CN219501105U

CN219501105U - Thrombolysis device capable of realizing thrombolysis in pulmonary artery branch

Info

Publication number: CN219501105U
Application number: CN202320565551.7U
Authority: CN
Inventors: 邓礼明; 邓至和; 熊国祚
Original assignee: Second Hospital University Of South China
Current assignee: Second Hospital University Of South China
Priority date: 2023-03-22
Filing date: 2023-03-22
Publication date: 2023-08-11
Anticipated expiration: 2033-03-22

Abstract

The thrombus taking device capable of taking thrombus in pulmonary artery branch comprises a thrombus taking catheter and a thrombus dragging catheter; the front end of the thrombolytic catheter is provided with a front port, and the rear end of the thrombolytic catheter is provided with a thrombolytic port, an operation port A and an operation port B; the rear end of the towing bolt guide pipe is provided with a guide wire port A and a liquid injection port, and the front end of the towing bolt guide pipe is provided with a guide wire port B and an annular water bag; the dragging bolt guide pipe is movably inserted into the pipe inner cavity of the sucking bolt guide pipe, the rear end of the dragging bolt guide pipe extends out of the sucking bolt guide pipe through the operation port B, and the front end of the dragging bolt guide pipe extends out of the sucking bolt guide pipe through the front port. The utility model has the advantages that the thrombus cleaning device has better cleaning effect on thrombus in pulmonary artery trunk, first-stage branch vessel, second-stage branch vessel and even third-stage branch vessel, and can open vessels in a larger range and restore pulmonary artery blood flow to be smooth compared with the existing thrombus removing catheter.

Description

Thrombolysis device capable of realizing thrombolysis in pulmonary artery branch

Technical Field

The utility model relates to the technical field of medical equipment, in particular to a thrombus taking device capable of taking thrombus in pulmonary artery branches.

Background

Pulmonary embolism refers to a clinical syndrome in which various emboli block pulmonary artery or its branches to cause pulmonary circulation and right heart failure, including pulmonary thromboembolism, fat embolism, etc. The incidence rate of the pulmonary embolism is second to coronary heart disease and hypertension in cardiovascular diseases, the clinical manifestation is mainly pulmonary circulation and respiratory dysfunction, and when pulmonary artery and branches thereof are blocked by thrombus, the right heart failure caused by the overload of right ventricular pressure is the main cause of death of pulmonary embolism patients. In Europe, the clinical incidence rate of pulmonary embolism is 0.4 per mill-1.0 per mill, the total death rate of PE patients is 3% -8%, wherein the death rate of PE patients within 1h of incidence is up to 10%, and the death rate of PE patients without effective treatment is up to 30%; PE patients diagnosed and treated in time account for 2% -8% of the total mortality. The incidence rate of pulmonary embolism in China is in an ascending trend year by year, and the pulmonary embolism is one of the main death reasons of inpatients at present. Thus, a rapid and effective treatment is critical for patients with acute pulmonary embolism.

A typical CT vascular image of the pulmonary artery of an acute pulmonary embolism patient is shown in FIG. 8, where it is evident that there is thrombus in both the trunk and branches of the patient's pulmonary artery. The main treatment methods of acute pulmonary embolism include anticoagulation, thrombolysis, percutaneous catheter intervention and surgical treatment. Anticoagulation is not capable of rapidly relieving serious right ventricular dysfunction of patients when treating acute middle-high risk pulmonary embolism patients; thrombolysis may present a greater risk of bleeding; surgical treatments are generally used as alternative remedies. Therefore, the method is an optimal treatment scheme for interventional therapy of patients with high bleeding risk and thrombolytic contraindications.

The percutaneous catheter interventional therapy is to clear thrombus in pulmonary artery by catheter interventional method, improve the right heart function of the patient, improve the survival rate of the patient, be more direct and effective than anticoagulation and thrombolysis, and have less influence on all tissues and organs of the whole body. The interventional therapy is that under DSA, a catheter is punctured by femoral vein into human body, and is advanced upwards along blood vessel, and reaches the main trunk of pulmonary artery via inferior vena cava-right atrium-right ventricle, so as to facilitate the operations of breaking, dissolving and sucking thrombus.

However, the outer diameter of the existing catheter is usually larger than the inner diameter of the pulmonary artery branch (which is too thin to ensure thrombus aspiration efficiency), and the catheter can reach the junction of the pulmonary artery trunk and the pulmonary artery branch at the deepest, so that the deep thrombus of the pulmonary artery branch is difficult to treat.

Disclosure of Invention

The utility model aims to overcome the defects of the prior art, and provides a thrombus taking device capable of taking thrombus in pulmonary artery branches, which solves the problems that anticoagulation treatment is not suitable for acute middle-high risk pulmonary embolism patients, thrombus dissolving treatment for pulmonary embolism is easy to increase bleeding risk of patients, and thrombus treatment capacity of interventional operation treatment for deep parts of pulmonary artery branches is poor.

The technical scheme of the utility model is as follows: the thrombus taking device capable of taking thrombus in pulmonary artery branch comprises a thrombus taking catheter and a thrombus dragging catheter; the front end of the thrombolytic catheter is provided with a front port, and the rear end of the thrombolytic catheter is provided with a thrombolytic port, an operation port A and an operation port B; a tube cavity is arranged in the thrombolytic catheter, one end of the tube cavity is communicated with the front port, and the other end of the tube cavity is communicated with the thrombolytic port, the operation port A and the operation port B; the rear end of the towing bolt guide pipe is provided with a guide wire port A and a liquid injection port, the front end of the towing bolt guide pipe is provided with a guide wire port B and an annular water bag, the guide wire port B is positioned at the front end part of the towing bolt guide pipe, the annular water bag is arranged on the outer wall of the front end of the towing bolt guide pipe in a surrounding mode, a guide wire channel which is used for communicating the guide wire port A with the guide wire port B is arranged in the towing bolt guide pipe, and a liquid flow channel which is used for communicating the liquid injection port with the annular water bag is also arranged in the towing bolt guide pipe; the dragging bolt guide pipe is movably inserted into the pipe inner cavity of the sucking bolt guide pipe, the rear end of the dragging bolt guide pipe extends out of the sucking bolt guide pipe through the operation port B, and the front end of the dragging bolt guide pipe extends out of the sucking bolt guide pipe through the front port.

The utility model further adopts the technical scheme that: it also comprises a guide wire A and a guide wire B; the guide wire A is matched with the thrombolytic catheter for use and is used for guiding the advancing path of the thrombolytic catheter; the guide wire B is matched with the thrombolytic catheter and used for guiding the advancing path of the thrombolytic catheter.

The utility model further adopts the technical scheme that: a sealing cap A is detachably arranged on an operation opening A of the bolt suction catheter, and a sealing cap B is detachably arranged on an operation opening B of the bolt suction catheter.

The utility model further adopts the technical scheme that: the outer diameter of the tube of the thrombolytic catheter is 8-10F, the outer diameter of the tube of the thrombolytic catheter is 3-4F, and 1F is 0.333mm.

Compared with the prior art, the utility model has the following advantages: the thrombus removing catheter has a good thrombus removing effect on the main pulmonary artery, the first-stage branch blood vessel, the second-stage branch blood vessel and even the third-stage branch blood vessel, and can open the blood vessel in a larger range and restore the pulmonary artery blood flow to be smooth compared with the existing thrombus removing catheter.

The utility model is further described below with reference to the drawings and examples.

Drawings

FIG. 1 is a schematic diagram of the structure of the present utility model;

fig. 2 is an enlarged view of a portion a of fig. 1;

FIG. 3 is a state diagram of step 2 of the method of use of the present utility model;

FIG. 4 is a state diagram of the 4 th step of the method of use of the present utility model;

FIG. 5 is a state diagram of step 5 of the method of use of the present utility model;

FIG. 6 is a state diagram during step 6 of the method of use of the present utility model;

FIG. 7 is a state diagram at the end of step 6 of the method of use of the present utility model;

fig. 8 is a CT angiogram of pulmonary artery of a pulmonary embolism patient.

Legend description: a thrombolysis catheter 1; a front port 11; a suction port 12; an operation port a13; an operation port B14; a tube lumen 15; a sealing cap a16; a sealing cap B17; a tow pin conduit 2; a guide wire port a21; a liquid injection port 22; a guide wire port B23; an annular water bladder 24; a guidewire channel 25; a guidewire port a100; a guide wire port B200; the sheath 300 is pierced.

Detailed Description

Example 1:

as shown in fig. 1-2, a thrombolytic device capable of realizing thrombolysis in pulmonary artery branches comprises a thrombolytic catheter 1 and a thrombolytic catheter 2.

The front end of the thrombolytic catheter 1 is provided with a front port 11, and the rear end of the thrombolytic catheter 1 is provided with a thrombolytic port 12 for connecting a negative pressure suction device (which is an external device), an operation port A13 for inserting a guide wire A100 and an operation port B14 for inserting a thrombolytic catheter 2. The inside of the thrombolytic catheter 1 is provided with a tube cavity 15, one end of the tube cavity 15 is communicated with the front port 11, and the other end is communicated with the thrombolytic port 12, the operation port A13 and the operation port B14. The rear end of the towing pin catheter 2 is provided with a guide wire port A21 for inserting a guide wire B200 and a liquid injection port 22 for connecting a liquid injection and suction device (which is an external device), the front end of the towing pin catheter 2 is provided with a guide wire port B23 and an annular water bag 24, the guide wire port B23 is positioned at the front end part of the towing pin catheter 2, the annular water bag 24 is arranged on the outer wall of the front end of the towing pin catheter 2 in a surrounding manner, the inside of the towing pin catheter 2 is provided with a guide wire channel 25 for communicating the guide wire port A100 with the guide wire port B200, and the inside of the towing pin catheter 2 is also provided with a liquid flow channel for communicating the liquid injection port 22 with the annular water bag 24. The towing bolt catheter 2 is movably inserted in the tube cavity 15 of the bolt catheter 1, the rear end of the towing bolt catheter extends out of the bolt catheter 1 through the operation port B14, and the front end of the towing bolt catheter extends out of the bolt catheter 1 through the front port 11.

Preferably, it further comprises a guide wire a100 and a guide wire B200. The guide wire A100 is matched with the thrombolytic catheter 1 for guiding the advancing path of the thrombolytic catheter 1, when the guide wire A100 is matched with the thrombolytic catheter 1, the front port 11 of the thrombolytic catheter 1 passes through the rear end of the guide wire A100, and then the thrombolytic catheter 1 is advanced along the guide wire A100, so that the tube inner cavity 15 and the operation port A13 of the thrombolytic catheter 1 sequentially pass through the rear end of the guide wire A100. The guide wire B200 is used in cooperation with the thrombolytic catheter 2, and is used for guiding the advancing path of the thrombolytic catheter 2, when the guide wire B200 is required to be matched with the thrombolytic catheter 2, the guide wire port B23 of the thrombolytic catheter 2 passes through the rear end of the guide wire B200, and then the thrombolytic catheter 2 is advanced along the guide wire B200, so that the guide wire channel 25 of the thrombolytic catheter 2 sequentially passes through the rear end of the guide wire B200.

Preferably, the sealing cap a16 is detachably mounted on the operation port a13 of the hydrant duct 1, and the sealing cap B17 is detachably mounted on the operation port B14 of the hydrant duct 1.

Preferably, the outer diameter of the tube of the thrombolytic catheter 1 is 8-10F, the outer diameter of the tube of the thrombolytic catheter 2 is 3-4F and 1F is 0.333mm.

Brief description of the utility model the method of use of the utility model:

first, assuming that a thrombus in a patient's pulmonary artery exists in a main trunk of the pulmonary artery and branches of the pulmonary artery, the thrombus in the main trunk of the pulmonary artery is simply referred to as a main trunk thrombus, and the thrombus in the branches of the pulmonary artery is simply referred to as a branch thrombus, referring to fig. 3 to 7, the thrombus removal operation is performed substantially as follows.

1. Puncturing the femoral vein to leave the puncture sheath 300 on the body surface; the guide wire A100 is placed under the assistance of DSA, the front end of the guide wire A100 sequentially passes through the puncture sheath 300, the inferior vena cava, the right atrium and the right ventricle and reaches the main trunk of the pulmonary artery, at the moment, the rear end of the guide wire A100 is positioned outside the body, and a tube placing path is established.

2. The suction catheter 1 is placed under the assistance of DSA, the front port 11 of the suction catheter 1 passes through the rear end of the guide wire A100, reaches the main trunk of the pulmonary artery along the placement path established by the guide wire A100, and then the guide wire A100 is extracted, at the moment, the front port 11 of the suction catheter 1 does not pass through the main thrombus and is positioned at the proximal end.

3. Ensuring that the operation port A13 and the operation port B14 are in a closed state, connecting the thrombus sucking port 12 with a negative pressure suction device (peripheral thrombus sucking system), starting the negative pressure suction device, and sucking out the main thrombus; opening a cap A16 on an operation port A13 or a cap B17 on an operation port B14, injecting contrast medium through the operation port A13 or the operation port B14, and observing the suction effect of the main thrombus through DSA; if the thrombus is sucked up, the next step is carried out, if the thrombus is not sucked up, the operation process of sucking up the thrombus and injecting the contrast agent for verification in the step is repeated until the thrombus is sucked up, and the next step is carried out.

4. With the operation port a13 and the operation port B14 ensured to be in an opened state, the guide wire B200 is placed through the opened operation port B14 or the opened operation port a13, the front end of the guide wire B200 is sent into the target pulmonary artery branch containing the branch thrombus with the assistance of DSA, at this time, the rear end of the guide wire B200 is positioned outside the body, and a tube placing path is established.

5. The thrombolytic catheter 2 is placed under the assistance of the DSA machine, the wire guide port B23 of the thrombolytic catheter 2 passes through the wire guide B200, the placement path established along the wire guide B200 reaches the target pulmonary artery branch, and the distal end of the thrombolytic catheter 2 is ensured that the wire guide port B23 and the annular water sac 24 both pass through the branch thrombus.

6. Connecting the liquid injection port 22 of the thrombolytic catheter 2 to a liquid injection suction device (an injector or a peristaltic pump), starting the liquid injection suction device, injecting developer into the annular water bag 24 of the thrombolytic catheter 2, filling the annular water bag 24 of the thrombolytic catheter 2, abutting against the inner wall of the blood vessel of the target pulmonary artery branch, and temporarily blocking the blood flow of the target pulmonary artery branch; the operator pulls the thrombolytic catheter 2 outside the patient, so that the annular water bag 24 of the thrombolytic catheter 2 pushes the branch thrombus to move towards the pulmonary artery trunk until the branch thrombus is brought to the front port 11 of the thrombolytic catheter 1; the fill port 22 of the tow pin conduit 2 is then connected to a liquid injection suction device which is activated to pump out the developer from the annular bladder 24, causing the annular bladder 24 to collapse.

7. Ensuring that the operation port A13 and the operation port B14 are in a closed state, connecting the suction port 12 of the suction catheter 1 with a negative pressure suction device, starting the negative pressure suction device, and extracting the branched thrombus; opening the cap A16 or the cap B17 of the thrombus suction catheter 1 to expose the operation port A13 or the operation port B14, injecting contrast medium through the operation port A13 or the operation port B14, and observing the suction effect of the branched thrombus through a DSA machine; if the thrombus is sucked up, the next step is carried out, if the thrombus is not sucked up, the operation process of sucking up the thrombus and injecting the contrast agent for verification in the step is repeated until the thrombus is sucked up, and the next step is carried out.

8. The trailing catheter 2, the suction catheter 1 and the puncture sheath 300 are withdrawn in sequence, and the puncture point is pressed.

Claims

1. The thrombus taking device capable of taking thrombus in pulmonary artery branch is characterized in that: comprises a thrombolysis catheter and a thrombolysis catheter; the front end of the thrombolytic catheter is provided with a front port, and the rear end of the thrombolytic catheter is provided with a thrombolytic port, an operation port A and an operation port B; a tube cavity is arranged in the thrombolytic catheter, one end of the tube cavity is communicated with the front port, and the other end of the tube cavity is communicated with the thrombolytic port, the operation port A and the operation port B; the rear end of the towing bolt guide pipe is provided with a guide wire port A and a liquid injection port, the front end of the towing bolt guide pipe is provided with a guide wire port B and an annular water bag, the guide wire port B is positioned at the front end part of the towing bolt guide pipe, the annular water bag is arranged on the outer wall of the front end of the towing bolt guide pipe in a surrounding mode, a guide wire channel which is used for communicating the guide wire port A with the guide wire port B is arranged in the towing bolt guide pipe, and a liquid flow channel which is used for communicating the liquid injection port with the annular water bag is also arranged in the towing bolt guide pipe; the dragging bolt guide pipe is movably inserted into the pipe inner cavity of the sucking bolt guide pipe, the rear end of the dragging bolt guide pipe extends out of the sucking bolt guide pipe through the operation port B, and the front end of the dragging bolt guide pipe extends out of the sucking bolt guide pipe through the front port.

2. The thrombolytic device of claim 1 for achieving thrombolysis in pulmonary artery branches, wherein: it also comprises a guide wire A and a guide wire B; the guide wire A is matched with the thrombolytic catheter for use and is used for guiding the advancing path of the thrombolytic catheter; the guide wire B is matched with the thrombolytic catheter and used for guiding the advancing path of the thrombolytic catheter.

3. The thrombolytic device of claim 2 for effecting thrombolysis in pulmonary artery branches, wherein: a sealing cap A is detachably arranged on an operation opening A of the bolt suction catheter, and a sealing cap B is detachably arranged on an operation opening B of the bolt suction catheter.

4. The thrombolytic device of claim 2 for effecting thrombolysis in pulmonary artery branches, wherein: the outer diameter of the tube of the thrombolytic catheter is 8-10F, the outer diameter of the tube of the thrombolytic catheter is 3-4F, and 1F is 0.333mm.