CN205964238U

CN205964238U - Install in canalis haemalis and can retrain stent delivery system again

Info

Publication number: CN205964238U
Application number: CN201620090269.8U
Authority: CN
Inventors: T.莫克; C.莱斯; W.凯莉; E.比勒菲尔德; A.库马
Original assignee: Flexible Stenting Solutions Inc
Current assignee: Flexible Stenting Solutions Inc
Priority date: 2015-01-31
Filing date: 2016-01-29
Publication date: 2017-02-22
Anticipated expiration: 2026-01-29
Also published as: CN205831970U; CN105832451A; TW201630573A; TW201632154A; CN105832452A; CN105832453A; WO2016123503A1; WO2016123509A1; TW201630574A; WO2016123540A1; CN205729576U

Abstract

The utility model relates to an install in canalis haemalis and can retrain stent delivery system again. The device has the first and second thin long tubular members that can be axial motion for the casing in the canalis haemalis, has cyclic annular lock, and it constructs in a mode of operation fixedly and release intraluminal device in another mode of operation, and this intraluminal device sets up on the thin long tubular member of second at the nearside quilt of distally stopper coaxially. Actuator on the casing can extract or make it to go forward first and second tubular member. Extract in order to arrange the support tubular member and make a tubular member advance in order to retrain the support again. Before retraining again, extract the 2nd tubular member so that the distally stopper closes with cyclic annular halving. The device can have directional control spare, and it is by the actuator joint in order only to allow first thin long tubular component to move and only allow the distad motion of first thin long tubular component when breaking away from the joint for the proximad of casing.

Description

Intraluminal device and can tie bracket induction system again

Cross-Reference to Related Applications

According to 35 USC § 119 or Paris Convention, this application claims the US provisional patent that on January 31st, 2015 submits to Application（Lawyer's Reference Number FSS5013USPSP）U.S. Provisional Patent Application No. submitted to on July 27th, 2015（Lawyer's Reference Number FSS5014USPSP）Priority, the full content of these temporary patent applications is incorporated by reference herein.

Technical field

It relates to the field of medical treatment device, and more particularly relate to controllably arrange support and constrain again The medical treatment device of support of local arrangement or induction system and method.In some applications, it relates to being used for conveying in body The self-expanding pipe intracavity implant using in body passage or pipe（" support "）System, its particularly with repair due to disease Narrow or the blood vessel of obturation is useful.

Background technology

In medical domain, intraluminal prosthesis be widely used for implantable intravascular, bile duct or organism other be similar to Lumen.These prostheses are commonly referred to as support, and are used for keeping, open or expand tubular structure.By Palmaz in 1985 The United States Patent (USP) 4 that November 7 submitted to, gives an example of conventional support, the full content of this patent is to join in 733,665 The mode examined is incorporated herein.This support is usually referred to as balloon expandable stent.Generally, this support is by stainless solid Pipe is made.Afterwards, the wall of support is produced a series of cutting.Support has the first small diameter, and its permission is passed through will Support pressure is held on foley's tube through human vasculature's transfer gantry.Apply footpath in foley's tube inside tubular element During to the power stretching out, support also has the second, diameter of expansion.

However, in some vasculars（As arteria carotis or femoral artery,superficial）In use, this support is often unrealistic 's.Arteria carotis easily from the outside entrance of human body, and usually can be observed by the neck in a people and see.At him Or place the patient of the balloon expandable stent being made up of stainless steel etc. in her arteria carotis because of activity day by day Easily it is subject to major injury.Act on the sufficiently large power of patient's neck（For example due to declining）Support is may result in subside thus leading Cause the damage to patient.For the other shortcomings preventing this from occurring and in order to overcome balloon expandable stent, develop Self-expanding support.The action as spring of self-expanding support, and it is restored to their expansion or plant after being extruded Enter construction.

United States Patent (USP) 4,665, discloses a type of self-expanding support in 771, this support has radial and axial Flexible elastic tubular main body, has predetermined diameter, and this diameter when relative to each other axially moving in the end of main body is Variable, and this support is respectively rigidity but flexible elasticity filament elements are formed, these filament elements by multiple Limit the helical structure of radial direction self expandable.In the art, the support of this type is referred to as " Weaving type support " and at this So appellation in literary composition.

Other types of self-expanding support uses alloy, such as Nitinol（Nitinol）, this alloy is being designed to In the medical treatment device of insertion patient body, there are shape memory and/or super elastic characteristics.Shape memory characteristic enables these devices Enough deforming consequently facilitating being inserted in body cavity or chamber, in body, being then heated such that this device returns to it " memory " shape.On the other hand, super elastic characteristics generally enable metal deform and are restrained to deformation state thus just In accommodating the medical treatment device insertion patient body of this metal, this deformation leads to phase transformation.Once in body cavity, then can remove Constraint to super-elasticity component, thus reduces its interior stress so that super-elasticity component can be by being converted to original phase and extensive Arrive the not deformed shape of its original again or close to it（Because the shape of implantation is designed to have some deformation, to provide Power opens its implanted blood vessel to support）.

The alloy with shape memory/super elastic characteristics generally has at least two phases.These are mutually martensitic phase and Austria Family name's body phase, martensitic phase has relatively low tensile strength and is stable under relatively lower temp, and austenite phase has Of a relatively high tensile strength and be stable at a temperature of higher than martensitic phase.

When metal stress being applied to display super elastic characteristics（As Nitinol）Sample when, this sample be in one temperature Degree, austenite is stable when higher than this temperature（That is, the temperature that martensitic phase completes to the transformation of austenite phase）, this sample Elastic deformation is occurred to reach specific stress level until it, in this stress level, then alloy experiences from austenite phase to horse The stress-induced phase transformation of family name's body phase.When phase transformation is carried out, significantly strain increases alloy experience, but has little or no corresponding Stress increase.Strain increases and stress keeps substantially constant, until austenite phase completes to the transformation of martensitic phase.Afterwards, The increase further of stress is necessary for leading to deform further.Martensite metal is sent out when applying additional stress first Then raw elastic deformation has the plastic deformation of permanent residual deformation.

If the load that will act on sample before any permanent deformation occurs removes, then martensite sample is by elasticity Ground recovers and changes back to austenite phase.The reduction of stress first results in the reduction of strain.When the reduction of stress reaches geneva When phase transformation returns to the level of austenite phase, the stress level in sample will keep substantially constant（But considerably smaller than Ovshinsky Body is converted to the constant stress level of martensite）Until completing to the transformation of austenite phase, that is, exist significantly strain recover but Only insignificant corresponding stress reduces.After changing back to austenite and completing, further stress reduction leads to elasticity Strain reduces.Causing significant strain when applying load and when removing load from deformation under the stress of relative constancy This ability recovered is commonly known as superelastic or pseudoelastic.This property just because of material makes it can be used for manufacturing Pipe cuts self-expanding support.Mention in prior art and the metal alloy with super elastic characteristics is used for intention is inserted into patient The medical treatment device in body or otherwise using in patient body.See, for example, United States Patent (USP) No.4,665,905 （Jervis）With United States Patent (USP) No.4,925,445（Sakamoto et al.）.

Conventional conveying systems currently used for self-expanding support are so-called " fixing and pullings（pin and pull）” System.The following is an example of " fixing and pulling " system.This induction system includes oversheath, and this oversheath is with far-end Elongated tubular member with near-end and lumen therethrough.Typical oversheath be by outer polymeric layer, interpolymer layer with And made by the braiding enhancement layer between internal layer and outer layer.Enhancement layer is more rigid than internal layer and outer layer." fixing and drawing Drag " in system, exactly this oversheath " pulling "." fixing and pulling " system also includes being coaxially located in oversheath Interior axle.This axle has the near-end of the near-end proximad extension in the distally extending far-end of the far-end of sheath and in sheath.? In " fixing and pulling " system, exactly this axle is " fixed ".

" fixing and pulling " system also has the structure for limiting self-expanding support with respect to the proximal motion of axle, For example being fixedly attached to interior axle thus serving as the ring of motionless nearside stop, during arranging, withdrawing sheath in proximad When the support held of pressure can be loaded in a proximal direction against this ring.It is somebody's turn to do the nearside that " support is spacing " structure is located at sheath distal end. Size positioned at the tapered distal top of the end of interior axle can be configured to contact with the interior diameter of oversheath, and this distally Top is alternatively referred to as nose cone or expander.

Finally, " fixing and pulling " system includes the self-expanding support in sheath.This support is being easy to conveying It reduces and with the interior diameter of oversheath, CONTACT WITH FRICTION occurs under diametric state, more specifically sends out with the interior diameter of the internal layer of oversheath Raw CONTACT WITH FRICTION.Support is located between position limiting structure and the far-end of sheath, and a part for axle is disposed coaxially the chamber of support In pipe.During arranging when sheath is removed and so that support is moved together with this sheath（Because support is straight with sheath CONTACT WITH FRICTION between footpath）, support contacted with position limiting structure.When the near-end of support is contacted with position limiting structure mount proximal end to Proximal movement is prevented from, and position limiting structure provides the reaction force acting on support, and this reaction force and sheath act on and prop up Frictional force on frame is equal and contrary.

In order to from " fixing and pulling " system arrangement support, by System guides to treatment position.Then, operator（Medical science Professional）With a hand, the interior axle that the near-end proximad in oversheath extends is fixed on patient.This action secures The position of the longitudinal axis of patient's lumen along implantation support for the interior axle.This action is " to fix " in " fixing and pulling " system Step.Doctor pulls oversheath with his or her another hand proximad（By a part for oversheath from patient towards " Gu Fixed " pull out）Thus not constraining, exposing and arrange support.This action is " to pull " step in " fixing and pulling " system Suddenly.

The early stage example of another kind of " fixing and pulling " system is the United States Patent (USP) 4,580 submitted to as on April 8th, 1986, Gianturco stent delivery system described in 568.In the induction system of this prior art, oversheath is single material The pipe of material, this pipe does not have in its interior reinforcement structure.The cylindrical flush end with the diameter no better than sheath interior diameter pushes away Send device to be inserted in sheath to be located at after support.Then, using pusher or interior axle, support is pushed to shield from the near-end of sheath The far-end of set.Exposed support and complete support by fixing interior axle with respect to patient body and being withdrawn on sheath Arrangement, this stent-expansion when removing radial constraint, such as shown in Fig. 4 and Fig. 5 of United States Patent (USP) 4,580,568, this patent Content be incorporated by reference herein.

Early stage self-expanding support on another kind of market is Wallstent.This support is braiding, and at it by cloth Change length when putting（Shorten）And diameter（Increase）, and the change of its length is obvious.The U.S. authorizing Wallsten is special Profit 4,655,771（Hereinafter referred to as " Wallsten "）Describe several induction systems for Weaving type support, this patent In be referred to as " tubular body ".Show one of these induction systems in Figure 11 of Wallsten, its be described below " Another embodiment of the assembly for making tubular body expansion is shown in Figure 11.This assembly constitutes flexible apparatus, should Apparatus is used for the tubular body being in contraction state to import in such as blood vessel and then make this tubular body when being positioned in it Expansion.The each several part of apparatus by flexible outer tube 61 and coaxial, be also that flexible inner tube 62 forms.In outer tube one End, is disposed with control member 63.Another control member 64 is attached to the free end of inner tube 62.So, inner tube 62 can be with respect to Outer tube 61 axially displacement.It is attached with piston 65 in the other end of inner tube 62, this piston 65 is when in motion along the inwall of outer tube 61 Advance.When apparatus will be to be used, first the tubular expandable main body 69 being in contraction state be placed in pipe 61, carry The inner tube 62 of piston 65 is located in the rear portion 66 of outer tube 61.In fig. 11, the original position of piston 65 is to be represented by dashed line 67 Place.So, in original position, the tubular body 69 that a part for pipe 61 is retracted is filled.During implanting, device is pliable Bent tube inserts the position for implantation of blood vessel.Then, component 64 is made to move on the direction of arrow 68, the master that will shrink Body 69 is released through the end 70 of pipe 61, and make tubular body 69 leaves the part expansion of tube end 70 until expanding position at it Put 71 its interior bonds with blood vessel wall 72.For the sake of simplicity, in fig. 11 tubular body 69 and 71 is illustrated as two bendings The line of shape.For the main body 21 of expansion is engaged with blood vessel wall 72, by making component 63 move on the direction of arrow 73 Tube end 70 is made to move.By one end of piston 65 backup main body 60, and the main body 69 of contraction is made to move.Therefore, by component Rightabout motion while 64 and 63 and implanted, the displacement of component 64 is more than the displacement of component 63 ".As being used for The induction system of Gianturco support, its sheath is not reinforced, but the pipe of homogenous material, and its interior axle does not extend across Support, but terminate at the near-end of the support being constrained on oversheath far-end.Interior axle and oversheath are coaxial, and have Hold the overall diameter of the interior diameter of support more than swedged " constrained " or pressure.

When self-expanding support from its constrained in case conveying construction be converted to its cloth in the lumen of patient's vascular During the expansion state put, total length can be due to being referred to as shortening（foreshortening）Effect and reduce.The contracting being occurred Short amount depends on the design of support and the amount of the radial dilatation being experienced during arranging.The precise geometrical shape of patient's vascular Shape may not be known and can suffer from change and scrambling, including different degrees of vascular calcified.Shorten percentage It is generally defined as delivery conduit loading condition（Pressure is held）With nominal placement diameter（That is, the mark that support intention has when arrangement Note diameter, i.e. " 10 mm support " has the nominal placement diameter of 10 mm）Between stent length change divided by delivery conduit Loading condition（Pressure is held）When stent length, then be multiplied by 100.Some self-expanding supports are designed to be restricted to support shortening Unconspicuous amount（For example, less than 10%）.However, due to design, arrangement environment and other factorses, self-expanding support can shorten Reach obvious amount（For example, more than 10%）.

When being significantly shorter, by rack arrangement in body cavity or chamber（As vascular, artery, vein or conduit）Interior its Expected axial location can be more difficult.Shorten the far-end that effect can show support, when support in proximal end arrangement in body cavity or chamber In（For example when the distal dilation of support and engage or two kinds of situations with inner vessel wall）When support far-end can proximal motion. By shortening these motions being led to, support can be made to shift from its desired location, thus leading to be arranged in mistake or be not Optimal position.

Self-expanding rack arrangement may not be solved treated disease in unexpected position, for example when support not When covering the total length of diseased part of vascular or not building bridge in aneurysm.The general categories being adopted in such cases can Including the position that another support is placed on overlap.However, which increasing length and the difficulty of operation.Additionally, being arranged in non- Desired location for example may undesirably affect the anatomical structure of vascular system by the connection of obstruction and another vascular.Cause This is it is desirable to reorientating the support misplacing position rather than arranging another support.

For the ease of making support reorientate, there is some technology and be used for before fully arranging support by support more about Bundle is in the oversheath of induction system, and the near-end of support is stayed in oversheath.Can be by making oversheath to remote on support Slideslip and it is radially collapsed back to its pressure hold diameter, and tie bracket again.In order to resist due to making sheath in support Upper sheath produced by friction when advancing acts on axial force on support, the near-end of tie bracket can make it can not be with respect to Sheath and inner member distal motion.The design of some induction systems provides the near-end for tie bracket so that it can not be distad transported Dynamic feature, see, for example, the commonly assigned U.S. Patent Application Serial Number 12/ of the CO-PENDING of on October 5th, 2009 submission 573,527（Lawyer's Reference Number FSS5004USNP）The sequence number 13/494,567 submitted to on June 12nd, 2012（Lawyer's Reference Number FSS5004USCIP）, this two patent applications are incorporated by reference herein, and european patent application No.0696442 The A2 and open No.2007/0233224 A1 of United States Patent (USP).

Utility model content

Therefore, we have recognized that desirably to provide and are easy to constrain local arrangement support thus allowing to reorientate again Self-expanding stent delivery system and method.Similarly, it is desirable to provide compensate the self-expanding stent delivery system that support shortens And method.The technology of the disclosure as described by following data meets these and other objects.

The disclosure includes a kind of intraluminal device for arranging and constraining expansible intracavitary unit, and this device has： Housing；The first elongated tubular member extending and can axially moving with respect to housing from housing；From housing extend and can The second elongated tubular member axially moving with respect to housing, the second elongated tubular member has far-end, and far-end carries radially Prominent distally stop, wherein, the second elongated tubular member is disposed coaxially in the first elongated tubular member；Ring-type Lock, fixes expansible intracavitary unit and discharges in chamber in another mode of operation in Cheng Yi mode of operation of ring-type Lock structure Device, wherein, ring-type lock is disposed coaxially in the second elongated tubular member and is disposed coaxially the first elongated tubular In shape component, and wherein, ring-type lockset has the interior diameter of the effective overall diameter less than distally stop；Rotation on housing Button, knob is connected to the first elongated tubular member by flexible ring element so that the manipulation of knob makes the first elongated tubular member phase Housing is axially movable；And the sliding part on housing, sliding part is connected to flexible ring element.

In one aspect, knob provides mechanical advantage so that the first elongated tubular member is axial with respect to the correspondence of housing Motion is less than input motion.

In one aspect, ring-type lock can have multiple depressions, and these depressions are configured to capture the unit of expansible intracavitary unit Part.

In one aspect, described device may include friction actuator, and friction actuator is coaxially set in the distally of housing Put in the first elongated tubular member.

In one aspect, described device may include and is disposed coaxially in the second elongated tubular member and extends from housing Through the interior elongated tubular member of distally stop, wherein, this interior elongated tubular member includes lumen and lumen is in fluid communication Proximal port and the distal part with the multiple eyelets being in fluid communication with lumen.Described intraluminal device also can have taper Distal top, this distal top has multiple grooves, and these grooves are configured to adjoin the first elongated tubular product structure when distal top The outflow of the fluid of supply from the eyelet of interior elongated tubular member is allowed during the far-end of part.

The disclosure also include one kind can tie bracket induction system again, this system has：Housing；From housing extend and can The first elongated tubular member axially moving with respect to housing；Extend and can axially move with respect to housing from housing Second elongated tubular member, the second elongated tubular member has far-end, and far-end carries radially projecting distally stop, wherein, Second elongated tubular member is disposed coaxially in the first elongated tubular member；Ring-type is locked, and ring-type lock is disposed coaxially In second elongated tubular member and be disposed coaxially in the first elongated tubular member, wherein, ring-type lockset has less than distally The interior diameter of the effective overall diameter of stop；It is releasably secured to the Self-expanded stent of ring-type lock；Knob on housing, Knob the first elongated tubular member is connected to by flexible ring element so that the manipulation of knob make the first elongated tubular member with respect to Housing is axially movable；And the sliding part on housing, sliding part is connected to flexible ring element.

The disclosure also includes a kind of method for arrangement with constraining expansible intracavitary unit again.The method may include：Carry For intraluminal device, this device has：Housing；The first elongated tubular extending and can axially moving with respect to housing from housing Shape component；The second elongated tubular member extending and can axially moving with respect to housing from housing, the second elongated tubular product structure Part has far-end, and far-end carries radially projecting distally stop, and wherein, the second elongated tubular member is disposed coaxially the In one elongated tubular member；Releasedly fix the ring-type lock of expansible intracavitary unit, wherein, ring-type lock is disposed coaxially In second elongated tubular member and be disposed coaxially in the first elongated tubular member, and wherein, ring-type lockset has little Interior diameter in the effective overall diameter of distally stop；Knob on housing, it is thin that knob is connected to first by flexible ring element Tubular member；And the sliding part on housing, sliding part is connected to flexible ring element；Intraluminal device is remotely located Desired locations in patient's vascular system；And manipulate knob so that the first elongated tubular member is axially transported with respect to housing Move to make the part exposure of expansible intracavitary unit.

In one aspect, methods described may include the sliding part being connected to flexible ring element manipulating on housing, so that First elongated tubular member is axially movable with respect to housing proximad.

In one aspect, the second actuator being connected to the second elongated tubular member on housing can be manipulated so that Two elongated tubular member are axially movable with respect to housing proximad and are closed with ring-type interlocking until distally stop.Further, may be used Make the first elongated tubular member with respect to housing distal motion thus constraining expansible intracavitary unit again.Make the first elongated tubular The second actuator can be exerted a force to, to keep distally stop and ring-type interlocking while shape component is distad axially movable Close.

In one aspect, sensible second actuator may include and removes the lid being arranged on the second actuator, thus when removal During lid, the second actuator is visible.

In one aspect, when making the first elongated tubular member distad be axially movable with respect to housing, can manipulate The distally of housing is disposed coaxially the friction actuator in the first elongated tubular member.

In one aspect, intraluminal device can have and be disposed coaxially in the second elongated tubular member and prolong from housing Extend through the interior elongated tubular member of distally stop, wherein, interior elongated tubular member includes what lumen and lumen were in fluid communication Proximal port and the distal part with the multiple eyelets being in fluid communication with lumen.By intraluminal device remotely located Before desired locations, can be by rinse fluid art supply to proximal port thus leading to rinse fluid art to flow from eyelet.Intraluminal device Can have the tapered distal top with multiple grooves so that leading to rinse fluid art to be transmitted rinse fluid art supply to proximal port Through the 3rd elongated tubular member eyelet and when distal top adjoin the first elongated tubular member far-end when from groove stream Go out.

Brief description

Further feature and advantage are by from disclosure preferred embodiment as shown in the accompanying drawings in greater detail below Illustrate to become obvious, in the accompanying drawings, throughout all views, identical reference generally refers to identical part or element, and And wherein：

Fig. 1 show according to embodiment be in initial construction can tie bracket induction system again；

What Fig. 2 showed the support with local arrangement according to embodiment can tie bracket induction system again；

Fig. 3 show according to embodiment be ready for constraining again can tie bracket induction system again；

Fig. 4 show according to embodiment during constraining again can tie bracket induction system again；

Fig. 5 show according to embodiment after constraining again can tie bracket induction system again；

Fig. 6 show according to embodiment return to arrangement construction can tie bracket induction system again；

Fig. 7 show according to embodiment can the housing of tie bracket induction system again interior views；

Fig. 8 A show according to embodiment can tie bracket induction system again actuator component；

Fig. 8 B shows the alternate embodiment of the actuator of system shown in Fig. 8 A；

Fig. 8 C shows the perspective view of the associated components of the actuator in Fig. 8 B；

Fig. 8 D shows the decomposition diagram of the part of the near-end positioned at handle；

Fig. 9 show according to embodiment can tie bracket induction system again Direction Control Unit；

Figure 10 show according to embodiment be in rack arrangement construction can again tie bracket induction system direction control Assembly processed；

Figure 11 show according to embodiment be in support constrain again construction can tie bracket induction system again direction Control assembly；

Figure 12 show according to another embodiment can tie bracket induction system again；

Figure 13 show according to embodiment there is nearside stop can tie bracket induction system again；

Figure 14 A show according to embodiment there is single port flushing can tie bracket induction system again；

Figure 14 B shows the downside of the removable lid shown in Figure 14 A；

Figure 15 show according to embodiment have single port flushing can tie bracket induction system again end-view；

Figure 16 shows the self-expanding support being in constrained construction according to embodiment；And

Figure 17 shows the self-expanding support being in arrangement construction according to embodiment.

Specific embodiment

Starting it should be understood that the disclosure is not limited to the material of particular instantiation, framework, routine, method Or structure, because these can change.Therefore, although this Class Options multiple（Similar or identical to described herein that A bit）Can be used for enforcement or the embodiment of the disclosure, but there is described herein preferred material and method.

It should also be understood that term used herein is intended merely to describe the mesh of the specific embodiment of the disclosure , and it is not intended to be restricted.

The detailed description stated below in conjunction with the accompanying drawings is intended that the description as exemplary embodiment of this disclosure, and It is not intended to represent the only exemplary embodiment that can implement the disclosure.Term " the example being used throughout this specification Property " refer to " serving as example, example or illustration ", and need not be understood as that than other examples embodiment more preferably or Advantageously.Describe in detail and include detail, for providing the mesh of the detailed understanding of the exemplary embodiment to this specification 's.People in the art will be understood that the exemplary embodiment of this specification can not have the situation of these details Lower enforcement.In some cases it is thus well known that construction and device is to illustrate in block diagram form, so as to avoid making herein to The novelty of the exemplary embodiment going out becomes indigestion.

Only for convenient and clearly purpose, can with regard to accompanying drawing user's tropism term, for example top, bottom, left and right, Upper and lower, up, above, lower section, below, later, overleaf with above.These and similar directionality art Language is not construed as limiting by any way the scope of the present disclosure.

Unless otherwise prescribed, whole technology used herein and scientific terminology have the skill with disclosure art The identical implication that art personnel are generally understood.

As used in this article, not only include can be by another device for term " expansible intracavitary unit "（Such as sacculus）Expand Device, and include can in the case of without another device can self expandable to be expanded to the dress of its operative configuration Put.Finally, as used in the present specification and in the appended claims, singulative " ", " one " and " being somebody's turn to do " include plural institute Refer to object, unless clearly referred else in context.

It is in the stent delivery system of CONTACT WITH FRICTION in the interior diameter of self-expanding support and elongated tubular member（For example wrap Include those stent delivery systems of the self-expanding support being made up of Nitinol）In, friction can be at a relatively high.Do not using In the case of the nearside stop of the proximal force in support for the antagonism or some other mechanisms, by outer elongated tubular member near Side is extracted and possibly cannot successfully be exposed and thus discharge support.On the contrary, available tubular element proximad pulls support.Therefore, Most self-expanding stent delivery system has the structure of so-called nearside stop, puts down when making outer tubular member proximad Move and equal and contrary power is applied to the near-end of support with this nearside stop when exposing and arranging support.Setting depending on support Meter, this can spring loads support against stop, and far-end can be to remote when far-end is no longer influenced by the constraint of outer tubular member Side is ejected.This motion can lead to support to be arranged longitudinally at by the axis along vascular to be different from together with the shortening of support during expansion The position of desired locations.When the support determining local arrangement is in less than optimal position, in order to solve these and its Its situation, the technology of the disclosure provides a kind of stent delivery system, and it has the support constraining local arrangement again thus will prop up Frame is repositioned to be arranged in the ability of more desirable position.

Constrain again including so that outer tubular member is distally advanced so that its expansion support on slide and compand Support, until the total length of support suffers restraints and no longer contacts with blood vessel wall.When returning to this construction, can not draw Stretch or otherwise support is reorientated in the case of the danger of injured blood vessel.Therefore, the support delivery system of the disclosure System may include nearside stop, reaction force distad is put on the near-end of support thus offsetting edge and outer tubular structure The proximal friction power of the overall diameter of support of part contact is thus allow to extract tubular element thus exposing support during arranging.With This simultaneously, the stent delivery system of the disclosure can have far-end position limiting structure, to apply the active force of proximad, is constraining the phase again Between, the active force of this proximad is offset and the rubbing of distad acting on of making tubular element advance on the overall diameter of support to be associated Wiping power.

It is not provided that when making tubular element distally advance enough reaction forces can have undesirable consequence.Example As contacted with blood vessel wall so that of the support at small diameter ought be made in the far-end of the after-poppet partly arranged When the individual relatively motionless expansion diameter far-end being partially toward support is advanced, due to propping up caused by the friction with outer tubular member The distal motion of frame may result in the part reversion in the distally in close proximity to constraint tubulose member distal end of support to enter（Locally Ground）The part of the release of support of arrangement.As another example, the expansion of the support contacting with blood vessel wall can be to remote Slideslip, thus lead to wound.In the art it is known that system is used for providing the anti-work of suitable proximad applied as described above Structure firmly.However, the support showing obvious shortening can have significant length when constraining again increasing.Therefore, when with Compensate the mode of this length increase again tie bracket when, the technology of the disclosure provides the reaction of the nearside orientation acting on support Power.

A kind of can tie bracket induction system embodiment includes as shown in Figure 1 schematically again intraluminal device 10, and And could generally have：Extend along the housing 12 of longitudinal axes L-L extension, from housing 12 and axial fortune can be done with respect to housing 12 The first dynamic elongated tubular member 14（It is also referred to as sheath or external member）And also extend from housing 12 and can relatively The second elongated tubular member 16 axially moving in housing 14.First elongated tubular member 14 can have any suitable knot Structure, such as extruded polymer and encapsulated enhancement layer in the polymer（Such as metal braid）Composite construction, such as ability Field technique personnel understood.Second elongated tubular member 16 is disposed coaxially in the first elongated tubular member 14.Housing The 12 multiple actuators of carrying, these actuators operable are thus realize the first elongated tubular member 14 and the second elongated tubular member 16 with respect to housing 12 motion.

As shown in FIG., the first actuator is configured to knob 18.For example, knob 18 can be by dialling that short cylinder is formed Wheel, this thumb wheel can have embossing or veined overall diameter to assist to pass power from operator in the case of nonslipping It is delivered to thumb wheel.Depending on make knob 18 rotate direction, the first elongated tubular member 14 can be made to advance with respect to housing 12 or Exit.In this embodiment, the second actuator is configured to sliding part 20（Such as tab, button or knob）.Sliding part 20 can join Be connected to the second elongated tubular member 16, thus sliding part 20 proximal direction motion make the second elongated tubular member 16 with respect to Housing 12 exits, and sliding part 20 motion in a distal direction make the second elongated tubular member 16 with respect to housing 12 before Enter.

Generally, sliding part 20 can be connected to the second elongated tubular member 16, thus the linear motion of sliding part 20 is with 1:1 Ratio is converted to the linear motion of the second elongated tubular member 16.Sliding part 20 has from farthest side position to nearest side position Travel range.As will be following described in certain embodiments, when being in its farthest side position, sliding part 20 engages The direction controlling part being associated with knob 18（Not shown in Fig. 1）So that knob 18 is only extracting first with respect to housing 12 The side of elongated tubular member 14 rotates up.Correspondingly, the motion of the first elongated tubular member 14 is limited to proximal motion. When sliding part 20 is from its farthest side position proximal motion, it is disengaged with direction controlling part so that knob 18 only exists The side that the first elongated tubular member 14 is advanced is made to rotate up, thus the first elongated tubular member 14 is limited to distad only do Motion.

Inner tubular member 22 also can extend from housing 12 and have the fixed relationship with housing, thus terminating in its far-end In the tapered tip 24 expanding, this tapered tip can be one or separate and be also referred to as nose cone or expander. Inner tubular member 22 has the lumen 26 extending between its near-end and its far-end.Inner tubular member can be by poly- for wire leading pipe Other combinations of acid imide or polymer well known by persons skilled in the art are made.In one aspect, distal top 24 is permissible It is radiopaque.The size of lumen 26 can be configured to closely follow on seal wire 28.As shown in FIG., seal wire 28 can be from Through the valve 30 of sealing in housing 12（Such as Luer lock）Proximad extends, and this valve 30 is in fluid communication and seal wire 28 with lumen 26 Also top 24 can be extended distally beyond.In the embodiment not using seal wire, inner member can be the solid elongated of no lumen Cylindrical member.

Support 32 can be arranged in the far-end of the first elongated tubular member 14 so that in the first elongated tubular member 14 Support 32 is constrained in its pressure and holds shape by diameter.When being held by pressure, support 32 is engaged with ring-type lock 34, thus limit bracket 32 phase For the lengthwise movement of ring-type lock 34, and during arranging when support 32 is expanded, it is from ring-type lock 34 release.Ring-type lock 34 Can have the maximum outside dimension of the interior diameter less than the first elongated tubular member 14, with by extracting the first elongated tubular product respectively Component 14 or before making the first elongated tubular member 14 and then the arrangement of support 32 that carries out or reduce friction during constraining again.

The far-end of the second elongated tubular member 16 extends beyond ring-type lock 34 and includes radially projecting distally stop 36, distally stop 36 has the effective overall diameter of the interior diameter more than ring-type lock 34 so that second elongated tubular member 16 Proximal motion may result in distally stop 36 to engage with ring-type lock 34.The outside dimension of distally stop 36 when support pressure is held Less than the interior diameter of support 32, thus distally stop 36 can be made in the case of the interference not being derived from support 32 to move to ring The distally of shape lock 34.Any suitable structure can be used for the second elongated tubular member 16, including gathering that such as braid is strengthened Acid imide.When sliding part 20 is in its farthest side position with respect to housing 12, distally stop 36 can be in and ring-type lock 34 initial position is spaced the pre-position of desired distance, to adapt to during arranging when making support 32 expand due to shortening The distal motion of caused ring-type lock 34.

3rd elongated tubular member 38 can also be extended from housing 12 with fixed relationship, has far-end, and this far-end has structure Cause the diameter that proximally direction is engaged with ring-type lock 34 so that nearside stop is served as in the end of the 3rd elongated tubular member 38 40.3rd elongated tubular member 38 can be disposed coaxially in the first elongated tubular member 14 and be disposed coaxially the In two elongated tubular member 16.Because the 3rd elongated tubular member 38 has the fixed relationship with housing 12, distally is spacing Device 40 also keeps fixed position, and when suitably manipulating knob 18 and sliding part 20, can make the first elongated tubular member respectively 14 and second elongated tubular member 16 together with distally stop 36 with respect to its advance or exit.3rd elongated tubular member 38 Can have the physical property of change in length, for example, pass through that there is the relatively flexible distal length being formed by polymeric material Proximal length with the relative stiffness being formed by stainless steel hypotube.In the structure substituting, the 3rd elongated tubular member 38 can The physical property of substantially invariable flexibility is had on total length.Can be used for the suitable polymeric of the structure of the 3rd elongated tubular member 38 One example of material is polyether-ether-ketone（PEEK）.

In an illustrated embodiment, housing 12 has another actuator in the form of quick disposed slide 42. As will be explained below describe, the first elongated tubular member 14 that sliding part 42 can be fixed in housing 12 is so that grasp Author can manipulate sliding part 42 to realize the 1 of the first elongated tubular member 14:1 relative motion is so that arrangement or again tie bracket 32.Quick disposed slide 42 can have travel range on housing 12, and it be enough to allow the first elongated tubular member 14 Fully exit thus fully exposing support 32 to arrange.There may be the nearside boundary of the travel range exceeding this length. In the illustrated embodiment, the profile of quick disposed slide 42 is not extended past the outmost surface of housing 12 to reduce due to prominent Go out the possibility that structure is stuck in the unexpected translation of the sliding part causing on object.

On the other hand, intraluminal device 10 also can have the friction actuator using clasper 44 form, to promote The direct manipulation of one elongated tubular member 14.In one embodiment, clasper 44 can be elongated by being disposed coaxially first Elastic polymeric material on tubular element 14 is formed.Generally, clasper 44 is located at the distally of housing 12, but still is located at patient's The nearside of inlet point.Although clasper 44 can coaxially slide along the first elongated tubular member 14, when applying inward pressure When clasper 44 can show and greatly the rubbing and allow manually to make tubular element of the first elongated tubular member 14 Advance or exit.For example, if individually manipulate housing 12 on actuator to realize the first elongated tubular member 14 or other The desired motion of tubular element, the length of the first elongated tubular member 14 outside patient body may make intraluminal device 10 Tubular portion will tend to bend.Therefore, clasper 44 allows to exert a force in the position much closer apart from patient body First elongated tubular member 14 is to reduce any bending tendency.

It is only used as example and not restricted, operator can start the arrangement of support 32 by operation knob 18, This can provide mechanical advantage to allow to control the motion of the first elongated tubular member 14 to a greater degree.Once operator is to support 32 placement satisfaction, then may want to manipulate quick disposed slide 42 to complete extracting and releasing of the first elongated tubular member 14 Put support 32.If however, wishing tie bracket 32 again before completing arrangement, operator can manipulate in the opposite direction Knob 18 and/or using clasper 44 so that the first elongated tubular member 14 negative side on support 32 marches forward.

For the ease of the desired locations being placed on support 32 in patient's vascular system, can be by one or more radiopaques Mark is fixed to the tubular element of intraluminal device 10（One or more）Position.For example, inner tubular member 22 illustrates Mark 46.Although be shown within the distally of distally stop 36 only for descriptive purpose, mark 46 can be according to need Will and position with provide with regard to the placement of support 32 feedback and/or instruction can be by the first elongated tubular before tie bracket 32 again The limitation that shape component 14 is extracted may be no longer practical or safety.

As will be appreciated, mark 46 can be configured to nearside place mark, the initial alignment for induction system and It is used for arranging support 32 during the withdrawal of the first elongated tubular member 14.Nearside can be placed the finger as axial location for the mark Show, in this axial positions, if the near-end being arranged to its nominal diameter so support will rest against in blood vessel wall.Because inner tube Shape component 22 keeps fixing with respect to housing 12, so can keep constant in intra-operative mark 46.The near-end institute of estimating stent The position reaching is useful information for operator, and it is permissible so that nearside is axially movable when placing and being flagged with intra-operative Lead to the mistake when placing support, or unnecessarily constrain again and arrange again, if this motion is not by operator institute Lead to.

On the other hand, mark 46 can be positioned so as to serve as and constrains boundary marker again, as mentioned.This passes through instruction first The farthest withdrawal of elongated tubular member 14（After this still can reliably tie bracket 32 again）And for operator be Useful information, and can be seen when observing fluoroscope（It is shown in all radiopaque structures in target area）.As It is discussed below, then constrains boundary marker altematively or additionally to determine with respect to the position of quick disposed slide 42 Position is on housing 12.

The construction of Fig. 1 shows that intraluminal device 10 is ready to proceed to the expectation in patient's vascular system on seal wire 28 Position is to arrange support 32, such as in the body cavity being limited by blood vessel wall 48.As illustrated, ring-type lock 34 is spacing by nearside Device 40 engages, thus stop the proximal motion of support 32 when the first elongated tubular member 14 is extracted.In Fig. 2-6 schematically Illustrate including knob 18 and sliding part 20 the exemplary operation of actuator and manipulation, and the far-end in intraluminal device 10 Arrangement the effect that tie bracket 32 is formed again.The adjacent nearside stop 36 of ring-type lock 34 is made in initial construction in the body Benefit be when radiopaque for distally support traffic sign placement in target location operator can immediately begin to withdraw first thin Tubular member 14, without the gap closing nearly between side stop and ring-type lock before the disposing.This simplifies operation And shorten and the related time of performing the operation, and provide thereupon patient can exposure radiation amount reduction.

Start from Fig. 2, once making intraluminal device 10 proceed to the desired locations in patient's vascular system, then as shown in the figure Operator can make knob 18 rotate（And/or manipulate quick disposed slide 42）To extract the first elongated tubular member 14.When from When the first elongated tubular member 14 extracted by support 32, the free part of support 32 is in vascular intramedullary expansion, thus and body cavity Blood vessel wall 48 contact.Because this is the obvious support shortening, so the total length of support 32 has shortened, and this shortening is extremely A few part has occurred and that in the first elongated tubular member 14.The far-end of support 32 having been expanded to contact with blood vessel wall 48 can Keep relatively motionless in vascular.Therefore, as illustrated, the near-end of support 32 and the ring-type lock 34 releasedly fixed are the Move, to distally axial direction Horizon, the space reaching between nearside stop 40 and ring-type lock 34, this nearside limits in one elongated tubular member 14 Position device 40 can be fixing with respect to housing 12 and patient.

Second elongated tubular member 16 keeps relative motionless, distally stop 36 with the position of correspondingly distally stop 36 Positioned at enough distal side of the far-end of pusher pipe nearside stop 40, the shortening of this support 32 will not push into ring-type lock 34 It is in contact with it or limits the distal motion of the support 32 caused by shortening.If the position to arranged support for the operator Put satisfaction, then the first elongated tubular member 14 can fully be withdrawn the near-end of support 32, thus allowing it to expand into along it Total length is contacted with vascular 48 and due to radial dilatation from ring-type lock 34 release.As can be seen, when elongated first When tubular element 14 is extracted, quick disposed slide 42 also translates with respect to housing 12 proximad.As needed, rotation can be utilized One of button 18 and sliding part 42 or both realize the arrangement of support 32.

Alternatively if it is desired to support 32 is reorientated and the first elongated tubular member 14 be not yet pulled out through conjunction Suitable constrains boundary marker again（As mark 46）, then can as described by with regard to Fig. 3-5 implementing constraining again of support 32.For As the beginning constraint manipulation again schematically showing in Fig. 3, sliding part 20 its farthest side position from housing 12 can be manipulated Proximal motion.When sliding part 20 proximal motion, it leads to the corresponding proximal motion of the second elongated tubular member 16 Until distally stop 36 is engaged with ring-type lock 34.When distally stop 36 is contacted with ring-type lock 34, resistance can be felt.By In shortening, when arranging the support 32 of major part, the relatively small proximal motion of sliding part 20 can with make distally Stop 36 is relevant with ring-type lock 34 joints.As will be described in greater detail below, so that sliding part 20 proximad is shifted can make The direction controlling part being associated with knob 18 is disengaged, thus allow to make the first elongated tubular member 14 advance prevent simultaneously into The extracting of one step.

Then, Fig. 4 schematically shows the first elongated tubular member 14 and advances with tie bracket 32 again.Can be by manipulating Knob 18 and/or sliding part 42 and implement the advance of the first elongated tubular member 14.However, due to be likely to occur in patient or Friction at the haemostatic valve of guide of other sources docking is it is desirable to manipulate clasper 44 with by the first elongated tubular product structure Part 14 is pushed in the body of patient, thus leading to it to advance on support 32 and tie bracket 32 again.As described above, grasping Device 44 can be located at the position of relatively close guide to reduce what the first elongated tubular member 14 when applying thrust bent Tendency.

Operator can keep the tension force of the aspiration level on sliding part 20 using touch feedback, thus keeping distally spacing The engaging and compensate any relative of when stent length is increased due to constraining again support 32 of device 36 and ring-type lock 34 Proximal motion.Distally stop 36 is kept to contact and support 32 can be maintained at tensioning with ring-type lock 34 with the proximal force of desired amount State and assist the first elongated tubular member 14 support 32 go forward into rather than by the constrained part of support 32 distad Push, this may lead to unintended movements in vascular system for the support.The proximal force being applied to distally stop 36 is not anticipated Support 32 proximad is pulled by figure.Due to the first elongated tubular member 14 and coupling between knob 18 and sliding part 42, no matter Operator's whether operated actuator or realize using clasper 44 advancing, the advance of the first elongated tubular member 14 leads to revolve The rotation of button 18 and sliding part 42 motion on indicated direction.When operator's applying power is to be kept into distally stop 36 When engaging with ring-type lock 34, sliding part 20 also can proximal motion, and support 32 is elongated when being constrained again.

When the first elongated tubular member 14 is advanced in the total length of support 32, intraluminal device 10 can be in Fig. 5 The construction schematically showing.Distally stop 36 still can be engaged with ring-type lock 34, and sliding part 20 can be positioned on relatively Nearside in its farthest side position of housing.However, the first elongated tubular member 14 and sliding part 20 have returned to theirs Initial position, support 32 is by completely radial constraint.Subsequently, as schematically shown in Fig. 6, operator can manipulate sliding part 20 with It is returned to its farthest side position with respect to housing 12.This leads to the second elongated tubular member 16 with respect to nearside stop 40 are distally advanced, so that intraluminal device 10 returns to the construction shown in Fig. 1, thus can be as needed by support 32 weight New definition.In the embodiment with direction controlling part, making sliding part 20 return to its farthest side position can make direction controlling part It is re-engaged, thus the first elongated tubular member 14 can be pulled out and not advance.

For an embodiment, show the suitable embodiment with regard to housing 12 and its actuator in Fig. 7-11 enters one Step details.Start from Fig. 7, show the schematic cutaway view of housing 12.Knob 18（For the sake of clarity gone in this view Remove）It is associated with Direction Control Unit 50, as described below, Direction Control Unit 50 and then be connected to the first elongated tubular product The near-end 52 of component 14.Near-end 52 is also directly coupled to quick disposed slide 42.Using connecting rod 54 by sliding part 20 It is connected to the near-end 56 of the second elongated tubular member 16.The near-end 58 of the 3rd elongated tubular member 38 is in the first elongated tubular member 14 And second elongated tubular member 16 near-end between position be attached to housing 12.Near-end 56 in the second elongated tubular member 16 Nearside, the near-end 60 of inner tubular member 22 is attached to housing 12.

As described above, this construction allows the first elongated tubular member 14 and the second elongated tubular member 16 with respect to housing 12 Independently progress or extract, and the 3rd elongated tubular member 38 and inner tubular member 22 have fixing relative position.First is thin Tubular member 14 is disposed coaxially in the 3rd elongated tubular member 38, and the 3rd elongated tubular member 38 is coaxially set Put in the second elongated tubular member 16, the second elongated tubular member 16 and then be disposed coaxially on inner tubular member 22. Direction Control Unit 50 includes travelling gear 62, and this travelling gear 62 shares an axle with knob 18 and is fixed to knob 18, thus knob 18 rotates together with travelling gear 62.The tooth of travelling gear 62 engages thus by knob 18 with driven pulley 64 Rotary motion transfer to driven pulley 64.Flexible ring element（Not shown in this view）It is arranged on around driven pulley 64 And around idler pulley 66.Sliding part 42 by flexible ring component load-bearing and is fixed to the near-end of the first elongated tubular member 14 52, as mentioned.If necessary, can adjust gear ratio and/or diameter of pulley and providing mechanical advantage, consequently facilitating first is elongated The extracting and/or advance, as mentioned above of tubular element 14.For example, the rotation input from knob 18 can be reduced, to export reduction Linear convergent rate and the motion to the first elongated tubular member 14 applies bigger control.Alternatively, as needed, can increase Given rotation input, is faster extracted with realizing or advances.

The element of flexible ring drivetrain is schematically shown, flexible ring element is implemented as in this embodiment in Fig. 8 A Belt 68.As will be appreciated, flexible ring element can also be V-type band, toothed belt, chain, muscle or any other suitable Construction.Belt 68 traveling around driven pulley 64 and idler pulley 66.Additionally, belt 68 is fixed to sliding part 42, should Sliding part 42 and then be fixed to the near-end 52 of the first elongated tubular member 14.Therefore, the rotary motion of knob 18 is converted into Linear motion is thus making the first elongated tubular member 14 advance according to direction of rotation or extracting.Flexible ring element can be in fully Tensioning state under to give the friction with the expected degree of driven pulley axle 70.

Flexible ring element may be configured to assume relatively low elongation under the service load that highest is expected（Such as about 3%）, Because any elongation of tensioning member can be considered the input delay for operator or error.Additionally, spring element can be inserted Enter flexible ring means path thus providing constant tension force and increasing the friction with driven pulley 64.Can using substitute or its Its technology increasing friction, such as by using the multiple winding in driven pulley axial flexibility ring element.Additionally, can V-shaped groove is used together with single winding or helicla flute is used together with multiple winding, thus strengthening and flexible ring element Joint.

As described above, travelling gear 62 and knob 18 can be coaxial and be fixed to knob 18, thus this two Element rotates together.Similarly, ratchet 70 can be also coaxial with knob 18 and be fixed to knob 18.View in Fig. 8 A In, knob 18 and travelling gear 62 are partly cut away to show ratchet 70.If necessary, knob 18, travelling gear 62 and/or Ratchet 72 may be integrally formed.By connector 72, connecting rod 54 can be fixed to the near-end 56 of the second elongated tubular member 16, So that sliding part 20 is deviateed from the longitudinal axis of the tubular element being coaxially disposed to avoid being interfered with sliding part 42, thus permit Permitted them to be movable with respect to each other.For example, connector 72 can be the single unitary member shaping as needed, with by solid Fixed attachment and be connected directly to connecting rod 54 and the near-end 56 of the second elongated tubular member 16, if or entering by dry part Row connects so that connector 72 is with 1:The linear motion of sliding part 20 is directly transformed into the second elongated tubular product structure by 1 ratio The linear motion of part 16.

Reference picture 8B, shows via being inserted in opening 59b（Component 58a's）Tab 59a is elongated by the 3rd for convex The annex of the near-end 58a of tubular element 38 is attached to an alternate embodiment of housing 12.Near-end 58a is connected to the tubulose of fluting Component 57, the near-end of this tubular element 57 permission component 16 or shuttle 56 are along longitudinal axes L-L in generally linear path The middle bending translating and there is little or caused less than the actuating due to sliding part 20 connecting rod 54.Inner tubular member The nearside of the shuttle 56 in the second elongated tubular member 16 for 22 near-end 60 is attached to housing 12.

As seen in fig. 8 c, a part for the outer surface of shuttle 56 is trapped in the groove 57a of slotted component 57, thus Guarantee to exist little when shuttle 56 is translated along axis L-L by the outer rail being provided by groove 57a or do not have Deviation.And, shuttle 56 is provided with pass through openings 56a, in pass through openings 56a, component 38（Not shown）Serve as wearing The internal guide rail of shuttle 56, is shown in further detail in Fig. 8 D.

The further details of an embodiment of Direction Control Unit 50, wherein, one are schematically shown in Fig. 9 Or multiple elasticity deflectable element serve as can be with the ratchet of the indented joint of ratchet 70.Direction Control Unit may include the first elasticity can Deflecting element 74, this first elastic deflectable element 74 has the one end 76 being installed in housing 12 and relative free end 78, this free end 78 is optionally engaged thus allowing rotate counterclockwise and limiting dextrorotation with the tooth 80 on ratchet 70 Turn, as directed.Sliding part 20 includes the first cam 82, when sliding part 20 is in its farthest side position with respect to housing 12 When, this first cam 82 is engaged so that free end 78 is engaged with ratchet 70 with the first elastic deflectable element 74.As will Understand, this construction allows ratchet 70 to exist（In shown perspective view）Rotate in counter clockwise direction, because tooth 80 can make first The free end 78 of elastic deflectable element 74 deflects and allows to rotate.However, ratchet 70 rotates in the clockwise direction Engaged free end 78 is not made to deflect, thus being essentially prevented from ratchet in the rotation that this side up.By as above institute State and make ratchet 70 be connected to the first elongated tubular member 14, thus when sliding part 20 be in its farthest side position and with direction control When assembly 50 processed engages, the first elongated tubular member 14 can be pulled out but will not advance.

Direction Control Unit 50 may also include the second elastic deflectable element 84, and this second elastic deflectable element 84 has It is installed in the one end 86 in housing 12 and relative free end 88, this free end is optionally engaged with the tooth 80 on ratchet 70 Thus allowing to turn clockwise and limiting rotate counterclockwise.When sliding part 20 is in its farthest side position with respect to housing 12 When, the second cam 90 on sliding part is engaged with the second elastic deflectable element 84, so that the tooth of free end 88 and ratchet 70 80 are disengaged.In shown construction, the second elastic deflectable element 84 is disengaged, so that the first elastic deflectable unit Part 74 controls the direction of rotation of ratchet 70, as mentioned above.However, when sliding part 20 proximal motion, the second cam 90 and Two elastic deflectable elements 84 are disengaged so that free end 88 bounces back into its non-offset position engaging with tooth 80.

Similarly, when sliding part 20 proximal motion, the first cam 82 is also departed from the first elastic deflectable element 74 Engage, thus allowing that it takes its non-offset position and free end 78 is disengaged with tooth 80.Therefore, sliding part 20 is from it The proximal motion that distal position starts allows ratchet 70 to rotate in the clockwise direction, because tooth 80 can make the second elasticity inclined The free end 88 turning element 84 deflects thus allowing to turn clockwise.The rotate counterclockwise of ratchet 70 is limited, because should Motion does not make the free end 88 of joint deflect.Additionally, because ratchet 70 is connected to the first elongated tubular member 14, working as When making sliding part 20 from its farthest side position proximal motion and being disengaged with Direction Control Unit 50, but this is first elongated Tubular element 14 can advance but not be pulled out.

Schematically show in Figure 10 and Figure 11 and be in arrangement and the Direction Control Unit 50 constraining construction again Diagram.In shown in Fig. 10 arrangement construction, sliding part 20 is in its farthest side position with respect to housing 12 so that first Cam 82 is engaged with the first elastic deflectable element 74 and the second cam 90 is engaged with the second elastic deflectable element 84.First The joint of cam 82 makes the first elastic deflectable element 74 be displaced to from nominal disengaged position to engage with ratchet 70, and the The joint of two cams 90 makes the second elastic deflectable element 84 open from its nominal combined deviation of ratchet 70.Therefore, the first elasticity Deflectable element 74 permission ratchet 70 rotates counterclockwise and limits ratchet 70 and rotates clockwise.Sliding part 20 also can have gripper 92, this gripper 92 is pinned with the protuberance 94 of housing 12 when being in its farthest side position.Therefore, once being released, need to compare The relatively bigger power of the power needed for sliding part 20 rectilinear translation is made so that gripper 92 is deflected.This arrangement prevents sliding part 20 Unexpected rectilinear translation, for example during transportation or use in during the operation, and rest on farthest side position until Intentionally make sliding part 20 proximal motion.And, the interaction of gripper 92 and protuberance 94 provides positive feedback, shows to slide Part 20 returns to its farthest side position after constraint manipulation again, sends signal and shows Direction Control Unit 50 by sliding part 20 engage and can extract the first elongated tubular member 14 now after the reorientating of support 32.

Correspondingly, show in Figure 11 and constrain construction again, wherein, sliding part 20 has been moved to the near of its farthest side position Side, as directed.In this construction, the first cam 82 is disengaged with the first elastic deflectable element 74, and the second cam 90 are disengaged with the second elastic deflectable element 84.First elastic deflectable element 74 returns to its non-offset position and not Engage with ratchet 70, and the second elastic deflectable element 84 returns to its non-offset position thus engaging with ratchet 70.Therefore, Second elastic deflectable element 84 permission ratchet 70 rotates clockwise and limits ratchet 70 and rotates counterclockwise.

The intraluminal device 100 of the replacement of the technology being embodied as the disclosure is schematically shown in Figure 12.With Also different using single inner tubular member outside two tubular elements, the feature related to inner tubular member can be incorporated to the second tubulose In component.Unless otherwise stated, similar element has corresponding reference（For example, the housing 112 of intraluminal device 110 Housing 12 corresponding to intraluminal device 10）.So, intraluminal device 100 generally may include housing 112, extends from housing 112 And can extend also and being capable of phase with respect to the first elongated tubular member 114 that housing 112 axially moves and from housing 112 The second elongated tubular member 116 that housing 114 is axially moved.The first actuator on housing 112 is configured to knob 118 And the first elongated tubular member 114 can be made to advance or extract the first elongated tubular member 114.It is configured to sliding part 120 Second actuator is connected to the second elongated tubular member 116, thus the motion of sliding part 120 makes the second elongated tubular member 116 Advance and extract the second elongated tubular member 116.Knob 118 also can have Direction Control Unit as above, with basis Whether sliding part 120 is engaged with direction controlling part（That is, it is in its farthest side position with respect to housing 112）And it is thin to limit first The direction of motion that tubular member 114 is allowed.In this embodiment, the second elongated tubular member 116 is in its terminating at distal ends In the tapered tip 124 expanding, and there is the lumen 126 extending between its proximal and distal ends.Seal wire 128 can be from housing 112 proximads extend through the valve 130 of the sealing being in fluid communication with lumen 126（As Luer lock）, and seal wire 128 also can be to remote Side extends beyond top 124.

In the embodiment not using seal wire, the second elongated tubular member 116 can be the solid elongate cylinder of no lumen Shape component.Support 132 can be arranged in the far-end of the first elongated tubular member 114, with the ring-type lock 134 releasedly fixed It is constrained in pressure to hold in construction.The far-end of the second elongated tubular member 116 is extended beyond ring-type lock 134 and has and can be locked with ring-type The radially projecting distally stop 136 of 134 joints.3rd elongated tubular member 138 can also be with fixed relationship from housing 112 Extend, the 3rd elongated tubular member 138 has far-end, and this far-end has diameter, be configured to proximally direction and ring-type and lock 134 Engage, thus forming nearside stop 140.3rd elongated tubular member 38 can have the fixed relationship with housing 112, with nearly Side stop 140 is maintained at corresponding fixed position.Housing 112 may also comprise quick disposed slide 142, and this quick arrangement is slided Moving part 142 is operatively coupled to the first elongated tubular member 114, as mentioned above.Intraluminal device 110 can have clasper 144, It is also similar to that above-described embodiment.Additionally, the second elongated tubular member 116 can have one or more radiopaque marks（As mark Will 146）, with indicate support 132 nearside place, constrain again boundary or with the operation phase implemented with intraluminal device 100 The other suitable instruction closed.

The another embodiment of the disclosure of the intraluminal device similar to Fig. 1 is schematically shown in Figure 13.Unless It is otherwise noted, similar element has corresponding reference（For example, the housing 212 of intraluminal device 210 corresponds in vascular The housing 12 of device 10）.So, intraluminal device 200 generally may include housing 212, extend from housing 212 and can be with respect to The first elongated tubular member 214 that housing 212 axially moves and also extend from housing 212 and can be with respect to housing 214 The second elongated tubular member 216 axially moving.The first actuator on housing 212 is configured to knob 218 and can make One elongated tubular member 214 is advanced or is extracted the first elongated tubular member 214.It is configured to the second actuator of sliding part 220 It is connected to the second elongated tubular member 216, thus the motion of sliding part 220 makes the second elongated tubular member 216 advance and extract Second elongated tubular member 216.According to sliding part 220 whether knob 218 also can have Direction Control Unit as above, with Engage with direction controlling part（That is, it is in its farthest side position with respect to housing 212）And limit the first elongated tubular member 214 institute The direction of motion allowing.In this embodiment, inner tubular member 222 extends from housing 212, and can be solid with housing 212 Determine relation.Inner tubular member 222 and has at it proximally and distally in the top 224 of the taper expanding in its terminating at distal ends Between extend lumen 226.

Seal wire 228 can extend through the valve 230 of the sealing being in fluid communication with lumen 226 from housing 212 proximad（As Rule Lock）, and seal wire 228 also can extend distally beyond top 224.Support 232 may be disposed at the first elongated tubular member 214 Far-end in, be constrained in pressure and held construction with the ring-type lock 234 releasedly fixed.The far-end of the second elongated tubular member 216 prolongs Extend over ring-type lock 234 and be there is the radially projecting distally stop 236 that can be engaged with ring-type lock 234.3rd elongated tubular Shape component 238 can also be extended from housing 212 with fixed relationship, has the far-end with nearside stop 240, this nearside stop 240 have and lock 234 with respect to the diameter that the 3rd elongated tubular member 238 increases with proximally direction and ring-type and engage.Here is real Apply in example, nearside stop 240 can be attached to the single element of the 3rd elongated tubular member 238 or can be one 's.3rd elongated tubular member 238 can have the fixed relationship with housing 212, be maintained at corresponding with nearly side stop 240 Fixed position.

Housing 212 may also comprise quick disposed slide 242, and this quick disposed slide 242 is operatively coupled to first Elongated tubular member 214, as mentioned above.Intraluminal device 210 can have clasper 244, is also similar to that above-described embodiment.This Outward, the second elongated tubular member 216 can have one or more radiopaque marks（Such as mark 246）, to indicate support 232 Nearside place, constrain boundary or relevant with the operation implemented with intraluminal device 200 other suitable instruction again.

Another embodiment of the disclosure is schematically shown, it is also similar to that the intraluminal device of Fig. 1 in Figure 14 A, And similar element has corresponding reference（For example, the housing 312 of intraluminal device 310 corresponds to intraluminal device 10 housing 12）, unless otherwise stated.Here, intraluminal device 300 generally may include housing 312, extend from housing 312 and Can extend also and can relatively with respect to the first elongated tubular member 314 that housing 312 axially moves and from housing 312 The second elongated tubular member 316 axially moving in housing 314.It is configured to the first actuator on the housing 312 of knob 318 The first elongated tubular member 314 can be made to advance or the first elongated tubular member 314 is extracted.It is configured to the of sliding part 320 Two actuators are connected to the second elongated tubular member 316, thus before the motion of sliding part 320 makes the second elongated tubular member 316 Enter and be pulled out.Knob 318 also can have Direction Control Unit as above, with according to sliding part 320 whether with direction Control piece engages（That is, it is in its farthest side position with respect to housing 312）And limit the first elongated tubular member 314 and allowed The direction of motion.In this embodiment, inner tubular member 322 extends from housing 312, and can be fixing closing with housing 312 System.Inner tubular member 322 prolongs in the tapered tip 324 and having expanding between its proximal and distal ends in its terminating at distal ends The lumen 326 stretched.

Seal wire 328 can extend through the valve 330 of the sealing being in fluid communication with lumen 326 from housing 312 proximad（As Rule Lock）, and seal wire 328 also can extend distally beyond top 324.Support 332 can be arranged on the first elongated tubular member 314 Far-end in, be constrained in pressure and held in shape with the ring-type lock 334 releasedly fixed.The far-end of the second elongated tubular member 316 Extend beyond ring-type lock 334, and be there is the radially projecting distally stop 336 that can be engaged with ring-type lock 334.3rd is elongated Tubular element 338 can also be extended from housing 312 with fixed relationship, has far-end, and the nearside that far-end has increase diameter is spacing Device 340 is engaged with ring-type lock 334 with proximally direction.3rd elongated tubular member 338 can have the fixing pass with housing 312 System, is maintained at corresponding fixed position with nearly side stop 340.

As directed, in this embodiment, ring-type lock 334 can be free floating and have portions of proximal, this is near Side part be dimensioned to cooperation in the interior diameter of the 3rd elongated tubular member 338.In one aspect, ring-type lock 334 Portions of proximal can have enough distances, thus when support 332 experience the maximum amount of shorten when ring-type lock 334 some amount still So stay in the interior diameter of the 3rd elongated tubular member 338, thus keep ring-type lock 334 and the 3rd elongated tubular member 338 it Between relation.Ring-type lock 334 can have mid portion, and this mid portion has the diameter of increase, and it can be by nearside stop 340 Engage.The distal part of ring-type lock 334 can have enough diameters, to engage with support 332 when support is held by pressure thus inciting somebody to action Support is fixed.Ring-type lock 334 can be overall or can be formed by many individually elements as expected.Housing 312 May also comprise quick disposed slide 342, this quick disposed slide 342 is operatively coupled to the first elongated tubular member 314, As mentioned above.Intraluminal device 310 can have clasper 344, is also similar to that above-described embodiment.Additionally, the second elongated tubular product structure Part 316 can have one or more radiopaque marks（As mark 346）, place, constrain boundary again with the nearside indicating support 332 Limit or the other suitable instruction relevant with the operation implemented with intraluminal device 300.

In an illustrated embodiment, housing 312 may include positioned at adjacent with the travel range of quick disposed slide 342 Correct position constrain boundary marker 350 again.This represent still will enable support 332 reliably constrained again first thin The farthest withdrawal of tubular member 314.Constraining boundary marker 350 again can be used as the conjunction of the far-end positioned at intraluminal device 300 Suitable radiopaque mark（Such as 346）Replacement or supplement and provide.Housing 312 also can have removable lid 352, to protect Sliding part 320 and help prevent the accidental operation during rack arrangement.If it is desire to reorientating support 332, opening Before beginning to constrain process again, operator removes lid 352 first with sensible sliding part 320.

With intraluminal device implement operation before, executable rinsing step with air is discharged from system so that The amount of the air that intra-operative may introduce minimizes.In order to contribute to this rinsing step, the design of the disclosure allows through single Individual port is rinsed.As shown in fig. 14 a, the distal part of inner tubular member 322 can have and lumen 326 fluid communication Multiple eyelets.Before so that intraluminal device 310 is advanced on seal wire 328, can be by rinse fluid art（As physiological saline）Source even It is connected to valve 330 to be transported to this fluid in the near-end of lumen 326.When lumen is filled, the air in system will be arranged Go out until fluid outflow hole eye 354 and flow through between the first elongated tubular member 314, support 332 and inner tubular member 322 Any space.Operator can temporarily block the distal openings of lumen 326 to force the fluid over eyelet 354.Additionally, as Figure 15 End-view in schematically show, the overall diameter of the distal top 324 of taper can closely correspond to the first elongated tubular product structure The interior diameter of part 314 so that during rinsing step multiple grooves 356 contribute to the outflow of fluid and air.

As discussed above, it is possible to use in the vascular of the technology being embodied as the disclosure, induction system is come propping up of arranging Frame can be self expandable.An example being in the support 32 that pressure holds construction is schematically shown in the side view of Figure 16, It, using the helical form geometry being fully connected, has length L when support is held by pressure_cOutside when support is held by pressure Diameter D_c.For example, when in the distal part being arranged on the first elongated tubular member 14, the construction shown in Figure 16 corresponding to Constrained state completely.As shown in FIG., suitable feature（Such as eyelet etc.）Can be mutual with the corresponding depression on ring-type lock 34 Act on fixed support 32 in a mode of operation and discharge support 32 in another mode of operation.When elongated first When tubular element 14 fully pulls out arrangement support 32, it can be according to the geometry of vascular in patient's vascular intramedullary expansion, directly To maximum non-constrained length L_ncWith diameter D_nc, according to its design parameter schematically showing in the side view of Figure 17.Work as expansion Zhang Shi, the feature of support 32 is discharged from ring-type lock 34, thus being discharged.Pressure holds the difference between length and nominal arrangement length It is considered as obvious when more than 10%.When being arranged, if the far-end of support is contacted with blood vessel wall in stent-expansion, Then it can be motionless with respect to vascular.Therefore, when arranging support, the near-end of support can distal motion to allow stent-expansion.

As will be appreciated, any suitable design can be applied to the ring that is used together with disclosure intraluminal device Shape is locked.This ring-type lock can be interacted so that when being held in oversheath support by pressure with the support being in its pressure and holding diameter, Support and ring-type lock together with motion or with fixed relationship keep together with motionless.Bracket lock can axially be shorter than support.Generally, Bracket lock can hold the relatively short length of support with pressure（Up to 4 or 5 mm）Interact.When support is not in permission and bracket lock Elastic deformation in the diameter of reduction of contact（Constrained）And when temperature exceedes transition temperature, support self expandable arrives its " memory " shape, and no longer interact with bracket lock and be released.Bracket lock may be configured to the 3rd elongated tubular member or There is mechanical interaction in nearside stop, to stop the motion in a proximal direction of support and ring-type lock set.

Similarly, bracket lock may be configured to, with distally stop, mechanical interaction occurs, to stop support and ring-type lock The distal motion of assembly.At least a portion of ring-type lock can be formed by rigid material, applies in the torque design and axial force When being added to this material, it keeps general cylindrical shape.Some embodiments of ring-type lock passively radially discharge support（That is, support It is not constrained in the diameter of reduction by ring-type lock）.Some embodiments of bracket lock radially discharge support on one's own initiative（That is, do not cause Dynamic, a part for support is also constrained in the diameter of reduction by bracket lock）.In certain embodiments, can be by the structural elements of support Part realizes the contact between support and ring-type lock.For example, scaffold pole can extend up to certain distance radially inward, and can be with Comply with the deformable material contact of the ring-type lock around strut or other structures component, with fixing in a mode of operation Frame and in another mode of operation discharge support.In some embodiments of induction system, ring-type lock is free to axial direction Translate and around tubular element（Such as second elongated tubular member 16）Longitudinal axis rotation, ring-type lock be carried on this tubulose On component.

In some embodiments of induction system, the length between nearside stop and distally stop can be variable And determined by operator, but initially when being ready to use, when whole support by radially constrained in external member when, ring The possible axial travel distance of shape lock can be more than 20 the percent of stent length（20）To adapt to shorten, and in other It is more than 25 the percent of this length in embodiment（25）.In certain embodiments, ring-type is locked between two stops Possible axial travel distance is variable and is determined by operator, but initially can be more than corresponding to when being ready to use The expected greatly predetermined length shortening.

Give description above with reference to presently disclosed embodiment of the present utility model.The utility model art Technical staff will be understood that can be substantially not deviating from principle of the present utility model, in the case of spirit and scope Implement the change in described structure and change.As understood by those skilled in the art, accompanying drawing is not drawn necessarily to scale. Therefore, description above is not construed as being pertaining only to precise structure described and illustrated in the accompanying drawings, but it is understood that Become consistent with claims and support claims, it is comprehensively and reasonable that claims should have them Scope.

Claims

1. a kind of intraluminal device for arranging and constraining expansible intracavitary unit is it is characterised in that include：

Housing；

The first elongated tubular member extending and can axially moving with respect to described housing from described housing；

The second elongated tubular member extending and can axially moving with respect to described housing from described housing, described second is thin Tubular member has far-end, and described far-end carries radially projecting distally stop, wherein, described second elongated tubular member It is disposed coaxially in described first elongated tubular member；

Ring-type is locked, and fixes and discharge described chamber in another mode of operation in described Cheng Yi mode of operation of ring-type Lock structure Interior device, wherein, described ring-type lock is disposed coaxially in described second elongated tubular member and is disposed coaxially In described first elongated tubular member, and wherein, described ring-type lockset has the effective overall diameter less than described distally stop Interior diameter；

Knob on the housing, described knob is connected to described first elongated tubular member by flexible ring element so that institute The manipulation stating knob makes described first elongated tubular member be axially movable with respect to described housing；And

Sliding part on the housing, described sliding part is connected to described flexibility ring element.

2. intraluminal device as claimed in claim 1 is it is characterised in that described knob provides mechanical advantage so that described the One elongated tubular member is less than input motion with respect to the corresponding axially-movable of described housing.

3. intraluminal device as claimed in claim 1 is it is characterised in that described ring-type lock includes multiple depressions, the plurality of Depression is configured to capture the element of described expansible intracavitary unit.

4. intraluminal device as claimed in claim 1 is it is characterised in that the distally being additionally included in described housing is coaxially set Put the friction actuator in described first elongated tubular member.

5. intraluminal device as claimed in claim 1 is it is characterised in that also include being disposed coaxially described second elongated Extend past in tubular element and from described housing the interior elongated tubular member of described distally stop, wherein, described interior elongated Tubular element includes proximal port that lumen and described lumen be in fluid communication and has multiple with what described lumen was in fluid communication The distal part of eyelet.

6. intraluminal device as claimed in claim 5 is it is characterised in that described intraluminal device includes the distally top of taper End, described distal top has multiple grooves, and the plurality of groove is configured to that to adjoin described first elongated when described distal top The outflow of the fluid of supply from the eyelet of described interior elongated tubular member is allowed during the far-end of tubular element.

7. one kind can again tie bracket induction system it is characterised in that include：

Housing；

Ring-type is locked, and described ring-type lock is disposed coaxially in described second elongated tubular member and is disposed coaxially described In first elongated tubular member, wherein, described ring-type lockset has the interior diameter of the effective overall diameter less than described distally stop；

Self-expanded stent, described Self-expanded stent is releasably secured to described ring-type lock；