CN117064505A - System and method for treating acute and subacute arteriovenous thrombosis - Google Patents
System and method for treating acute and subacute arteriovenous thrombosis Download PDFInfo
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- CN117064505A CN117064505A CN202311093980.XA CN202311093980A CN117064505A CN 117064505 A CN117064505 A CN 117064505A CN 202311093980 A CN202311093980 A CN 202311093980A CN 117064505 A CN117064505 A CN 117064505A
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- umbrella
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- wall
- thrombus
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- 238000000227 grinding Methods 0.000 claims abstract description 71
- 210000004204 blood vessel Anatomy 0.000 claims abstract description 24
- 238000001990 intravenous administration Methods 0.000 claims description 17
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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
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320758—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven
-
- 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
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/01—Filters implantable into blood vessels
- A61F2/013—Distal protection devices, i.e. devices placed distally in combination with another endovascular procedure, e.g. angioplasty or stenting
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- 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
- A61B2017/22001—Angioplasty, e.g. PCTA
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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
- A61B2017/22038—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 a guide wire
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- 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
- A61B2017/22079—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 suction of debris
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- 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
- A61B2017/2212—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/32—Surgical cutting instruments
- A61B2017/320004—Surgical cutting instruments abrasive
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B2017/320052—Guides for cutting instruments
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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
- A61B17/32—Surgical cutting instruments
- A61B2017/320064—Surgical cutting instruments with tissue or sample retaining means
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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
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320758—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven
- A61B2017/320775—Morcellators, impeller or propeller like means
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Abstract
The application relates to a system and a method for treating acute and subacute arteriovenous thrombosis, which are characterized by comprising an adherence filter umbrella, a retraction device, a guide wire, a grinding suction tube, a fixed tube and an intermediate tube; the open end of the wall-attached filter umbrella can be clung to the wall of a blood vessel; the wall-attached filter umbrella comprises a first wall-attached filter umbrella and a second wall-attached filter umbrella; the opening of the first adherence filter umbrella faces to the opening of the second adherence filter umbrella; the retraction device is used for retracting and releasing the adherence filter umbrella; the grinding suction pipe can grind and suck thrombus in a rotating way; the head end of the middle pipe is fixedly connected with the second adherence filter umbrella; the advantages are as follows: the thrombus-sucking and removing device has higher thrombus-sucking and removing rate, can effectively remove thrombus in the acute or subacute stage, continuously contracts the range of thrombus and intensively removes the thrombus in the thrombus-sucking process by attaching the wall-filtering umbrella devices at the two ends of the thrombus, has high safety, is not easy to damage the vessel wall, has small wound, can complete the whole thrombus-removing process through puncture intervention, and is fast in postoperative recovery of patients.
Description
[ field of technology ]
The application relates to the technical field of medical instruments, in particular to a system and a method for treating acute and subacute arteriovenous thrombosis.
[ background Art ]
Arterial and venous clot formation, i.e. "thrombosis", is the basis for a variety of vascular diseases such as myocardial infarction, ischemic cerebral stroke, arterial occlusion of the lower extremities, and venous thrombosis (DVT). Solid thrombi block blood flow in blood vessels, cause ischemia and hypoxia of tissues supplied by the blood vessels, cause ischemic death of corresponding target organs such as myocardial cells, intracranial nerve cells, muscle cells and the like, and possibly cause death of patients in severe cases.
The elimination of thrombus is sometimes solubilized by a chemical thrombolytic drug (tissue plasminogen activator or urokinase), and in particular by the placement of a thrombolytic catheter within the thrombus through which the chemical thrombolytic drug gradually dissolves the thrombus. However, this catheterization thrombolysis treatment has its own limitations, mainly including: firstly, the treatment time window is very short, for example, thrombolysis is carried out within 3-6 hours of the onset of acute ischemic cerebral apoplexy (possibly, the patient has missed the optimal thrombolysis treatment time after the cerebral apoplexy diagnosis is clear); secondly, the risk of blood vessel rupture and bleeding is greatly increased while thrombolysis treatment is carried out, and fatal complications such as cerebral hemorrhage or visceral hemorrhage can be seriously caused; finally, even if the patient is fully prescribed thrombolytic therapy, about 25% of the patient's thrombolytic therapy is unsuccessful.
In view of the limitations of chemothrombolytic therapy described above, various medical devices have been developed that remove thrombus instantaneously by surgical procedures. In all types of thrombus removal devices currently in mainstream, there are certain limitations. The direct operation blood vessel represented by the thrombus taking catheter is cut for thrombus taking, so that the thrombus taking catheter has larger trauma to a patient, is slow in postoperative recovery, has more complications and is limited in application, and the thrombus taking effect is poor because of the existence of a valve in a vein; the thrombus aspiration system represented by Angiojet produces a low pressure by a liquid flowing at a high speed, thereby producing a vacuum effect to aspirate thrombus fragments, but is only applied to fresh thrombus at the time of disadvantage, subacute thrombus may cause thrombus aspiration failure due to partial mechanization. At the same time, the thrombus fragments broken up by the high-speed flowing liquid flow along with the blood flow in the blood vessel, for example, the fallen thrombus during the DVT treatment can cause fatal pulmonary embolism. The thrombus rotary cutting device represented by Rotarex mechanically crushes and sucks thrombus through a thrombus suction catheter, and has the defect that in the operation process, the high-speed rotary cutting device is highly close to the vessel wall in the thrombus suction process, so that the vessel wall can be shredded, massive hemorrhage is caused, and hemorrhagic shock death of a patient is seriously caused. Secondly, thrombus fragments generated in the process of thrombus suction can flow to the far end of the blood vessel along with blood, and the corresponding thinner blood vessel is continuously blocked and cannot be removed. A vacuum thrombus-sucking catheter represented by Indigo is used for sucking out thrombus in blood vessel by utilizing external near vacuum negative pressure. The method has the defects of narrow application range, main application of aspiration of small vessel thrombus, huge blood loss of patients in the vacuum negative pressure aspiration process, and severe hemorrhagic shock of the patients. Others entangle the thrombus through the wire, basket, and coil and then pull out of the body through the catheter. These devices may damage the vessel wall, and the thrombus is easily dislodged during the procedure of pulling out of the body, with a high failure rate.
Chinese patent application: CN104582608A discloses a device and system for thrombus treatment, a thrombus treatment device comprising: a support wire; a main body frame portion disposed about an axis defined by the support wire; one or more tethers, each tether having a first end and a second end; and a filter element extending from the body frame portion. Each of the one or more tethers is attached at a first end thereof to the body frame portion and at a second end thereof to a collar that couples the second end of each of the plurality of tethers to the support wire. When the collar is positioned substantially within the region inside the main body frame portion, rotational actuation of the support wire causes rotational movement of the one or more tethers.
In summary, there is no report at present that the thrombolysis clearance is high for acute and subacute arteriovenous, pulmonary embolism caused by escape in thrombosis is avoided, and the vessel wall is not easily damaged.
[ application ]
The application aims to provide a system and a method for preventing pulmonary embolism caused by escape in thrombus operation and not easily damaging the vessel wall, wherein the thrombolysis clearance rate is higher for acute and subacute arteriovenous.
In order to achieve the above purpose, the technical scheme adopted by the application is as follows:
a system for treating acute and subacute arteriovenous thrombosis comprises an adherence filter umbrella, a retraction device, a guide wire, a grinding suction tube, a fixed tube and a middle tube;
the opening end of the wall-attached filter umbrella can be clung to the wall of a blood vessel; the wall-attached filter umbrella comprises a first wall-attached filter umbrella and a second wall-attached filter umbrella; the opening of the first adherence filter umbrella faces to the opening of the second adherence filter umbrella;
the retraction device is used for retracting and releasing the adherence filter umbrella; the device comprises a first retraction device and a second retraction device, wherein the first retraction device contracts and releases the first adherence filter umbrella, and the second retraction device contracts and releases the second adherence filter umbrella;
a grinding straw which can grind and suck thrombus in a rotating manner;
the head end of the middle pipe is fixedly connected with the second adherence filter umbrella.
As a preferable example, the outer end of the grinding straw is provided with a fixed pipe, and the head end of the fixed pipe is fixedly connected with the first adherence filter umbrella.
More preferably, the first adherence umbrella comprises a filter screen, adherence umbrella ribs, a first fixed ring and a second fixed ring, wherein the first fixed ring is fixedly connected with a fixed pipe, the head end of the first fixed ring is connected with the filter screen, the opening end of the filter screen is provided with the adherence umbrella ribs, the adherence umbrella ribs are fixedly connected with the second fixed ring, and the second fixed ring is connected with the head end of the fixed pipe.
As another preferable example, the first adherence filter umbrella is arranged on the grinding straw.
As another preferable example, the first retraction device is a first wall-attached filter umbrella accommodating tube, and the first wall-attached filter umbrella accommodating tube can accommodate the contracted first wall-attached filter umbrella.
As another preferable example, the second adherence filter umbrella comprises a filter screen, a filter screen framework and a third fixing ring, one end of the third fixing ring is fixedly connected with the head end of the middle pipe, the other end of the third fixing ring is fixedly connected with one end of the filter screen framework, and the filter screen is fixedly connected with the outer part of the filter screen framework.
More preferably, the second retraction device of the second adherence filter umbrella comprises a traction wire, a sliding compression device and a push tube, wherein the sliding compression device comprises a limiting ring and a sliding sheath, and the sliding sheath is sleeved on the middle tube; one end of the traction wire is connected with the head end of the filter screen framework, and the other end of the traction wire penetrates through the limiting ring and is fixed on the distal end of the sliding sheath; the limiting ring is fixed on the middle pipe and positioned in the moving track of the sliding sheath.
As another preferable example, the opening end of the adherence filter umbrella is provided with a developing element, so that the adherence condition of the capturing net surface can be observed.
As another preferable example, the diameter of the middle pipe is larger than that of the guide wire and smaller than that of the grinding suction pipe, and the middle pipe can be sleeved on the guide wire.
In order to achieve the second purpose, the application adopts the following technical scheme:
a method of using the system for treating acute and subacute intravenous arterial thrombosis according to any of the preceding claims, comprising the steps of;
presetting a guide wire at a position of blocking a blood vessel;
the second adherence filter umbrella which enters a compressed state along the guide wire is released after reaching a preset position, so that the second adherence filter umbrella is clung to the vascular wall;
the grinding pipe and the first adherence filter umbrella in a compressed state are arranged outside a pipe carrying the second adherence filter umbrella, and the first adherence filter umbrella is released at a preset position and clings to the wall of a blood vessel;
the grinding suction pipe starts to grind and suck thrombus; simultaneously, the distance between the first adherence filter umbrella and the second adherence filter umbrella is pulled up;
and after the rotary grinding is finished, withdrawing the first adherence filter umbrella, the grinding straw and the second adherence filter umbrella, pulling out the guide wire, and completing the removal of thrombus.
As a preferable example, the grinding suction pipe is opened in the process of withdrawing the first adherence filter umbrella and the second adherence filter umbrella so as to synchronously suck thrombus in the first adherence filter umbrella and the second adherence filter umbrella.
The application has the advantages that:
1. the thrombus absorbing time window is longer, and the thrombus in the acute or subacute stage can be effectively removed except for old thrombus (after 1 month of onset);
2. the thrombus removing rate is higher, the thrombus is continuously contracted and concentrated in the thrombus removing process by attaching the wall filter umbrella devices at the two ends of the thrombus, and the thrombus is continuously removed by the rotary grinding and sucking device in the middle;
3. the application has high safety, and most thrombus including thrombus fragments are limited in the middle of the filter umbrella blood vessel at the two ends in the whole thrombus sucking process, and can not fall off to the far end of the blood vessel. Meanwhile, the rotary grinding and thrombus absorbing device is positioned in the normal position of the vascular lumen and is far away from the vascular wall, so that the vascular wall is not easy to be damaged;
4. the application has small wound, does not need to cut thrombus for thrombus removal by operation, can complete the whole thrombus removal process by puncture intervention, and has quick recovery after operation.
[ description of the drawings ]
FIG. 1 is a schematic diagram of an adherent filter umbrella structure of a system and method for treating acute and subacute intravenous thrombosis according to the present application.
FIG. 2 is a schematic illustration of another adherent filter umbrella configuration of a system and method for treating acute and subacute intravenous thrombosis in accordance with the present application.
FIG. 3 is a schematic diagram of the structure of an intermediate tube-bonded wall-mounted filter umbrella of the present application for use in a system and method for treating acute and subacute arteriovenous thrombosis.
FIG. 4 is a schematic diagram of the structure of example 2 of a system and method for treating acute and subacute intravenous arterial thrombosis according to the present application.
FIG. 5 is a schematic view of two attached umbrellas deployed at the thrombus site for a system and method of treating acute and subacute intravenous thrombosis according to the present application.
FIG. 6 is a schematic illustration of a two-wall-attached umbrella-gathered thrombus of the present application for use in a system and method for treating acute and subacute intravenous thrombus.
FIG. 7 is a diagram of the steps in the removal of thrombus for a system and method of treating acute and subacute intravenous thrombus in accordance with the present application.
FIG. 8 is a schematic diagram of the structure of example 3 of a system and method for treating acute and subacute intravenous arterial thrombosis according to the present application.
[ detailed description ] of the application
The application is further described below with reference to examples and with reference to the accompanying drawings.
Reference numerals and components referred to in the drawings are as follows:
| 1. wall-attached filter umbrella | 11. First adherence filter umbrella |
| 12. Second adherence filter umbrella | 2. Grinding suction pipe |
| 3. Winding and unwinding device | 31. First retraction device |
| 311. First adherence umbrella holding tube | 32. Second retraction device |
| 321. Traction wire | 322. Sliding compression device |
| 3221. Limiting ring | 3222. Sliding sheath |
| 323. Push tube | 4. Guide wire |
| 5. Fixed pipe | 6. Intermediate pipe |
Example 1
In the present document, "proximal" and "distal" are relative orientations, relative positions, directions of elements or actions relative to each other from the perspective of a physician using the medical device, although "proximal" and "distal" are not intended to be limiting, and "distal" generally refers to the end of the medical device that first enters the patient during normal operation, and "proximal" generally refers to the end of the medical device that is proximal to the physician during normal operation. "distal" and "proximal" in this document do not refer to the ends of the structure, but rather to the relative positions. Herein, "axial" generally refers to a direction along a central axis, such as along the central axis of the capturing unit or support member, "radial" generally refers to a direction perpendicular to the axial direction, and "circumferential" refers to a direction about the central axis.
An attached filter umbrella 1, wherein the opening end of the attached filter umbrella can be clung to the wall of a blood vessel; the wall-attached filter umbrella comprises a first wall-attached filter umbrella 11 and a second wall-attached filter umbrella 12;
the first adherence filter umbrella 11 and the second adherence filter umbrella 12 have the functions of gathering, capturing, scraping, transferring, intercepting and guiding out thrombus, the adherence filter umbrella 1 can be porous or net-shaped, the net-shaped adherence filter umbrella can be a woven filter umbrella, the flexibility of the filter umbrella is good whether the filter umbrella is porous or net-shaped, blood vessels are not easy to damage, the resistance generated by the resistance during the withdrawing and the collecting is small, the conveying and the recovering are convenient, the filter umbrella with good flexibility is easy to collapse inwards and deform excessively, the support with metal can be assisted to use, or the filter umbrella can be made of metal or alloy materials, preferably, the metal material with the shape memory effect is selected, and the defects can be overcome.
Wherein the mesh density and number of the wall-attached umbrella 1 can collect thrombus and reduce the probability of thrombus escaping to distant branches, and can allow blood to pass through, including but not limited to old thrombus, new-born thrombus and sticky thrombus, and the mesh shape is not limited, and can be any suitable shape, such as: diamond, diamond-like, rectangular, circular, oval, etc., or combinations thereof.
The grinding suction pipe 2 can grind thrombus and can perform suction at the same time, and comprises a grinding rotating part and a suction part, wherein the grinding rotating part can grind thrombus in a rotating way; the thrombus grinding device comprises a rotary grinding head and a driving device, wherein the driving device provides power to generate torque to drive the rotary grinding head to rotate at high speed so as to grind a large thrombus, the rotary grinding head can be cylindrical or fusiform in shape, can be of an integrated structure or is formed by connecting a plurality of parts, and the material and the top end shape of the rotary grinding head need to have a good rotary grinding effect but do not scratch blood vessels, so that the safety of the rotary grinding head is improved; the suction can be operated by manual squeezing or electric power to generate enough negative air pressure to suck broken thrombus or blood clots or particles falling or broken during the process of breaking the thrombus out of the body (there is a waste liquid collecting device for collecting the same). The connection mode between the grinding and rotating part and the suction part can be connected together through a common control system, and can be circuit connection or mechanical connection, so that the function of simultaneously carrying out the grinding and suction processes is realized, and the operation by one hand of an operator is facilitated.
Example 2
The application comprises an adherence filter umbrella 1, a retraction device 3, a guide wire 4, a grinding suction pipe 2, a fixed pipe 5 and a middle pipe 6, wherein the adherence filter umbrella 1 comprises a first adherence filter umbrella 11 and a second adherence filter umbrella 12, and when the application is horizontally arranged, the opening of the first adherence filter umbrella 11 faces to the opening of the second adherence filter umbrella 12; the retraction device 3 is used for retracting and releasing the adherence filter umbrella 1; the grinding suction pipe 2 can be used for sucking thrombus by screwing edges, the first adherence filter umbrella 11 can be arranged at the head end of the fixed pipe 5, and the second adherence filter umbrella 12 can be arranged at the head end of the middle pipe 6.
In this embodiment, it is preferable that the retraction device 3 can perform various adjustments along with the shape of the wall-attached filter umbrella 1, the retraction device 3 is an external connection retraction tube retraction/release or an internal pushing/external sliding device retraction/release wall-attached filter umbrella, referring to fig. 1 of the present application, which is one shape of the wall-attached filter umbrella 1 of the present application, and the retraction device 3 can be an external connection tube retraction/release wall-attached filter umbrella; the adherence umbrella 1 comprises a filter screen, two adherence umbrella ribs, a first fixing ring and a second fixing ring, which are all made of nickel-titanium alloy or other alloy materials, preferably metal materials with shape memory effect; the filter screen is fixedly connected with the annular parts of the two adherence umbrella ribs; the specific structure is that, take the first adherence filter umbrella as an example: the first adherence filter umbrella 11 is arranged at the head end of the fixed pipe 5, the retraction device 3 of the first adherence filter umbrella 11 is a first adherence filter umbrella accommodating pipe 311 arranged at the outer end of the fixed pipe 5, and the first adherence filter umbrella accommodating pipe 311 is provided with a proper space for accommodating the contracted first adherence filter umbrella 11;
referring to fig. 2 of the present application, this is another form of the wall-attached filter umbrella 1 of the present application, wherein the wall-attached filter umbrella 1 includes a filter screen, a filter screen framework, and a third fixing ring; the winding and unwinding device 3 comprises a traction wire 321, a sliding compression device 322 and a push pipe 323, one end of the third fixing ring is fixedly connected with the head end of the middle pipe 6, and the other end of the third fixing ring is fixedly connected with the tail end of the filter screen framework; the head end of the filter screen framework is connected with a traction wire 321; the filter screen is fixedly connected outside the filter screen framework, so that the framework plays a role in supporting the filter screen; the sliding compression device 322 comprises a limiting ring 3221 and a sliding sheath 3222, the sliding sheath 3222 is sleeved on the middle tube 6 and can axially move along the middle tube 6, the limiting ring 3221 is fixed on the middle tube 6 and is positioned in the moving track of the sliding sheath 3222, and the traction wire 321 passes through the limiting ring 3221 and is fixed on the distal end of the sliding sheath 3222; the pushing tube 323 pushes the sliding sheath 3222 to move so as to drive the traction wire 321 to pull the outer end of the filter screen framework to compress towards the middle tube 6.
The two modes of the wall-attached filter umbrella 1 and the retraction device can be independently used or mixed for the application, and the wall-attached filter umbrella 1 and the retraction device 3 can be provided with developing elements; the first form of the wall-attached filter umbrella may be disposed at two wall-attached umbrella ribs, and the second form of the wall-attached filter umbrella may be disposed at an open end or a middle end of the filter screen skeleton, so as to facilitate observation of wall-attached conditions of the capturing mesh surface, and the developing elements are preferably plural, and the plural developing elements may be distributed at any suitable positions.
In this embodiment, the first wall-attached filter umbrella 11 may be disposed at the head end of the fixed pipe 5, and the second wall-attached filter umbrella 12 may be disposed at the head end of the intermediate pipe 6; as described above, the attached umbrella 1 and the retraction device 3 are provided with two forms, but in the present embodiment, referring to fig. 4, the preferable form is: the first adherence filter umbrella 11 comprises a filter screen, two adherence umbrella ribs, a first fixing ring and a second fixing ring; the first receiving and releasing device 31 is an external recovery pipe for recovery/release, and the external recovery pipe is a first adherence umbrella accommodating pipe 311; the second adherence filter umbrella 12 is positioned at the head end of the middle pipe 6, the diameter of the middle pipe 6 is larger than that of the guide wire 4 and smaller than that of the grinding suction pipe 2, and the second adherence filter umbrella can be sleeved on the guide wire 4; the second adherence filter umbrella 12 comprises a filter screen, a filter screen framework and a third fixing ring; and the second retraction device 32 comprises a traction wire 321, a sliding compression device 322 and a push tube 323; the sliding compression device 322 comprises a limiting ring 3221 and a sliding sheath 3222; the push pipe 323 can be sleeved on the middle pipe 5; the grinding straw 2 is positioned between the intermediate tube 6 and the fixed tube 5.
For the device in this embodiment, the position between the fixed tube 5 and the intermediate tube 6 can be adjusted to achieve the effect of gathering the ground thrombus; the existence of new and old thrombus in thrombus content is known, the new thrombus is softer, and the old thrombus has tight adhesion of blood vessels and is hard; in the process of rotary grinding, soft thrombus can be directly formed into blocks to fall off possibly in the first half section of the rotary grinding, so that a common filter screen is difficult to recover after the thrombus is covered, the thrombus is extruded outwards due to the force of the compression of the common filter screen in the process of recovering the filter screen, and large thrombus is easy to escape in the recovering process.
Meanwhile, the first wall-attached filter umbrella 11 and the second wall-attached filter umbrella 12 can also effectively scrape and collect thrombus attached to the vessel wall in the displacement process, no matter which form the wall-attached filter umbrella 1 is, the wall of the vessel can be tightly attached, and the displacement process can play a scraping role on the thrombus on the vessel wall, so that the probability of removing the thrombus is further increased as a part of a thrombus removing procedure.
In this embodiment, it is preferable that the external connection part of the grinding straw 2 is a grinding and sucking device, and the grinding and sucking device can control the rotation grinding and sucking of the grinding straw 2, and preferably, the grinding and sucking device can independently control the independent sucking, the independent grinding and the mixed grinding and sucking of the grinding straw 2; when the pushing tube 323 pushes the sliding sheath 3222 to compress the second adherence filter umbrella 12 into the affected part of the patient to block the affected part, the pushing tube 323 is withdrawn to guide other devices for dredging, and after the second adherence filter umbrella 12 is completely dredged, a small amount of thrombus content possibly contained in the second adherence filter umbrella 12 cannot be removed, and the thrombus is not easily escaped in the second adherence filter umbrella 12 shrinking process without being removed, so that the effect of being difficult to recover is caused, at the moment, the grinding and sucking tube 2 can be used as the pushing tube, wherein preferably, the grinding and sucking device for controlling the grinding and sucking tube 2 can independently control the independent suction, the independent grinding and the mixed suction grinding and the rotation; the mixed suction mill is closed, the independent suction is started, the sliding sheath is pushed to compress the second adherence filter umbrella 12, most of contents in the second adherence filter umbrella 12 are crushed and extruded through internal extrusion force in the compression process, meanwhile, the mill suction pipe starts to independently suck, extruded contents are sucked out, and the second adherence filter umbrella 12 can be contracted, so that two purposes are achieved.
The specific use mode is as follows:
in actual use of the apparatus, the operator selects a vascular access to reach the affected part, sends the guide wire 4 to the affected part along the vascular access, see (1) of fig. 7, under the guidance of the guide wire 4, the intermediate tube 6 passes through the guide wire 4 with the second wall-mounted umbrella 12 in a contracted state, the contracted state of the second wall-mounted umbrella 12 is completed by the push tube 323 at the rear end supporting the sliding sheath 3222, see (2) of fig. 7, and after the second wall-mounted umbrella 12 reaches the designated position, the push tube 323 is withdrawn, and the second wall-mounted umbrella 12 is released, see (3) of fig. 7. Sleeving the grinding suction pipe 2 on the middle pipe 6, and sequentially placing the fixed pipe 5 and the first adherence filter umbrella accommodating pipe 311 in the middle pipe, wherein the fixed pipe 5 is fixedly connected with the first adherence filter umbrella 11, and the first adherence filter umbrella 11 when placed is positioned in the first adherence filter umbrella accommodating pipe 311, see (4) of fig. 7; after reaching the designated position, the first adherence filter umbrella accommodating pipe 311 is withdrawn, the first adherence filter umbrella 11 is unfolded, see (5) of fig. 7, then the grinding suction pipe 2 is opened for rotary grinding and suction, the positions of the two adherence filter umbrellas 1 can be adjusted in the rotary grinding suction process, thrombus is gathered, the density of thrombus between the two adherence filter umbrellas 1 is increased, and the suction efficiency is improved.
It should be noted that, the device for controlling the position of the attached filter umbrella and the external device for controlling the grinding straw, etc. described in this embodiment belong to the prior art, and are not described in detail in the present application.
Example 3
Referring to fig. 8, the present embodiment is substantially the same as embodiment 2, except that the first wall-attached filter umbrella 11 is located at the rear end of the sucking portion of the sucking tube 2, the first wall-attached filter umbrella accommodating tube 311 is sleeved on the rear end portion of the sucking tube 2 to accommodate the first wall-attached filter umbrella 11, and therefore, the fixing tube 5 in embodiment 2 is not present in this embodiment any more, and the rest is the same as the arrangement in embodiment 2.
It should be noted that, in this embodiment, the fixing tube and the grinding straw 2 in embodiment 2 are combined, so that the effect that when the operator uses the grinding suction part to rotationally grind and suck and move forward, the first wall-attached filter umbrella 11 can move forward along with the movement of the grinding suction part to gather, so that the operator does not need to separate out another mind to control the position between the two wall-attached filter umbrellas, and the operator can operate by one hand, so that the effects of gathering, rotationally grinding, sucking and scraping thrombus can be achieved in a simple rotational grinding process. The operator may choose according to the clinical patient's condition.
The foregoing is merely a preferred embodiment of the present application and it should be noted that modifications and additions to the present application may be made by those skilled in the art without departing from the principles of the present application and such modifications and additions are to be considered as well as within the scope of the present application.
Example 4
A method of using the system for treating acute and subacute intravenous arterial thrombosis according to any of the preceding claims, comprising the steps of;
presetting a guide wire at a position of blocking a blood vessel;
the second adherence filter umbrella 12 which enters a compressed state along the guide wire 4 is released after reaching a preset position, so that the second adherence filter umbrella 12 is tightly attached to the vascular wall;
the grinding pipe 2 and the first adherence filter umbrella 11 in a compressed state are arranged outside a pipe carrying the second adherence filter umbrella 12, and the first adherence filter umbrella 11 is released at a preset position and clings to the vessel wall;
the grinding suction pipe 2 starts to grind and suck thrombus; simultaneously, the distance between the first adherence filter umbrella 11 and the second adherence filter umbrella 12 is pulled up;
and after the spin grinding is finished, the first adherence filter umbrella 11, the grinding straw and the second adherence filter umbrella 12 are retracted, the guide wire 4 is pulled out, and the thrombus is removed.
In this embodiment, it is preferable that the grinding suction pipe is opened during the process of retracting the first wall-mounted filter umbrella 11 and the second wall-mounted filter umbrella 12 to synchronously suck thrombus in the first wall-mounted filter umbrella 11 and the second wall-mounted filter umbrella 12.
It should be noted that the time window of the thrombus absorbing device is longer, and the thrombus in the acute or subacute stage can be effectively removed except for old thrombus (after 1 month of onset); the thrombus removing rate is high, the thrombus is continuously contracted and concentrated in the thrombus removing process by attaching the filter umbrella devices at the two ends of the thrombus, and the thrombus is continuously removed by the rotary grinding and sucking device in the middle; the safety is high, and in the whole thrombus sucking process, most thrombus including thrombus fragments are limited in the middle of the umbrella filtering blood vessels at the two ends, and the thrombus fragments cannot fall off to the far ends of the blood vessels. Meanwhile, the rotary grinding and thrombus absorbing device is positioned in the normal position of the vascular lumen and is far away from the vascular wall, so that the vascular wall is not easy to be damaged; the application has small wound, does not need to cut thrombus for thrombus removal by operation, can complete the whole thrombus removal process by puncture intervention, and has quick recovery after operation.
Claims (10)
1. A system for treating acute and subacute arteriovenous thrombosis, which is characterized by comprising an adherence filter umbrella, a retraction device, a guide wire, a grinding suction tube, a fixed tube and a middle tube;
the opening end of the wall-attached filter umbrella can be clung to the wall of a blood vessel; the wall-attached filter umbrella comprises a first wall-attached filter umbrella and a second wall-attached filter umbrella; the opening of the first adherence filter umbrella faces to the opening of the second adherence filter umbrella;
the retraction device is used for retracting and releasing the adherence filter umbrella; the device comprises a first retraction device and a second retraction device, wherein the first retraction device contracts and releases the first adherence filter umbrella, and the second retraction device contracts and releases the second adherence filter umbrella;
a grinding straw which can grind and suck thrombus in a rotating manner;
the head end of the middle pipe is fixedly connected with the second adherence filter umbrella.
2. The system for treating acute and subacute intravenous thrombosis as recited in claim 1, wherein said abrasion tube is provided at an outer end thereof with a securing tube, said securing tube having a head end fixedly connected to said first attachment umbrella.
3. The system for treating acute and subacute intravenous thrombosis of claim 2, wherein the first wall-attached umbrella comprises a filter screen, wall-attached umbrella ribs, a first fixed ring and a second fixed ring, the first fixed ring is fixedly connected with a fixed tube, the head end of the first fixed ring is connected with the filter screen, the open end of the filter screen is provided with the wall-attached umbrella ribs, the wall-attached umbrella ribs are fixedly connected with the second fixed ring, and the second fixed ring is connected with the head end of the fixed tube.
4. The system for treating acute and subacute intravenous thrombosis as in claim 1, wherein said first attached umbrella is disposed on said abrasive tube.
5. The system for treating acute and subacute intravenous thrombosis as in claim 1, wherein said first deploying and retracting means is a first wall-mounted umbrella receiving tube capable of receiving a collapsed first wall-mounted umbrella.
6. The system for treating acute and subacute intravenous thrombosis according to claim 1, wherein said second wall-mounted filter umbrella comprises a filter mesh, a filter mesh frame and a third fixing ring, one end of said third fixing ring is fixedly connected to said intermediate tube head end, the other end is fixedly connected to one end of said filter mesh frame, and said filter mesh is fixedly connected to the outside of said filter mesh frame.
7. The system for treating acute and subacute intravenous thrombosis as in claim 6, wherein said second retraction means of said second attached umbrella comprises a pull wire, a sliding compression means, a push tube, said sliding compression means comprising a stop collar, a sliding sheath, said sliding sheath being disposed over said intermediate tube; one end of the traction wire is connected with the head end of the filter screen framework, and the other end of the traction wire penetrates through the limiting ring and is fixed on the distal end of the sliding sheath; the limiting ring is fixed on the middle pipe and positioned in the moving track of the sliding sheath.
8. The system for treating acute and subacute intravenous thrombosis of claim 1, wherein said open end of said wall-mounted umbrella is provided with a visualization element for viewing wall-mounting of the capturing mesh.
9. A method of using the system for treating acute and subacute intravenous arterial thrombosis according to any one of claims 1-8, comprising the steps of:
presetting a guide wire at a position of blocking a blood vessel;
the second adherence filter umbrella which enters a compressed state along the guide wire is released after reaching a preset position, so that the second adherence filter umbrella is clung to the vascular wall;
the grinding pipe and the first adherence filter umbrella in a compressed state are arranged outside a pipe carrying the second adherence filter umbrella, and the first adherence filter umbrella is released at a preset position and clings to the wall of a blood vessel;
the grinding suction pipe starts to grind and suck thrombus; simultaneously, the distance between the first adherence filter umbrella and the second adherence filter umbrella is pulled up;
and after the rotary grinding is finished, withdrawing the first adherence filter umbrella, the grinding straw and the second adherence filter umbrella, pulling out the guide wire, and completing the removal of thrombus.
10. The method of claim 9, wherein the first and second wall-mounted umbrellas are retracted and the grinding tube is opened to simultaneously aspirate the thrombus in the first and second wall-mounted umbrellas.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202311093980.XA CN117064505A (en) | 2023-08-29 | 2023-08-29 | System and method for treating acute and subacute arteriovenous thrombosis |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202311093980.XA CN117064505A (en) | 2023-08-29 | 2023-08-29 | System and method for treating acute and subacute arteriovenous thrombosis |
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| CN117064505A true CN117064505A (en) | 2023-11-17 |
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| CN202311093980.XA Pending CN117064505A (en) | 2023-08-29 | 2023-08-29 | System and method for treating acute and subacute arteriovenous thrombosis |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN117379139A (en) * | 2023-12-13 | 2024-01-12 | 东南大学泰州生物医药与医疗器械研究院 | Escape-preventing thrombus taking device |
-
2023
- 2023-08-29 CN CN202311093980.XA patent/CN117064505A/en active Pending
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN117379139A (en) * | 2023-12-13 | 2024-01-12 | 东南大学泰州生物医药与医疗器械研究院 | Escape-preventing thrombus taking device |
| CN117379139B (en) * | 2023-12-13 | 2024-03-05 | 东南大学泰州生物医药与医疗器械研究院 | Escape-preventing thrombus taking device |
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