CN217611357U

CN217611357U - Alcohol ablation catheter and adjustable bending conveying system with mapping electrode thereof

Info

Publication number: CN217611357U
Application number: CN202121129093.XU
Authority: CN
Inventors: 廖洪涛; 杨洋; 宋亚东
Original assignee: Shenzhen Huitai Medical Equipment Co ltd
Current assignee: Shenzhen Huitai Medical Equipment Co ltd
Priority date: 2021-05-25
Filing date: 2021-05-25
Publication date: 2022-10-21
Anticipated expiration: 2031-05-25

Abstract

The utility model discloses an alcohol ablation catheter and adjustable curved conveying system who takes mark mapping electrode thereof, the technical problem that solve reduce the degree of difficulty that the catheter got into coronary vein. The utility model discloses a first pipe distal end is equipped with end electrode and diplopore pipe, and the pipe wall of diplopore pipe is opened porosely, is L shape at the diplopore pipe distal end of free state, and there is first ring electrode on the surface, is provided with alcohol ablation pipe, is equipped with second pipe and separated time joint from the distal end to the near-end, and separated time joint connection has inflation valve, and second pipe wall has second ring electrode outward, and the sacculus, second pipe distal end stretch out the hole. Compared with the prior art, the utility model, first pipe distal end gets into coronary sinus mouth more easily, and first pipe distal end is opened porosely for the injection contrast medium can also melt the easier Marshall vein of carrying of pipe with alcohol, makes second ring electrode paste with coronary sinus inner wall and closely, and electrophysiological signal gathers stably, makes things convenient for the operation, reduces the use quantity of pipe when performing the operation, improves operation efficiency.

Description

Alcohol ablation catheter and adjustable bending conveying system with mapping electrode thereof

Technical Field

The utility model relates to a medical surgical instrument, especially a conveyor that is used for carrying alcohol to the heart coronary vein and melts pipe, injection contrast medium and go on the mark survey to the coronary vein in order to melt in order to treat atrial fibrillation to Marshall ligament.

Background

Atrial fibrillation (atrifibrillation) is the most common type of tachyarrhythmia in clinic, and is not only aggravated with age but also increased in death rate when patients are complicated by other cardiovascular diseases. With the development of intracardiac electrophysiology and catheter ablation methods, people are gradually aware that the Marshall Ligament (LOM) is closely related to atrial arrhythmia, and the influence is particularly significant in the branch Marshall vein of the coronary sinus because a complex neural network consisting of a large number of autonomic nerves exists in the coronary sinus and is communicated with the adjacent epicardial nerve plexus, so that the electrical activity conduction reentry of the coronary sinus and the left and right atria and the conduction delay of the coronary sinus and the coronary sinus are closely related to the formation of atrial fibrillation. The Marshall vein gradually degenerates along with the development of the fetal heart, and forms a ligament in an occlusion way, namely the Marshall ligament, the included venules (Marshall vein) and the myocardial fibers (Marshall bundle) of the Marshall ligament originate from the muscle tissue at the near end of the coronary sinus and can be obliquely inserted into the back wall of the left auricle, the left superior pulmonary vein or the free wall of the left atrium, and the connection forms an anatomical matrix formed by the back-turning excitation. It has been found that Marshall veins can produce autonomous electrical activity, and that stimulation of Marshall ligaments can easily induce local electrical activity and thus atrial fibrillation, while ablation of Marshall veins can abolish such electrical activity. In mitral isthmus-mediated atypical atrial flutter, the Marshall ligament can be a valid target when isthmus ablation is ineffective.

In the alcohol ablation catheter delivery structure in the prior art, the far end is straight, and the coronary vein into which the alcohol ablation catheter is to enter is narrow and bent and is difficult to enter smoothly, so that the difficulty in entering the coronary vein is high, the success of entering the coronary vein can be realized by the personal technology of an operating doctor, the alcohol ablation catheter delivery structure is single in function, the alcohol ablation catheter delivery structure only has the function of delivering the alcohol ablation catheter, and the rest of the alcohol ablation catheter delivery structure needs to be realized by a plurality of catheters together with the injection of a contrast agent and the mapping function.

Disclosure of Invention

The utility model aims at providing an alcohol ablation catheter and take adjustable curved conveying system of mark mapping electrode thereof, the technical problem that solve reduces the degree of difficulty that the catheter got into coronary vein, improves operation efficiency.

The utility model adopts the following technical scheme: an alcohol ablation catheter and an adjustable bending conveying system with a mapping electrode are provided with a first catheter, wherein the first catheter is provided with a terminal electrode and a double-hole tube which are sequentially connected from the far end, the tube wall of the double-hole tube is provided with holes, the double-hole tube has elasticity, the far end of the double-hole tube is L-shaped in a free state, at least three groups of annular first ring electrodes are sleeved on the surface of the double-hole tube at intervals, and each group of two first ring electrodes are sleeved on the surface of the double-hole tube; an alcohol ablation catheter is arranged in the adjustable bending conveying system with the mapping electrode, a second catheter and a branching joint which are sequentially connected are arranged on the alcohol ablation catheter from the far end to the near end, the near end of the branching joint is connected with an inflation valve, second ring electrodes are sleeved outside the wall of the second catheter at intervals, a balloon is sleeved between the two second ring electrodes at the far end, and an inflation pipe, an alcohol and guide wire conveying pipe are arranged in the second catheter; the far end of the inflation tube is hermetically connected with the balloon, and the near end of the inflation tube is connected with an inflation valve; the distal end of the second catheter extends out of the bore.

The utility model discloses a second pipe is equipped with the second pipe shaft, and second ring electrode has been put to the outer interval cover of second pipe shaft pipe wall, and the sacculus has been put to second pipe shaft pipe wall overcoat between two second ring electrodes of farthest end.

The utility model discloses a first pipe is connected with luer connector through the handle device, the distal end of alcohol and seal wire conveyer pipe to the distal end of second pipe shaft, near-end and standard luer connector connection.

The utility model discloses a standard luer connector is connected with the hose, and the hose setting is in first pipe and handle device.

The utility model discloses a diplopore pipe is bent to make it be the opening cyclic annular, and the plane that the opening cyclic annular constitutes is 0 ~ 90 degree contained angles with first pipe axis, forms the structure of the curved type in space.

The utility model discloses a termination electrode distal end tip shape is the hemisphere, and spherical arc surface is towards the distal end.

The utility model discloses a diplopore pipe is the tubulose, is equipped with first lumen and second lumen, and first lumen and second lumen are the through-hole, and the axis of first lumen and second lumen is parallel with the axis of diplopore pipe, the hole is located the pipe wall of first lumen side, distance the 10 ~ 64mm of end electrode distal end.

The utility model discloses a second pipe shaft distal end tip is the hemisphere.

The sacculus of the utility model adopts latex, rubber or nylon.

The double-hole pipe of the utility model adopts block polyether amide resin, polyurethane, block polyamide or nylon. Compared with the prior art, first pipe distal end is equipped with the hole, end electrode and first ring electrode, the curved type of diplopore pipe distal end is spatial state, specially to the curved type of coronary sinus shape, make first pipe distal end get into coronary sinus mouthful more easily, open porosely in first pipe distal end side direction, can be used to inject the contrast medium, can also melt the easier transport of pipe with alcohol and advance Marshall vein, make second ring electrode paste with coronary sinus inner wall and lean on closely, electrophysiological signal gathers stably, make things convenient for the operation, reduce the use quantity of pipe when performing the operation, reduce patient's economic burden, make the operation safe swift more, greatly increased the validity and the operability of operation, reduce the operation degree of difficulty, improve operation efficiency.

Drawings

Fig. 1 is a schematic structural diagram of the present invention.

Fig. 2 is a schematic view of the structure of the distal end of the catheter of the present invention.

Fig. 3 is a schematic structural view of the bent catheter tube of the present invention.

Fig. 4 is a schematic view (one) of the bent type of the dual-hole tube of the present invention.

Fig. 5 is a schematic view (ii) of the bent dual-hole tube of the present invention.

Fig. 6 is a schematic structural view of the double-hole tube of the present invention.

Fig. 7 is an axial sectional view of the catheter shaft of the present invention.

Fig. 8 is a schematic structural view of the handle device of the present invention.

Fig. 9 is a schematic view of the structure of the alcohol ablation catheter of the present invention.

Fig. 10 is a schematic view of the structure of the distal end of the alcohol ablation catheter of the present invention.

Figure 11 is a schematic view of the side hole extension of the delivery catheter of the alcohol ablation catheter of the present invention.

Fig. 12 is a schematic view of the structure of the side hole extending out of the distal end of the delivery catheter of the alcohol ablation catheter of the present invention.

Detailed Description

The present invention will be described in further detail with reference to the accompanying drawings and examples.

As shown in fig. 1, the alcohol ablation catheter and the adjustable bending conveying system with the mapping electrode of the alcohol ablation catheter of the utility model are composed of two parts of the alcohol ablation catheter and the conveying catheter of the alcohol ablation catheter, the conveying catheter of the alcohol ablation catheter is provided with the alcohol ablation catheter for the adjustable bending conveying system with the mapping electrode, and the adjustable bending conveying system with the mapping electrode is provided with the alcohol ablation catheter.

The adjustable bending conveying system with the mapping electrode is provided with a first catheter 2 and a handle device 1 which are connected in sequence from the far end to the near end, and the near end of the handle device 1 is connected with a connector 7 and a luer joint 8.

A hose 44 is connected to the standard luer fitting 8, the hose 44 being arranged within the first conduit 2 and the handle device 1.

The first catheter 2 is provided with a tip electrode 3, a double-hole tube 4 and a first tube body 5 which are connected in sequence from the distal end. The wall of the double-hole pipe 4 is provided with holes 6.

As shown in fig. 2, the distal end of the tip electrode 3 is hemispherical, and the spherical arc surface faces the distal end, and the proximal end of the tip electrode 3 is embedded and connected to the distal end of the double-hole tube 4 by using the thermal fusion process method in the prior art. The length of the end electrode 3 is 0.3-5 mm, preferably 1-4 mm, and the outer diameter of the end electrode 3 is the same as that of the diplopore tube 4. The terminal electrode 3 is made of platinum-iridium alloy or gold.

The double-hole tube 4 is tubular, and two lumens are disposed therein, namely a first lumen 41 and a second lumen 42. The first lumen 41 and the second lumen 42 are through holes, and the axes of the first lumen 41 and the second lumen 42 are parallel to the axis of the double-hole tube 4 and are communicated with the inner cavity of the first tube body 5.

The outer diameter of the double-hole tube 4 is 1 to 3.7mm, preferably 1.6 to 2.7mm, the length is 20 to 200mm, preferably 50 to 100mm, the inner diameter of the first tube cavity 41 is 0.3 to 1.5mm, preferably 0.75 to 0.85mm, and the inner diameter of the second tube cavity 42 is 0.2 to 1.4mm, preferably 0.6 to 0.7mm.

The hole 6 is located on the tube wall of the first tube cavity 41 side of the double-hole tube 4, the diameter is 0.3-3 mm, preferably 1-2 mm, and the distance between the hole 6 and the far end of the end electrode 3 is 10-64 mm.

The double-hole pipe 4 is made of block polyether amide resin PEBAX, polyurethane, block polyamide or nylon and has elasticity, so that the bending degree of the double-hole pipe 4 can be adjusted through the handle device 1.

In the free state, the distal end of the double-hole tube 4 is L-shaped, as shown in fig. 4.

As shown in fig. 3 and 5, the bending degree of the double-hole pipe 4 is adjusted to be in an open ring shape, and a plane formed by the open ring shape forms an included angle of 0 to 90 degrees with the axis of the first conduit 2, so that a space bending structure is formed.

At least three groups of annular first ring electrodes 43 are sleeved on the surface of the double-hole tube 4 at intervals, each group of two first ring electrodes are provided, the inner diameter of each first ring electrode 43 is 0.33-4 mm, preferably 1-3 mm, the outer diameter is 0.38-4.05 mm, preferably 1.05-3.05 mm, the width is 0.2-4 mm, preferably 1-3 mm. The ring electrode 3 adopts platinum iridium alloy or gold.

The inner side of the first ring electrode 3 is connected with a first lead wire which is electrically connected with the connector 7 through the first lumen 41, the first tube body 5 and the handle device 1. The first wire is a copper wire with a diameter of 0.01-0.5 mm, preferably 0.1-0.2 mm. The copper wire is coated with a coating layer, and the insulating strength of the coating layer is not lower than 500V, preferably not lower than 2000V.

The proximal end of the terminal electrode 3 is welded with a stay wire steel wire 9, and the stay wire steel wire 9 is connected with the handle device 1 through the second lumen 42 and the first tube body 5.

As shown in fig. 6, a tubular rivet tube 10 is disposed at the welding position of the wire drawing steel wire 9 and the terminal electrode 3, and is sleeved on the wire drawing steel wire 9 at the welding position of the terminal electrode 3 and the wire drawing steel wire 9 and welded to the wire drawing steel wire 9, the rivet tube 10 is located at the distal end face of the second lumen 42, and a rivet tube sleeve 101 is wrapped around the surface of the rivet tube 10. The surface of the stay wire steel wire 9 is sleeved with the stay wire outer tube 11 for preventing the stay wire steel wire 7 from generating friction with the inner wall of the second tube cavity 42 in the pulling process to influence the bending shape of the double-hole tube 4.

As shown in fig. 7, the first pipe body 5 is tubular. The proximal end of the first tube body 5 is connected with the distal end of the handle device 1, and the distal end of the first tube body 5 is connected with the double-hole tube 4.

The first pipe body 5 has an outer diameter of 0.8 to 5.4mm, preferably 1.6 to 2.7mm, an inner diameter of 0.5 to 4mm, preferably 1 to 2mm, a length of 400 to 2100mm, preferably 800 to 1050mm.

The first tubular body 5 is made of PEBAX, polyurethane, block polyamide or nylon, and a stainless steel wire mesh 51 is embedded in the wall of the first tubular body 5 according to the prior art (patent application No. 202020703562.3).

The connector 7 may be placed at the proximal end of the handle device 1 by extension wires or may be placed inside the handle device 1.

The distal end of the standard luer 8 is connected with 1 hose 44, and the hose 44 can extend out of the hole 6 through the handle device 1, the first tube body 5 and the first tube cavity 41.

The flexible pipe 44 is a composite film PTFEPI which is made of polyurethane PU, PEBAX, nylon or polyimide as a base film and double-sided composite modified polytetrafluoroethylene, and the flexible pipe 44 is in sliding fit connection with the inner wall of the first pipe cavity 41 in the first pipe cavity 41. The outer diameter of the hose 44 is 0.2 to 1.5mm, preferably 0.5 to 0.75mm. The tube 44 may be used to inject contrast media into the blood vessel from the luer 8 through the port 6, or an alcohol ablation catheter may be fed from the luer 8 and extended out through the port 6 into the blood vessel.

As shown in fig. 8, the handle device 1 according to the prior art (patent application No. 202020703562.3) is provided with a handle case 13 in the form of a rotary body having a through hole 12 coaxial therewith, a handle cover 14 screwed to the outer edge of the distal end of the handle case 13, and a handle cover hole 15 coaxial with the through hole 12 formed in the handle cover 14. A push rod 16 is disposed within the distal end of the handle housing 13, the push rod 16 extending distally from the handle cover 14.

The handle device 1 is provided with a limit bolt 17, a lock nut 18 and a steel wire fixing column 19.

The push rod 16 is controlled in its extent of axial movement within the handle housing 13 by a limit bolt 17.

A locking nut 18 fixedly attaches the proximal end of the first shaft 5 to the push rod 16.

The stay wire steel wire 8 passes through the second tube cavity 42 and the first tube body 5 and then is connected with the steel wire fixing column 19 through the through hole 12 of the handle shell 13.

The push rod 16 is pushed to the far end along the axial direction, the push rod 16 extends out of the handle shell 13, the sum of the lengths of the double-hole tube 4, the first tube body 5 and the handle device 1 is increased, the length of the stay wire steel wire 8 is unchanged, and the double-hole tube 4 with elasticity is bent, so that the bending degree of the double-hole tube 4 is adjusted.

As shown in fig. 9, the alcohol ablation catheter is provided with a second catheter 20 and a branching connector 24 which are connected in sequence from the distal end to the proximal end, and the proximal end of the branching connector 24 is connected with an inflation valve 25.

As shown in fig. 10, the second catheter 20 has a second tubular body 22, a distal end of which is a hemisphere, second ring electrodes 23 are disposed at intervals outside a tube wall of the second tubular body 22 on a proximal side of the hemisphere, a balloon 21 is disposed outside a tube wall of the second tubular body 22 between two second ring electrodes 23 on a distal end, and a proximal end of the second tubular body 22 is connected to the branching connector 24.

Second body 22 is made of a block of polyetheramide resin PEBAX, polyurethane, block polyamide or nylon.

The number of the second ring electrodes 23 is 2 to 20, preferably 2 to 10, and the outer diameter of the second ring electrodes 23 is 0.15 to 2.05mm, preferably 0.35 to 1.05mm.

The balloon 21 is made of latex, rubber or nylon.

Along the inside of the second tube body 22, there are an inflation tube 221, an alcohol and guide wire delivery tube 222, a second guide wire 26 and a second guide wire lumen 27.

The inflation tube 221 is hollow tube, the distal end of the inflation tube 221 is hermetically connected with the balloon 21, the proximal end is connected with the output end of the inflation valve 25, and the balloon 21 is inflated through the inflation valve 25.

The alcohol and guide wire delivery tube 222 is hollow and tubular, and the distal end of the alcohol and guide wire delivery tube 222 is connected to the distal end of the second tube body 22, and the proximal end is connected to a standard luer 8 for delivering alcohol or a guide wire to the coronary vein.

The second wire 26 electrically connects the second ring electrode 23 and the connector 7. The second guidewire 26 is disposed within the guidewire lumen 27. The second wire 26 is a copper wire having a diameter of 0.01 to 0.5mm, preferably 0.1 to 0.2mm. The copper wire is coated with a coating layer, and the insulating strength of the coating layer is not lower than 500V, preferably not lower than 2000V.

As shown in fig. 11, the distal end of the alcohol ablation catheter enters from the luer 8, through the flexible tube 44 into the steerable delivery system with mapping electrodes, and the second catheter 20 finally protrudes from the bore 6 into the coronary vein for electrophysiological signal detection or treatment.

The utility model discloses a use method: the far end of the adjustable bending conveying system with the mapping electrode is pushed into the heart from the femoral artery, the bending angle of the double-hole tube 4 is controlled by the adjusting handle device 1, so that the end electrode 3 and the double-hole tube 4 smoothly enter the coronary sinus orifice, the first ring electrode 43 is attached to the inner wall of the coronary sinus, the adjustable bending conveying system with the mapping electrode is continuously moved towards the near end and the far end, and the electrocardio physiological information of each point is obtained. Injecting contrast agent into coronary vein through a hose 44, a second catheter 20 and a hole 6 via a standard luer connector 8, then introducing the alcohol ablation catheter into Marshall vein via the luer connector 8 and the hole 6, inflating the balloon 21 by an inflation valve 25 as shown in figure 12, locking the inflation valve 25 after completely blocking the blood vessel, obtaining electrophysiological information of each point at the target position via a second ring electrode 23, and then injecting anhydrous alcohol into the blood vessel via the standard luer connector 8 to complete the alcohol ablation operation.

The utility model discloses realize simultaneously on a pipe that the contrast medium is injected and carry alcohol to melt the pipe and carry out alcohol and melt to have the mapping ability that real-time supervision melts the effect.

The utility model discloses can conveniently put into coronary vein with the adjustable curved conveying system who takes the mapping electrode, its distal end is equipped with hole 6, can be used for injecting the contrast medium earlier, shows the Marshall vein, and hole 6 makes the alcohol ablation catheter get into the Marshall vein more easily for second ring electrode 23 pastes with coronary sinus inner wall and leans on closely, gathers the electrophysiological signal stability. The adjustable bending conveying system with the mapping electrode is provided with the end electrode 3 and the first ring electrode 43, so that the real-time acquisition of electrocardiosignals in the operation process can be realized, and the operation effect can be evaluated. The far end of the double-hole pipe 4 can be released to be in an L shape (natural state), the plane formed by the opening ring shape in the bent shape forms an included angle with the first guide pipe 2 to form a space bent shape state, and the bent shape is specially aiming at the shape of the coronary sinus, so that the far end of the first guide pipe 2 can enter the coronary sinus orifice more easily. The alcohol ablation catheter can ensure that the balloon inflation process is smoother, and the operation is convenient.

The utility model discloses a pipe realizes multiple functions, reduces the use quantity of pipe when performing the operation, reduces patient's economic burden, makes the operation safe swift more, at the validity and the operability of clinically greatly increased operation, reduces the operation degree of difficulty, saves the operation time, improves operation efficiency.

Claims

1. An alcohol ablation catheter and an adjustable bending delivery system with a mapping electrode are provided with a first catheter (2), and are characterized in that: the first catheter (2) is provided with a terminal electrode (3) and a double-hole tube (4) which are sequentially connected from the far end, the wall of the double-hole tube (4) is provided with a hole (6), the double-hole tube (4) has elasticity, the far end of the double-hole tube (4) is L-shaped in a free state, at least three groups of annular first ring electrodes (43) are sleeved on the surface of the double-hole tube (4) at intervals, and each group of two first ring electrodes are arranged; an alcohol ablation catheter is arranged in the adjustable bending conveying system with the mapping electrode, a second catheter (20) and a branching joint (24) which are sequentially connected are arranged on the alcohol ablation catheter from the far end to the near end, the near end of the branching joint (24) is connected with an inflation valve (25), second ring electrodes (23) are sleeved outside the wall of the second catheter (20) at intervals, a balloon (21) is sleeved between the two second ring electrodes (23) at the far end, and an inflation pipe (221) and an alcohol and guide wire conveying pipe (222) are arranged in the pipe along the second catheter (20); the far end of the inflation tube (221) is hermetically connected with the balloon (21), and the near end is connected with an inflation valve (25); the distal end of the second conduit (20) extends out of the bore (6).

2. The alcohol ablation catheter and the adjustable bending delivery system with the mapping electrode thereof according to claim 1, characterized in that: the second catheter (20) is provided with a second catheter body (22), second ring electrodes (23) are sleeved outside the catheter wall of the second catheter body (22) at intervals, and a balloon (21) is sleeved outside the catheter wall of the second catheter body (22) between the two second ring electrodes (23) at the farthest ends.

3. The alcohol ablation catheter and the adjustable bending delivery system with the mapping electrode thereof according to claim 2, characterized in that: the first catheter (2) is connected with a luer connector (8) through a handle device (1), the far end of the alcohol and guide wire conveying pipe (222) is connected to the far end of the second pipe body (22), and the near end of the alcohol and guide wire conveying pipe is connected with a standard luer connector (8).

4. The alcohol ablation catheter and the adjustable bending delivery system with the mapping electrode thereof according to claim 3, characterized in that: the standard luer connector (8) is connected with a hose (44), and the hose (44) is arranged in the first conduit (2) and the handle device (1).

5. The alcohol ablation catheter and the adjustable bending delivery system with the mapping electrode thereof according to claim 4, wherein: the double-hole pipe (4) is bent to be in an open ring shape, and a plane formed by the open ring shape forms an included angle of 0-90 degrees with the axis of the first guide pipe (2) to form a space bending structure.

6. The alcohol ablation catheter and the adjustable bending delivery system with the mapping electrode thereof according to claim 5, characterized in that: the shape of the distal end of the terminal electrode (3) is hemispherical, and the spherical arc surface faces the distal end.

7. The alcohol ablation catheter and the adjustable bending delivery system with the mapping electrode thereof according to claim 6, wherein: the double-hole tube (4) is tubular and is provided with a first tube cavity (41) and a second tube cavity (42), the first tube cavity (41) and the second tube cavity (42) are through holes, the axis of the first tube cavity (41) and the axis of the second tube cavity (42) are parallel to the axis of the double-hole tube (4), and the hole (6) is located on the tube wall of the side of the first tube cavity (41) and is far away from the far end of the end electrode (3) by 10-64 mm.

8. The alcohol ablation catheter and the adjustable bending delivery system with the mapping electrode thereof according to claim 7, characterized in that: the distal end of the second tube body (22) is hemispherical.

9. The alcohol ablation catheter and the adjustable bending delivery system with the mapping electrode thereof according to claim 8, characterized in that: the sacculus (21) is made of latex, rubber or nylon.

10. The alcohol ablation catheter and the adjustable bending delivery system with mapping electrodes thereof according to claim 9, characterized in that: the double-hole pipe (4) is made of block polyether amide resin, polyurethane, block polyamide or nylon.