FR2660851A1 - Device for unblocking vascular channels, such as the arteries - Google Patents

Device for unblocking vascular channels, such as the arteries Download PDF

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Publication number
FR2660851A1
FR2660851A1 FR9004964A FR9004964A FR2660851A1 FR 2660851 A1 FR2660851 A1 FR 2660851A1 FR 9004964 A FR9004964 A FR 9004964A FR 9004964 A FR9004964 A FR 9004964A FR 2660851 A1 FR2660851 A1 FR 2660851A1
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France
Prior art keywords
tool
means
characterized
device according
comprises
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Withdrawn
Application number
FR9004964A
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French (fr)
Inventor
Koskas David
Camus Michel
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CARDIAL SA
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CARDIAL SA
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Priority to FR9004964A priority Critical patent/FR2660851A1/en
Publication of FR2660851A1 publication Critical patent/FR2660851A1/en
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/3205Excision instruments
    • A61B17/3207Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/320758Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven

Abstract

The invention relates to a device (1) for unblocking vascular channels, such as the arteries, which device comprises: - at least one instrument (3) of the rotary type equipped with at least one cutting edge (4), - at least one drive means (5) generating, at least indirectly, a movement for activating the abovementioned instrument (3), - at least one flexible member (6), called the transmission member, this device being characterised in that, instead of consisting of a drive means moving the instrument in constant rotation in one defined direction, the drive means (5) comprises a means for moving the instrument in alternating rotation, on the one hand over at least two predetermined angular extents of opposite directions, and on the other hand at least two angular speeds which are likewise predetermined and of opposite kinds. <IMAGE>

Description

L'invention se rapporte à un dispositif de désobstruction de conduits vasculaires tels des artères. The invention relates to a vascular conduits clearing device such arteries.

Tel que cela est connu, les parois de certains conduits vasculaires peuvent se charger de dépôts dits plaques d'athérome qui, notanrent, engendrent l'obstruction de ces conduits. As is known, the walls of some vascular conduits can take over deposits called atherosclerotic plaques, notanrent, cause obstruction of the ducts.

Pour remédier à l'obstruction de vaisseaux, il est connu de prélever récaniquement ces dépôts athéromateux au moyen d'un outil introduit par le biais d'un cathéter au niveau du site à traiter. To remedy the blockage of vessels, it is known to take récaniquement these atheromatous deposits using a tool introduced through a catheter at the treatment site.

Ces outils sont classiquement animés d'un mouvement rotatif continu dans un sens donne et ont leur partie active sensiblement conçue comme celle d'une fraise d'usinage. These tools are conventionally driven in a continuous rotational movement in one direction gives substantially designed and have their active part such as a bur.

Généralement, les dépôts athéromateux précités sont calcifiés et donc tres durs ce qui implique l'utilisation de fraises diamentées entraînées en rotation à plusieurs milliers de tours par minute. Generally, the aforementioned calcified atherosclerotic deposits are very hard and thus implying the use of strawberries diamentées rotated at several thousand revolutions per minute.

On reproche aux dispositifs de désobstruction ainsi constitues d'être trop agressifs vis à vis des parois des vaisseaux traites qu'en outre, ils sollicitent trop énergiquement en torsion, ce qui est néfaste compte tenu de la relative fragilité ce type de sollicitations mécaniques de ces parois altérées. Are blamed for clearing devices thus formed to be too aggressive with respect to walls of the treated vessel in addition, they request too strongly in torsion, which is detrimental in view of the relative fragility of this type of mechanical stresses of these altered walls.

De plus, avec ce type de dispositif de désobstruction, on contrôle mal la trajectoire de l'outil dans le conduit vasculaire, lequel outil peut tendre à perforer la paroi vasculaire. Furthermore, with this type of clearing device, it is difficult to control the trajectory of the tool in the vascular conduit, which tool may tend to puncture the vessel wall.

Un résultat que l'invention vise à obtenir est un dispositif de désobstruction de conduits vasculaires qui rerédi e aux inconvénients précités. A result which the invention aims to obtain is a clearing device for vascular conduits e rerédi the aforementioned drawbacks.

A cet effet, l'invention a pour objet un dispositif du type précité notamment caractérisé en ce qu'au lieu de consister en un moyen moteur d'entraînement en rotation continue de l'outil dans un sens déterminé, le woyen moteur comprend un moyen d'entraînement de l'outil en rotation alternative selon, d'une part, au moins deux amplitudes angulaires prédéterminées de sens opposes, et, d'autre part, au moins deux vitesses angulaires salement prédéterminées et de signes opposés. To this end, the invention relates to a device of the abovementioned type in particular characterized in that, instead of consisting of a drive motor means in continuous rotation of the tool in a given direction, the engine comprises means woyen driving the tool in rotation according to an alternative, on the one hand, at least two predetermined angular amplitudes of opposite directions, and, secondly, at least two predetermined angular velocities badly and opposite signs.

L invention sera bien comprise à l'aide de la description ci-aprés faite à titre d'exemple non limitatif en regard du dessin ci-annexe qui représente schématiquement The invention will be better understood using the description hereinafter, given by way of example with reference to the following attached drawing representing schematically
- figure 1 : le dispositif de l'invention vue en coupe longitudinale, - figure 1: the device of the invention seen in longitudinal section,
- figure 2 : à plus grande échelle, une vue selon F de la figure 1. - Figure 2: on an enlarged scale, a view according to F of Figure 1.

En se reportant au dessin, on voit un dispositif 1 de désobstruction de conduits vasculaires 2 tels des artères. Referring to the drawing, one sees a device 1 for unblocking vascular conduit 2 such as arteries.

Le dispositif comprend The device comprises
- au moins un outil 3 de type rotatif doté d'au moins une arête de coupe 4, - at least one 3 type rotary tool with at least one cutting edge 4,
- au moins un moyen moteur 5 générant au moins indirectement un mouvement d'actionnement de l'outil 3 précité, - at least a motor means 5 generating at least indirectly an actuation movement of the aforesaid tool 3,
- au moins un organe flexible 6, dit de transmission, et dont l'une 7 des extrémités 7, 8 est accouplée à l'outil 3 tandis que l'autre extrémité 8 est accouplée au moyen 5 moteur. - at least one flexible member 6, said transmission, and of which one 7 of the ends 7, 8 is coupled to the tool 3 while the other end 8 is connected through motor 5.

Selon l'invention, au lieu de consister en un moyen moteur d'entraînement en rotation continue de l'outil dans un sens déterminé, le moyen 5 moteur comprend un moyen d'entraînement de l'outil en rotation alternative selon, d'une part, au moins deux amplitudes angulaires prédéterminées de sens opposes, et, d'autre part, au moi nus deux vitesses angulaires également prédéterminées et de signes opposés. According to the invention, instead of consisting of a motor means continuously rotating the tool in a predetermined direction, the means 5 comprises a motor of the tool in alternative rotation driving means according to the one hand, at least two predetermined angular amplitudes of opposite directions, and on the other hand, the self bare two angular velocities also predetermined and opposite signs.

De préférence, le moyen moteur comprend des organes de réglage des valeurs des amplitudes et des vitesses angulaires précitées. Preferably, the driving means comprises actuators the values ​​of the amplitudes and of the above angular velocities.

Les deux amplitudes angulaires sont, par exemple, identiques et de l'ordre de cent vingts degrés. The two angular amplitudes are, for example, identical and of the order of hundred eighty degrees.

Par exemple, le moyen moteur 5 imprime à l'outil un mouvement de l'ordre de cinquante alternances par secondes. For example, the average motor 5 prints to the tool movement of around fifty beats per second.

Conforément à l'invention, l'outil rotatif 3 utilisé comprend au foins deux arêtes 4 de coupe, chacune active dans l'un des deux sens de rotation. Conforément to the invention, the rotating tool 3 used comprises at fever two edges 4 cutting each active in one of two directions of rotation.

De manière connue, l'organe de transmission 6 est logé dans un tube souple 9 dit cathéter. In known manner, the transmission member 6 is housed in a flexible tube 9 said catheter.

Selon l'invention, ve l'outil comprend au moins une face frontale 10 dans laquelle, notamment en partie centrale, débouche au moins un premier canal 11 qui s'étend par ailleurs tout au long de l'outil et se prolonge lla dans l'organe de transmission sensiblement jusqu'à son extrémité 8 accouplée au moyen moteur 5 et, d'autre part, au moins une face dorsale 12 entre laquelle et la face extrême 13, en vis à vis d'un cathéter qui loge l'organe d'entraînement, subsiste un passage 14 relié à un second canal 15 qui s'étend quant à lui longitudinalement au cathéter et ce sensibleirent jusqu'à son extrémité libre voisine du moyen 5 moteur. According to the invention, ve the tool comprises at least one end face 10 in which, in particular central portion opens at least a first channel 11 which also extends throughout the tool lla and extends in transmission member 8 substantially up to its end connected to the motor means 5 and, on the other hand, at least a dorsal face 12 between which and the end face 13, facing a catheter which houses the body drive, a passage 14 remains connected to a second channel 15 which extends longitudinally in turn to the catheter and this sensibleirent to its neighboring free end of the motor means 5.

L'un 11 de ces canaux 11, 15 est relie à un moyen 16 d'injection de fluide tandis que l'autre 15 est relié à un moyen 17 d'aspiration de fluide. One 11 of these channels 11, 15 is connected to a means 16 for injecting fluid and the other 15 is connected to means 17 for fluid suction.

Confor-éri ent l'invention, c'est le canal 11 débouchant dans la face frontale 10 de l'outil qui est relié au moyen 16 d'injection de fluide tandis que le canal 15 débouchant par le passage 14 au droit de la face dorsale 12 de cet outil est relié au moyen 17 d'aspiration de fluide. Ent-ERI in accordance with the invention, the channel 11 opens into the end face 10 of the tool which is connected to means 16 for injecting fluid while channel 15 opening through the passage 14 to the right of the face back 12 of the tool 17 is connected by means of fluid aspiration.

D'une part, l'outil comporte un corps 18 globalement cylindrique de révolution et ce corps 18 porte des parties actives minces 19 telles des lames présentant chacune, en saillie, par rapport au dit corps 18 au moins une arête de coupe 4 et, d'autre part, au moins certaines de ces arêtes s'étendent sensiblement parallélement à l'enveloppe du corps cylindrique depuis le bord périphérique de la face dorsale 12 de l'outil jusque dans le plan de la face frontale 10 de cet outil. On the one hand, the tool comprises a generally cylindrical body of revolution 18 and said body 18 has thin portions 19 active such blades each having in projecting relationship with respect to said body 18 at least one cutting edge 4 and, secondly, at least some of the ridges extend substantially parallel to the envelope of the cylindrical body from the peripheral edge of the back face 12 of the tool into the plane of the front face 10 of the tool.

De préférence, chaque lame 19 s'étend dans un plan sensiblement radial au corps cylindrique de l'outil et présente au droit de la paroi cylindrique de cet outil, deux arêtes 4 qui, situées de part et d'autre d'un plan médian à la lame, convergent vers ce plan médian et ce, depuis la face frontale 10 de l'outil vers la surface dorsale 12. Preferably each blade 19 extends in a substantially radial plane with the cylindrical body of the tool and has the right to the cylindrical wall of the tool, which two edges 4, located on either side of a median plane at the blade converging towards this median plane and, since the end face 10 of the tool to the back surface 12.

Ces fores permettent d'optimiser le décolmatage des lames de l'outil. These drilled optimize the declogging of the blades of the tool.

Conformément à l'invention, au moins certaines des parties actives 19 de l'outil comportent une face extrême 20 sensiblernent radiale et située au niveau de la face frontale 10 de l'outil avec dans cette face extrême au moins une rainure 21 qui s'étend sensiblement parallèlement aux flancs 22 de la lame qui constitue la partie active considérée. According to the invention, at least some of the active 19 of the tool parts have a radial end face 20 sensiblernent and located at the end face 10 of the tool in this end face at least one groove 21, which s' extends substantially parallel to the flanks 22 of the blade which constitutes the active portion considered.

Le dispositif de l'invention permet de remédier aux inconvénients des dispositifs animés d'un mouvement rotatif continu dans un sens déterminé. The device of the invention overcomes the drawbacks animated devices of a continuous rotary movement in a determined direction.

Précisément, il obvie à un échauffement notable induit au droit des parois vasculaires par les dispositifs connus. Specifically, it obviates a significant temperature rise induced to the right of the vessel walls by the known devices.

Egalement, il permet l'élimination des particules de la plaque d'athérome détachées par l'outil. Also, it allows the elimination of the particles of the atheromatous plaque detached by the tool.

De plus, l'alternance de mouvements de l'outil est moins agressive pour les conduits vasculaires que le mouvement rotatif continu des dispositifs connus. In addition, the alternating movements of the tool is less aggressive to the vascular conduits that the continuous rotational movement of the known devices.

Eventuellement, l'outil porte sur sa face frontale 10 au moins une excroissance centrale 23 qui constitue un nez de centrage dans un éventuel canal 24 pouvant subsister au centre du conduit vasculaire à traiter. Optionally, the tool holder on its end face 10 at least one central projection 23 which constitutes a centering nose in a prospective channel 24 may remain at the center of the vascular duct to be treated.

Le cathéter porte l'outil au moins par le biais d'un moyen 25 de guidage en rotation qui comporte au moins un passage 26 en vue d'assurer la continuité du conduit 15 débouchant à l'extrémité du cathéter 9 voisine de l'outil. The catheter carries the tool at least through a means 25 for guiding in rotation which comprises at least one passage 26 in order to ensure the continuity of the duct 15 opening at the end of nine neighboring catheter of the tool .

Claims (9)

REVENDICATIONS
1. Dispositif (1) de désobstruction de conduits vasculaires (2) tels des artères, lequel dispositif comprend 1. Device (1) for clearing of vascular conduits (2) such as arteries, which apparatus comprises
- au moins un outil (3) de type rotatif doté d'au moins une arête de coupe (4), - at least one tool (3) of the rotary type provided with at least one cutting edge (4),
- au moins un moyen moteur (5) générant au moins indirectement un mouvement d'actionnement de l'outil (3) précité, - at least one motor means (5) generating at least indirectly an actuation movement of the tool (3) supra,
- au moins un organe flexible (6), dit de transmission, et dont l'une (7) des extrémités (7, 8) est accouplée à l'outil (3) tandis que l'autre extrémité (8) est accouplée au moyen moteur (5), - at least one flexible member (6), said transmission, and of which one (7) of the ends (7, 8) is coupled to the tool (3) while the other end (8) is coupled to motor means (5),
ce dispositif étant CARACTERISE en ce qu'au lieu de consister en un moyen moteur d'entraînement en rotation continue de l'outil dans un sens déterminé, le moyen moteur (5) comprend un moyen d'entraînement de # l'outil en rot rotation alternative selon, d'une part, au moins deux amplitudes angulaires prédéterminées de sens opposés, et, d'autre part, au moins deux vitesses angulaires également prédéterminées et de signes opposés. this device being characterized in that, instead of consisting of a motor means continuously rotating the tool in a given direction, the motor means (5) comprises a driving means of the tool # rot reciprocal rotation according, firstly, at least two predetermined angular amplitudes in opposite directions, and, secondly, at least two angular velocities also predetermined and opposite signs.
2. Dispositif selon la revendication 1 caractérisé en ce que l'outil rotatif (3) utilisé comprend au moins deux arêtes (4) de coupe, chacune active dans l'un des deux sens de rotation. 2. Device according to claim 1 characterized in that the rotating tool (3) used comprises at least two edges (4) for cutting each active in one of two directions of rotation.
3. Dispositif selon la revendication 1 ou 2 caractérisé en ce que l'outil comprend au moins une face frontale (10) dans laquelle, notamment en partie centrale, débouche au moins un premier canal (11) qui s'étend par ailleurs tout au long de l'outil et se prolonge (lla) dans l'organe de transmission sensiblement jusqu'à son extrémité (8) accouplée au moyen moteur (5) et, d'autre part, au moins une face dorsale (12) entre laquelle et la face extrême (13), en vis à vis d'un cathéter qui loge l'organe d'entraînement, subsiste un passage (14) relié à un second canal (15) qui s'étend quant à lui longitudinalement au cathéter et ce sensiblement jusqu'à son extrémité libre voisine du moyen moteur (5). 3. Device according to claim 1 or 2 characterized in that the tool comprises at least one front face (10) wherein, in particular central portion emerges at least one first channel (11) extending also at along the tool and extends (lla) in the transmission element substantially to its end (8) coupled to the motor means (5) and, on the other hand, at least a dorsal face (12) between which and the end face (13) facing a catheter which houses the drive member, remains a passage (14) connected to a second channel (15) extending longitudinally in turn to the catheter and it substantially to its neighboring free end of the motor means (5).
4. Dispositif selon la revendication 3 caractérisé en ce que l'un (11) des canaux (11, 15) est relié à un moyen (16) d'injection de fluide tandis que l'autre (15) est relié à un moyen (17) d'aspiration de fluide. 4. Device according to claim 3 characterized in that one (11) of the channels (11, 15) is connected to means (16) for injecting fluid and the other (15) is connected to means (17) for fluid suction.
5. Dispositif selon la revendication 4 ou 5 caractérisé en ce que c'est le canal (11) débouchant dans la face frontale (10) de l'outil qui est relié au moyen (16) d'injection de fluide tandis que le canal (15) débouchant par le passage (14) au droit de la face dorsale (12) de cet outil est relié au moyen (17) d'aspiration de fluide. 5. Device according to claim 4 or 5 characterized in that it is the duct (11) opening into the end face (10) of the tool which is connected to means (16) for injecting fluid while the channel (15) opening through the passage (14) to the right of the dorsal face (12) of the tool is connected to means (17) for fluid suction.
6. Dispositif selon l'une quelconque des revendications 7 à 5 caractérisé en ce que d'une part, l'outil comporte un corps (18) globalement cylindrique de révolution et ce corps (18) porte des parties actives minces (19) telles des lames présentant chacune, en saillie, par rapport au dit corps (18) au moins une arête de coupe (4) et, d'autre part, au moins certaines de ces arêtes s'étendent sensiblement parallèlement à l'enveloppe du corps cylindrique depuis le bord périphérique de la face dorsale (12) de l'outil jusque dans le plan de la face frontale (10) de cet outil. 6. Device according to any one of claims 7-5 characterized in that on the one hand, the tool comprises a body (18) generally cylindrical in shape and said body (18) carries thin active parts (19) such blades each having in projecting relationship with respect to said body (18) at least one cutting edge (4) and, secondly, at least some of the ridges extend substantially parallel to the envelope of the cylindrical body from the peripheral edge of the dorsal face (12) of the tool into the plane of the end face (10) of this tool.
7. Dispositif selon la revendication 6 caractérisé en ce qu'au moins certaines des parties actives (19) de l'outil comportent une face extrême (20) sensiblement radiale et située au niveau de la a face frontale (10) de l'outil avec dans cette face extrême au moins une rainure (21) qui s'étend sensiblement parallèlement aux flancs (22) de la lame qui constitue la partie active considérée. 7. Device according to claim 6 characterized in that at least some of the active parts (19) of the tool comprises an end face (20) substantially radial and located at the a front face (10) of the tool with this end face at least one groove (21) extending substantially parallel to the flanks (22) of the blade which is considered the active portion.
8. Dispositif selon l'une quelconque des revendications 1 à 7 caractérisé en ce que le cathéter porte l'outil au moins par le biais d'un moyen (25) de guidage en rotation qui comporte au moins un passage (26) en vue d'assurer la continuité du conduit (15) débouchant à l'extrémité du cathéter (9) voisine de l'outil. 8. Device according to any one of claims 1 to 7 characterized in that the catheter carries the tool at least through a means (25) for guiding in rotation which comprises at least one passage (26) for to ensure continuity of the duct (15) opening at the end of the catheter (9) adjacent to the tool.
9. Dispositif selon l'une quelconque des revendications 1 à 8 caractérisé en ce que l'outil porte sur sa face frontale (10) au moins une excroissance centrale (23) qui constitue un nez de centrage dans un éventuel canal (24) pouvant subsister au centre du conduit vasculaire à traiter. 9. Device according to any one of claims 1 to 8 characterized in that the tool carries on its end face (10) at least a central protuberance (23) which constitutes a centering nose in a prospective channel (24) being remain the center of the vascular duct to be treated.
FR9004964A 1990-04-11 1990-04-11 Device for unblocking vascular channels, such as the arteries Withdrawn FR2660851A1 (en)

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US10045782B2 (en) 2015-07-30 2018-08-14 Covidien Lp Surgical stapling loading unit with stroke counter and lockout
US10213204B2 (en) 2015-10-02 2019-02-26 Covidien Lp Micro surgical instrument and loading unit for use therewith
US10111660B2 (en) 2015-12-03 2018-10-30 Covidien Lp Surgical stapler flexible distal tip

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