CN116965884A - Vascular occlusion opening instrument - Google Patents
Vascular occlusion opening instrument Download PDFInfo
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- CN116965884A CN116965884A CN202311227361.5A CN202311227361A CN116965884A CN 116965884 A CN116965884 A CN 116965884A CN 202311227361 A CN202311227361 A CN 202311227361A CN 116965884 A CN116965884 A CN 116965884A
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- opening
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- rod
- rear end
- sliding block
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- 206010053648 Vascular occlusion Diseases 0.000 title claims abstract description 19
- 208000021331 vascular occlusion disease Diseases 0.000 title claims abstract description 19
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Classifications
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- 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
- A61B17/22004—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 using mechanical vibrations, e.g. ultrasonic shock waves
- A61B17/22012—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00743—Type of operation; Specification of treatment sites
- A61B2017/00778—Operations on blood vessels
-
- 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
- A61B17/22004—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 using mechanical vibrations, e.g. ultrasonic shock waves
- A61B17/22012—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
- A61B2017/22014—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire
- A61B2017/22015—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire with details of the transmission member
- A61B2017/22017—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire with details of the transmission member the ultrasonic transmitting members being fibres
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- 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
- A61B17/22004—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 using mechanical vibrations, e.g. ultrasonic shock waves
- A61B17/22012—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
- A61B2017/22025—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement applying a shock wave
-
- 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
- A61B2017/22051—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 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
-
- 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
- A61B2017/22051—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 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
- A61B2017/22065—Functions of balloons
- A61B2017/22068—Centering
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Molecular Biology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Mechanical Engineering (AREA)
- General Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Vascular Medicine (AREA)
- Dentistry (AREA)
- Surgical Instruments (AREA)
Abstract
The invention provides a vascular occlusion opening instrument, which relates to the field of medical instruments and comprises an outer tube, a supporting and positioning part, an energy amplifying handle, an opening rod and a power source; the supporting and positioning part is arranged at the front end of the outer tube and comprises a radial expansion state and a radial contraction state; the energy amplifying handle comprises a handle shell, a sliding block, a front spring and a rear spring, wherein the sliding block, the front spring and the rear spring are arranged in the handle shell; the opening rod passes through the outer tube, and the rear end of the opening rod passes through the handle shell and is fixedly connected with the sliding block; the power source is connected to the rear end of the opening rod or the sliding block and is used for driving the opening rod to vibrate back and forth and/or rotate circumferentially relative to the outer tube. The invention can open the occlusion in the middle of the blood vessel, and can improve the opening strength in the opening process of front and back vibration, thereby obviously improving the success rate of opening, improving the efficiency of opening and reducing the risk of operation; in addition, the supporting and positioning part can be arranged to support and expand the opened part while opening, so that the step of additionally introducing the volume reducing device in the prior art is omitted, and the operation is simpler and more convenient.
Description
Technical Field
The invention relates to the field of medical appliances, in particular to a vascular occlusion opening appliance.
Background
The arteriosclerosis obliteration is that systemic atherosclerosis is locally expressed in limbs, is that systemic arterial intima and layers thereof are in degenerative and proliferative changes, so that the wall of a blood vessel is hardened and reduced and loses elasticity, and the distal blood flow is progressively reduced or interrupted due to secondary thrombosis; usually starting from an artery and then possibly affecting veins, typically progressing distally to proximally, lesions are distributed in segments, with the vessels between the two segments being relatively normal, well in the coronary and peripheral arteries. Occlusive lesions more than three months may be referred to as chronic total occlusion (chronic total occlusion, CTO) lesions, which account for more than 30% of occlusive lesions, resulting in distal ischemia, myocardial infarction, and even amputation, death.
The intracavitary interventional therapy has become the first choice therapeutic mode of CTO pathological change, and the intracavitary interventional therapy utensil of the usual use includes seal wire, sacculus, support, volume reduction equipment etc., among the prior art, the treatment includes at least: firstly, pushing a guide wire to a lesion site along a human body lumen through a puncture, wherein the head end of the guide wire is generally soft in order to avoid damaging blood vessels in the pushing process, and after the guide wire reaches the lesion site, the occlusion section of the lesion site cannot be opened by directly utilizing the distal (front) part of the guide wire, and after a catheter is needed to be placed, different types of guide wires are exchanged through the catheter until the guide wire can pass through the occlusion lesion; second, the lumen size of the occlusion is further enlarged using guidewire-advanced balloon catheters, thrombolytic catheters, or other rotational milling type of reduction instruments, which may also include, but are not limited to, implantable stent-stenting. The whole process needs to change the opening and expanding instruments, and has complex operation and long operation time.
For the first step, due to the CTO lesion caused by atherosclerosis, the occlusion section is accompanied with a hard fibrous cap and calcified plaque, the texture is hard, the problems of long time consumption, damage to the vascular wall and low opening success rate of a guide wire opening process exist, and the opening failure of the occlusion section is one of the main problems of the current failure of the interventional treatment operation in the cavity of the CTO lesion.
More specifically, for the opening type device used in the first step, the following three types are mainly included at present:
(1) The unpowered rotary grinding is carried out, a single catheter structure is adopted, the catheter is extended into the lesion occlusion position, the catheter is manually rotated and forwards applied with force, and the calcification points of the occlusion position are subjected to friction cutting, so that the opening purpose is realized; the mode has low opening efficiency;
(2) The active power rotary grinding comprises a rotary power source and a guide wire connected with the rotary power source, wherein a rotary grinding head is arranged at the front end of the guide wire, the guide wire is extended into a lesion occlusion position by virtue of a catheter, and the guide wire is driven to rotate by the rotary power source to rub calcification points of the occlusion position, so that the opening purpose is realized; however, in the way, the opening efficiency of the rotary grinding opening mode for the complete occlusion is low, the rotary grinding has no function of impacting and vibrating to open calcification points, the high rotation speed of the grinding head can also cause the decomposition of hemoglobin cells, and especially the high temperature generated by the high-speed rotation of the grinding head can easily cause the aggregation of blood platelets, thereby influencing the opening effect; the overlong opening time also has the risk that the interaction between the rotary power source and the guide wire causes the guide wire to be broken or the rotary grinding head at the front end of the guide wire is perforated outside the blood vessel;
(3) The ultrasonic shock wave opening comprises an ultrasonic generator, a connector and a guide wire or catheter structure, the guide wire or catheter is stretched into the lesion occlusion, and the calcification points of the occlusion are knocked by ultrasonic energy carrying the ultrasonic vibration of the guide wire or catheter; however, in this way, the aperture of the opening is smaller, and in the opening process, the position of the through hole of the front opening head is difficult to control, the opening hole is irregular, the opening function is not provided, the edge of the blood vessel and the calcification point is easy to open, the blood vessel intima is damaged, and the opening head can even penetrate the blood vessel to enter the inner layer of the blood vessel intima, so that the operation risks such as blood vessel perforation and the like are caused.
For the second step, the prior art developed volume reduction devices such as vibrating balloons, thrombolytic catheters, rotational milling catheters, aspiration catheters, etc. in order to provide a larger effective lumen diameter for thrombus and calcification removal; when the volume reduction effect is poor, the stent is required to be placed in the expanded lumen, but the stent can stimulate endothelial hyperplasia after being placed, so that restenosis in the stent is caused, and the occlusion rate in the middle and long periods exceeds 50%.
Disclosure of Invention
The invention aims to provide a vascular occlusion opening device, which is used for alleviating the technical problems in the prior art.
In order to achieve the above purpose, the embodiment of the present invention adopts the following technical scheme:
the embodiment of the invention provides a vascular occlusion opening instrument which comprises an outer tube, a supporting and positioning part, an energy amplifying handle, an opening rod and a power source.
The support positioning part is arranged at the front end of the outer tube and comprises a radial expansion state and a radial contraction state; the energy amplifying handle comprises a handle shell, a sliding block, a front spring and a rear spring, wherein the sliding block, the front spring and the rear spring are arranged in the handle shell, the handle shell is connected to the rear end of the outer tube, the front end of the front spring is in contact with the front wall of the inner cavity of the handle shell, the rear end of the front spring is in contact with the front end face of the sliding block, and the front end of the rear spring is in contact with the rear end face of the sliding block; the opening rod passes through the outer tube, the front end of the opening rod passes through the supporting and positioning part, and the rear end of the opening rod passes through the handle shell and is fixedly connected with the sliding block; the power source is connected to the rear end of the opening rod or the sliding block and is used for driving the opening rod to vibrate back and forth and/or rotate circumferentially relative to the outer tube.
In this embodiment:
the supporting and positioning part is arranged, so that the supporting and positioning part can be operated to be opened in a radial expansion state during opening, the outer tube extending into the blood vessel of a patient is centered and positioned, the opening rod in the outer tube is centered and positioned along with the opening rod, and then, a power source is started to drive the opening rod to vibrate back and forth and/or rotate circumferentially relative to the outer tube so as to perform centered high-energy opening on calcification points, the opening efficiency is improved, and meanwhile, the risk of perforation of the blood vessel in the opening process is reduced;
in addition, due to the arrangement of the energy amplifying handle, when the power source drives the opening rod to vibrate back and forth relative to the outer tube, the opening rod slides back and forth relative to the handle shell with the sliding block, so that in the double-spring structure of the front spring and the rear spring, one spring is pressed, the other spring is pulled, larger energy storage is generated, the auxiliary power source improves the back and forth reciprocating vibration amplitude and vibration frequency of the opening rod, reciprocating impact vibration is provided, the capability of opening the vascular occlusion position of the opening rod is higher, the extending distance of the front end of the opening rod can be effectively limited, opening strength and efficiency are further improved, and surgical risks possibly caused by overlong opening time are reduced.
In the structure, not only can the central opening of the occlusion in the blood vessel be realized, but also the opening force can be improved in the opening process of front-back vibration, so that the success rate of opening can be obviously improved, the opening efficiency can be improved, and the operation risk can be reduced; in addition, the supporting and positioning part can be arranged to support and expand the opened part while opening, so that the step of additionally introducing a volume reducing device in the prior art is omitted, and the operation is simpler and more convenient; in addition, the blocking position can be flexibly adapted to blocking structures of different types by operating the front and back vibration drilling and/or circumferential rotation grinding of the opening rod according to specific conditions such as blocking hardness of the blocking position, blocking section length and the like, and the use is simple and convenient, and the opening efficiency is higher.
In some alternative implementations of this embodiment, the support positioning portion employs a memory mesh stent configured to assume a radially expanded state in a released free state; in other alternative implementations of this embodiment, the support locator uses a non-compliant balloon.
In an alternative implementation manner of the present embodiment, preferably, in the energy amplifying handle, a guide rail extending along a front-back direction is provided on a peripheral wall of an inner cavity of the handle shell, and the slider is slidably mounted on the guide rail.
In an alternative implementation manner of the present embodiment, preferably, the vascular occlusion opening apparatus further includes a Y-valve and a plug, where the Y-valve is fixedly or integrally connected to a front end of the handle shell of the energy amplifying handle and is fixedly connected to a rear end of the outer tube; the plug is arranged at the rear end of the handle shell of the energy amplification handle to plug the handle shell, and a through hole for the opening rod to pass through is formed in the plug.
In an alternative implementation manner of this embodiment, it is preferable that the opening rod adopts a hollow tube structure.
Further, this embodiment includes at least the following more specific alternative implementations:
in a first alternative embodiment, the rear end of the opening rod passes through the rear end of the handle shell of the energy amplifying handle, and the power source comprises a movable handle fixedly connected to the rear end of the opening rod.
In a second type of optional embodiment, based on the first type of optional structure, the power source further includes an ultrasonic vibrator installed at the rear end of the moving handle.
In a third alternative embodiment, based on the first alternative structure, the power source further includes a rotary grinding motor mounted at the rear end of the moving handle.
In a fourth alternative embodiment, in the energy amplification handle, a guide rail extending along the front and back direction is arranged on the peripheral wall of the inner cavity of the handle shell, and the sliding block is slidably mounted on the guide rail; the power source comprises a rotating motor, a transmission rod and a transmission mechanism; the transmission rod passes through a perforation arranged on the side wall of the handle shell, the first end of the transmission rod is fixedly connected with the sliding block, and the second end of the transmission rod is connected with the rotating motor through the transmission mechanism; the transmission mechanism is configured to be capable of sliding back and forth along the handle housing with the slider under the rotational driving force of the rotary motor. Further, the transmission mechanism comprises a carrying guide rail block, a spiral rail is arranged on the outer peripheral surface of the carrying guide rail block, one end of the carrying guide rail block is fixedly connected with an output shaft of the rotating motor, and the second end of the transmission rod is limited and is in sliding connection with the spiral rail.
In a fifth alternative embodiment, in the energy amplifying handle, a guide rail extending along the front and back direction is arranged on the peripheral wall of the inner cavity of the handle shell, and the sliding block is slidably mounted on the guide rail; the power source comprises a rotating motor, a transmission rod and a transmission mechanism; the transmission rod passes through a perforation arranged on the side wall of the handle shell, the first end of the transmission rod is fixedly connected with the sliding block, and the second end of the transmission rod is connected with the rotating motor through the transmission mechanism; the transmission mechanism is configured to be capable of sliding back and forth along the handle housing with the slider under the rotational driving force of the rotary motor. Further, the transmission mechanism comprises a drive bevel gear, a transmission bevel gear and a crank; the driving bevel gear is sleeved on the output shaft of the rotating motor, the driving bevel gear is vertical and meshed with the driving bevel gear, the driving input end of the crank is connected to the eccentric point of the driving bevel gear, the driving rod is used as a rocker, and the second end of the driving rod is connected to the driving output end of the crank.
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.
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 an isometric view of the overall structure of some alternative embodiments of a vaso-occlusive opening apparatus (first class of alternative embodiments, which are classified according to the type of power source) provided by an embodiment of the present invention;
FIG. 2 is a cross-sectional view of the general structure of the vaso-occlusive opening device shown in FIG. 1;
FIG. 3 is an enlarged view of the part of the structure of the portion A in FIG. 2;
FIG. 4 is an enlarged view of a portion of the structure of the portion B in FIG. 2;
FIG. 5 is an isometric view of the overall structure of alternative embodiments of a vaso-occlusive opening device provided in accordance with an embodiment of the present invention;
FIG. 6 is an enlarged view of a portion of the structure of the portion C in FIG. 5;
FIG. 7 is an isometric view of a second alternate embodiment of a vaso-occlusive opening apparatus according to an embodiment of the present invention, divided according to power source type;
FIG. 8 is an enlarged view of a portion of the vaso-occlusive opening device of FIG. 7 at the D site;
FIG. 9 is an isometric view of a third alternative embodiment of a vascular occlusion activation device according to an embodiment of the present invention, the third alternative embodiment being defined by a type of power source;
FIG. 10 is an enlarged view of a portion of the vaso-occlusive opening device of FIG. 9 at the E site;
FIG. 11 is an isometric view of a fourth alternative embodiment of a vascular occlusion activation device according to an embodiment of the present invention, the fourth alternative embodiment being defined by a type of power source;
FIG. 12 is an enlarged view of a portion of the F-site of the vaso-occlusive opening device of FIG. 11;
FIG. 13 is a cross-sectional view of the general structure of the vaso-occlusive opening device of FIG. 11;
FIG. 14 is an enlarged view of the part of the G-site of FIG. 13;
fig. 15 is an isometric view of the overall structure of a fifth alternative embodiment of a vaso-occlusive opening apparatus according to an embodiment of the present invention, divided according to the type of power source;
FIG. 16 is an enlarged view of a portion of the H-site of the vaso-occlusive opening device of FIG. 15;
FIG. 17 is an enlarged view of a portion of the structure of the portion I in FIG. 16;
FIG. 18 is a cross-sectional view of the general structure of the vaso-occlusive opening device of FIG. 15;
FIG. 19 is an enlarged view of a portion of the structure of the J portion of FIG. 18;
fig. 20 is an enlarged view of a part of the structure of the K portion in fig. 19.
Icon: 1-an outer tube; 11-a supporting and positioning part; 2-an energy-magnifying handle; 21-a handle shell; 22-slide block; 23-front springs; 24-rear spring; 25-jackscrews; 3-an open lever; a 4-Y valve; 5-plugs; 6-moving the handle; 7-acoustic wave vibrators; 8-a rotary grinding motor; 91-a rotating electrical machine; 92-transmission rod; 93-a transmission mechanism; 931—carry a rail block; 9310-spiral track; 932-drive bevel gear; 933-drive bevel gear; 934-crank.
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 "front end", "rear end", "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 of describing the present invention and simplifying the description, and are not indicative or implying that the apparatus or element to be referred to must have a specific direction, be configured and operated in a specific direction, and thus 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 invention, the end of the medical instrument close to the operator is taken as the rear end of the medical instrument during operation, and the end of the medical instrument entering the blood vessel of the patient is taken as the front end of the medical instrument.
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.
The present embodiment provides a vascular occlusion opening device, referring first to fig. 1 to 4, which includes an outer tube 1, a supporting and positioning portion 11, an energy amplifying handle 2, an opening rod 3, and a power source. Wherein, support location portion 11 locates outer tube 1 front end, and this support location portion 11 includes radial expansion state and radial contraction state. The energy amplifying handle 2 comprises a handle shell 21, a sliding block 22, a front spring 23 and a rear spring 24, wherein the sliding block 22, the front spring 23 and the rear spring 24 are arranged in the handle shell 21, the handle shell 21 is connected to the rear end of the outer tube 1, the front end of the front spring 23 is in contact with the front wall of the inner cavity of the handle shell 21, the rear end of the front spring is in contact with the front end face of the sliding block 22, and the front end of the rear spring 24 is in contact with the rear end face of the sliding block 22, and the rear end of the rear spring is in contact with the rear wall of the inner cavity of the handle shell 21. The opening rod 3 passes through the outer tube 1, the front end of which passes through the supporting and positioning part 11, and the rear end of which passes through the handle shell 21 and is adhered or fixedly connected to the slide block 22 through a jackscrew 25 or other structures. The power source is connected to the rear end of the opening rod 3 or the sliding block 22, and is used for driving the opening rod 3 to vibrate back and forth and/or rotate circumferentially relative to the outer tube 1.
In this embodiment, the supporting and positioning portion 11 is provided, so that the supporting and positioning portion 11 can be operated to be expanded in a radial expansion state during opening, and then the outer tube 1 extending into the blood vessel of a patient is centrally positioned, the opening rod 3 in the outer tube 1 is centrally positioned along with the opening rod, and then a power source is started to drive the opening rod 3 to vibrate back and forth and/or circumferentially rotate relative to the outer tube 1, so as to perform high-energy opening on calcifications centrally, improve the opening efficiency, and simultaneously reduce the risk of perforation of the blood vessel in the opening process; in addition, due to the arrangement of the energy amplification handle 2, when the power source drives the opening rod 3 to vibrate forwards and backwards relative to the outer tube 1, the opening rod 3 drives the sliding block 22 to slide forwards and backwards relative to the handle shell 21, so that one spring is pressed and the other spring is pulled in the double-spring structure of the front spring 23 and the rear spring 24, larger energy storage is generated, the auxiliary power source improves the amplitude and the vibration frequency of the forward and backward reciprocating vibration of the opening rod 3, and reciprocating impact vibration is provided, so that the capability of opening the vascular occlusion of the opening rod 3 is stronger, the extending distance of the front end of the opening rod 3 can be effectively limited, the opening strength and the opening efficiency are further improved, and the operation risk possibly caused by overlong opening time is reduced.
In the structure, the opening can be realized at the middle of the occlusion in the blood vessel, and the opening force can be improved in the front-back vibration opening process, so that the opening success rate and the opening efficiency can be obviously improved, the operation risk is reduced, in addition, the opening can be realized at the opening-out part while the supporting and positioning part 11 is arranged, the step of additionally introducing a volume-reducing device in the prior art is omitted, and the operation is simpler and more convenient; in addition, the blocking position can be flexibly adapted to different blocking structures to be opened according to specific conditions such as blocking hardness of the blocking position, blocking section length and the like, and the opening rod 3 is operated to vibrate back and forth to drill holes and/or circumferentially rotate to grind the blocking position, so that the device is simple and convenient to use and has higher opening efficiency.
With continued reference to fig. 1 to 4, in some alternative implementations of the present embodiment, the supporting and positioning portion 11 employs a memory mesh stent configured to assume a radially expanded state in a free state after being released, specifically, the memory mesh stent may be prefabricated using a nickel-titanium memory alloy wire, and preferably, the memory mesh stent is not connected with a covering film, that is, is made into a bare mesh stent structure, so as to avoid obstruction to a blood flow path; further, it is preferable that the mesh stent has a cylindrical structure in the middle region in the longitudinal direction after radial expansion as shown in fig. 3, so as to increase the contact area with the inner wall of the blood vessel of the patient in the radially expanded state as much as possible, thereby improving the supporting ability thereof.
Referring to fig. 5 and 6, in other alternative implementations of the present embodiment, the supporting and positioning portion 11 may also use a non-compliant balloon, where the shape of the compliant balloon after pressurization changes due to external pressure, so that the positioning effect is not ideal, and the positioning performance is better because the shape of the non-compliant balloon does not change due to external pressure after pressurization.
In an alternative implementation manner of this embodiment, preferably, in the energy amplification handle 2, a guide rail extending along the front and rear direction is provided on the peripheral wall of the inner cavity of the handle shell 21, and the sliding block 22 is slidably mounted on the guide rail, where the length of the guide rail is smaller than that of the inner cavity of the handle shell 21, so as to reserve a space for separating the guide rail for the sliding block 22, and when the opening rod 3 needs to be rotated, the sliding block 22 is moved forward or backward relative to the handle shell 21, so that the sliding block 22 is separated from the guide rail, and the opening rod 3 can be driven to rotate by using a power source.
In an alternative implementation manner of the present embodiment, it is preferable that the vascular occlusion opening device further includes a Y-valve 4 and a plug 5, and the Y-valve 4 is fixedly or integrally connected to the front end of the handle shell 21 of the energy amplification handle 2 and fixedly connected to the rear end of the outer tube 1; the plug 5 is arranged at the rear end of the handle shell 21 of the energy amplification handle 2 to plug the handle shell 21, a through hole for the opening rod 3 to pass through is formed in the plug 5, the Y-shaped valve 4 can be used for introducing cooling liquid or helping to dissolve biological solvent for blocking calcification or used for connecting broken fragments in the sucking opening process of the sucking equipment, and the plug 5 has the function of preventing blood leakage.
In an alternative implementation of this embodiment, it is preferable that the opening rod 3 adopts a tube structure, and the front end thereof is preferably provided with an arc-shaped grinding head.
Further, for better operation, it is preferable that developing rings or other developing marks are provided at the front and rear ends of the above-mentioned supporting and positioning portion 11, respectively.
In addition, in this embodiment, the optional structures of the power source have multiple forms, so that different opening modes can be flexibly selected according to the patient condition, and different opening effects can be achieved, and the multiple optional structures of this embodiment are divided according to the types of the power source, and this embodiment at least includes the following more specific optional embodiments:
first class of alternative embodiments
As shown in fig. 1 to 6, the rear end of the opening lever 3 penetrates out of the rear end of the handle housing 21 of the energy amplifying handle 2, and the power source includes a moving handle 6 fixedly connected to the rear end of the opening lever 3.
The supporting and positioning part 11 is utilized to perform central positioning in the blood vessel, so that the opening is more centered, the risk of perforation of the blood vessel in the opening process is reduced, the moving handle 6 is pulled to enable the sliding block 22 to move backwards, the front spring 23 in the energy amplifying handle is stretched, the rear spring 24 is compressed, the front end of the opening rod 3 can easily pass through an occlusion region by utilizing the energy storage of the double springs, and meanwhile, the double springs can effectively limit the length of the opening rod 3 extending out of the supporting and positioning part 11 at the front end of the outer tube 1 and provide reciprocating impact vibration, so that the opening efficiency is improved; when the moving handle 6 is pushed to disengage the slider 22 from the guide rail, the moving handle 6 can be manually rotated to manually spin open the occlusion region.
Second class of alternative embodiments
Referring to fig. 7 and 8, on the basis of the first alternative structure, the power source further includes an ultrasonic vibrator 7 mounted at the rear end of the moving handle 6, and when the wall thickness is smaller than 1mm, the ultrasonic energy of the ultrasonic vibrator 7 can be utilized to fully block calcification, and under the reinforcing effect of double-spring energy storage in the energy amplifying handle 2, the front end of the opening rod 3 is carried to easily pass through the blocking area, and meanwhile, the double springs effectively limit the extending length of the opening rod 3, and provide reciprocating impact vibration, so that the opening efficiency is improved.
Third class of alternative embodiments
Referring to fig. 9 and 10, on the basis of the first alternative structure, the power source further includes a rotary grinding motor 8 mounted at the rear end of the moving handle 6, and when some of the blocking positions are seriously calcified and the blocking area is long, the rotary grinding motor 8 is used for driving the opening rod 3 to rotate and grind the blocking positions, so as to perform efficient opening of drilling, and it is required to specifically specify that, in the energy amplification handle 2, the inner cavity peripheral wall of the handle shell 21 is provided with a guide rail extending forwards and backwards, the slide block 22 is slidably mounted under the structure of the guide rail, the guide rail can be provided with a short length, and the slide block 22 is separated from the guide rail by sliding the moving handle 6 forwards or backwards, and then the rotary grinding motor 8 is used for driving the opening rod 3 to rotate and grind the blocking positions.
Fourth class of alternative embodiments
Referring to fig. 11 to 14, in the present alternative embodiment, in the energy-magnifying handle 2, a guide rail extending in the front-rear direction is provided on the peripheral wall of the inner cavity of the handle case 21, and the slider 22 is slidably mounted on the guide rail; the power source includes a rotary motor 91, a transmission rod 92, and a transmission mechanism 93; the transmission rod 92 passes through a through hole formed in the side wall of the handle shell 21, and is fixedly connected to the sliding block 22 at a first end and connected to the rotary motor 91 at a second end through a transmission mechanism 93; the transmission mechanism 93 is configured to be capable of sliding back and forth along the handle case 21 with the slider 22 by the rotational driving force of the rotary motor 91. Further, the transmission mechanism 93 includes a mounting rail block 931, a spiral rail 931 is provided on an outer peripheral surface of the mounting rail block 931, one end of the mounting rail block 931 is fixedly connected to an output shaft of the rotary electric machine 91, and a second end of the transmission rod 92 is limited and slidably connected to the spiral rail 931.
When the rotary electric machine 91 is started, the mounting guide rail block 931 rotates along with the output shaft of the rotary electric machine 91, the second end of the transmission rod 92 moves along the spiral rail 9310, and the opening rod 3 moves forward and backward to open the vascular occlusion under the constraint that the slider 22 slides forward and backward along the guide rail in the handle case 21.
In this alternative embodiment, preferably, the power source structure provided in any one of the first to third alternative embodiments may be further provided, specifically, the rear end of the opening rod 3 may be further penetrated out of the rear end of the handle shell 21 of the energy amplifying handle 2, and the power source may further include a moving handle 6 fixedly connected to the rear end of the opening rod 3, further optionally, the rear end of the moving handle 6 is selectively connected with an ultrasonic vibrator 7 or a rotational grinding motor 8, and in practical application, an operator should flexibly switch between the power source modes of the moving handle 6, the ultrasonic vibrator 7, the rotational grinding motor 8 and the rotational motor 91 for performing efficient opening of the vascular occlusion.
Fifth class of alternative embodiments
Referring to fig. 15 to 20, in the present alternative embodiment, in the energy amplifying handle 2, a guide rail extending in the front-rear direction is provided on the peripheral wall of the inner cavity of the handle case 21, and a slider 22 is slidably mounted on the guide rail; the power source includes a rotary motor 91, a transmission rod 92, and a transmission mechanism 93; the transmission rod 92 passes through a through hole formed in the side wall of the handle shell 21, and is fixedly connected to the sliding block 22 at a first end and connected to the rotary motor 91 at a second end through a transmission mechanism 93; the transmission mechanism 93 is configured to be capable of sliding back and forth along the handle case 21 with the slider 22 by the rotational driving force of the rotary motor 91. Further, the transmission mechanism 93 includes a drive bevel gear 932, a transmission bevel gear 933, and a crank 934; the drive bevel gear 932 is sleeved on the output shaft of the rotary motor 91, the drive bevel gear 933 is vertical and meshed with the drive bevel gear 932, the drive input end of the crank 934 is connected to the eccentric point of the drive bevel gear 933, the drive rod 92 serves as a rocker, and the second end of the drive rod 92 is connected to the drive output end of the crank 934.
When the rotary motor 91 is started, the drive bevel gear 932, the drive bevel gear 933, and the crank 934 are operated in succession, and the drive lever 92 is operated, so that the vascular occlusion site is opened by the forward and backward movement of the opening lever 3 under the restriction that the slider 22 slides forward and backward along the guide rail in the handle case 21.
In this alternative embodiment, preferably, the power source structure provided in any one of the first to third alternative embodiments may be further provided, specifically, the rear end of the opening rod 3 may be further penetrated out of the rear end of the handle shell 21 of the energy amplifying handle 2, and the power source may further include a moving handle 6 fixedly connected to the rear end of the opening rod 3, and further optionally, the rear end of the moving handle 6 is selectively connected to the ultrasonic vibrator 7 or the rotary grinding motor 8; for example, as shown in fig. 15 to 20, that is, the power source structure provided in the second alternative embodiment is additionally provided, so that the power source further includes a view of the moving handle 6 and the ultrasonic vibrator 7 fixedly connected to the rear end of the opening rod 3, and other alternative structures can be obtained by referring to the change of the view; in practical application, the operator should flexibly switch between the power source modes of the movable handle 6, the ultrasonic vibrator 7, the rotary grinding motor 8 and the rotary motor 91 according to different lesion structures, and the vascular occlusion is opened efficiently.
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 vascular occlusion opening device, characterized by: comprising the following steps:
an outer tube (1);
the supporting and positioning part (11) is arranged at the front end of the outer tube (1) and comprises a radial expansion state and a radial contraction state;
the energy amplifying handle (2) comprises a handle shell (21), and a sliding block (22), a front spring (23) and a rear spring (24) which are arranged in the handle shell (21), wherein the handle shell (21) is connected to the rear end of the outer tube (1), the front end of the front spring (23) is in contact with the front wall of an inner cavity of the handle shell (21), the rear end of the front spring is in contact with the front end surface of the sliding block (22), and the front end of the rear spring (24) is in contact with the rear end surface of the sliding block (22), and the rear end of the rear spring is in contact with the rear wall of the inner cavity of the handle shell (21);
the opening rod (3) passes through the outer tube (1), the front end of the opening rod passes through the supporting and positioning part (11), and the rear end of the opening rod passes through the handle shell (21) and is fixedly connected with the sliding block (22);
and the power source is connected to the rear end of the opening rod (3) or the sliding block (22) and is used for driving the opening rod (3) to vibrate back and forth and/or rotate circumferentially relative to the outer tube (1).
2. The vaso-occlusive opening device of claim 1, wherein: the supporting and positioning part (11) adopts a memory grid bracket which is configured to be in a radial expansion state in a free state after being released;
alternatively, the support positioning portion (11) is a non-compliant balloon.
3. The vaso-occlusive opening device of claim 1, wherein: in the energy amplification handle (2), a guide rail extending along the front and back is arranged on the peripheral wall of an inner cavity of the handle shell (21), and the sliding block (22) is slidably arranged on the guide rail.
4. The vaso-occlusive opening device of claim 1, wherein: the vascular occlusion opening instrument further comprises a Y-shaped valve (4) and a plug (5), wherein the Y-shaped valve (4) is fixedly or integrally connected to the front end of a handle shell (21) of the energy amplification handle (2) and is fixedly connected to the rear end of the outer tube (1); the plug (5) is arranged at the rear end of the handle shell (21) of the energy amplification handle (2) to plug the handle shell (21), and a perforation for the opening rod (3) to pass through is arranged on the plug (5).
5. The vaso-occlusive opening device of claim 1, wherein: the opening rod (3) adopts a hollow pipe body structure.
6. The vaso-occlusive opening device of claim 1, wherein: the rear end of the opening rod (3) penetrates out of the rear end of the handle shell (21) of the energy amplification handle (2), and the power source comprises a movable handle (6) fixedly connected to the rear end of the opening rod (3).
7. The vaso-occlusive opening device of claim 6, wherein: the power source also comprises an ultrasonic vibrator (7) arranged at the rear end of the movable handle (6).
8. The vaso-occlusive opening device of claim 6, wherein: the power source also comprises a rotary grinding motor (8) arranged at the rear end of the movable handle (6).
9. A vaso-occlusive opening device according to claim 3, wherein: the power source comprises a rotary motor (91), a transmission rod (92) and a transmission mechanism (93);
the transmission rod (92) passes through a perforation arranged on the side wall of the handle shell (21), the first end of the transmission rod is fixedly connected with the sliding block (22), and the second end of the transmission rod is connected with the rotating motor (91) through the transmission mechanism (93);
the transmission mechanism (93) is configured to be capable of sliding back and forth along the handle case (21) with the slider (22) under a rotational driving force of the rotary motor (91).
10. The vaso-occlusive opening device of claim 9, wherein:
the transmission mechanism (93) comprises a carrying guide rail block (931), a spiral rail (931) is arranged on the outer peripheral surface of the carrying guide rail block (931), one end of the carrying guide rail block (931) is fixedly connected to an output shaft of the rotating motor (91), and the second end of the transmission rod (92) is limited and is slidably connected in the spiral rail (931);
alternatively, the transmission mechanism (93) includes a drive bevel gear (932), a transmission bevel gear (933), and a crank (934); the driving bevel gear (932) is sleeved on an output shaft of the rotating motor (91), the driving bevel gear (933) is vertical and meshed with the driving bevel gear (932), a driving input end of the crank (934) is connected to an eccentric point of the driving bevel gear (933), the driving rod (92) serves as a rocker, and a second end of the driving rod is connected to a driving output end of the crank (934).
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| CN202311227361.5A CN116965884B (en) | 2023-09-22 | 2023-09-22 | Vascular occlusion opening instrument |
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| CN202311227361.5A CN116965884B (en) | 2023-09-22 | 2023-09-22 | Vascular occlusion opening instrument |
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| CN116965884B (en) | 2024-02-27 |
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