CN115120305A - Bolt taking device and bolt taking system - Google Patents

Bolt taking device and bolt taking system Download PDF

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Publication number
CN115120305A
CN115120305A CN202210824222.XA CN202210824222A CN115120305A CN 115120305 A CN115120305 A CN 115120305A CN 202210824222 A CN202210824222 A CN 202210824222A CN 115120305 A CN115120305 A CN 115120305A
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CN
China
Prior art keywords
embolectomy
support
ring
connecting ring
guide
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Granted
Application number
CN202210824222.XA
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Chinese (zh)
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CN115120305B (en
Inventor
郭力友
李爽
夏洁
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Suzhou Zhongtian Medical Device Technology Co ltd
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Suzhou Zhongtian Medical Device Technology Co ltd
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Priority to CN202210824222.XA priority Critical patent/CN115120305B/en
Priority claimed from CN202210824222.XA external-priority patent/CN115120305B/en
Publication of CN115120305A publication Critical patent/CN115120305A/en
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Publication of CN115120305B publication Critical patent/CN115120305B/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements 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
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/01Filters implantable into blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/01Filters implantable into blood vessels
    • A61F2/011Instruments for their placement or removal
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/01Filters implantable into blood vessels
    • A61F2/013Distal protection devices, i.e. devices placed distally in combination with another endovascular procedure, e.g. angioplasty or stenting
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements 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
    • A61B2017/22038Implements 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements 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
    • A61B2017/22079Implements 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 suction of debris
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements 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
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2212Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0058Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0096Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
    • A61F2250/0098Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers radio-opaque, e.g. radio-opaque markers

Abstract

The invention relates to the technical field of medical instruments, and particularly discloses a thrombus taking device and a thrombus taking system. The device comprises a guide part and a thrombus removal module, wherein the guide part extends along the length direction of a blood vessel; the bolt taking module comprises a bolt taking support and a first connecting ring, the bolt taking support is sleeved on the guide piece and comprises a support extending end, a support catching net and a support converging end which are connected end to end, the support converging end is fixedly connected with the first connecting ring, and the first connecting ring is sleeved on the guide piece; the support catches the net and has formed the parallelogram net, and the parallelogram net is the spiral distribution around the axis of guide, and the support catches the net and can drive the axis rotation of first connecting ring around the guide. This device is through catching the structural optimization of on-net parallelogram net to the support, can make the support catch the net and rotate when moving and meet the hindrance, makes and gets to tie the support and produce the self-adaptation rotation to the guarantee is to the ability of catching of embolus, promotes and gets the bolt effect.

Description

Bolt taking device and bolt taking system
Technical Field
The invention relates to the technical field of medical instruments, in particular to a thrombus taking device and a thrombus taking system.
Background
Pulmonary artery embolism is a potential life-threatening disease, acute pulmonary artery embolism can cause systemic hypotension and even whole heart failure, and further causes death of patients, and is one of three fatal cardiovascular diseases which are parallel to myocardial infarction and stroke. The most common embolus in pulmonary embolism is thrombus. The current common treatment modes mainly comprise the treatment operation modes of pulmonary artery intimal stripping, thrombus suction, catheter thrombolysis, mechanical thrombus extraction and the like. Among them, mechanical thrombus removal mainly removes thrombus by crushing, suction, stent or basket thrombus removal, and has become a focus of research in recent years. The mechanical thrombus removal technology comprises the steps of expanding a stent, then embedding the stent with thrombus, dragging the thrombus into an aspiration catheter, and aspirating the thrombus out of a body by using an aspiration device.
However, the current thrombus removal device is mainly used for embedding the thrombus through the stent so as to take the stent and the thrombus into the catheter and remove the stent and the thrombus out of the body. However, in the thrombus removal process, the thrombus can be broken and fall off, and the fallen thrombus can block the downstream blood vessel along with the blood flow.
Disclosure of Invention
The invention aims to provide a bolt taking device and a bolt taking system, so as to improve the capability of collecting bolts and improve the effect of bolt taking operation.
In order to achieve the purpose, the invention adopts the following technical scheme:
a thrombus removal device can be arranged in a blood vessel and comprises a guide piece and a thrombus removal module; the guide member extends along a length of the blood vessel; the bolt taking module comprises a bolt taking support and a first connecting ring, the bolt taking support is sleeved on the guide piece and comprises a support extending end, a support catching net and a support converging end which are connected end to end, the support converging end is fixedly connected to the first connecting ring, and the first connecting ring is sleeved on the guide piece; the support catching net forms parallelogram grids which are spirally distributed around the axis of the guide piece, and the support catching net can drive the first connecting ring to rotate around the axis of the guide piece.
In a preferred embodiment of the thrombectomy device, one of the first connecting rings and the associated one of the thrombectomy holders are used as a thrombectomy group, and at least one of the thrombectomy groups is provided.
In a preferred embodiment of the embolectomy device, two embolectomy groups are provided, and the parallelogram meshes on the two embolectomy supports are helical around the axis of the guide in opposite directions, so that the rotation directions of the two embolectomy groups are opposite.
As a preferred technical scheme of the bolt taking device, the outer peripheral wall of the guide part is convexly provided with a limiting bulge, and when the bolt taking support moves relative to the guide part, the first connecting ring is stopped by the first connecting ring and abuts against the limiting bulge.
As a preferred technical scheme of the embolectomy device, the parallelogram grid is provided with long sides and short sides, the ratio of the length of the long sides to the length of the short sides is larger than a proportional threshold, and the included angle between the long sides and the short sides is within an angle threshold range.
As a preferable technical scheme of the thrombus removal device, the ratio threshold is 1.1, and the angle threshold ranges from 60 degrees to 120 degrees.
As a preferable technical scheme of the thrombus removal device, a second connecting ring is fixedly connected to the stretching end of the stent, and the second connecting ring is sleeved on the guide member and can move along the length direction of the blood vessel.
As a preferred technical scheme of the bolt taking device, the first connecting ring comprises a first inner ring, a middle ring and a first outer ring which are sequentially sleeved from inside to outside, a plug-in port is penetrated through the middle ring, and the plug-in port is communicated with the end face of the middle ring; the inserting port, the first inner ring and the first outer ring form an inserting groove, and the support bundling end is inserted in the inserting groove.
The utility model provides a bolt system of getting, includes distal end protection device and foretell bolt device of getting, distal end protection device is located including weaving silk and cover the device skeleton of guide part, the one end of device skeleton is connected with the filter screen that weaving silk formed, distal end protection device's opening with the opening of getting the bolt support is just right.
As a preferable technical scheme of the thrombus taking system, the thrombus taking system further comprises a push rod, a guide catheter and a thrombus absorption catheter which are sequentially sleeved from inside to outside, the thrombus taking device and the far-end protection device can be contracted in the guide catheter, one end of the guide piece, which is far away from the far-end protection device, is fixedly connected to the push rod, and the thrombus absorption catheter is used for recovering a thrombus, the far-end protection device and the thrombus taking device.
The invention has the beneficial effects that:
the embolectomy device can avoid the obstruction of blood vessels to the stent catching net in the process of withdrawing the embolectomy device by means of the design of parallelogram grids on the embolectomy support, so that the embolectomy support can rotate around the axis of the guide piece in a self-adaptive manner, the capturing capacity of emboli is enhanced, the condition that the embolus drops in the withdrawing process is avoided, and the efficiency of embolectomy operation is improved. Meanwhile, the structural improvement ensures that the thrombus taking support has excellent flexibility and torque damage resistance, has good wall attaching capability in a bent blood vessel and can adapt to blood vessels of different shapes; when resistance is met during retraction, the embolectomy support can also generate self-adaptive rotation, and the resistance is automatically avoided, so that the damage to the blood vessel is reduced. The structure has the advantages of high thrombus extraction efficiency, no damage to blood vessels, easy improvement of developability and prevention of embolus falling.
The embolectomy system can collect the dropped and broken embolus fragments out of the body by means of the far-end protection device, and prevent the downstream blood vessel from being blocked. The filter screen can effectively realize the catching action of the embolus. The design that the far-end protection device is right opposite to the opening of the embolectomy support can surround emboli from two sides, and therefore the risk that the emboli is separated from the embolectomy system is greatly reduced.
Drawings
FIG. 1 is a schematic structural diagram of a thrombectomy system according to an embodiment of the present invention;
FIG. 2 is a partially expanded view of an embolectomy stent provided in accordance with an embodiment of the present invention;
FIG. 3 is a schematic structural diagram of another bolt-removing module according to an embodiment of the present invention;
FIG. 4 is a schematic structural view of another thrombectomy support according to the embodiment of the present invention;
fig. 5 is a schematic structural diagram of a remote protection device provided in an embodiment of the present invention;
FIG. 6 is a partially expanded view of a device skeleton according to an embodiment of the present invention;
FIG. 7 is a partial expanded view of a carcass woven portion and a woven wire provided in accordance with an embodiment of the present invention;
FIG. 8 is a partially expanded view of another alternative thrombectomy stent provided in accordance with embodiments of the present invention;
FIG. 9 is a schematic structural view of a device skeleton and a braiding mandrel provided in accordance with an embodiment of the present invention;
FIG. 10 is a cross-sectional view of a first connecting ring provided by an embodiment of the present invention;
FIG. 11 is a cross-sectional view of a first coupling ring provided in accordance with an embodiment of the present invention;
FIG. 12 is a cross-sectional view of a third connector ring provided in accordance with an embodiment of the present invention;
FIG. 13 is a partial cross-sectional view of a tether system provided in accordance with an embodiment of the present invention;
FIG. 14 is a first cross-sectional view of a blood vessel, an embolus, and an embolectomy system provided in accordance with an embodiment of the present invention;
FIG. 15 is a second cross-sectional view of a blood vessel, an embolus, and an embolectomy system provided in accordance with an embodiment of the present invention;
fig. 16 is a schematic structural diagram of another embolectomy system provided by the embodiment of the invention.
In the figure:
100. a thrombus taking device; 110. a thrombus taking support; 111. a stent extension end; 112. a support is used for catching the net; 113. a support binding end; 114. a bracket connector; 120. an inner tube; 121. an inner pipe convex ring; 130. an open pore end; 140. a first connecting ring; 141. a first inner ring; 142. a middle ring; 143. a first outer ring; 144. inserting grooves; 150. an inner rod; 160. the end of the inner rod; 170. a second connection ring;
200. a distal protection device; 210. a device skeleton; 211. a framework connecting rod; 212. a skeleton-knitted portion; 213. weaving holes; 214. a skeleton hole; 215. a framework connector; 220. weaving silk; 230. a third connecting ring; 231. a second inner ring; 232. a second outer ring; 240. a fourth connecting ring; 300. a guide wire; 400. a push rod; 500. a guide catheter; 600. a thrombus-aspiration catheter;
800. weaving a mandrel; 910. a blood vessel; 920. an embolus; 921. embolic debris.
Detailed Description
In order to make the technical problems solved, technical solutions adopted and technical effects achieved by the present invention clearer, the technical solutions of the embodiments of the present invention will be described in further detail below with reference to the accompanying drawings. 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.
In the description of the present invention, unless expressly stated or limited otherwise, the terms "connected," "connected," and "fixed" are to be construed broadly, e.g., as meaning permanently connected, removably connected, or integral to one another; can be mechanically or electrically connected; either directly or indirectly through intervening media, either internally or in any other relationship. The specific meanings of the above terms in the present invention can be understood in a specific case to those of ordinary skill in the art.
In the present invention, unless otherwise expressly stated or limited, "above" or "below" a first feature means that the first and second features are in direct contact, or that the first and second features are not in direct contact but are in contact with each other via another feature therebetween. Also, the first feature being "on," "above" and "over" the second feature includes the first feature being directly on and obliquely above the second feature, or merely indicating that the first feature is at a higher level than the second feature. A first feature being "under," "below," and "beneath" a second feature includes the first feature being directly under and obliquely below the second feature, or simply meaning that the first feature is at a lesser elevation than the second feature.
The technical scheme of the invention is further explained by the specific implementation mode in combination with the attached drawings.
As shown in fig. 1, 2, 14 and 15, the present embodiment provides an embolectomy device 100, which can be placed in a blood vessel 910, and comprises a guide member and an embolectomy module; the guide extends along the length of vessel 910; the bolt taking module comprises a bolt taking bracket 110 and a first connecting ring 140, the bolt taking bracket 110 is sleeved on the guide piece and comprises a bracket extending end 111, a bracket catching net 112 and a bracket converging end 113 which are connected end to end, the bracket converging end 113 is fixedly connected to the first connecting ring 140, and the first connecting ring 140 is sleeved on the guide piece; the support catching net 112 forms a parallelogram grid which is spirally distributed around the axis of the guide, and the support catching net 112 can drive the first connecting ring 140 to rotate around the axis of the guide.
By means of the design of the parallelogram grids on the embolectomy support 110, the embolectomy device 100 can avoid the obstruction of the blood vessel 910 to the support catching net 112 in a rotating mode in the process of withdrawing the embolectomy device 100, and further realize the self-adaptive rotation of the embolectomy support 110 around the axis of the guide piece, so that the catching capacity of embolus 920 is enhanced, the condition that the embolus 920 falls off in the process of withdrawing is avoided, and the efficiency of embolectomy operation is improved. Meanwhile, the structural improvement enables the embolectomy stent 110 to have excellent flexibility and torque failure resistance, and good wall-adhering capability in the curved blood vessel 910, so that the stent can adapt to blood vessels 910 with different shapes; when resistance is met during retraction, the embolectomy stent 110 can also generate self-adaptive rotation, so that the resistance is automatically avoided, and the damage to the blood vessel 910 is reduced. The structure has the advantages of high thrombus removal efficiency, no damage to blood vessels 910, easy development improvement and capability of preventing embolus 920 from falling off.
In this embodiment, the extending end 111 of the bracket is a rod-shaped member, and one end is fixed to the bracket catching net 112; the holder extension end 111 is provided with at least one, and the developability of the plug holder 110 can be enhanced by fixing a developing material (developing ring or developing ring) to the holder extension end 111. The bracket collecting end 113 is a rod-shaped member, and has at least one end fixedly connected to the bracket catching net 112 and the other end inserted into the first connecting ring 140.
Preferably, the stent 110 is made by cutting a shape memory alloy tube, and then performing heat treatment, shaping and polishing.
Specifically, the rotation direction of the embolectomy holder 110 is determined according to the extending direction of the parallelogram mesh.
In this embodiment, a first coupling ring 140 and an associated embolectomy support 110 serve as an embolectomy group, at least one of which is provided. The arrangement of the bolt taking group is helpful for improving the bolt taking capability of the bolt taking device 100, the catching capability of the bolt taking device 100 on bolts 920 with different sizes and shapes is improved, the probability of repeated bolt taking is reduced, and the efficiency of bolt taking operation is improved.
In another embodiment of this embodiment, as shown in fig. 3, 14 and 15, two bolt sets are provided, and the parallelogram meshes of the two bolt supports 110 are twisted around the axis of the guide in opposite directions, so that the rotation directions of the two bolt sets are opposite. Two bolt groups are arranged at intervals along the extending direction of the guide piece, and two adjacent bolt groups can have partial area overlapping. Through the limitation on the rotation direction of the two bolt taking groups, the action of the bolt taking module during withdrawal can be adjusted, so that the bolt taking capacity can be further improved, and the risk that the bolt 920 falls off is reduced. In other embodiments of this embodiment, the rotation directions of the two bolt sets are the same.
With continued reference to fig. 2, further, the parallelogram grid has a long side and a short side, a ratio of the length of the long side to the length of the short side is greater than a proportional threshold, and an included angle between the long side and the short side is within an angle threshold range. The design limits the size ratio of the long side to the short side and the range of the included angle, and limits the parallelogram grids, so that the self-adaptive capacity of the rotation of the bolt taking bracket 110 is ensured, and the rotation action of the first connecting ring 140 is accurately and effectively completed.
In this embodiment, the proportional threshold is 1.1, and the angular threshold ranges from 60 ° to 120 °. Preferably, the ratio of the length of the long side to the length of the short side is within 1.5-3.
As shown in fig. 4, 14 and 15, in another embodiment of this embodiment, the stent expansion end 111 is fixedly connected with a second connection ring 170, and the second connection ring 170 is sleeved on the guide member and can move along the length direction of the blood vessel 910. The second connecting ring 170 can slide freely along with the contraction or expansion of the embolectomy stent 110, which is beneficial to completing the delivery action of the embolectomy stent 110 and can avoid the condition that the stent extending end 111 damages the blood vessel 910.
As shown in fig. 10, 11, 14 and 15, in the present embodiment, the first connecting ring 140 includes a first inner ring 141, a middle ring 142 and a first outer ring 143 that are sequentially sleeved from inside to outside, the middle ring 142 has a plug-in port penetrating therethrough, and the plug-in port is communicated with an end face of the middle ring 142; the insertion opening, the first inner ring 141 and the first outer ring 143 form an insertion groove 144, and the bracket converging end 113 is inserted into the insertion groove 144. Specifically, the end of the bracket converging end 113 away from the bracket catching net 112 is provided with a bracket connector 114, and the bracket connector 114 completely extends into the insertion groove 144. The first inner ring 141 provides a penetrating space for the guide member, and the processing cost of the first connecting ring 140 is greatly reduced by means of the way of forming the insertion groove 144 by the split design of the first inner ring 141, the middle ring 142 and the first outer ring 143. The design ensures the stable connection between the bracket converging end 113 and the first connecting ring 140, and reduces the risk of position deviation or falling off of the thrombectomy bracket 110 in the thrombectomy process.
Preferably, each member of the first connecting ring 140 is cut from a metal or polymer tube.
In this embodiment, the components of the connecting ring and the guide piece can be connected together by glue, laser welding and the like. The specific connection method is a conventional technical means in the art, and is well known by those skilled in the art, and will not be described herein.
As shown in fig. 13, in this embodiment, the outer peripheral wall of the guide member is convexly provided with a limiting protrusion, and when the bolt taking bracket 110 is displaced relative to the guide member, the first connecting ring 140 is stopped by the first connecting ring 140 and abuts against the limiting protrusion. Under the condition that the thrombus removal support 110 is withdrawn or pushed forwards, the limiting protrusion drives the thrombus removal support 110 to move by directly contacting with the first connecting ring 140 and ensures that the first connecting ring 140 can rotate in a self-adaptive manner, so that the thrombus removal device 100 can smoothly and stably operate.
Preferably, the limiting protrusion is made of medical metal or polymer material, such as medical stainless steel, nitinol, cobalt-based alloy, titanium alloy or magnesium alloy, or developing material such as gold, platinum iridium, platinum tungsten or tantalum can be selected to increase the proximal developability of the embolectomy stent 110; the limiting protrusion is connected with the inner tube 120 by glue bonding, laser welding or hot melt welding.
In other embodiments of this embodiment, the limiting protrusion is a spherical member, and the above design greatly reduces the contact area between the limiting protrusion and the first connecting ring 140, thereby reducing the rotation resistance of the bolt-removing bracket 110.
As shown in fig. 1, 14 and 15, the present embodiment further provides an embolectomy system, which can be placed in a blood vessel 910, and comprises an embolectomy device 100 and a distal protection device 200; the thrombus removal device 100 comprises a guide part and a thrombus removal module, the far-end protection device 200 comprises a device framework 210, a knitting wire 220 and a third connecting ring 230 which are connected end to end, the guide part is sleeved with the device framework 210, the knitting wire 220 is wound on one end of the device framework 210, the knitting wire 220 is gathered in the third connecting ring 230, the guide part is sleeved with the third connecting ring 230, and an opening of the far-end protection device 200 is opposite to an opening of the thrombus removal support 110.
The embolectomy system can collect the fallen and broken embolus fragments 921 out of the body by means of the distal protection device 200, and prevent the downstream blood vessel 910 from being blocked. The setting of filter screen can realize effectively the action of catching embolus 920, can realize the zonulae occludens of filter screen and device skeleton 210 through the design of weaving silk 220 winding in device skeleton 210, has reduced the risk of distal end protection device 200 damage, weave silk 220 and draw in the design of third go-between 230 and make the filter screen mesh narrow gradually from embolus 920 near-end to embolus 920 distal end, realized the optimization to the filter screen effect of catching from this. The design that the distal protection device 200 faces the opening of the embolectomy support 110 can surround the embolus 920 from two sides, so that the risk that the embolus 920 is separated from the embolectomy system is greatly reduced. The bolt taking device 100 and the far-end protection device 200 are arranged in a split manner, so that the bolt taking operation process of the bolt taking system is improved, a complex bolt taking working environment can be coped with, the working flexibility can be greatly improved, and the bolt taking operation efficiency can be improved; through the design that the guide member is sleeved by the third connection ring 230, the distal protection device 200 and the embolectomy device 100 can be quickly positioned, and the embolectomy operation can be smoothly and accurately completed by the design of a split structure.
The embolectomy system is small in size, and the distal protection device 200 and the embolectomy device 100 are both easy to improve visualization. The distal protection device 200 has the advantage of good adherence, effectively reducing the risk of injury to the blood vessel 910. The filter screen is the toper structure, and the mesh of toper filter screen is by embolus 920 near-end to embolus 920 distal end taper, and then can promote the effect of catching to different size embolus piece 921.
Specifically, the thickness of the filter screen is 10-1000 μm, and the mesh diameter of the filter screen is 10-1000 μm.
As shown in fig. 1, 5, 14 and 15, the filter screen separates the device framework 210 from the inner wall of the blood vessel 910, and the surface of the filter screen is smooth, so that the damage of the device framework 210 to the inner wall of the blood vessel 910 can be reduced; the diameter of the knitting yarn 220 is 0.05-0.3mm, and the material is medical polymer yarn or medical metal wire; the filter screen can be provided with at least one developing wire of platinum iridium, platinum tungsten, platinum and the like, so that the filter screen can be integrally developed. The selection of the specific material of the filter screen is well known in the art, and is well known to those skilled in the art, and will not be described herein.
The above design allows the filter screen to collect emboli 920 without obstructing blood flow. The device framework 210 is formed by cutting or weaving medical memory alloy pipes and then performing heat treatment and shaping; the filter screen is woven by medical wires or punched by medical membrane material, and can be coated on the outer surface of the device framework 210 by hot melting, bonding, welding and other modes.
As shown in fig. 5-7, a frame connector 215 is further disposed on the other side of the frame link 211, the frame connector 215 is fixedly connected to a fourth connecting ring 240, and the fourth connecting ring 240 is sleeved on the guide member. The fourth connecting ring 240 is arranged to realize the positioning effect of the device framework 210 and the guide piece, further facilitate the positioning of the distal end protection device 200 and the embolectomy device 100, and avoid the situation that the framework connecting rod 211 damages the blood vessel 910.
In this embodiment, the device frame 210 includes a frame link 211 and a frame knitting part 212 disposed on one side of the frame link 211, the frame knitting part 212 forms frame holes 214, the frame holes 214 are uniformly spaced around the axis of the guide, the frame knitting part 212 has knitting holes 213 therethrough, and the plurality of knitting holes 213 are uniformly spaced around the frame holes 214; each of the knitting filaments 220 passes through one of the knitting holes 213, and both ends thereof are fixedly coupled to the third coupling ring 230. Specifically, the weaving holes 213 are cut by laser. The connecting structure of the knitting yarn 220 on the device framework 210 is simple, the connecting strength is high, the problem of falling or deviation is not easy to occur, and the effect of thrombus removal operation is guaranteed.
The distance d between every two adjacent weaving holes 213 in the circumferential direction of the skeleton connecting rod 211 is the same, and the above design ensures that the weaving holes 213 are uniformly distributed on the skeleton connecting rod 211. The reinforced convex plate is arranged near the weaving hole 213, the reinforced convex plate avoids the situation that the strength of the framework connecting rod 211 is reduced due to the arrangement of the weaving hole 213, so that the strength of each part of the framework connecting rod 211 is the same, and the expansion action of the framework connecting rod 211 is more uniform due to the arrangement.
Preferably, the portion of the bobbin weaving portion 212 where the bobbin holes 214 are formed and uniformly spaced around the axis of the guide is divided into a weaving frame, and the third connection ring 230 connected to the weaving frame through the weaving wire 220, the weaving wire 220 connected to the weaving frame, and the weaving frame form a storage net pocket; the storage net bag is provided with at least one, and the weaving frame of the next storage net bag is coaxially and fixedly connected with one end, far away from the bolt taking device 100, of the weaving frame of the previous storage net bag.
The setting of a plurality of string bags of accomodating makes the filter screen denser, helps improving distal end protection device 200's catching ability, has promoted distal end protection device 200 to the effect of catching of the embolus piece 921 of different sizes and shapes, has reduced embolus piece 921 and has blockked up vascular 910's risk again.
As shown in fig. 9, the process flow of the distal protection device 200 includes the following steps: sleeving the device framework 210 on the outer surface of the weaving mandrel 800, so that the device framework 210 and the weaving mandrel 800 are relatively fixed; the weaving wire 220 is penetrated through the weaving hole 213, and both ends of the weaving wire 220 are connected with the weaving machine; after weaving is completed, the filter screen and the device framework 210 are subjected to heat setting; after the setting is completed, both ends of the braided wire 220 are fixed by the third connection ring 230.
As shown in fig. 5-7 and 12, in the present embodiment, the third connection ring 230 includes a second inner ring 231 and a second outer ring 232 coaxially sleeved on the second inner ring 231, and the second inner ring 231 and the second outer ring 232 form a receiving cavity; both ends of the braided wire 220 are threaded into the accommodating cavities. Specifically, the second inner ring 231 is fixedly connected to the second outer ring 232.
The second inner ring 231 provides a penetrating space for the guide member, and the processing cost of the third connection ring 230 is greatly reduced by means of a manner of forming an accommodating cavity by means of a split design of the second inner ring 231 and the second outer ring 232. The above design ensures the firm connection between the braided wire 220 and the third connecting ring 230, and reduces the risk of position deviation or falling off of the filter screen during the embolectomy process.
Specifically, the braided wire 220 and the third connection ring 230 are fixedly connected by welding, gluing, or the like. The second inner ring 231 can be cut from a medical polymer or metal tube, and the second outer ring 232 can be made of developing materials such as platinum iridium, platinum tungsten or platinum, so that the developing performance of the far end of the embolus 920 is better.
Through the mode of promoting the developability, can make thrombectomy device 100 and distal end protection device 200 all can wholly develop, and then help guaranteeing the transport of thrombectomy system, expand and withdraw the accurate completion of action.
With continued reference to fig. 1, 14 and 15, in this embodiment, the embolectomy system further includes a pushing rod 400, a guiding catheter 500 and a thrombus extraction catheter 600, which are sequentially sleeved from inside to outside, wherein the embolectomy device 100 and the distal protection device 200 can be retracted in the guiding catheter 500, one end of the guiding element away from the distal protection device 200 is fixedly connected to the pushing rod 400, and the thrombus extraction catheter 600 is used for sucking the embolus 920 during the operation and recovering the distal protection device 200 and the embolectomy device 100. The bolt taking system is simple and reliable in structure and stable in operation, and ensures that bolt taking operation by the bolt taking system can be smoothly and efficiently completed through mutual matching work among all components.
In this embodiment, the guiding member includes an inner tube 120 and a guide wire 300, an opening tip 130 is fixedly connected to one end of the inner tube 120 close to the distal end protection device 200, the guide wire 300 passes through the inner tube 120 and the opening tip 130, the first connecting ring 140 is sleeved on the inner tube 120, and the guide wire 300 passes through the third connecting ring 230 and is connected to the distal end protection device 200. The design of the guide wire 300 with low rigidity is selected, so that the positioning difficulty of the guide piece and the far-end protection device 200 is reduced, and the guide piece and the far-end protection device 200 can be smoothly and quickly aligned.
Specifically, the limiting protrusion on the inner tube 120 is an inner tube convex ring 121, and the inner tube convex ring 121 is sleeved on the outer side wall of the inner tube 120.
The embodiment also provides a thrombus removal method applied to the thrombus removal system, which comprises the following steps:
the method comprises the following steps: a puncture is made at the target site and a puncture hole is created and an embolectomy system is advanced through the puncture hole to the embolic site of blood vessel 910, with distal protection device 200 placed distal to the embolic site, through embolus 920.
Step two: the guiding catheter 500 is withdrawn, releasing the distal protection device 200, and the distal protection device 200 is gradually deployed until it conforms to the inner wall of the blood vessel 910.
Step three: the guide catheter 500 is withdrawn after the guide wire 300 and the guide catheter 500 are used to guide the embolectomy device 100 through the embolus 920, and the embolectomy device 100 is released, so that the embolectomy device 100 is gradually expanded until the embolus 920 is completely wrapped by the embolus removing bracket 110.
Step four: guide catheter 500 is withdrawn from blood vessel 910.
Step five: after the embolectomy support 110 is sufficiently engaged with the embolus 920, the embolectomy device 100 and the embolus 920 located in the embolectomy device 100 are withdrawn into the embolus-sucking catheter 600.
Step six: the distal protective device 200 and the embolic debris 921 located in the distal protective device 200 are withdrawn into the thrombus catheter 600, withdrawing the thrombus catheter 600 out of the blood vessel 910.
The thrombus removal method successfully completes the expansion action of the thrombus removal system by positioning and expanding the far-end protection device 200, positioning the thrombus removal device 100 by the guide wire 300 and finally expanding the thrombus removal device 100; the planning of the above process is simple and accurate, the flexibility of positioning the embolectomy device 100 and the far-end protection device 200 is guaranteed by utilizing split design, and the positioning time of the embolectomy device 100 and the far-end protection device 200 is effectively shortened, so that the embolectomy operation can be smoothly and efficiently completed. The method has the advantages of wide application range, simplicity and convenience in operation and low workload, effectively simplifies the process of embolectomy operation, reduces the risk of embolectomy misoperation, improves embolectomy effect, reduces the risk of residue of embolus fragments 921, and ensures the personal safety of patients.
After deployment in the vessel 910, the thrombectomy stent 110 gradually expands with increasing temperature, binding with the embolus 920. If an embolectomy procedure does not completely remove embolus 920, embolectomy device 100 may be re-deployed for retrieval until embolus 920 is completely removed.
As shown in fig. 16, in another embodiment of this embodiment, the guide member includes an inner rod 150 and a guide wire 300, one end of the inner rod 150 near the distal end protection device 200 is fixedly connected with an inner rod tip 160, the guide wire 300 passes through the inner rod 150 and the inner rod tip 160, and both the first connection ring 140 and the third connection ring 230 are sleeved on the inner rod 150.
Specifically, the limiting protrusion on the inner rod 150 is an inner rod convex ring, and the inner rod convex ring is sleeved on the outer side wall of the inner rod 150.
The embodiment also provides another embolectomy method, which is applied to the embolectomy system and comprises the following steps:
the method comprises the following steps: the puncture is made at the target site and a puncture hole is formed, the embolectomy system is passed through the puncture hole into the embolus site of the blood vessel 910, the guide wire 300 and the inner rod 150 are passed through the embolus 920 in sequence, and the distal end protection device 200 is placed at the distal end of the embolus site.
Step two: the guiding catheter 500 is withdrawn, the distal protection device 200 and the embolectomy device 100 are released, the distal protection device 200 is gradually expanded until the distal protection device is attached to the inner wall of the blood vessel 910, and the embolectomy device 100 is gradually expanded until the embolectomy stent 110 completely covers the embolus 920.
Step three: guide catheter 500 is withdrawn from blood vessel 910.
Step four: after the thrombus taking support 110 is fully combined with the thrombus 920, the pushing rod 400 is retracted towards the thrombus guiding tube 600, the thrombus taking device 100 and the distal end protection device 200 are successively collected in the thrombus guiding tube 600, and the thrombus 920 in the thrombus taking device 100 and the thrombus debris 921 in the distal end protection device 200 are collected in the thrombus guiding tube 600.
Step five: the thrombus catheter 600 is withdrawn from the blood vessel 910.
According to the thrombus removal method, the inner rod 150 is positioned by using the guide wire 300, the distal end protection device 200 and the thrombus removal device 100 are positioned, and the distal end protection device 200 and the thrombus removal device 100 are unfolded to complete the unfolding action of the thrombus removal system, so that the unfolding action of the thrombus removal system can be smoothly completed by the above process; the embolectomy method also ensures that the embolectomy operation can be smoothly and efficiently finished.
It should be understood that the above-described embodiments of the present invention are merely examples for clearly illustrating the present invention, and are not intended to limit the embodiments of the present invention. Other variations and modifications will be apparent to persons skilled in the art in light of the above description. And are neither required nor exhaustive of all embodiments. Any modification, equivalent replacement, and improvement made within the spirit and principle of the present invention should be included in the protection scope of the claims of the present invention.

Claims (10)

1. An embolectomy device capable of being placed within a blood vessel (910), comprising:
a guide extending along a length of the blood vessel (910);
the bolt taking module comprises a bolt taking support (110) and a first connecting ring (140), the bolt taking support (110) is sleeved on the guide piece and comprises a support extending end (111), a support catching net (112) and a support restraining end (113) which are connected end to end, the support restraining end (113) is fixedly connected to the first connecting ring (140), and the first connecting ring (140) is sleeved on the guide piece;
the support catching net (112) forms parallelogram grids which are distributed spirally around the axis of the guide piece, and the support catching net (112) can drive the first connecting ring (140) to rotate around the axis of the guide piece.
2. The embolectomy device of claim 1, wherein one of the first connecting rings (140) and the associated one of the embolectomy supports (110) are provided as a set of embolectomy devices, at least one of which is provided.
3. The embolectomy device of claim 2, wherein there are two embolectomy devices, and the parallelogram meshes on the two embolectomy supports (110) are helical about the axis of the guide in opposite directions, so that the rotation directions of the two embolectomy devices are opposite.
4. The embolectomy device of claim 1, wherein the outer peripheral wall of the guide member is convexly provided with a limiting protrusion, and when the embolectomy support (110) is displaced relative to the guide member, the first connecting ring (140) is stopped by the first connecting ring (140) and abuts against the limiting protrusion.
5. The embolectomy device of claim 1, wherein the parallelogram grid has long sides and short sides, the ratio of the length of the long sides to the length of the short sides is greater than a proportional threshold, and the included angle between the long sides and the short sides is within an angular threshold range.
6. The embolectomy device of claim 5, wherein the ratio threshold is 1.1 and the angular threshold ranges from 60 ° to 120 °.
7. The embolectomy device of claim 1, wherein a second connection ring (170) is fixed to the stent expansion end (111), and the second connection ring (170) is sleeved on the guiding member and can move along the length direction of the blood vessel (910).
8. The embolectomy device of claim 1, wherein the first connecting ring (140) comprises a first inner ring (141), a middle ring (142) and a first outer ring (143) which are sequentially sleeved from inside to outside, the middle ring (142) is penetrated with an insertion port, and the insertion port is communicated with an end face of the middle ring (142); the insertion port, the first inner ring (141) and the first outer ring (143) form an insertion groove (144), and the support bundling end (113) is inserted into the insertion groove (144).
9. An embolectomy system, comprising a distal end protection device (200) and the embolectomy device of any of claims 1-8, wherein the distal end protection device (200) comprises a braided wire (220) and a device skeleton (210) sleeved on the guide member, one end of the device skeleton (210) is connected with a filter screen formed by the braided wire (220), and an opening of the distal end protection device (200) is opposite to an opening of the embolectomy support (110).
10. The embolectomy system of claim 9, further comprising a pushing rod (400), a guiding catheter (500) and a thrombus absorbing catheter (600) which are sequentially sleeved from inside to outside, wherein the embolectomy device and the distal protection device (200) can be retracted in the guiding catheter (500), one end of the guiding element, which is far away from the distal protection device (200), is fixedly connected to the pushing rod (400), and the thrombus absorbing catheter (600) is used for recovering emboli (920), the distal protection device (200) and the embolectomy device (100).
CN202210824222.XA 2022-07-13 Bolt taking device and bolt taking system Active CN115120305B (en)

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Application Number Priority Date Filing Date Title
CN202210824222.XA CN115120305B (en) 2022-07-13 Bolt taking device and bolt taking system

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CN115120305B CN115120305B (en) 2024-04-30

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