CN117137609B - Cryoablation device with ablation record and saccule positioning functions - Google Patents

Cryoablation device with ablation record and saccule positioning functions Download PDF

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Publication number
CN117137609B
CN117137609B CN202311084922.0A CN202311084922A CN117137609B CN 117137609 B CN117137609 B CN 117137609B CN 202311084922 A CN202311084922 A CN 202311084922A CN 117137609 B CN117137609 B CN 117137609B
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Prior art keywords
balloon
pipe
tube
jet head
connecting plate
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CN202311084922.0A
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CN117137609A (en
Inventor
吴立群
凌天佑
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Ruinjin Hospital Affiliated to Shanghai Jiaotong University School of Medicine Co Ltd
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Ruinjin Hospital Affiliated to Shanghai Jiaotong University School of Medicine Co Ltd
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Priority to CN202311084922.0A priority Critical patent/CN117137609B/en
Publication of CN117137609A publication Critical patent/CN117137609A/en
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    • GPHYSICS
    • G01MEASURING; TESTING
    • G01LMEASURING FORCE, STRESS, TORQUE, WORK, MECHANICAL POWER, MECHANICAL EFFICIENCY, OR FLUID PRESSURE
    • G01L11/00Measuring steady or quasi-steady pressure of a fluid or a fluent solid material by means not provided for in group G01L7/00 or G01L9/00
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00214Expandable means emitting energy, e.g. by elements carried thereon
    • A61B2018/0022Balloons
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345Vascular system
    • A61B2018/00351Heart
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577Ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A61B2018/0231Characteristics of handpieces or probes
    • A61B2018/0262Characteristics of handpieces or probes using a circulating cryogenic fluid
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A61B2018/0293Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques using an instrument interstitially inserted into the body, e.g. needle
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08Accessories or related features not otherwise provided for
    • A61B2090/0804Counting number of instruments used; Instrument detectors

Abstract

The application discloses a cryoablation device with ablation recording and balloon positioning functions, which comprises an inner catheter, an outer catheter, a balloon and a refrigerant supply pipe positioned between the inner catheter and the outer catheter; the refrigerant supply pipe comprises a conveying pipe and a jet head connected to the end part of the conveying pipe; the jet head is connected with a recording tube through a communicating tube, and the recording tube comprises a tube body and an end plate fixedly connected with the end of the tube body; the end plate is provided with a pressure sensor, a piston is arranged in the pipe body, and the piston is connected with a pressing plate capable of pressing the pressure sensor through a spring; the connecting plate is provided with an inner cavity, and the inner cavity of the connecting plate is communicated with the inner space of the pipe body. The cryoablation balloon can display the balloon position in an open three-dimensional system and record the number of times of ablation, so that a doctor can adjust the balloon position more conveniently, the pulmonary vein opening can be plugged more favorably, and the ablation effect is enhanced.

Description

Cryoablation device with ablation record and saccule positioning functions
Technical Field
The application relates to the technical field of pulmonary vein cryoablation, in particular to a cryoablation device with ablation record and balloon positioning functions.
Background
Atrial fibrillation is a condition of arrhythmia, which may be sometimes or continuously present, and when atrial fibrillation occurs, the chaotic heart rhythm of the patient suffering from atrial fibrillation causes blood to accumulate in the atrium and form thrombus, and the thrombus falls off from the heart area and possibly enters the brain to cause stroke, so that the patient suffering from atrial fibrillation needs to be treated appropriately to prevent the stroke. Atrial fibrillation was initially treated with antiarrhythmic drugs, and as technology developed, catheter ablation for the pulmonary veins emerged, which achieved electrical isolation of the pulmonary veins to block the conduction of abnormal electrical signals by creating scar tissue lesions around the pulmonary veins, which could be created by heating (radio frequency ablation) or cooling body tissue (cryoablation). More and more clinical data prove that the postoperative cardiovascular hospitalization of cryoablation is less, the requirement rate of repeated operation is less, the effect of isolating pulmonary veins is reliable, the operation technology is simpler and more practical, the learning curve is short, and the method is a more effective solution for preventing atrial fibrillation recurrence.
Currently, cryoablation techniques also have the following problems: in one operation, four pulmonary vein ports are usually required to be sequentially ablated, after one pulmonary vein port is ablated, the cryoballoon is required to be moved to the other pulmonary vein port, and the operation of ablation is carried out by inflating again, so that the repeated ablation is required to be carried out in one operation, the ablated parts and the non-ablated parts are confused by doctors, and if the number of times of ablation can be recorded, errors can be avoided to a certain extent; in addition, in the cryoablation process, the balloon needs to be positioned, and the existing cryoballoon has poor positioning effect, so that the operation difficulty is increased, and the ablation effect is reduced.
Disclosure of Invention
The invention aims to: the application aims to overcome the defects of the prior art and provides a cryoablation device with ablation recording and balloon positioning functions.
The technical scheme is as follows: a cryoablation device comprising an inner catheter, an outer catheter, a balloon, and a refrigerant supply tube positioned between the inner catheter and the outer catheter; the front end of the balloon is connected with the front end of the inner catheter, and the rear end of the balloon is connected with the front end of the outer catheter; the refrigerant supply pipe comprises a conveying pipe and a jet head connected to the end part of the conveying pipe, and a plurality of jet holes are formed in the jet head; the jet head is connected with a recording tube through a communicating tube, the recording tube comprises a tube body and an end plate fixedly connected with the end of the tube body, and the tube body is connected with the jet head through a connecting plate; the end plate is provided with a pressure sensor, a piston is arranged in the pipe body, and the piston is connected with a pressing plate capable of pressing the pressure sensor through a spring; the connecting plate is provided with an inner cavity, and the inner cavity of the connecting plate is communicated with the inner space of the pipe body.
Further, a first developing ring is installed at the inner conduit, and a second developing ring is installed at the recording tube.
Therefore, the balloon can be integrally developed and positioned through the two developing rings, so that the balloon angle can be conveniently positioned, a doctor can conveniently adjust the balloon angle, the balloon can be tightly attached to a target ablation area, and the blocking effect is enhanced.
Further, the communicating pipe is an arc pipe.
Therefore, the connection between the recording tube and the jet head is more stable, and the gas circulation in the tube is smoother.
Further, the connection plate is a flexible connection plate.
Therefore, when the air is not filled, the air pressure in the flexible connecting plate between the recording pipe and the air jet head is small, and when the air bag is contracted, the flexible connecting plate can be compressed, so that the volume of the balloon catheter is conveniently contracted, and the movement of the balloon catheter is facilitated; when injecting the refrigerant, flexible connecting plate and recording tube inner space intercommunication to expand because inside high pressure makes the recording tube also by expanding, and the piston tube is similar after the recording tube is expanded, and the removal of piston is more stable on the one hand, thereby the work of recording atmospheric pressure is more stable, and on the other hand makes two developing rings expand certain distance in the space, is favorable to the location to the circumference angle of sacculus more.
Further, the outer side wall of the inner conduit is provided with a first groove, and the jet head is fixedly arranged at the first groove.
So that the refrigerant supply pipe can be fixedly installed at the inner guide pipe, and is more stable when gas is charged through the supply pipe.
Further, the first groove is provided with a second groove, and the second groove is used for installing a lead wire of the pressure sensor.
Thereby protecting the lead wires of the pressure sensor and enabling the pressure sensor to work stably.
Further, the first developing ring is positioned between the front end of the inner conduit and the jet head; the second developing ring is located between the communicating pipe and the connecting plate.
Therefore, the two developing rings are unfolded for a certain distance in the longitudinal space, and the positioning of the circumferential angle of the balloon is more facilitated.
The beneficial effects are that: 1) The recording tube is arranged at the air jet head, and the times of ablation can be recorded through the information of the internal pressure sensor, so that the times of ablation completion in each operation are continuously recorded, and the operation errors of doctors are avoided;
2) By arranging two developing rings, the whole balloon can be developed and positioned; therefore, the circumferential direction of the balloon can be recorded through the matching of the two developing rings, so that the balloon angle can be conveniently positioned, a doctor can conveniently adjust the balloon angle, the balloon can be more tightly attached to a target ablation area, and the blocking effect is enhanced;
3) The flexible connecting plate is arranged between the air jet head and the recording pipe, so that when the air is not filled, the flexible connecting plate can be compressed, the volume of the balloon catheter can be conveniently contracted, and the balloon catheter can be conveniently moved; when injecting the refrigerant, the inside high pressure of flexible connecting plate to expand and make the record pipe also by expanding, on the one hand the work of record atmospheric pressure is more stable, on the other hand makes two developing rings expand certain distance in the space, is favorable to the location to the circumference angle of sacculus more.
Drawings
FIG. 1 is an overall schematic of a cryoballoon;
FIG. 2 is a schematic view of a cryoballoon at a first view angle;
FIG. 3 is an enlarged view of area A;
FIG. 4 is a schematic view of a freezing balloon at a second view angle;
FIG. 5 is an enlarged view of region B;
in which figures 2-5, for the purpose of illustrating the balloon internal structure, a portion of the balloon is cut away and a portion of the recording tube is cut away, so that the internal illustration is more clear.
Detailed Description
Reference numerals: 1 an inner catheter; 1.1 a first developer ring; 1.2 a first groove; 1.2.1 second grooves; 2 an outer catheter; 3, a balloon; 4 a refrigerant supply tube; 4.1 a conveying pipe; 4.2 a jet head; 4.2.1 spray holes; 6, recording a tube; 6.1 pressing plate; 6.2 springs; 6.3 a piston; 6.4 a second developer ring; 7 communicating pipe; and 8, connecting a plate.
As shown in the figure: a cryoablation device with ablation recording and balloon positioning functions, which comprises an inner catheter 1, an outer catheter 2, a balloon 3 and a refrigerant supply pipe 4 positioned between the inner catheter 1 and the outer catheter 2; the front end of the balloon 3 is connected with the front end of the inner catheter 1, and the rear end is connected with the front end of the outer catheter 2; the refrigerant supply pipe 4 comprises a conveying pipe 4.1 and a jet head 4.2 connected to the end part of the conveying pipe 4.1, wherein the jet head 4.2 is provided with a plurality of jet holes 4.2.1; the jet head 4.2 is connected with a recording pipe 6 through a communicating pipe 7, and the communicating pipe 7 is an arc pipe; the recording tube 6 comprises a tube body and an end plate fixedly connected with the end of the tube body, the tube body is connected with the jet head 4.2 through a connecting plate 8, and the connecting plate 8 is a flexible connecting plate; a pressure sensor is arranged at the end plate, a piston 6.3 is arranged in the pipe body, and the piston 6.3 is connected with a pressing plate 6.1 capable of pressing the pressure sensor through a spring 6.2; the connecting plate 8 is provided with an inner cavity, and the inner cavity of the connecting plate 8 is communicated with the inner space of the pipe body.
A first developing ring 1.1 is arranged at the inner guide pipe 1, and a second developing ring 6.4 is arranged at the recording pipe 6; the first developing ring 1.1 is positioned between the front end of the inner conduit 1 and the jet head 4.2; the second developing ring 6.4 is located between the communicating pipe 7 and the connecting plate 8. The outer side wall of the inner conduit 1 is provided with a first groove 1.2, and the jet head 4.2 is fixedly arranged at the first groove 1.2. The first groove 1.2 is provided with a second groove 1.2.1, and the second groove 1.2.1 is used for installing a lead wire of the pressure sensor.
As shown in the figure, the cryoablation balloon can display the balloon position in an open three-dimensional system and record the number of times of ablation, so that a doctor can adjust the balloon position more conveniently, the pulmonary vein opening can be plugged more conveniently, and the ablation effect is enhanced. When in operation, after the freezing saccule reaches the pulmonary vein port, firstly, air is filled into the saccule through the refrigerant supply pipe, so that the saccule seals the pulmonary vein to reflux blood, and the whole saccule can be developed and positioned due to the two developing rings, so that the circumferential direction of the saccule can be recorded through the matching of the two developing rings, the saccule angle can be conveniently positioned, a doctor can conveniently adjust the saccule angle, the saccule can be tightly attached to a target ablation area, and the sealing effect is enhanced; after confirming that the balloon was completely sealed, a refrigerant (liquid N) was injected through a refrigerant supply tube 2 O), the refrigerant is vaporized and absorbs heat, so that the temperature of the balloon is rapidly reduced, and the temperature of the balloon is reducedAnd the pulmonary vein tissue which is abutted against the saccule is subjected to low-temperature ablation for a long time to make the pulmonary vein tissue frozen and necrotized, so that electric conduction block is formed, and pulmonary vein isolation is realized.
In one procedure, four pulmonary vein ostia are typically ablated sequentially; after one pulmonary vein port is ablated, the frozen gas is required to be recovered, the frozen balloon is moved to the other pulmonary vein port, and the ablation operation is carried out by re-inflation, so that the gas is required to be inflated and exhausted for a plurality of times; the cryoablation sacculus of this application is provided with recording pipe and jet head intercommunication, and jet head lasts the jet head and jet head intercommunication when filling the refrigerant to the recording pipe is also higher with the jet head intercommunication, and higher atmospheric pressure can drive the piston, thereby makes the clamp plate continuously press pressure sensor, when pressure sensor's measured value lasts more than setting for threshold value settlement time, the record is for accomplishing once to ablate the number of times of accomplishing in each operation and last being recorded, avoids doctor's operation to make mistakes.
In addition, when not filling gas, the inside atmospheric pressure of flexible connecting plate between recording tube and the air jet head is very little, therefore when contracting the sacculus, flexible connecting plate can be compressed, conveniently contracts the volume of sacculus pipe to make things convenient for the removal of sacculus pipe. But when injecting the refrigerant, the inside high pressure of flexible connecting plate to expand and make the recording tube also expanded, similar piston cylinder after the recording tube is expanded, on the one hand the removal of piston is more stable, thereby the work of record atmospheric pressure is more stable, on the other hand makes two development rings expand certain distance in the space, is favorable to the location to the circumference angle of sacculus more.
While the invention has been shown and described with respect to the preferred embodiments, it will be understood by those skilled in the art that various changes and modifications may be made therein without departing from the scope of the invention as defined in the following claims.

Claims (4)

1. A cryoablation device with ablation recording and balloon positioning functions, which is characterized by comprising an inner catheter, an outer catheter, a balloon and a refrigerant supply pipe positioned between the inner catheter and the outer catheter; the front end of the balloon is connected with the front end of the inner catheter, and the rear end of the balloon is connected with the front end of the outer catheter; the refrigerant supply pipe comprises a conveying pipe and a jet head connected to the end part of the conveying pipe, and a plurality of jet holes are formed in the jet head; the jet head is connected with a recording tube through a communicating tube, the recording tube comprises a tube body and an end plate fixedly connected with the end of the tube body, and the tube body is connected with the jet head through a connecting plate; the end plate is provided with a pressure sensor, a piston is arranged in the pipe body, and the piston is connected with a pressing plate capable of pressing the pressure sensor through a spring; the connecting plate is provided with an inner cavity, and the inner cavity of the connecting plate is communicated with the inner space of the pipe body; a first developing ring is arranged at the inner guide pipe, and a second developing ring is arranged at the recording pipe; the connecting plate is a flexible connecting plate; the first developing ring is positioned between the front end of the inner guide pipe and the jet head; the second developing ring is located between the communicating pipe and the connecting plate.
2. The cryoablation device of claim 1 wherein the communicating tube is an arced tube.
3. The cryoablation device of claim 1 wherein the inner catheter outer sidewall has a first groove and the jet head is fixedly mounted in the first groove.
4. A cryoablation device having ablation recording and balloon positioning as recited in claim 3 wherein said first recess has a second recess for mounting leads of said pressure sensor.
CN202311084922.0A 2023-08-25 2023-08-25 Cryoablation device with ablation record and saccule positioning functions Active CN117137609B (en)

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CN202311084922.0A CN117137609B (en) 2023-08-25 2023-08-25 Cryoablation device with ablation record and saccule positioning functions

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CN117137609B true CN117137609B (en) 2024-04-05

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN1774239A (en) * 2003-01-29 2006-05-17 埃-皮尔制药公司 Active drug delivery in the gastrointestinal tract
CN103781443A (en) * 2011-04-13 2014-05-07 低温疗法有限公司 Plaque stabilisation using cryoenergy
CN108778149A (en) * 2016-01-04 2018-11-09 康福乐医疗公司 System and method for treating MVO
CN113331935A (en) * 2021-06-01 2021-09-03 黄松群 Novel atrial fibrillation cryoablation device beneficial to pulmonary vein plugging
CN113573672A (en) * 2018-12-07 2021-10-29 雷森斯医疗有限公司 Cooling device and cooling method

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7727228B2 (en) * 2004-03-23 2010-06-01 Medtronic Cryocath Lp Method and apparatus for inflating and deflating balloon catheters
US9622806B2 (en) * 2013-07-15 2017-04-18 Medtronic Cryocath Lp Heated electrodes for continued visualization of pulmonary vein potentials
US10492842B2 (en) * 2014-03-07 2019-12-03 Medtronic Ardian Luxembourg S.A.R.L. Monitoring and controlling internally administered cryotherapy
US20210169545A1 (en) * 2019-12-06 2021-06-10 Medtronic Cryocath Lp Active pressure control and method of fault monitoring

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN1774239A (en) * 2003-01-29 2006-05-17 埃-皮尔制药公司 Active drug delivery in the gastrointestinal tract
CN103781443A (en) * 2011-04-13 2014-05-07 低温疗法有限公司 Plaque stabilisation using cryoenergy
CN108778149A (en) * 2016-01-04 2018-11-09 康福乐医疗公司 System and method for treating MVO
CN113573672A (en) * 2018-12-07 2021-10-29 雷森斯医疗有限公司 Cooling device and cooling method
CN113331935A (en) * 2021-06-01 2021-09-03 黄松群 Novel atrial fibrillation cryoablation device beneficial to pulmonary vein plugging

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