CN204839623U - Be applicable to coronary artery perforate in vascular plugging device - Google Patents
Be applicable to coronary artery perforate in vascular plugging device Download PDFInfo
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- CN204839623U CN204839623U CN201520026758.2U CN201520026758U CN204839623U CN 204839623 U CN204839623 U CN 204839623U CN 201520026758 U CN201520026758 U CN 201520026758U CN 204839623 U CN204839623 U CN 204839623U
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Abstract
The utility model provides a be applicable to coronary artery perforate in vascular plugging device. Impel subassembly and coronary artery perforation shutoff subassembly including injection pressure boost subassembly, coronary artery perforation shutoff, coronary artery perforation shutoff impels the subassembly to be guided seal wire, sacculus, jacket sleeve, seal wire, guide cover, socket, to be kept set, to be annotated the liquid adapter sleeve by flexible alloy and constitute, coronary artery perforation shutoff subassembly mainly comprises the shutoff module and the sealing cap of different shapes rule. Shutoff module and sealing cap one end are connected through articulated, sealing cap comprises sealing cap flip convex spherical and sealing cap concave spherical surface, shutoff module middle part is provided with the thread eye, the outside of thread eye sets up sealing cap, sealing cap can only open to the outside, because of blood direction and pressure, automatically, cover the sealing cap in the shutoff module, sealing cap is with the thread eye shutoff of shutoff module, can satisfy different shapes, the hematal perforation of size, the hematal perforation of shutoff completely, reduce the risk that blood exosmoses, reduce the postoperative complication, the present invention has good application value.
Description
Technical field
This utility model relates to biomedicine technical field, concrete, and this utility model relates to a kind of technical field of coronary arterial perforation medium vessels plugging device.
Background technology
Coronary heart disease (
coronaryarteryheartdisease,cHD) being called for short coronary heart disease, is a kind of modal heart disease.Coronary heart disease is atherosis and cause because coronary artery there occurs.This atherosis speckle, is deposited on coronary endometrium, in the course of time, coronary artery tube chamber Serious Stenosis is even blocked, cause Oligemia, for hypoxgia, the nutrition supply of cardiac muscle reduces, produce the performance of a series of ischemic thus, as uncomfortable in chest, suffocated breathing, angina pectoris, make the impact that the normal work of heart is subject in various degree, severe patient can cause myocardial infarction and even cause death.
Cardiac stent operation and coronary heart disease coronary intervention treat that coronary heart disease is the most frequently used, the most promising method at present.Cardiac stent operation temporarily can dredge coronary artery, improves heart of patient blood supply, patient in imminent danger is sustained life normally.Briefly, the process of cardiac stent operative treatment is puncture vessel, and conduit is moved ahead in the blood vessel, arrives coronary artery pathological changes place, with special transfer system, support is transported to the position needing to lay, places, withdraws from conduit, terminate operation.But existingly clinically to show, when carrying out cardiac stent operation to patients with coronary heart disease, seal wire, in the vascular process by blocking, inevitably touches blood vessel, thus causes secondary damage (perforation).If repair cardiac stent not in time to perform the operation the secondary damage caused, the death of patient likely can be caused.Ellis retrospective analysis 12900 examples accept the patient of coronary intervention, and wherein 62 examples there occurs arteria coronaria perforation (0.5%), and Ajlui retrospective study 8932 accepts coronary intervention patient, arteria coronaria perforation incidence rate 0.4%.Although arteria coronaria perforation incidence rate is low, if once occur to endanger seriously for patient vitals, according to statistics: if process case fatality rate after there is arteria coronaria perforation in PCI art not in time up to 9%.
From percutaneous transluminal coronary angioplasty (PTCA) appearance in 1977 so far, coronary heart disease coronary intervention (PCI) treatment increases year by year, PCI with its Wicresoft, blood vessels open passband is high, complication rate is low, is more and more widely used in clinical compared with coronary bypass surgery.But still have complication to occur in PCI operation, arteria coronaria perforation is one of severe complication in art.The incidence rate of coronary arterial perforation is lower, is 0.1%-0.9%, once occur to cause pericardial tamponade to cause death.
Clinical observation in recent years shows, along with the increase coronary arterial perforation of performing the operation and pericardial tamponade are also constantly increasing incidence rate.Its rescue and treatment key are Timeliness coverage and make a definite diagnosis the state of an illness, need to guide descending paracentesis pericardii and drain also row shutoff perforation place in time at X-ray machine in time.Patient's routine carries out row PCI art after coronary angiography, in art or postoperatively occur pericardial tamponade symptom, show as uncomfortable in chest, breathe hard, blood pressure drops, whole body are clammy, can occur the junctional area rhythm of the heart, even sudden cardiac arrest is quivered in room speed, room.Color Sonography shows: a large amount of hydrops in pericardium.Coronary angiography shows: coronary blood tracheal rupture, contrast agent spills blood vessel to pericardium.Patient happens suddenly pericardial tamponade symptom, should give pericardiocentesis drainage as early as possible, after puncture needle is thrust pericardial cavity, J-shaped guide wire is sent into pericardial cavity, withdraws from puncture needle afterwards, and along seal wire, 6F pigtail catheter is sent into pericardial cavity, extracting liquid.Simultaneously with a sacculus in perforation place or the compressing of near-end 6-8atm long-time low pressure continuous expansion, each 30s-120s until boring close, accumulation balloon expandable time 20min-60min.Local contrast agent exosmose through balloon expandable compressing after stop, stopping balloon compression after there is not pericardial tamponade.Still have after sacculus is observed as discharged and exosmose on a small quantity, show to be badly in need of shutoff vascular puncture mouth.
Through retrieval, at present a lot of research is the research about vascular compression hemostasis, has no report, for occurring that arteria coronaria is bored a hole about the perform the operation research of blood vessel shutoff of the patient's secondary damage caused of PCI, many employings sacculus low pressure is expanded, and pushes the measures such as gelfoam in microtubular.Further, the secondary damage Shi Qu autologous tissue in treatment cardiac stent operation at present carries out darning vascular puncture.But the size, shape etc. of autologous tissue can not match with the bore of secondary damage, likely there will be the danger that blood vessel shutoff is not tight, plugging effect is bad, cause complication, even cause the death of patient.Also have no relevant size shape both at home and abroad suitable, and the mould that body can not be caused to repel carries out the report of shutoff to the blood vessel of secondary damage.Therefore, explore and study clinical manipulation conveniently, plugging effect is excellent, plugging material is safe and cheap, not easily cause the blood vessel shutoff perforation system device of complications of patients undergoing, for the perforation of reparation blood vessel promptly and accurately, rescue patient, promotes that the aspects such as the development of medical industry all have great importance.
Summary of the invention
Effectively solve PCI to perform the operation the present Research of plugging device of the vascular puncture caused for having no both at home and abroad at present, and plugging effect is good, plugging material safety, plugging device structure is simple, clinical manipulation is plugging device easily, this utility model provides a kind of coronary arterial perforation medium vessels plugging system device, be intended to the plugging system device that a kind of vascular puncture caused of performing the operation for treatment PCI is provided, the plugging effect of this blood vessel plugging system device is excellent, the PCI that can be applicable to various shape performs the operation the shutoff of the vascular puncture caused, and in clinical manipulation process, blocking component in blood vessel plugging system device can not come off in the blood vessel, thus cause the complication of patient.
Main technical schemes of the present utility model:
A kind of blood vessel shutoff perforation system device that this utility model provides mainly comprises injection pressurizing pack, arteria coronaria perforation shutoff propulsion assembly and arteria coronaria perforation blocking component, and injection pressurizing pack is made up of syringe, Pressure gauge, rubber tube; Arteria coronaria perforation shutoff propulsion assembly guides seal wire, sacculus, jacket pipe, seal wire, guiding cover, socket, maintainance set, fluid injection adapter sleeve to form by flexible alloys; Arteria coronaria perforation blocking component is primarily of the plugging module of difformity rule and plugging cap composition.Described plugging module different, not of uniform size, and the centre bit of each plugging module is equipped with a thread eye, in arteria coronaria perforation blocking component, plugging module and plugging cap one end are by being articulated and connected, plugging cap renovates convex spherical by plugging cap and plugging cap concave spherical surface forms, thread eye is provided with in the middle part of plugging module, the arranged outside plugging cap of thread eye, plugging cap can only opening laterally, during operation, flexible alloys guides seal wire through the inner side at plugging module hollow place, namely plugging module penetrates without one end thread eye of plugging cap, renovate edge between convex spherical and plugging cap concave spherical surface through there being the plugging cap of plugging cap to pass, in using, after only needing that plugging module is pushed artery-clogging by sacculus, extract flexible alloys out and guide seal wire, now plugging module is just retained in artery-clogging, because of blood direction and pressure, automatically the plugging cap in plugging module can be covered, thus by the thread eye shutoff of plugging cap by plugging module.During clinical operation, this blood vessel plugging system device is utilized to be sent to perforation place of blood vessel by with the blocking component that flexible alloys guides seal wire to be connected, and blocking component is got lodged in perforation place of blood vessel, stop exosmosing of blood, shutoff patients with coronary artery disease carries out PCI and to perform the operation the vascular puncture caused, thus reduce the ratio of secondary damage patient death in PCI operation, there is good clinical value.
This utility model specifically provides one to be applicable to arteria coronaria perforation medium vessels plugging device, described blood vessel plugging device mainly comprises injection pressurizing pack, arteria coronaria perforation shutoff propulsion assembly and arteria coronaria perforation blocking component, and injection pressurizing pack is made up of syringe, Pressure gauge, rubber tube; Arteria coronaria perforation shutoff propulsion assembly guides seal wire, sacculus, jacket pipe, seal wire, guiding cover, socket, maintainance set, fluid injection adapter sleeve to form by flexible alloys; Arteria coronaria perforation blocking component is primarily of the plugging module of difformity rule and plugging cap composition.
In this utility model, in injection pressurizing pack, the left side of syringe connects hand-held handle, the right side connection rubber tube of syringe, upper end, syringe side to the right Bonding pressure table.
In this utility model, in arteria coronaria perforation shutoff propulsion assembly, flexible alloys guides seal wire and seal wire by welding at pad, jacket pipe right-hand member is blind cover, left end inserts fluid injection adapter sleeve, offset with liquid injection hole, the socket that seal wire is arranged by guiding cover one end passes through maintainance set, is convenient to pull and push operation; Liquid is connected by rubber tube, fluid injection adapter sleeve and liquid injection hole, is controlled the opening and closing of sacculus by injection pressurizing pack, guides seal wire for pushing plugging module to perforation place of corresponding arteria coronaria by flexible alloys.
In this utility model, in arteria coronaria perforation blocking component, plugging module and plugging cap one end are by being articulated and connected, plugging cap renovates convex spherical by plugging cap and plugging cap concave spherical surface forms, thread eye is provided with in the middle part of plugging module, the arranged outside plugging cap of thread eye, plugging cap can only opening laterally, during operation, flexible alloys guides seal wire through the inner side at plugging module hollow place, namely plugging module penetrates without one end thread eye of plugging cap, renovate edge between convex spherical and plugging cap concave spherical surface through there being the plugging cap of plugging cap to pass, in using, after only needing that plugging module is pushed artery-clogging by sacculus, extract flexible alloys out and guide seal wire, now plugging module is just retained in artery-clogging, because of blood direction and pressure, automatically the plugging cap in plugging module can be covered, thus by the thread eye shutoff of plugging cap by plugging module.
Can according to actual needs, the above-mentioned arteria coronaria perforation medium vessels plugging device that is applicable to is made further optimization and/or improvements and is further described.
In this utility model, plugging module different, not of uniform size, the shape of plugging module can be olive-shaped, ellipsoid shape, round bead shape, coniform, dumbbell shaped, nail shape, drops, cone-shaped, the various shape such as polygon-shaped, polygon-shaped to can be tetragon, pentagon, hexagon, octagon etc. multiple, and the shape of plugging module can select corresponding plugging module according to arteria coronaria medium vessels hole difformity of boring a hole.
In this utility model, the plugging cap arranged in plugging cap renovates convex spherical and plugging cap concave spherical surface size, shape and plugging module adapt.
In this utility model, the center of each plugging module is provided with a thread eye, and thread eye aperture and PTCA seal wire adapt, and common PTCA seal wire is exactly that flexible alloys of the present invention guides seal wire.
In this utility model, plugging module and plugging cap adopt safe and reliable and can make by biodegradable biocompatible materials, and biocompatible materials is by being cross-linked into hydrogel and being formed in a mold.
In this utility model, the material of plugging module and plugging cap preferentially can select gelatin (gelatin).
In this utility model, the material of plugging module and plugging cap can be selected from material below:
(1) polyester (
polyester, as PLA, PLLA, PLGA, PGA, PDLA etc.);
(2) polyesteramide (
polyesteramide);
(3) polyester acid anhydride (
polyanhydride);
(4) polycarbonate (PC);
(5) collagen protein (
collagen).
In this utility model, sacculus all adopts to be had elastic medical macromolecular materials and makes.
In this utility model, flexible alloys guides seal wire, sacculus, jacket pipe, seal wire, guiding cover, socket to adopt medical material to make.
By implementing the concrete utility model content of this utility model, following beneficial effect can be reached:
(1) operating time is shortened: when the vascular puncture that shutoff coronary heart disease coronary intervention causes, generally adopt following methods clinically: one is inject gelfoam in microtubular; Two is inject own fat tissue in microtubular; Three is push spring hitch in microtubular; Four is from the body of patient self, get one piece of tissue accordingly, and after penetrating seal wire, sacculus is pushed into the perforation near-end of shutoff blood vessel.The present invention is the perforation of the blocking component shutoff blood vessel by using setting, thus decreases the time of operation.
(2) misery of patient is reduced: utilize existing external object to carry out shutoff to perforation blood vessel, instead of the tissue of patient self, and the material that in blood vessel shutoff perforation system device, blocking component is used is gelatin, can not cause the repulsion of body, thus decrease the misery of patient.
(3) operation process is simple: only need to utilize blood vessel plugging device can be transported to perforation place, by perforation place of blood vessel shutoff by the corresponding blocking component of shutoff vascular puncture.Concrete operating process with utilize cardiac stent operation device to carry out the similar process of cardiac stent operation, reduce operating difficulty.
(4) effect is good: the mould made in the present invention is not of uniform size, different, can carry out shutoff to different bore, difform vascular puncture.The material that mould in the present invention adopts is the gelatin that body can not be caused to repel, during use, after only needing, with sacculus, plugging module is pushed artery-clogging, extract flexible alloys out and guide seal wire, now plugging module is just retained in artery-clogging, because of blood direction and pressure, automatically the plugging cap in plugging module can be covered, thus by the thread eye shutoff of plugging cap by plugging module, the ratio of the patient death that minimizing causes due to operation secondary damage, especially the secondary damage when carrying out coronary heart disease coronary intervention to Coronary Heart Disease Patients, by utilizing blood vessel plugging system device of the present invention, shutoff is carried out to the blood vessel of patient, plugging effect is good, thus decrease the mortality rate of patient.
(5) danger that complication occurs is decreased.Utilize autologous tissue to carry out in the process of shutoff, autologous tissue likely comes off in the blood vessel, thus causes risk that blocking component master props up or cause serious complication.In present system device, the diameter of the hollow cavity of blocking component and the overall diameter of seal wire match, when therefore utilizing blood vessel plugging system device to carry out shutoff to perforation place of blood vessel, blocking component can not come off, and causes main of plug or cause serious complication because this reducing shutoff tissue loss.
(6) plugging material is cheap: the material that in blood vessel plugging system device, blocking component utilizes is gelatin, gelatin cheap, and the manufacturing process of blocking component mould and blocking component is simple.Therefore, when utilizing blocking component to carry out shutoff in clinical operation, material can not cause too high expense.
(7) application prospect is extensive: the present invention can be widely used in medical industry, effectively treats vascular puncture complication, reducing patient causes secondary damage mortality rate due to operation, having great importance for effectively treating patient.
Accompanying drawing explanation
Figure 1 shows that the structural representation being applicable to arteria coronaria perforation medium vessels plugging device.
Figure 2 shows that the structure for amplifying schematic diagram being applicable to arteria coronaria perforation shutoff propulsion assembly in arteria coronaria perforation medium vessels plugging device.
Figure 3 shows that and be applicable to blocking component structure for amplifying schematic diagram one in arteria coronaria perforation medium vessels plugging device.
Figure 4 shows that and be applicable to blocking component partial enlargement structural representation one in arteria coronaria perforation medium vessels plugging device.
Figure 5 shows that in Fig. 4, I is to plugging cap assembly enlarged partial sectional view.
Figure 6 shows that and be applicable to blocking component partial enlargement structural representation two in arteria coronaria perforation medium vessels plugging device.
Figure 7 shows that in Fig. 6, A is to plugging cap assembly enlarged partial sectional view.
Figure 8 shows that and be applicable to blocking component partial enlargement structural representation three in arteria coronaria perforation medium vessels plugging device.
Figure 9 shows that in Fig. 8, B is to plugging cap assembly enlarged partial sectional view.
Figure 10 shows that seal wire causes arteria coronaria perforation radiography figure.
Figure 11 shows that injecting gelfoam contrast agent suspension in employing microtubular causes complication one illustration, in figure, A arrow is depicted as and guides seal wire to cause the perforation of arteria coronaria many places, there is acute heart tamponade rapidly in patient, B arrow is depicted as in microtubular and pushes gelfoam contrast agent suspension, because dynamics of injecting not easily is grasped, cause in suspension adverse current to nearly section support, C arrow is depicted as in the nearly section of arteria coronaria and nearly stage casing support and acute thrombus occurs, D arrow is depicted as acute thrombus and advances in Left main artery, cause Left main artery thrombosis shadow, left anterior descending branch acute occlusion, there is acute extensive anterior myocardial infarction.
Figure 12 shows that the shutoff success radiography figure being suitable for arteria coronaria of the present invention perforation medium vessels plugging device.
In Fig. 1-12: 1-flexible alloys guide seal wire, 2-blocking component, 3-pad, 4-liquid outlet, 5-sacculus, 6-jacket pipe, 7-seal wire, 8-to guide cover, 9-socket, 10-maintainance set, 11-fluid injection adapter sleeve, 12-liquid injection hole, 13-rubber tube, 14-liquid, 15-Pressure gauge, 16-impregnator, 21-thread eye, 22-are hinged, 23-plugging cap, 24-plugging cap renovate convex spherical, 25-plugging cap concave spherical surface.
Detailed description of the invention
Below in conjunction with drawings and Examples, this utility model is done and describes in detail further.
1 to accompanying drawing 12 by reference to the accompanying drawings, illustrate, but this utility model is not limited to following embodiment for embodiment.
In this utility model, for convenience of description, the description being applicable to the relative position relation of arteria coronaria perforation medium vessels plugging device each assembly be with reference to the accompanying drawings 1 Butut mode be described, as: the position relationship of upper and lower, left end, right-hand member, left side, right side, inner side and outer side etc. determines according to the Butut direction of Figure of description.
embodiment one: be applicable to arteria coronaria perforation medium vessels plugging device
The arteria coronaria perforation medium vessels plugging device that is applicable to of this utility model employing specifically describes as follows:
See accompanying drawing 1 to accompanying drawing 9, be applicable to arteria coronaria perforation medium vessels plugging device and comprise injection pressurizing pack, arteria coronaria perforation shutoff propulsion assembly and arteria coronaria perforation blocking component, injection pressurizing pack is made up of syringe (16), Pressure gauge (15), rubber tube (13); Arteria coronaria perforation shutoff propulsion assembly guides seal wire (1), sacculus (5), jacket pipe (6), seal wire (7), guiding cover (8), socket (9), maintainance set (10), fluid injection adapter sleeve (11) to form by flexible alloys; Arteria coronaria perforation blocking component forms primarily of the plugging module (2) of difformity rule and plugging cap (23).
In this utility model, in injection pressurizing pack, the left side of syringe (16) connects hand-held handle, the right side connection rubber tube (13) of syringe (16).
In this utility model, in arteria coronaria perforation shutoff propulsion assembly, flexible alloys guides seal wire (1) and seal wire (7) by welding at pad (3), jacket pipe (6) right-hand member is blind cover, left end inserts fluid injection adapter sleeve (11), offset with liquid injection hole (12), the socket (9) that seal wire (7) is arranged by guiding cover (8) one end passes through maintainance set (10), is convenient to pull and push operation; Liquid (14) is connected with liquid injection hole (12) by rubber tube (13), fluid injection adapter sleeve (11), being controlled the opening and closing of sacculus (5) by injection pressurizing pack, guiding seal wire (1) for pushing plugging module (2) to perforation place of corresponding arteria coronaria by flexible alloys.
In this utility model, in arteria coronaria perforation blocking component, plugging module (2) is connected by hinged (22) with plugging cap (23) one end, plugging cap (23) renovates convex spherical (24) by plugging cap and plugging cap concave spherical surface (25) forms, plugging module (2) middle part is provided with thread eye (21), the arranged outside plugging cap (23) of thread eye (21), plugging cap (23) can only opening laterally, during operation, flexible alloys guides seal wire (1) through the inner side at plugging module (2) hollow place, namely plugging module (2) penetrates without one end thread eye (21) of plugging cap (23), renovate edge between convex spherical (24) and plugging cap concave spherical surface (25) through there being the plugging cap of plugging cap (23) to pass, in using, after only needing that plugging module (2) is pushed artery-clogging by sacculus (5), extract flexible alloys out and guide seal wire (1), now plugging module (2) is just retained in artery-clogging, because of blood direction and pressure, automatically the plugging cap (23) in plugging module (2) can be covered, thus by thread eye (21) shutoff of plugging cap (23) by plugging module (2).
Can according to actual needs, the above-mentioned arteria coronaria perforation medium vessels plugging device that is applicable to is made further optimization and/or improvements and is further described.
In this utility model, plugging module (2) different, not of uniform size, the shape of plugging module (2) can be olive-shaped, ellipsoid shape, round bead shape, coniform, dumbbell shaped, nail shape, drops, cone-shaped, the various shape such as polygon-shaped, polygon-shaped to can be tetragon, pentagon, hexagon, octagon etc. multiple, and the shape of plugging module (2) can select corresponding plugging module according to arteria coronaria medium vessels hole difformity of boring a hole.
In this utility model, the plugging cap arranged in plugging cap (23) renovates convex spherical (24) and plugging cap concave spherical surface (25) size, shape and plugging module (2) adapt.
In this utility model, the centre bit of each plugging module (2) is equipped with thread eye (21), and thread eye aperture and PTCA seal wire adapt, and common PTCA seal wire is exactly that flexible alloys of the present invention guides seal wire (1).
In the selection of material, the past has some researchs to use polyurethane and polypropylene as expandable material as plugging module (2).Although these artificial macromolecular materials have very excellent mechanical property, as elasticity, intensity etc., the biocompatibility of these macromolecular materials, particularly vivo degradation performance is unsatisfactory.And biomacromolecule has incomparable advantage in biocompatibility and degradation property.Gelatin is exactly class application biopolymer very widely, is used for multiple field such as medicament, food by FDA approval, and be such as exactly one by the widely used gelfoam of medical circles and typically represent, its safety is obvious to all.In this utility model, plugging module (2) and plugging cap (23) adopt safe and reliable and can make by biodegradable biocompatible materials, and biocompatible materials is by being cross-linked into hydrogel and being formed in a mold.
In this utility model, the material of plugging module (2) and plugging cap (23) preferentially can select the biocompatible materials of gelatin (gelatin) and polyvinyl alcohol (PVA).
In this utility model, the material of plugging module (2) and plugging cap (23) can be selected from material below:
(1) polyester (
polyester, as PLA, PLLA, PLGA, PGA, PDLA etc.);
(2) polyesteramide (
polyesteramide);
(3) polyester acid anhydride (
polyanhydride);
(4) polycarbonate (PC);
(5) collagen protein (
collagen).
In this utility model, sacculus (4) all adopts to be had elastic medical macromolecular materials and makes.
In this utility model, flexible alloys guides seal wire (1), sacculus (5), jacket pipe (6), seal wire (7), guiding cover (8), socket (9) to adopt common medical suitable material to make.
embodiment two: the application being applicable to arteria coronaria perforation medium vessels plugging device
Data and method: in the 5000 routine patients that retrospective analysis in January, 2008 ~ 2012 year October performs the operation at hospital row PCI, 6 examples there occurs the arteria coronaria that seal wire causes and bore a hole, and incidence rate is 0.12%, wherein male 4 example, women 2 example, 55 ± 12.5 years old age.After finding arteria coronaria perforation in art, seal wire is placed in cut position.Accompanying drawing 10 reality to be bored a hole radiography figure for seal wire causes arteria coronaria.
1. overcome by the following several method of employing the technical problem that seal wire causes arteria coronaria perforation:
(1) gelfoam is injected in common microtubular, the method first microtubular is sent to blood vessel cut place under guide seal wire supports, withdraw from guide seal wire, be mixed into after gelfoam is ground in contrast agent, make gelfoam contrast agent mixed liquor, use syringe to extract above-mentioned mixed liquor and slowly push microtubular, with shutoff perforation cut place, in clinical practice, the method has certain side effect: one, gelfoam contrast agent mixed liquor adverse current, cause the nearly section of perforation/cut normal branch impaired blood flow, thus people is for increasing the weight of infarct size; Its two, gelfoam contrast agent mixed liquor is also non-solid, therefore plugging effect owes desirable first, needs repeatedly shutoff, and needs dosage bigger than normal, easily brings out local blood coagulation waterfall, causes acute thrombotic risk in all the other arteria coronaria, original support in clinical practice.Known see accompanying drawing 11, by injecting gelfoam contrast agent suspension in microtubular, to cause complication one illustration known, and in figure, A arrow is depicted as and guides seal wire to cause the perforation of arteria coronaria many places, and patient occurs acute heart tamponade rapidly; In figure, B arrow is depicted as in microtubular and pushes gelfoam contrast agent suspension, because the dynamics of injecting not easily is grasped, causes in suspension adverse current to nearly section support; In figure shown in C arrow: in the nearly section of arteria coronaria and nearly stage casing support, acute thrombus occurs; In figure, D arrow is depicted as acute thrombus and advances in Left main artery, causes Left main artery thrombosis shadow, left anterior descending branch acute occlusion, occurs acute extensive anterior myocardial infarction.
(2) spring hitch is pushed in common microtubular: in this kind of method, there is many unfavorable factors: A: spring hitch size is mated with blood vessel diameter and not easily grasped; B: when running into curved blood vessel, microtubular not easily puts in place, spring hitch release difficulty; C: spring hitch is non-biocompatible, there is potential potential safety hazard to organism in indwelling permanent foreign body in arteria coronaria; D: because of non-expansibility own, therefore in retracting spring bolt process, accidental escape phenomenon.
(3) select and be provided by the inventionly applicable to arteria coronaria perforation medium vessels plugging device: put at arterial sheath the plugging module (2) getting the employing respective shapes of the corresponding size of cut blood vessel in pipe position and be through on external seal wire, namely flexible alloys guides seal wire (1), site of perforation is pushed to sacculus (5), withdrawing flexible alloys guides seal wire (1) and sacculus (5) in cut place, the plugging cap (23) of plugging module (2) can under the impact of blood flow, automatic closedown, and sealer center cavity thread eye (21), proximal vessel success shutoff of now boring a hole.Radiography observes plugging effect, can see accompanying drawing 9,12, and accompanying drawing 9 reality to be bored a hole radiography figure for seal wire causes arteria coronaria.
2. result: see accompanying drawing 11 and accompanying drawing 12 known, the whole shutoff success of 6 routine patient, adopt and be provided by the inventionly applicable to arteria coronaria perforation medium vessels plugging device, the plugging module (2) that the employing respective shapes of the corresponding size of cut blood vessel is got at pipe position is put at arterial sheath, known see accompanying drawing 12, shutoff success, shutoff perforation success rate 100%.Monitoring after operation: pericardial tamponade sign does not appear in patient, does not increase the cycle in hospital, all cures and leaves hospital.
3. conclusion
(1) select the suitable sacculus of arteria coronaria perforation place blood vessel diameter and deliver to perforation director's time (10-15 minute) low pressure expansion (≤4atm) along seal wire, the method has the danger increasing cut, aggravates disease.Not easily grasp because spring hitch size is mated with blood vessel diameter simultaneously, when running into curved blood vessel, microtubular not easily puts in place, spring hitch release difficulty, spring hitch is non-biocompatible, indwelling permanent foreign body in arteria coronaria, potential potential safety hazard is existed to organism, and because of non-expansibility own, therefore in retracting spring bolt process, accidental escape phenomenon.
(2) adopt microtubular that thrombin is injected vascular puncture place, thrombin is that water preparation can not block cut at once, and there is certain side effect: one is gelfoam contrast agent mixed liquor adverse current, cause the nearly section of perforation/cut normal branch impaired blood flow, thus people is for increasing the weight of infarct size; Two are gelfoam contrast agent mixed liquor and non-solid, therefore plugging effect owes desirable first, needs repeatedly shutoff, and needs dosage bigger than normal, easily bring out local blood coagulation waterfall, cause acute thrombotic risk in all the other arteria coronaria, original support in clinical practice.
(3) adopt and be provided by the inventionly applicable to arteria coronaria perforation medium vessels plugging device, the plugging module (2) that the employing respective shapes of the corresponding size of cut blood vessel is got at pipe position is put at arterial sheath, be through on external seal wire, site of perforation is pushed to sacculus, withdraw seal wire and sacculus in cut place, radiography observes plugging effect, visible shutoff success, shutoff perforation success rate 100%.
What this utility model provided is applicable to arteria coronaria perforation medium vessels plugging device, the plugging module (2) that the employing respective shapes of the corresponding size of cut blood vessel is got at pipe position is put at arterial sheath, be through on external seal wire, site of perforation is pushed to sacculus, withdraw seal wire and sacculus in cut place, radiography observes plugging effect, visible shutoff success, shutoff EllisI type perforation success rate 100%.
Shown by above-mentioned real series embodiment, in this utility model, the feature such as size, diameter, shape of perforation blood vessel is observed by shadowgraph technique, select suitable plugging module (2), bore is connected with the seal wire in shutoff vascular puncture system and device, thus utilizing system and device of the present utility model that plugging module (2) is delivered to perforation place of blood vessel, shutoff is carried out in the perforation of blood vessel, and radiography observes plugging effect.Utilize this utility model to carry out shutoff to perforation blood vessel, decrease the misery of to get perforation that tissue carries out shutoff blood vessel from autologous patient being caused; In system and device, the peripheral diameter of seal wire and the bore of mould match, and therefore when performing the operation, can not produce the phenomenon that plugging module (2) drops, and decrease the risk causing blocking component master to prop up and the danger causing even more serious complication; Plugging module (2) in system and device has various different shape and not of uniform size, therefore, it is possible to meet the perforation of blood vessel of difformity, size, and can the perforation of shutoff blood vessel completely, reduce the risk of blood extravasation, save the life of patient; Reduce operating difficulty, shorten operating time, reduce post-operative complication.
As mentioned above; this utility model can be realized preferably; the above embodiments are only be described preferred implementation of the present utility model; not scope of the present utility model is limited; under the prerequisite not departing from this utility model design spirit; the various distortion that those of ordinary skill in the art make the technical solution of the utility model and improvement, all should fall in protection domain that this utility model determines.
Claims (6)
1. one kind is applicable to arteria coronaria perforation medium vessels plugging device, it is characterized in that, described blood vessel plugging device mainly comprises injection pressurizing pack, arteria coronaria perforation shutoff propulsion assembly and arteria coronaria perforation blocking component, and injection pressurizing pack is made up of syringe, Pressure gauge, rubber tube, arteria coronaria perforation shutoff propulsion assembly guides seal wire, sacculus, jacket pipe, seal wire, guiding cover, socket, maintainance set, fluid injection adapter sleeve to form by flexible alloys, arteria coronaria perforation blocking component is primarily of the plugging module of difformity rule and plugging cap composition, in described injection pressurizing pack, the left side of syringe connects hand-held handle, the right side connection rubber tube of syringe, in described arteria coronaria perforation shutoff propulsion assembly, flexible alloys guides seal wire and seal wire by welding at pad, and jacket pipe right-hand member is blind cover, left end inserts fluid injection adapter sleeve, offset with liquid injection hole, the socket that seal wire is arranged by guiding cover one end passes through maintainance set, is convenient to pull and push operation, liquid is connected by rubber tube, fluid injection adapter sleeve and liquid injection hole, is controlled the opening and closing of sacculus by injection pressurizing pack, guides seal wire for pushing plugging module to perforation place of corresponding arteria coronaria by flexible alloys, in described arteria coronaria perforation blocking component, plugging module and plugging cap one end are by being articulated and connected, plugging cap renovates convex spherical by plugging cap and plugging cap concave spherical surface forms, thread eye is provided with in the middle part of plugging module, the arranged outside plugging cap of thread eye, plugging cap can only opening laterally, during operation, flexible alloys guides seal wire through the inner side at plugging module hollow place, namely plugging module penetrates without one end thread eye of plugging cap, renovate edge between convex spherical and plugging cap concave spherical surface through there being the plugging cap of plugging cap to pass, in using, after only needing that plugging module is pushed artery-clogging by sacculus, extract flexible alloys out and guide seal wire, now plugging module is just retained in artery-clogging, because of blood direction and pressure, automatically the plugging cap in plugging module can be covered, thus by the thread eye shutoff of plugging cap by plugging module.
2. be applicable to arteria coronaria perforation medium vessels plugging device as claimed in claim 1, it is characterized in that, described plugging module different, not of uniform size, the shape of plugging module selects corresponding plugging module according to arteria coronaria perforation medium vessels hole difformity.
3. be applicable to arteria coronaria perforation medium vessels plugging device as claimed in claim 2, it is characterized in that, the shape of described plugging module is ellipsoid shape, round bead shape, coniform, dumbbell shaped, nail shape, drops, cone-shaped, polygon-shaped various shape.
4. be applicable to arteria coronaria perforation medium vessels plugging device as claimed in claim 3, it is characterized in that, described plugging module is polygon-shaped various shape, and polygon-shaped is that tetragon, pentagon, hexagon, octagon are multiple polygon-shaped.
5. be applicable to arteria coronaria perforation medium vessels plugging device as claimed in claim 1, it is characterized in that, the plugging cap arranged in described plugging cap renovates convex spherical and plugging cap concave spherical surface size, shape and plugging module adapt.
6. be applicable to arteria coronaria perforation medium vessels plugging device as claimed in claim 1, it is characterized in that, the center of described each plugging module is provided with a thread eye, and thread eye aperture and PTCA seal wire adapt.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201520026758.2U CN204839623U (en) | 2015-01-15 | 2015-01-15 | Be applicable to coronary artery perforate in vascular plugging device |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201520026758.2U CN204839623U (en) | 2015-01-15 | 2015-01-15 | Be applicable to coronary artery perforate in vascular plugging device |
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|---|---|
| CN204839623U true CN204839623U (en) | 2015-12-09 |
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| CN201520026758.2U Expired - Fee Related CN204839623U (en) | 2015-01-15 | 2015-01-15 | Be applicable to coronary artery perforate in vascular plugging device |
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Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108125730A (en) * | 2018-02-27 | 2018-06-08 | 北京裕恒佳科技有限公司 | Artificial blood vessel's preformed hole locking device and its conveying device |
| CN109512481A (en) * | 2018-12-19 | 2019-03-26 | 首都医科大学附属北京安贞医院 | It is a kind of for treating the occlusion catheter and application method of coronary arterial perforation |
| CN110882051A (en) * | 2019-12-26 | 2020-03-17 | 康沣生物科技(上海)有限公司 | A cryoablation system that facilitates monitoring of fluid flow conditions |
-
2015
- 2015-01-15 CN CN201520026758.2U patent/CN204839623U/en not_active Expired - Fee Related
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN108125730A (en) * | 2018-02-27 | 2018-06-08 | 北京裕恒佳科技有限公司 | Artificial blood vessel's preformed hole locking device and its conveying device |
| CN109512481A (en) * | 2018-12-19 | 2019-03-26 | 首都医科大学附属北京安贞医院 | It is a kind of for treating the occlusion catheter and application method of coronary arterial perforation |
| CN109512481B (en) * | 2018-12-19 | 2024-11-05 | 首都医科大学附属北京安贞医院 | A occluding catheter for treating coronary artery perforation and a method of use thereof |
| CN110882051A (en) * | 2019-12-26 | 2020-03-17 | 康沣生物科技(上海)有限公司 | A cryoablation system that facilitates monitoring of fluid flow conditions |
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