CN116942253B - Radial supporting force adjustable thrombus taking device - Google Patents

Radial supporting force adjustable thrombus taking device Download PDF

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Publication number
CN116942253B
CN116942253B CN202311214188.5A CN202311214188A CN116942253B CN 116942253 B CN116942253 B CN 116942253B CN 202311214188 A CN202311214188 A CN 202311214188A CN 116942253 B CN116942253 B CN 116942253B
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tube
thrombus
net
thrombectomy
taking
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CN202311214188.5A
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CN116942253A (en
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荆洪娟
柯长奋
黄嘉平
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Hangzhou Yike Medical Technology Co ltd
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Hangzhou Yike Medical Technology Co ltd
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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
    • 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
    • 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
    • A61B2017/22072Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an instrument channel, e.g. for replacing one instrument by the other
    • 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

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention discloses a thrombus taking device with adjustable radial supporting force, which comprises a thrombus taking tube, an outer pushing tube, an inner pushing tube, a first thrombus taking net and a second thrombus taking net, wherein the proximal end of the first thrombus taking net is a fixed end and is connected with the thrombus taking tube, the second thrombus taking net is connected between the outer pushing tube and the inner pushing tube, after the first thrombus taking net and the second thrombus taking net are released, the first thrombus taking net is released in situ at a thrombus in a blood vessel, the second thrombus taking net is attached to the inner wall of the distal end of the first thrombus taking net to form an integral thrombus taking net, and when the outer pushing tube moves along a preset direction and generates relative displacement with the inner pushing tube, the second thrombus taking net can be driven to deform to adjust the radial supporting force of the first thrombus taking net.

Description

Radial supporting force adjustable thrombus taking device
Technical Field
The invention relates to the technical field of medical instruments, in particular to a thrombus taking device with adjustable radial supporting force.
Background
In order to improve the thrombus removing effect, more and more mechanical thrombus removing devices are designed to adjust the radial supporting force of the thrombus removing net so as to ensure that the thrombus removing net can be fully combined with the inner wall of a blood vessel to better embed thrombus, for example, chinese patent CN113520519a discloses an adjustable bracket type thrombus removing device which adjusts the distance between the proximal end and the distal end of the thrombus removing net through an operation wire, when the distance between the proximal end and the distal end of the thrombus removing net is compressed, the radial force of the thrombus removing net is larger, and when the distance between the proximal end and the distal end of the thrombus removing net is stretched, the radial force of the thrombus removing net is smaller. Although CN113520519a can realize that the radial supporting force of the thrombus-taking net is adjustable to better attach to the inner wall of the blood vessel and embed thrombus, because CN113520519a indirectly changes the radial supporting force by shortening the length of the thrombus-taking net, the mesh size of the thrombus-taking net can be changed in the process of shortening the length of the thrombus-taking net, if the mesh is too large, thrombus in the thrombus-taking net can be easily caused to escape, if the mesh is too small, thrombus can be easily caused to be difficult to enter the thrombus-taking net, and thus, the adjustment needs to be repeated for multiple times to realize better thrombus-taking effect.
Disclosure of Invention
The invention aims to solve the technical problem that the prior art has the defects, and provides the thrombus taking device with adjustable radial supporting force.
According to the invention, there is provided a thrombus removing device with adjustable radial supporting force, comprising a thrombus removing tube, a pushing tube and a thrombus removing net, wherein the pushing tube and the thrombus removing net are positioned in the thrombus removing tube, the thrombus removing tube is used for conveying the pushing tube and the thrombus removing net to an intravascular thrombus formation position, the thrombus removing net comprises a first thrombus removing net and a second thrombus removing net, the proximal end of the first thrombus removing net is a fixed end and is connected with the thrombus removing tube, the distal end of the first thrombus removing net is a free end, the pushing tube comprises an outer pushing tube and an inner pushing tube, the second thrombus removing net is connected between the outer pushing tube and the inner pushing tube, after the thrombus removing net is released, the first thrombus removing net is released in situ at the intravascular thrombus position, the second thrombus removing net is attached to the inner wall of the distal end of the first thrombus removing net to form an integral thrombus removing net, and the pushing tube is configured to move along a preset direction and can drive the second thrombus removing net to deform so as to adjust the radial supporting force of the first thrombus removing net.
Further, the thrombus taking tube comprises a first thrombus taking tube and a second thrombus taking tube, the distal end of the inner pushing tube penetrates through the first thrombus taking tube and then stretches into the second thrombus taking tube and is connected with the distal end of the second thrombus taking tube, the proximal end of the first thrombus taking net is connected with the distal end of the first thrombus taking tube, and the second thrombus taking tube is used for arranging the first thrombus taking net cover in the second thrombus taking net cover.
Further, a guide surface which is convenient for arranging the first thrombus removing net cover in the second thrombus removing pipe is arranged at the proximal end of the second thrombus removing pipe.
Further, the proximal end of the second embolectomy tube is aligned with the distal end of the first embolectomy tube to form an integral embolectomy tube.
Further, the second thrombus removing pipe is used for arranging the first thrombus removing net cover on the inner pushing pipe.
Further, the proximal end of the second thrombus removing net is a fixed end and is connected with the distal end of the outer pushing tube, the distal end of the second thrombus removing net is also a fixed end and is connected with the inner pushing tube, and the first thrombus removing tube is used for arranging the second thrombus removing net cover on the inner pushing tube.
Further, after the thrombus removing tube conveys the pushing tube and the thrombus removing net to the thrombus formation position in the blood vessel, when the outer pushing tube and the inner pushing tube are configured to move along the proximal end to the distal end direction together and generate preset relative displacement with the first thrombus removing tube, the first thrombus removing net and the second thrombus removing net are released, and the outer wall of the second thrombus removing net is attached to the inner wall of the distal end of the first thrombus removing net.
Further, after the first and second embolectomy nets are released, and when the outer pushing tube is configured to move in a predetermined direction and relatively displace with the inner pushing tube, the second embolectomy net is formed into a disk shape and presses the distal inner wall of the first embolectomy net to fit against the inner wall of the blood vessel.
Further, the outer push tube is configured to remove the force between the outer push tube and the inner push tube after movement in a predetermined direction and relative displacement with the inner push tube.
Further, the outer push tube is configured to move in a predetermined direction and to displace relative to the inner push tube for 30-100S to further cancel the force between the outer push tube and the inner push tube.
Compared with the prior art, the invention sets the thrombus taking net as the first thrombus taking net and the second thrombus taking net which can be separated relatively, and the second thrombus taking net is adjusted to deform to directly and radially act on the inner wall of the distal end of the first thrombus taking net, and finally the inner wall of the distal end of the first thrombus taking net is extruded to be tightly attached to the inner wall of a blood vessel.
Drawings
The invention will be more fully understood and its attendant advantages and features will be more readily understood by reference to the following detailed description, taken in conjunction with the accompanying drawings.
Fig. 1 is a schematic structural view of a thrombolytic device according to an embodiment of the present invention with a thrombolytic mesh in a contracted state.
Fig. 2 is a cross-sectional view of fig. 1.
Fig. 3 is a schematic view of the first embolectomy tube and first embolectomy net of fig. 2.
Fig. 4 is a schematic structural view of the outer push tube, the inner push tube, the second embolectomy and the second embolectomy of fig. 2.
Fig. 5 is a cross-sectional view of fig. 4.
Fig. 6 is a schematic structural view of a thrombolytic device according to an embodiment of the present invention with a thrombolytic mesh in an expanded state.
In the accompanying drawings: 1 is a first thrombus taking pipe, 2 is a second thrombus taking pipe, 3 is an outer pushing pipe, 4 is an inner pushing pipe, 5 is a first thrombus taking net, and 6 is a second thrombus taking net.
It should be noted that the drawings are for illustrating the invention and are not to be construed as limiting the invention. Note that the drawings representing structures may not be drawn to scale. Also, in the drawings, the same or similar elements are denoted by the same or similar reference numerals.
Detailed Description
In order that the invention may be more readily understood, a detailed description of the invention is provided below along with specific embodiments and accompanying figures.
The terms "proximal" and "distal" in the sense of the present invention should be understood as meaning, viewed from the direction of the attending physician, the term "proximal" referring to the end proximal to the attending physician, i.e. corresponding to the "left end" referred to with reference to the accompanying drawings, and the term "distal" referring to the end distal to the attending physician, i.e. corresponding to the "right end" referred to with reference to the accompanying drawings.
The structure of the thrombus removing device of this embodiment includes a thrombus removing tube, a pushing tube and a thrombus removing net, which are located in the thrombus removing tube, as shown in fig. 1 to 6, the thrombus removing tube is used for accommodating the pushing tube and the thrombus removing net, and conveying the pushing tube and the thrombus removing net to the thrombus formation site in the blood vessel, and the pushing tube is used for releasing the thrombus removing net in the thrombus removing tube to realize mechanical thrombus removing. The thrombus taking tube comprises a first thrombus taking tube 1 and a second thrombus taking tube 2 which can be relatively separated, the first thrombus taking tube 1 and the second thrombus taking tube 2 are sequentially arranged from near to far, the near end of the second thrombus taking tube 2 can be aligned with the far end of the first thrombus taking tube 1 to form an integral thrombus taking tube, the pushing tube comprises an outer pushing tube 3 and an inner pushing tube 4 which are sleeved inside and outside, the outer pushing tube 3 can move along the inner part of the first thrombus taking tube 1, the inner pushing tube 4 can move along the inner part of the outer pushing tube 3, the far end of the inner pushing tube 4 penetrates through the outer pushing tube 3, the first thrombus taking tube 1 stretches into the second thrombus taking tube 2 and is connected with the second thrombus taking tube 2, for example, the far end of the inner pushing tube 4 is fixedly connected inside the far end of the second thrombus taking tube 2, the thrombus taking net comprises a first thrombus taking net 5 and a second thrombus taking net 6 which can be relatively separated, and the second thrombus taking net 6 can be attached to the far end inner wall of the first thrombus taking net 5 to form an integral thrombus taking net.
The first and second embolectomy nets 5 and 6 are self-expanding nets and have a plurality of meshes, so that the first and second embolectomy nets 5 and 6 have a contracted state in which they are radially contracted and an expanded state in which they are radially expanded, the first embolectomy net 5 is used for in-situ release of thrombus in a blood vessel for embedding the thrombus, and the second embolectomy net 6 is used for blocking the distal end of the first embolectomy net 5 and adjusting the radial supporting force of the second embolectomy net 6. Specifically, the first thrombolytic mesh 5 is sleeved on the inner push tube 4 and covered by the second thrombolytic tube 2, namely, the second thrombolytic tube 2 covers the first thrombolytic mesh 5 inside and enables the first thrombolytic mesh 5 to shrink between the inner push tube 4 and the second thrombolytic tube 2, the proximal end of the second thrombolytic tube 2 is provided with a guide surface which is convenient for covering the first thrombolytic mesh 5 inside, the proximal end of the first thrombolytic mesh 5 is a fixed end and is connected with the distal end of the first thrombolytic tube 1, the distal end of the first thrombolytic mesh 5 is a free end, the released first thrombolytic mesh 5 is radially expanded to form a cone shape with small proximal end and large distal end and is just positioned at an intravascular thrombus, the second thrombolytic mesh 6 is sleeved on the inner push tube 4 and is covered by the first thrombolytic tube 1, namely, the first thrombolytic tube 1 covers the second thrombolytic mesh 6 inside and enables the second thrombolytic mesh 6 to shrink between the inner push tube 4 and the first thrombolytic tube 1, the proximal end of the second embolectomy 6 is a fixed end and is fixedly connected with the distal end of the outer pushing tube 3, the distal end of the second embolectomy 6 is a fixed end and is connected with the inner pushing tube 4, namely, the second embolectomy 6 is connected between the outer pushing tube 3 and the inner pushing tube 4, the released second embolectomy 6 radially expands to form a shape with two small ends and large middle and is just jointed with the distal end inner wall of the first embolectomy 5 to form an integral embolectomy, at the moment, if the outer pushing tube 3 or the inner pushing tube 4 is operated to generate relative displacement between the outer pushing tube 3 and the inner pushing tube 4, the second embolectomy 6 is driven to deform to adjust the radial supporting force of the first embolectomy 5, as the second embolectomy 6 directly acts on the distal end inner wall of the first embolectomy 5 radially, and finally the distal end inner wall of the first embolectomy 5 is extruded to be more closely jointed with the inner wall of a blood vessel, therefore, the mesh diameter of the first thrombus removing net 5 is not excessively changed to influence the embedding of thrombus or cause the thrombus to escape easily, the thrombus removing effect is better, and in addition, the damage to the inner wall of the blood vessel is not caused because the distal end with weak radial force of the first thrombus removing net 5 is only regulated.
In the initial state, as shown in fig. 1-2, the first and second thrombectomy nets 5 and 6 are in a contracted state of radial contraction, the first thrombectomy net 5 is compressed between the inner pushing tube 4 and the second thrombectomy tube 2, the second thrombectomy net 6 is compressed between the inner pushing tube 4 and the first thrombectomy tube 1, that is, the second thrombectomy net 6 and the first thrombectomy net 5 are sequentially arranged from near to far, and the second thrombectomy net 6 and the first thrombectomy net 5 are arranged at intervals, so that the whole thrombectomy net is not formed, and meanwhile, the proximal end of the second thrombectomy tube 2 is aligned with the distal end of the first thrombectomy tube 1, so that the whole thrombectomy tube is formed, and the whole is compact.
When the thrombus is taken, the sheath is firstly inserted into the blood vessel, and one part of the sheath is penetrated in the blood vessel, and the other part of the sheath is exposed out of the blood vessel. The first and second embolectomy tubes 1, 2, the outer push tube 3, the inner push tube 4, the first and second embolectomy nets 5 and 6 in the initial state are then conveyed to the thrombus formation site in the blood vessel by means of the arc surface formed by the distal ends of the guide wire and the second embolectomy tube 2, and the first embolectomy net 5 is ensured to be just positioned at the thrombus formation site in the blood vessel by means of the radiography result. Then, the outer pushing tube 3 and the inner pushing tube 4 are pushed along the proximal direction along with the first thrombus removing tube 1, the second thrombus removing tube 2 and the second thrombus removing net 6 move along with the outer pushing tube 3 and the inner pushing tube 4 towards the distal direction, the first thrombus removing net 5 is connected with the first thrombus removing tube 1 to keep the position unchanged, when the outer pushing tube 3 and the inner pushing tube 4 generate preset relative displacement relative to the first thrombus removing tube 1, the first thrombus removing net 5 is not covered by the second thrombus removing tube 2, the first thrombus removing net 5 is released and formed into a conical shape with a small proximal end and a large distal end and is attached to the inner wall of a blood vessel, meanwhile, the second thrombus removing net 6 extends out of the first thrombus removing tube 1 to be released and formed into a shape with a large middle between two small ends, and the second thrombus removing net 6 is attached to the inner wall of the distal end of the first thrombus removing net 5 to form an integral thrombus removing net, namely, as shown in fig. 6, the thrombus removing net is embedded and collected. In the process, the outer pushing tube 3 or the inner pushing tube 4 is operated to generate relative displacement between the outer pushing tube 3 and the inner pushing tube 4 so as to drive the second thrombus removing net 6 to deform to form a disc shape to adjust the radial supporting force of the first thrombus removing net 5, in the adjusting process, the acting force between the outer pushing tube 3 and the inner pushing tube 4 can be eliminated after the initial adjustment so as to prevent damage to the inner wall of a blood vessel, the acting force between the outer pushing tube 3 and the inner pushing tube 4 can be continuously eliminated for 30-100 seconds, and finally the distal end part with weak radial supporting force of the second thrombus removing net 6 can be attached to the inner wall of the blood vessel so as to improve the thrombus embedding capability of the second thrombus removing net 6, and thus the thrombus removing effect of the whole thrombus removing net is improved.
After the thrombus is removed, the first thrombus removing tube 1, the outer pushing tube 3 and the inner pushing tube 4 are retracted, so that the whole thrombus removing device embedded with thrombus is pulled into the sheath tube, the second thrombus removing net 6 can be recovered to deform through relative movement between the outer pushing tube 3 and the inner pushing tube 4 or the inner pushing tube 4 is released, the second thrombus removing net 6 can automatically recover to deform, the thrombus is smoothly pulled into the sheath tube, and finally the whole thrombus removing device is retracted out of a blood vessel along with the sheath tube, so that the thrombus removing operation is completed.
It will be appreciated that although the invention has been described above in terms of preferred embodiments, the above embodiments are not intended to limit the invention. Many possible variations and modifications of the disclosed technology can be made by anyone skilled in the art without departing from the scope of the technology, or the technology can be modified to be equivalent. Therefore, any simple modification, equivalent variation and modification of the above embodiments according to the technical substance of the present invention still fall within the scope of the technical solution of the present invention.

Claims (9)

1. A thrombus removing device with adjustable radial supporting force, comprising a thrombus removing tube, a pushing tube and a thrombus removing net, wherein the pushing tube and the thrombus removing net are positioned in the thrombus removing tube, the thrombus removing tube is used for conveying the pushing tube and the thrombus removing net to a thrombus formation position in a blood vessel, the thrombus removing net is characterized in that the thrombus removing net comprises a first thrombus removing net (5) and a second thrombus removing net (6), the proximal end of the first thrombus removing net (5) is a fixed end and is connected with the thrombus removing tube, the distal end of the first thrombus removing net (5) is a free end, the pushing tube comprises an outer pushing tube (3) and an inner pushing tube (4), the second thrombus removing net (6) is connected between the outer pushing tube (3) and the inner pushing tube (4), after the thrombus removing net is released, the first thrombus removing net (5) is released in situ at the thrombus formation position in the blood vessel, the second thrombus removing net (6) is attached to the inner wall of the distal end of the first thrombus removing net (5) to form an integral thrombus removing net, and the outer pushing tube (3) is configured to move along a preset direction and generate relative displacement with the pushing tube (4), and the second thrombus removing net (6) can be adjusted to generate radial deformation; the thrombus taking tube comprises a first thrombus taking tube (1) and a second thrombus taking tube (2), the far end of the inner pushing tube (4) penetrates through the first thrombus taking tube (1) and then stretches into the second thrombus taking tube (2) to be connected with the far end of the second thrombus taking tube (2), the near end of the first thrombus taking net (5) is connected with the far end of the first thrombus taking tube (1), and the second thrombus taking tube (2) covers the first thrombus taking net (5) in the second thrombus taking tube.
2. The thrombectomy device according to claim 1, wherein the proximal end of the second thrombectomy tube (2) is provided with a guide surface for facilitating the housing of the first thrombectomy net (5) therein.
3. The thrombectomy device according to claim 1, wherein the proximal end of the second thrombectomy tube (2) is aligned with the distal end of the first thrombectomy tube (1) to form a unitary thrombectomy tube.
4. The thrombectomy device according to claim 1, wherein the second thrombectomy tube (2) houses the first thrombectomy mesh (5) on the inner push tube (4).
5. The thrombectomy device according to claim 1, wherein the proximal end of the second thrombectomy net (6) is a fixed end and is connected to the distal end of the outer push tube (3), the distal end of the second thrombectomy net (6) is also a fixed end and is connected to the inner push tube (4), and the first thrombectomy tube (1) covers the second thrombectomy net (6) on the inner push tube (4).
6. The thrombectomy device according to claim 5, wherein after the thrombectomy tube delivers the pusher tube and the thrombectomy net to the intravascular thrombus formation site, the outer pusher tube (3) and the inner pusher tube (4) are configured to move together in a proximal-distal direction and to generate a predetermined relative displacement with the first thrombectomy tube (1), the first thrombectomy net (5) and the second thrombectomy net (6) are released and an outer wall of the second thrombectomy net (6) is in contact with a distal inner wall of the first thrombectomy net (5).
7. The thrombectomy device according to claim 6, wherein after the first and second thrombectomy nets (5, 6) are released and the outer push tube (3) is configured to move in a predetermined direction and to be relatively displaced from the inner push tube (4), the second thrombectomy net (6) is formed in a disk shape and presses the distal inner wall of the first thrombectomy net (5) to be fitted to the inner wall of the blood vessel.
8. The thrombectomy device according to claim 7, wherein the outer push tube (3) is configured to move in a predetermined direction and to counteract a force between the outer push tube (3) and the inner push tube (4) upon relative displacement with the inner push tube (4).
9. The thrombectomy device according to claim 7, wherein the outer push tube (3) is configured to move in a predetermined direction and to displace relative to the inner push tube (4) for 30-100S to further remove the force between the outer push tube (3) and the inner push tube (4).
CN202311214188.5A 2023-09-20 2023-09-20 Radial supporting force adjustable thrombus taking device Active CN116942253B (en)

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