CN116942255A - Thrombus removing device - Google Patents
Thrombus removing device Download PDFInfo
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- CN116942255A CN116942255A CN202311198424.9A CN202311198424A CN116942255A CN 116942255 A CN116942255 A CN 116942255A CN 202311198424 A CN202311198424 A CN 202311198424A CN 116942255 A CN116942255 A CN 116942255A
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- 208000007536 Thrombosis Diseases 0.000 title claims abstract description 284
- 230000002093 peripheral effect Effects 0.000 claims abstract description 5
- 239000000463 material Substances 0.000 claims description 6
- 230000003247 decreasing effect Effects 0.000 claims description 3
- 239000007787 solid Substances 0.000 claims description 3
- 210000004204 blood vessel Anatomy 0.000 abstract description 45
- 208000005189 Embolism Diseases 0.000 abstract description 14
- 230000006378 damage Effects 0.000 abstract description 12
- 238000007917 intracranial administration Methods 0.000 abstract description 9
- 230000002537 thrombolytic effect Effects 0.000 description 19
- 238000000034 method Methods 0.000 description 10
- 230000008569 process Effects 0.000 description 9
- 239000003146 anticoagulant agent Substances 0.000 description 7
- 239000012634 fragment Substances 0.000 description 5
- 238000010586 diagram Methods 0.000 description 4
- 238000004519 manufacturing process Methods 0.000 description 4
- 230000000149 penetrating effect Effects 0.000 description 4
- 239000000243 solution Substances 0.000 description 4
- 208000032382 Ischaemic stroke Diseases 0.000 description 3
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- 229910001000 nickel titanium Inorganic materials 0.000 description 3
- 208000024248 Vascular System injury Diseases 0.000 description 2
- 208000012339 Vascular injury Diseases 0.000 description 2
- 206010053648 Vascular occlusion Diseases 0.000 description 2
- 230000017531 blood circulation Effects 0.000 description 2
- 239000003814 drug Substances 0.000 description 2
- 230000003073 embolic effect Effects 0.000 description 2
- 230000002349 favourable effect Effects 0.000 description 2
- 238000009998 heat setting Methods 0.000 description 2
- 230000006872 improvement Effects 0.000 description 2
- 208000014674 injury Diseases 0.000 description 2
- 238000003698 laser cutting Methods 0.000 description 2
- 229960000103 thrombolytic agent Drugs 0.000 description 2
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
- A61B2017/2217—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions single wire changing shape to a gripping configuration
Abstract
The invention provides a thrombus removing device, which relates to the field of medical appliances, and comprises a linear constraint piece, wherein a constraint limiting part is arranged at the far end; the thrombus taking support is made of a single wire and comprises a proximal push-pull section and a thrombus taking section which are connected in sequence; the most distal end of the thrombus taking bracket is fixedly or integrally or limitedly connected with the constraint limiting part; the thrombus collecting structure with the closed distal end, the open proximal end and the hollow area on the peripheral surface is prefabricated in a free state of the thrombus collecting section, and when the proximal push-pull section is pulled towards the proximal section side relative to the linear constraint piece, the diameter of each part of the thrombus collecting structure can be pulled to be smaller, and when the proximal push-pull section is pushed towards the distal section side relative to the linear constraint piece, the diameter of each part of the thrombus collecting structure can be pushed to be larger. The invention relieves the problems of easy secondary embolism, low thrombus taking efficiency, easy damage to blood vessels, complex overall structure, large volume, poor flexibility, incapability of passing through tortuous intracranial blood vessels, more consumables, high cost and the like of the traditional thrombus taking device.
Description
Technical Field
The invention relates to the field of medical instruments, in particular to a thrombus removing device.
Background
Acute ischemic stroke is a nerve tissue injury caused by ischemic necrosis of local brain tissue due to sudden blockage of cerebral blood flow, and is a main disease of death and disability of middle-aged and elderly people. Vascular recanalization is a key to treating acute ischemic stroke, and the current conventional methods for treating acute ischemic stroke mainly comprise two main categories: intravascular thrombolysis and mechanical thrombolysis.
The intravascular thrombolysis is characterized in that the thrombolytic agent is injected into the vicinity of a focus in a blood vessel where a lesion is located through a catheter, and a very high thrombolytic agent concentration is formed at the local moment of the focus, so that the thrombolysis speed is accelerated, the chance of vascular recanalization is further increased, but some problems exist: firstly, intravenous thrombolysis should be performed within 3 hours of onset, arterial thrombolysis time window is within 6 hours, and few patients can receive thrombolytic therapy; secondly, thrombolysis treatment is only suitable for thrombus with smaller volume, and the effect on thrombus with large volume and small volume is not ideal; in addition, thrombolysis requires a very large dose of thrombolytic drug to dissolve, but this also easily causes various complications with a high risk; to solve these problems with intravascular thrombolysis, mechanical thrombolysis is used to remove the embolized thrombus from patients who are not suitable for drug thrombolysis.
The mechanical thrombus taking device in the prior art mainly comprises an open loop structure as provided by a patent CN114681009A, wherein the open loop structure is a wire braiding structure, and a far end has no closed area; and a closed loop structure as provided in patent CN113730056a, which is also a wire braided structure, having a closed region at the distal end.
However, whatever existing structure is at least provided with the problems that (1) secondary embolism is easy to be caused, (2) thrombus taking efficiency is low, (3) blood vessels are easy to be damaged, and (4) the existing thrombus taking device is complex in overall structure, large in size, poor in flexibility, more in consumable materials, high in cost and the like, and can not pass through tortuous intracranial blood vessels.
Disclosure of Invention
The invention aims to provide a thrombus removing device, which is used for solving the problems that the existing thrombus removing device is easy to cause secondary embolism, low in thrombus removing efficiency, easy to damage blood vessels, complex in overall structure, large in size, poor in flexibility, more in consumable materials, high in cost and the like, and can not pass through tortuous intracranial blood vessels.
In order to achieve the above purpose, the embodiment of the present invention adopts the following technical scheme:
an embodiment of the present invention provides a thrombus removal device including: a linear restraint and a thrombus taking bracket; specifically, the linear constraint piece is made of hard materials, the proximal end of the linear constraint piece is used as a push-pull end of the constraint piece, and the distal end of the linear constraint piece is provided with a constraint limiting part; the thrombus taking support is made of metal single wires or nickel-titanium alloy single wires and comprises a proximal push-pull section and a thrombus taking section which are sequentially connected from a proximal end to a distal end; the most distal end of the thrombus taking support is fixedly or integrally or limitedly connected with the constraint limiting part; the thrombus collecting structure is characterized in that the thrombus collecting section is prefabricated into a thrombus collecting structure with a closed far end, an open near end and a hollowed-out area on the peripheral surface in a free state, the diameter of each part of the thrombus collecting structure can be pulled to be smaller when the near-end push-pull section is pulled to the near-end side relative to the linear constraint piece, and the diameter of each part of the thrombus collecting structure can be pushed to be larger when the near-end push-pull section is pushed to the far-end side relative to the linear constraint piece.
In some alternative implementations of the embodiments of the invention, it is more preferred that the thrombus removal section is helical about the linear constraint, comprising a distal tapered section of increasing diameter distally from the proximal section and a proximal tapered section of decreasing diameter distally from the proximal section, the proximal face of the distal tapered section forming the proximal opening of the thrombus removal section; the distal tapered section has a pitch less than the pitch of the proximal tapered section.
In some optional implementations of the embodiments of the present invention, it is preferable that the thrombus removal stent further includes a distal connection section, a proximal end of the distal connection section is integrally connected to a distal end of the thrombus removal section, and a distal end of the distal connection section is fixedly or integrally or limitedly connected to the constraint limiter.
Further preferably: the proximal push-pull section and the distal connecting section of the thrombus taking support are both straight sections.
In some alternative implementations of the embodiments of the invention, it is preferable that: the linear constraint piece adopts a constraint wire or a solid constraint rod or a hollow constraint rod provided with an axially-through guide wire cavity.
In some alternative implementations of the embodiments of the invention, it is preferable that: the constraint limiting part comprises a limiting block.
Further preferably: the most distal end of the thrombus taking support is provided with a limiting ring, and the limiting ring is in limiting fit with the limiting block.
In some alternative implementations of the embodiments of the invention, it is preferable that: and a guide head is arranged on the linear constraint piece and positioned at the far end side of the constraint limiting part.
In some alternative implementations of the embodiments of the invention, it is preferable that: and a developing part is arranged on the thrombus taking support and/or the linear constraint piece at a position corresponding to the distal end of the thrombus taking section or a position positioned on the whole distal end side of the thrombus taking section.
In some alternative implementations of embodiments of the invention: the push-pull end of the restraint member is provided with a locking structure for locking the push-pull section at the proximal end of the thrombus taking support.
In particular, in the context of the present invention, the foregoing "and/or" means "and/or" preceding structures are either simultaneously or alternatively arranged with "and/or" following structures.
Specifically, the development idea of the embodiment of the invention is as follows:
in view of the problems with the prior art thrombolytic devices described in the background section, applicant has further analyzed and studied the related structures of the prior art, and analyzed:
(1) Secondary embolism is easily caused, and main reasons include: (1) after the main body of the thrombus taking device is unfolded in a blood vessel, the radial supporting force is reduced along with the increase of the diameter of the blood vessel, and the diameter of a blood vessel at the proximal end is larger than that of a blood vessel at the distal end during retraction, so that the catching force on thrombus is insufficient and the thrombus is easy to fall off; (2) after the main body of the thrombus taking device is unfolded in a blood vessel, the radial supporting force is overlarge, the existing closed-loop structure is easy to cause vascular injury, thrombus can be cut, broken fragments of the thrombus can float to the far end, various thrombus fixing structures can be designed on the thrombus taking section of the existing thrombus taking device, and the more the area of the fixed thrombus is, the more the cutting area is in the fixing process, and the more the escaped thrombus is; the existing thrombus taking device basically has no penetrating force, can not penetrate through a thrombus occlusion part and can only be released near the end side in the thrombus, so that escaping thrombus fragments can not be trapped and captured, and the remote secondary embolism is extremely easy to cause;
(2) The thrombus taking efficiency is low, and main reasons include: in the present thrombus removing device, as described in (1), the thrombus is released only near the end side inside the thrombus, and in the releasing process, the thrombus removing part is pressed by the circumferential pressure of the thrombus at the intravascular position, so that the release is blocked, the expanding area is affected, the released thrombus removing position is located inside the thrombus, the single thrombus removing is incomplete, and the thrombus removing efficiency is affected; in addition, the radial supporting force of the existing thrombus taking support is not adjustable, if the supporting force is too small, thrombus is not easy to be embedded and firmly combined with the thrombus, so that the thrombus is taken out, the thrombus taking success rate is low, and in the case, a proper thrombus taking device is also required to be replaced, so that the thrombus taking efficiency is low; the open loop structure has weak capability of intercepting and capturing thrombus, and can reduce thrombus taking efficiency;
(3) Vulnerable blood vessels, the main reasons include: the thrombus taking structure of the existing thrombus taking device is mostly formed by laser cutting, and the cut section has the risk of damaging blood vessels in the expanding process; when the main body of the thrombus taking device is unfolded in a blood vessel, the radial supporting force is too large, so that the blood vessel injury is very easy to cause;
(4) The existing thrombus taking device has complex integral structure, large volume, poor flexibility, more consumables and high cost, and can not pass through tortuous intracranial blood vessels.
Based on the above analysis, the applicant makes breakthrough improvement on the structure of the existing thrombus removing device to alleviate or even completely solve a series of problems described in the background art, specifically, the applicant adopts the thrombus removing device provided by the embodiment of the present invention, including: a linear restraint and a thrombus taking bracket; the linear constraint piece is made of hard materials, the proximal end of the linear constraint piece is used as a push-pull end of the constraint piece, and the distal end of the linear constraint piece is provided with a constraint limiting part; the thrombus taking bracket is made of metal single wires or nickel-titanium alloy single wires and comprises a proximal push-pull section and a thrombus taking section which are sequentially connected from a proximal end to a distal end; the most distal end of the thrombus taking bracket is fixedly or integrally or limitedly connected with the constraint limiting part; the thrombus collecting structure with the closed distal end, the open proximal end and the hollow area on the peripheral surface is prefabricated in a free state of the thrombus collecting section, and when the proximal push-pull section is pulled towards the proximal section side relative to the linear constraint piece, the diameter of each part of the thrombus collecting structure can be pulled to be smaller, and when the proximal push-pull section is pushed towards the distal section side relative to the linear constraint piece, the diameter of each part of the thrombus collecting structure can be pushed to be larger.
In this embodiment, in the structure of the thrombus taking support, the diameter of the thrombus taking section is adjustable, and at least the following effects are achieved:
(1) Preventing secondary embolism: because the thrombus removing bracket is made of a single wire, when the thrombus removing bracket is compressed to the limit, the whole thrombus removing bracket can be of a monofilament structure, namely, the volume of the thrombus removing device can be compressed to two linear structures comprising a linear constraint piece and the thrombus removing bracket, under the structure, a smaller conveying catheter and an auxiliary outer catheter can be used for conveying, and further, the thrombus removing device can be expanded and applied to a vascular lesion position with smaller diameter such as an intracranial blood vessel, the application range is wider, and the conveying catheter with smaller diameter can penetrate thrombus at a vascular occlusion position more easily, further, the proximal opening of the thrombus removing section 22 is released at the downstream of the thrombus, the thrombus collecting structure of the thrombus removing section is utilized for intercepting the cut and free fragmented thrombus, and the downstream distal secondary embolism is effectively avoided;
(2) Improving the thrombus taking efficiency: as described in (1), the proximal opening of the thrombus removal section is released downstream of the thrombus, and when released, the thrombus removal section is not subjected to circumferential pressure of the thrombus, and further can be fully unfolded, free thrombus can be collected to the greatest extent, and the thrombus is prevented from drifting to a distal blood vessel; in addition, the diameter of the thrombus taking section can be flexibly adjusted according to the condition of the inner diameter of the blood vessel so as to adjust the radial supporting force of the thrombus taking section, and the thrombus taking time delay of replacing the thrombus taking device is avoided so as to improve the thrombus taking success rate;
(3) Reducing damage to the vessel wall: the thrombus taking support is made of a single wire, the damage to the inner wall of a blood vessel is small in the unfolding process after the thrombus taking support is released, the diameter of a thrombus taking section can be flexibly adjusted, and the damage to the wall of the blood vessel due to overlarge radial supporting force is further avoided;
(4) The thrombus removing device provided in this embodiment can be manufactured by, but not limited to, heat setting, and has a simple structure and manufacturing process and low manufacturing cost.
In summary, the embodiment of the invention relieves the problems of easy secondary embolism, low thrombus taking efficiency, easy damage to blood vessels, complex overall structure, large volume, poor flexibility, incapability of passing through tortuous intracranial blood vessels, more consumables, high cost and the like of the traditional thrombus taking device.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings that are needed in the description of the embodiments or the prior art will be briefly described, and it is obvious that the drawings in the description below are some embodiments of the present invention, and other drawings can be obtained according to the drawings without inventive effort for a person skilled in the art.
FIG. 1 is a schematic view showing the overall structure of a first alternative structure of a thrombus removal device according to an embodiment of the present invention;
FIG. 2 is a schematic diagram showing the overall structure of a first alternative structure of the thrombus removal device according to the present invention;
fig. 3 is a schematic diagram of the overall structure of the thrombus removal device according to the embodiment of the present invention in a state in which the second optional structure stop ring is separated from the stop block;
fig. 4 is a schematic diagram showing the overall structure of a thrombus removal device according to the second embodiment of the present invention in a state in which a second optional structure stop collar is separated from a stop block;
fig. 5 is a schematic diagram of the overall structure of the thrombus removal device according to the present invention in a state in which the second alternative structure stop ring is separated from the stop block;
FIG. 6 is a schematic view showing the overall structure of a third alternative structure of the thrombus removal device according to the present invention;
FIG. 7 is a schematic view showing a first alternative structure of a thrombus removal device according to an embodiment of the present invention;
FIG. 8 is a second schematic view showing the steps of using the first alternative structure of the thrombus removal device according to the present invention;
FIG. 9 is a schematic view showing a third step of using a first alternative structure of the thrombus removal device according to the present invention;
fig. 10 is a schematic view showing a step of using a first alternative structure of the thrombus removal device according to the embodiment of the present invention.
Icon: 100-blood vessel; 110-thrombosis; 200-a delivery catheter; 300-auxiliary outer catheter; 1-a linear constraint; 11-a constraint limit part; a 111-limiting block; 112-limiting rings; 2-a thrombus taking bracket; 21-a proximal push-pull section; 22-a thrombus taking section; 221-a proximal conical section; 222-a distal conical section; 23-distal connecting segment; 3-guide head.
Detailed Description
For the purpose of making the objects, technical solutions and advantages of the embodiments of the present invention more apparent, the technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present invention, and it is apparent that the described embodiments are some embodiments of the present invention, but not all embodiments of the present invention. The components of the embodiments of the present invention generally described and illustrated in the figures herein may be arranged and designed in a wide variety of different configurations.
Thus, the following detailed description of the embodiments of the invention, as presented in the figures, is not intended to limit the scope of the invention, as claimed, but is merely representative of selected embodiments of the invention. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
It should be noted that: like reference numerals and letters designate like items in the drawings, and thus once an item is defined in one drawing, no further definition or explanation thereof is necessary in the subsequent drawings.
In the description of the present invention, it should be noted that, directions or positional relationships indicated by terms such as "proximal", "distal", "front", "rear", "inner", "outer", etc., are directions or positional relationships based on those shown in the drawings, or those that are conventionally put in place when the inventive product is used, are merely for convenience in describing the present invention and simplifying the description, and are not indicative or implying that the apparatus or element in question must have a specific direction, be configured and operated in a specific direction, and therefore should not be construed as limiting the present invention. Furthermore, the terms "first," "second," and the like, are used merely to distinguish between descriptions and should not be construed as indicating or implying relative importance.
In particular, in the present invention, the end of the medical device close to the operator is the proximal end of the medical device during surgery, and the end of the medical device entering the blood vessel of the patient is the distal end of the medical device (the front end of the medical device, the downstream in the blood flow direction, and the rear end of the medical device, the upstream in the blood flow direction, are the proximal ends).
In the description of the present invention, it should also be noted that, unless explicitly specified and limited otherwise, the terms "disposed," "mounted," and "connected" are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected; can be directly connected or indirectly connected through an intermediate medium, and can be communication between two elements. The specific meaning of the above terms in the present invention will be understood in specific cases by those of ordinary skill in the art.
Some embodiments of the present invention are described in detail below with reference to the accompanying drawings. The following embodiments and features of the embodiments may be combined with each other without conflict.
In view of the problems with the prior art thrombolytic devices described in the background section of this specification, applicant has further analyzed and studied the related structures of the prior art, and analyzed:
(1) Secondary embolism is easily caused, and main reasons include: (1) after the main body of the thrombus taking device is unfolded in a blood vessel, the radial supporting force is reduced along with the increase of the diameter of the blood vessel, and the diameter of a blood vessel at the proximal end is larger than that of a blood vessel at the distal end during retraction, so that the catching force on thrombus is insufficient and the thrombus is easy to fall off; (2) after the main body of the thrombus taking device is unfolded in a blood vessel, the radial supporting force is overlarge, the existing closed-loop structure is easy to cause vascular injury, thrombus can be cut, broken fragments of the thrombus can float to the far end, various thrombus fixing structures can be designed on the thrombus taking section 22 of the existing thrombus taking device, and the more the area of the fixed thrombus is, the more the cutting area is in the fixing process, and the more the escaped thrombus is; the existing thrombus taking device basically has no penetrating force, can not penetrate through a thrombus occlusion part and can only be released near the end side in the thrombus, so that escaping thrombus fragments can not be trapped and captured, and the remote secondary embolism is extremely easy to cause;
(2) The thrombus taking efficiency is low, and main reasons include: in the present thrombus removing device, as described in (1), the thrombus is released only near the end side inside the thrombus, and in the releasing process, the thrombus removing part is pressed by the circumferential pressure of the thrombus at the intravascular position, so that the release is blocked, the expanding area is affected, the released thrombus removing position is located inside the thrombus, the single thrombus removing is incomplete, and the thrombus removing efficiency is affected; in addition, the radial supporting force of the existing thrombus taking support 2 is not adjustable, if the supporting force is too small, thrombus is not easy to be embedded and firmly combined with the thrombus, so that the thrombus is taken out, the thrombus taking success rate is low, and in the case, a proper thrombus taking device is also replaced, so that the thrombus taking efficiency is low; the open loop structure has weak capability of intercepting and capturing thrombus, and can reduce thrombus taking efficiency;
(3) Vulnerable blood vessels, the main reasons include: the thrombus taking structure of the existing thrombus taking device is mostly formed by laser cutting, and the cut section has the risk of damaging blood vessels in the expanding process; when the main body of the thrombus taking device is unfolded in a blood vessel, the radial supporting force is too large, so that the blood vessel injury is very easy to cause;
(4) The existing thrombus taking device has complex integral structure, large volume, poor flexibility, more consumables and high cost, and can not pass through tortuous intracranial blood vessels.
Based on the above analysis, the applicant carried out a breakthrough improvement on the structure of the existing thrombus-removing device, and obtained the present embodiment, so as to alleviate or even completely solve a series of problems described in the background art, in particular:
referring to fig. 1 and 2, the present embodiment provides a thrombus removing device including a wire-type restraint member 1 and a thrombus taking-out holder 2; the linear restraint 1 is made of hard materials, the proximal end of the linear restraint is used as a push-pull end of the restraint, and the distal end of the linear restraint is provided with a restraint limit part 11; the thrombus taking support 2 is made of metal single wires or nickel-titanium alloy single wires, and the thrombus taking support 2 comprises a proximal push-pull section 21 and a thrombus taking section 22 which are sequentially connected from a proximal end to a distal end; the most far end of the thrombus taking bracket 2 is fixedly or integrally or limitedly connected with the constraint limit part 11; the thrombus collecting section 22 is prefabricated as a thrombus collecting structure having a closed distal end, an open proximal end and a hollowed-out area in the peripheral surface in a free state, and the diameter of each portion of the thrombus collecting structure can be pulled to become smaller when the proximal push-pull section 21 is pulled to the proximal side with respect to the linear constraint member 1, and the diameter of each portion of the thrombus collecting structure can be pushed to become larger when the proximal push-pull section 21 is pushed to the distal side with respect to the linear constraint member 1.
Referring to fig. 7 to 9, the method of using the thrombus removal device provided in the present embodiment is as follows:
first, referring to fig. 7, holding the wire-type restriction member 1 stationary, pulling the proximal push-pull section 21 proximally relative to the wire-type restriction member 1, pulling the thrombus-extracting section 22 backward, and the diameters of the respective parts of the thrombus collecting structure are reduced to compress the thrombus-extracting stent 2 until the thrombus-removing device is compressed into the delivery catheter 200, and then delivering the delivery catheter 200 to the proximal side of the thrombus 110 in the blood vessel 100 along the auxiliary outer catheter 300 for supporting or thrombolysis;
second, referring to fig. 8, the delivery catheter 200 is pushed distally so that the proximal opening of the thrombus removal section 22 of the thrombus removal stent 2 inside the delivery catheter 200 enters the interior of the thrombus 110 and passes through the thrombus 110 to the distal side of the thrombus 110;
third, referring to fig. 9, the linear constraint member 1 is kept stationary, and the distal end position of the thrombus taking stand 2 is fixed by the linear constraint member 1, so that the distal end thereof is prevented from being far away from the thrombus 110; the proximal push-pull section 21 of the thrombus taking support 2 is pushed to the distal side relative to the linear constraint piece 1 by the back-pull conveying catheter 200, the thrombus taking section 22 is released, and in the releasing process, the diameters of the thrombus collecting structure of the thrombus taking section 22 are pushed to be larger, meanwhile, the proximal opening of the thrombus taking section 22 is positioned at the distal side of the thrombus 110, so that broken thrombus 110 fragments can be intercepted in the thrombus collecting structure of the thrombus taking section 22, the possibility that the thrombus 110 is washed to the end blood vessel 100 is avoided or obviously reduced, and secondary embolism at the distal end of the blood vessel 100 is avoided;
fourth, referring to fig. 10, the push-pull end of the constraining member and/or the proximal push-pull section 21 of the embolic stent 2 are withdrawn, and at the same time, the delivery catheter 200 is withdrawn, the embolic stent 2 cuts and intercepts the collected thrombus during withdrawal, and finally the collected thrombus 110 is withdrawn outside the body after being withdrawn inside the auxiliary outer catheter 300.
Among other things, the functions of the auxiliary outer catheter 300 include: the auxiliary outer catheter 300 is used for auxiliary support, so that quick opening is facilitated, or the auxiliary outer catheter 300 is used for auxiliary injection of thrombolytic medicaments, so that thrombus removal efficiency is further improved; if a thrombus which is particularly stubborn is encountered, the thrombus can be removed by adopting a plurality of thrombus removing modes.
In this embodiment, through the above structure, the diameter of the thrombus taking section 22 in the structure of the thrombus taking support 2 is adjustable, which has at least the following effects:
(1) Preventing secondary embolism: because the thrombus removing bracket 2 is made of a single wire, when the thrombus removing bracket 2 is compressed to the limit, the whole thrombus removing bracket 2 can be in a monofilament structure, namely, the volume of the thrombus removing device can be compressed to two linear structures comprising the linear constraint piece 1 and the thrombus removing bracket 2, under the structure, a smaller conveying catheter 200 and an auxiliary outer catheter 300 can be selected for transportation, and further, the thrombus removing device can be expanded and applied to a vascular lesion with smaller diameter such as an intracranial blood vessel, the application range is wider, and the conveying catheter 200 with smaller diameter can more easily penetrate thrombus at the vascular occlusion, further, the proximal opening of the thrombus removing section 22 is released at the downstream of the thrombus, and the thrombus collecting structure of the thrombus removing section 22 is utilized for intercepting the cut and free fragmented thrombus, so that the downstream distal secondary embolism is effectively avoided;
(2) Improving the thrombus taking efficiency: as described in (1), the proximal opening of the thrombus removal section 22 is released downstream of the thrombus, and when released, the thrombus removal section 22 is not subjected to circumferential pressure of the thrombus, and can be fully deployed, so that free thrombus can be collected to a maximum extent, and the thrombus is prevented from drifting to a distal blood vessel; in addition, the diameter of the thrombus taking section 22 can be flexibly adjusted according to the condition of the inner diameter of the blood vessel so as to adjust the radial supporting force of the thrombus taking section 22, and the thrombus taking time delay of replacing the thrombus taking device is avoided so as to improve the thrombus taking success rate;
(3) Reducing damage to the vessel wall: the thrombus taking support 2 is made of a single wire, the damage to the inner wall of a blood vessel is small in the unfolding process after the thrombus taking support is released, the diameter of the thrombus taking section 22 can be flexibly adjusted, and the damage to the wall of the blood vessel due to overlarge radial supporting force is further avoided;
(4) The thrombus removing device provided in this embodiment can be manufactured by, but not limited to, heat setting, and has a simple structure and manufacturing process and low manufacturing cost.
In summary, the embodiment of the invention relieves the problems of easy secondary embolism, low thrombus taking efficiency, easy damage to blood vessels, complex overall structure, large volume, poor flexibility, incapability of passing through tortuous intracranial blood vessels, more consumables, high cost and the like of the traditional thrombus taking device.
In this embodiment, the specific structure of the thrombus-taking section 22 in the thrombus-taking support 2 is various, for example, but not limited to, a net structure formed by winding monofilaments, etc., wherein, in order to make the structure simpler and easier to control, preferably, in some alternative implementations of the embodiment of the present invention, as shown in fig. 1 to 6, the thrombus-taking section 22 is in a spiral shape of the wound-type restraint 1, and includes a distal conical section 222 with a diameter gradually increasing from the proximal section to the distal section and a proximal conical section 221 with a diameter gradually decreasing from the proximal section to the distal section, and the proximal end surface of the distal conical section 222 forms a proximal opening of the thrombus-taking section 22; the pitch of the distal tapered section 222 is smaller than the pitch of the proximal tapered section 221. Under this structure, the proximal end face of the distal tapered section 222 forms the proximal opening of the thrombus taking section 22, and the proximal end face of the distal tapered section 222 can be released at the distal side of the thrombus 110, but the proximal tapered section 221 is released inside the thrombus 110, when the proximal tapered section 221 is radially unfolded, the thrombus 110 can be cut in a large range, the thrombus removal efficiency is accelerated, the pitch of the distal tapered section 222 is smaller than that of the proximal tapered section 221, and then a transitional connection section structure is provided between the proximal end of the thrombus taking section 22 and the distal end of the proximal push-pull section 21, on the one hand, and on the other hand, the proximal end of the distal tapered section 222 can be ensured to have a proximal opening with a sufficiently large area for collecting thrombus.
With continued reference to fig. 1-6, in some alternative implementations of the present invention, it is preferred that the thrombolytic device 2 further comprises a distal connecting section 23, the proximal end of the distal connecting section 23 is integrally connected to the distal end of the thrombolytic section 22, the distal end of the distal connecting section 23 is fixedly or integrally or limitedly connected to the constraining and limiting section 11, and in order to ensure that the thrombi removal device has a minimum volume when compressed, it is further preferred that the proximal push-pull section 21 and the distal connecting section 23 of the thrombolytic device 2 are both straight sections.
In some alternative implementations of the embodiments of the invention, as shown in figures 1 and 2, a wire-type constraint 1 is used.
As shown in fig. 3 to 5, in some alternative implementations of the embodiment of the present invention, the linear constraint member 1 is a solid constraint rod or a hollow constraint rod provided with an axially-through guide wire cavity, and preferably, the linear constraint member 1 is a hollow constraint rod provided with an axially-through guide wire cavity, so as to facilitate transportation and guidance through the guide wire and improve the efficiency of penetrating thrombus.
As shown in fig. 1 to 5, in some alternative implementations of the embodiment of the present invention, it is preferable that the constraint limiter 11 includes a limiter 111.
As shown in fig. 3 to 5, in some further preferred embodiments, the most distal end of the thrombus-taking stand 2 is provided with a limiting ring 112, and the limiting ring 112 is in limiting fit with the limiting block 111 (in the separated state, the limiting assembly modes include but are not limited to a limiting connection assembly mode such as clamping or interference fit).
As shown in fig. 6, in some alternative implementations of the embodiment of the present invention, a guide head 3 is provided on the linear constraint member 1 at the distal end side of the constraint limit portion 11, and the structure of the guide head 3 has a guiding function as compared with the structure of the linear constraint member 1 using a hollow constraint rod provided with a guide wire lumen penetrating axially, but is simpler and more convenient to apply.
In some alternative implementations of the embodiments of the invention, it is preferable that: the thrombus removing holder 2 and/or the linear constraining member 1 is provided with a developing portion (not shown) at a position corresponding to the distal end of the thrombus removing section 22 or at a position on the distal end side of the entire thrombus removing section 22, and the developing portion is preferably provided at the constraining and limiting portion 11, but may be of a developing ring structure.
In some alternative implementations of the embodiments of the invention, it is preferable that: the push-pull end of the constraining member is provided with a locking structure (not shown) for locking the proximal push-pull section 21 of the thrombus taking support 2, the locking structure is favorable for locking the state after the diameter of the thrombus taking section 22 is adjusted, and is favorable for stable thrombus cutting and thrombus taking in use.
Finally, it should be noted that:
1. in the present specification, "and/or" means "and/or" preceding structure is provided simultaneously or alternatively with "and/or" following structure;
2. in the present specification, each embodiment is described in a progressive manner, and each embodiment is mainly described by differences from other embodiments, and identical and similar parts between the embodiments are only required to be seen with each other; the above embodiments in the present specification are only for illustrating the technical solution of the present invention, and are not limiting; although the invention has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical scheme described in the foregoing embodiments can be modified or some or all of the technical features thereof can be replaced by equivalents; such modifications and substitutions do not depart from the spirit of the invention.
Claims (10)
1. A thrombus removal device, characterized in that: comprising the following steps:
a linear constraint element (1) made of hard materials, wherein the proximal end of the linear constraint element is used as a push-pull end of the constraint element, and the distal end of the linear constraint element is provided with a constraint limiting part (11);
the thrombus taking support (2) is made of a single wire and comprises a proximal push-pull section (21) and a thrombus taking section (22) which are sequentially connected from a proximal end to a distal end; the most distal end of the thrombus taking support (2) is fixedly or integrally or limitedly connected with the constraint limiting part (11); the thrombus collecting section (22) is prefabricated into a thrombus collecting structure with a closed distal end, an open proximal end and a hollowed-out area on the peripheral surface in a free state, and when the proximal push-pull section (21) is pulled towards the proximal section side relative to the linear constraint piece (1), the diameter of each part of the thrombus collecting structure can be pulled to be smaller, and when the proximal push-pull section (21) is pushed towards the distal section side relative to the linear constraint piece (1), the diameter of each part of the thrombus collecting structure can be pushed to be larger.
2. The thrombi removal device of claim 1, wherein: the thrombus taking section (22) is in a spiral shape around the linear constraint piece (1) and comprises a distal conical section (222) with the diameter gradually increasing from the proximal section to the distal end and a proximal conical section (221) with the diameter gradually decreasing from the proximal section to the distal end, and the proximal end face of the distal conical section (222) forms a proximal opening of the thrombus taking section (22);
the pitch of the distal tapered section (222) is smaller than the pitch of the proximal tapered section (221).
3. The thrombi removal device of claim 1, wherein: the thrombus taking support (2) further comprises a distal end connecting section (23), the proximal end of the distal end connecting section (23) is integrally connected to the distal end of the thrombus taking section (22), and the distal end of the distal end connecting section (23) is fixedly or integrally or limitedly connected to the constraint limiting part (11).
4. The thrombus removal device of claim 3, wherein: the proximal push-pull section (21) and the distal connecting section (23) of the thrombus taking support (2) are straight sections.
5. The thrombi removal device of claim 1, wherein: the linear constraint piece (1) adopts a constraint wire or a solid constraint rod or a hollow constraint rod provided with an axially-through guide wire cavity.
6. The thrombi removal device of claim 1, wherein: the constraint limiting part (11) comprises a limiting block (111).
7. The thrombi removal device of claim 6, wherein: the most distal end of the thrombus taking support (2) is provided with a limiting ring (112), and the limiting ring (112) is in limiting fit with the limiting block (111).
8. The thrombi removal device of claim 1, wherein: the linear constraint piece (1) is provided with a guide head (3) at the far end side of the constraint limiting part (11).
9. The thrombi removal device of claim 1, wherein: and a developing part is arranged on the thrombus taking support (2) and/or the linear constraint piece (1) and at a position corresponding to the distal end of the thrombus taking section (22) or a position positioned on the whole distal end side of the thrombus taking section (22).
10. The thrombi removal device of claim 1, wherein: the push-pull end of the restraint piece is provided with a locking structure for locking the push-pull section (21) at the proximal end of the thrombus taking support (2).
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202311198424.9A CN116942255B (en) | 2023-09-18 | 2023-09-18 | Thrombus removing device |
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| CN202311198424.9A CN116942255B (en) | 2023-09-18 | 2023-09-18 | Thrombus removing device |
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| CN116942255B CN116942255B (en) | 2023-12-12 |
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| US20030018354A1 (en) * | 2001-07-18 | 2003-01-23 | Roth Noah M. | Integral vascular filter system with core wire activation |
| US20110295305A1 (en) * | 2008-12-30 | 2011-12-01 | Massimo Morero | Blood clot removal device |
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| CN116942255B (en) | 2023-12-12 |
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