CN219126552U - Single-cavity balloon catheter for taking out thrombus of renal carcinoma inferior vena cava cancer - Google Patents

Single-cavity balloon catheter for taking out thrombus of renal carcinoma inferior vena cava cancer Download PDF

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Publication number
CN219126552U
CN219126552U CN202222054901.1U CN202222054901U CN219126552U CN 219126552 U CN219126552 U CN 219126552U CN 202222054901 U CN202222054901 U CN 202222054901U CN 219126552 U CN219126552 U CN 219126552U
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balloon
catheter
cancer
vena cava
cavity
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陈锐
冯翔
王林辉
王柯男
王正
牟伟明
朱凌煊
祝宝华
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First Affiliated Hospital of Naval Military Medical University of PLA
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First Affiliated Hospital of Naval Military Medical University of PLA
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    • Y02TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
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    • Y02A50/00TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
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Abstract

The utility model provides a single-cavity lower cavity vein cancer embolus extraction balloon catheter with umbrella kidney cancer, which comprises a catheter, wherein the inner cavity of the catheter is a channel for injecting balloon liquid, one end of the catheter is connected with an injector interface, the other end of the catheter is closed, a single-cavity axial balloon is arranged on the outer ring close to the closed end and is communicated with the inner cavity of the catheter, and the balloon liquid is injected into the catheter through the injector interface; the single-cavity axial balloon is filled to form a regular spherical balloon, and the regular spherical balloon is coaxial with the catheter section. The single-cavity axial balloon is adopted, the single-cavity axial balloon is inflated after the balloon liquid is injected, the stress point of the traction balloon is positioned at the center of the balloon, the stress is uniform, the cancer plug is not easy to fall off, the problem that the balloon is irregular in shape due to the fact that the center position deviates after the balloon of the Foley catheter is filled in the prior art is avoided, the sealing performance of the blood vessel is good, the risk of an operation is reduced, the operation difficulty of operators is also reduced, and the cancer plug of the inferior vena cava can be safely and effectively treated.

Description

Single-cavity balloon catheter for taking out thrombus of renal carcinoma inferior vena cava cancer
Technical Field
The utility model relates to the technical field of medical auxiliary instruments, in particular to a single-cavity renal carcinoma inferior vena cava cancer embolus extraction saccule catheter.
Background
Renal carcinoma combined with inferior vena cava carcinoma embolus treatment background: renal cancer is one of the most common malignant tumors in the urinary system, early renal cancer surgery is easier, but the middle and late stages of renal cancer can invade the venous system and progress to renal cancer complicated with renal vein and inferior vena cava cancer embolism (IVCTT), and the proportion of such patients in all renal cancer patients can reach 10%. For patients with renal cancer with tumor invading the inferior vena cava, the prognosis can be effectively improved by radical excision of renal cancer and extraction of inferior vena cava cancer plug, and the tumor specific survival rate is 40-65% in 5 years. Renal cancer combined with venous cancer plug stratification (stratification according to the Mayo medical center in the united states): grade 0, cancer plugs are confined inside renal veins; the cancer suppository is positioned at the renal vein opening and enters the inferior vena cava, and the top end of the cancer suppository is less than 2cm away from the renal vein opening; grade II, the cancer suppository invades the inferior vena cava opening below the hepatic vein level, and the distance between the top of the cancer suppository and the renal vein opening is more than or equal to 2cm; grade III, cancer embolism exceeds intrahepatic inferior vena cava level, but lies below diaphragm; grade IV, the cancer plug extends onto the diaphragm, including into the atrium.
Background of current renal cancer combined inferior vena cava cancer embolus surgical treatment: the current operation treatment technology has a certain defect that for cancer embolism which invades the inferior vena cava, the inferior vena cava needs to be cut and the thrombus is taken, the longer the cutting distance is, the greater the operation risk is; therefore, we have tried to extend into the inferior vena cava incision using a clinically usual catheter (e.g., F16, 20ml Foley balloon), insert up to its tip beyond the tip of the cancer plug, inject 20ml saline into the balloon to fill the balloon, and gently pull down to pull out the tumor plug in the vena cava in cooperation with the curved forceps. The method utilizes the filled air bag to pull out the cancer plug from the vein, reduces the scope of inferior vena cava incision, reduces the risk of operation, and is ideal in that the filled air bag can completely seal the vena cava, thereby effectively preventing the cancer plug from entering the blood circulation to form fatal pulmonary embolism and metastasis. However, intravenous procedures using urinary catheters have the following technical drawbacks:
1. the catheter is designed to drain urine, and is a double-cavity catheter, wherein one cavity is responsible for draining urine, the other cavity is responsible for injecting balloon liquid into the balloon, and when the catheter is used for taking out the lower vena cava cancer plug, the effect of draining urine is not needed, and meanwhile, the double-cavity channel can lead blood to flow out through the catheter, so that the catheter is not suitable for a thrombus taking application scene;
2. there is no catheter specially used for thrombus removal of renal cancer inferior vena cava cancer, but the thrombus removal method of inferior vena cava cancer requires that the central position of the balloon after expansion is on the long axis of the catheter, if a Foley catheter is used, the central position of the balloon deviates from the center of the catheter after filling, the shape of the balloon is not regular sphere, and the balloon cannot expand to the required diameter, so that cancer thrombus is easy to remain or fall off in veins; 3. the saccule of the catheter cannot be clearly developed under X rays, and the relative positions of the cancer plug, the inferior vena cava and the catheter cannot be determined in real time; determining the insertion depth according to the cancer thrombus length or the intra-operative exploration condition which is prompted by the imaging examination in the thrombus taking process, wherein the Foley balloon catheter has no size mark, and the insertion depth cannot be accurately estimated;
4. in the process of thrombus taking, the saccule can not completely block the cancer thrombus, if the cancer thrombus clung to the vessel wall is encountered, the cancer thrombus can be partially missed and fall off, the missing can cause short-term recurrence of tumors, and the fall off can cause fatal complications such as pulmonary embolism.
How to safely and effectively treat cancer plugs of inferior vena cava, reduce the operation difficulty, adapt to the application scene of thrombus taking, closely attach with the wall of the inferior vena cava and prevent tiny cancer plugs from falling off becomes a problem which needs to be solved urgently.
Disclosure of Invention
Aiming at the problems existing in the prior art, the utility model provides a single-cavity extraction balloon catheter for the inferior vena cava cancer plug with umbrella kidney cancer, which aims to solve at least one technical problem.
The technical scheme of the utility model is as follows: the single-cavity lower cavity vein cancer embolus extraction balloon catheter with umbrella kidney cancer comprises a catheter, wherein the inner cavity of the catheter is a channel for injecting balloon liquid, one end of the catheter is connected with an injector interface, the other end of the catheter is closed, a single-cavity axial balloon is arranged on the outer ring close to the closed end and is communicated with the inner cavity of the catheter, and the balloon liquid is injected into the catheter through the injector interface; the single-cavity axial balloon is filled to form a regular spherical balloon, and the regular spherical balloon is coaxial with the catheter section.
The single-cavity axial balloon is adopted, the single-cavity axial balloon is inflated after the balloon liquid is injected, the stress point of the traction balloon is positioned at the center of the balloon, the stress is uniform, the cancer plug is not easy to fall off, the problem that the balloon is irregular in shape due to the deviation of the center position after filling of the balloon of the Foley catheter is avoided, the tightness of the blood vessel is good, the risk of operation is reduced, the operation difficulty of operators is also reduced, and the cancer plug of the inferior vena cava can be safely and effectively treated; the prior surgery is changed from a highly risky surgery to a relatively less risky surgery, and the prior surgery is changed from a partially inoperable patient to a patient who can receive the surgery.
Preferably, the catheter is a single-cavity catheter, and a liquid guide hole is formed in the position, corresponding to the single-cavity axial balloon, of the other end of the catheter, and is communicated with the single-cavity axial balloon.
The catheter adopts a single-cavity catheter, the diameter of the catheter is obviously reduced, the catheter can pass through the periphery of a cancer plug and reach the near-heart end of the cancer plug, and the catheter is suitable for the application scene of thrombus taking.
Preferably, the umbrella-shaped structure is arranged outside the single-cavity axial balloon, a metal supporting net is arranged on the inner wall of the umbrella-shaped structure, and the metal supporting net is expanded by the single-cavity axial balloon. The outer surface of the umbrella-shaped structure is a film layer, and the film layer is tightly attached to the blood vessel wall after the metal supporting net is unfolded.
The umbrella-shaped structure with the metal supporting net is adopted, the problem of insufficient tightness of a simple balloon is solved, serious complications such as heart embolism and pulmonary embolism caused by falling of a tiny cancer plug are prevented, the umbrella-shaped structure tightly attached to the wall of the inferior vena cava has a scraping effect on the cancer plug attached to the wall of the blood vessel, the damage to the wall of the blood vessel is avoided, the cancer plug attached to the wall of the blood vessel can be removed, and the cancer plug is ensured to be removed completely.
Drawings
FIG. 1 is a schematic view of the structure of a single lumen axial balloon of the present utility model when not inflated.
Fig. 2 is a partial enlarged view of a of fig. 1.
Fig. 3 is a schematic view of the structure of the single lumen axial balloon of the present utility model when inflated.
Fig. 4 is a partial enlarged view of B of fig. 3.
Fig. 5 is a front view of fig. 4.
In the figure: 1. a single lumen axial balloon; 2. an umbrella-like structure; 3. a conduit; 4. a syringe interface; 5. a liquid guiding hole; 6. a metal support net.
Detailed Description
The utility model is further described below with reference to the accompanying drawings.
Referring to fig. 1-5, the structures, proportions, sizes, etc. shown in the drawings attached hereto are shown only in order to facilitate the understanding and appreciation of the present utility model by those skilled in the art, and are not meant to restrict the manner in which the present utility model may be implemented, so that any modification of structures, changes in proportions, or adjustments of sizes, etc. that do not affect the efficacy or achievement of the present utility model, are within the scope of the present utility model. Also, the terms such as "upper," "lower," "left," "right," "middle," and "a" and the like recited in the present specification are merely for descriptive purposes and are not intended to limit the scope of the utility model, but are intended to provide relative positional changes or modifications without materially altering the technical context in which the utility model may be practiced.
The first embodiment, a single-cavity lower vena cava cancer plug extraction balloon catheter with umbrella kidney cancer, referring to fig. 1 and 4, comprises a catheter 3, wherein the inner cavity of the catheter 3 is a channel for injecting balloon liquid, one end of the catheter 3 is connected with an injector interface 4, the other end of the catheter 3 is closed, a single-cavity axial balloon 1 is arranged on the outer ring close to the closed end, the single-cavity axial balloon 1 is communicated with the inner cavity of the catheter 3, and balloon liquid (such as physiological saline) is injected into the catheter 3 through the injector interface 4; the single-cavity axial balloon 1 is filled to form a regular spherical balloon, and the regular spherical balloon is coaxial with the section 3 of the catheter. The single-cavity axial balloon is adopted, the single-cavity axial balloon is inflated after the balloon liquid is injected, the stress point of the traction balloon is positioned at the center of the balloon, the stress is uniform, the cancer plug is not easy to fall off, the problem that the balloon is irregular in shape due to the deviation of the center position after filling of the balloon of the Foley catheter is avoided, the tightness of the blood vessel is good, the risk of operation is reduced, the operation difficulty of operators is also reduced, and the cancer plug of the inferior vena cava can be safely and effectively treated; the prior surgery is changed from a highly risky surgery to a relatively less risky surgery, and the prior surgery is changed from a partially inoperable patient to a patient who can receive the surgery.
In the second embodiment, referring to fig. 2, the catheter 3 is a single-lumen catheter, and a liquid guiding hole 5 is disposed at a position corresponding to the single-lumen axial balloon 1 at the other end of the catheter 3, and the liquid guiding hole 5 is communicated with the single-lumen axial balloon 1. The catheter adopts a single-cavity catheter, is specially designed for taking out the cancer plug in the inferior vena cava, is designed into a single-cavity channel according to the requirement, and meanwhile, the diameter of the catheter is obviously reduced due to the reduction of other cavity channels, so that the catheter is beneficial to passing around the cancer plug and reaching the near-heart end of the cancer plug, and is suitable for the application scene of thrombus taking.
In a third embodiment, based on the first embodiment, the single-cavity axial balloon 1 is made of silica gel, and a hyaluronic acid layer is coated on the surface of the single-cavity axial balloon 1; the single-cavity axial center balloon 1 is internally provided with a metal mark which can be developed under X rays. The utility model adopts the metal mark which can be developed under X-ray, the position of the saccule can be accurately displayed in operation, the relative positions of the cancer plug and the inferior vena cava and the catheter can be grasped through perspective in operation, the insertion depth can be determined according to the length of the cancer plug prompted by imaging examination or the probing condition in operation in the process of taking the plug, and the technical problems that the Foley air sac catheter has no size mark and the insertion depth can not be accurately estimated are solved.
Based on the first embodiment, referring to fig. 3, fig. 4 and fig. 5, an umbrella-shaped structure 2 is arranged outside the single-cavity axial balloon 1, a metal supporting net 6 is arranged on the inner wall of the umbrella-shaped structure 2, and the metal supporting net 6 is expanded by expanding, pushing and expanding the single-cavity axial balloon 1; the outer surface of the umbrella-shaped structure 2 is a film layer, and the film layer is tightly attached to the wall of a blood vessel after the metal supporting net 6 is unfolded; the metal support net 6 is made of titanium metal. The umbrella-shaped structure with the metal supporting net is adopted, the problem of insufficient tightness of a simple balloon is solved, serious complications such as heart embolism and pulmonary embolism caused by falling of a tiny cancer plug are prevented, the umbrella-shaped structure tightly attached to the wall of the inferior vena cava has a scraping effect on the cancer plug attached to the wall of the blood vessel, the damage to the wall of the blood vessel is avoided, the cancer plug attached to the wall of the blood vessel can be removed, and the cancer plug is ensured to be removed completely.
In a fifth embodiment, on the basis of the fourth embodiment, the outer ring of the catheter 3 is marked with graduations along the axial direction. The utility model marks the scale on the catheter, can help an operator to accurately evaluate the insertion depth, and is convenient for the operator to evaluate the position of the saccule in the inferior vena cava.
In a sixth embodiment, on the basis of the first embodiment, the injector port 4 is provided with an automatic sealing device, and the automatic sealing device adopts a hydraulic control one-way valve. The utility model injects the sacculus liquid from the injector interface during operation, and the hydraulic control one-way valve prevents the sacculus liquid from flowing reversely like a common one-way valve; when the operation is finished, the one-way valve is jacked up by the input pressure of the control end, so that the saccule liquid reversely flows out from the injector interface.
The working procedure of the inferior vena cava cancer embolus extraction operation of the utility model is as follows:
a) Sequentially freeing and controlling the inferior vena cava below the distal end of the cancer plug, the inferior vena cava below the level of the 2 nd hepatic portal, the left renal vein and the right renal vein;
b) Sequentially blocking the inferior vena cava, the right renal vein and the left renal vein below the distal end of the cancer plug, cutting the inferior vena cava on the surface of the cancer plug, placing a lower vena cava cancer plug extraction catheter through the cut, enabling a single-cavity axial balloon 1 at the front section of the catheter to cross the top level of the cancer plug, and observing the position of the catheter 3 by adopting X-ray for intraoperative fluoroscopy if necessary;
c) Injecting the balloon liquid into the single-cavity axial balloon 1 through the injector interface 4, so that the single-cavity axial balloon 1 is inflated to be the same as or slightly larger than the diameter of the inferior vena cava, and simultaneously, the umbrella-shaped structure 2 is expanded and unfolded under the pushing action of the single-cavity axial balloon 1 to cling to the vessel wall, and if necessary, the single-cavity axial balloon can be confirmed by adopting X-ray perspective in an X-ray operation;
d) The catheter 3 is pulled out from the incision, and the single-cavity axial balloon 1 and the umbrella-shaped structure 2 are used for taking out the cancer plug from the inferior vena cava incision.
Example eight the working procedure of the inferior vena cava embolus + thrombus removal procedure of the present utility model is as follows:
a) Similar to the seventh embodiment, the catheter 3 is inserted downwards and the inferior vena cava below the distal end of thrombus, the inferior vena cava below the level of the 2 nd portal, the left renal vein and the right renal vein are sequentially dissociated and controlled on the basis of the catheter 3 inserted upwards in the seventh embodiment;
b) Sequentially blocking the inferior vena cava, the left renal vein and the right renal vein below the distal end of the thrombus, incising the inferior vena cava on the surface of the cancer plug, and taking out the cancer plug;
c) Blocking the inferior vena cava near the heart end after the cancer plug is completely taken out;
d) Loosening a blood vessel sling below the distal end of the thrombus, placing a human inferior vena cava cancer plug through the incision, and taking out the catheter 3 to the distal end of the thrombus;
e) And injecting the balloon liquid through the catheter 3, expanding the single-cavity axial center balloon 1, expanding the umbrella-shaped structure 2, clinging to the wall of a blood vessel, taking out the thrombus from the far-end vein by using the single-cavity axial center balloon 1 of the lower vena cava cancer plug taking out catheter and the umbrella-shaped structure 2, and blocking the distal lower vena cava after confirming that the thrombus is completely taken out.
In specific implementation, the volume of the single-cavity axial center balloon 1 can be definitely determined, the model is divided into various models with the diameter of 18mm to 40mm, the diameter of the inferior vena cava of the application part can be evaluated according to preoperative imaging for selection, the capacity of the physiological saline injection can be calculated, personalized selection is achieved, and a better matching effect is obtained;
the utility model adopts biocompatible materials, has no irritation to patients and no antigenicity;
the utility model provides the social and economic benefits for effectively treating patients with renal cancer accompanied with inferior vena cava cancer embolism: (1) Changing the surgery with great risk from the previous surgery to the surgery with relatively small risk, and changing part of the patients which can not be operated from the previous surgery to the patients which can be operated; (2) The utility model effectively reduces huge medical cost caused by intensive care unit monitoring possibly caused by the traditional operation mode, and by adopting the utility model to perform operation treatment, the operation success rate can be predicted to be improved from 50% to 90%, and 40% of patient operation failure is avoided; the utility model can shorten the originally estimated intensive care time of 7 days to 1 day, and reduce the medical expense by about 6 ten thousand yuan per person; (3) Changing the range of surgical treatment in the advanced stage of renal cancer reduces the proportion of patients who are subjected to expensive targeted therapy due to incapacity of surgery, for example, patients can not perform surgery, only targeted therapy is adopted, the average medical treatment per month starts at about 1 ten thousand yuan, the median survival time is 12 months, and the average expenditure is 12 ten thousand yuan per person; the utility model is expected to effectively reduce the social medical expense from the aspects.
The foregoing is merely a preferred embodiment of the present utility model and it should be noted that modifications and adaptations to those skilled in the art may be made without departing from the principles of the present utility model, which are intended to be comprehended within the scope of the present utility model.

Claims (9)

1. The utility model provides a single chamber area umbrella kidney cancer inferior vena cava cancer embolus takes out sacculus pipe, includes pipe (3), the inner chamber of pipe (3) is the passageway that sacculus liquid was poured into, its characterized in that: one end of the catheter (3) is connected with an injector interface (4), the other end of the catheter (3) is closed, a single-cavity axial balloon (1) is arranged on the outer ring close to the closed end, the single-cavity axial balloon (1) is communicated with the inner cavity of the catheter (3), and balloon liquid is injected into the catheter (3) through the injector interface (4); the single-cavity axial balloon (1) is filled and then forms a regular spherical balloon, and the regular spherical balloon is coaxial with the section of the catheter (3) where the regular spherical balloon is positioned.
2. The single lumen umbrella renal carcinoma inferior vena cava carcinoma embolus retrieval balloon catheter of claim 1, wherein: the catheter (3) is a single-cavity catheter, liquid guide holes (5) are formed in the positions, corresponding to the single-cavity axial saccule (1), of the other end of the catheter (3), and the liquid guide holes (5) are communicated with the single-cavity axial saccule (1).
3. The single lumen umbrella renal carcinoma inferior vena cava carcinoma embolus retrieval balloon catheter of claim 1, wherein: the surface of the single-cavity axial balloon (1) is covered with a hyaluronic acid layer.
4. The single lumen umbrella renal carcinoma inferior vena cava carcinoma embolus retrieval balloon catheter of claim 1, wherein: the single-cavity axial balloon (1) is internally provided with a metal mark which can be developed under X rays.
5. The single lumen umbrella renal carcinoma inferior vena cava carcinoma embolus retrieval balloon catheter of claim 1, wherein: the single-cavity axial balloon (1) is externally provided with an umbrella-shaped structure (2), the inner wall of the umbrella-shaped structure (2) is provided with a metal supporting net (6), and the metal supporting net (6) is expanded by expanding, pushing and expanding the single-cavity axial balloon (1).
6. The single lumen umbrella renal carcinoma inferior vena cava carcinoma embolus retrieval balloon catheter of claim 5, wherein: the outer surface of the umbrella-shaped structure (2) is a film layer, and the film layer is tightly attached to the blood vessel wall after the metal supporting net (6) is unfolded.
7. The single lumen umbrella renal carcinoma inferior vena cava carcinoma embolus retrieval balloon catheter of claim 5, wherein: the outer ring of the guide tube (3) is marked with scales along the axial direction.
8. The single lumen umbrella renal carcinoma inferior vena cava carcinoma embolus retrieval balloon catheter of claim 1, wherein: an automatic sealing device is arranged on the injector interface (4).
9. The single lumen umbrella renal carcinoma inferior vena cava carcinoma embolus retrieval balloon catheter of claim 1, wherein: the diameter of the single-cavity axial balloon (1) is 18-40 mm.
CN202222054901.1U 2022-08-05 2022-08-05 Single-cavity balloon catheter for taking out thrombus of renal carcinoma inferior vena cava cancer Active CN219126552U (en)

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Application Number Priority Date Filing Date Title
CN202222054901.1U CN219126552U (en) 2022-08-05 2022-08-05 Single-cavity balloon catheter for taking out thrombus of renal carcinoma inferior vena cava cancer

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN202222054901.1U CN219126552U (en) 2022-08-05 2022-08-05 Single-cavity balloon catheter for taking out thrombus of renal carcinoma inferior vena cava cancer

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CN219126552U true CN219126552U (en) 2023-06-06

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