CN114391921A - Multifunctional thrombus treatment device and use method thereof - Google Patents
Multifunctional thrombus treatment device and use method thereof Download PDFInfo
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- CN114391921A CN114391921A CN202210015578.9A CN202210015578A CN114391921A CN 114391921 A CN114391921 A CN 114391921A CN 202210015578 A CN202210015578 A CN 202210015578A CN 114391921 A CN114391921 A CN 114391921A
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- 238000013156 embolectomy Methods 0.000 claims description 79
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
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- A—HUMAN NECESSITIES
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- A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
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- A61B2017/22072—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an instrument channel, e.g. for replacing one instrument by the other
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22082—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for after introduction of a substance
- A61B2017/22084—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for after introduction of a substance stone- or thrombus-dissolving
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22094—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for crossing total occlusions, i.e. piercing
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Abstract
The invention provides a multifunctional thrombus treatment device and a use method thereof, the multifunctional thrombus treatment device comprises a guide wire, a variable diameter thrombus taking support, a fixed catheter and a recovery catheter, wherein the net part at the far end of the variable diameter thrombus taking support is higher in density so as to realize the purpose of netting escaping tiny thrombus, the far end of the variable diameter thrombus taking support is provided with a sliding opening and sleeved outside the guide wire, the near end of the variable diameter thrombus taking support is connected with the far end of the fixed catheter, the straight channels of the variable diameter thrombus taking support can be adjusted by adjusting the positions of the guide wire and the fixed catheter so as to fully capture thrombus with different sizes in a blood vessel, the recovery catheter is sleeved on the outer wall of the fixed catheter and can be used for accommodating the variable diameter thrombus taking support, not only can the thrombus be captured to the maximum extent by repeatedly changing the diameter of the variable diameter thrombus taking support, but also can dissolve in advance for large and difficult-to-capture thrombus through the fixed catheter and the recovery catheter, The thrombus is caught after the reduction, and a plurality of treatment methods of thrombolysis, thrombus extraction and net thrombus are completed simultaneously.
Description
Technical Field
The invention relates to the field of medical equipment, in particular to a multifunctional thrombus treatment device capable of simultaneously realizing thrombolysis and thrombus removal and a using method thereof.
Background
Abnormal blood flow in blood vessels is caused by abnormal blood flow in the blood vessels, and the abnormal blood flow can cause a series of adverse effects such as tissue hypoxia, abnormal intravascular pressure, cardiac load aggravation and even heart failure, so the abnormal blood flow in the blood vessels generally needs to be restored or rebuilt through a catheter intervention technology.
Many adverse consequences also arise when a blood vessel is constricted or occluded, such as turbulent blood flow, slow flow rates, and the formation of blood clots that restrict blood supply to areas downstream of the vascular system. Stroke may be initiated when a blood clot is located in the neurovascular system; when a blood clot is located in the pulmonary artery vasculature, pulmonary embolism may be initiated, leading to patient death. In addition, obstructions such as atherosclerosis and plaques thereof may also become dangerous when they restrict blood flow, causing abnormal blood flow, causing various vascular diseases.
Therefore, there is a clinical need for an effective drug, device or/and system for removing thrombus plaque, so as to remove the plaque obstruction in the blood vessel in time, open the occluded blood vessel, capture the sloughed thrombus tissue, and reduce ischemia and necrosis of the distal organ tissue blood vessel caused by the sloughed thrombus.
At present, thrombolysis, mechanical thrombus removal and other methods are widely adopted to remove thrombus. Thrombolytic therapy is mainly to inject thrombolytic drugs into a thrombus part through a catheter to remove thrombus plaques, the method is mostly used for early thromboembolism and has poor effect on large plaques and long-term hardened plaques, and percutaneous mechanical thrombus removal (PMT) is to remove intravascular obstructions by using a mechanical device, and comprises the modes of dissolving, crushing, sucking, stent or basket thrombus removal and the like, and is a current clinical main treatment means.
One type of conventional percutaneous mechanical thrombectomy device is to insert a balloon catheter into the blood vessel and through the clot, and then expand the balloon to compress the clot against the vessel wall or into the distal vessel to open the blocked vessel. This method cannot remove the thrombus, and the biggest problem is that the crushed thrombus falls off, resulting in re-embolization of the distal blood vessel.
Another type of self-expanding stent is delivered to the thrombus site through a microcatheter, from which the stent is released for expansion to embed the thrombus within the stent and then withdrawn into the catheter. In this method, although the thrombus can be removed compared with the above-mentioned balloon dilatation, since the diameter of the stent after the expansion is fixed and disposable, if the thrombus cannot be captured for the first time, the thrombus removal operation fails, and on the other hand, since the mesh of the stent is fixed, only the thrombus smaller than the mesh of the stent can be captured and the thrombus larger than the mesh is substantially ineffective, so that the clinical effect thereof is limited. In addition, since the distal end of the stent is developed for this method, there is also a problem of thrombus escape.
Therefore, the single traditional thrombus treatment method, whether thrombolysis, balloon thrombus expansion or mechanical thrombus removal, can not effectively treat the thrombus problem. The inventors have considered that, in order to solve the above problems, a clinically ideal mechanical thrombectomy device should include both: 1) the invention provides a channel for injecting thrombolytic drugs, 2) strong thrombus capture capability, and 3) function of preventing dropped thrombus plaques from escaping, and the invention is an innovative product integrating catheter drug thrombolysis, efficient mechanical thrombus extraction and thrombus escape prevention, while the mechanical thrombus extraction device in the prior art lacks the function.
Disclosure of Invention
The invention provides a multifunctional thrombus treatment device and a use method thereof, wherein a channel for injecting thrombolytic drugs is arranged, the multifunctional thrombus treatment device has strong thrombus capture capacity and a function of preventing dropped thrombus plaques from escaping, and can effectively solve the problems of thrombus dropping, poor thrombus taking effect and the like in a single thrombus treatment device.
A first aspect of the present invention provides a multifunctional thrombus treatment device, including:
a guide wire;
the recovery catheter is sleeved on the outer wall of the guide wire, and a first containing cavity is formed between the inner wall of the recovery catheter and the outer wall of the guide wire;
but reducing thrombectomy support, but reducing thrombectomy support is network structure, the guide wire is worn to locate but reducing thrombectomy support, but the diameter of reducing thrombectomy support is changeable, but reducing thrombectomy support is through changing the blood vessel or the thrombus of self diameter in order to be suitable for different width, first appearance chamber is used for accomodating but reducing thrombectomy support is used for carrying the medicine.
According to one embodiment of the invention, the variable-diameter embolectomy support comprises a far-end net part, a middle net part and a near-end net part which are sequentially connected, the far-end net part and the near-end net part are mutually closed to squeeze the middle net part so as to increase the diameter of the middle net part, and the far-end net part and the near-end net part are mutually separated to stretch the middle net part so as to decrease the diameter of the middle net part.
According to one embodiment of the invention, one end of the distal net part, which is far away from the middle net part, is slidably fitted with the guide wire by providing a sliding opening which is sleeved on the outer wall of the guide wire, and the sliding opening is axially slid along the guide wire to approach or be far away from the proximal net part.
According to an embodiment of the present invention, further comprising:
the fixed catheter is sleeved on the outer wall of the guide wire, the fixed catheter penetrates through the recovery catheter, the first accommodating cavity is formed between the inner wall of the recovery catheter and the outer wall of the fixed catheter, and one end, far away from the middle net portion, of the near-end net portion is fixedly connected with one end of the fixed catheter.
According to an embodiment of the present invention, a second cavity is disposed on an inner wall of the fixed catheter and an outer wall of the guiding wire, the second cavity penetrates through two ends of the fixed catheter, an end of the second cavity, which is far away from the proximal net portion, is used for injecting a drug, and an end of the second cavity, which is close to the proximal net portion, is used for outputting the drug.
According to an embodiment of the present invention, further comprising:
the connecting handle is provided with a guide wire channel, a first channel and a second channel, the guide wire channel is used for conveying the guide wire, the first channel is used for conveying the fixed catheter, and the second channel is used for conveying the recovery catheter.
According to one embodiment of the invention, the connection handle comprises a proximal handle and a distal handle detachably connected, the guide wire channel and the first channel are provided on the proximal handle, and the second channel is provided on the distal handle.
According to one embodiment of the invention, the distal end of the guide wire extends from the distal end of the variable diameter embolectomy stent and is provided with a flexible tip.
According to one embodiment of the invention, the density of the distal end of the variable diameter embolectomy stent is greater than the density of the proximal end of the variable diameter embolectomy stent.
The second aspect of the present invention provides a method for using the multifunctional thrombus treatment device, comprising the steps of:
controlling the diameter of the variable-diameter thrombus taking support to be smaller than that of a blood vessel, so that the guide wire penetrates into the blood vessel and penetrates through thrombus;
injecting medicine into the first cavity from one end of the first cavity close to the proximal end of the guide wire, so that the medicine is output from the distal end of the first cavity close to the guide wire and acts on thrombus to soften or decompose the thrombus;
increasing the diameter of the variable-diameter embolectomy support, so that the variable-diameter embolectomy support penetrates thrombus originally positioned on the outer side of the variable-diameter embolectomy support in the diameter increasing process and the thrombus is contained between the inner side of the variable-diameter embolectomy support after the diameter is increased and the outer side of the guide wire, and capturing the thrombus;
the recovery catheter is sleeved on the outer wall of the guide wire, and a first containing cavity is formed between the inner wall of the recovery catheter and the outer wall of the guide wire;
the variable diameter embolectomy support is of a net structure, the guide wire penetrates through the variable diameter embolectomy support, and the diameter of the variable diameter embolectomy support is variable.
Specifically, the method for using the multifunctional thrombus treatment device may further include:
under the condition that the diameter of a blood vessel at a thrombus part is larger or the gap between the blood vessel and a blood vessel wall is larger, a recovery catheter accommodating the variable-diameter thrombus taking support is inserted into the blood vessel, passes through thrombus tissues, and is withdrawn, and the guide wire naturally expands at the thrombus part to capture thrombus;
under the condition that the diameter of a blood vessel at a thrombus part is small and a recovery catheter cannot penetrate through the thrombus part, the recovery catheter containing the variable-diameter thrombus taking support is inserted into the part close to the thrombus part, the variable-diameter thrombus taking support is fixed to the minimum diameter, then the variable-diameter thrombus taking support below the minimum diameter is pushed out of the recovery catheter and further penetrates through thrombus tissues, and the support is opened to the maximum diameter to capture thrombus.
Increasing the diameter of the variable-diameter embolectomy support, so that the variable-diameter embolectomy support penetrates thrombus originally positioned on the outer side of the variable-diameter embolectomy support in the diameter increasing process and the thrombus is contained between the inner side of the variable-diameter embolectomy support after the diameter is increased and the outer side of the guide wire, and capturing the thrombus; the diameter of the stent is repeatedly changed to capture the thrombus tissue to the maximum extent.
When, before or after the thrombus is captured by repeatedly changing the diameter of the stent, the medicine is injected from the near end of the first containing cavity, the second containing cavity or/and the third containing cavity, and the medicine flows out near or inside the thrombus tissue at the far end of the first containing cavity, the second containing cavity or/and the third containing cavity so as to soften or decompose the thrombus and increase the effect of capturing the thrombus by the stent.
And the variable-diameter embolectomy support is accommodated in the first containing cavity of the recovery catheter and leaves the blood vessel along with the recovery catheter.
The embodiment of the invention has the following beneficial effects:
on the one hand, in the multi-functional thrombus treatment device of this embodiment, through setting up that self diameter is adjustable but the thrombus support is got to the reducing carries out the regulation of self diameter according to the not blood vessel of unidimensional to move smoothly in the not blood vessel of equidimensional, and can increase self diameter until the butt thrombus according to the size of thrombus, realize the seizure to the thrombus of equidimension not in the blood vessel.
On the other hand, by arranging the recovery catheter which forms the first cavity between the recovery catheter and the guide wire, the thrombus can be dissolved in a mode of injecting medicine into the first cavity, or the thrombus with larger volume is decomposed into a plurality of thrombus with smaller volume which can be captured by the thrombus-capturing stent body, or the thrombus is softened, the softened thrombus is easier to be extruded and cut by the diameter-variable thrombus-capturing stent in the diameter increasing process, the effect of capturing the thrombus by the diameter-variable thrombus-capturing stent is further improved, meanwhile, the diameter-variable thrombus-capturing stent after completing the thrombus capture can be accommodated in the first cavity in a mode of reducing the diameter of the stent, and then the stent leaves the blood vessel along with the recovery catheter, the recovery catheter plays a role in wrapping the thrombus in the diameter-variable thrombus-capturing stent, and prevents the thrombus from separating from the blood vessel and escaping from blocking other branch blood vessels in the process of leaving the blood vessel by the diameter-variable thrombus-capturing stent, the structure is simple.
On the other hand, on the basis of the variable-diameter thrombus taking support, the density of the far end of the variable-diameter thrombus taking support is set to be higher than that of the near end of the variable-diameter thrombus taking support, so that in the process of moving thrombus, thrombus with small volume can be collected by the far end of the variable-diameter thrombus taking support after being separated from the middle of the support body, and therefore the thrombus is prevented from being separated from other branch blood vessels due to the escape condition, the structure is simple, and the using effect is good.
Drawings
In order to more clearly illustrate the technical solutions of the present invention or the prior art, the drawings needed to be used in the description of the embodiments or the prior art will be briefly described below, and it is obvious that the drawings in the following description are some embodiments of the present invention, and it is obvious for those skilled in the art to obtain other drawings based on these drawings without creative efforts.
Wherein:
FIG. 1 is a schematic structural view of a multifunctional thrombus treatment device in an embodiment of the present invention;
FIG. 2 is an enlarged view of detail A of FIG. 1;
FIG. 3 is an enlarged view of detail B of FIG. 1;
FIG. 4 is an enlarged view of detail C of FIG. 1;
FIG. 5 is a schematic structural view of a variable diameter thrombectomy stent in state one according to an embodiment of the present invention;
FIG. 6 is a schematic structural view of a variable diameter thrombectomy stent in state two according to an embodiment of the present invention;
FIG. 7 is a schematic structural view of a variable diameter thrombectomy stent in state three according to an embodiment of the present invention;
FIG. 8 is a schematic structural view of a variable diameter thrombectomy stent in state four in an embodiment of the present invention;
FIG. 9 is a schematic structural view of an orifice and a third cavity in an embodiment of the present invention;
FIG. 10 is an image of the multifunctional thrombus treatment device in example 1 of the present invention in the carotid artery of an animal;
reference numerals:
1. a guide wire; 11. a proximal end stop; 12. a distal stop; 13. a flexible tip; 14. a third cavity; 15. spraying a hole; 2. a recovery conduit; 21. a first cavity; 3. the diameter-variable thrombus taking support; 31. a distal net section; 32. an intermediate net section; 33. a proximal net section; 34. a slide opening; 4. fixing the catheter; 41. a second cavity; 5. a connecting handle; 51. a guidewire channel; 52. a first channel; 53. a second channel; 54. a proximal handle; 55. a distal handle; 56. a guidewire adjuster; 6. thrombosis; 7. a blood vessel.
Detailed Description
In order to make the objects, technical solutions and advantages of the present invention clearer, the technical solutions of the present invention will be clearly and completely described below with reference to the accompanying drawings, and it is obvious that the described embodiments are some, but not all embodiments of the present invention. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
Referring to fig. 1 to 10, an embodiment of the present invention provides a multifunctional thrombus treatment device, including:
a guide wire 1;
the recovery catheter 2 is sleeved on the outer wall of the guide wire 1, and a first containing cavity 21 is formed between the inner wall of the recovery catheter 2 and the outer wall of the guide wire 1;
but reducing thrombectomy support 3, but reducing thrombectomy support 3 is network structure, but guide wire 1 wears to locate but reducing thrombectomy support 3, but the diameter of reducing thrombectomy support 3 is changeable, but reducing thrombectomy support 3 is through changing the blood vessel 7 or the thrombus 6 of self diameter in order to be suitable for different widths, first appearance chamber 21 is used for accomodating but reducing thrombectomy support 3 is used for carrying the medicine.
Specifically, the variable diameter embolectomy holder 3 can be moved relative to the retrieval catheter 2 in position to achieve the effect of storing the variable diameter embolectomy holder 3 in the retrieval catheter 2, and it should be noted that, the diameter-variable embolectomy bracket 3 can be accommodated in the recovery catheter 2 by moving the diameter-variable embolectomy bracket 3 in the axial direction of the recovery catheter 2, the diameter-variable embolectomy bracket 3 can be accommodated in the recovery catheter 2 by moving the recovery catheter 2 in the axial direction of the diameter-variable embolectomy bracket 3, understandably, the inner diameter of the recovery catheter 2 is larger than the minimum diameter of the diameter-variable thrombus taking support 3 which can be contracted after catching the thrombus 6, and the skilled person can judge the minimum diameter of the diameter-variable thrombus taking support 3 which can be contracted after catching the thrombus 6 according to the mastered knowledge.
All the benefits mentioned in this description can be achieved simultaneously in one operation by this embodiment.
It should be noted that, a person skilled in the art may design the outer diameter of the recovery catheter 2 to be smaller than the inner diameter of each blood vessel 7 to move the recovery catheter 2 in each blood vessel 7, or may design the outer diameter of the recovery catheter 2 to be smaller than the inner diameter of the blood vessel 7 to be acted upon by a targeted design according to the blood vessel 7 to be acted upon, or may design the outer diameter of the recovery catheter 2 to be smaller than the inner diameter of the cardiovascular and cerebrovascular vessels when the multifunctional thrombus treatment device is used for treating cardiovascular and cerebrovascular vessels, or may design the outer diameter of the recovery catheter 2 to be smaller than the inner diameter of the vena cava when the multifunctional thrombus treatment device is used for treating vena cava thrombus.
In the multifunctional thrombus treatment device of the embodiment, the variable diameter thrombus removal stent 3 with an adjustable self diameter is arranged, the self diameter is adjusted according to the blood vessels 7 with different diameters, so as to smoothly move in the blood vessels 7 with different sizes, as shown in fig. 5, the variable diameter thrombus removal stent 3 reduces the self diameter to the minimum diameter, after the thrombus 6 passes through, the self diameter can be increased according to the size of the thrombus 6 until the thrombus 6 abuts against, so that the thrombus 6 with different sizes in the blood vessel 7 can be captured, and the variable diameter thrombus removal stent 3 is in a completely opened state structure as shown in fig. 6.
Through setting up and leading between the guide wire 1 and forming first recovery pipe 2 that holds chamber 21, the accessible on the one hand is to the mode of first appearance chamber 21 injection, realizes the dissolution to thrombus 6, decomposes thrombus 6 of great volume into a plurality of can be got the less thrombus 6 of volume of embolus support 3 seizure by the variable diameter, or softens thrombus 6, thrombus 6 after the softening is changeed in getting the extrusion cutting of embolus support 3 by the variable diameter that is in the diameter increase in-process, the effect of thrombus 6 is caught to the support 3 of getting embolus by the variable diameter has further been improved.
The variable-diameter thrombus taking support 3 after the thrombus 6 is captured can be accommodated in the first accommodating cavity 21 in a manner of reducing the diameter of the variable-diameter thrombus taking support 3, a structure shown in fig. 8 is formed, then the variable-diameter thrombus taking support leaves the blood vessel 7 along with the recovery catheter 2, the recovery catheter 2 plays a role in wrapping the thrombus 6 in the variable-diameter thrombus taking support 3, the thrombus 6 is prevented from being separated and escaping in the process that the variable-diameter thrombus taking support 3 leaves the blood vessel 7, and then the condition of blocking other branch blood vessels 7 is avoided, and the structure is simple.
As shown in fig. 2, according to an embodiment of the present invention, the variable diameter embolectomy stent 3 includes a distal net portion 31, a middle net portion 32 and a proximal net portion 33 which are connected in sequence, the distal net portion 31 and the proximal net portion 33 are close to each other to press the middle net portion 32 so as to increase the diameter of the middle net portion 32, and the distal net portion 31 and the proximal net portion 33 are separated from each other to stretch the middle net portion 32 so as to decrease the diameter of the middle net portion 32.
It should be noted that the diameter of the variable diameter embolectomy stent 3, which is composed of the distal net part 31, the middle net part 32 and the proximal net part 33, can be changed by making the distal net part 31, the middle net part 32 and the proximal net part 33 telescopically, hingedly or flexibly connected between each two net parts, or the diameter of the variable diameter embolectomy stent 3 can be changed by making the materials of the distal net part 31, the middle net part 32 and the proximal net part 33 flexible.
According to an embodiment of the present invention, an end of the distal net portion 31 away from the intermediate net portion 32 is slidably engaged with the guide wire 1 by providing a sliding opening 34 sleeved on an outer wall of the guide wire 1, and the sliding opening 34 is slidably moved toward or away from the proximal net portion 33 along an axial direction of the guide wire 1.
It will be appreciated that in this embodiment, by providing the sliding opening 34 to slidably engage with the guide wire 1, the guide wire 1 can guide the movement of the distal end of the variable diameter embolectomy stent 3 to allow smooth movement, thereby allowing the variable diameter embolectomy stent 3 to be smoothly expanded or contracted.
As shown in fig. 3 and 9, according to an embodiment of the present invention, the method further includes:
the fixed guide tube 4 is sleeved on the outer wall of the guide wire 1, the fixed guide tube 4 penetrates through the recovery guide tube 2, the first accommodating cavity 21 is formed between the inner wall of the recovery guide tube 2 and the outer wall of the fixed guide tube 4, and one end, far away from the middle net part 32, of the near-end net part 33 is fixedly connected with one end of the fixed guide tube 4.
Specifically, the guide wire 1 is slidably fitted to the fixed catheter 4, and the guide wire 1 is relatively movable with respect to the fixed catheter 4 in the axial direction of the fixed catheter 4, the fixed catheter 4 is slidably fitted to the recovery catheter 2, and the fixed catheter 4 is relatively movable in the axial direction of the recovery catheter 2.
More specifically, as shown in fig. 2, the medical device further includes a near-end limiting member 11 and a far-end limiting member 12, the near-end limiting member 11 and the far-end limiting member 12 are sleeved on the guide wire 1, and are sequentially distributed along a direction from the near end of the guide wire 1 to the far end of the guide wire 1, the near-end limiting member 11 abuts against the joint of the fixed catheter 4 and the variable-diameter embolus-taking support 3, so as to limit the maximum diameter of the variable-diameter embolus-taking support 3, and the far-end limiting member 12 abuts against the sliding opening 34, so as to limit the minimum diameter of the variable-diameter embolus-taking support 3.
According to one embodiment of the invention, the density of the variable diameter embolectomy stent 3 is greater at its distal end than at its proximal end.
Through setting up the distal end density of distal end net part 31 to be greater than the density of near end net part 33, in the in-process of removing thrombus 6, the thrombus 6 that the volume is less is followed after the middle part net part breaks away from, can be collected by distal end net part 31 to avoid thrombus 6 to take place to break away from and the condition about escaping and block up other branch blood vessel 7, simple structure, excellent in use effect.
In this embodiment, when taking the embolism, but reducing thrombectomy support 3 with fixed catheter 4 passes through 6 positions on thrombus under the guide of guide wire 1 after, but release reducing thrombectomy support 3 to through adjusting distal end locating part 12 and near-end locating part 11, make but reducing thrombectomy support 3 changes repeatedly so that thrombus 6 is fully caught and gets into in the support, drags backward guide wire 1 but reducing thrombectomy support 3 and fixed catheter 4 gets into in recovery catheter 2, thrombus 6 of escaping is along with the blood flow to but reducing thrombectomy support 3 during the distal end flows, by the density great the partial net of distal end portion 31 catches to prevent the emergence of escaping.
Specifically, in this embodiment, the diameter of the variable diameter thrombectomy stent 3 can be arbitrarily and repeatedly adjusted by repeatedly pushing and pulling the guide wire 1, and the sizes of the proximal net portion 33, the distal net portion 31 and the middle net portion 32 are changed, so that the chance of capturing the thrombi 6 is increased, and the effect of the thrombectomy is enhanced.
Specifically, the usage of the distal end limiting member 12 is as follows: the guide wire 1 is pushed, so that the guide wire 1 and the fixed catheter 4 move relatively to each other and the guide wire 1 moves towards the far end direction, the far end limiting part 12 is abutted against and pushes the sliding opening 34 to be far away from the fixed catheter 4, the distance between one end of the variable diameter embolectomy support 3, which is used for connecting the fixed catheter 4, and one end of the variable diameter embolectomy support 3, which is used for connecting the sliding opening 34, is increased, the diameter of the variable diameter embolectomy support 3 is reduced while the variable diameter embolectomy support 3 is stretched, the variable diameter embolectomy support 3 forms a state structure as shown in fig. 5, otherwise, the guide wire 1 and the fixed catheter 4 move relatively to each other and the guide wire 1 moves towards the near end direction, and the variable diameter embolectomy support 3 recovers under the elastic action of the variable diameter embolectomy support 3 after losing the support of the far end limiting part 12, that is, the diameter of the variable diameter embolectomy support 3 is increased to the diameter of the variable diameter embolectomy support 3 in the natural state, and the variable diameter embolectomy support 3 is in the state structure as shown in fig. 6.
Understandably, the outer diameter of the distal stop 12 is larger than the inner diameter of the sliding opening 34, so that the distal stop 12 can abut against and push the sliding opening 34.
Understandably, the maximum diameter of the variable diameter embolectomy support 3 is determined by the position of the proximal end limiting part 11 on the guide wire 1, and the use mode of the proximal end limiting part 11 is as follows: when the elastic property of the variable diameter embolectomy support 3 is not inactivated, the diameter of the variable diameter embolectomy support 3 is maintained at a certain fixed value in a natural state, that is, when the variable diameter embolectomy support 3 is not abutted by the distal end limiting part 12 and the proximal end limiting part 11, and when the elastic property of the variable diameter embolectomy support 3 is inactivated, or a barrier such as a thrombus 6 exists at the distal end of the variable diameter embolectomy support 3, and the barrier generates a relative acting force towards the proximal end on the distal end of the variable diameter embolectomy support 3, the diameter of the variable diameter embolectomy support 3 may be continuously increased under the pushing of the acting force until the diameter of the variable diameter embolectomy support 3 exceeds the diameter of the variable diameter embolectomy support 3 in a natural state, if the diameter of the variable diameter embolectomy support 3 is not limited, the blood vessel 7 is extruded due to the overlarge diameter of the variable diameter embolectomy support 3, which causes a serious consequence, therefore, by providing the proximal limiting member 11, when the guiding guidewire 1 and the fixed catheter 4 move relatively and move proximally to a certain position along the axial direction of the variable diameter embolectomy support 3, the proximal limiting member 11 will abut against the distal end of the fixed catheter 4, and because the proximal limiting member 11 and the distal limiting member 12 are fixed to the guiding guidewire 1, the distance between the proximal limiting member 11 and the distal limiting member 12 is constant, and at this time, the proximal limiting member 11 cannot continue to move proximally, and the distal limiting member 12 cannot continue to move proximally, the variable diameter embolectomy support 3 forms a state structure as shown in fig. 7, and the sliding opening 34 having a tendency to move proximally cannot continue to move proximally due to the abutting action of the distal limiting member 12, that is, the guiding guidewire 1 cannot continue to move proximally, further avoiding the diameter of the variable diameter embolectomy stent 3 from increasing continuously.
It should be noted that, only the distal end limiting member 12 may be provided to reduce the diameter of the variable diameter embolectomy support 3, and the self diameter is increased until the diameter returns to the original shape by the elasticity of the variable diameter embolectomy support 3, and the proximal end limiting member 11 is omitted, but accordingly, the beneficial effect of the proximal end limiting member 11 is lost, and meanwhile, other limiting members penetrating through the guide wire 1 may be further added at any position inside the variable diameter embolectomy support 3.
Specifically, but reducing thrombectomy support 3 is woven by shape memory materials such as nickel titanium alloy silk and forms to the effect of realization through self elastic effect reconversion, just but reducing thrombectomy support 3 still can add the weaving silk of a plurality of X-ray development, namely reducing thrombectomy support 3 is woven by a plurality of nickel titanium alloy silk and a plurality of X-ray development weaving silk and forms, and understandably, nickel titanium alloy silk can be one or many, and X-ray development weaving silk also can be one or many.
More specifically, the proximal end limiting part 11 and the distal end limiting part 12 are provided with developing materials, and the whole process of the embolectomy process is visible through the developing weaving wire and the developing bracket straight-through adjusting ring.
Understandably, in this embodiment, the outer diameter of the guiding wire 1 is smaller than the inner diameter of the fixing catheter 4, the outer diameter of the fixing catheter 4 is smaller than the inner diameter of the recovery catheter 2, the guiding wire 1 is inserted into the fixing catheter 4, the fixing catheter 4 is inserted into the recovery catheter 2, in an initial state, the variable-diameter embolectomy stent 3 is integrally contained in the recovery catheter 2, and at least part of the guiding wire 1 penetrates out of the recovery catheter 2 from the distal end of the fixing catheter 4.
The embodiment has at least two use modes, in the first use mode, the recovery catheter 2 is in a fixed state, the guide wire 1 and the fixed catheter 4 move together, and the diameter-variable embolectomy stent 3 can be driven to extend out of the distal end of the recovery catheter 2 or retract into the recovery catheter 2;
in the second usage mode, the recovery catheter 2 and the fixed catheter 4 are fixed, at this time, the near end of the variable diameter embolectomy support 3 (i.e. the connecting position of the variable diameter embolectomy support 3 and the fixed catheter 4) is in a fixed state, the guide wire 1 slides relative to the fixed catheter 4 and drives the movement of the variable diameter embolectomy support 3, so that the variable diameter embolectomy support 3 can be driven to expand or contract, the variable diameter embolectomy support 3 can correspond to the internal structure of the blood vessel 7 and/or the structure of the thrombus 6, and actions such as cutting, scraping and contracting are realized.
In addition, guide wire 1 in this embodiment, fixed catheter 4 sets up to the structure that cup joints in proper order with retrieving pipe 2, can make guide wire 1 and the variable footpath and get a bolt support 3 and all hold in retrieving pipe 2, by guide wire 1, the variable footpath gets a bolt support 3, the overall structure of the pipe bracket component that fixed catheter 4 and retrieve pipe 2 constitute is more compact, in the operation process, just need not to set up other seal wires separately, not only can reduce the volume of keeping the equipment in patient's health in getting a bolt operation process, in order to reduce the injury that causes patient's health, can also be convenient for the transportation and the use of pipe bracket component, the time of clinical intervention operation has greatly been simplified, excellent in use effect.
According to an embodiment of the present invention, a second cavity 41 is disposed on an inner wall of the fixed catheter 4 and an outer wall of the guide wire 1, the second cavity 41 penetrates through two ends of the fixed catheter 4, and an end of the second cavity 41 away from the proximal net portion 33 is used for injecting a drug, so that the injected drug is output from an end of the second cavity 41 close to the proximal net portion 33, so as to further improve a thrombolytic effect.
Specifically, the outer wall of the fixed catheter 4 may further be provided with a plurality of drug delivery holes, and the plurality of drug delivery holes are disposed at positions close to the distal end of the fixed catheter 4; with the arrangement, when the thrombolytic liquid medicine is conveyed through the fixed catheter 4, the liquid medicine can be diffused through the medicine applying hole, so that the medicine applying range of the liquid medicine is improved, and the using effect is good.
As shown in fig. 4, according to an embodiment of the present invention, further includes:
the device comprises a connecting handle 5, wherein a guide wire channel 51, a first channel 52 and a second channel 53 are formed in the connecting handle 5, the guide wire channel 51 is used for conveying the guide wire 1, the first channel 52 is used for conveying the fixed catheter 4, and the second channel 53 is used for conveying the recovery catheter 2.
It can be understood that, in the present embodiment, by providing the above-mentioned connection handle 5, the guiding wire 1, the fixing catheter 4 and the recovery catheter 2 can be controlled to be delivered through the guiding wire channel 51, the first channel 52 and the second channel 53, respectively, so as to achieve embolectomy, which is compact and easy to operate, and meanwhile, the thrombolytic or other therapeutic drugs are injected into the third cavity 14, the second cavity 41 and the first cavity 21 through the guiding wire channel 51, the first channel 52 and the second channel 53, respectively.
Specifically, the first channel 52 and the second channel 53 are both tee pipes, one nozzle of the first channel 52 is suitable for being communicated with the guide wire channel 51 and guiding the guide wire 1 to pass in, the other nozzle is suitable for fixing the guide pipe 4 to pass in, the third nozzle is suitable for being communicated with one nozzle of the second channel 53 and fixing the guide pipe 4 to pass out, the third nozzle is also suitable for injecting thrombolytic drugs or other therapeutic drugs, the other nozzle of the second channel 53 is suitable for recovering the guide pipe 2 to pass in or injecting thrombolytic drugs or other therapeutic drugs, and the third nozzle is suitable for recovering the guide pipe 2 to pass out.
According to one embodiment of the present invention, the connection handle 5 comprises a proximal handle 54 and a distal handle 55 detachably connected, the guide wire channel 51 and the first channel 52 are provided on the proximal handle 54, and the second channel 53 is provided on the distal handle 55.
Through the arrangement of the detachably connected proximal handle 54 and the distal handle 55, in the use process, the proximal handle 54 and the distal handle 55 with corresponding structures can be selected and combined according to actual surgical requirements, and the distal handle 55 can be further provided with a third channel, a fourth channel and the like to realize corresponding functions, which is not limited uniquely herein.
Specifically, the connection handle 5 is further provided with a guide wire adjusting member 56, the guide wire 1 is inserted into the guide wire adjusting member 56, and the guide wire adjusting member 56 is used for driving the guide wire 1 to move relative to the connection handle 5, and more specifically, an external thread which is in threaded fit with the guide wire adjusting member 56 is arranged on the peripheral side of the guide wire 1, so that the purpose that the guide wire 1 moves relative to the connection handle 5 can be achieved by rotating the guide wire adjusting member 56.
More specifically, in the present embodiment, the extending direction of the first channel 52 and the extending direction of the guide wire channel 51 have an angle therebetween, and the first channel 52 is inclined toward the direction close to the proximal end of the connection handle 5; the second channel 53 also extends at an angle to the guide wire channel 51, and the second channel 53 is inclined towards the proximal end of the connection handle 5; from this setting, connecting handle 5 whole forms Y type structure, not only can improve fixed pipe 4 and retrieve pipe 2's transport resistance, avoids blockking up and buckles, and in the use, medical personnel only need to grip connecting handle 5 and can operate guide wire 1, fixed pipe 4 and retrieve pipe 2 respectively, and it is convenient to use.
According to one embodiment of the invention, the distal end of the guide wire 1 extends from the distal end of the variable diameter thrombectomy stent 3 and is provided with a flexible tip 13.
With this arrangement, when the guide wire 1 is inserted into the blood vessel 7, the flexible tip 13 can deform when touching the inner wall of the blood vessel 7 or an obstacle in the blood vessel 7, so as to avoid puncture injury to the inner wall of the blood vessel 7.
Specifically, a third cavity 14 penetrating through two ends of the guide wire 1 is arranged inside the guide wire 1, the guide wire 1 is provided with a nozzle hole 15 for communicating the third cavity 14 with the outside of the guide wire 1, and a drug is injected into the third cavity 14 from the proximal end of the guide wire 1 so as to be output to the outside of the guide wire 1 through the nozzle hole 15.
More specifically, one end of the jet hole 15 for outputting the medicine to the outside of the guide wire 1 faces the variable diameter embolectomy stent 3.
The second aspect of the present invention provides a method for using the multifunctional thrombus treatment device, comprising the steps of:
controlling the diameter of the variable-diameter embolectomy stent 3 to be smaller than that of a blood vessel 7, so that the guide wire 1 penetrates into the blood vessel 7 and the guide wire 1 penetrates through a thrombus 6;
injecting a medicine into the first cavity 21 from one end of the first cavity 21 close to the proximal end of the guide wire 1, so that the medicine is output from the distal end of the first cavity 21 close to the guide wire 1 and acts on the thrombus 6 to soften or decompose the thrombus 6;
increasing the diameter of the variable-diameter thrombus removal support 3, enabling the variable-diameter thrombus removal support 3 to penetrate through the thrombus 6 originally positioned on the outer side of the variable-diameter thrombus removal support 3 in the diameter increasing process, and enabling the thrombus 6 to be accommodated between the inner side of the variable-diameter thrombus removal support 3 with the increased diameter and the outer side of the guide wire 1, so as to capture the thrombus 6;
specifically, the diameter of the variable-diameter embolectomy support 3 is increased, so that the variable-diameter embolectomy support 3 penetrates through the thrombus 6 originally positioned on the outer side of the variable-diameter embolectomy support 3 in the diameter increasing process, and the thrombus 6 is accommodated between the inner side of the variable-diameter embolectomy support 3 with the increased diameter and the outer side of the guide wire 1, and the thrombus 6 is captured;
simultaneously with, before or after the thrombus is captured by repeatedly changing the diameter of the stent, the medicine is injected from the proximal end of the first cavity 21, the second cavity 41 and/or the third cavity 14, and flows out from the distal end of the first cavity 21, the second cavity 41 and/or the third cavity 14 near or inside the thrombus tissue 6 so as to soften or decompose the thrombus 6 and increase the effect of capturing the thrombus by the stent.
Example 1: the multifunctional thrombus treatment device of the present invention was produced as shown in FIG. 1. The produced variable-diameter thrombus taking stent 3 is implanted into the carotid artery of a pig. Under an X-ray machine, the diameter-variable thrombus taking support 3 prepared by the developing wire and the near-end limiting piece 11 and the far-end limiting piece 12 on the guide wire 1 of the multifunctional thrombus treatment device are clearly visible, the guide wire 1 is pushed and pulled, and the diameter-variable thrombus taking support 3 can freely change in the carotid artery. The guide wire 1 is unfolded, and the diameter-variable thrombus taking support 3 can be easily collected into the recovery catheter 2. Fig. 10 is an image of a variable diameter embolectomy stent 3 in the porcine carotid artery.
In the description herein, references to the description of the term "one embodiment," "some embodiments," "an example," "a specific example," or "some examples," etc., mean that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of an embodiment of the invention. In this specification, the schematic representations of the terms used above are not necessarily intended to refer to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples. Furthermore, various embodiments or examples and features of different embodiments or examples described in this specification can be combined and combined by one skilled in the art without contradiction.
Finally, it should be noted that: the above examples are only intended to illustrate the technical solution of the present invention, but not to limit it; although the present invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some technical features may be equivalently replaced; and such modifications or substitutions do not depart from the spirit and scope of the corresponding technical solutions of the embodiments of the present invention.
Claims (10)
1. A multi-functional thrombus treatment device, comprising:
a guide wire (1);
the recovery catheter (2) is sleeved on the outer wall of the guide wire (1), and a first containing cavity (21) is formed between the inner wall of the recovery catheter (2) and the outer wall of the guide wire (1);
the variable-diameter thrombus taking support (3) is of a net structure, and the guide wire (1) penetrates through the variable-diameter thrombus taking support (3);
the diameter of the variable-diameter thrombus removal support (3) is changed to adapt to blood vessels (7) or thrombus (6) with different widths, and the first cavity (21) is used for accommodating the variable-diameter thrombus removal support (3) and delivering medicines.
2. The multifunctional thrombus treatment device according to claim 1, wherein the variable diameter thrombus removal stent (3) comprises a distal net part (31), a middle net part (32) and a proximal net part (33) which are connected in sequence, the distal net part (31) and the proximal net part (33) are close to each other to squeeze the middle net part (32) so as to increase the diameter of the middle net part (32), and the distal net part (31) and the proximal net part (33) are separated from each other to stretch the middle net part (32) so as to decrease the diameter of the middle net part (32).
3. The multifunctional thrombus treatment device according to claim 2, wherein one end of the distal net portion (31) away from the intermediate net portion (32) is slidably fitted to the guide wire (1) by providing a sliding opening (34) which is fitted over an outer wall of the guide wire (1), and the sliding opening (34) is slidably moved toward or away from the proximal net portion (33) along an axial direction of the guide wire (1).
4. The multifunctional thrombus treatment device according to claim 3, further comprising:
the guide wire guiding device comprises a fixed catheter (4), wherein the fixed catheter (4) is sleeved on the outer wall of the guide wire (1), the fixed catheter (4) penetrates through the recovery catheter (2), a first accommodating cavity (21) is formed in the inner wall of the recovery catheter (2) and between the outer walls of the fixed catheter (4), and one end of the middle net portion (32) and one end of the fixed catheter (4) are fixedly connected with each other, and the near-end net portion (33) is far away from the middle net portion (32).
5. The multifunctional thrombus treatment device according to claim 4, wherein a second cavity (41) is formed in the inner wall of the fixing catheter (4) and the outer wall of the guide wire (1), the second cavity (41) penetrates through two ends of the fixing catheter (4), one end of the second cavity (41) far away from the proximal net part (33) is used for injecting a medicament, and one end of the second cavity (41) close to the proximal net part (33) is used for outputting the medicament.
6. The multifunctional thrombus treatment device according to claim 5, further comprising:
the device comprises a connecting handle (5), wherein a guide wire channel (51), a first channel (52) and a second channel (53) are formed in the connecting handle (5), the guide wire channel (51) is used for conveying the guide wire (1), the first channel (52) is used for conveying the fixing catheter (4), and the second channel (53) is used for conveying the recovery catheter (2).
7. The multifunctional thrombus treatment device according to claim 6, wherein the connection handle (5) comprises a proximal handle (54) and a distal handle (55) which are detachably connected, the guide wire channel (51) and the first channel (52) are provided on the proximal handle (54), and the second channel (53) is provided on the distal handle (55).
8. The multifunctional thrombus treatment device according to claim 1, wherein the distal end of the guide wire (1) extends from the distal end of the variable diameter embolectomy stent (3) and is provided with a flexible tip (13).
9. The multifunctional thrombus treatment device according to claim 1, wherein the density of the variable diameter thrombus removal stent (3) at the distal end is greater than that at the proximal end.
10. A method for using the multifunctional thrombus treatment device according to any one of claims 1 to 9, comprising the steps of:
controlling the diameter of the variable-diameter embolectomy stent (3) to be smaller than the diameter of a blood vessel (7), so that the guide wire (1) extends into the blood vessel (7) and the guide wire (1) passes through a thrombus (6);
injecting a drug into the first cavity (21) from one end of the first cavity (21) close to the proximal end of the guide wire (1), so that the drug is output from the distal end of the first cavity (21) close to the guide wire (1) and acts on the thrombus (6) to soften or decompose the thrombus (6);
increasing the diameter of the variable-diameter embolectomy support (3), enabling the variable-diameter embolectomy support (3) to penetrate through thrombus (6) originally positioned on the outer side of the variable-diameter embolectomy support (3) in the diameter increasing process, and enabling the thrombus (6) to be accommodated between the inner side of the variable-diameter embolectomy support (3) with the increased diameter and the outer side of the guide wire (1), so as to capture the thrombus (6);
the variable-diameter embolectomy support (3) is accommodated in a first accommodating cavity (21) of the recovery catheter (2) and leaves a blood vessel (7) along with the recovery catheter (2).
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