KR20120131522A - Intravascular therapeutic operating apparatus - Google Patents

Abstract

PURPOSE: A surgical instrument for blood vessel treatment is provided to increase the success rate of surgery by forming a punching member to be moved or rotated forward and backward. CONSTITUTION: A power transmission member(9) is moved or rotated along a conduit. A punching member(11) is combined with the top end of the power transmission member. A conduit moving device is combined with the conduit. The punching member is protruded from the head of the conduit moving device. A punching member rotating device(19) rotates the punching member in the forward or backward direction.

Description

[0001] The present invention relates to an intravascular therapeutic operating apparatus,

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical apparatus for treating blood vessels used for treating blood vessels by removing chronic total occlusion (CTO) lesions in the blood vessels.

Generally, cholestatic closure is caused by accumulation of lipid-rich cholesterol on the inner wall of the blood vessel, resulting in closure of the lumen of the blood vessel. The multilayered lipid and thrombus complexes constituting the chronic preclinical lesions of the blood vessels thus formed are replaced with collagen as time passes, and collagen forms a mass of multimolecular molecules from a single molecule, (calcification) to form the phosphorylation layer, preventing blood circulation.

As a treatment method for such chronic occlusion, a method of chemically decomposing and reperforating the fibrin-collagen complex in the closed portion and a method of physically puncturing are used.

Physical perforation of the chronically occluded lesion can be accomplished by threading the wire tip provided to the catheter and rotating the thread in the lesion.

However, the conventional treatment method of physically perforating the chronic preclinical lesion has a problem in that the procedure is performed inside a very narrow blood vessel, so that the inner wall of the blood vessel may be damaged during the procedure, thereby lowering the success rate of the surgery.

SUMMARY OF THE INVENTION Accordingly, the present invention has been made to solve the above-mentioned problems, and it is an object of the present invention to provide a vascular treatment method and a vascular treatment method which can prevent damage to the inner wall of a blood vessel during physical removal of a chronic pre- And to provide a surgical apparatus for use therewith.

In order to achieve the object of the present invention as described above, the present invention is a conduit provided with a space in the longitudinal direction therein, the head is coupled to the front end of the conduit, the head is provided with a hole in the longitudinal direction of the conduit, Blood vessel damage prevention unit coupled to the head, a power transmission member inserted into the conduit to move or rotate along the conduit, a perforated member coupled to the distal end of the power transmission member to puncture the blocked portion of the vessel, the conduit is coupled to the Conduit moving means for moving the conduit forward and backward relative to the power transmission member so as to protrude the perforation member from the head, and the power transmission member is coupled to the perforation member rotating means for rotating the perforating member in the forward or reverse direction. Including;

The blood vessel damage preventing unit is coupled between the plurality of balls arranged in a predetermined distance in front of the head, the plurality of the ball and the head and in close contact with the inner wall of the vessel in the radial direction based on the cross-section of the blood vessel or Provided is a surgical device for treating blood vessels including a ball support elastic member to return to an initial position.

The ball is provided with a hole, the ball supporting elastic member is preferably made of a wire having an elastic force is fitted into the hole provided in the ball to connect the ball and the head.

It is preferable that three to five balls are arranged.

The head is coupled to a head turning means for changing the direction, the head turning means is a lever hinged to the case, coupled to the lever and the head tilting the direction of the head changes in accordance with the movement of the lever It is preferable that the wire is disposed on the outer periphery of the tilting wire and the tube coupled to the head and the case.

The tube is preferably made of a synthetic resin pipe or coil spring.

The conduit has one end connected to the conduit rotation means, the conduit rotation means is a conduit rotation drive source coupled to the case, the shaft gear is coupled to the rotary shaft of the conduit rotation drive source, the conduit is rotated in engagement with the shaft gear It is preferable to include another gear that is engaged.

The conduit moving means is a conduit moving drive source coupled to the case, a shaft gear coupled to the rotary shaft of the conduit moving drive source, the gear is engaged with the shaft gear forward or reverse the conduit in the longitudinal direction by forward and reverse rotation of the shaft gear And another gear to which the conduit is coupled.

It is coupled to the power transmission member comprises a punching member moving means for repeatedly moving the punching member in the forward, backward direction, the punching member moving means is a drive source for moving the punching member coupled to the case, coupled to the rotating shaft to the drive source An eccentric member, a coupling groove into which the eccentric member is fitted, is provided and preferably includes a guide forward or backward along the case and to which the power transmission member is connected.

The conduit is made of a flexible tube, it is preferred that the coil spring is provided in a predetermined section on the head side portion.

The punching member rotating means includes a driving source for rotating the punching member disposed inside the case, and is preferably coupled to one end of the power transmission member to the rotation shaft of the driving source for rotating the punching member.

In the present invention as described above, the operator perforates the blocked portion of the vessel in the state where the perforated member is located in the center of the vessel while increasing the diameter of the vessel by moving the balls to the inner wall of the vessel in the process of perforating the blocked lesion of the vessel. Absence of damage to the vessel wall can be prevented, thereby increasing the therapeutic effect of chronic obstructive lesions of the vessel.

In addition, the present invention can be moved or rotated repeatedly in the front, rear direction by the drive source, the operation is convenient, it is possible to easily change the direction of the punching member, it is possible to perform a precise procedure.

1 is a view showing the external appearance of a surgical device for treating blood vessels that can be applied to chronic total occlusion lesions of blood vessels to explain an embodiment of the present invention.
FIG. 2 is a diagram illustrating an internal structure of the main part of FIG. 1.
3 is a view for explaining the configuration and operation of the punching member moving means for explaining an embodiment of the present invention.
FIG. 4 is a diagram schematically illustrating a cut IV-IV part of FIG. 3.
5 is a view for explaining the configuration of the punching member moving means for explaining an embodiment of the present invention.
6 is a view for explaining the main configuration of the perforation member moving means to explain the embodiment of the present invention.
7 is a view for explaining a perforation member rotating means for explaining an embodiment of the present invention.
FIG. 8 is a detailed view of portion A of FIG. 7.
9 is a view showing the main configuration of the conduit moving means and the conduit rotation means for explaining an embodiment of the present invention.
10 is a view for explaining the operation of the conduit moving means for explaining an embodiment of the present invention.
FIG. 11 is an enlarged view of the operation result of the conduit moving means by expanding the portion B of FIG. 10.
12 is a view showing a state before the head direction switching means for explaining an embodiment of the present invention.
FIG. 13 is a view illustrating a state in which the head turning means is operated to explain an embodiment of the present invention.

DETAILED DESCRIPTION Hereinafter, exemplary embodiments of the present invention will be described in detail with reference to the accompanying drawings so that those skilled in the art may easily implement the present invention. The present invention may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein. In order to clearly illustrate the present invention, parts not related to the description are omitted, and the same or similar components are denoted by the same reference numerals throughout the specification.

1 is a perspective view for explaining an embodiment of the present invention, Figure 2 is a view showing the internal structure of the disassembled part in Figure 1, showing a surgical device for vascular treatment.

Surgical device for treatment of blood vessels of an embodiment of the present invention, the case 1, the conduit (3), the head 5, the blood vessel damage prevention portion 7, the power transmission member 9, the perforation member 11 forming the appearance , Conduit moving means (13), head turning means (15), conduit rotating means (17), drilling member rotating means (19), and drilling member moving means (21) are shown.

Case 1 is provided with a space inside and the appearance can be made in the shape of a pistol so that the operator can easily hold and use.

The conduit 3 has a head 5 coupled to the distal end and provided with a space in which the power transmission member 9 can be accommodated along its length.

Conduit (3) is a portion that is inserted into the interior of the blood vessel is preferably made of a flexible tube of synthetic resin material. However, the embodiment of the present invention is not limited to the conduit (3) consisting of a flexible tube, a coil spring-coated tube, or a member such as a long elongated wire is braided, and a synthetic resin coated structure may be used. .

And it is preferable that the conduit 3 consists of the coil spring 23 in a fixed section in the head 5 side part. As such, the coil spring 23 provided at the distal end of the conduit 3 has excellent flexibility and restoring force to facilitate the change of direction of the head 5 and to easily return to the original position.

That is, the conduit 3 may be coupled to the head 5 at the distal end, the coil spring 23 is coupled to the head 5, the flexible tube may be coupled to the coil spring 23.

As shown in FIG. 8, the head 5 has a rounded tip shape, which is easily inserted into the blood vessel, and is shown in the holes 5a and 8 in the longitudinal direction of the conduit 3. ) Is provided. Through the holes 5a of the head 5, the puncturing member 11 may be received inside or protrude outward.

The tip of the head 5 is provided with a blood vessel damage preventing portion 7 (shown in FIG. 8). The blood vessel damage preventing unit 7 according to the embodiment of the present invention includes a plurality of balls 25 and a ball support elastic member 27 for fixing the balls 25 to the head 5.

The balls 25 are preferably arranged symmetrically four. In addition, the balls 25 are preferably arranged at a position spaced apart from the head (5). In particular, the balls 25 are preferably arranged on the same circumference. In the exemplary embodiment of the present invention, four balls 25 are illustrated and described, but the present invention is not limited thereto, and three or five balls may be disposed.

Holes 25a are drilled in the balls 25 so that the ball support elastic member 27 may be fitted like a bead. The balls 25 may contact the inner wall of the blood vessel, and thus may be made of steel or synthetic resin, which is harmless to the human body.

The ball support elastic member 27 may be made of a material such as a wire that is thin and long and has elastic force. The ball support elastic member 27 may be fitted into the hole 25a of the ball 25 and coupled to the head 5 by welding or the like. The ball support elastic member 27 serves to closely contact the inner wall of the blood vessel 25 or return to the initial position in the radial direction based on the cross section of the blood vessel by the elastic force. That is, the ball supporting elastic member 27 is preferably coupled to the head 5 so that the elastic force acts in the direction in which the balls 25 always return to their initial positions.

The structure of the blood vessel damage preventing unit 7 according to the embodiment of the present invention has a plurality of balls 14 supporting the inner wall of the blood vessel when the puncturing member 11 punctures the blocked portion of the blood vessel, so that the puncture member 11 always maintains the blood vessel. It can be located in the center.

The power transmission member 9 is inserted along the longitudinal direction in the conduit 3 and may be made of an elastic body such as a long wire. This power transmission member 9 can move or rotate along the longitudinal direction of the conduit 3.

The front end of the power transmission member 9 is coupled with a punching member 11 for puncturing the blocked portion of the blood vessel. The perforated member 11 may have a tip portion shaped like a flat head screwdriver tool. The puncturing member 11 serves to puncture the blocked portion of the blood vessel while rotating or repeatedly moving forward or backward.

The perforation member 11 is preferably of a size that can be accommodated or protruded into a hole provided in the head 5.

The conduit moving means 13 is arrange | positioned inside the case 1, as shown to FIG. 2, FIG. 9, FIG. A conduit 3 is coupled to the conduit moving means 13 and the conduit 3 can be moved forward or backward relative to the power transmission member 9 to protrude the perforated member 11 from the head 5.

The conduit moving means 13 may include a drive source 29 for moving the conduit, a shaft gear 31 and a gear 33.

The drive source 29 for conduit movement is fixedly installed in the case 1 and may be made of a motor. And the shaft gear 31 is coupled to the shaft of the drive source 29 for the conduit movement. The gear 33 is coupled to the shaft gear 31. The gear 33 coupled to the shaft gear 31 of the drive source 29 for conduit movement is disposed inside the case 1 so as to be movable in the longitudinal direction of the conduit 3. In the gear 33 coupled to the shaft gear 31, the gear teeth are preferably arranged to transmit the rotational force of the shaft gear 31 in a right angle direction. Accordingly, as the shaft gear 31 of the driving source 29 for moving the conduit forward or reverse rotates, the conduit 3 can be moved forward or backward in the longitudinal direction.

If the conduit 3 is moved relative to the power transmission member 9 along the longitudinal direction of the conduit 3 by the drive source 29 for conduit movement while the power transmission member 9 is stopped, the perforation member 11 Can protrude from the head 5 or be inserted into the head 5.

The head turning means 15 may include a lever 35, a tilting wire 37, and a tube 39, as shown in FIGS. 2 and 12.

As shown in FIG. 2, the lever 35 is hinged to the case 1. And the tilting wire 37 connects between the head 5 and the lever 35. The tilting wire 37 is preferably arranged on one side of the conduit 3. The tilting wire 37 may change the direction of the head 5 by pulling the head 5 or releasing the pulled state.

12, the outer periphery of the tilting wire 37 may include a tube 39 coupled between the head 5 and the case 1. The tube 39 serves to guide the tilting wire 37 to operate smoothly.

In the embodiment of the present invention, the head turning means 15 is illustrated by showing a structure that can be manually operated by the lever 35, but is not limited to this, the lever 35 using a drive source such as a motor Instead, a structure that can be operated automatically is also applicable.

Conduit rotation means 17 may be coupled to the conduit (3) to rotate the conduit (3). The conduit rotating means 17 is arranged inside the case 1. As shown in FIGS. 2 and 9, the conduit rotating means 17 includes a shaft gear 43 coupled to the shaft of the conduit rotation driving source 41, a conduit rotation driving source 41, and a shaft gear ( Another gear 45 coupled to 43).

Conduit rotation drive source 41 is made of a motor is preferably coupled in a fixed state inside the case (1). And the shaft gear 43 coupled to the conduit rotation drive source 41 is meshed with another gear 45. One end of the conduit 3 is fixedly coupled to the gear 45 coupled to the shaft gear 43 of the conduit rotation drive source 41. Therefore, when the shaft gear 43 of the conduit rotation drive source 41 rotates, the gear 45 rotates and the conduit 3 can rotate as a whole.

The gear 45 that is rotated by the conduit rotation drive source 41 is preferably coupled integrally with the gear 33 that is rotated by the conduit movement drive source 29. That is, the gear 45 rotated by the conduit rotation drive source 41 can move forward and backward with respect to the longitudinal direction of the conduit, and the gear 33 rotated by the drive source 29 for conduit movement so as to rotate. And integrally combined with

The punching member rotating means 19, as shown in Figs. 2, 3 and 7, includes a driving member 47 for rotating the punching member disposed inside the case 1. The power transmission member 9 is coupled to the drive source 47 for rotating the punching member by a clamp C (shown in FIGS. 2, 3, and 7). Therefore, the power transmission member 9 may rotate as the driving member 47 for rotating the drilling member rotates, and the drilling member 11 may also rotate while the power transmission member 9 rotates. The driving member 47 for rotating the punching member may be alternately rotated in the forward and reverse directions for a predetermined time under the control of a separate control device.

The punching member moving means 21 serves to repeatedly move the punching member 11 in the forward and backward directions along the longitudinal direction of the power transmission member 9.

As shown in Figs. 2, 3, and 4, the punching member moving means 21 includes a drive source 49 for moving the punching member, the eccentric member 51 (shown in Fig. 5), and the guide 53. It may include.

The driving member 49 for moving the punching member is made of a motor and may be fixedly coupled to the case 1. And the eccentric member 51 is coupled to the shaft of the drive source 49 for moving the punching member. The eccentric member 51 is preferably disposed at an eccentric position on the axis of rotation of the drive source 49 for moving the punching member.

On the other hand, the guide 53 (shown in FIGS. 2, 3 and 6) can move along the inside of the case 1 in the longitudinal direction of the conduit 3. The guide 53 may be provided with a guide groove 53a guided along the inside of the case 1, and the case 1 may be provided with a guide protrusion (not shown) fitted into the guide groove 53a.

In addition, the guide 53 may be disposed on the outer circumferential surface of the driving member 47 for rotating the punching member to be integrally coupled with the driving source 47 for rotating the punching member. Of course, the power transmission member 9 is coupled to the drive source 47 for rotating the punching member. In the exemplary embodiment of the present invention, the power transmission member 9 is directly coupled to the driving member 47 for rotating the punching member, and the guide 53 is illustrated with an example of coupling to the driving source 47 for rotating the punching member. The power transmission member 9 may be directly coupled to the guide 53 but is not limited thereto.

In addition, the guide 53 is provided with a coupling groove 53b (shown in FIG. 6) into which the eccentric member 51 described above is inserted. The coupling groove 53b may have a long groove. Therefore, when the eccentric member 51 rotates, the guide 53 may repeat forward and backward along the longitudinal direction of the power transmission member 9.

Referring to the operation of the embodiment of the present invention made in this way in detail as follows.

In order to puncture the blocked portion of the blood vessel, the operator inserts the conduit 3 into the interior of the blood vessel while the perforation member 11 is disposed inside the head 5 to move the head 5 along the blood vessel to the lesion side. Let's do it.

If it is necessary to change the moving direction of the head 5 along the curved blood vessel in this process, the lever 35 is pulled to the extent desired by the operator while driving the conduit rotation drive source 41.

The conduit rotation drive source 41 can be driven by operation of a switch (not shown) connected thereto. When the conduit rotation drive source 41 rotates, the shaft gear 43 coupled to the shaft of the conduit rotation drive source 41 rotates, and the conduit 3 rotates as a whole.

And when the lever 35 is pulled, one side of the head 5 is pulled while the tilting wire 37 is pulled, and the head 5 faces the direction in which the tilting wire 37 is bent (FIGS. 12 and 13). Reference).

As such, the head 5 may be directed in a desired direction by the operation of the conduit rotation drive source 41 and the lever 35, and the head 5 may be safely moved along the blood vessel.

As such, when the head 5 is positioned on the lesion by the operator's work, the operator operates the conduit moving drive source 29.

When a switch (not shown) for driving the conduit moving drive source 29 in the forward direction to drill a blocked portion of the blood vessel is operated, the shaft gear 31 coupled to the conduit moving drive source 29 while the conduit moving drive source 29 is driven. Rotate). As the shaft gear 31 is rotated, driving force is transmitted to the gear 33 and the conduit 3 is pulled (see FIG. 10).

At this time, the conduit 3 moves relative to the power transmission member 9, so that the perforation member 11 coupled to the distal end of the power transmission member 9 comes to the front of the head 5 (see FIG. 11).

As the perforated member 11 comes out of the front of the head, the plurality of balls 25 are pushed toward the inner wall of the blood vessel. Then, while the plurality of balls 25 simultaneously support the inner wall of the vessel, the puncture member 11 is disposed at the center of the vessel.

Subsequently, when the switch (not shown) for operating the drive member 47 for rotating the punching member is operated, the power transmission member 9 is rotated while the drive member 47 for rotating the punching member is operated.

Therefore, the punching member 11 coupled to the distal end of the power transmission member 9 may puncture the blocked portion of the blood vessel while rotating. In one example of the embodiment of the present invention, the drive member 47 for rotating the punching member may be controlled by a separate control unit (not shown).

Through the control unit, the drive source 47 for rotating the punching member is defined as one time (defined as one time that the punching member rotates 360 degrees), and performs one reverse rotation after the forward rotation, or two reverse rotations after the two forward rotations. By repeatedly performing the puncture effect on the blocked blood vessel can be efficiently performed.

And when the switch (not shown) which drives the drive member 49 for moving a drilling member moves, the eccentric member 51 is rotated, while the drive member 49 for moving a drilling member moves. While the eccentric member 51 is rotated in the guide groove 53a provided in the guide 53, the guide 53 is repeatedly moved forward and backward.

Then, the driving member 47 for rotating the punching member coupled to the guide 53 is coupled to the power transmission member 9 so that the power transmission member 9 can puncture the blocked portion of the blood vessel while repeating forward and backward.

Therefore, the embodiment of the present invention serves to guide the puncture member 11 to the central portion of the vessel by a plurality of balls 25 to prevent the puncture member from being biased within the vessel to damage the inner wall of the vessel during the procedure This can increase the success rate of surgery.

While the present invention has been particularly shown and described with reference to exemplary embodiments thereof, it is to be understood that the invention is not limited to the disclosed exemplary embodiments, but, on the contrary, And it goes without saying that the invention belongs to the scope of the invention.

1. case, 3. conduit,
5. Head, 5a. Holes, 7. prevent blood vessel damage,
9. power transmission member, 11. perforation member,
13. conduit movement means, 15. head turning means,
17. conduit rotation means, 19. perforation member rotation means,
21. Perforation member moving means, 23. Coil spring,
25. Ball, 25a. Holes, 27. elastic members for ball support,
29. drive source for conduit movement, 31. shaft gear,
33. gear, 35. lever,
37. Tilting wire, 39. Tube,
41. Drive sources for conduit rotation, 43. Shaft gears,
45. gear, 47. drive source for drilling member rotation,
49. Driving source for drilling member movement, 51. Eccentric member,
53. Guide, 53a. Guide groove, 53b. Coupling Groove,

Claims (10)

A conduit provided with space along the longitudinal direction therein,
A head coupled to a distal end of the conduit and provided with a hole penetrated in the longitudinal direction of the conduit in a central portion thereof;
Blood vessel damage prevention unit coupled to the head,
A power transmission member inserted into the conduit to move or rotate along the conduit,
Perforated member coupled to the front end of the power transmission member for puncturing the blocked portion of the blood vessel, and
Conduit moving means coupled to the conduit to move the conduit relatively forward and backward relative to the power transmission member to protrude the perforated member from the head, and
The power transmission member is coupled and includes a punching member rotating means for rotating the punching member in the forward or reverse direction,
The blood vessel damage prevention unit
A plurality of balls arranged at a constant distance in front of the head,
Ball support elastic member is coupled between the plurality of the ball and the head to contact the inner wall of the blood vessel in the radial direction relative to the cross section of the blood vessel or to return to the initial position
Surgical device for vascular treatment comprising a. The method according to claim 1,
The ball is provided with a hole,
The ball support elastic member is made of a wire having an elastic force is inserted into a hole provided in the ball surgical device for blood vessel treatment to connect the ball and the head. The method according to claim 1,
The ball is a surgical device for treating blood vessels are arranged three to five. The method according to claim 1,
The head is coupled to the head turning means for changing the direction,
The head turning means
Lever hinged to the case,
A tilting wire coupled to the lever and the head, the direction of which the head is changed according to the movement of the lever,
Surgical device for vascular treatment disposed on the outer periphery of the tilting wire and comprising a tube coupled to the head and the case. The method of claim 4,
The tube is
Surgical device for vascular treatment consisting of a pipeline of synthetic resin material or made of a coil spring. The method according to claim 1,
The conduit has one end connected to the conduit rotating means,
The conduit rotating means
Drive source for conduit rotation coupled to the case,
A shaft gear coupled to a rotating shaft of the drive source for rotating the conduit,
Another gear engaged with the shaft gear and rotating and the conduit coupled thereto
Surgical device for vascular treatment comprising a. The method according to claim 1,
The conduit means of transportation
Drive source for conduit movement coupled to the case,
A shaft gear coupled to a rotating shaft of the driving source for moving the conduit,
Another gear that is engaged with the shaft gear and forwards or retracts the conduit in the longitudinal direction by forward and reverse rotation of the shaft gear, and another gear to which the conduit is coupled.
Surgical device for vascular treatment comprising a. The method according to claim 1,
It is coupled to the power transmission member comprises a punching member moving means for repeatedly moving the punching member in the forward, backward direction,
The perforated member moving means
Driving source for moving the punched member coupled to the case,
An eccentric member coupled to a rotating shaft on the drive source,
A guide groove is provided to which the eccentric member is fitted and is moved forward or backward along the case and connected to the power transmission member.
Surgical device for vascular treatment comprising a. The method according to claim 1,
The conduit
Surgical device consisting of a flexible tube, the coil spring is provided in a predetermined section on the head side portion. The method according to claim 1,
The punching member rotating means
And a driving source for rotating the punching member disposed inside the case, and being coupled to one end of the power transmission member to a rotation axis of the driving member for rotating the punching member.

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