CN204072153U - A kind of utensil for the treatment of arterial occlusion pathological changes - Google Patents
A kind of utensil for the treatment of arterial occlusion pathological changes Download PDFInfo
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- CN204072153U CN204072153U CN201420507704.3U CN201420507704U CN204072153U CN 204072153 U CN204072153 U CN 204072153U CN 201420507704 U CN201420507704 U CN 201420507704U CN 204072153 U CN204072153 U CN 204072153U
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Abstract
The utility model discloses a kind of utensil for the treatment of arterial occlusion pathological changes, comprise Vascular Ultrasonography conduit, treatment microtubular and treatment seal wire; Vascular Ultrasonography conduit and treatment microtubular combining as a whole; A treatment seal wire part is positioned at treatment microtubular, and another part passes treatment microtubular from sidewall exit.This utility model is by Vascular Ultrasonography conduit and treat microtubular and combine as a whole, and utilize two-chamber microtubular to adjust the treatment true chamber of seal wire intravasation, treatment seal wire, by thrombosis sucking-off, is once cured, eliminated postoperative hidden danger; The intervention that this utility model solves coronary artery, peripheral arterial and other organ conduit occlusions again extensively treating is treated in operation and is treated the problem that seal wire not easily enters true chamber.
Description
Technical field
This utility model relates to arterial occlusion therapeutic appliance technical field.
Background technology
Coronary heart disease is the first killer of harm humans health, and chronic total occlusion of coronary artery (CTO) is a most serious type.Coronary chronic total occlusion (chronic total occlusion, CTO) pathological changes is defined as the course of disease 3 months, coronarography finding local obliteration, forward blood flow disappear completely, Distal blood flow thrombolysis in myocardial infarction test (thrombolysis in myocardial infarction, TIMI) 0 grade; Or rarely seen a little forward blood flow passes through but fills (TIMI blood flow 1 grade) without distal vessels, the latter is also referred to as " functional " CTO.CTO pathological changes accounts for all 12%-20% accepting PCI (percutaneous coronary intervention, PCI) patient in clinical, and the technical difficulty of CTO pathological changes interventional therapy is maximum, success rate is low.The meaning of success PCI is can reduction of patient angina pectoris symptom, improves cardiac function and reduces the needs of coronary bypass (CABG), extending patient's life-span.Adopt interventional therapy CTO pathological changes, a maximum difficult problem is that seal wire is difficult to successfully pass through this type of pathological changes and successfully enter true chamber, is therefore considered to the maximum obstacle in current PCI field and challenge.
Clinical in evaluating in the common method of coronary atherosclerosis at present, traditional coronary angiography is considered to the golden index evaluating Coronary Artery Lesions always.But this method also shows many weak points in the middle of clinical practice application.As, it can only show the situation of tube chamber, can not the tube wall at lesions showed place and atheromatous plaque, can not provide the details of atheromatous plaque form and character, likely make doctor underestimate the degree of coronary stenosis.This just makes the accuracy evaluating coronary atherosclerosis and interventional therapy curative effect according to coronary angiography reduce.Especially the proposition of Coronary arterial remodeling (remodeling) this concept in recent years, makes people have to reappraise the reliability of coronary angiography in coronary heart disease diagnosis and treatment.Early stage at coronary atherosclerosis, along with the increase of atheromatous plaque area, arteria coronaria is underwent compensatory enlargement, and Lumen Area can without narrow, this process and Coronary arterial remodeling.Now coronary angiography often performance without exception.
Intravascular ultrasound utilizes conduit that one high frequency miniature ultrasonic probe is imported Endovascular to detect, then show the fine anatomic information of cardiovascular organization structure and geometric shape through electronic imaging system.Because ultrasonic probe is directly placed in Endovascular detection, therefore, intravascular ultrasound not only can the size of Measurement accuracy tube chamber and atheromatous plaque or fibrous plaque, the more important thing is that it can provide the cardinal principle organizational information of atheromatous plaque, being obviously better than radiography when showing the pathological change form because of the complexity caused by interventional therapy.
Intravascular ultrasound plays more and more important effect at CTO interventional therapy, and the CTO forward direction seal wire that current IVUS instructs mainly contains two kinds: the IVUS seal wire instructed by technology and enters true chamber by the seal wire puncture of the false intracavity instructed without entry technique and the IVUS of stump CTO pathological changes.
The seal wire that IVUS instructs is by the entry technique without stump CTO pathological changes: generally, Doppler flow mapping development fully clearly contribute to identifying with branch without stump CTO pathological changes entrance, but sometimes rely on Doppler flow mapping video picture merely, can not identify the entrance of CTO, seal wire can not correctly puncture inaccessible section starting point.In this case, if branch is enough large, IVUS conduit can enter branch, in the process withdrawing IVUS conduit, is easy to the vessel profile identifying CTO initial part.Under IVUS image guides, handle seal wire puncture CTO entrance, improve the success rate that seal wire passes through.The hardness of CTO initial part speckle can also being judged simultaneously according to IVUS Features, providing information for selecting guiding wire.
The seal wire puncture of the false intracavity that IVUS instructs enters true chamber: in CTO intervention procedure, under seal wire usually enters inner membrance, form false chamber, seal wire can not arrive the true chamber of far-end, and this is the chief reason of operative failure.Even if the parallel seal wire technology of application standard, sometimes seal wire also can cause false chamber to tear expansion, once extend more than the far-end of CTO pathological changes in false chamber under inner membrance, will affect the radiography video picture in the true chamber of far-end.If occur that this situation does not have IVUS usually can have to stop operation technique.IVUS can differentiate true chamber and false chamber.The IVUS feature in true chamber comprises and there is branch vessel, has inner membrance and the middle layer to surround around tube chamber.And there is not above-mentioned IVUS sign in false chamber.IVUS instructs and confirms to guide seal wire to be again punctured to true chamber from false chamber.Think when additive method failure at present and don't possess reverse intervention condition, still have an appointment 60% CTO pathological changes to can be passed through the method successfully open-minded.The method technology is considered to the last weapon of interventional therapy CTO.But the method still has certain limitation, Vascular Ultrasonography conduit and puncture seal wire are separated, and it is more difficult that ultrasound catheter and seal wire enter inaccessible blood vessel simultaneously, and seal wire operation easier is large.Because ultrasound catheter and seal wire position are not fixed, need the position again determining puncture seal wire before each seal wire puncture, then determine the relation of target and puncture seal wire, finally grasp puncture direction.Puncture accuracy rate declines, and operating procedure is many, and x-ray exposure rate increases, and has a strong impact on success rate of operation.And likely causing inaccessible elongated segment, postoperative complication increases, and cannot promote.
Utility model content
The technical problems to be solved in the utility model is to provide a kind of utensil for the treatment of arterial occlusion pathological changes, by Vascular Ultrasonography conduit and treatment microtubular combining as a whole, utilize two-chamber microtubular to adjust the treatment true chamber of seal wire intravasation, treatment seal wire is by thrombosis sucking-off, once cure, eliminate postoperative hidden danger; The intervention that this utility model solves coronary artery, peripheral arterial and other organ conduit occlusions again extensively treating is treated in operation and is treated the problem that seal wire not easily enters true chamber.
For solving the problems of the technologies described above, technical solution adopted in the utility model is: a kind of utensil for the treatment of arterial occlusion pathological changes, comprises Vascular Ultrasonography conduit, treatment microtubular and treatment seal wire; Vascular Ultrasonography conduit and treatment microtubular combining as a whole;
Vascular Ultrasonography catheter proximal end is provided with ring-shaped ultrasonic probe and opening, and the end of Vascular Ultrasonography conduit is provided with connecting pin, and the inside of Vascular Ultrasonography conduit is provided with guiding wire; The tail end of guiding wire stretches out outside Vascular Ultrasonography conduit from the guide wire exit openings be positioned at Vascular Ultrasonography duct wall;
Vascular Ultrasonography pipe inner wall is provided with the holding wire connecting described ultrasonic probe and connecting pin;
Vascular Ultrasonography conduit outer wall is provided with locating clip; Entering after in body and position is determined until Vascular Ultrasonography conduit and treatment seal wire uses locating clip Vascular Ultrasonography conduit and human body to be fixed, the slippage of Vascular Ultrasonography conduit can be prevented, be not easy to cause a deviation in operation process, ensure that the accuracy of orientation treatment, improve success rate of operation.
Locating clip can be any clip with positioning function.
The front end for the treatment of microtubular is provided with treatment guide wire exit openings, is provided with witness marker on the left for the treatment of guide wire exit openings;
Be positioned at treatment microtubular sidewall on the left of witness marker and be provided with sidewall exit, a treatment seal wire part is positioned at treatment microtubular, and another part passes treatment microtubular from sidewall exit;
The front end for the treatment of seal wire is provided with piston and pin mouth, and treatment seal wire tail end is provided with piston cap, is provided with connecting filament between piston and piston cap.
Guiding wire comprises head, outer tube, interior pipe, annular air-pocket, middle armature assembly and hands handle; Outer tube one end is connected with head, and interior pipe front end is positioned at outer tube and is communicated with annular air-pocket; The length of outer tube is greater than the length of annular air-pocket, is less than the length of interior pipe; The other end of interior pipe is connected with middle armature assembly, and middle armature assembly is connected with handle.
The distance of guide wire exit openings and ultrasonic probe is 30 ~ 40cm.
The distance for the treatment of guide wire exit openings and witness marker is 1mm.
The distance of sidewall exit and witness marker is 40 ~ 50cm, and witness marker and treatment seal wire are provided with scale, can see with ultrasonic probe.
Treatment seal wire tail end and piston cap are provided with sags and crests.
Treatment microtubular and Vascular Ultrasonography conduit can merge into a cavity, called after ultrasound catheter, other structures are identical with said structure, treatment seal wire and guiding wire are co-located in ultrasound catheter, ultrasound catheter is provided with sidewall exit, a treatment seal wire part is positioned at ultrasound catheter, and another part passes ultrasound catheter from sidewall exit.
Vascular Ultrasonography catheter outer is vinyon layer, and internal layer is PTFE coating, is the network structure of braided steel wire between skin and internal layer.The main material for the treatment of microtubular is politef, and the main material for the treatment of seal wire is Low Density Polyethylene and Merlon, and the head material of guiding wire is rustless steel.
Treat microtubular in this utility model instrument and can increase the handling of guiding wire, improve the penetration capacity of guiding wire and be convenient to the replacing of seal wire, treatment seal wire both can puncture to thrombosis, can utilize needle tubing principle again, treatment seal wire piston cap upwards extracts drive piston movement, can form vacuum in treatment seal wire inside, pressure differential will promote " thrombosis " and enter treatment seal wire, treatment seal wire piston by " thrombosis " sucking-off, once can be cured, eliminates postoperative hidden danger.That during CTO gets involved, one is very practical, effective instrument.
Seal wire is by being the successful foundation stone of intervention.The major obstacle got involved in pathological changes at CTO cannot understand arteria coronaria out of shape after being vascular occlusion, and patient can not the direction of advance of paying attention seal wire.And after blood vessel chronic occlusion, after thrombosis polarizes fibers, quality is hard.Treatment seal wire cannot penetrate pathological changes and accurately arrive the true chamber of distal vessels.
Treatment seal wire effectively combines with intravascular ultrasound two-chamber microtubular by this utility model.The similar needle tubing for the treatment of seal wire, can by " thrombosis " sucking-off; Intravascular ultrasound two-chamber microtubular is formed by both Vascular Ultrasonography conduit (Monorail rapid exchange system) and treatment microtubular (the overall exchange system of Over-The-Wire) are conjuncted, apparatus external diameter is little, treatment seal wire easily synchronously enters lesion with ultrasonic two-chamber microtubular, and two-chamber microtubular increases the handling for the treatment of seal wire effectively.
For the type that sickness rate in CTO pathological changes is higher--be positioned at bifurcation without stump CTO pathological changes, intravascular ultrasound two-chamber microtubular can provide well treats platform, Vascular Ultrasonography conduit in intravascular ultrasound two-chamber microtubular enters branch along seal wire, different according to the hardness of seal wire, the more single microtubular of guiding wire puncture force adds 2 to 8 times.Because therapentic part is relatively fixing, treatment seal wire can also obtain better handling.Vascular Ultrasonography conduit in Vascular Ultrasonography two-chamber microtubular can manifest CTO initial part entrance structure, contributes to the direction of patient's accurate assurance treatment, improves the success rate that treatment seal wire enters CTO pathological changes.
Adopt intravascular ultrasound two-chamber microtubular, Vascular Ultrasonography conduit follows up into the guiding wire in false chamber, occupies the entrance in false chamber, stops treatment seal wire to repeat to enter false chamber.Adopt intravascular ultrasound two-chamber microtubular can provide the support force doubled than single chamber microtubular.Therefore intravascular ultrasound two-chamber microtubular can improve the success rate that treatment seal wire enters true chamber greatly.Vascular Ultrasonography two-chamber microtubular can show tube wall and characteristics of lesion in addition, can the puncture of inner membrance inner tissue be looked for finally to enter true chamber by guiding treatment seal wire, because two conduits are conjuncted, treatment seal wire is relative with the position of ultrasonic probe fixing, more easily determine relation between guiding wire and target, contribute to paying attention orientation treatment, improve success rate of operation further.
Its operation principle is:
During interventional therapy, first Vascular Ultrasonography conduit is sent into arteria coronaria entrance, for bifurcation without stump CTO pathological changes, guiding wire is delivered to branch vessel through guiding catheter, and Vascular Ultrasonography two-chamber microtubular is delivered to bifurcation along guiding wire, utilize its Vltrasonic device, the inlet location of display blood vessel, the characteristics of lesion at inaccessible initial position, according to the information that ultrasonic examination provides, select appropriate therapeutic seal wire, treat seal wire under ultrasound guidance through treatment microtubular stereotactic puncture Occlusion entrance, and by " thrombosis " sucking-off.The true chamber of distal vessels can not be entered under guiding wire intravasation inner membrance, then send into Vascular Ultrasonography two-chamber microtubular along entering subintimal guiding wire, send into treatment seal wire through treatment microtubular simultaneously, vascular ultrasound understands structural pipe wall, characteristics of lesion and the treatment seal wire relation with pathological changes, according to the ultrasonic information provided, select appropriate therapeutic seal wire, and to the correct plastotype for the treatment of seal wire.Under ultrasound guidance, treat seal wire and finally enter the true chamber of distal vessels through treatment microtubular stereotactic puncture searching inner membrance inner tissue.When needs Vascular Ultrasonography two-chamber microtubular enters inaccessible section, when cannot enter because of the reason such as occlusive tissue is hard or the false chamber of blood vessel is less, small-diameter balloon low-pressure can be adopted to expand, then send into this device and complete interventional therapy.
The beneficial effect adopting technique scheme to produce is: this utility model is by Vascular Ultrasonography conduit and treat microtubular and combine as a whole, two-chamber microtubular is utilized to adjust the treatment true chamber of seal wire intravasation, treatment seal wire, by thrombosis sucking-off, is once cured, is eliminated postoperative hidden danger; The intervention that this utility model solves coronary artery, peripheral arterial and other organ conduit occlusions again extensively treating is treated in operation and is treated the problem that seal wire not easily enters true chamber.
Accompanying drawing explanation
Below in conjunction with the drawings and specific embodiments, this utility model is described in further detail.
Fig. 1 is structural representation of the present utility model;
Fig. 2 is the structural representation of guiding wire;
1 is ultrasonic probe, and 2 is treatment guide wire exit openings, and 3 is witness marker, and 4 is guide wire exit openings, 5 is treatment microtubular, and 6 is connecting pin, and 7 is Vascular Ultrasonography conduit, and 8 is sidewall exit, 9 is treatment seal wire, and 10 is piston, and 11 is piston cap, 12 is connecting filament, and 13 is guiding wire, and 14 is head, 15 is outer tube, and 16 is interior pipe, and 17 is annular air-pocket, 18 is middle armature assembly, and 19 is handle, and 20 is locating clip.
Detailed description of the invention
Embodiment 1
Treat a utensil for arterial occlusion pathological changes, comprise Vascular Ultrasonography conduit 7, treatment microtubular 5 and treatment seal wire 9; Vascular Ultrasonography conduit 7 is with treatment microtubular 5 and combine as a whole;
Vascular Ultrasonography conduit 7 front end is provided with ring-shaped ultrasonic probe 1 and opening, and the end of Vascular Ultrasonography conduit 7 is provided with connecting pin 6, and the inside of Vascular Ultrasonography conduit 7 is provided with guiding wire 13; The tail end of guiding wire 13 stretches out outside Vascular Ultrasonography conduit 7 from the guide wire exit openings 4 be positioned at Vascular Ultrasonography conduit 7 sidewall;
Vascular Ultrasonography pipe inner wall is provided with the holding wire connecting described ultrasonic probe and connecting pin;
Vascular Ultrasonography conduit outer wall is provided with locating clip 20;
The front end for the treatment of microtubular 5 is provided with treatment guide wire exit openings 2, is provided with witness marker 3 on the left for the treatment of guide wire exit openings 2;
Be positioned at treatment microtubular sidewall on the left of witness marker 3 and be provided with sidewall exit 8, treatment seal wire 9 part is positioned at treatment microtubular 5, and another part passes treatment microtubular 5 from sidewall exit 8;
The front end for the treatment of seal wire 9 is provided with piston 10 and pin mouth, and treatment seal wire 9 tail end is provided with piston cap 11, is provided with connecting filament 12 between piston 10 and piston cap 11.
Guiding wire comprises head 14, outer tube 15, interior pipe 16, annular air-pocket 17, middle armature assembly 18 and handle 19; Outer tube 15 one end is connected with head 14, and interior pipe 16 front end is positioned at outer tube and is communicated with annular air-pocket 17; The length of outer tube 15 is greater than the length of annular air-pocket 17, is less than the length of interior pipe 16; The other end of interior pipe 16 is connected with middle armature assembly 18, and middle armature assembly 18 is connected with handle 19.
Guide wire exit openings 4 is 30 ~ 40cm with the distance of ultrasonic probe 1.
Treatment guide wire exit openings 2 is 1mm with the distance of witness marker 3.
Sidewall exit 8 is 40 ~ 50cm with the distance of witness marker 3.
Treatment seal wire tail end and piston cap 11 are provided with sags and crests.
Above-mentioned instrument coronary artery, peripheral arterial and other organ conduit occlusions intervention again extensively treating treat in application.
The using method of the present embodiment instrument is: during use, at blood vessel correct position clip, first ultrasound catheter is introduced into blood vessel, then guiding wire is from the opening part intravasation inner membrance of ultrasound catheter, and send into Vascular Ultrasonography two-chamber microtubular along entering subintimal guiding wire, vascular ultrasound understands structural pipe wall, characteristics of lesion etc., according to the ultrasonic information provided, select appropriate therapeutic seal wire, and to the correct plastotype for the treatment of seal wire, send into treatment seal wire through treatment microtubular simultaneously.Under ultrasound guidance, treat seal wire and finally enter the true chamber of distal vessels through treatment microtubular stereotactic puncture searching inner membrance inner tissue.When needs Vascular Ultrasonography two-chamber microtubular enters inaccessible section, when cannot enter because of the reason such as occlusive tissue is hard or the false chamber of blood vessel is less, then utilize annular air-pocket low-pressure to expand, then send into this device and complete interventional therapy.
Claims (6)
1. treat a utensil for arterial occlusion pathological changes, it is characterized in that: comprise Vascular Ultrasonography conduit (7), treatment microtubular (5) and treatment seal wire (9); Vascular Ultrasonography conduit (7) and treatment microtubular (5) combine as a whole;
Vascular Ultrasonography conduit (7) front end is provided with ring-shaped ultrasonic probe (1) and opening, and the end of Vascular Ultrasonography conduit (7) is provided with connecting pin (6), and the inside of Vascular Ultrasonography conduit (7) is provided with guiding wire (13); The tail end of guiding wire (13) stretches out Vascular Ultrasonography conduit (7) outward from the guide wire exit openings (4) be positioned at Vascular Ultrasonography conduit (7) sidewall;
Vascular Ultrasonography pipe inner wall is provided with the holding wire connecting described ultrasonic probe and connecting pin;
Vascular Ultrasonography conduit outer wall is provided with locating clip (20);
The front end for the treatment of microtubular (5) is provided with treatment guide wire exit openings (2), and treatment guide wire exit openings (2) left side is provided with witness marker (3);
Witness marker (3) left side is positioned at treatment microtubular sidewall and is provided with sidewall exit (8), and treatment seal wire (9) part is positioned at treatment microtubular (5), and another part passes treatment microtubular (5) from sidewall exit (8);
The front end for the treatment of seal wire (9) is provided with piston (10) and pin mouth, and treatment seal wire (9) tail end is provided with piston cap (11), is provided with connecting filament (12) between piston (10) and piston cap (11).
2. the utensil for the treatment of arterial occlusion pathological changes according to claim 1, is characterized in that guiding wire comprises head (14), outer tube (15), interior pipe (16), annular air-pocket (17), middle armature assembly (18) and handle (19); Outer tube (15) one end is connected with head (14), and interior pipe (16) front end is positioned at outer tube and is communicated with annular air-pocket (17); The length of outer tube (15) is greater than the length of annular air-pocket (17), is less than the length of interior pipe (16); The other end of interior pipe (16) is connected with middle armature assembly (18), and middle armature assembly (18) is connected with handle (19).
3. the utensil for the treatment of arterial occlusion pathological changes according to claim 1, is characterized in that described guide wire exit openings (4) is 30 ~ 40cm with the distance of ultrasonic probe (1).
4. the utensil for the treatment of arterial occlusion pathological changes according to claim 1, is characterized in that described treatment guide wire exit openings (2) is 1mm with the distance of witness marker (3).
5. the utensil for the treatment of arterial occlusion pathological changes according to claim 1, is characterized in that described sidewall exit (8) is 40 ~ 50cm with the distance of witness marker (3).
6. the utensil for the treatment of arterial occlusion pathological changes according to claim 1, is characterized in that, treatment seal wire tail end and piston cap (11) are provided with sags and crests.
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| CN201420507704.3U CN204072153U (en) | 2014-09-04 | 2014-09-04 | A kind of utensil for the treatment of arterial occlusion pathological changes |
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Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104586473A (en) * | 2015-02-16 | 2015-05-06 | 田进文 | Rapid exchange double-lumen micro catheter for reverse thrombolysis and use method thereof |
| CN107427285A (en) * | 2015-04-13 | 2017-12-01 | 内尔松·若热·特谢拉·多斯·桑托斯·保罗 | The device for intracardiac and intravascular surgical operation with endo-luminal ultrasound probe |
| CN108024785A (en) * | 2015-06-15 | 2018-05-11 | 新宁研究院 | Intravascular imaging catheter and its application method |
| CN117582252A (en) * | 2024-01-18 | 2024-02-23 | 上海爱声生物医疗科技有限公司 | Interventional therapy system and ultrasonic catheter for interventional therapy |
| CN117582252B (en) * | 2024-01-18 | 2024-04-30 | 上海爱声生物医疗科技有限公司 | Interventional therapy system and ultrasonic catheter for interventional therapy |
-
2014
- 2014-09-04 CN CN201420507704.3U patent/CN204072153U/en active Active
Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104586473A (en) * | 2015-02-16 | 2015-05-06 | 田进文 | Rapid exchange double-lumen micro catheter for reverse thrombolysis and use method thereof |
| CN107427285A (en) * | 2015-04-13 | 2017-12-01 | 内尔松·若热·特谢拉·多斯·桑托斯·保罗 | The device for intracardiac and intravascular surgical operation with endo-luminal ultrasound probe |
| CN107427285B (en) * | 2015-04-13 | 2021-04-27 | 内尔松·若热·特谢拉·多斯·桑托斯·保罗 | Device for intracardiac and endovascular surgery with an intracavity ultrasound probe |
| CN108024785A (en) * | 2015-06-15 | 2018-05-11 | 新宁研究院 | Intravascular imaging catheter and its application method |
| CN117582252A (en) * | 2024-01-18 | 2024-02-23 | 上海爱声生物医疗科技有限公司 | Interventional therapy system and ultrasonic catheter for interventional therapy |
| CN117582252B (en) * | 2024-01-18 | 2024-04-30 | 上海爱声生物医疗科技有限公司 | Interventional therapy system and ultrasonic catheter for interventional therapy |
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