CN117224821A - Carotid shunt tube and carotid surgical instrument - Google Patents

Carotid shunt tube and carotid surgical instrument Download PDF

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Publication number
CN117224821A
CN117224821A CN202311207793.XA CN202311207793A CN117224821A CN 117224821 A CN117224821 A CN 117224821A CN 202311207793 A CN202311207793 A CN 202311207793A CN 117224821 A CN117224821 A CN 117224821A
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CN
China
Prior art keywords
carotid
tube
sheath
shunt
carotid artery
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CN202311207793.XA
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Chinese (zh)
Inventor
罗明尧
田晨
赵嘉伟
王俊雨
方坤
舒畅
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Fuwai Hospital of CAMS and PUMC
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Fuwai Hospital of CAMS and PUMC
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Priority to CN202311207793.XA priority Critical patent/CN117224821A/en
Publication of CN117224821A publication Critical patent/CN117224821A/en
Pending legal-status Critical Current

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Abstract

The invention relates to the technical field of medical equipment, in particular to a carotid shunt tube and a carotid artery surgical instrument, wherein the carotid shunt tube comprises: the outer walls of the tube bodies at the two ends of the diverting tube body are provided with saccules; one end of the sheath tube is communicated with the middle part of the diversion tube body, and is arranged at a preset angle with the diversion tube body, and the other end of the sheath tube is a free end; and one end of the balloon catheter matched with the balloon is communicated with the balloon, and the other end of the balloon catheter is provided with a stop valve. The carotid artery transfer tube provided by the technical scheme can not only meet the temporary blood transfer function of the existing product, but also integrate the function of a vascular sheath, and interventional instruments such as a guide wire, a catheter and the like can be conveyed to a tandem lesion part through the sheath, so that the surgical stripping operation and the interventional operation can be simultaneously implemented through only one vascular incision, the operation is simplified, the complications related to the operation access are reduced, and the risk of cerebral infarction in the operation can be effectively reduced.

Description

Carotid shunt tube and carotid surgical instrument
Technical Field
The invention relates to the technical field of medical appliances, in particular to a carotid shunt tube and a carotid artery surgical appliance.
Background
Carotid stenosis (carotidid stenosis) is one of the etiologies of the initiation of ischemic stroke. Carotid stenosis is mainly caused by atherosclerosis. Risk factors for carotid stenosis include hypertension, smoking, diabetes, hyperlipidemia, familial genetic factors, and the like. Although the good sites of carotid stenosis are the carotid sinus and the initial segment of the internal carotid artery, the detection rate of intracranial and extracranial carotid tandem lesions is increasing year by year. As shown in fig. 1, the carotid bifurcation combined total carotid (common carotid stenosis, CCA)/innominate arterial (innominate artery, IA) stenosis was 4.8% of total carotid stenosis. About 1/6 of patients with acute ischemic stroke present with intracranial (intracranial internal carotid artery, ICA) and extracranial tandem lesions of the carotid artery. The carotid cascade lesion is heavier than the stenosis of a single part, and the incidence rate of ischemic cerebral apoplexy of patients with the stenosis at the joint and bifurcation of the common carotid artery and the innominate carotid artery is up to 17% -30%.
Carotid endarterectomy (carotid endarterectomy) is currently considered the preferred surgical intervention as a surgical intervention to ablate the C1 segment of the carotid artery, the distal plaque of the common carotid artery and remove stenosis. Stenosis of the cervical total/innominate initial part, and stenosis of the C2 section and above of the internal carotid artery, because of great anatomical difficulty and great surgical trauma, vascular intervention is the first choice.
Carotid shunt (shunt) plays a very important role in carotid endarterectomy surgery, and can reduce cerebral ischemia time caused by carotid occlusion. When the existing carotid shunt is used, after a carotid sinus is incised by an operation, the inner end of a shunt neck is reversely inserted into the carotid artery, a priming shunt balloon is fixed, then the main end of the shunt neck is inserted into the common carotid artery, the priming shunt balloon is fixed, an open system realizes that arterial blood flows into the carotid artery from the common carotid artery through the shunt, and temporary blood perfusion of brain tissue at one side of the operation is established.
The prior art means can not simultaneously complete the carotid endangium peeling operation and the intervention treatment of carotid serial lesions (the positions comprise the proximal end of the common carotid artery, the distal end of the internal carotid artery and the intracranial segment of the internal carotid artery) through one vascular incision, and the lesions comprise stenotic lesions and neoplastic lesions such as aneurysms, or the risk of cerebral infarction caused by thrombus and debris falling in the operation is not effectively avoided. If the lesions of the initial segment of the common carotid artery and the lesions of the internal carotid artery are to be treated synchronously, additional direct-vision carotid artery puncture or establishment of a vascular access through femoral artery is often required, the risks of surgical trauma and vascular injury at the puncture part are increased, and a certain cerebral infarction risk is faced.
Disclosure of Invention
In order to solve the problems in the related art, the embodiment of the invention provides a carotid shunt and a carotid artery surgical instrument.
In a first aspect, an embodiment of the present invention provides a carotid shunt, including:
the outer walls of the tube bodies at the two ends of the diverting tube body are provided with saccules;
one end of the sheath tube is communicated with the middle part of the diversion tube body, and is arranged at a preset angle with the diversion tube body, and the other end of the sheath tube is a free end;
and one end of the balloon catheter matched with the balloon is communicated with the balloon, and the other end of the balloon catheter is provided with a stop valve.
According to the embodiment of the invention, the sheath tube is one and forms a preset angle with the diversion tube body along the obliquely downward direction; or,
the number of the sheath pipes is two, one sheath pipe forms a preset angle with the diversion pipe body along the obliquely lower direction, and the other sheath pipe forms a preset angle with the diversion pipe body along the obliquely upper direction.
According to an embodiment of the invention, the sheath is flexibly connected to the shunt body.
According to the embodiment of the invention, a transition pipe is arranged between the sheath pipe and the diversion pipe body.
According to an embodiment of the invention, the transition pipe is arranged at a preset angle to the transfer pipe body.
According to an embodiment of the present invention, the preset angle is 30-45 degrees.
According to an embodiment of the present invention, the preset angle is 45 degrees.
According to an embodiment of the invention, a haemostatic valve is connected at the free end.
According to the embodiment of the invention, the inner wall of the diversion pipe body is provided with scale marks.
According to the embodiment of the invention, the inner diameter of the diversion pipe body and the sheath pipe is not smaller than 5-6F.
In a second aspect, embodiments of the present invention provide a carotid artery surgical device comprising a carotid shunt according to any of the first aspects and an interventional device delivered into the carotid artery via the sheath.
According to an embodiment of the invention, the interventional instrument comprises one or more of the following: guide wires, catheters, balloons and stents.
The embodiment of the invention provides a carotid shunt tube, which comprises: the outer walls of the tube bodies at the two ends of the diverting tube body are provided with saccules; one end of the sheath tube is communicated with the middle part of the diversion tube body, and is arranged at a preset angle with the diversion tube body, and the other end of the sheath tube is a free end; and one end of the balloon catheter matched with the balloon is communicated with the balloon, and the other end of the balloon catheter is provided with a stop valve. The carotid artery transfer tube provided by the technical scheme can not only meet the temporary blood transfer function of the existing product, but also integrate the function of a vascular sheath, and interventional instruments such as a guide wire, a catheter and the like can be conveyed to a tandem lesion part through the sheath, so that the surgical stripping operation and the interventional operation can be simultaneously implemented through only one vascular incision, the operation is simplified, the complications related to the operation access are reduced, and the risk of cerebral infarction in the operation can be effectively reduced.
It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention as claimed.
Drawings
Other features, objects and advantages of the present invention will become more apparent from the following detailed description of non-limiting embodiments, taken in conjunction with the accompanying drawings. In the drawings:
fig. 1 is a schematic view of an internal carotid artery of the prior art.
Fig. 2 is a schematic structural diagram of a carotid shunt according to an embodiment of the present invention.
Fig. 3 is a schematic structural diagram of a carotid shunt according to another embodiment of the invention.
Fig. 4 is a schematic structural view of a carotid shunt according to another embodiment of the invention.
Description of the embodiments
Hereinafter, exemplary embodiments of the present invention will be described in detail with reference to the accompanying drawings so that those skilled in the art can easily implement them. In addition, for the sake of clarity, portions irrelevant to description of the exemplary embodiments are omitted in the drawings.
In the present invention, it should be understood that terms such as "comprises" or "comprising," etc., are intended to indicate the presence of features, numbers, steps, acts, components, portions, or combinations thereof disclosed in the present specification, and are not intended to exclude the possibility that one or more other features, numbers, steps, acts, components, portions, or combinations thereof are present or added.
In addition, it should be noted that, without conflict, the embodiments of the present invention and the features of the embodiments may be combined with each other. The invention will be described in detail below with reference to the drawings in connection with embodiments.
The prior art means can not simultaneously complete the carotid endangium peeling operation and the intervention treatment of carotid serial lesions (the positions comprise the proximal end of the common carotid artery, the distal end of the internal carotid artery and the intracranial segment of the internal carotid artery) through one vascular incision, and the lesions comprise stenotic lesions and neoplastic lesions such as aneurysms, or the risk of cerebral infarction caused by thrombus and debris falling in the operation is not effectively avoided. If the lesions of the initial segment of the common carotid artery and the lesions of the internal carotid artery are to be treated synchronously, additional direct-vision carotid artery puncture or establishment of a vascular access through femoral artery is often required, the risks of surgical trauma and vascular injury at the puncture part are increased, and a certain cerebral infarction risk is faced.
The carotid artery diversion tube provided by the embodiment of the invention not only can meet the temporary blood diversion function of the existing product, but also integrates the function of a vascular sheath, and interventional instruments such as a guide wire, a catheter and the like can be conveyed to a tandem lesion part through the sheath, so that the surgical stripping operation and the simultaneous implementation of the interventional operation can be realized through only one vascular incision, the operation is simplified, the complications related to the operation access are reduced, and the risk of cerebral infarction in the operation is effectively reduced.
Fig. 2 is a schematic structural diagram of a carotid shunt according to an embodiment of the present invention.
As shown in fig. 2, the carotid shunt includes a shunt body 10 and a sheath 20. The outer walls of the tube bodies at the two ends of the diversion tube body 10 are provided with a balloon 11 and a balloon 12; one end of the sheath 20 is communicated with the middle part of the diversion pipe body 10 and is arranged at a preset angle with the diversion pipe body 10, and the other end of the sheath 20 is a free end; the carotid shunt further comprises balloon catheters 13 which are matched with the balloons 11 and the balloons 12, one end of one balloon catheter 13 is communicated with the balloon 11, the other balloon catheter 13 is communicated with the balloon 12, and the other end of each balloon catheter 13 is provided with a stop valve 14 for preventing the balloon from leaking gas.
The carotid shunt tube provided by the invention realizes the function of a conventional carotid shunt tube in carotid endarterectomy through a vascular incision, and then is sent into a guide wire, a catheter and various interventional instruments through a sheath tube, so that the serial lesions at the proximal end of the carotid artery or the distal end of the carotid artery can be treated synchronously.
According to an embodiment of the present invention, the sheath 20 is flexibly connected to the transfer tube 10. For example, the connection portion may be made of a flexible material, and the material may be appropriately selected with reference to the prior art, which will not be described herein.
According to an embodiment of the present invention, a transition pipe (not shown) is provided between the sheath 20 and the transfer pipe body 10.
According to an embodiment of the present invention, the transition pipe is disposed at a predetermined angle with respect to the diverting pipe body 10. When the sheath 20 is flexibly connected to the shunt body 10, the predetermined angle is preferably an oblique angle, for example, the predetermined angle is 30-45 degrees, more preferably 45 degrees, so that the interventional instrument can be delivered to the site of the tandem lesion. In some cases, the predetermined angle may be 90 degrees, considering the elasticity of the flexible material, as shown in fig. 2, and simply bent upward or downward in use to adaptively deliver the access instrument into the common carotid artery or the internal carotid artery.
According to an embodiment of the invention, a haemostatic valve is connected at the free end. Specifically, the free end of the sheath 20 is passed by an interventional instrument, and a hemostatic valve 22 is connected to the free end via a hose 21 to prevent blood from flowing out of the free end during surgery.
According to the embodiment of the invention, the inner wall of the diversion pipe body 10 is provided with scale marks, so that the position of the diversion pipe body stretching into the blood vessel can be conveniently determined.
According to the embodiment of the invention, the inner diameters of the diversion tube body 10 and the sheath tube 20 are not smaller than 5-6F, and further, the inner diameter of the transition tube is not smaller than 5-6F, so that the diversion tube is convenient for passing through interventional instruments such as a 0.014 inch-0.038 inch guide wire, a 5-6F catheter, a 5-6F balloon and a 5-6F bracket.
Fig. 3 is a schematic structural diagram of a carotid shunt according to another embodiment of the invention. Fig. 3 shows the number of the sheath pipes 20 as one and forms a predetermined angle with the transfer pipe body 10 in the obliquely downward direction, specifically, the predetermined angle is 45 degrees. Other technical details may refer to the embodiment shown in fig. 2, and will not be described here. It should be noted that, in the embodiment shown in fig. 3, for example, if the lower end of the shunt body 10 is placed in the common carotid artery, since the preset angle of the sheath 20 is set in the obliquely downward direction, the catheter is suitable for passing the interventional instrument into the internal carotid artery to treat the tandem lesion, and the interventional instrument cannot be delivered into the common carotid artery any more.
Fig. 4 is a schematic structural view of a carotid shunt according to another embodiment of the invention.
As shown in fig. 4, the number of the sheath pipes 20 is two, one sheath pipe forms a preset angle with the transfer pipe 10 in the obliquely downward direction, and the other sheath pipe 20 forms a preset angle with the transfer pipe 10 in the obliquely upward direction. Other technical details may refer to the embodiment shown in fig. 2, and will not be described here. Unlike the embodiment of fig. 3, by providing two sheaths 20, the interventional instrument can be delivered into the internal carotid artery through the sheaths 20 in the obliquely downward direction to treat the tandem lesion, and the interventional instrument can be delivered into the common carotid artery through the sheaths 20 in the obliquely upward direction to treat the tandem lesion at the same time, so that the surgical operation is further simplified, and the complications related to the surgical approach are reduced.
According to an embodiment of the present invention, the two sheaths 20 may communicate with the diverting tube body 10 through one transition tube each, so that the two sheaths 20 may not communicate with each other and may be spaced apart from each other. Of course, under suitable process, two sheath tubes 20 may also be in communication with the transfer tube body 10 through one transition tube, which is not limited in this regard by the present invention.
It should be understood that the carotid shunt in the embodiment of fig. 4 is schematically illustrated by using only two sheaths 20 as an example, and that more sheaths 20 may be provided as needed, which is not described herein.
Taking the carotid artery transfer tube in the embodiment of fig. 4 as an example, when the carotid artery transfer tube is used, after the carotid artery sinus is incised by an operation, one end of the carotid artery transfer tube is inserted into the carotid artery, the carotid artery transfer tube is fixed by inflating a balloon through a balloon catheter, then the other end of the carotid artery transfer tube is inserted into the common carotid artery, the carotid artery is fixed by inflating a balloon through a balloon catheter, arterial blood flows into the carotid artery from the common carotid artery through the carotid artery transfer tube, and temporary blood perfusion of brain tissue at one side of the operation is established.
Referring to fig. 1, in particular, when treating a carotid artery (CCA) tandem lesion (not shown in the figure), an interventional instrument is delivered through a sheath, and a temporary hemostatic forceps clamp one end of a carotid shunt tube, which is close to an Internal Carotid Artery (ICA), so as to avoid micro emboli and air entering the internal carotid artery along with blood flow during operation and reduce risk of postoperative cerebral infarction. When the internal carotid artery serial lesion is treated, the interventional instrument is sent into through the sheath tube, the temporary hemostatic forceps clamp one end of the internal carotid artery current transfer tube, which is close to the common carotid artery, so that the internal carotid artery blood flow is reversed in a short time, and the micro-emboli generated in the internal carotid artery lesion treatment process can flow along with the reverse blood flow, flow out of the body through the current transfer tube, and the risk of postoperative cerebral infarction is reduced.
Based on the same or similar inventive concept, the present invention also provides a carotid artery surgical instrument comprising a carotid shunt as described in the above embodiments and an interventional instrument delivered into the carotid artery via the sheath.
According to an embodiment of the invention, the interventional instrument comprises one or more of the following: guide wires, catheters, balloons and stents.
Other relevant technical details of the embodiments of the present invention may be referred to the above embodiment section, and are not described herein.
Compared with the prior art, the carotid artery bypass tube provided by the embodiment of the invention can not only meet the temporary blood bypass function of the existing product, but also integrate the function of a vascular sheath, and interventional instruments such as a guide wire, a catheter and the like can be conveyed to a serial lesion part through the sheath, so that the surgical stripping operation and the interventional operation can be simultaneously implemented through only one vascular incision, the operation is simplified, the complications related to the operation approach are reduced, and the risk of cerebral infarction in the operation is effectively reduced.
The above description is only illustrative of the preferred embodiments of the present invention and of the principles of the technology employed. It will be appreciated by persons skilled in the art that the scope of the invention referred to in the present invention is not limited to the specific combinations of the technical features described above, but also covers other technical features formed by any combination of the technical features described above or their equivalents without departing from the inventive concept. Such as the above-mentioned features and the technical features disclosed in the present invention (but not limited to) having similar functions are replaced with each other.

Claims (10)

1. A carotid shunt, comprising:
the outer walls of the tube bodies at the two ends of the diverting tube body are provided with saccules;
one end of the sheath tube is communicated with the middle part of the diversion tube body, and is arranged at a preset angle with the diversion tube body, and the other end of the sheath tube is a free end;
and one end of the balloon catheter matched with the balloon is communicated with the balloon, and the other end of the balloon catheter is provided with a stop valve.
2. The carotid shunt according to claim 1, wherein the sheath is one and forms a predetermined angle with the shunt body in a diagonally downward direction; or,
the number of the sheath pipes is two, one sheath pipe forms a preset angle with the diversion pipe body along the obliquely lower direction, and the other sheath pipe forms a preset angle with the diversion pipe body along the obliquely upper direction.
3. Carotid shunt according to claim 1 or 2, wherein the sheath is flexibly connected to the shunt body.
4. A carotid shunt according to claim 3, wherein a transition tube is provided between the sheath and the shunt tube.
5. The carotid shunt tube of claim 4, wherein the transition tube is disposed at a predetermined angle to the shunt tube.
6. The carotid shunt of claim 5 wherein the predetermined angle is 30-45 degrees.
7. The carotid shunt of claim 6 wherein the predetermined angle is 45 degrees.
8. The carotid shunt according to claim 1, wherein a hemostatic valve is connected at the free end.
9. A carotid surgical device comprising a carotid shunt according to any one of claims 1-8 and an interventional device delivered into the carotid artery via the sheath.
10. The carotid surgical instrument of claim 9, wherein the interventional instrument comprises one or more of the following: guide wires, catheters, balloons and stents.
CN202311207793.XA 2023-09-19 2023-09-19 Carotid shunt tube and carotid surgical instrument Pending CN117224821A (en)

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CN117224821A true CN117224821A (en) 2023-12-15

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN2761149Y (en) * 2005-01-25 2006-03-01 董国祥 Carotid shunt tube
CN202236818U (en) * 2011-10-18 2012-05-30 复旦大学附属中山医院 Intracarotid bypass block catheter with double saccules
CN206239874U (en) * 2016-07-29 2017-06-13 宝鸡市德尔医疗器械制造有限责任公司 Carotid shunt
CN216495542U (en) * 2021-10-14 2022-05-13 安徽医科大学第一附属医院 Intracranial artery operation shunt tube
CN115700108A (en) * 2022-11-07 2023-02-07 深圳市慧极创新医疗科技有限公司 Transfer flow pipe in carotid endarterectomy
CN219579694U (en) * 2022-11-27 2023-08-25 天津汇森医疗科技有限公司 Novel carotid artery current transfer catheter

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN2761149Y (en) * 2005-01-25 2006-03-01 董国祥 Carotid shunt tube
CN202236818U (en) * 2011-10-18 2012-05-30 复旦大学附属中山医院 Intracarotid bypass block catheter with double saccules
CN206239874U (en) * 2016-07-29 2017-06-13 宝鸡市德尔医疗器械制造有限责任公司 Carotid shunt
CN216495542U (en) * 2021-10-14 2022-05-13 安徽医科大学第一附属医院 Intracranial artery operation shunt tube
CN115700108A (en) * 2022-11-07 2023-02-07 深圳市慧极创新医疗科技有限公司 Transfer flow pipe in carotid endarterectomy
CN219579694U (en) * 2022-11-27 2023-08-25 天津汇森医疗科技有限公司 Novel carotid artery current transfer catheter

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