RU207870U1 - Device for mechanochemical stem sclerobliteration of veins - Google Patents

Abstract

The utility model relates to medicine, in particular to devices intended for sclerotherapy of varicose veins. The device for mechanochemical stem sclerobliteration of veins includes a coaxially mounted catheter and a mandrel, the end of which is made in the form of pull-out parts with elements intended for contact with the vein walls, on legs, a v-connector installed at the proximal end of the catheter with a side channel for introducing a sclerosant and with a straight channel associated with the device control knob. Elements intended for contact with the walls of the vein, in the form of platforms, are made in the form of electrodes. Mandrin is made conductive with a sleeve installed at its end, designed to cover the end hole of the catheter, and with sliding parts fixed on it. Pull-out elements and platform legs are insulated. On the wall of the distal end of the catheter, holes are circularly made for introducing a sclerosant and they are located proximal to the sliding elements. The handle is equipped with a plug connected to a conductive mandrel. The technical result solved by the proposed utility model is the creation of a device for mechanochemical stem sclerobliteration of veins, which provides significantly effective adhesion (obliteration) of the vein walls due to their additional damage as a result of thermal effects on the vein endothelium. 4 ill.

Description

The proposed useful model relates to medicine, and in particular to devices intended for sclerotherapy of varicose veins.

It is known that mechanochemical endovenous ablation is one of the least traumatic methods of treating varicose veins, based on mechanical damage to the inner wall of the vein followed by the introduction of a sclerosing drug.

To perform this method, devices for mechanochemical stem sclerobliteration of veins have been developed.

A device for mechanochemical stem sclerobliteration is known, including a v-connector installed at the proximal end of the catheter with a lateral channel for introducing a sclerosant, and with a straight channel associated with the device control handle (https://yandex.ru/turboiterramed.ru/s/phlebo / metods / klarivejn-clarivein).

In the known device, the cutting element is made in the form of a rotating sharp catheter head, which makes up to 3.5 thousand revolutions per minute, cutting off the inner layer of the vessel.

In parallel, a sclerosing drug is injected through a hollow catheter, which is "mixed" in the lumen of the vessel and, with the help of a rotating sharp head, acts on the vascular wall, damaging it.

The disadvantages of this design are:

- the impossibility of uniform filling of the vein with the foam form of the sclerosant due to its introduction through the end hole of the catheter and the probable erosion of microfoam inside the vein by the blood flow;

- insufficient damage to the endothelium with a cutting instrument and less effective obliteration of the treated vein sections.

The closest to the claimed technical solution is a device for mechanochemical stem sclerobliteration of veins, including a coaxially installed catheter and a mandrel end, which is made in the form of retractable elements with scratching microhooks on the legs, installed at the proximal end of the catheter ν- a connector with a side channel for introducing a sclerosant, and with a direct channel connected to the device control handle (https://phlebo.center/lechenie-varikoza/mekhano-khimicheskaya-obliteratsiya-moca-clarivein-i-flebogrif)

The disadvantages of this design are also: the impossibility of uniform filling of the vein with the foam form of the sclerosant due to its introduction through the end opening of the catheter and the probable erosion of the micro-foam inside the vein by the blood flow;

insufficient damage to the endothelium by microhooks and less effective obliteration of areas of the treated vein.

The technical result, solved by the proposed utility model, is the creation of a device for mechanochemical stem sclerobliteration of veins, which provides significantly effective adhesion (obliteration) of the vein walls due to their additional damage as a result of thermal action on the vein endothelium.

The technical result in the proposed utility model is achieved by creating a device for mechanochemical stem sclerobliteration of veins, including a coaxially installed catheter and a mandrel end, which is made in the form of retractable parts with elements intended for contact with the vein walls, on legs, installed at the proximal end of the catheter, a v-connector with a lateral channel for introducing a sclerosant, and with a straight channel connected to the control handle of the device, in which, according to the utility model, the elements intended for contact with the walls of the vein in the form of pads are made in the form of electrodes, and the mandrel is made conductive with a sleeve installed at its end , designed to overlap the end hole of the catheter and with the retractable parts attached to it, while the retractable elements and legs of the platforms are isolated, and the holes for the introduction of the sclerosant are circularly made on the wall of the distal end of the catheter and they are located proximal to the retractable elements, and the handle equipped with a plug connected to a conductive mandrel.

The proposed useful model makes it possible to significantly increase the area of damage to the vein endotherium during surgery by increasing the contact of the sclerosant with the damaged part of the vein.

The use of the proposed device will allow not to apply compression in the postoperative period.

The proposed utility model has the ability to use any electrosurgical apparatus.

The essence of the proposed utility model is illustrated by the following description and graphic material, where:

FIG. 1 shows a diagram of the device for mechanochemical stem sclerobliteration of veins;

FIG. 2 shows a diagram of the device in working condition;

FIG. 3 shows the assembled sliding parts with platforms;

FIG. 4 shows the sliding parts with platforms in working form.

A device for mechanochemical stem sclerobliteration of veins, includes a coaxially installed catheter 1 and a conductive mandrel 2 end, which is made in the form of a retractable part 3 with elements intended for contact with the vein walls in the form of platforms 4, made in the form of electrodes on the legs 5, installed at the proximal end catheter 1 v-connector 6 with a side channel 7 for introducing a sclerosant, and with a straight channel 8 connected to the control handle of the device 9, which has a plug 10 connected to a conductive mandrel 2.

Depending on the technical tasks, any electrosurgical apparatus can be connected to the plug 10.

The current-conducting mandrel 2 is made with a bushing 11 installed at its end, designed to cover the end hole of the catheter and with sliding parts 3 fixed on it with platforms 4 made in the form of electrodes, in order to eliminate the loss of power of impact on the platforms.

Moreover, the height of the pads 4 protruding beyond the insulated part is equal to the thickness of the endothelium of the vein wall.

The retractable parts 3 and the legs 5 of the platforms 4 are insulated to exclude the thermal effect of the vein on the blood, and, in addition to mechanical damage, damage occurs as a result of the thermal effect of the platforms 3 on the vein endothelium.

For a more even distribution of the sclerosant (for example, a foam form) along the walls of the vein, holes 12 are circularly made on the wall of the distal end of the catheter 1 for the introduction of the sclerosant (at least four holes offset along the length).

The operation of the device for mechanochemical stem sclerobliteration of veins is carried out as follows:

With an incision in the groin fold, the mouth of the great saphenous vein is isolated in layers at the place where it flows into the femoral vein.

The tributaries of the great saphenous vein and the vein itself at the confluence are ligated. The vein is cut open.

At the inner ankle, the source of the great saphenous vein is isolated with a transverse incision up to 1.5 cm. The vein is cut open. The distal part is ligated.

A catheter of a device for mechanochemical stem sclerobliteration of veins is inserted into the proximal section to the groin area. The proximal area is ligated.

The device is connected via plug 10 to a current source, which can be any electrosurgical apparatus.

With the help of the lateral channel for the introduction of the sclerosant 7 of the V-connector 6, a pre-formed sclerosan is injected, for example, the micro-foamy substance is turned on into the catheter 1, and the micro-foam substance begins to flow through the holes 12 in the catheter into the vein lumen, because the end of the catheter is closed with a sleeve 11 designed to overlap the end opening of the catheter 1.

Then the control knob of the device 9 begins to move the catheter relative to the conductive mandrel 2 while simultaneously opening the electrodes in the form of sliding parts 3 with pads 4, which, in contact with the endothelium, provide a much larger area of its thermal damage by the action of high-frequency currents in coagulation mode from electrosurgical high-frequency generators (EHHF) and, accordingly, significantly effective adhesion (obliteration) and slow removal of the catheter from the vein

After removal of the catheter, the distal part of the transected vein is ligated.

If the operation is performed on 2 legs, then a liquid form of sclerosan (about 10 ml - 1% solution) is injected into the lumen of the vein of the contralateral limb.

When operating on 2 legs, you can use the micro-foam form on both sides.

Experimental testing of the proposed device was carried out and the following results were obtained: Reducing the time of disability. The patient begins to walk from the first hours after the operation. The first 10 days of compression around the clock, then another week in the daytime - a significant reduction in intraoperative trauma; -high cosmeticity of the intervention, for example, during surgery on the small saphenous vein, an incision is made in the popliteal fold, and the distal part of the vein is isolated at the outer ankle.

Claims (1)

A device for mechanochemical stem sclerobliteration of veins, including a coaxially installed catheter and a mandrel, the end of which is made in the form of retractable parts with elements intended for contact with the vein walls, on legs, a v-connector installed at the proximal end of the catheter with a lateral channel for introducing a sclerosant and with a straight channel connected to the control handle of the device, characterized in that the elements intended for contact with the walls of the vein, in the form of pads, are made in the form of electrodes, and the mandrel is made conductive with a sleeve installed at its end designed to cover the end opening of the catheter, and with the sliding parts fixed on it, while the sliding elements and legs of the platforms are isolated, and holes for introducing the sclerosant are circularly made on the wall of the distal end of the catheter and they are located proximal to the sliding elements, and the handle is equipped with a plug connected to a conductive mandrel.

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