CN115869510A - Conveying sheath pipe and conveying system for interventional therapy of structural heart disease - Google Patents

Conveying sheath pipe and conveying system for interventional therapy of structural heart disease Download PDF

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Publication number
CN115869510A
CN115869510A CN202211503040.9A CN202211503040A CN115869510A CN 115869510 A CN115869510 A CN 115869510A CN 202211503040 A CN202211503040 A CN 202211503040A CN 115869510 A CN115869510 A CN 115869510A
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CN
China
Prior art keywords
section
sheath
main body
delivery sheath
delivery
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
CN202211503040.9A
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Chinese (zh)
Inventor
肖相龙
周志勇
李龙斌
黄亨明
徐军
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Suzhou Huihe Medical Technology Co ltd
Shanghai Huihe Healthcare Technology Co Ltd
Original Assignee
Suzhou Huihe Medical Technology Co ltd
Shanghai Huihe Healthcare Technology Co Ltd
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Application filed by Suzhou Huihe Medical Technology Co ltd, Shanghai Huihe Healthcare Technology Co Ltd filed Critical Suzhou Huihe Medical Technology Co ltd
Priority to CN202211503040.9A priority Critical patent/CN115869510A/en
Publication of CN115869510A publication Critical patent/CN115869510A/en
Pending legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/0021Catheters; Hollow probes characterised by the form of the tubing
    • A61M25/0023Catheters; Hollow probes characterised by the form of the tubing by the form of the lumen, e.g. cross-section, variable diameter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0102Insertion or introduction using an inner stiffening member, e.g. stylet or push-rod
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133Tip steering devices
    • A61M25/0136Handles therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0133Tip steering devices
    • A61M25/0141Tip steering devices having flexible regions as a result of using materials with different mechanical properties
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00Anatomical parts of the body
    • A61M2210/12Blood circulatory system
    • A61M2210/125Heart

Abstract

The invention relates to a conveying sheath and a conveying system for interventional therapy of structural heart disease, wherein the conveying sheath comprises: an implant sheath, a delivery sheath, and a catheter sheath; the implant sheath comprises a first main body section and a first bendable section; the delivery sheath comprises a second main body section and a second bendable section; the outer wall of the first bendable section is provided with a first convex part, and the outer wall of the second bendable section is provided with a second convex part. After the sheath tube is bent, when the delivery sheath is pushed, pulled or rotated or implanted, the force storage of the delivery sheath in the catheter sheath can be reduced, the resistance of the implanted sheath in the delivery sheath is reduced, the force value and torque transmission from the near end to the far end during the pushing, pulling and rotating of the sheath tube is improved, the bending change of the delivery sheath and the redundant deflection of the implanted device driven by the stored force are reduced, and the accuracy of the implanted device in the heart are further improved.

Description

Conveying sheath pipe and conveying system for interventional therapy of structural heart disease
The invention relates to a separate application of a conveying sheath and a conveying system for interventional therapy of structural heart disease, which has the application date of 2022, 9 and 19 and the application number of 2022111337136.
Technical Field
The invention belongs to the technical field of medical instruments, and particularly relates to a conveying sheath and a conveying system for interventional therapy of structural heart diseases.
Background
For structural heart diseases such as valve regurgitation, congenital defects and the like, the traditional treatment mode is a surgical chest-opening operation, but the chest-opening operation has the defects of long operation time, large wound to a patient and slow recovery, and the intervention treatment is mainstream due to quick operation, small wound and quick recovery. The main mode of intervention treatment is that after femoral and cervical artery/vein puncture, a sheath tube is sent into the heart to establish a delivery channel from the outside to the inside of the body, and an implantation instrument (such as an occluder, a clamping device, a valve repair instrument, a valve replacement instrument, a radio frequency ablation instrument, a stent, a saccule, a vascular plug, a filter and the like) can be delivered to a diseased part or recovered through the delivery channel.
In the spiral three-dimensional four-cavity structure of the heart, the precise positioning of the implantation instrument needs the combination of degrees of freedom in multiple directions, thereby putting high requirements on the delivery system of the heart. The conveying system for structural heart disease usually includes three layers of sheaths, namely an outer catheter sheath, a middle conveying sheath and an inner implantation sheath, the proximal ends of the three layers of sheaths are respectively provided with a handle for independently controlling and adjusting the movement of the head end of the sheath, and an implantation instrument is connected to the head end of the implantation sheath. Specific degrees of freedom may include: the catheter sheath can be bent in a plane mode, such as a puncture interatrial septum establishing channel; the conveying sheath can be independently bent in a plane mode after extending out of the catheter sheath, the length of the conveying sheath extending out of the catheter sheath can be adjusted, and the two plane bends can be combined in different bending radius and degree modes. Meanwhile, the conveying sheath can rotate in the catheter sheath, so that the two planes can be bent and twisted to form different space bending types. The implantation instrument can be pointed to the focus position, for example, the valve ring clamp is pointed to the P3 position of the posterior valve of the mitral valve by the bending adjustment of the catheter sheath and the push-pull, rotation and bending adjustment of the delivery sheath in the catheter sheath; the implantation sheath can be pushed and pulled and rotated in the delivery sheath, and the relative distance between the implantation instrument and a lesion can be controlled by pushing and pulling the implantation sheath, such as the position of the valve ring clamp close to or far away from a posterior valve P3 of a mitral valve, but the orientation of the valve ring clamp is kept unchanged. Rotating the implant sheath may control the rotation of the implant instrument, such as adjusting the plane in which the valve ring clip opens to coincide with the plane of the valve annulus. The implantation instrument can be accurately delivered to the focus position and accurately clamped or released by combining a series of freedom degrees of the delivery system and adjusting.
When the bending of the conveying system is adjusted, a part of bending type of the conveying sheath is arranged in the bending type of the catheter sheath and tightly presses the inner wall of the catheter sheath on the inner side of the bending type of the catheter sheath, so that part of shape interference and large internal friction force exist between the conveying sheath and the catheter sheath, the conveying sheath is enabled to push and rotate in the catheter sheath with large resistance, and particularly when the conveying sheath rotates to form a space bending, the bending type of the conveying sheath can drive the bending type of the catheter sheath to synchronously rotate to a certain extent, so that the in-place performance of an implantation instrument is influenced, meanwhile, torque transmission is difficult to transmit from the near end to the far end of the sheath tube, and the head end needs the near end conveying sheath to rotate to a large angle for storing force when a certain space included angle is formed at the head end. A part of the passive bending of the implantation sheath is tightly pressed on the inner wall of the delivery sheath outside the bending type of the delivery sheath in the delivery sheath, so that a large internal friction force exists between the implantation sheath and the delivery sheath, and the implantation sheath has large pushing and rotating resistance in the delivery sheath. The main expression is that when the implantation sheath is pushed and pulled, the bending shape of the head end of the delivery sheath is changed to change the orientation of the implantation instrument, so that the bending needs to be adjusted and positioned again, the operation time is prolonged, and the working strength of a doctor is increased; when the implantation sheath is rotated, torque is difficult to transfer from the proximal end to the distal end of the implantation sheath, the rotation angle of a handle of the proximal implantation sheath is far larger than that of an implantation instrument, and internal stored force is mainly concentrated on a bending section of the delivery sheath. When the angle of the implantation instrument is adjusted by rotating the implantation sheath, a part of internal accumulated force is released in the process of pushing and pulling the implantation sheath, so that the angle of the implantation instrument is continuously deflected, and the angle of the implantation instrument needs to be adjusted again. These problems can bring trouble to doctors, and the bending control, push-pull and rotation need to be adjusted continuously, so that the operation time is prolonged.
In order to reduce the mutual interference among the three layers of sheath tubes during bending of the conveying system in the prior art, the clearance among the three layers of sheath tubes is increased for some conveying systems, so that the range of mutual movement among the sheath tubes of each layer is increased, and the purpose of reducing the matching resistance is achieved. However, this solution has the disadvantage that: after the large gaps are overlapped layer by layer, the outer diameter of the catheter sheath is far larger than that of a common catheter sheath, so that the trafficability of the catheter sheath in a blood vessel is lost, and the injury to the blood vessel is increased. Still some conveying systems set up hydrophilic coating through the surface at each layer sheath pipe to reduce the coefficient of friction between each layer sheath pipe, thereby promote sheath pipe push-and-pull and twist reverse performance. Although the increase of the hydrophilic coating can reduce the friction coefficient between the sheath tubes of each layer to a certain extent, the increase of the hydrophilic coating also brings the risk of coating falling off, thereby possibly causing complications such as stroke.
Disclosure of Invention
One technical problem to be solved by the present invention is to provide a delivery sheath capable of reducing mutual interference between three layers of sheaths without increasing the outer diameter of the catheter sheath and other possible risks.
Another technical problem to be solved by the present invention is to provide a delivery system comprising the above-mentioned delivery sheath.
In order to achieve the purpose, the invention adopts the technical scheme that:
the present invention provides, in one aspect, a delivery sheath for interventional therapy of structural heart disease, the delivery sheath comprising:
an implant sheath comprising a first body segment at a proximal end, a first bendable segment at a distal end and capable of bending deformation; a delivery sheath, which comprises a second main body section at the proximal end part and a second bendable section at the distal end part and can be bent and deformed, and the delivery sheath can be movably sleeved outside the implantation sheath;
the catheter sheath comprises a third main body section and a third bendable section which is connected with the distal end of the third main body section and can be bent and deformed, and the catheter sheath can be movably sleeved outside the delivery sheath;
wherein the implant sheath further comprises a first variable diameter section connected between the distal end of the first body section and the proximal end of the first bendable section, the first variable diameter section having a distal outer diameter smaller than a proximal outer diameter thereof, the first bendable section having an outer diameter smaller than the first body section outer diameter; the delivery sheath further comprises a second variable diameter section connected between the distal end of the second body section and the proximal end of the second bendable section, the distal end of the second variable diameter section having an outer diameter smaller than the outer diameter of the proximal end thereof, the second bendable section having an outer diameter smaller than the outer diameter of the second body section;
and/or the implant sheath further comprises a plurality of first protrusions disposed on an outer wall of the first bendable section and protruding outwardly, and the delivery sheath further comprises a plurality of second protrusions disposed on an outer wall of the second bendable section and protruding outwardly.
According to some specific and preferred embodiments, the first bendable section has an outer diameter equal to the outer diameter of the distal end of the first variable diameter section, and the first body section has an outer diameter equal to the outer diameter of the proximal end of the first variable diameter section; the second bendable section has an outer diameter equal to an outer diameter of the distal end of the second variable diameter section, and the second body section has an outer diameter equal to an outer diameter of the proximal end of the second variable diameter section.
According to some specific and preferred embodiments, the first tapered section has an outer diameter that gradually decreases from the proximal end to the distal end, and the second tapered section has an outer diameter that gradually decreases from the proximal end to the distal end.
According to some specific and preferred embodiments, the length of the first variable diameter section is between 5mm and 30mm, and the length of the second variable diameter section is between 5mm and 30mm.
According to some specific and preferred embodiments, the outer diameter of the first body section is 85% to 99% of the inner diameter of the delivery sheath, and the outer diameter of the first bendable section is 70% to 95% of the inner diameter of the delivery sheath; the outer diameter of the second main body section is 90-99% of the inner diameter of the catheter sheath, and the outer diameter of the second bendable section is 70-95% of the inner diameter of the catheter sheath.
According to some specific and preferred embodiments, the first body section has a wall thickness greater than a wall thickness of the first bendable section, and the second body section has a wall thickness greater than a wall thickness of the second bendable section.
According to some specific and preferred embodiments, the implantation sheaths have equal inner diameters, the delivery sheaths have equal inner diameters, and the catheter sheaths have equal inner diameters.
According to some specific and preferred embodiments, said first and second projections are both circumferential projections.
More preferably, the outer diameter of the first convex part is 85% to 99% of the inner diameter of the delivery sheath, and the outer diameter of the first main body section and the outer diameter of the first bendable section are equal and 70% to 95% of the inner diameter of the delivery sheath; the outer diameter of the second convex part is 90-99% of the inner diameter of the catheter sheath, and the outer diameter of the second main body section is equal to the outer diameter of the second bendable section and is 70-95% of the inner diameter of the catheter sheath.
More preferably, the outer diameter of the first convex part is 85% to 99% of the inner diameter of the delivery sheath, the outer diameter of the first main body section is 85% to 99% of the inner diameter of the delivery sheath, and the outer diameter of the first bendable section is 70% to 95% of the inner diameter of the delivery sheath; the outer diameter of the second convex part is 90-99% of the inner diameter of the catheter sheath, the outer diameter of the second main body section is 90-99% of the inner diameter of the catheter sheath, and the outer diameter of the second bendable section is 70-95% of the inner diameter of the catheter sheath.
According to some specific and preferred embodiments, a plurality of said first protrusions are distributed along an axial spacing of said first bendable section and a plurality of said second protrusions are distributed along an axial spacing of said second bendable section.
According to some specific and preferred embodiments, the outer wall of the first body segment is also provided with a plurality of first protrusions distributed at intervals along the axial direction of the first body segment, and the outer wall of the second body segment is also provided with a plurality of second protrusions distributed at intervals along the axial direction of the second body segment.
More preferably, the number of the first protrusions on the first body segment is 3-20, wherein when the implantation sheath is extended out of the delivery sheath to the most distal state, one first protrusion is provided on each of the first body segment at the proximal end of the second body segment and the distal end of the first body segment; the number of the second protrusions on the second body segment is 3 to 20, wherein when the delivery sheath is extended out of the catheter sheath to the farthest state, one second protrusion is provided on each of the second body segment at the proximal end of the third body segment and the distal end of the second body segment.
According to some specific and preferred embodiments, the first bendable section comprises a flexible section at a distal end, a first transition section distally connected to a proximal end of the flexible section; the first main section has a hardness greater than the first transition section has a hardness greater than the flexible section; or, the first bendable section comprises a flexible section at a distal end, a proximal end of the flexible section being connected to a distal end of the first variable diameter section, and the first body section has a hardness greater than that of the flexible section;
the second bendable section comprises a first bending section positioned at the distal end part and a second transition section of which the distal end is connected with the proximal end of the first bending section; the hardness of the second main body section is greater than that of the second transition section and is greater than that of the first bend-adjusting section;
the third bendable section comprises a second bending section positioned at the distal end part and a third transition section of which the distal end is connected with the proximal end of the second bending section; the hardness of the third main body section is greater than that of the third transition section and is greater than that of the second bending section; the length of the flexible section is not shorter than the total length of the first turning section and the second transition section, and the length of the second transition section is not shorter than the total length of the second turning section and the third transition section.
More preferably, the length of the flexible section is 0cm to 8cm longer than the total length of the first bending section and the second transition section; the length of the second transition section is 0 cm-5 cm longer than the total length of the second bending adjusting section and the third transition section.
More preferably, 2 to 8 first convex parts are arranged on the flexible section, wherein when the implantation sheath extends out of the delivery sheath to the farthest state, 1 first convex part is arranged on the flexible section at the far end of the first bending section; the second transition section is provided with 2-6 second convex parts, wherein when the delivery sheath extends out of the catheter sheath to the farthest state, 1 second convex part is arranged on the second transition section at the far end of the second bending adjusting section.
According to some specific and preferred embodiments, two end faces of the first convex portion and the second convex portion in the axial direction are rounded arc faces.
A second aspect of the present invention provides a delivery system comprising the above-mentioned delivery sheath, a first operating handle mounted on a proximal end of an implantation sheath of the delivery sheath, a second operating handle mounted on a proximal end of a delivery sheath of the delivery sheath, and a third operating handle mounted on a proximal end of a catheter sheath of the delivery sheath.
Due to the application of the technical scheme, compared with the prior art, the invention has the following advantages:
by improving the structure of the conveying sheath tube, the invention can reduce the force storage of the conveying sheath in the catheter sheath and the resistance of the implanted sheath in the conveying sheath when the conveying sheath tube is pushed, pulled or rotated or implanted after the conveying sheath tube is bent, improve the force value and torque transmission from the near end to the far end when the sheath tube is pushed, pulled and rotated, and reduce the bending change of the conveying sheath and the redundant deflection of the implanted instrument driven by the stored force, thereby further improving the accuracy and the in-place performance of the implanted instrument in the heart and reducing the influence on the functionality of the instrument.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present application, the drawings needed to be used in the description of the embodiments are briefly introduced below, and it is obvious that the drawings in the following description are only some embodiments of the present application, and it is obvious for those skilled in the art to obtain other drawings without creative efforts.
FIG. 1 is a schematic view of a mating structure of a conveying system without bend adjustment according to an embodiment of the present invention;
FIG. 2 is a schematic view of a conveying system according to an embodiment of the present invention in a planar curved configuration;
FIG. 3 is a schematic view of a conveying system according to an embodiment of the present invention forming a space-bending type structure;
FIG. 4 is a schematic view of the delivery system of an embodiment of the present invention with the binder in an open position;
FIG. 5 is an enlarged view of a portion of FIG. 1;
FIG. 6 is an enlarged view of a portion of FIG. 2;
FIG. 7 is an enlarged view of a portion of FIG. 3;
FIG. 8 is an enlarged view of a portion of FIG. 4;
FIG. 9 is a schematic view of the clamp of FIG. 8 after being rotated by a certain angle;
FIG. 10 is a schematic view of the delivery system of an embodiment of the present invention shown deployed into the heart;
FIG. 11 is a schematic view of the delivery system of the present invention after entry into the heart and release of the clip;
FIG. 12 is a schematic view of a curved catheter sheath according to an embodiment of the present invention;
FIG. 13 is a schematic view of the delivery system of an embodiment of the present invention in a flat curved configuration with the implant sheath partially extended and the delivery sheath extended to a distal-most configuration;
fig. 14 is a sectional view of the delivery sheath of example 1;
FIG. 15 is an enlarged view of a portion of FIG. 14;
fig. 16 is a sectional view of the delivery sheath of example 2;
FIG. 17 is an enlarged view of a portion of FIG. 16;
fig. 18 is a sectional view of the delivery sheath of example 3;
FIG. 19 is an enlarged view of a portion of FIG. 18;
wherein, 1, implanting a sheath; 2. a delivery sheath; 3. a catheter sheath; 4. a first operating handle; 5. a second operating handle; 6. a third operating handle; 7. a clamp; 8. a pull wire; 11. a first body segment; 12. a first bendable section; 121. a flexible section; 122. a first transition section; 13. a first variable diameter section; 14. a first convex portion; 21. a second body segment; 22. a second bendable section; 221. a first bend adjusting section; 222. a second transition section; 23. a second variable diameter section; 24. a second convex portion; 31. a third body segment; 32. a third bendable section; 321. a second bend adjusting section; 322. and a third transition section.
Detailed Description
In the following, only certain exemplary embodiments are briefly described. As those skilled in the art will recognize, the described embodiments may be modified in various different ways, all without departing from the spirit or scope of the embodiments of the invention. Accordingly, the drawings and description are to be regarded as illustrative in nature, and not as restrictive.
In the description of the present application, it is to be understood that distal refers to the end of the instrument or component that is distal from the operator, and proximal refers to the end of the instrument or component that is proximal to the operator; axial refers to a direction parallel to the line joining the distal and proximal centers of the device or component, radial refers to a direction perpendicular to the axial direction, and circumferential or circumferential refers to a direction around the axial direction; inner and outer are positions defined relative to the distance of the center of the instrument or component, where inner is a position near the center of the instrument or component and outer is a position away from the center of the instrument or component. The foregoing directional terms are used merely to facilitate description of the embodiments and to simplify description, and are not intended to indicate or imply that the referenced device or element must have a particular orientation, be constructed and operated in a particular orientation, and are therefore not to be considered limiting of the embodiments.
Furthermore, the terms "first", "second" and "first" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defined as "first" or "second" may explicitly or implicitly include one or more of that feature. In the description of the embodiments of the present invention, "a plurality" means two or more unless specifically limited otherwise.
In this application, unless expressly stated or limited otherwise, the terms "mounted," "connected," "secured," and the like are to be construed broadly and encompass, for example, both fixed and removable connections or integral parts thereof; either directly or indirectly through intervening media, either internally or in any other relationship. Specific meanings of the above terms in the embodiments of the present invention can be understood by those of ordinary skill in the art according to specific situations.
The following disclosure provides many different embodiments or examples for implementing different configurations of embodiments of the invention. To simplify the disclosure of embodiments of the invention, the components and arrangements of specific examples are described below. Of course, they are merely examples and are not intended to limit embodiments of the present invention. Furthermore, embodiments of the present invention may repeat reference numerals and/or letters in the various examples, such repetition is for the purpose of simplicity and clarity and does not in itself dictate a relationship between the various embodiments and/or configurations discussed.
Embodiments of the present invention will be described in detail below with reference to the accompanying drawings.
Referring to fig. 1-11, the present application provides a delivery system including a delivery sheath and a handle. The conveying sheath tube comprises an implantation sheath 1, a conveying sheath 2 which can be movably sleeved outside the implantation sheath 1 and a catheter sheath 3 which can be movably sleeved outside the conveying sheath 2. The handle comprises a first operating handle 4 mounted at the proximal end of the implantation sheath 1, a second operating handle 5 mounted at the proximal end of the delivery sheath 2, and a third operating handle 6 mounted at the proximal end of the catheter sheath 3. An implantation instrument, such as a clip 7, is releasably attached to the distal end of the implantation sheath 1.
Wherein, the catheter sheath 3 and the delivery sheath 2 are adjustable bending sheaths, and the bending direction and the bending degree of the distal end of the delivery sheath 2 and the distal end of the catheter sheath 3 can be controlled by operating the second operating handle 5 and the third operating handle 6 respectively. The implantation sheath 1 is an unadjustable bending sheath, but can be bent passively, namely the implantation sheath 1 cannot adjust the bending direction and the bending angle of the distal end of the implantation sheath 1 through the first operating handle 4, but the distal end of the implantation sheath 1 can be bent along with the bending of the delivery sheath 2.
As shown in fig. 13, the implantation sheath 1 includes a first main body segment 11 at a proximal end portion, a first bendable segment 12 at a distal end portion and capable of bending deformation; wherein the first bendable segment 12 includes a flexible segment 121 at a distal end portion, and a first transition segment 122 connected at a distal end to a proximal end of the flexible segment 121. The hardness of the first body section 11 is greater than the hardness of the first transition section 122 than the hardness of the flexible section 121. The realization is controlled through first operating handle 4 and is implanted the handle of the action such as the push-and-pull of apparatus, rotation, open and shut, release and implant the structure of sheath 1, is not the focus of this application, and the structure that realizes this function adopts current structure can, and here is no longer repeated.
As shown in fig. 13, the delivery sheath 2 comprises a second main body segment 21 at the proximal end, a second bendable segment 22 at the distal end and capable of bending deformation; wherein the second bendable section 22 comprises a first bending section 221 at the distal end portion, and a second transition section 222 at the distal end portion connected to the proximal end of the first bending section 221. The second main body section 21 has a hardness greater than that of the second transition section 222 than that of the first bending adjustment section 221, so that when the second bendable section 22 is controlled to bend by operating the second operating handle 5, the second main body section 21 slightly bends, the second transition section 222 bends to a certain extent, and the first bending adjustment section 221 bends significantly. The structure for controlling the bending degree of the distal end of the delivery sheath 2 by the second operating handle 5 is not the focus of the present application, and the structure for realizing the function may be an existing structure, for example, the distal end of the delivery sheath 2 is bent by the pull wire 8 connected to the distal end of the delivery sheath 2 and the second operating handle 5.
As shown in fig. 12 and 13, the catheter sheath 3 includes a third main body section 31, a third bendable section 32 connected to a distal end of the third main body section 31 and capable of bending deformation; wherein the third bendable section 32 comprises a second bendable section 321 at a distal end portion, and a third transition section 322 having a distal end connected to a proximal end of the second bendable section 321. The hardness of the third main body section 31 is greater than that of the third transition section 322 than that of the second bending adjustment section 321, so that when the third bendable section 32 is controlled to bend by operating the third operating handle 6, the third main body section 31 slightly bends, the third transition section 322 bends to a certain extent, and the second bending adjustment section 321 bends to a significant extent. The structure for controlling the bending degree of the distal end of the catheter sheath 3 by the third operating handle 6 is not the focus of the present application, and the structure for realizing the function can be an existing structure, for example, the distal end of the catheter sheath 3 is bent by the pull wire 8 connected to the distal end of the catheter sheath 3 and the third operating handle 6.
In the present application, each segment of the sheath is set to different hardness, and conventional techniques in the field can be adopted, which is not described herein again.
The third operating handle 6 in this application is a solitary handle, and first operating handle 4 and second operating handle 5 can be two solitary handles, also can be a handle that the collection dress is as an organic whole. In the treatment of the delivery system, the second operating handle 5 is positioned at the proximal end of the third operating handle 6 and at the distal end of the first operating handle 4, the delivery sheath 2 extends from the distal end of the catheter sheath 3, the implantation sheath 1 extends from the distal end of the delivery sheath 2, and the implantation instrument is connected at the distal end of the implantation sheath 1, as shown in fig. 1 and 2. When the delivery system is used in a heart cavity combination mode, the catheter sheath 3 is delivered to a designated position, and then small-amplitude bending control is carried out on the catheter sheath 3 through the third operating handle 6; the assembled delivery sheath 2 and the implantation sheath 1 are conveyed to a designated position along the inner cavity of the catheter sheath 3, and during the conveying process, the operations of bending control, rotation and the like are simultaneously carried out to complete the placement of the implantation instrument. Fig. 3 and 4 show that the catheter sheath 3 and the delivery sheath 2 are formed in a planar bending shape by operating the second operating handle 5 and the third operating handle 6. Fig. 5 and 6 show that the catheter sheath 3 and the delivery sheath 2 jointly form a spatial bending type by operating the second operating handle 5 and rotating the second operating handle 5 and operating the third operating handle 6, namely, the planar bending type formed by the catheter sheath 3 and the planar bending type formed by the delivery sheath 2 are not on the same plane. Fig. 7 and 8 show that the folder 7 is opened by operating the first operating handle 4, and fig. 9 shows that the folder 7 is rotated by rotating the first operating handle 4. Fig. 10 shows a schematic view of the location of a delivery sheath entering the right atrium from the inferior vena cava and passing to the left atrium to repair the mitral valve, and fig. 11 shows a schematic view after release of the clip 7.
Specifically, as shown in fig. 13, the length of the flexible section 121 is not shorter than the total length of the first bending section 221 and the second transition section 222, and preferably, when the implantation sheath 1 extends out of the delivery sheath 2 to the most distal state, part of the flexible section 121 is located in the second main body section 21. According to some specific and preferred embodiments, the length of the flexible section 121 is 0cm to 8cm longer than the total length of the first turning section 221 and the second transition section 222. The first bend-adjusting section 221 can partially or completely extend out of the second bend-adjusting section 321, as desired. The length of the second transition section 222 is not shorter than the total length of the second turning section 321 and the third transition section 322, and preferably, when the delivery sheath 2 extends out of the catheter sheath 3 to the farthest state, part of the second transition section 222 is located in the third main body section 31. According to some specific and preferred embodiments, the length of the second transition section 222 is 0cm to 5cm longer than the total length of the second bend section 321 and the third transition section 322. The arrangement of the lengths of the sections can facilitate the conveying system to achieve all the degrees of freedom required by operation.
When the conveying system is used for controlling bending in a combined mode, the catheter sheath 3 and the conveying sheath 2 are used for actively controlling bending, the implanted sheath 1 is used for controlling bending passively, and the bending control strength or the bending control angle of the conveying sheath 2 is larger than that of the catheter sheath 3, so that the inner side of the bending type of the conveying sheath 2 can be tightly attached to the inner cavity of the catheter sheath 3 on the inner side of the bending type of the catheter sheath 3 in the bending control process of the conveying system, and larger pressure is generated; the outside of the curve of the implantation sheath 1 will abut against the lumen of the delivery sheath 2 outside the curve of the delivery sheath 2 and generate a large pressure. The huge pressure generated when the three-layer sheath controls the bending leads to that the three-layer sheath necessarily generates larger friction force when mutually pushing and pulling or rotating, which is the source of the internal stored force of the conveying system and influences the bending control in-place performance of the conveying system and the control performance of the action of the implantation instrument to a great extent.
In order to solve the above problems, the present application will now be described in detail by taking three embodiments as examples, wherein the implant sheath 1 and the delivery sheath 2 of the present application are structurally modified, and the catheter sheath 3 may be a conventional sheath, such as a catheter sheath 3 with an inner diameter of 5.0-7.0 mm and an outer diameter of 6.0-8.5 mm.
The specific structure of embodiment 1 is shown in fig. 14 and 15.
In this embodiment, the implant sheath 1 further comprises a first variable diameter section 13 connected between the distal end of the first body section 11 and the proximal end of the first bendable section 12. The distal end of the first variable diameter section 13 has an outer diameter smaller than that of the proximal end thereof, and the first bendable section 12 has an outer diameter smaller than that of the first main body section 11. Preferably, the first bendable section 12 has an outer diameter equal to the outer diameter of the distal end of the first variable diameter section 13, and the first body section 11 has an outer diameter equal to the outer diameter of the proximal end of the first variable diameter section 13. Preferably, the outer diameter of the first variable diameter section 13 is gradually reduced from the proximal end to the distal end, so that the outer wall of the first variable diameter section 13 is a rounded conical surface. More preferably, the length of the first variable diameter section 13 is 5 mm-30 mm, so that the ineffective distance is reduced as much as possible, the adherence area of the implantation sheath 1 and the delivery sheath 2 is reduced when the implantation sheath 1 is bent, and the first variable diameter section 13 is prevented from being bent due to stress concentration.
In this embodiment, the delivery sheath 2 further comprises a second variable diameter section 23 connected between the distal end of the second body section 21 and the proximal end of the second bendable section 22. The distal end of the second variable diameter section 23 has an outer diameter smaller than that of the proximal end thereof, and the second bendable section 22 has an outer diameter smaller than that of the second main body section 21. Preferably, the second bendable section 22 has an outer diameter equal to the outer diameter of the distal end of the second variable diameter section 23, and the second body section 21 has an outer diameter equal to the outer diameter of the proximal end of the second variable diameter section 23. Preferably, the outer diameter of the second variable diameter section 23 is gradually reduced from the proximal end to the distal end, so that the outer wall of the second variable diameter section 23 is a rounded conical surface. More preferably, the length of the second variable diameter section 23 is 5mm to 30mm, so that the ineffective distance is reduced as much as possible, the adhering area of the delivery sheath 2 and the catheter sheath 3 when the delivery sheath 2 is bent is reduced, and the phenomenon that the delivery sheath 2 is bent due to stress concentration at the second variable diameter section 23 is avoided.
The first variable diameter section 13 has a hardness smaller than that of the first main body section 11 and greater than that of the first transition section 122, and the second variable diameter section 23 has a hardness smaller than that of the second main body section 21 and greater than that of the second transition section 222.
According to another embodiment, not shown, the first variable diameter section 13 is a first transition section 122. That is, the first bendable section 12 includes a flexible section 121 at a distal end portion, a proximal end of the flexible section 121 is connected to a distal end of the first variable diameter section 13, and the first body section 11 has a hardness greater than that of the flexible section 121.
The stiffness of the first reducer section 13 is gradually reduced from the first body section 11 toward the flexible section 121.
Although the outer diameter of each section of the implantation sheath 1 and the outer diameter of each section of the delivery sheath 2 are different, the inner diameter of each section of the implantation sheath 1 is equal, the inner diameter of each section of the delivery sheath 2 is equal, and the inner diameter of each section of the catheter sheath 3 is equal. That is, the inner diameter of the first main body section 11, the inner diameter of the first bendable section 12, and the inner diameter of the first variable diameter section 13 are equal, the inner diameter of the second main body section 21, the inner diameter of the second bendable section 22, and the inner diameter of the second variable diameter section 23 are equal, and the inner diameter of the third main body section 31 and the inner diameter of the third bendable section 32 are equal.
In this embodiment, the outer diameter of the first main body section 11 is 85% to 99% of the inner diameter of the delivery sheath 2, the outer diameter of the first bendable section 12 is 70% to 95% of the inner diameter of the delivery sheath 2, and the outer diameter of the first bendable section 12 is smaller than the outer diameter of the first main body section 11. The outer diameter of the second main body section 21 is 90% -99% of the inner diameter of the catheter sheath 3, the outer diameter of the second bendable section 22 is 70% -95% of the inner diameter of the catheter sheath 3, and the outer diameter of the second bendable section 22 is smaller than the outer diameter of the second main body section 21.
The improvement of the structure and the size of the implantation sheath 1 and the delivery sheath 2, on one hand, the wall thickness of the first main body section 11 is larger than that of the first bendable section 12, the wall thickness of the second main body section 21 is larger than that of the second bendable section 22 while the outer diameter of the catheter sheath 3 is not increased and the inner diameter of the implantation sheath 1 is not reduced, the wall thickness of the main body section is increased, the mechanical property of the tube body is improved, the loss of force value and torque transmission from the near end to the far end when the sheath tube is pushed, pulled and rotated is reduced, and therefore the sheath tube has stronger mechanical transmission capacity; on the other hand, the gap between the first body segment 11 and the second body segment 21 is reduced, and the gap between the second body segment 21 and the third body segment 31 is reduced, so that the implantation sheath 1, the delivery sheath 2 and the catheter sheath 3 keep better coaxiality, and the deformation interference caused by the rotation due to the fact that the bending shape of the body segment of the sheath at the inner layer is obviously larger than that of the sheath at the outer layer can be prevented; on the other hand, starting from the diameter-changing section of the sheath tube positioned on the inner layer, in the bending type of the sheath tube positioned on the outer layer, the bendable section with a certain length is not contacted with the inner wall of the sheath tube positioned on the outer layer (as shown in fig. 15), so that the contact area of the two layers of sheath tubes is reduced, the friction force generated by the mutual motion between the two layers of sheath tubes is reduced, and the transmission of the mechanical property of the sheath tube positioned on the inner layer is promoted.
The specific structure of embodiment 2 is shown in fig. 16 and 17.
In this embodiment, the distal end of the first body segment 11 is connected to the proximal end of the first bendable segment 12, and the distal end of the second body segment 21 is connected to the proximal end of the second bendable segment 22. The first body section 11 and the first bendable section 12 have the same inner and outer diameters, respectively, and the second body section 21 and the second bendable section 22 have the same inner and outer diameters, respectively.
This embodiment sets up a plurality of convex first convex parts 14 outside through setting up on the outer wall of the first bendable section 12 of implanting sheath 1 and the outer wall of first main part section 11, set up a plurality of convex second convex parts 24 outside on the outer wall of the second bendable section 22 of transport sheath 2 and the outer wall of second main part section 21, so that the cooperation contact of the two-layer sheath pipe that contacts changes from the face contact into the multiple spot contact, thereby area of contact between the two-layer sheath pipe has been reduced to the overwhelming extent, the frictional force that mutually supports the production when greatly reduced two-layer sheath pipe tunings and bends, and then promoted the transmission of the mechanical properties of the sheath pipe that is located the inlayer.
Wherein, the first convex portion 14 and the second convex portion 24 can be a plurality of dispersed convex points, preferably, the first convex portion 14 and the second convex portion 24 are both annular convex points, the plurality of first convex portions 14 are distributed at intervals along the axial direction of the implantation sheath 1, and the plurality of second convex portions 24 are distributed at intervals along the axial direction of the delivery sheath 2.
Preferably, the outer diameter of the first protrusion 14 is 85% to 99% of the inner diameter of the delivery sheath 2, and the outer diameter of the implantation sheath 1 is 70% to 95% of the inner diameter of the delivery sheath 2. The outer diameter of the second convex part 24 is 90-99% of the inner diameter of the catheter sheath 3, and the outer diameter of the delivery sheath 2 is 70-95% of the inner diameter of the catheter sheath 3.
Preferably, the number of the first protrusions 14 on the first main body segment 11 is 3 to 20. Wherein, when the implantation sheath 1 extends out of the delivery sheath 2 to the farthest state, a first convex part 14 is arranged on the first main body section 11 near the proximal end of the second main body section 21, and the first convex part 14 is the convex part closest to the proximal end position on the implantation sheath 1. The distal end of the first body segment 11 is also provided with 1 first protrusion 14.
Preferably, the flexible segment 121 is provided with 2 to 8 first protrusions 14. Wherein, when the implantation sheath 1 extends out of the delivery sheath 2 to the farthest state, 1 first convex part 14 is arranged on the flexible section 121 near the distal end of the first bending section 221.
Preferably, the number of the second protrusions 24 on the second body segment 21 is 3 to 20, wherein when the delivery sheath 2 is extended out of the catheter sheath 3 to the farthest state, one second protrusion 24 is provided on the second body segment 21 near the proximal end of the third body segment 31, and the second protrusion 24 is the closest protrusion on the delivery sheath 2. The distal end of the second body segment 21 is also provided with 1 second protrusion 24.
Preferably, the second transition section 222 is provided with 2 to 6 second protrusions 24. Wherein, when the delivery sheath 2 extends out of the catheter sheath 3 to the farthest state, 1 second convex part 24 is arranged on the second transition section 222 near the distal end of the second turning section 321.
The two end surfaces of the first convex part 14 and the second convex part 24 in the axial direction are smooth arc surfaces, so that when the implantation sheath 1 or the delivery sheath 2 is withdrawn, the first convex part 14 and the second convex part 24 do not interfere with the distal end surface of the sheath tube of the outer layer to influence the withdrawal of the implantation sheath 1 or the delivery sheath 2.
The specific structure of embodiment 3 is shown in fig. 18 and 19.
The implant sheath 1 of this embodiment further includes a first variable diameter section 13 connected between the distal end of the first main body section 11 and the proximal end of the first bendable section 12, and the specific structure of the first variable diameter section 13 is the same as that of embodiment 1. The delivery sheath 2 further comprises a second variable diameter section 23 connected between the distal end of the second main body section 21 and the proximal end of the second bendable section 22, and the specific structure of the second variable diameter section 23 is the same as that of embodiment 1.
This embodiment is provided with a plurality of outwardly convex first protrusions 14 on the outer wall of the first bendable section 12 of the implant sheath 1, and the specific structure of the first protrusions 14 is the same as that of embodiment 2. A plurality of second protrusions 24 protruding outward are provided on the outer wall of the second bendable section 22 of the delivery sheath 2, and the specific structure of the second protrusions 24 is the same as that of embodiment 2.
In this embodiment, the outer diameter of the first protrusion 14 is 85% to 99% of the inner diameter of the delivery sheath 2, the outer diameter of the first main body section 11 is 85% to 99% of the inner diameter of the delivery sheath 2, and the outer diameter of the first bendable section 12 is 70% to 95% of the inner diameter of the delivery sheath 2. The outer diameter of the second convex part 24 is 90-99% of the inner diameter of the catheter sheath 3, the outer diameter of the second main body section 21 is 90-99% of the inner diameter of the catheter sheath 3, and the outer diameter of the second bendable section 22 is 70-95% of the inner diameter of the catheter sheath 3.
The implant sheath 1 and the first protrusion 14 are integral in the present application; the delivery sheath 2 and the second protrusion 24 are also integral.
The embodiments can improve the torque transmissibility of the sheath, reduce the matching contact area of the sheath in each layer, and further reduce the friction force when the sheath is matched in each layer. Therefore, when the catheter sheath 3 and the conveying sheath 2 are combined to form a space bending type, compared with the existing conveying sheath, when the far end forms the same space included angle, the relative rotation angle of the handles of the near-end catheter sheath 3 and the conveying sheath 2 is reduced, the interference resistance between the catheter sheath 3 and the conveying sheath 2 is reduced, the influence on the action and the functionality of the instrument is reduced, the requirements of connection of all parts of the instrument on tensile strength and torsion resistance are reduced, and the safety and the effectiveness of the instrument are improved; the resistance between the implantation sheath 1 and the conveying sheath 2 in the bending control state is reduced, when the implantation sheath 1 is operated to push and pull and rotate to drive the implantation sheath 1 to link the degrees of freedom of the implantation instrument such as extending forwards, retreating or rotating, the force value and torque transmission efficiency is higher, and the implantation instrument acts more accurately; the resistance between the implantation sheath 1 and the conveying sheath 2 in the bending control state is reduced, after the handle of the implantation sheath 1 is operated to rotate to drive the implantation sheath 1 to be linked with the implantation instrument to rotate to adjust the position, the internal force storage of the conveying system is reduced, and the situation that the implantation instrument continues to rotate in an excessive manner due to the release of the internal force storage when the implantation sheath 1 is pushed and pulled is reduced.
The above embodiments are merely illustrative of the technical ideas and features of the present invention, and the purpose thereof is to enable those skilled in the art to understand the contents of the present invention and implement the present invention, and not to limit the protection scope of the present invention. All equivalent changes made in accordance with the spirit of the invention.

Claims (10)

1. A delivery sheath for interventional therapy of structural heart disease, characterized by: the delivery sheath includes:
an implantation sheath (1) comprising a first main body section (11) at a proximal end, a first bendable section (12) at a distal end and capable of bending deformation;
a conveying sheath (2) which comprises a second main body section (21) at the proximal end part and a second bendable section (22) at the distal end part and capable of bending and deforming, wherein the conveying sheath (2) can be movably sleeved outside the implanting sheath (1);
the catheter sheath (3) comprises a third main body section (31) and a third bendable section (32) which is connected with the distal end of the third main body section (31) and can be bent and deformed, and the catheter sheath (3) can be movably sleeved outside the delivery sheath (2);
the implantation sheath (1) further comprises a plurality of first protrusions (14) disposed on an outer wall of the first bendable section (12) and protruding outwardly, and the delivery sheath (2) further comprises a plurality of second protrusions (24) disposed on an outer wall of the second bendable section (22) and protruding outwardly.
2. The delivery sheath for interventional treatment of structural heart disease as set forth in claim 1, wherein: the first convex portions (14) and the second convex portions (24) are both annular protrusions, the first convex portions (14) are distributed along the axial direction of the first bendable section (12) at intervals, and the second convex portions (24) are distributed along the axial direction of the second bendable section (22) at intervals.
3. The delivery sheath for interventional treatment of structural heart disease as set forth in claim 1, wherein: the outer diameter of the first convex part (14) is 85% -99% of the inner diameter of the conveying sheath (2), the outer diameter of the first main body section (11) is equal to the outer diameter of the first bendable section (12), and the outer diameter of the first main body section is 70% -95% of the inner diameter of the conveying sheath (2); the outer diameter of the second convex part (24) is 90-99% of the inner diameter of the catheter sheath (3), and the outer diameter of the second main body section (21) is equal to the outer diameter of the second bendable section (22) and is 70-95% of the inner diameter of the catheter sheath (3).
4. The delivery sheath for interventional treatment of structural heart disease as set forth in claim 1, wherein: the outer wall of the first main body section (11) is also provided with a plurality of first convex parts (14) which are distributed at intervals along the axial direction of the first main body section (11), and the outer wall of the second main body section (21) is also provided with a plurality of second convex parts (24) which are distributed at intervals along the axial direction of the second main body section (21).
5. The delivery sheath for interventional structured cardiology procedures of claim 1, wherein: the number of the first convex parts (14) on the first main body section (11) is 3-20, wherein when the implantation sheath (1) extends out of the delivery sheath (2) to the farthest state, one first convex part (14) is respectively arranged on the first main body section (11) at the proximal end of the second main body section (21) and the distal end of the first main body section (11); the number of the second protrusions (24) on the second body section (21) is 3-20, wherein when the delivery sheath (2) extends out of the catheter sheath (3) to the farthest state, one second protrusion (24) is arranged on the second body section (21) at the proximal end of the third body section (31) and the distal end of the second body section (21).
6. The delivery sheath for interventional treatment of structural heart disease as set forth in claim 1, wherein: the inner diameters of all sections of the implantation sheath (1) are equal, the inner diameters of all sections of the delivery sheath (2) are equal, and the inner diameters of all sections of the catheter sheath (3) are equal;
and/or two end faces of the first convex part (14) and the second convex part (24) in the axial direction are cambered surfaces in smooth transition.
7. The delivery sheath for interventional treatment of structural heart disease as set forth in claim 1, wherein: the first bendable section (12) comprises a flexible section (121) at a distal end portion, a first transition section (122) connected at a distal end to a proximal end of the flexible section (121); the first main section (11) has a hardness greater than the first transition section (122) has a hardness greater than the flexible section (121);
the second bendable section (22) comprises a first bending section (221) at the distal end part, and a second transition section (222) of which the distal end is connected with the proximal end of the first bending section (221); the hardness of the second main body section (21) is greater than the hardness of the second transition section (222) is greater than the hardness of the first turning section (221);
the third bendable section (32) comprises a second bending section (321) at the distal end part, and a third transition section (322) of which the distal end is connected with the proximal end of the second bending section (321); the hardness of the third main body section (31) is greater than the hardness of the third transition section (322) is greater than the hardness of the second turning section (321);
the length of the flexible section (121) is not shorter than the total length of the first turning section (221) and the second transition section (222), and the length of the second transition section (222) is not shorter than the total length of the second turning section (321) and the third transition section (322).
8. The delivery sheath for interventional structured cardiology procedures of claim 7, wherein: the length of the flexible section (121) is 0-8 cm longer than the total length of the first bending adjusting section (221) and the second transition section (222); the length of the second transition section (222) is 0-5 cm longer than the total length of the second bending section (321) and the third transition section (322).
9. The delivery sheath for interventional structured cardiology procedures of claim 7, wherein: 2-8 first convex parts (14) are arranged on the flexible section (121), wherein 1 first convex part (14) is arranged on the flexible section (121) at the far end of the first bending adjusting section (221) when the implantation sheath (1) extends out of the delivery sheath (2) to the farthest state; 2-6 second protrusions (24) are arranged on the second transition section (222), wherein 1 second protrusion (24) is arranged on the second transition section (222) at the distal end of the second turning section (321) when the delivery sheath (2) extends out of the catheter sheath (3) to the farthest state.
10. A conveyor system, characterized by: the delivery system comprises a delivery sheath according to any one of claims 1 to 9, a first operating handle (4) mounted at a proximal end of an implantation sheath (1) of the delivery sheath, a second operating handle (5) mounted at a proximal end of a delivery sheath (2) of the delivery sheath, and a third operating handle (6) mounted at a proximal end of a catheter sheath (3) of the delivery sheath.
CN202211503040.9A 2022-09-19 2022-09-19 Conveying sheath pipe and conveying system for interventional therapy of structural heart disease Pending CN115869510A (en)

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CN202211133713.6A CN115212426B (en) 2022-09-19 2022-09-19 A carry sheath pipe and conveying system for structural heart disease intervenes treatment

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