CN220069828U - Lower cavity electrode wire pulling-out device capable of adjusting bending - Google Patents

Lower cavity electrode wire pulling-out device capable of adjusting bending Download PDF

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Publication number
CN220069828U
CN220069828U CN202321620155.6U CN202321620155U CN220069828U CN 220069828 U CN220069828 U CN 220069828U CN 202321620155 U CN202321620155 U CN 202321620155U CN 220069828 U CN220069828 U CN 220069828U
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tube
sheath
controllable
catheter sheath
bending
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昃峰
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Peking University Peoples Hospital
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Peking University Peoples Hospital
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Abstract

The utility model relates to a bendable lower cavity electrode lead pulling-out device, which belongs to the field of minimally invasive intervention in cardiology, and comprises an inner sheath tube and a controllable bending catheter sheath, wherein the controllable bending catheter sheath comprises a controllable bending catheter sheath and a control handle, an inner tube channel is arranged in the control handle, the proximal end of the controllable bending catheter sheath is arranged in the inner tube channel, and the proximal end of the controllable bending catheter sheath is fixedly butted with and communicated with the inner tube channel; the bending degree of the distal end of the controllable bending catheter sheath is controllable, and the inner sheath tube penetrates from the inner tube channel of the control handle and is arranged in the controllable bending catheter sheath in a penetrating way. The bending-adjustable lower cavity electrode lead pulling-out device disclosed by the utility model is used for carrying out lower cavity electrode lead pulling-out operation, so that the lower cavity electrode lead pulling-out device can be more efficient and more convenient to capture an electrode lead in a heart cavity.

Description

Lower cavity electrode wire pulling-out device capable of adjusting bending
Technical Field
The utility model belongs to the field of minimally invasive intervention in cardiology, and particularly relates to a lower cavity electrode lead pulling-out device with adjustable bending.
Background
For over five decades, cardiac rhythm implant devices such as cardiac pacemakers (abbreviated as "pacemakers"), buried cardioverter defibrillators (ICDs), and Cardiac Resynchronization Therapy (CRTs), have improved the quality of life of patients, as well as saved the lives of more patients. However, with the proliferation of the number of implants, the conditions of capsular bag infection, infectious endocarditis, equipment upgrading, electrode lead failure and the like are growing year by year, so that the current cases of removing the intravenous electrode lead are increasing. For example: about 10% of the pacemakers' electrode leads fail or become infected, and all of these electrode leads have to be pulled out; the mortality rate is markedly increased in patients with heart rhythm implant devices, particularly those with infections involving the tricuspid valve. There are about 24000 cases of transvenous electrode wire removal surgery worldwide per year, with 2/3 of the implanted device infections.
The current electrode lead removing device comprises an upper cavity removing device (such as a laser sheath, a mechanical sheath and the like) and a lower cavity removing device (such as a Needle Eye Snare, english name is Needle's Eye Snare), and the current application of the lower cavity removing device in China is increasing in cases of removing the electrode lead. The heart internal medicine of the people hospitals of Beijing university is the largest electrode lead pulling-out treatment center in China at present, 200-300 patients receiving electrode lead pulling-out every year, the number of electrode lead pulling-out is 500-800, and the heart is the center for carrying out electrode lead pulling-out at earliest in China. The university of Beijing people hospital in 2019 published the experience of applying lower cavity electrode wire removal for the maximum sample size in China, and the number of electrode wire removal exceeded 900. At present, part of the foreign centers also use the lower cavity removing device as a first-choice tool for removing the electrode wires, and relevant analysis is made on the safety and effectiveness of the lower cavity removing device.
The existing electrode lead pulling device has no design with adjustable bend, the head end of a sheath tube cannot be adjusted in the process of electrode lead pulling, capturing of an electrode lead is not facilitated, and particularly when the electrode lead is seriously adhered, the electrode is captured at the tricuspid ring part or a low-position atrium, so that the pulling operation is difficult.
Disclosure of Invention
Aiming at the problems, the utility model aims to provide a lower cavity electrode lead pulling-out device with adjustable bending, which is used for solving the problems that the head end of a sheath tube cannot be adjusted in the process of electrode lead pulling-out in the existing lower cavity electrode lead pulling-out device, and the capturing of an electrode lead is not facilitated.
In order to achieve the above purpose, the present utility model adopts the following technical scheme:
the utility model discloses a lower cavity electrode lead pulling device with adjustable bending, which comprises:
the inner sheath tube is internally provided with a fixed guide wire at the far end, the inner sheath tube is internally provided with a movable guide wire, the tail end of the movable guide wire is in butt joint with a push rod, the push rod is provided with a handle, and the far end of the movable guide wire extends out of the inner sheath tube forwards or is buried in the inner sheath tube backwards in the process of holding the handle to push forwards or pull out the push rod backwards;
the controllable bending catheter sheath comprises a controllable bending catheter sheath and a control handle, wherein an inner tube channel is arranged in the control handle, and the proximal end of the controllable bending catheter sheath is arranged in the inner tube channel or fixedly butted with the inner tube channel and communicated with the inner tube channel;
the bending degree of the distal end of the controllable bending catheter sheath is controllable, and the inner sheath tube penetrates from the inner tube channel of the control handle and penetrates into the controllable bending catheter sheath.
Further, the controllable curved catheter sheath is a controllable sheath with a hemostatic valve controllable curved sheath.
Further, a sheath tube is arranged outside the inner sheath tube, and a ferrule is arranged between the inner sheath tube and the sheath tube; the handle is provided with a joint for butting the injector, and the interior of the joint is communicated with the interior of the inner sheath tube and is in sealing connection through the handle;
thereby forming a needle eye snare.
Further, the controllable bending catheter sheath is a combined tube body formed by mutually nesting an inner tube, a middle tube and an outer tube, the distal end of the combined controllable bending catheter sheath is a bendable tube section, the tail end of the distal end is provided with a soft head end, and meanwhile, the distal end parts of the tube bodies of the inner tube and the middle tube are respectively provided with an inner tube notch and a middle tube notch which are uniformly distributed and have a certain length and width, so that a bendable structure is formed;
in addition, the combined controllable bending catheter sheath is connected with the catheter sheath, and the catheter body which is partially penetrated in the control handle is a straight tube body;
the control handle comprises a handle and a knob mechanism, the handle is fixedly connected with a controllable bending catheter sheath penetrating into the handle through a positioning sleeve, the knob mechanism comprises a knob, a cutting sleeve and a positioning pin which are arranged at the rear part of the handle, the knob is sleeved on the cutting sleeve, and a driving structure of a tube body at the far end bending part of the controllable bending catheter sheath is formed by connecting a thread structure between the knob and the cutting sleeve; the clamping sleeve is sleeved on the cylinder at the rear part of the handle and is in positioning connection with the clamping sleeve through the positioning pin and the two positioning gaskets.
Further, an inner tube incision arranged on the inner tube is arranged towards the outer tube direction of the controllable bending catheter sheath, and an intermediate tube incision on the intermediate tube is arranged towards the central direction of the controllable bending catheter sheath.
Further, the proximal end part of the inner tube in the controllable bending catheter sheath is fixed on a cylinder at the rear part of the handle through a positioning washer after penetrating into the central hole of the handle;
the middle tube in the controllable bending catheter sheath is fixed through a positioning sleeve arranged in the far end of the handle; the outer tube in the controllable bending catheter sheath is directly clamped and fixed by the far end port of the handle.
Further, the distal end of the outer tube is provided as a soft tip;
the far end of the inner tube and the far end of the middle tube are provided with head end metal tubes, and the inner tube and the middle tube are metal material pieces and are welded with the head end metal tubes.
Due to the adoption of the technical scheme, the utility model has the following advantages:
the utility model provides a lower cavity electrode wire pulling-out device with adjustable bending, which takes an inner sheath tube of a needle eye snare and a guide wire thereof as a main body, introduces the design of the adjustable bending sheath tube, and designs the lower cavity electrode wire pulling-out device with adjustable bending on the basis of the existing electrode wire pulling-out device. The controllable bending of the catheter sheath is regulated, and the bending of the head end tube body is regulated through the rotation of the tail part, so that the electrode wire is captured. The bending-adjustable design of the head end can push the capturing device of the inner cavity to more positions in the heart cavity, particularly the electrode wire at the lower position in the heart cavity can provide a better direction to capture and pull out the electrode wire. In a word, the lower cavity electrode lead pulling-out device with the adjustable bend disclosed by the utility model is used for carrying out lower cavity electrode lead pulling-out operation, so that the lower cavity electrode lead pulling-out device can be more efficient and more convenient to capture an electrode lead in a heart cavity.
Drawings
Various other advantages and benefits will become apparent to those of ordinary skill in the art upon reading the following detailed description of the preferred embodiments. The drawings are only for purposes of illustrating the preferred embodiments and are not to be construed as limiting the utility model. Like parts are designated with like reference numerals throughout the drawings.
FIG. 1 is a schematic diagram of a lower chamber electrode lead remover with adjustable bending according to embodiment 1 of the present utility model;
fig. 2 is a schematic structural view of the needle eye snare disclosed in embodiment 1 of the present utility model;
FIG. 3 is a schematic view showing the structure of a sheath tube of the needle eye snare disclosed in embodiment 1 of the present utility model;
FIG. 4 is a schematic three-dimensional view of the steerable catheter sheath disclosed in example 1 of the present utility model;
FIG. 5 is a front view of the steerable catheter sheath disclosed in example 1 of the present utility model;
FIG. 6 is a longitudinal cross-sectional view of a steerable catheter sheath disclosed in example 1 of the present utility model;
FIG. 7 is a longitudinal cross-sectional view of the steerable catheter sheath disclosed in example 1 of the present utility model;
fig. 8 is a longitudinal sectional view of the control handle disclosed in embodiment 1 of the present utility model.
Detailed Description
Exemplary embodiments of the present utility model will be described in more detail below with reference to the accompanying drawings. While exemplary embodiments of the present utility model are shown in the drawings, it should be understood that the present utility model may be embodied in various forms and should not be limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the utility model to those skilled in the art.
It should be noted that, the proximal end refers to an end of the apparatus close to the user, and the corresponding end far from the user is a distal end, which is the same as the following.
The utility model discloses a bendable lower cavity electrode lead pulling-out device, which is a clinical practical medical instrument and is mainly applied to pulling out a pacemaker electrode lead. The utility model is based on needle eye snare, combines the clinical practice, introduces the design of adjustable curved sheath tube into electrode wire pulling device, can directly reference the controllable sheath with hemostatic valve controllable curved sheath, realizes the turning in one dimension of left and right direction, can redesign the controllable curved catheter sheath capable of turning, improves the common lower cavity electrode wire pulling device into the adjustable curved lower cavity electrode wire pulling device, can adjust the bending degree through the outer sheath tube in the electrode wire pulling process, achieves better multidirectional electrode wire pulling, and improves the success rate of electrode wire capturing and pulling.
Example 1
Embodiment 1 provides a bending-adjustable lower cavity electrode lead removing device, and the structure of the device is described in detail below with reference to the accompanying drawings.
Referring to fig. 1, 6 to 8, the bending-adjustable lower lumen electrode lead wire removing device comprises an inner sheath tube 1 and a bending-controllable catheter sheath 3,
a fixed guide wire 11 is arranged in the distal end of the inner sheath tube 1, a movable guide wire 12 is arranged in the inner sheath tube 1, the tail end of the movable guide wire 12 is in butt joint with a push rod 13, the push rod 13 is provided with a handle 14, and the distal end of the movable guide wire 12 extends out of the inner sheath tube 1 forwards or is buried in the inner sheath tube 1 backwards in the process of holding the handle 14 to push forwards or pull the push rod 13 backwards;
referring to fig. 4 to 6, the steerable catheter sheath 3 includes a steerable catheter sheath 31 and a control handle 32, wherein an inner tube channel 100 is provided in the control handle 32, and a proximal end of the steerable catheter sheath 31 is disposed in the inner tube channel 100 or a proximal end of the steerable catheter sheath 31 is fixedly butted with and mutually communicated with the inner tube channel 100;
the bending degree of the distal end of the controllable bending catheter sheath 3 is controllable, and the inner sheath tube 1 penetrates from the inner tube channel 100 of the control handle 32 and penetrates into the controllable bending catheter sheath 31.
Specifically, a sheath tube 2 is arranged outside the inner sheath tube 1, as shown in fig. 3, and a ferrule is arranged between the inner sheath tube 1 and the sheath tube 2; the handle 14 is provided with a joint 15 for butting against the injector, and the interior of the joint 15 is communicated with the interior of the inner sheath tube 1 and is in sealing connection through the handle 14;
thereby forming a needle eye snare as shown in fig. 2.
Among them, needle Eye Snare, also called "Needle Eye catcher", english name Needle's Eye Snare.
The needle eye snare imports medicine, the import number of which is "national food medicine supervision (in) word 2013, 3771001 (change)". Needle eye snare sets are available on the market under the english name Needle's Eye Snare Retrieval Set.
Needle eye snare sets were developed and manufactured by kuke Medical inc (handy Medical inc.) and the product was designed for percutaneous retrieval of catheters, cardiac electrodes, catheter or guidewire segments and other foreign objects. The specifications are LR-NES541, LR-NES001, LR-NES002, LR-SSN001, LR-SSN002.
For more structural information on needle eye snares, see U.S. patent 08/458827.
Controllable catheter sheath with hemostatic valve (Agilis NxT) as imported drug, english name: hemostasis Introducer, its import approval document is: the product consists of an expander, a guide wire and a controllable sheath, wherein the 3211778 th or 3773000 th of the national food and medicine monitoring instrument (in) is 2008 or 2012. As a specific embodiment for realizing the controllable bending degree of the distal end of the controllable bending catheter sheath 3, a controllable sheath with a hemostatic valve controllable bending catheter sheath may be used.
As a specific embodiment for realizing the controllable bending degree of the distal end of the controllable bending catheter sheath 3, specifically, referring to fig. 7, the controllable bending catheter sheath 31 is a combined tube body formed by nesting three layers of an inner tube 311, a middle tube 312 and an outer tube 313, the distal end of the combined controllable bending catheter sheath 31 is a bendable tube section, and a soft end 314 is arranged at the distal end, meanwhile, the distal end parts of the tube bodies of the inner tube 311 and the middle tube 312 are respectively provided with an inner tube incision 3111 and a middle tube incision 3121 which are uniformly distributed and have a certain length and width, thereby forming a bendable structure;
in addition, the combined controllable curved catheter sheath 31 is a straight tube body connected with and partially penetrating the control handle 32.
Referring to fig. 8, the control handle 32 includes a handle 321 and a knob mechanism, the handle 321 is fixedly connected with a controllable bending catheter sheath 31 penetrating into the handle 321 through a positioning sleeve 322, the knob mechanism includes a knob 412, a cutting sleeve 413 and a positioning pin 414 which are arranged at the rear part of the handle 321, the knob 412 is sleeved on the cutting sleeve 413, and a driving structure of a tube body at the far end bending part of the controllable bending catheter sheath 31 is formed by connecting the knob 412 with the cutting sleeve 413 through a thread structure; the clamping sleeve 413 is sleeved on a cylinder at the rear part of the handle 321 and is in positioning connection with the clamping sleeve through a positioning pin 414 and two positioning gaskets 415.
Specifically, the inner tube incision 3111 provided on the inner tube 311 is provided toward the outer tube direction of the steerable catheter sheath 31, and the intermediate tube incision 3121 on the intermediate tube 312 is provided toward the tube center direction of the steerable catheter sheath 31.
Specifically, the proximal end portion of the inner tube 311 in the controllable bending catheter sheath 31 is fixed on the cylinder at the rear of the handle 321 via a positioning washer 415 after penetrating into the central hole of the handle 321;
the middle tube 312 in the controllable bending catheter sheath 31 is fixed by a positioning sleeve 322 arranged in the distal end of a handle 321; the outer tube 313 in the controllable bending catheter sheath 31 is directly clamped and fixed by the distal end port of the handle 321.
Specifically, the distal end of the outer tube 313 is provided with a soft end 314, and the soft end 314 is made of soft polymer material silica gel and polyamide with lower hardness;
the outer tube 313 is made of nylon, polyamide and polytetrafluoroethylene materials;
the distal ends of the inner tube 311 and the intermediate tube 312 are provided with a head end metal tube 315, and the inner tube 311 and the intermediate tube 312 are metal material pieces and are welded with the head end metal tube 315.
Finally, it should be noted that: the above embodiments are only for illustrating the technical solution of the present utility model, and are not limiting; although the utility model has been described in detail with reference to the foregoing embodiments, it will be understood by those of ordinary skill in the art that: the technical scheme described in the foregoing embodiments can be modified or some technical features thereof can be replaced by equivalents; such modifications and substitutions do not depart from the spirit and scope of the technical solutions of the embodiments of the present utility model.

Claims (7)

1. A lower chamber electrode lead pulling device capable of adjusting bending, which is characterized by comprising:
the inner sheath tube (1), the inside of inner sheath tube (1) distal end is provided with fixed seal wire (11), the inside of inner sheath tube (1) is provided with movable seal wire (12), the tail end butt joint of movable seal wire (12) has push rod (13), push rod (13) are furnished with handle (14), grip handle (14) forward push or pull out backward push rod (13) in the in-process, the distal end of movable seal wire (12) stretches out forward inner sheath tube (1) or is hidden backward in inner sheath tube (1);
the controllable curved catheter sheath (3) comprises a controllable curved catheter sheath (31) and a control handle (32), wherein an inner pipe channel (100) is arranged in the control handle (32), and the proximal end of the controllable curved catheter sheath (31) is arranged in the inner pipe channel (100) or the proximal end of the controllable curved catheter sheath (31) is fixedly butted with the inner pipe channel (100) and communicated with each other;
the bending degree of the distal end of the controllable bending catheter sheath (3) is controllable, and the inner sheath tube (1) penetrates from the inner tube channel (100) of the control handle (32) and penetrates into the controllable bending catheter sheath (31).
2. The bending-adjustable lower cavity electrode lead pulling device according to claim 1, wherein,
the controllable bending catheter sheath (3) is a controllable sheath with a hemostatic valve controllable bending catheter sheath.
3. The bending-adjustable lower cavity electrode lead pulling device according to claim 1, wherein,
a sheath tube (2) is arranged outside the inner sheath tube (1), and a ferrule is arranged between the inner sheath tube (1) and the sheath tube (2);
the handle (14) is provided with a joint (15) for butting the injector, and the interior of the joint (15) is communicated with the interior of the inner sheath tube (1) and is in sealing connection through the handle (14);
thereby forming a needle eye snare.
4. The bending-adjustable lower cavity electrode lead pulling device according to claim 1, wherein,
the controllable bending catheter sheath (31) is a combined tube body formed by mutually nesting three layers of an inner tube (311), a middle tube (312) and an outer tube (313), the distal end of the combined controllable bending catheter sheath (31) is a flexible tube section, a soft head end (314) is arranged at the tail end of the distal end, and meanwhile, the distal end parts of the tube bodies of the inner tube (311) and the middle tube (312) are respectively provided with an inner tube incision (3111) and a middle tube incision (3121) which are uniformly distributed and have a certain length and width, so that a flexible structure is formed;
in addition, the combined controllable bending catheter sheath (31) is connected with a pipe body which is partially penetrated in the control handle (32) and is a straight pipe body;
the control handle (32) comprises a handle (321) and a knob mechanism, the handle (321) is fixedly connected with a controllable bending catheter sheath (31) penetrating into the handle (321) through a positioning sleeve (322), the knob mechanism comprises a knob (412), a clamping sleeve (413) and a positioning pin (414), the knob (412) is sleeved on the clamping sleeve (413), and a driving structure of a tube body at the far end bending part of the controllable bending catheter sheath (31) is formed by connecting a thread structure between the knob and the clamping sleeve; the clamping sleeve (413) is sleeved on a cylinder at the rear part of the handle (321), and is in positioning connection with the clamping sleeve through a positioning pin (414) and two positioning washers (415).
5. The bending-adjustable lower cavity electrode lead pulling device according to claim 4, wherein,
an inner tube incision (3111) arranged on the inner tube (311) is arranged towards the outer tube direction of the controllable bending catheter sheath (31), and an intermediate tube incision (3121) on the intermediate tube (312) is arranged towards the central tube direction of the controllable bending catheter sheath (31).
6. The bending-adjustable lower cavity electrode lead pulling device according to claim 4, wherein,
the proximal end part of the inner tube (311) in the controllable bending catheter sheath (31) is fixed on a cylinder at the rear part of the handle (321) through a positioning gasket (415) after penetrating into the central hole of the handle (321);
the middle tube (312) in the controllable bending catheter sheath (31) is fixed through a positioning sleeve (322) arranged in the far end of the handle (321); the outer tube (313) in the controllable bending catheter sheath (31) is directly clamped and fixed by the far-end port of the handle (321).
7. The bending-adjustable lower cavity electrode lead pulling device according to claim 4, wherein,
the distal end of the outer tube (313) is provided as a soft tip (314);
the far end of inner tube (311) with the distal end of intermediate tube (312) is provided with head end metal pipe (315), inner tube (311) intermediate tube (312) are metal material spare, all weld with head end metal pipe (315).
CN202321620155.6U 2023-06-25 2023-06-25 Lower cavity electrode wire pulling-out device capable of adjusting bending Active CN220069828U (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN202321620155.6U CN220069828U (en) 2023-06-25 2023-06-25 Lower cavity electrode wire pulling-out device capable of adjusting bending

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
CN202321620155.6U CN220069828U (en) 2023-06-25 2023-06-25 Lower cavity electrode wire pulling-out device capable of adjusting bending

Publications (1)

Publication Number Publication Date
CN220069828U true CN220069828U (en) 2023-11-24

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