 1012 is one, the through grooves 1013 are provided at the proximal end of the blade 1011 having the largest vertical distance from the outer surface to the rotation shaft 110, and a part of the resolvers 1012 is always positioned in the through grooves 1013 during the relative rotation between the through grooves 1013 and the resolvers 1012.
When the number of the through grooves 1013 is one and the number of the corresponding decomposition parts 1012 is plural, the through grooves 1013 are provided at the proximal end of the blade 1011 having the largest vertical distance from the outer surface to the rotation shaft 110, and the plurality of decomposition parts 1012 alternately pass through the conveying grooves 1012 and the through grooves 1013 in the circumferential direction in order during the relative rotation between the through grooves 1013 and the plurality of decomposition parts 1012, and at least one part of the decomposition parts 1012 is always located in the through grooves 1013.
When the number of the through grooves 1013 is one and the corresponding decomposition units 1012 are plural, the decomposition units 1012 pass through the plurality of the conveying grooves 1012 and the through grooves 1013 in the circumferential direction in order in the process of relatively rotating the plurality of the through grooves 1013 and the decomposition units 1012, and at least a part of the decomposition units 1012 is always located in at least one through groove 1013.
In another embodiment, when one or more through slots 1013 are circumferentially provided on the cutter head 101, a decomposition portion 1021 is correspondingly provided on the limiting member 102, and at this time, the circumferential length (arc length) of the connection between the decomposition portion 1021 and the inner wall of the limiting member 102 is greater than the circumferential width of any one of the conveying slots 1012, so as to ensure that at least a portion of at least one decomposition portion 1021 is always located in one through slot 1013, so as to achieve decomposition of the cut tissue while maintaining axial limitation of the cutter head 101.
In another embodiment, the cutter head 101 may be provided with a plurality of through slots 1013 along an axial direction, and a plurality of decomposers 1021 are correspondingly provided on the limiting member 102 along an axial direction at intervals. When the cutter head 101 rotates, the plurality of dividing portions 1021 in the axial direction divide the tissue in the corresponding conveying grooves 1012 at the same time. Similarly, at least a portion of at least one break-up portion 1021 is located within one of the through slots 1013 to maintain axial retention of the cutter head 101.
In embodiment 1, the axial widths of the plurality of decomposition parts and the axial widths of the plurality of through grooves 1013 are equal to or smaller than each other, and on the premise that the plurality of decomposition parts 1021 and the plurality of through grooves 1013 can be engaged and can rotate relatively, the cutter head 101 is not displaced in the axial direction relative to the stopper 102, and further, in order to smooth the transition of the relative rotation between the plurality of decomposition parts 1021 and the plurality of through grooves 1013 and not interfere with each other, the axial widths L1 of the plurality of decomposition parts 1021 in the entire circumferential direction are the same, and the circumferential widths L2 of the corresponding plurality of through grooves 1013 in the circumferential direction are the same.
In another embodiment, the axial width L1 of the breaking part 1021 and the axial width L2 of the through slot 1013 in the cutter head 101 may be set to different values, i.e. the axial position of the breaking part 1021 in the through slot 1013 may be changed, the axial width L1 of the breaking part 1021 is smaller than the axial width L2 of the through slot 1013, and the medical cutting assembly 10 has an axial expansion and contraction length variation (L2-L1) along the axial direction. By adjusting the axial distance of the proximal end of the split 1021 relative to the proximal end of the through slot 1013, i.e., varying the amount of protrusion of the cutter head 101 from the sleeve 103; when the medical cutting assembly 10 does not include the cannula 103, the axial distance from the distal end of the bit 101 to the distal end of the limiter 102 is varied by adjusting the axial distance of the proximal end of the resolution portion 1021 relative to the proximal end of the through slot 1013. Essentially, whether the medical cutting assembly 10 includes a cannula 103 or not, the axial distance of the proximal end of the adjustment resolution portion 1021 relative to the proximal end of the through slot 1013 is the axial distance from the distal end of the adjustment bit 101 to the distal end of the stop 102. Thus, the cutter head 101 has at least two different extension lengths with respect to the stop 102 or sleeve 103. When the extension length is maximum, the portion of the distal end of the cutter head 101 for cutting is maximum, the cutting capability of the cutter head 101 is strongest, and the distal end of the breaking part 1021 abuts against the distal end of the through slot 1013, the medical cutting assembly 10 in this state is suitable for cutting serious, coaxial calcified lesions; when the projected length is minimized, the portion for cutting of the distal end of the cutter head 101 is minimized, and the cutting ability of the cutter head 101 is relatively minimized, and at this time, the proximal end portion of the resolution portion 1021 abuts against the proximal end portion of the through slot 1013, the medical cutting assembly 10 in this state is suitable for cutting curved, irregular lesion sites. Thus, the medical cutting assembly 10 of this embodiment has good adaptability to different practical situations.
In embodiment 1, the breaking part 1021 includes a side 1022, and when the cutter head 101 rotationally cuts the excessive tissue in the blood vessel, the tissue minced by the cutter head 101 reaches the position of the through groove 1013 along the conveying groove 1012. At this time, the limiting member 102 is relatively fixed, the cutter head 101 rotates, the conveying groove 1012 rotates along with the cutter head 101, so that the conveying groove 1012 can drive the tissue in the conveying groove 1012 to rotate, and the through groove 1013 is also driven to be combined with and separated from the decomposition part 1021, namely, the side 1022 of the decomposition part 1021 is driven to continuously enter and leave the conveying groove 1012, at this time, the tissue is continuously collided with the side 1022 of the decomposition part 1021 and is cut after dislocation, and therefore, the tissue is decomposed into a tissue with smaller volume, and the subsequent tissue transportation is more facilitated. In the present embodiment, the side 1022 is provided as a plane perpendicular to the proximal end face or the distal end face of the decomposition portion 1021.
In another embodiment, the side 1022 is provided as an inclined surface inclined to the proximal end surface or the distal end surface of the decomposition portion 1021.
In another embodiment, the side 1022 may be configured to be non-planar, for example, the side 1022 may be configured to be curved or otherwise uniformly curved, or a portion of the side 1022 may be raised or recessed to form an irregular surface.
As shown in fig. 5, fig. 5 is a schematic diagram showing the operation of the distal end of the volume reduction catheter system of example 1. The volume-reducing catheter system 11 comprises the medical cutting assembly 10, the cutter head 101 is driven by the transmission shaft 1015 to rotate, and the sleeve 103 is rigidly connected with the limiting piece 102. In this embodiment, the sleeve 103 and the limiting member 102 are welded, the distal end of the transmission shaft 1015 passes through the limiting member 102 and is connected to the cutter head 101, the proximal end of the transmission shaft 1015 is connected to a motor assembly outside the body, and the motor assembly is controlled by a motor. The distal end portion of the cutter head 101 is exposed to effect cutting of tissue, and the cannula 103 covers at least the through slot 1013 of the cutter head 101 to effect radial restraint of the cutter head 101 and substantially prevent the cut tissue transported by the cutter head 101 from radially exiting the delivery slot 1012. After the distal exposed portion of the cutter head 101 cuts tissue, the tissue to be delivered moves proximally along the delivery slot 1012, is broken down into smaller tissue by the breaking up section 1021 upon reaching the position of the pass through slot 1013, and is then continued to be transported proximally, since the cut tissue is broken down again into smaller tissue, rapid and efficient delivery is facilitated, thereby improving the cutting and delivery efficiency as a whole.
When the extension length of the cutter head 101 needs to be adjusted, the current position of the limiting piece 102 is kept unchanged, and the axial position of the cutter head 101 is adjusted by adjusting the axial position of a transmission shaft 1015 connected with the proximal end of the cutter head 101.
Further, the surface of the drive shaft 1015 is provided with a spiral-extending transport groove 1016, and the transport groove 1016 can transport the minute tissue, which has been collided and decomposed by the decomposition part 1021, to the proximal end of the drive shaft 1015 until it is finally transported to the outside of the body. In addition, the surface of the drive shaft 1015 is sleeved with a protection sleeve 1017, the protection sleeve 1017 on one hand protects the blood vessel or external tissue at the position of the drive shaft 1015, and on the other hand prevents the micro-tissue to be transported from being separated from the volume-reducing catheter system 11 in the radial direction. The protection sleeve 1017 is thermally fused to the proximal end of the stop 102 and is in interference fit with the proximal end of the stop 102.
Example 2
As shown in fig. 6, fig. 6 is a schematic structural view of a limiting member on a medical cutting assembly in the volume reduction catheter system of embodiment 2. The same parts of the volume reduction catheter system and the medical cutting assembly of embodiment 2 as those of embodiment 1 are not described in detail herein. In the previous embodiment, the limiting member is rigidly connected to the sleeve, i.e. the limiting member and the sleeve act as a whole, and the limiting member and the sleeve can be formed into a whole by welding, integral molding or the like, or the structure of the limiting member can be changed, and a part of the limiting member replaces the sleeve. In the stopper of embodiment 2, the decomposition portion 2021 is provided so as to be located on the inner wall of the middle portion of the stopper 202. After the limiting member 202 is assembled with the cutter head, a portion of the distal tube wall of the limiting member 202 is at least partially sleeved outside the proximal end of the cutter head. At this point, a portion of the distal tube wall of stop 202 performs the same function as the cannula of previous embodiment 1. The limiting member 202 in embodiment 2 is structurally changed from that in embodiment 1, so that the design of the sleeve is omitted, the production efficiency is improved, the process cost is reduced, and whether the possible processing problems of sufficient connection strength, good sealing performance and the like between the sleeve and the limiting member are not considered.
The term cannula in the following description of the modification based on embodiment 2 refers to a portion of the distal tube wall of the stop 202 that functions the same as the cannula in this embodiment.
Example 3
In embodiment 3, the connection manner between the cutter head and the limiting member is different from that in embodiment 1, the arrangement of the sleeve is the same as that in embodiment 1, and the parts of the volume-reducing catheter system and the medical cutting assembly of embodiment 3, which are the same as those of embodiment 1, are not described herein.
Fig. 7 to 9 show an exploded view of the medical cutting assembly of example 3, fig. 8 shows an installation view of the cutter head and the stopper in the medical cutting assembly of example 3, and fig. 9 shows a structure view of the stopper of the medical cutting assembly of example 3. In this embodiment, the medical cutting assembly 30 includes a coaxially mounted cutter head 301, a stop 302, and a cannula 303. It should be clear that, except for the change of the connection position structure of the cutter head 301 and the stopper 302, the structure, function and related extension not related to the connection position structure in embodiment 3 continue to follow the contents in embodiment 1.
In the embodiment 3, a conveying groove 3012 is formed between two adjacent cutting edges 3011, a plurality of through grooves 3013 are also formed at the proximal end of the cutter head 301, each through groove 3013 penetrates through the cutting edge 3011 where it is located in the circumferential direction and communicates with the conveying groove 3012 adjacent to the cutting edge 3011, it should be noted that the through groove 3013 is located at the proximal inner side of the cutting edge 3011, the bottom surface 30131 of the through groove 3013 forms a step surface with the inner wall surface 30111 at the proximal end of the cutting edge 3011, and the distance from the bottom surface 30131 of the through groove 3013 to the axis of rotation of the cutter head 301 is greater than the distance from the inner wall surface 30111 at the proximal end of the cutting edge 3011 to the axis of rotation of the cutter head 301.
The stopper 302 includes a decomposition portion 3021 and a connection portion 3022, the decomposition portion 3021 being provided at a position of the distal end of the connection portion 3022 near the end portion, the decomposition portion 3021 protruding outward from the outer wall of the connection portion 3022.
In the present embodiment, in order to ensure that the decomposition portion 3021 can be accommodated in the through groove 3013, in addition to satisfying the related arrangement with respect to the axial width in embodiment 1, the following two requirements are required to be satisfied:
first, the distance from the top surface 30211 of the split part 3021 to the rotation axis of the stopper 302 is smaller than or equal to the distance from the bottom surface 30131 of the through groove 3013 to the rotation axis of the cutter head 301;
second, the distance from the inner wall surface 30111 of the proximal end of the blade 3011 to the axis of the swivel shaft of the cutter head 301 is greater than or equal to the distance from the surface 30221 of the connection portion 3022 to the axis of the swivel shaft of the stopper 302. Since the cutter head 301 and the stopper 302 are coaxially disposed, the rotation axis of the cutter head 301 and the rotation axis of the stopper 302 are collinear.
When the cutter head 301 rotates, the splitting section 3021 alternately enters the through-groove 3013 and the conveying groove 1012, and the splitting section 3021 collides with the tissue in the conveying groove 3012 and splits it into a smaller volume of tissue. In order to achieve a better breaking-down effect, in the case where the above-described requirements are satisfied, the distance from the top surface 30211 of the breaking-down portion 3021 to the rotational axis of the stopper 302 is greater than or equal to the distance from the inner wall surface 30111 of the proximal end of the blade 3011 to the rotational axis of the cutter head 301.
To ensure that the drive shaft can properly rotate the tool bit 301 in the volume reduction catheter system of embodiment 3, the center portion of the stop member 302 is provided with a channel 3023 extending through the proximal end to the distal end thereof to facilitate insertion of the drive shaft.
Example 4
Embodiment 4 is an improvement over embodiment 3, in embodiment 4, the tissue is transported through a transporting cavity inside the cutter head, the transporting cavity is a cavity arranged inside the cutter head, the transporting cavity comprises an input port positioned at the distal end of the cutter head and an output port positioned at the proximal end of the cutter head, the output port is close to the through slot, the tissue cut by the distal end of the cutter head enters the transporting cavity from the input port, leaves the transporting cavity from the output port, and collides with the decomposition part structure to be further decomposed when reaching the through slot position.
Further, a delivery slot structure as in embodiment 1 may be provided inside the delivery lumen to facilitate transport of the tissue.
Example 5
Based on embodiments 1-4, in order to increase the decomposition efficiency of the medical cutting assembly, a decomposition groove may be provided on the inner wall of the cannula, when the cutter head and the cannula relatively rotate, the redundant tissue conveyed in the conveying groove collides with the side wall of the decomposition groove to realize further decomposition, and the larger the side wall area of the decomposition groove is, the higher the decomposition efficiency is, and for a decomposition groove with a fixed shape, the highest decomposition efficiency of the whole medical cutting assembly is improved when the decomposition groove penetrates through the wall of the cannula to form a window.
As shown in fig. 10, fig. 10 is a schematic structural diagram of a distal end of the volume-reducing catheter system in embodiment 5, and the same parts of the volume-reducing catheter system and the medical cutting assembly in embodiment 5 as those in embodiments 1-4 are not described herein, and the main improvement of embodiment 5 is that in embodiment 5, a decomposition tank is added on the cannula 403 of the medical cutting assembly, and the decomposition tank needs to be in communication with the conveying tank (or conveying cavity) at least at a certain moment, so that tissue in the conveying tank (or conveying cavity) enters the decomposition tank to collide with an inner side wall of the decomposition tank to achieve further decomposition, and in order to achieve better effect, the decomposition tank in embodiment 5 penetrates through the wall of the cannula 403 to form a first window 4031. The first window 4031 can improve the resolution efficiency of the window position to some extent. Specifically, when the cutter head 401 rotates at a high speed, a portion of the cut tissue in the conveying groove (or conveying chamber) collides with the side wall of the first window 4031, and is further decomposed.
Since the first window 4031 is small relative to the entire surface of the cannula 403 and the outer surface of the cannula 403 is in small clearance with the inner wall of the blood vessel, little tissue to be proximally transported will exit the medical cutting assembly from the first window 4031 when the tool bit 401 is rotated at high speed.
In order to obtain a better decomposition effect, the setting of the first window 4031 satisfies: at least one break-up portion is located in the axial direction between the distal end and the proximal end of the first window 4031. The reason is that the cutter head and the limiting piece in the medical cutting assembly relatively rotate to drive the conveying groove and the decomposing part to relatively rotate, and the decomposing part collides with redundant tissues in the conveying groove along the circumferential direction, so that the redundant tissues in the conveying groove are collided, shifted and sent to be further decomposed, and part of the collided and shifted redundant tissues collide with the inner wall of the first window 4031 again, so that further decomposition is caused, that is, the decomposing part drives the redundant tissues in the conveying groove to collide with the side wall of the first window 4031 when passing through the conveying groove, and the decomposing effect of the first window 4031 at the position is the best.
Example 6
As shown in fig. 11, fig. 11 is a schematic view showing the structure of the distal end of the volume reduction catheter system in embodiment 6. The volume reduction catheter system and the medical cutting assembly of embodiment 6 are improved based on embodiment 5, and the same parts of the volume reduction catheter system and the medical cutting assembly of embodiment 6 as those of embodiment 5 are not described herein, and the main difference between them is that, based on embodiment 5, the medical cutting assembly of embodiment 3 is newly added with a decomposing tank, and the decomposing tank penetrates through the wall of the cannula 503 to form a second window 5032, the original first window is located at the back of the second window 5032 and is not shown, the second window 5032 is located at the distal end of the cannula 503, the side wall of the second window 5032 collides with the cut tissue located inside the distal end of the cannula 503, and the tissue is further decomposed into smaller tissues, so that the decomposing efficiency of the medical cutting assembly at the distal end position of the cannula 503 is improved.
Embodiment 6 is an improvement over the design of the single decomposition tank of embodiment 5, i.e., embodiment 6 is a new addition of decomposition tanks at different locations on the limiter than the decomposition tanks of embodiment 5 to increase the decomposition efficiency at different locations, thereby increasing the overall decomposition efficiency of the medical cutting assembly. Therefore, based on this idea, the embodiment in which a plurality of decomposition tanks are provided on the stopper should be regarded as an embodiment equivalent to embodiment 5 or 6. In addition, in the embodiment of the new decomposition groove on the medical cutting assembly of embodiment 5 and embodiment 6, the specific shape and number of the decomposition grooves are not limited, and at least one decomposition part is located between the proximal end and the distal end of one of the decomposition grooves along the axial direction of the stopper for better decomposition effect.
The above examples illustrate only a few embodiments of the invention, which are described in detail and are not to be construed as limiting the scope of the invention. It should be noted that it will be apparent to those skilled in the art that several variations and modifications can be made without departing from the spirit of the invention, which are all within the scope of the invention. Accordingly, the scope of protection of the present invention is to be determined by the appended claims.
While the embodiments of the present invention have been described in detail, the present invention is not limited to the embodiments, and various equivalent modifications and substitutions can be made by those skilled in the art without departing from the spirit of the present invention, and these equivalent modifications and substitutions are intended to be included in the scope of the present invention as defined in the appended claims. Furthermore, embodiments of the invention and features of the embodiments may be combined with each other without conflict.
Claims (9)
1. The medical cutting assembly comprises a cutter head and a limiting piece rotationally connected with the cutter head, and is characterized in that the cutter head comprises a conveying part, the limiting piece comprises a decomposing part, and the decomposing part penetrates through the conveying part when the cutter head and the limiting piece rotate relatively;
the cutter head comprises a plurality of cutting edges extending from a proximal end to a distal end, the conveying part comprises a conveying groove positioned between two adjacent cutting edges, at least one cutting edge is provided with a through groove, and the through groove is communicated with the conveying groove adjacent to the cutting edge; when the cutter head and the limiting piece rotate relatively, the decomposing part passes through the conveying groove for many times.
2. The medical cutting assembly of claim 1, wherein one or more of said split portions are provided, and wherein said cutting head has at least a portion of at least one of said split portions positioned within one of said through slots during rotation thereof to axially retain said cutting head.
3. The medical cutting assembly of claim 1, wherein there are a plurality of said splits, at least two of said splits being spaced apart along a circumferential or axial direction of said stop.
4. The medical cutting assembly of claim 1, wherein the blade extends helically from the proximal end to the distal end, and the helix angle of the flutes decreases progressively from the distal end to the proximal end.
5. The medical cutting assembly of claim 1, further comprising a sleeve coupled to the limiter, the sleeve being disposed about the bit and the limiter and covering at least the break-up portion in an axial direction.
6. The medical cutting assembly of claim 5, wherein the cannula is provided with a plurality of breakup grooves, and the breakup grooves are in communication with the delivery portion at least at one time when the cutter head and the limiter rotate relative to each other.
7. The medical cutting assembly of claim 1, wherein the break-up portion is located in a middle portion of the limiter and a portion of the limiter is sleeved at least outside of the proximal end of the cutter head.
8. The medical cutting assembly of claim 5 or 7, wherein the axial width of the split is less than the axial width of the through slot, and wherein the axial position of the proximal end of the split relative to the proximal end of the through slot is adjustable.
9. A volume reduction catheter system comprising the medical cutting assembly of any one of claims 1-8, further comprising a drive shaft that rotates the bit, a distal end of the drive shaft passing through the limiter and being connected to the bit.
Priority Applications (4)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202010918066.4A CN114130493B (en) | 2020-09-03 | 2020-09-03 | Medical cutting assembly and volume reducing catheter system |
| US18/024,228 US20230263549A1 (en) | 2020-09-03 | 2021-09-02 | Medical Cutting Assembly and Volume Reduction Catheter System |
| EP21863650.4A EP4209184A1 (en) | 2020-09-03 | 2021-09-02 | Medical cutting assembly and volume reduction catheter system |
| PCT/CN2021/116163 WO2022048586A1 (en) | 2020-09-03 | 2021-09-02 | Medical cutting assembly and volume reduction catheter system |
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| Application Number | Priority Date | Filing Date | Title |
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| CN202010918066.4A CN114130493B (en) | 2020-09-03 | 2020-09-03 | Medical cutting assembly and volume reducing catheter system |
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| CN114130493A CN114130493A (en) | 2022-03-04 |
| CN114130493B true CN114130493B (en) | 2024-02-20 |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| JP2004233267A (en) * | 2003-01-31 | 2004-08-19 | Yamatake Corp | Temperature sensor |
| CN101511284A (en) * | 2006-06-30 | 2009-08-19 | 阿瑟罗迈德公司 | Atherectomy devices and methods |
| WO2014059150A1 (en) * | 2012-10-10 | 2014-04-17 | Avinger, Inc. | Occlusion-crossing devices |
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| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US8361094B2 (en) * | 2006-06-30 | 2013-01-29 | Atheromed, Inc. | Atherectomy devices and methods |
| US9314263B2 (en) * | 2006-06-30 | 2016-04-19 | Atheromed, Inc. | Atherectomy devices, systems, and methods |
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Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2004233267A (en) * | 2003-01-31 | 2004-08-19 | Yamatake Corp | Temperature sensor |
| CN101511284A (en) * | 2006-06-30 | 2009-08-19 | 阿瑟罗迈德公司 | Atherectomy devices and methods |
| WO2014059150A1 (en) * | 2012-10-10 | 2014-04-17 | Avinger, Inc. | Occlusion-crossing devices |
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