CN116492010A

CN116492010A - Thrombolysis/drug injection catheter

Info

Publication number: CN116492010A
Application number: CN202210076301.7A
Authority: CN
Inventors: 钟文
Original assignee: Individual
Current assignee: Individual
Priority date: 2022-01-21
Filing date: 2022-01-21
Publication date: 2023-07-28

Abstract

The invention provides a quick exchange catheter for thrombolysis in thrombus or super-selective injection in blood vessel, which consists of a perfusion tube and a wire tube provided with a wire tube, a distal section provided with a communication hole and a plurality of perfusion side holes, and is characterized in that the proximal section and the middle section of the wire tube are positioned in the lumen of the perfusion tube, the distal end of the perfusion tube is terminated and completely fused on the wall of the wire tube between the communication hole and a proximal annular mark, wherein the length of the wire tube from the communication hole to the wire outlet is obviously longer than that from the communication hole to the wire outlet, and the quick exchange catheter has the beneficial effects that: 1. the outer diameter of the guide wire tube with the filling side hole is designed to be minimum in theory, so that the thrombus falling off can be reduced to the greatest extent; 2. the liquid medicine can be injected into different parts of thrombus through a plurality of perfusion side holes with different orientations at the distal section of the catheter at the same time, so that the contact area between the liquid medicine and the thrombus can be remarkably increased, and the thrombolysis effect is further improved; 3. compared with the similar conduit, the patent design greatly simplifies the manufacturing process.

Description

Thrombolysis/drug injection catheter

Technical Field

The invention relates to a rapid exchange catheter which is mainly used for thrombolysis of a thrombus built-in tube or super-selected injection in blood vessels such as coronary artery, cerebral artery, spleen artery and renal artery, and has the following three advantages in thrombolysis: 1. the outer diameter of the distal section of the thrombolytic catheter which needs to be inserted into thrombus and provided with a perfusion side hole is designed to be minimum in theory (the outer diameter of the thrombolytic catheter is the same as that of the guide wire tube of the PTCA balloon catheter), so that the trafficability of the distal end of the catheter can be further increased, and the thrombus falling and thromboembolism caused by the entering of the catheter into thrombus can be greatly reduced; 2. more than 3 filling side holes with different opening directions are arranged on different cross sections of the distal section of the thrombolysis catheter, and thrombolysis liquid medicine can be simultaneously injected into different parts of thrombus from different directions through the filling side holes, so that the contact area between the thrombolysis liquid medicine and the thrombus can be increased, and the thrombolysis effect is further improved; 3. compared with similar ducts, the structure of the duct is simple, and the manufacturing process is greatly simplified.

Background

At present, there is no rapid exchange thrombolytic catheter available for clinical use, and only three types of catheters with thrombolytic function are published in patent documents of the national intellectual property office of the people's republic of China: first category: for the quick exchange double-cavity microcatheter with only one drug infusion hole at the distal end, the guide wire cavity and the drug infusion cavity are independently arranged and are parallel at the distal end of the catheter, and the defect is that: 1. the diameter of the catheter part inserted into thrombus is thicker, so that the trafficability of the catheter is poor, on one hand, more thrombus can be touched, and the thrombus can be caused to be embolized by a small blood vessel at the far end, so that the thrombolysis effect is affected; on the other hand, the occluded blood vessel with heavier stenosis cannot be fixed; 2. the remote end of the thrombolytic medicine infusion cavity is provided with only one infusion hole, so that the contact area of thrombolytic medicine liquid and thrombus is small, and the thrombolytic effect is affected. The second category: in the first type of catheter, a plurality of drug infusion holes are arranged at the far section of the catheter, but are arranged in a single row, so that the openings of the drug infusion holes are only oriented towards the same direction, and the contact area between thrombolytic drug liquid and thrombus is increased but cannot be maximized. Third category: is a rapid exchange thrombolysis balloon catheter: the technical scheme for solving the problem that the diameter of the distal end of the catheter inserted into thrombus is minimized is as follows: 1. the perfusion cavity consists of an inner tube cavity and a guide wire-perfusion shared cavity; 2. the guide wire cavity consists of a guide wire-perfusion shared cavity and a guide wire pipe; 3. the guide wire tube is positioned in the inner tube, the proximal section of the guide wire tube penetrates out of the inner tube and the outer tube, the guide wire tube is opened on the tube wall of the outer tube to form a guide wire outlet, the inner diameter of the distal section of the guide wire tube is gradually increased from the near to the far, and the distal end of the guide wire tube is freely opened in the inner cavity of the inner tube; 4. the inner diameter of the proximal middle section of the guide wire tube is smaller than the inner diameter of the guide wire-perfusion shared cavity, but larger than the diameter of the PTCA guide wire; 5. the inner diameter of the inner tube where the guide wire tube is positioned is larger than that of the inner tube adjacent to the distal end of the guide wire tube; 6. the guidewire-infusion common lumen diameter is larger than the guidewire lumen. Briefly, the balloon thrombolytic catheter achieves the two purposes of rapid exchange and minimization of the catheter diameter with perfusion side hole parts by two designs that the distal section of the catheter resembles a horn-like structure and the diameter of the common cavity of guide wire and perfusion is larger than that of the guide wire cavity, but the following defects still exist: 1. the diameter of the guide wire-perfusion shared cavity is larger than that of the guide wire cavity, so that the inner diameter and the outer diameter of the guide wire-perfusion shared pipe which enters thrombus are not designed to be minimum theoretically; 2. the manufacturing process of the catheter is complex.

The technical scheme adopted for solving the technical problems is as follows: the catheter consists of a perfusion tube and a guide wire tube and has the following structure: 1. the perfusion tube and the wire guide tube are round tubes with uniform thickness and equal tube wall thickness, wherein the perfusion tube is obviously longer than the wire guide tube, and the inner diameter of the perfusion tube is larger than the outer diameter of the wire guide tube; 2. the distal section of the guide wire tube is provided with a guide wire inlet, a distal annular mark, a pouring side hole, a proximal annular mark, a communication hole and a guide wire outlet from far to near in sequence, wherein (1) the length of the guide wire tube from the communication hole to the guide wire outlet is obviously longer than that from the communication hole to the guide wire inlet, the communication hole of the guide wire tube and a proximal section thereof are completely positioned in a pouring cavity of the pouring tube, and the proximal end of the communication hole is opened on the tube wall of the pouring tube to form the guide wire outlet; (2) At least three perfusion side holes with different opening directions and different cross sections of the catheter are distributed on the perfusion side hole section of the distal section of the guide wire tube, and annular marks at two ends of the perfusion side hole are respectively adjacent to the farthest and nearest perfusion side holes; (3) At least one communication hole is arranged on the guide wire tube, and the holes are closely adjacent; 3. the proximal end of the infusion tube is a medicine injection port, the shape and the size of an end hole of the infusion tube are suitable for connecting the ports of the balloon pressurizing pump and the ring handle injector, the infusion tube has high-pressure-resistant water tightness, the distal end of the infusion tube is terminated and completely fused on the wall of the guide wire tube between the communication hole and the proximal annular mark, and the infusion cavity in the infusion tube can be communicated with the guide wire cavity only through the communication hole; 4. the perfusion cavity and the guide wire cavity which are communicated through the communication hole are not communicated with the outside except the medicine injection port, the guide wire outlet, the guide wire inlet and the perfusion side holes, and have water tightness. Thus, the perfusion cavity is communicated with the guide wire cavity through the communication hole, the length of the guide wire tube from the communication hole to the perfusion side hole is obviously shorter than that from the communication hole to the guide wire outlet, and according to the fluid dynamics principle, when the guide wire penetrates through the guide wire cavity, the resistance from the communication hole to the perfusion side hole is obviously smaller than that from the communication hole to the guide wire outlet, and when the high-pressure injection into the perfusion cavity, the liquid medicine flows into the guide wire cavity through the communication hole, can completely reach the perfusion side hole from the guide wire cavity far from the communication hole, and is injected into thrombus from the perfusion side hole.

The beneficial effects of the invention are as follows: 1. the diameter of a guide wire cavity in a guide wire pipe (which is only slightly larger than the outer diameter of a guide wire) which is required to be inserted into the distal section of a thrombolytic catheter in thrombus is designed to be the thinnest theoretically, so that the thrombus falling and thromboembolism caused by the entering or passing of the thrombolytic drug injection catheter through thrombus lesions can be reduced to the maximum extent; 2. compared with the most advanced thrombolysis balloon catheter, the invention only consists of two parts of the perfusion tube and the wire guide tube, and the perfusion cavity is communicated with the wire guide cavity through the simple communication hole, thereby achieving the purposes of quick exchange and minimum diameter of the catheter where the perfusion side hole is positioned, which can be obtained by the thrombolysis balloon catheter through complex structural design, and greatly simplifying the manufacturing process; 3. the rapid exchange function and the perfusion side holes with different orientations of the far section are reserved.

Drawings

The thrombolytic/drug infusion catheter is further described below with reference to the accompanying drawings.

FIG. 1 is a schematic longitudinal section of a thrombolytic/drug infusion catheter

FIG. 2 is a schematic longitudinal section view of an embodiment of a thrombolytic/drug infusion catheter

FIG. 3 is a schematic cross-sectional view of an overlapping section of a perfusion tube and a guidewire tube in an embodiment of a thrombolysis/drug-infusion catheter

In the figure, 1. A guidewire inlet; 2. a distal annular mark; 3. filling the side holes; 4. a guidewire tube; 5. a proximal annular mark; 6. a communication hole; 7. a perfusion tube; 8. a guidewire lumen; 9. a perfusion chamber; 10. a guidewire outlet; 11. a medicine injection port; 12. a finger guide wire; 13. thrombus; 14. and (5) blood vessels.

Detailed Description

In fig. 1, the proximal middle section of the shorter guide wire tube (4) is positioned in the perfusion tube (7), the proximal end of the shorter guide wire tube is opened on the tube wall of the perfusion tube (7) to form a guide wire outlet (10), two or more perfusion side holes (3) with different opening directions are arranged on different cross sections of the distal section of the shorter guide wire tube, and two ends close to the perfusion side holes are respectively provided with a proximal annular mark ring (5) and a distal annular mark (2); at least one communication hole (6) is arranged on the pipe wall of the guide wire pipe near-end annular mark ring (5), and the distal end of the perfusion pipe (7) is completely fused with the pipe wall of the guide wire pipe (4) between the communication hole (6) and the near-end annular mark, wherein the inner diameter of the guide wire pipe (10) is slightly larger than the diameter of the guide wire (12), and the distance from the communication hole (6) to the guide wire outlet (10) is larger than the distance from the communication hole (6) to the guide wire inlet (1). The perfusion cavity (9) of the thrombolytic catheter can be communicated with the guide wire cavity (8) only through the communication hole (6), and the perfusion cavity and the guide wire cavity can be communicated with the outside only through the medicine injection port (11), the guide wire outlet (10), the guide wire inlet (1) and the perfusion side hole (3).

In the embodiment of fig. 2, after guiding the guide wire (12) to be in place, the proximal end of the guide wire is inserted into the guide wire cavity (8) from the guide wire inlet (1) of the thrombolytic/drug injection catheter, the thrombolytic catheter is penetrated out of the guide wire outlet (10), then the guide wire (12) is fixed, the proximal annular mark (5) of the distal section of the thrombolytic catheter is just inserted into the thrombus (13) of the corresponding blood vessel (14), after the contrast agent is injected into the thrombus (13) through the drug injection port (11) at the proximal end of the thrombolytic catheter at high pressure, the contrast agent can flow to the distal section of the blood vessel completely after entering the thrombus (13) through the injection side hole (3), the thrombolytic drug is injected into the perfusion cavity (9) at high pressure of 4-10 atmospheres from the proximal end drug injection port (11) by the balloon pressurizing pump, then enters the guide wire cavity (8) through the communication hole (6), then flows through the distal section of the guide wire cavity, finally enters the thrombus (14) from the side hole (3), when the thrombolytic solution remains in the corresponding blood vessel (14), the injection side is rapidly injected at 15-20 atmospheres, and the injection side of the thrombolytic catheter can be completely withdrawn at the same time, and the annular mark is completely before the injection of the thrombus is completely removed at the distal end of the catheter.

In fig. 3, the guide wire tube (4) is positioned in the perfusion tube (7), a cavity gap between the perfusion tube (7) and the guide wire tube (4) is a perfusion cavity (11), and the guide wire (12) is guided to be inserted into the guide wire cavity (8) of the guide wire tube (4).

Claims

1. A thrombolysis/drug injection catheter is mainly used as a rapid exchange interventional instrument for thrombolysis in thrombus of blood vessel or super-selective drug injection in blood vessel, and consists of a perfusion tube and a wire guide tube, and is characterized in that: (1) The perfusion tube and the wire guide tube are round tubes with uniform thickness and equal tube wall thickness, wherein the perfusion tube is obviously longer than the wire guide tube, and the inner diameter of the perfusion tube is larger than the outer diameter of the wire guide tube; (2) The distal section of the guide wire tube is provided with a guide wire inlet, a distal annular mark, a plurality of perfusion side holes, a proximal annular mark and a communication hole from far to near in sequence; (3) The communication hole and the near section of the guide wire tube are completely positioned in the perfusion cavity of the perfusion tube, and the near end of the communication hole is opened on the wall of the perfusion tube to form a guide wire outlet; (4) The proximal end of the infusion tube is a medicine injection port, the distal end of the infusion tube is terminated and is completely fused on the wall of the guide wire tube between the communication hole and the proximal annular mark, and the infusion cavity in the infusion tube can be communicated with the guide wire cavity only through the communication hole; (5) The filling cavity and the guide wire cavity which are communicated through the communication hole are not communicated with the outside except the medicine injection port, the guide wire outlet, the guide wire inlet and the filling side hole, and have water tightness. (6) The length of the guide wire tube from the communication hole to the guide wire outlet is significantly longer than the length of the guide wire tube from the communication hole to the guide wire inlet.

2. The thrombolytic/drug-injecting catheter according to claim 1, wherein at least three perfusion side holes with different opening directions and different cross sections of the catheter are distributed on the perfusion side hole section of the distal section of the guide wire tube, and the annular marks at the two ends are respectively adjacent to the farthest and nearest perfusion side holes.

3. The thrombolytic/drug-injection catheter according to claim 1, wherein the end hole shape and size of the drug injection hole of the infusion cavity are suitable for connecting the balloon pressurization pump and the port of the ring handle injector, and have high-pressure-resistant water tightness.

4. The thrombolytic/drug-infusion catheter according to claim 1, wherein at least one communication hole is provided on the guide wire tube, and the holes are closely adjacent to each other.