RU2686956C1 - Device and method for safe positioning of coronary stent in coronary arteries - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: group of inventions refers to medical technology, namely, to an apparatus and method for the safe positioning of a coronary stent in the coronary arteries. Device for positioning a coronary stent in coronary arteries consists of a body with a rotor wheel. Upper part of the wheel protrudes above the housing, and the lower part is located inside the housing and is made as a single element with the screw. Screw interacts with rotation gear fitted on pressure cylinder to rotate thereon. Pressure cylinder interacts with an internal element of the fixing button provided with elements for accommodation of springs, on which the guide of the system of coronary stent delivery is located, the external part of which is a cylinder inside the body. Method for positioning a coronary stent in coronary arteries is characterized by the fact that when placing a system for delivering a coronary stent in the body of the device, pressing the fixation button located in the lateral portion of the body, internal element of which is lowered, removing pressure between rotation gear and pressure cylinder, and forming a through hole for arrangement of delivery system in guides through holes in front and rear parts of housing. Then, delivery system is introduced, locking button is released, fixing delivery system inside device, by means of screw rotation wheel operator, converting rotary motion of rotor wheel into reciprocal motion of propeller and rotation of rotation gear, moves fixed delivery system horizontally inside device for required distance.EFFECT: inventions allow maximally accurate, fast and safe positioning of the coronary stent in simple and complex anatomical coronary lesions, particularly in the coronary artery in the endovascular coronary stenting to restore the lumen narrowed as a result of the involvement of the artery.5 cl, 6 dwg

Description

The present invention is intended for use in medicine for the most accurate, fast and safe positioning of a coronary stent with simple and complex anatomical lesions of the coronary bed, in particular in the coronary artery during endovascular coronary stenting to restore the lumen of the narrowed artery as a result of lesions.

The device is intended for use in cases of osseous lesions of the coronary arteries, bifukarcionnyh lesions of the coronary arteries, including lesions of the left coronary artery trunk and the mouth of the right coronary artery, as well as with the stent stent implantation to reduce the overlap zone. The use of this device can significantly reduce the radiation load on the patient and medical personnel, as well as reduce the radiopaque load on the patient.

The device can be successfully used by young specialists in the period of their formation in interventional cardiology.

In addition, the claimed device can also be used for stenting the renal, visceral arteries in a similar way.

A number of devices for stent positioning in the coronary artery are known on the medical equipment market.

In particular, the device is known OSTIAL PRO company Merit Medical, USA (patent number US 6293964). In accordance with the patent, the device is a cone consisting of four legs, which is inserted with a coronary stent into a catheter guide. The catheter guide is installed selectively at the mouth of the coronary artery. A coronary stent is placed distal to the coronary artery through the coronary artery, after which the catheter guide is removed from the artery of the artery and the device is removed. When exiting the guide catheter, the paws of the device open and abut the aortic wall, as a result of which the tip of the guide catheter cannot be placed selectively in the orifice of the coronary artery, which is necessary when stenting the orifice of the left coronary artery and the orifice of the right coronary artery. The entire subsequent procedure for positioning the coronary stent in the affected area is carried out manually.

A disadvantage of the known device is its limited use, in particular, only with lesions of the mouth of the left coronary artery and the mouth of the right coronary artery, as well as manual positioning of the coronary stent.

It is also known “Device for safe positioning of the coronary stent in the coronary arteries” of the company “Seven Sans” LLC, RF patent №2598798.

The claimed device differs primarily:

- faster and more accurate positioning of the coronary stent in the coronary artery,

- positioning the stent mechanically, and not manually,

- reduction of radiation exposure to the patient and the medical staff due to the reduction of the time of positioning of the coronary stent,

- the possibility of using the device for lesions of any segment of the coronary bed,

- reducing the patient's load with a radiopaque substance due to a decrease in the time of positioning of the coronary stent.

- single use,

- ease of execution of the device configuration in the form of a surgeon’s hand,

- minimum weight and size characteristics,

- ease of use,

- profitability in manufacturing.

The device is industrially applicable.

The claimed device consists of a housing with a tail and a wheel of rotation of a screw, a screw that is made as a single element, a rotation gear interacting with a screw and placed on a pressure cylinder for rotation, which interacts with an internal element of the fixing button equipped with elements to accommodate the springs on which the guide for the coronary stent delivery system is located, the outer part of which is a cylinder inside the body.

The case, which has a cylindrical shape, is made of plastic by injection molding using shagreen coating at the points of contact with the operator's hand, the right and left halves of the case being made separately, and connected after the assembly of the mechanism. The housing in the upper part is provided with a screw rotation wheel located in the hole for the screw rotation wheel, and a fixing button located in the side opening of the housing. In the front part of the body, having a truncated shape, adapted to hold the operator’s left and thumb fingers, there are recesses, allowing the operator to fix the device in the desired position, while the recess for the left thumb is also a platform for fixing the coronary conductor, and the back one part of the body is designed as a palm rest of the right hand in the form of a tail.

In the case between the truncated part and the cylindrical part there is a wheel of rotation of the screw, the upper part of which protrudes above the case, and the lower part is located inside the case, made as a single part with a horizontal screw inside the case, interacting with the gear wheel of rotation, placed on the pressure cylinder for rotation which interacts with the internal element of the fixation button, equipped with elements for accommodating the springs on which the guide of the coronary stent delivery system is located , the outer part of which is a cylinder inside the case.

Alternatively, the device can be made with a delivery system already fixed in it. In this case, there is no stage of preliminary insertion of a coronary stent on the delivery system inside the device. The coronary stent on the delivery system is manually held to the coronary artery lesion zone, then the fixation button is pressed, a through hole is formed and the operator brings the device to the required distance to fix it with the fingers of his left hand, releases the fixation button and rotates the screw delivery system to the required distance for positioning the coronary stent inside the vessel. Also, when the button is pressed, the operator can reset the mechanism fixing the coronary stent delivery system, rotating the wheel in the required direction, which allows further positioning of the coronary stent forward or backward within the ruler size to each side.

As an embodiment, in order to safely place the stent on the delivery system, it is possible to use a hollow tube previously placed inside the device into which the delivery system with the stent is inserted, after which the tube is removed from the device.

Below is a list of the accompanying drawings.

FIG. 1 - general view, where

1 - device housing

2 - a cylindrical part of the body,

3 - front truncated part of the body,

4 - the rear part of the body,

5 - notch for the fingers of the left hand,

8 - palm rest in the form of a tail,

11 - screw rotation wheel.

FIG. 2 - top view, where

1 - device housing

2 - a cylindrical part of the body,

3 - front truncated part of the body,

4 - the rear part of the body,

5 - notch for the fingers of the left hand,

8 - palm rest in the form of a tail,

11 - screw rotation wheel.

FIG. 3 is a side view where

1 - device case

2 - a cylindrical part of the body,

3 - front truncated part of the body,

4 - the rear part of the body,

5 - notch for the fingers of the left hand,

8 - palm rest in the form of a tail,

11 - screw rotation wheel.

18 - commit button.

FIG. 4 is a sectional view of the device, where

1 - device housing

8 - palm rest of the right hand in the form of a tail,

9 - holes in the housing to accommodate the delivery system,

10 - delivery system

11 - the wheel of rotation of the screw

12 - screw

18 - button

7 - pressure cylinder,

13 - rotational gear,

14 - guides for the delivery system inside the case,

15 - the junction of the button with the pressure cylinder,

16 - spring.

FIG. 5 is a general view of the fixation mechanism, where

18 - commit button,

6 - zone of engagement of the delivery system on the rotation gear,

7 - pressure cylinder,

13 - rotational gear,

14 - guides for the delivery system inside the case,

15 - the junction of the button with the pressure cylinder,

16 - spring.

FIG. 6 - fixation mechanism in the analysis, where

18 - commit button,

6 - zone of engagement of the delivery system on the rotation gear,

7 - pressure cylinder,

13 - rotational gear,

14 - guides for the delivery system inside the case,

15 - the junction of the button with the pressure cylinder,

16 - spring

17 - elements for spring placement

Below is a description of the invention with reference to the attached drawings.

The device consists of a housing 1 (Fig. 1, Fig. 2) with a tail 8 (Fig. 1, Fig. 2, Fig. 3) and wheels of rotation of the screw 11 placed in it (Fig. 1, Fig. 2, Fig. 4 ), screw 12 (Fig. 4), which are made in the form of a single element, gear 13, (Fig. 4, Fig. 5, Fig. 6), interacting with the screw 12 (Fig. 4), and placed on the pressure cylinder 7 (Fig. 4, Fig. 5, Fig. 6), which interacts with the inner element of the fixing button 18 (Fig. 4, Fig. 5, Fig. 6), equipped with elements 17 (Fig. 6) to accommodate the springs 16 ( 4, Fig. 5, Fig. 6), on which the guide for the system is located avki 14 (Fig. 4, Fig. 5, Fig. 6), the outer part of which is a cylinder inside the case.

The housing 1 (Fig. 1), which has a cylindrical shape, is made of plastic by injection molding using a shagreen coat at the points of contact with the operator's hand, the right and left halves of the housing 1 (Fig. 1) are made separately and are connected after collection mechanism. The housing 1 (Fig. 1) in the upper part is provided with a wheel of rotation of the screw 11 (Fig. 1, Fig. 2, Fig. 3) located in the hole for the wheel of rotation of the screw, and the lock button 18 (Fig. 3, Fig. 4, Fig. 5, Fig. 6), placed in the side opening of the housing. In the front part of the body, having a truncated shape, adapted to hold the operator’s left and thumb, the recess 5 (Fig. 1, Fig. 2, Fig. 3) is made, allowing the operator to fix the device in the desired position, while the recess for the large The finger of the left hand also serves as a platform for fixing the coronary conductor, and the rear upper part of the housing 1 is designed as an emphasis for the palm of the right hand in the form of a tail 8 (Fig. 1, Fig. 2, Fig. 3).

In the case between the truncated part of it 3 (Fig. 1, Fig. 2, Fig. 3) and the cylindrical part 2 (Fig. 1, Fig. 2, Fig. 3) is located the wheel of rotation of the screw 11 (Fig. 1, Fig. 2 , Fig. 3), the upper part of which protrudes above the case, and the lower part is located inside the case, made as a single part with a horizontal screw 12 (Fig. 4) inside the case 1 (Fig. 4), interacting with the gear wheel of rotation 13 (Fig. 4). 4) placed on the pressure cylinder 7 (Fig. 4, Fig. 5, Fig. 6) with the possibility of rotation, which interacts with the internal element of the lock button 15 (Fig. 6), equipped with elements for placing the springs 16 (FIG. 4, FIG. 5, FIG. 6) which is guiding the delivery system coronary stent 14 (FIG. 4, FIG. 5, FIG. 6), the outer part of which is a cylinder within the housing.

To accommodate the delivery system 10 (Fig. 4) inside the device, the operator presses the fixation button 18 (Fig. 4, Fig. 5, Fig. 6), the inner element 15 (Fig. 5) is lowered, removing the pressure between the gear of rotation 13 (Fig 5) and a pressure cylinder 7 (FIG. 5), and a through hole 9 (FIG. 4) appears for inserting the delivery system 10 (FIG. 5) into the guides 14 (FIG. 5) inside the housing 1 through the openings 9 (FIG. 4), then the lock button 18 (Fig. 4, Fig. 5, Fig. 6) is released.

Through the holes 9 (Fig. 1) in the front and rear of the housing 1 (Fig. 1) and the front truncated part of the housing 3 (Fig 4), the delivery system 10 (Fig. 4) is inserted into the device. After that, the fixing button 18 is released (Fig. 4), and the delivery system 10 (Fig. 4) is fixed inside the device. Using the wheel of rotation of the screw 11 (Fig. 4), the operator, converting the rotational movement of the wheel of rotation of the screw 11 (Fig. 4) into the translational movement of the screw 12 (Fig. 4) and the rotational movement of the gear 13 (Fig. 4), moves the delivery system 10 (FIG. 4) horizontally inside the device.

As an embodiment of the invention, it is possible to use the device with the delivery system 10 (FIG. 4) previously fixed in it, while eliminating the need for preliminary placement of the delivery system inside the device.

As another embodiment of the invention, in order to safely place the stent on the delivery system, it is possible to use a hollow tube previously placed inside the device into which the delivery system 10 is inserted (Fig. 4) with the stent, after which the tube is removed from the device.

Claims (5)

1. A device designed for positioning a coronary stent in the coronary arteries, characterized in that it consists of a housing with a screw rotation wheel, the upper part of which protrudes above the housing, and the lower part is located inside the housing and made as a single element with a screw that interacts with a gear wheel rotation placed on the pressure cylinder with the possibility of rotation, which interacts with the inner element of the fixing button, equipped with elements for accommodating the springs, on which the direction is coronary stent delivery system, the outer part of which is a cylinder inside the body. 2. The device according to p. 1, characterized in that the casing is made of plastic using shagreen coating at the points of contact with the operator's hand. 3. The device according to p. 1, characterized in that the device is made with a delivery system with a stent pre-fixed in it. 4. The device according to claim 1, characterized in that a hollow tube has been previously inserted therein to accommodate a delivery system with a stent therein. 5. A method for positioning a coronary stent in the coronary arteries, characterized in that when placing the delivery system of the coronary stent in the device body, the fixation button located in the side of the body is pressed, the internal element of which is lowered, relieving the pressure between the rotation gear and the pressure cylinder , and thus forming a through hole for placing the delivery system in the guides through the holes in the front and rear parts of the housing, then the delivery system is inserted. The fixation device is released, fixing the delivery system inside the device, using the screw's rotation wheel, the operator, converting the rotational movement of the screw's rotation wheel into the translational movement of the screw and the rotational movement of the rotation gear, moves the fixed delivery system horizontally inside the device to the required distance.

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