CN217391376U - Catheter and catheter assembly for assisting implantation of coronary vein CRT (cathode ray tube) - Google Patents

Abstract

The embodiment of the disclosure provides a catheter and a catheter assembly for assisting implantation of a coronary vein CRT, which comprises a base and a catheter body, wherein the catheter body is installed on the base through the near end of the catheter body, the catheter body comprises an inner tube and an outer tube sleeved outside the inner tube, a cavity surrounded by the inner tube is used as a guide wire/infusion cavity, a cavity surrounded by the outer tube and the inner tube is used as a balloon cavity, a balloon and a shaping section capable of adjusting a bending angle are arranged at the far end of the catheter body, the balloon is communicated with the outer tube, and one or more developing marks are arranged at the far end of the catheter body. The coronary vein imaging device can quickly find and enter the coronary sinus in a patient body and temporarily block the coronary veins, achieves the function of coronary vein radiography, can also achieve quick establishment of a coronary sinus channel so as to implant a follow-up pacing electrode, and meanwhile reduces the exchange times of instruments, thereby assisting the operation of implantation of a coronary vein CRT.

Description

Catheter and catheter assembly for assisting implantation of coronary vein CRT (cathode ray tube)

Technical Field

The present disclosure relates to the field of medical devices, and more particularly, to a catheter and catheter assembly for assisting in the implantation of a coronary vein CRT.

Background

The three-cavity cardiac pacemaker implantation is a treatment method for artificially implanting a cardiac pacemaker (CRT/CRT-D), wherein the cardiac pacemaker comprises a pulse generator and an electrode lead, wherein the three-cavity cardiac pacemaker implantation is a treatment method for stimulating the heart by the pulse current with preset parameters generated by the pulse generator and passing through the electrode lead so as to replace a pacing point of the heart and further drive the heart to beat. The three-cavity cardiac pacemaker implantation technology indirectly paces the left ventricle by pacing branches of coronary sinus distributed outside the left ventricle wall so as to recover the synchronization of the left and right ventricular cardiac electrical activities, thereby achieving the purpose of treating the heart failure caused by the asynchrony of the double ventricular electrical activities, which is a safe and effective method for treating irreversible cardiac arrest and heart failure,

before the left ventricular pacing electrode is implanted, firstly, a coronary sinus ostium needs to be searched and a coronary vein channel needs to be established; then, the shape of the blood vessel converged into the coronary sinus vein is determined in a coronary vein angiography mode; finally, the pacing electrode is accurately sent into the branch of coronary vein to indirectly pace the left ventricle, wherein the radiography means that the substance containing the elements with high atomic number is taken in the radiodiagnosis, and then the radiograph is taken at the internal part to be diagnosed in advance to be used for medical diagnosis.

Considering that heart failure patients who need to implant the cardiac pacemaker are critical patients, they have low tolerance to surgery including surgery time. The heart of the implanted cardiac pacing is the key link to find a proper coronary vein branch for placing the left ventricular electrode, but the operation of the current related interventional instruments is difficult, and the obvious defect exists.

One of the current methods requires the use of additional CS electrode catheters, which results in high costs; and for patients with coronary venous sinus ostia abnormalities, CS electrode catheters have difficulty entering the ostia: the CS electrode catheter is of a solid structure, the head end of the CS electrode catheter is fixed in a bent mode, and a guide wire cannot pass through, so that the difficulty of finding the sinus ostia of the coronary veins is greatly increased and even the CS electrode catheter may fail when a patient with sinus ostia of the coronary veins or a valve is encountered or a patient needs to implant a CRT (cathode ray tube) from the right side; thus, excessive instrument exchanges increase the risk of dissection, the operation time is long, and the risk of infection is increased.

The other existing method has the defects that the bent shape is fixed and cannot be adjusted, and the bent shape is unclear in the in-vivo state, so that the operation difficulty of a doctor is increased. The blood vessel is blocked temporarily without a saccule to block the blood flow, the venous blood flows from the branch of the blood vessel to the main branch of the blood vessel, the contrast agent cannot reach the far end of the blood vessel under the impact of the blood flow, the contrast is not clear, if the branch of the blood vessel is complex, the blood vessel needs to be contrasted and selected again, and the uncertainty of the operation is increased; coaxiality is common and can cause vascular dissection. There is also an existing method III: the distal bending shape of the catheter for assisting the implantation of the coronary vein CRT is single: the key point for improving the operation efficiency is that the balloon catheter can be quickly found and enters the coronary venous sinus, and because the positions and the forms of the coronary sinus openings of different patients are different, a single fixed bent type is difficult to adapt to all patients, and the operation efficiency of the patient who is not suitable for the bent type is influenced. The curved balloon catheter cannot be visible in vivo: visualization of the curve in vivo is important to improve the efficiency of the procedure, which helps the physician quickly find the ostium of the coronary sinus. The shaft of the catheter assisting in CRT implantation of the coronary vein cannot support the entry of the sheath into the coronary sinus: a coronary venous access needs to be established prior to CRT implantation for subsequent implantation of pacing electrodes into the target vein. The balloon catheter is of a hollow structure and cannot support the sheath to enter the coronary sinus. Catheters that assist in CRT implantation of the coronary veins do not take into account the problem of potential vessel dissection when accessing the coronary sinus: coronary veins are particularly susceptible to vascular dissection, and catheter tips are generally relatively stiff and cannot be made very flexible. The catheter for assisting the CRT implantation of the coronary veins can solve the problem of coronary vein radiography, but does not solve the problem of facilitating the rapid implantation of the pacing electrode after the radiography. Because the target vein implanted by the pacing electrode belongs to a branch vein, the inner diameter of the vein is smaller, the target vein of part of patients has serious tortuosity, the pacing electrode is difficult to be placed in the target vein, aiming at the patients with the type, the implantation of the pacing electrode needs to be completed by other instruments additionally, the instrument exchange is increased, and the operation time is prolonged.

SUMMERY OF THE UTILITY MODEL

It is an object of the disclosed embodiments to provide a catheter and a catheter assembly for assisting in the implantation of a coronary vein CRT, which solves the problems in the prior art. In order to solve the technical problem, the embodiment of the present disclosure adopts the following technical solutions:

the embodiment of the disclosure provides a catheter for assisting implantation of a coronary vein CRT, which comprises a base and a catheter body, wherein the catheter body is installed on the base through a near end of the catheter body, the catheter body comprises an inner tube and an outer tube, the outer tube is arranged outside the inner tube in a sleeved mode, a cavity formed by the inner tube is used as a guide wire/infusion cavity, the cavity formed by the outer tube and the inner tube is used as a balloon cavity, a balloon and a shaping section capable of adjusting a bending angle are arranged at the far end of the catheter body, the balloon is communicated with the outer tube, and one or more developing marks are arranged at the far end of the catheter body.

In some embodiments, two ports are provided on the base, a guidewire/infusion port for threading a guidewire or injecting contrast media and a balloon inflation port for inflating/deflating a balloon.

In some embodiments, the plastic section has a hardness less than a hardness of other portions of the tubular body.

In some embodiments, the shaping segment is made of an elastomeric polymer material.

In some embodiments, the development indicia is disposed on the shaping segment.

In some embodiments, at least three visualization markers are provided on the plastic section, and the position of the distal end of the tube can be quickly determined by providing more than three visualization markers.

In some embodiments, the development mark has a positioning function.

The disclosed embodiment provides a catheter assembly, which comprises a catheter for assisting CRT implantation in coronary veins and at least one guide wire in any one of the above technical schemes,

in some embodiments, the number of guide wires is multiple.

In some embodiments, the guidewire has a hydrophilic coating.

The disclosed embodiment can quickly find and enter the coronary sinus in a patient body through the catheter with the auxiliary coronary vein CRT implantation for realizing the visual plastic section, can temporarily block the coronary vein through the balloon expansion on the catheter, and realizes the function of coronary vein radiography through injecting contrast medium from a guide wire/infusion cavity. In addition, utilize the support of carrying many seal wires in order to increase the seal wire simultaneously in the cavity of body the seal wire with under the dual support effect of body, can easily send into the coronary vein with the sheath pipe to realize the implantation of the quick establishment of coronary vein sinus passageway so that follow-up pacing electrode, reduce the exchange number of times of apparatus simultaneously, thereby supplementary coronary vein CRT implants's operation.

Drawings

In order to more clearly illustrate the embodiments of the present disclosure or the technical solutions in the prior art, the drawings needed to be used in the description of the embodiments or the prior art will be briefly introduced below, it is obvious that the drawings in the following description are only some embodiments described in the present disclosure, and for those skilled in the art, other drawings can be obtained according to the drawings without creative efforts.

Fig. 1 is a schematic structural view of a catheter for assisting CRT implantation in coronary veins according to an embodiment of the present disclosure;

fig. 2 is a schematic structural view of a catheter for assisting CRT implantation in coronary veins according to an embodiment of the present disclosure;

FIG. 3 is a schematic structural view of a catheter for assisting CRT implantation in coronary veins according to an embodiment of the present disclosure;

FIG. 4 is a schematic structural view of a catheter for assisting CRT implantation in coronary veins according to an embodiment of the present disclosure;

fig. 5 is a schematic structural diagram of a catheter for assisting CRT implantation in coronary veins according to an embodiment of the present disclosure.

Reference numerals:

1-a base; 2-a pipe body; 21-an inner tube; 22-an outer tube; 23-guidewire/infusion port; 24-balloon inflation port; 25-a shaping section; 26-an outlet; 27-side tube; 3-a balloon; 4-development marking; 5-strain relief boot.

Detailed Description

Various aspects and features of the disclosure are described herein with reference to the drawings.

It will be understood that various modifications may be made to the embodiments of the present application. Accordingly, the foregoing description should not be considered as limiting, but merely as exemplifications of embodiments. Other modifications will occur to those skilled in the art within the scope and spirit of the disclosure.

The accompanying drawings, which are incorporated in and constitute a part of the specification, illustrate embodiments of the disclosure and, together with a general description of the disclosure given above, and the detailed description of the embodiments given below, serve to explain the principles of the disclosure.

These and other characteristics of the present disclosure will become apparent from the following description of preferred forms of embodiment, given as non-limiting examples, with reference to the attached drawings.

It should also be understood that, although the present disclosure has been described with reference to some specific examples, a person of skill in the art shall certainly be able to achieve many other equivalent forms of the disclosure, having the characteristics as set forth in the claims and hence all coming within the field of protection defined thereby.

The above and other aspects, features and advantages of the present disclosure will become more apparent in view of the following detailed description when taken in conjunction with the accompanying drawings.

Specific embodiments of the present disclosure are described hereinafter with reference to the accompanying drawings; however, it is to be understood that the disclosed embodiments are merely exemplary of the disclosure that may be embodied in various forms. Well-known and/or repeated functions and structures have not been described in detail so as not to obscure the present disclosure with unnecessary or unnecessary detail. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching one skilled in the art to variously employ the present disclosure in virtually any appropriately detailed structure.

The specification may use the phrases "in one embodiment," "in another embodiment," "in yet another embodiment," or "in other embodiments," which may each refer to one or more of the same or different embodiments in accordance with the disclosure.

The disclosed embodiments relate to a catheter for assisting CRT implantation of coronary veins as a component of a catheter assembly for performing interventional therapy, which is suitable for use in the whole procedure of pacemaker implantation, and which can be used for finding a sinus ostium of a coronary vein, establishing a coronary vein passageway, performing coronary angiography, accessing a target vein, etc. during the procedure of pacemaker implantation.

As shown in fig. 1 and 2, the catheter includes a base 1 and a tube 2, the base 1 includes a main body having a cavity, and a distal end of the tube 2 needs to be maximally inserted into a patient when the catheter is used during a surgical procedure. Wherein, the base 2 is convenient for a user to hold the catheter for performing a surgical operation, the tube 2 is mounted on the base 1 through a proximal end thereof, which is an end portion for connecting with the base 1.

Further, as shown in fig. 3 and 4, set up on the base 1 body 2 is two cavity structures, and it includes that inner tube 21 and cover establish the outer tube 22 in the inner tube 21 outside is located the inboard the cavity that inner tube 21 encloses is as seal wire/transfusion cavity, and seal wire and/or contrast medium can reach the operating position in the patient through seal wire/transfusion cavity, outer tube 22 with the cavity that inner tube 21 encloses is as the sacculus chamber, the sacculus chamber is used for filling the gassing operation to the sacculus realization.

In addition, in order to facilitate the tube body 2 to be able to extend into the patient, the tube wall of the tube body 2 may be provided with a braided layer to enhance the rigidity of the tube body 2.

In order to ensure the connection between the inner tube 21 and the outer tube 22 and the base 1, an outlet 26 and two ports are provided on the base 1, as shown in fig. 4, a guide wire/infusion port 23 for the passage of a guide wire or the injection of a contrast agent and a balloon inflation port 24 for inflating/deflating the balloon. Further, both of these ports may be connected to a locking fitting having a standard luer internal taper configuration to facilitate connection to other devices, for example, the guidewire/infusion port 23 may be connected to a contrast supply via a fitting and the balloon inflation port 24 may be connected to a gas supply via a fitting. In order to realize that the base 1 is provided with two ports, a side tube 27 can be further arranged on the base 1, the bottom of the base 1 is provided with a guide wire/transfusion port 23, and one end of the side tube is provided with a balloon filling port 24.

In one embodiment, the inner tube 21 and the outer tube 22 respectively extend into the cavity of the base 1 and are fixedly connected with the inner wall of the cavity; the connection site of the outer tube 22 to the base 1 is close to the outlet 26, the connection site of the inner tube 21 to the base is close to the guide wire/infusion port 23, and the position where the side tube 27 communicates with the base 1 is located between the connection sites of the outlet 26 and the inner tube 21. Specifically, the inner tube 21 and the outer tube 22 extend into the cavity of the base 1, and the proximal ends of the inner tube 21 and the outer tube 22 are fixedly connected with different positions in the base 1, so that the guide wire/infusion port 23 and the balloon filling port 24 are communicated with different cavities in the tube body 2. The proximal ends of the inner tube 21 and the outer tube 22 and the different positions in the base 1 can be fixedly connected by gluing or the like. In addition, one end of the guide wire/infusion port 23 is in the shape of a luer cone; one end of the balloon inflation port 24 is in the shape of a luer taper. Furthermore, a strain relief sleeve 5 is provided between the base 1 and the tube body 2, so that the connection between the base 1 and the tube body 2 is tighter.

In order to facilitate the connection of the port with other components, the outer wall of the guide wire/infusion port 23 is provided with a locking rib; the outer wall of the balloon filling port 24 is provided with a locking ridge.

Further, with continued reference to fig. 1 and 2, to achieve clear coronary angiography at a predetermined location within the patient's body, a balloon 3 is provided at the distal end of the tubular body 2, the balloon 3 being in communication with the outer tube 22 and being inflated by gas through the outer tube 22, where the balloon 3 is a balloon-like structure that can be expanded by pressure into a shape (e.g., a prolate spheroid shape). The balloon 3 is also a compliant balloon, that is, after the balloon 3 is expanded to a predetermined diameter and the like, the diameter, the volume and the like of the balloon can be continuously increased along with the structure of the blood vessel along with the increase of the filling pressure, so that the balloon 3 can realize the function of temporarily blocking the blood vessel after the gas is filled, the blood backflow at the far end of the blocking part is blocked, and the developing operation of coronary sinus branches is further facilitated.

Specifically, the balloon 3 may be wrapped around the outlet of the balloon inflation lumen at the distal end between the inner tube 21 and the outer tube 22; or a through hole may be formed in the side wall of the outer tube 22 to communicate the balloon filling cavity between the inner tube 21 and the outer tube 22 with the space inside the balloon 3, and at this time, the balloon filling cavity between the inner tube 21 and the outer tube 22 is closed at the outlet at the distal end, so as to prevent the gas or liquid for expanding the balloon from entering the body of the patient.

As shown in fig. 1 and 2, a bending angle adjustable shaping section 23 is provided at a distal end of the tube body 2, where the distal end is an end of the tube body 2 opposite to the proximal end; the plastic segment can facilitate the tube body 2 to enter the coronary sinus, and particularly for patients with coronary sinus position variation, the bending angle of the plastic segment can be adjusted appropriately to quickly find the coronary sinus ostium. Like this, through setting up the flexible moulding section can provide the selection of more bending angles for the doctor, and the doctor can carry out certain degree's adjustment to the degree of bending according to the characteristics of patient's coronary sinus, makes the terminal coronary sinus mouth that reaches more easily of body 2.

Furthermore, in order to allow the bending angle of the shaping segment 25 to be adjusted freely, the stiffness of the plastic segment is less than the stiffness of other parts of the tubular body 2, especially the proximal part, so that the orientation of the shaping segment 25 can be adjusted by twisting the proximal tubular body of the tubular body 2 so that the plastic segment 23 at the distal end of the tubular body 2 can be quickly directed to the ostium of the coronary sinus by manipulation at the proximal end of the tubular body 2.

Further, the shaping section 23 may be made of an elastomer polymer material, for example, a high molecular polymer material (such as Pebax) to achieve the shaping function. After being deformed, the material has certain shape retention performance and elasticity within a certain range. After the doctor manually shapes, the bent shape after shaping cannot be completely destroyed in the process of entering the blood vessel because the material has certain elasticity. Because the memory alloy can be shaped only at 500 ℃, the product made of the memory alloy can not be reshaped by a doctor before clinical use, and only the bent shape of the product can be utilized for operation

Further, as shown in fig. 5, one or more developing marks 4 are arranged at the far end of the tube body 2, and the developing marks 4 can be arranged on the outer wall of the inner tube 21, so that the developing effect can be achieved, and the developing marks 4 can be prevented from falling off or scraping the inner wall of the lumen of the patient. The development marker 4 may be a marker detectable by X-ray, and the development marker 4 may be a development marker ring, and development can be performed at various angles by using the development marker 4. While controlling the outer diameter of the visualization marker ring to be smaller than the inner diameter of the outer tube 22 so that the filling of the balloon 3 with gas or liquid is not hindered.

In another embodiment, each of the development marks 4 may include a plurality of sub-marks, for example, each of the development marks 4 may be cut into 3 sub-marks, and adjacent sub-marks are connected by a connection line, so as to accurately obtain the position in the catheter.

In another embodiment, for example, in the case of maintaining the same hardness of the same section of the pipe, the development mark 4 may be a special-shaped mark, and the special-shaped mark is configured to distinguish the first, middle and end sections thereof, so as to achieve the effect of multiple marks.

Preferably, the spacing between adjacent ones of the development icons 4 is equal. Thus, the degree of bending of the distal end of the catheter 2 can be ensured to be visible by arranging the developing mark, and the doctor can conveniently and quickly determine the actual pointing direction of the catheter body 2 in the body. In addition, the equal intervals of the developing indicators 4 can provide a certain measuring function, and better assist an operator in operation. The number of the developed markers 4 is preferably 3 to 10, more preferably 5 to 8.

Preferably, the developing marks 4 are provided on the shaping segment, so that a state of a body curvature can be clearly displayed.

Further, at least three visualization markers 4 may be provided on the plastic segment, by which three or more visualization markers 4 the position of the distal end of the tube body 2 can be quickly determined. The doctor can realize the positioning function of three positions according to the positions of the three developing marks 4, thereby determining the position of the far end of the tube body 2 in the body of the patient and accurately delivering the electrode to the position of the sinus ostium of the coronary vein.

Specifically, considering that three non-collinear points can define a plane, when three of the development marks 4 are disposed on the shaping section, it is certain that the plane on which the curved shape of the shaping section is located can be determined. Thus, when the catheter is rotated and manipulated so that the tip end just enters the sinus ostium of the coronary vein, the plane of the curved shaped segment is uniquely determined with respect to the position of the heart, and the doctor observes three points of the visualized mark 4in the determined position by x-ray, that is, the three points are determined. That is, as long as the posture of the doctor observed each time of the operation is not changed, the doctor only needs to remember the relative positions and changes of the three visualization marks 4 before and after the last operation catheter enters the coronary sinus ostium, and can determine whether the next operation catheter points to the coronary sinus ostium or not according to the states of the visualization marks 4.

In one embodiment, the development mark 4 may further have a positioning and communication function, and a GPS module and a communication module, for example, may be disposed in any manner in the development mark 4, and the coordinate position of the development mark 4 may be transmitted through the GPS module and the communication module. The doctor can more accurately obtain the position of the distal end of the tube body 2 through calculation by acquiring the coordinate position of the development mark 4 through, for example, a mobile terminal.

Often set up a small amount of development marks on the body and can't provide the curved real state in vivo, can only see the projection of curved type under certain position, and through more than three development marks 4, the doctor can be according to the shape change and the relative position of development mark 4 can accurately judge the actual state of curved type in vivo, can also accurately acquire the three-dimensional position coordinate of coronary vein sinus ostium. Secondly, a certain measuring effect can be realized by arranging more than three developing marks 4, so that a doctor can conveniently judge the depth of the catheter inserted into the coronary vein. Thus, a doctor can judge the actual state of the plastic section 23 in the body according to the shape change of the visualization marker 4 and the relative position of the visualization marker 4, and the doctor can conveniently judge the depth of the catheter inserted into the coronary vein.

The coronary sinus can be quickly found and enters the coronary sinus in a patient body through the catheter with the visual plastic section, the coronary vein can be temporarily blocked through balloon expansion on the catheter, and the coronary vein radiography function is realized through injecting contrast medium from a guide wire/infusion cavity.

A second embodiment of the present disclosure is directed to a catheter assembly comprising a catheter according to any of the embodiments above and at least one guide wire having a hydrophilic coating, said guide wire extending into said inner tube 21, e.g. through a guide wire/infusion port, to reach a surgical site. For example, one or two 0.014inch guide wires can be fed into the guide wire/infusion lumen.

In particular, under the cooperation of a guide wire with a hydrophilic coating and a catheter, the coronary sinus ostium is reached in advance through the guide wire, and the coronary sinus is easier to enter than the catheter due to the thinner and softer head end of the guide wire, and a deeper position of the coronary vein can be reached. Therefore, under the matching of the catheter and the guide wire, the catheter is guided by the guide wire, and the influence of a coronary venous sinus valve can be avoided by utilizing the characteristic of soft far end of the guide wire.

The catheter can also avoid the risk of vascular dissection when entering the coronary venous sinus, particularly, after the guide wire enters the guide wire/transfusion cavity of the catheter, the guide wire/transfusion cavity is filled, and the catheter and the guide wire form a solid structure in a combined mode, so that the support performance of the catheter is greatly improved, the sheath can be easily led into the coronary venous sinus, vascular dissection is not easy to occur, and the operation risk is reduced.

In addition, the catheter assembly provided by the embodiment of the disclosure can be used for conveying a plurality of guide wires, the success rate of implanting the pacing electrode into the plurality of guide wires is higher than that of implanting the pacing electrode into a single guide wire, and the support performance is better, for example, the guide wire with lower hardness can be used for penetrating into the left ventricle electrode, and the other guide wire with higher hardness is used for reinforcing the rigidity of the first guide wire, so that the two guide wires straighten a tortuous blood vessel, the left ventricle electrode can be advanced in the tortuous blood vessel, and the pacing electrode can be conveniently and subsequently placed into a target vein through the guide wires under the condition that the target blood vessel is tortuous or complicated in shape. The catheter can be used for containing two guide wires of 0.014inch, for example, aiming at the situation that a pacing electrode is difficult to implant into a part of target veins, the catheter can directly place the double guide wires into the target veins, the application of the double guide wires is beneficial to improving the passing capacity of the pacing electrode, the pacing electrode is quickly placed into the target veins, the operation time is saved, and the operation success rate is improved.

In addition, because the body is hollow structure, and the support nature is not enough to support the sheath alone and get into coronary vein sinus mouth, this disclosed embodiment utilize under the prerequisite of the body support nature of pipe the support of many seal wires in order to increase the seal wire is carried simultaneously in the cavity of body the seal wire with under the dual support effect of body, can easily send the sheath into coronary vein to realize the implantation of following pacing electrode of quick the setting up of coronary vein sinus passageway, reduce the exchange number of times of apparatus simultaneously.

The catheter body can well enter a sinus orifice by conveying double guide wires into a patient body, the catheter body can further penetrate into a blood vessel, so that a branch blood vessel is imaged, and meanwhile, because the balloon is small in size, although one blood flow is blocked during imaging, the branch blood vessel at the other end of the balloon can be filled with blood through other blood vessels, and the blood flow at the two ends of the balloon is not hindered.

The embodiment of the invention has simple operation, can realize clear radiography, has good coaxiality, reduces interlayer risk, reduces the operation cost, reduces instrument exchange and saves the operation time.

The following describes a standard procedure for using the catheter assembly of the above-described embodiment in a cardiac pacemaker implantation procedure:

(1) local anesthesia is carried out on a patient, then the completeness of the catheter assembly needs to be detected in the step, 0.5ml of air is pushed through an injector to fill the balloon 3, whether the balloon 3 leaks air or not is checked, heparin saline is used for flushing the guide wire/infusion cavity, an ultra-smooth guide wire is sent into the guide wire/infusion cavity along the guide wire/infusion cavity, so that the smoothness of the guide wire/infusion cavity is detected, and the ultra-smooth guide wire is pushed into the tube body 2 for 1-2cm for standby.

(2) The method comprises the steps of using a long guide wire, sending the long guide wire into a long sheath of a cardiac pacemaker, then sending the long guide wire into a catheter along the long sheath, keeping the ultra-smooth guide wire at the front all the time in the process of sending the catheter into a patient body, roughly judging the position of an opening of a coronary sinus by using the radian and the toughness of a pipe body 2, sending the ultra-smooth guide wire to the far end of the coronary sinus, judging the main branch of the coronary sinus by the shape of a first guide wire, sending the catheter to the deep part of the coronary sinus along the ultra-smooth guide wire, and sending the long sheath of the cardiac pacemaker to the deep part of the coronary sinus under the double support of the ultra-smooth guide wire and the catheter.

(3) Withdraw from the super smooth seal wire, through seal wire/transfusion cavity transport shadow agent, confirm again the pipe is located coronary sinus owner to preliminary judgement vessel diameter and subsequent the aerifing size of sacculus 3 pushes away air 0.3-0.5ml through the syringe, fills up sacculus 3 is paid attention to not aerifing too much so as to avoid causing sacculus 3 excessively expands and arouses rupture or damage blood vessel, treats after sacculus 3 is aerifyd, through seal wire/transfusion cavity continuously pushes the contrast medium, carries out retrograde coronary sinus radiography under oblique 30 and positive and left front 45's angle in right front, finally judges out the position of target blood vessel. In this process, if the target vessel is not clearly displayed, the inflation amount can be adjusted, the inflation size of the balloon 3 can be changed, or the catheter can be advanced and retracted to change the position of the balloon 3 for re-imaging until a satisfactory target vessel image is obtained.

(4) The method comprises the steps of flushing a guide wire/infusion cavity by using heparin saline, feeding two PCI guide wires along the guide wire/infusion cavity, adjusting the directions of the PCI guide wires according to the image of a target blood vessel, finally feeding the two PCI guide wires into the target blood vessel, withdrawing the catheter, and feeding a left ventricular electrode into a patient body along the PCI guide wires. It is important to emphasize here that the delivery of two such PCI guide wires into the target vessel is important to aid in determining the diameter of the target vessel sufficient to pass the left ventricular electrode on the one hand, and to provide sufficient support for the left ventricular electrode to pass through.

(5) For different opening directions of blood vessels, for example, the angle between the target blood vessel and the main branch of coronary sinus is small, and at the moment, two PCI guide wires are placed; if the main branch angle of the target vessel and the coronary sinus is larger, the so-called back bend, the PCI guide wire or the left ventricular electrode can be more easily fed by the adjustable bending sheath; if the target vessel is close to the coronary sinus ostium, the strategy of anchoring a PCI guide wire (with higher rigidity) in the great cardiac vein, delivering another PCI guide wire (with lower rigidity) into the target vessel, and then withdrawing the guide wire of the great cardiac vein into the target vessel can reduce the operation time and the complexity of operation. When the inner diameter of the target blood vessel is larger, the catheter can be sent into the target blood vessel to directly exchange two PCI guide wires; the target blood vessel has a small inner diameter and can be fed into two PCI guide wires.

(6) The atrial and right ventricular electrodes are placed according to the standard procedure described above, ending the pacemaker implantation procedure.

Further, while operations are depicted in a particular order, this should not be understood as requiring that such operations be performed in the particular order shown or in sequential order. Under certain circumstances, multitasking and parallel processing may be advantageous. Likewise, while several specific implementation details are included in the above discussion, these should not be construed as limitations on the scope of the disclosure. Certain features that are described in the context of separate embodiments can also be implemented in combination in a single embodiment. Conversely, various features that are described in the context of a single embodiment can also be implemented in multiple embodiments separately or in any suitable subcombination.

Although the subject matter has been described in language specific to structural features and/or methodological acts, it is to be understood that the subject matter defined in the appended claims is not necessarily limited to the specific features or acts described above. Rather, the specific features and acts described above are disclosed as example forms of implementing the claims.

While the present disclosure has been described in detail with reference to the embodiments, the present disclosure is not limited to the specific embodiments, and those skilled in the art can make various modifications and alterations based on the concept of the present disclosure, and the modifications and alterations should fall within the scope of the present disclosure as claimed.

Claims (10)

1. The utility model provides a pipe of supplementary coronary vein CRT implantation, its includes base and body, the body is installed through its near-end on the base, the body includes that inner tube and cover establish the outer tube in the inner tube outside, the cavity that the inner tube encloses is as seal wire infusion chamber, the outer tube with the cavity that the inner tube encloses is as the sacculus chamber, its characterized in that the distal end of body sets up sacculus and adjustable bending angle's moulding section, the sacculus with the outer tube is linked together the distal end of body sets up one or more development mark.

2. The catheter of claim 1, wherein two ports are provided on the base, a guidewire/infusion port for threading a guidewire or injecting contrast media and a balloon inflation port for inflating/deflating a balloon.

3. The catheter of claim 1, wherein the shaped section has a hardness that is less than a hardness of other portions of the tube.

4. The catheter of claim 1, wherein the shaping segment is made of an elastomeric polymer material.

5. The catheter of claim 1, wherein the visualization indicia is disposed on the shaping segment.

6. The catheter of claim 5, wherein at least three visualization markers are provided on the shaping segment, and wherein the position of the distal end of the tube can be quickly determined by providing more than three visualization markers.

7. The catheter of claim 6, wherein the visualization marker has a locating function.

8. A catheter assembly comprising the catheter of any one of claims 1-7 and at least one guide wire.

9. The catheter assembly of claim 8, wherein the number of guide wires is multiple.

10. The catheter assembly of claim 8, wherein the guidewire has a hydrophilic coating.

Images