CN214967136U - Adjustable bent pipe for support conveyer and support conveyer - Google Patents

Abstract

The utility model discloses an adjustable return bend and support conveyer for support conveyer belongs to minimal access surgery technical field, for solving current support conveyer turn angle and be difficult to accurate control scheduling problem design. The utility model discloses adjustable return bend for support conveyer wears to be equipped with two piece at least traction wires including the section of can bending, transitional coupling ejector pin, back toughness multi-chamber pipe and the adjustment handle that connects gradually in the section of can bending, and fixed connection is in the different positions department of the inside front end of section of can bending respectively for the head end of whole traction wires, and the afterbody of whole traction wires is connected to the subassembly that turns to on the adjustment handle after passing different azimuth holes and the back toughness multi-chamber pipe of transitional coupling ejector pin respectively. The utility model discloses adjustable return bend and support conveyer for support conveyer pass through the traction wire and can make adjustable return bend advance in the serious and growth contained angle blood vessel of distortion to adaptation human vasculature's circuitous tortuous realizes tectorial membrane support's remote accurate transport and operation.

Description

Adjustable bent pipe for support conveyer and support conveyer

Technical Field

The utility model relates to a minimally invasive surgery technical field especially relates to a support conveyer is with adjustable return bend, including the support conveyer of this adjustable return bend and the ascending aorta tectorial membrane support and the conveying system subassembly including this support conveyer.

Background

Aortic aneurysms in the ascending aorta often involve the aortic sinus, which causes aortic insufficiency due to aortic valve insufficiency caused by aortic annular deformation and leaflet separation, and long-term effects on the aortic aneurysm cause heart failure. According to different aortic lesion distributions, aortic dissections can be classified into the following three types according to the DeBakey system: type i dissections originate in the ascending aorta and extend beyond the aortic arch to the descending aorta, and even the abdominal aorta, which is most common. Type ii dissections originate and are confined to the ascending aorta. DeBakey I, II can be identical to Stanford A.

At present, aortic aneurysm can only be treated by open surgery, such as open artificial blood vessel replacement (adopting dacron blood vessel replacement with artificial aortic valve and re-implanting coronary artery into dacron blood vessel), and Wheat operation. When the open surgical operation is carried out, cardiac arrest and extracorporeal circulation are needed, the operation wound is huge, and the death rate and complication rate are high.

Because the ascending aorta has a complex anatomical structure, the heart, valves and coronary arteries are arranged at the front proximal end, the branch arteries on the arch for supplying blood to the brain and the upper limbs are arranged at the rear end, the blood flow pressure of the ascending aorta is high, the flow rate is high, the pulsation and deformation amplitude of the vessel wall is large, and the danger and the weight of the ascending aorta interlayer are high, the stent conveyor cannot accurately convey the ascending aorta covered stent to a specified position, so that the intracavity minimally invasive technique is difficult to apply to the treatment of the ascending aorta.

SUMMERY OF THE UTILITY MODEL

An object of the utility model is to provide a can accurate adjustment turn direction and the adjustable return bend for support conveyer of turn angle degree.

Another objective of the present invention is to provide a stent delivery device capable of accurately delivering the ascending aorta covered stent to a specific position.

Still another object of the present invention is to provide an ascending aorta covered stent and a delivery system assembly for performing minimally invasive surgery on the ascending aorta interbody.

To achieve the purpose, on one hand, the utility model adopts the following technical scheme:

the utility model provides an adjustable return bend is used to support conveyer, includes the bendable section, transitional coupling ejector pin, back toughness multi-chamber pipe and the adjustment handle that connect gradually, wear to be equipped with two piece at least haulage wires in the bendable section, whole the head end difference fixed connection of haulage wire is in the different positions department of the inside front end of bendable section, whole the afterbody of haulage wire passes respectively the different azimuth holes of transitional coupling ejector pin and be connected to behind the back toughness multi-chamber pipe on the adjustment handle turn to the subassembly.

In particular, the steering assembly includes a plurality of bend adjustment sliders, each of the traction wires having a distal end fixedly attached to one of the bend adjustment sliders, the bend adjustment sliders being configured to retract or pay out the traction wire.

Particularly, the adjusting handle comprises an X-axis direction adjustable bending knob and a Y-axis direction adjustable bending knob, and the plurality of bending adjusting sliding blocks are respectively connected to the X-axis direction adjustable bending knob or the Y-axis direction adjustable bending knob.

Particularly, the steering assembly comprises four bending adjusting sliding blocks, two bending adjusting sliding blocks are connected to the X-axis direction bending adjusting knob, and the other two bending adjusting sliding blocks are connected to the Y-axis direction bending adjusting knob.

And particularly, the two bending adjusting sliding blocks are provided with left-handed external threads, the other two bending adjusting sliding blocks are provided with right-handed external threads, and the adjustable bending knob in the X-axis direction and the adjustable bending knob in the Y-axis direction are both simultaneously provided with left-handed and right-handed internal threads.

In particular, the steering assembly includes a spur gear and a rack that are in meshing engagement, a distal end of each of the pull wires being fixedly attached to one of the racks, the spur gear being configured to drive the rack to move as the spur gear rotates.

In particular, the steering assembly includes two spur gears and four racks, the two racks being respectively engaged with one of the spur gears from opposite sides.

In particular, the steering assembly further comprises two rotating handwheels, each of which is connected to one of the spur gears, the rotating handwheels being configured to drive the spur gears in rotation.

On the other hand, the utility model adopts the following technical scheme:

the utility model provides a support conveyer, includes outer sheath pipe and single intracavity well pipe, still includes foretell support conveyer and uses adjustable return bend, adjustable return bend cover is established the outside of single intracavity well pipe and wear to establish the inboard of outer sheath pipe.

On the other hand, the utility model adopts the following technical scheme:

the utility model provides an ascending aorta covered stent and conveying system subassembly, includes covered stent, still includes foretell support conveyer, at least partial cover is established when covered stent is the folded state the outside of adjustable return bend just wears to establish the inboard of sheath pipe.

The utility model discloses adjustable return bend is used to support conveyer is including the bendable section that connects gradually, the transitional coupling ejector pin, back toughness multicavity pipe and adjustment handle, can make adjustable return bend advance in the serious and growth contained angle blood vessel of distortion through the traction wire to adapt to the circuitous tortuous of human vasculature, realize tectorial membrane support's teletransmission and operation, solved the problem that ascending aorta intermediate layer should not carry out minimal access surgery, operative period mortality and complication incidence have been reduced, required in hospital and postoperative guardianship time are shorter.

Drawings

FIG. 1 is a schematic view of an ascending aorta covered stent and delivery system assembly according to an embodiment of the present invention;

FIG. 2 is a schematic structural diagram of a rack conveyor according to an embodiment of the present invention;

fig. 3 is a schematic view of the internal structure of the rack conveyor according to the embodiment of the present invention;

FIG. 4 is a schematic structural view of an end of a rack conveyor according to an embodiment of the present invention;

fig. 5 is a schematic structural diagram of an adjustable elbow according to an embodiment of the present invention;

fig. 6 is a schematic structural diagram of a transition connection ejector rod according to an embodiment of the present invention;

FIG. 7 is a schematic view of another preferred construction of a steering assembly according to an embodiment of the present invention;

FIGS. 8 to 12 are schematic views illustrating the process of delivering the stent graft by the stent delivery device.

In the figure:

100. a rack conveyor; 110. an outer sheath tube; 120. an adjustable bent pipe; 121. a bendable section; 122. a post-malleable multi-lumen tube; 123. drawing wires; 124. bending adjusting slide blocks; 125. the ejector rod is connected in a transition way; 130. a single lumen inner tube; 150. a flexible TIP head; 172. the knob can be bent in the X-axis direction; 173. a knob capable of being bent in the Y-axis direction; 200. covering a membrane stent; 210. a proximal bare crown stent; 220. a distal covered stent; 401. a hand wheel; 402. a spur gear; 403. a rack; 1251. an orientation hole.

Detailed Description

The technical solution of the present invention is further explained by the following embodiments with reference to the accompanying drawings.

Example one

The embodiment discloses an adjustable elbow for a stent conveyor, the stent conveyor, an ascending aorta covered stent and a conveying system assembly. As shown in FIG. 1, the ascending aorta stent graft and delivery system assembly includes a stent graft 200 and a stent conveyor 100. As shown in fig. 2 to 4, the stent transporter includes an outer sheath tube 110, a single-cavity inner middle tube 130, and an adjustable elbow 120, wherein the adjustable elbow 120 is sleeved outside the single-cavity inner middle tube 130 and penetrates the inner side of the outer sheath tube 110. When the stent graft 200 is in the closed state, it at least partially covers the outer side of the adjustable elbow 120 and passes through the inner side of the sheath tube 110.

Sometimes, the growth angle of the target lesion blood vessel is abnormally distorted, so an adjustable bending function is needed in the process of conveying the stent graft 200 by the stent conveyor 100, as shown in fig. 5 and 6, the adjustable bending for the stent conveyor comprises a bendable section 121, a transition connection ejector rod 125, a rear flexible multi-cavity tube 122 and an adjusting handle which are sequentially connected, at least two traction wires 123 are arranged in the bendable section 121 in a penetrating manner, the head ends of all the traction wires 123 are respectively and fixedly connected to different positions of the front end in the bendable section 121, and the tail portions of all the traction wires 123 respectively penetrate through different azimuth holes 1251 of the transition connection ejector rod 125 and a steering assembly connected to the adjusting handle after the rear flexible multi-cavity tube 122. The end of the single lumen inner tube 130 and the end of the outer sheath tube 110 are connected to an adjustment handle, respectively.

The preferable number of the drawing wires 123 is four, and four circular azimuth holes 1251 are symmetrically arranged in the middle shaft of the transition connection ejector rod 125. The bendable section 121 is preferably laser-engraved from a metal tube and can be bent in the radial direction; the bendable section 121 may also be a multi-lumen tube having a front section with a hardness less than a rear section. The built-in traction wire 123 can avoid cutting the inner wall of the blood vessel, and the use is safer.

The stent conveyor 100 of the ascending aorta covered stent and conveying system component can convey the covered stent 200 for isolating a target lesion blood vessel to a designated position to carry out ascending aorta intracavity isolation operation to treat ascending aorta dissection or aneurysm, is particularly suitable for treating A-type aorta dissection ascending aortic aneurysm, solves the problem that the ascending aorta dissection is not suitable for minimally invasive operation, reduces the mortality and complication rate in the operation period, and requires shorter hospitalization and postoperative monitoring time. The sheath tube 110 has sufficient axial and radial supporting force and compliance, and the adjustable elbow 120 can advance in a blood vessel with serious distortion and a small growth included angle so as to adapt to the circuitous and tortuous of a human vascular system and realize the remote delivery and operation of the covered stent 200.

The specific structure of the steering assembly is not limited, and the bendable section 121 can be pulled to turn by the corresponding traction wire 123. Preferably, the steering assembly includes a plurality of turn-adjusting sliders 124, and each of the traction wires 123 has a distal end fixedly connected to one of the turn-adjusting sliders 124, so that the traction wire 123 can be retracted or paid out by rotating or moving the turn-adjusting slider 124, thereby driving the bendable section 121 to turn in a corresponding direction.

On the basis of the above structure, the adjusting handle includes an X-axis direction adjustable bending knob 172 and a Y-axis direction adjustable bending knob 173, and the plurality of bending adjusting sliders 124 are respectively connected to the X-axis direction adjustable bending knob 172 or the Y-axis direction adjustable bending knob 173. Wherein, the X/Y axis direction takes the cross section of the blood vessel as a reference plane, and a vertical coordinate system is formed in the reference plane.

The steering assembly preferably includes four bend adjustment sliders 124, and the tail of each pull wire 123 is connected to one bend adjustment slider 124. Two bending adjusting sliders 124 are connected to the X-axis direction adjustable bending knob 172, and the other two bending adjusting sliders 124 are connected to the Y-axis direction adjustable bending knob 173. The bending adjustment slider 124 is driven to rotate or move by rotating the X-axis direction adjustable bending knob 172 or the Y-axis direction adjustable bending knob 173.

Preferably, the X-axis direction adjustable bending knob 172 and the Y-axis direction adjustable bending knob 173 are both provided with left-handed and right-handed internal threads, and of the four bending adjusting sliders 124, two bending adjusting sliders 124 are provided with left-handed external threads, which are respectively connected to the X-axis direction adjustable bending knob 172 and the Y-axis direction adjustable bending knob 173; the other two bending adjusting sliding blocks 124 are provided with right-handed external threads which are respectively connected to an X-axis direction bending adjusting knob 172 and a Y-axis direction bending adjusting knob 173. When the adjustable bending knob 172 in the X-axis direction (or the adjustable bending knob 173 in the Y-axis direction) is rotated clockwise or counterclockwise, one bending adjusting slider 124 can be driven to rotate or move, so that the corresponding traction wire 123 is driven to stretch, any bending direction and angle of the bendable section 121 are realized, and the bare crown support 210 at the proximal end can turn within the range of 360 degrees.

On the basis of the above structure, the outer sheath 110 preferably includes three layers arranged from inside to outside in sequence, the inner layer is made of PTFE material with smooth surface, the middle layer is made of metal wire wrap or woven mesh, and the outer layer is made of PEBAX, PU or PTFE material, so that the outer sheath has good compliance, and has sufficient support, bending resistance and inner and outer surface smoothness in both radial and axial directions.

Example two

The embodiment discloses an adjustable bent pipe for a stent conveyor, and the main structure of the adjustable bent pipe is the same as that of the embodiment I. The difference is that as shown in fig. 7, the steering assembly comprises a spur gear 402 and a rack 403 which are engaged, the end of each traction wire 123 is fixedly connected to one of the racks 403, and the spur gear 402 is configured to drive the rack 403 to move when it rotates.

The specific number of spur gears 402 and racks 403 is not limited and can be determined according to the specific number of pull wires 123. Preferably, the steering assembly includes two spur gears 402 and four racks 403, and the two racks 403 are respectively engaged with one spur gear 402 from opposite sides.

On the basis of the structure, the steering assembly further comprises two rotating handwheels 401, each rotating handwheel 401 is connected with one straight gear 402, and the rotating handwheels 401 are configured to drive the straight gears 402 to rotate, so that the racks 403 are driven to move, and the lower section of the head end of the multi-cavity pipe is pulled to be bent through the traction wire 123.

The using method of the ascending aorta covered stent and the delivery system component comprises the following steps:

step 1, constructing a channel, as shown in fig. 8 and 9, pushing the flexible TIP head 150 along the blood vessel until reaching the set position. Considering that the stent transporter 100 made of a four-layer structure is relatively stiff, the outer sheath 110 may be withdrawn first at a location with a large turn, and the stent graft 200 may be delivered to the target lesion site using the adjustable bend 120.

Step 2, after the covered stent 200 reaches the target disease displacement, as shown in fig. 10 and 11, the outer sheath 110 is removed, and the semi-expanded covered stent 200 is exposed; the single lumen inner tube and the single lumen inner middle tube 130 are pushed forward as a whole, exposing the proximal bare crown stent 210.

Step 3, withdrawing the single-lumen inner tube and the single-lumen inner middle tube 130 until the chronic dilator is aligned with the proximal bare crown stent 210; after the release angle is adjusted, the single-lumen inner tube is withdrawn independently, so that the chronic dilator expands radially, and the bound proximal bare crown stent 210 gradually expands along with the expansion of the chronic dilator.

And 4, adjusting the angle of the proximal bare crown stent 210 in the process of expanding the chronic dilator until the proximal bare crown stent 210 is attached to the inner wall of the target lesion blood vessel. That is, in the process of releasing the proximal bare crown stent 210, the angle of the proximal bare crown stent 210 can be adjusted at any time as needed.

Step 5, as shown in fig. 12, the drawstring is firstly drawn out, and the distal covered stent 220 is completely released; and then the single-lumen inner tube is pushed forward independently to slowly shrink the chronic dilator until the chronic dilator is completely separated from the proximal bare crown stent 210, thereby completing the release and angle adjustment of the proximal bare crown stent 210.

In the using method, the distal end covered stent 220 and the proximal end bare crown stent 210 are released respectively in sequence. By arranging the adjustable bent tube 120 and the chronic dilator, the release angle of the proximal bare crown support 210 can be adjusted while the proximal bare crown support is slowly released, so that the proximal bare crown support 210 can be anchored at a target position more accurately, and can be anchored accurately even if the target position is extremely limited, thereby realizing the completion of a minimally invasive operation in a diseased blood vessel of an ascending aorta with an abnormally complex physiological anatomical structure and extremely high critical importance.

In the prior art, when the covered stent is released, the near end of the covered stent is released first, the far end of the covered stent is in a contracted state, the covered stent is in a 'pocket' shape, a 'storm' effect is easily formed, the impact of blood flow on the covered stent is increased, the near cardiac end of the covered stent is easily displaced in serious cases, even the interlayer is broken due to stimulation to the inner wall of a blood vessel, and the covered stent is not suitable for ascending aorta with an abnormal and complex current physiological anatomical structure.

The ascending aorta covered stent and conveying system component can sequentially release the distal end covered stent 220 and the proximal bare crown stent 210 step by step, after the outer sheath tube 110 is removed, the distal end covered stent 220 bound by a soft membrane or binding wire with the diameter of 10mm-15mm is released in half, the flexibility is enhanced, the storm effect is reduced, and the safety and the feasibility of the minimally invasive surgery are further improved.

It should be noted that the foregoing is only a preferred embodiment of the present invention and the technical principles applied. It will be understood by those skilled in the art that the present invention is not limited to the particular embodiments described herein, but is capable of various obvious changes, rearrangements and substitutions as will now become apparent to those skilled in the art without departing from the scope of the invention. Therefore, although the present invention has been described in greater detail with reference to the above embodiments, the present invention is not limited to the above embodiments, and may include other equivalent embodiments without departing from the scope of the present invention.

Claims (10)

1. The utility model provides an adjustable return bend for support conveyer, its characterized in that, including flexible section (121), transitional coupling ejector pin (125), back toughness multi-chamber pipe (122) and the adjustment handle that connects gradually, wear to be equipped with two piece at least haulage wires (123) in flexible section (121), whole the head end of haulage wire (123) fixed connection respectively in the different positions department of the inside front end of flexible section (121), whole the afterbody of haulage wire (123) passes respectively different azimuth holes (1251) of transitional coupling ejector pin (125) and be connected to behind back toughness multi-chamber pipe (122) on the adjustment handle turn to the subassembly.

2. The adjustable elbow for a stent transporter according to claim 1, wherein the steering assembly comprises a plurality of bend adjusting sliders (124), the end of each of the pull wires (123) is fixedly connected to one of the bend adjusting sliders (124), and the bend adjusting sliders (124) are configured to retract or release the pull wires (123).

3. The adjustable elbow for stent delivery according to claim 2, wherein the adjustment handle comprises an X-axis direction adjustable bending knob (172) and a Y-axis direction adjustable bending knob (173), and the plurality of bending adjustment sliders (124) are respectively connected to the X-axis direction adjustable bending knob (172) or the Y-axis direction adjustable bending knob (173).

4. The adjustable elbow for stent delivery according to claim 3, wherein the steering assembly comprises four of the bend adjustment sliders (124), two of the bend adjustment sliders (124) are connected to the X-axis direction adjustable bending knob (172), and the other two of the bend adjustment sliders (124) are connected to the Y-axis direction adjustable bending knob (173).

5. The adjustable elbow for stent delivery device according to claim 4, wherein two of the bend adjusting sliders (124) are provided with left-handed external threads, the other two of the bend adjusting sliders (124) are provided with right-handed external threads, and the adjustable bending knob (172) in X-axis direction and the adjustable bending knob (173) in Y-axis direction are both provided with left-handed and right-handed internal threads.

6. The adjustable elbow for a stent transporter according to claim 1, wherein the steering assembly comprises a spur gear (402) and a rack (403) that are engaged, wherein the distal end of each of the pull wires (123) is fixedly connected to one of the racks (403), and wherein the spur gear (402) is configured to drive the rack (403) to move when the spur gear rotates.

7. The adjustable elbow for a stent transporter according to claim 6, wherein the steering assembly comprises two spur gears (402) and four racks (403), and wherein the two racks (403) are respectively engaged with one of the spur gears (402) from opposite sides.

8. The adjustable elbow for a stent transporter according to claim 7, wherein the steering assembly further comprises two rotating handwheels (401), each rotating handwheel (401) being connected to one of the spur gears (402), the rotating handwheels (401) being configured to drive the spur gears (402) in rotation.

9. A stent transporter, comprising an outer sheath tube (110) and a single-cavity inner middle tube (130), characterized by further comprising an adjustable elbow (120) for a stent transporter according to any one of claims 1 to 8, wherein the adjustable elbow (120) is sleeved outside the single-cavity inner middle tube (130) and penetrates inside the outer sheath tube (110).

10. An ascending aorta stent graft and delivery system assembly, comprising a stent graft (200), further comprising the stent delivery device (100) of claim 9, wherein the stent graft (200) in a collapsed state at least partially fits over the adjustable elbow (120) and inside the sheath (110).

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