WO2014166436A1 - Multi-electrode ablation catheter - Google Patents

Multi-electrode ablation catheter Download PDF

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Publication number
WO2014166436A1
WO2014166436A1 PCT/CN2014/075318 CN2014075318W WO2014166436A1 WO 2014166436 A1 WO2014166436 A1 WO 2014166436A1 CN 2014075318 W CN2014075318 W CN 2014075318W WO 2014166436 A1 WO2014166436 A1 WO 2014166436A1
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WO
WIPO (PCT)
Prior art keywords
electrode
configuration
perfusion
ablation catheter
distal
Prior art date
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PCT/CN2014/075318
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French (fr)
Chinese (zh)
Inventor
胡昌
陈诚
谭家宏
孙毅勇
陈艳
奚云珠
孙飞飞
罗七一
Original Assignee
上海微创电生理医疗科技有限公司
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Publication of WO2014166436A1 publication Critical patent/WO2014166436A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1492Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • A61B2018/00029Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1405Electrodes having a specific shape
    • A61B2018/1435Spiral
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/002Irrigation

Definitions

  • the present invention relates to a multi-electrode ablation catheter for multi-electrode discharge ablation of a target site within a human vessel, and more particularly to a multi-electrode ablation catheter for use in renal artery denervation therapy and pulmonary artery radiofrequency ablation.
  • Refractory hypertension also known as refractory hypertension, refers to the use of three or more antihypertensive drugs (including a diuretic) to treat hypertension that is still uncontrollable.
  • the latest animal and clinical trial data demonstrate that radiofrequency ablation of the renal sympathetic nerve using a percutaneous catheter can permanently and effectively reduce hypertension.
  • the method has a catheter intervention method, and the sympathetic nerve of the renal artery can be heated by the RF energy, which can weaken its activity and even lose its conduction function.
  • the method can not only effectively treat refractory hypertension, but also has the advantages of minimally invasive and no obvious complications. The industry sees this approach as a breakthrough and is considered a new way to treat refractory hypertension.
  • the traditional electrode uses a higher ablation power in the clinic, which is easy to form a local high temperature on the surface of the target, which is easy to cause thrombosis and eschar, which affects safety and effectiveness, and prolongs the operation time. Increase the suffering of the patient.
  • the perfusion solution can be evenly sprayed around the RF electrode at the same time as the RF ablation, so that the electrode can reach higher power without increasing the temperature rapidly, while ensuring the therapeutic effect. It can also prevent local high temperature from forming on the target surface, reduce the probability of scarring and thrombosis, and improve the safety and effectiveness of the operation.
  • the current distal segment is a spiral electrode ablation catheter that is valued in view of its ability to smoothly deliver aspiration into the vessel to the target site and to form a desired shape around the vessel's inner wall.
  • Those skilled in the art have developed a variety of electrode ablation catheters having a distal segment that is helical.
  • the Chinese Patent Application Publication No. CN102198015A discloses a retractable spiral stacking-type electrode catheter which is used in conjunction with a matching sheath.
  • the distal end of the catheter is a spiral stack ring type, which can be controlled by the expansion and contraction of the core core rod.
  • the shrinkage and unfolding of the spiral stack, the core of the method requires a certain hardness to control the shrinkage and unfolding of the spiral stack.
  • the catheter in this application does not have a perfusion fluid perfusion function, does not effectively cool the electrode and reduces the risk of scarring on the electrode surface, and does not guarantee sufficient ablation depth.
  • the Chinese Utility Model Patent Application Publication No. CN201469401U discloses a spiral-loop renal artery renal sympathetic nerve RF electrode catheter in which the electrode is a continuous spiral type, and the electrode is too large to effectively ensure the ablation depth. There is no special protective measure at the distal end of the electrode. When the catheter enters the renal artery, it is easy to cause perforation of the renal artery, and the risk is high.
  • the Chinese Patent Application Publication No. CN102488552A discloses a steerable spiral electrode catheter similar to the Chinese invention patent application disclosed in CN102198015A, which also controls the contraction of the catheter through the core mandrel, and also has no perfusate. Perfusion, can not effectively cool the electrode. There is a gap between the core rod and the main body of the catheter, and the core rod and the catheter body move with each other, which is liable to cause thrombus.
  • CN 1549694 A discloses a spiral electrophysiological catheter having a helically shaped distal section on which a plurality of electrodes can be disposed, the distal section extending therethrough
  • the core member is configured to have its helical configuration and can be reversibly deformed into a lower profile configuration for smooth delivery in the vessel, but: it only mentions that coolant can be used based on feedback of temperature data, without specific disclosure
  • the perfusion fluid infusion mechanism, and the electrode on the distal segment is preferably a spiral coil, obviously, the electrode itself cannot be The part of the flow path for the coolant is incapable of removing heat from the electrodes; in addition, the electrophysiological catheter can only be used in conjunction with the guiding catheter to deform the distal section into a lower profile and thus smoothly in the vessel Medium delivery, but when used in conjunction with a guiding catheter, it increases the total peripheral diameter, which increases the difficulty of delivery and increases patient discomfort in the thin vessel.
  • the Chinese Patent Application Publication No. CN101309651A discloses a multi-electrode ablation catheter suitable for discharge ablation at the position of a vascular orifice, which can control the adhesion of the electrode to the target position, but has a central core in a part of the structure. There is a gap between the rod and the catheter body, which is easy to cause a thrombus; the catheter also does not have the function of perfusion fluid perfusion.
  • U.S. Patent Application Publication No. US 2013/0304062 A1 discloses a spiral-type catheter for ablation, the change in the helical shape of the catheter is controlled by the contraction wire, and the ablation electrode can be effectively cooled by saline infusion.
  • the renal artery radiofrequency ablation catheter is the most critical and indispensable tool for the treatment of refractory hypertension by Catheter-based renal sympathetic denervation (RDN).
  • RDN Catheter-based renal sympathetic denervation
  • Clinical studies have shown that in order to obtain the best ablation end point for the effectiveness and safety of RDN, renal artery radiofrequency ablation catheters require a small outer diameter, can perform multiple ablation, and have the function of cold saline perfusion, but also need to be able to guide
  • the silk, the guiding sheath and the like cooperate to adjust the bending function and the safety inside the blood vessel.
  • Most of the existing patents only have a single function and a small part of the functions.
  • a multi-electrode ablation catheter having a distal section that is reversibly changeable between a helical configuration and a lower profile configuration for smooth delivery in the vessel, and utilizing placement on the distal section a plurality of electrodes ablate at a plurality of target points of the inner wall of the vessel to form a desired shape of ablation; and the catheter further has a perfusate perfusion mechanism capable of effectively utilizing the inner cavity of the electrode and the catheter to form a coolant perfusion flow path
  • the catheter can be flexibly selected for use in conjunction with the guiding catheter, the guide wire, and the guiding sheath for smooth delivery in the vessel depending on the application; in addition, the catheter can be utilized Control
  • the handle adjusts the size of the loop of the spiral configuration via a pull wire, so that the diameter of the spiral configuration can be adjusted when it is required to enter the vessel, and the diameter of the spiral configuration can be adjusted when the vicinity of the
  • the catheter can also adjust the bending deflection of the distal section of the catheter via a pull wire using a control handle such that the distal vessel bend deflection can be adjusted to enter the vessel position by the distal segment bending deflection.
  • the catheter can also be guided into the guide wire by means of the Luer interface of the control handle so that the distal section of the catheter can be changed to a ground state (circumferential configuration, such as a helical configuration or a ring configuration) and an expanded state by a guide wire when needed.
  • the low profile configuration allows the vessel to reach the target when needed.
  • the present invention provides a multi-electrode ablation catheter comprising a distal section, a body section and a control handle that are sequentially connected, at least a portion of the distal section being a circumferential configuration that can be reversibly changed to a lower profile configuration And a plurality of electrodes for ablation disposed thereon, wherein: the body segment and the control handle are provided with a perfusate channel; the distal segment comprises a perfusion fluid lumen, and the perfusion fluid lumen is on the side wall An opening; and each of the electrodes is provided with at least one perfusion hole, disposed circumferentially around the distal segment, and forming a cavity with the perfusate lumen, each perfusion hole via the cavity, a corresponding opening, The perfusate lumen, the perfusate channel is fluidly coupled to a source of perfusion fluid external to the catheter.
  • the helical configuration of the distal segment can be adjusted as desired, for example, when the multi-electrode catheter is to enter the vessel, it can be changed to a lower profile configuration for smooth access to the vessel and delivery therein.
  • the helical configuration of the distal segment can be restored to ablate against the target location on the sidewall, ensuring ablation depth and avoiding damage to surrounding tissue; and, the distal side can be utilized a plurality of electrodes disposed on the segment ablate at a plurality of target points of the inner wall of the vessel to form a desired shape of ablation; and the catheter further has a perfusate perfusion mechanism capable of effectively utilizing the lumen of the electrode and the catheter to form a cooling The liquid is perfused into the flow path, thereby efficiently removing heat from all parts of the electrode, including the inner and outer walls.
  • the circumferential configuration can take a variety of forms.
  • the distal segment is in a helical configuration, or the distal segment is in an annular configuration.
  • the respective electrodes are evenly distributed over a week of the distal segment portion that presents a circumferential configuration.
  • each of the smaller-sized electrodes can be used to form a desired ablation shape.
  • the perfusion holes on the respective electrodes are arranged in one or more rows, the perfusion holes in the single row are evenly arranged in the circumferential direction, and the perfusion holes in the adjacent rows are staggered. Thereby, the perfusate can be effectively infused into the respective regions of the electrode surface via the respective perfusion holes thus distributed, thereby effectively achieving the cooling and cooling effect of the electrodes.
  • the distal segment is a multi-lumen tube, which can be heat-treated according to the NITI shaped wire or the polymer material of the multi-lumen tube to maintain the spiral configuration or the annular configuration of the distal segment.
  • the heat treatment temperature is from 100 ° C to 140 ° C
  • the heat treatment time is from 30 minutes to 60 minutes.
  • the heat treatment parameters are: 110 ° C, 30 minutes.
  • the configuration of the multi-lumen tube facilitates the use of the respective chambers to accommodate the desired components, respectively, to avoid mutual interference between the members. To save space, it is also possible to accommodate some components together in the same cavity, while ensuring that some components do not interfere with each other, such as wires and temperature sensing wires.
  • a proximal side of the control handle is provided with a connector conduit, the connector conduit is provided with a first luer connector, and the perfusate channel is connected to the first luer connector via the connector conduit and the first luer connector Prime fluid source.
  • the perfusion hole is prepared by one of mechanical hole formation, electric spark hole formation, and laser hole formation.
  • the perfusion hole has a diameter of 0.02 mm to 0.5 mm, and the number of perfusion holes is 2 to 40.
  • the invention also provides a multi-electrode ablation catheter comprising a distal section, a main connection a body segment and a control handle, the distal segment is provided with a plurality of electrodes for ablation, wherein the distal segment is in an annular configuration, and the electrode is disposed on the annular ring of the annular configuration .
  • the design of the distal segment with the annular ring is adapted to the strict limitation of the longitudinal extension of the target, and the diameter of the annular ring can be reduced when it is delivered in the vessel, and can be closely attached to the inner wall of the vessel. Increase the diameter of the annular ring.
  • the distal section of the two multi-electrode ablation catheters is a multi-lumen tube, wherein one cavity has a nanowire, the control handle is coupled to the cable, under the adjustment of the control handle, the spiral configuration or The diameter of the annular ring changes or the bending deflection angle of the distal segment changes.
  • the diameter of the spiral configuration or the annular ring can be adjusted accurately and conveniently using the control handle as needed.
  • the diameter can be adjusted to facilitate smooth access to the vessel and delivery therein;
  • the diameter of the helical configuration or annular ring is smaller than the inner diameter of the vessel, so that the side wall of the vessel is not in close contact, the diameter can be adjusted to closely abut the target position on the sidewall to ensure the depth of ablation. And to avoid damage to the surrounding tissue.
  • the distal section of the two types of multi-electrode ablation catheters is a multi-lumen tube, wherein one lumen contains a guide wire, the access of the guide wire causes the distal section to straighten, and the withdrawal of the guidewire causes the distal section Restore configuration, such as returning a spiral configuration or returning a circular configuration.
  • the multi-electrode ablation catheter can be used in conjunction with a commercially available guidewire to facilitate convenient delivery.
  • the control handle is provided with a second luer connector on the proximal side, and the guide wire is guided into the catheter via the second luer, whereby the guide wire can be flexibly manipulated.
  • the present invention also provides a multi-electrode ablation catheter comprising a distal section, a body section and a control handle that are sequentially connected, the distal section being of a helical configuration, capable of reversibly changing to a lower profile configuration, and being disposed thereon
  • the distal segment is a multi-lumen tube, wherein one cavity contains a guide wire, the access of the guide wire makes the distal segment straight, and the withdrawal of the guide wire makes the distal side The segment returns to the helical configuration.
  • the multi-electrode ablation catheter in which the distal section is in a helical configuration can be used in conjunction with a commercially available guidewire to facilitate convenient delivery.
  • the present invention further provides a multi-electrode ablation catheter comprising a distal section, a body section and a control handle that are sequentially connected, the distal section being in a helical configuration, capable of reversibly changing to a lower profile configuration, and on which Arranging a plurality of electrodes for ablation, wherein: the distal segment is a multi-lumen tube, wherein a cavity has a nanowire, the control handle is coupled to the wire, and under the adjustment of the control handle, the spiral structure The size of the diameter of the type changes or the angle of deflection of the distal section changes.
  • the novel multi-polar ablation catheter can be coupled to the guidewire to deliver the ablation catheter to the target site, or can be coupled to the guidewire and the introducer sheath to deliver the ablation catheter to the target site.
  • the multi-polar ablation catheter has a saline perfusion function, and a certain number of perfusion holes are distributed on each ablation electrode, which can effectively perfuse the electrode, reduce the electrode problem and reduce the risk of scarring on the electrode surface.
  • a lower profile configuration or an unfolded state indicates a configuration that is closer to a straight line, such as a small diameter spiral configuration or an adjustable annular ring phase with a larger diameter spiral configuration or an adjustable annular ring, respectively, a low profile configuration.
  • the configuration of the helical configuration in the stretched (including straightened) state is a lower profile configuration than the original helical configuration.
  • the circumferential configuration or ground state represents a configuration that extends in the circumferential direction and has a variety of forms, such as a distal configuration of a helical configuration or a toroidal configuration.
  • the annular configuration represents a configuration in which the straight portion is connected to the annular ring, and the number and position of the annular ring can be determined as needed.
  • a week of the distal segment portion exhibiting a circumferential configuration represents a helical portion of the helical configuration of one pitch, and wherein the distal segment is of a circular configuration
  • a week of the distal segment portion that presents a circumferential configuration represents one of the annular rings.
  • the ring electrode means that the electrode is a hollow rotating body which is open at both ends in the axial direction, and the rotating body may be a straight cylinder, or may have an undulating circumference, and may be chamfered on both sides as far as necessary.
  • the term "fluid connection” means connected in such a way as to transfer fluid, for example two "fluidly connected” components, indicating that fluid can be transported between two components.
  • 1 illustrates a multi-electrode ablation catheter that can be passed through a guidewire and also has a perfusion fluid perfusion function, in accordance with an embodiment of the present invention
  • Figure 2 shows an illustration of Figure 1 taken to the left along the a-a line
  • Figure 3 shows a schematic view of a ring electrode having a boss
  • Figure 4 is a view showing the manner of fixing between the ring electrode shown in Figure 3 and the distal section of the catheter and the flow path of the perfusate;
  • Figure 5A is a schematic view showing the distribution of a perforated hole of a straight ring electrode and its surface
  • Figure 5B is a schematic view showing the distribution of a perforation hole of another straight ring electrode and its surface;
  • Figure 5C shows a schematic view of a further straight ring electrode and a perfusion hole distribution on its surface
  • Figure 6 is a view showing the manner of fixing the straight ring electrode and the distal section of the catheter and the flow path of the infusion solution;
  • Figure 7 is a schematic view of the multi-electrode ablation catheter of Figure 1 before and after the introduction of the guide wire;
  • Figure 8 is a cross-sectional view of Figure 7 taken along line b-b;
  • FIG. 9 shows a schematic view of a multi-electrode ablation catheter that can be used in conjunction with a guiding catheter, in accordance with an embodiment of the present invention.
  • Figure 10 shows a schematic view of a multi-electrode ablation catheter that can be used in conjunction with a guidewire in accordance with an embodiment of the present invention
  • Figure 1 1 shows a schematic view of a multi-electrode ablation catheter having a perfusion fluid perfusion function, in accordance with an embodiment of the present invention
  • Figure 12 shows the addition of a multi-electrode ablation for the adjustment of the helical configuration of the distal section of the multi-electrode ablation catheter based on the multi-electrode ablation catheter shown in Figure 11.
  • Figure 13 is a view showing the left side of the line c-c in Figure 12;
  • Figure 14 is a view showing a multi-electrode ablation catheter provided with the helical configuration adjustment mechanism shown in Figure 12 and before and after adjustment according to an embodiment of the present invention, the multi-electrode ablation catheter being used in conjunction with a guiding catheter;
  • FIG. 15 is a schematic view of a multi-electrode ablation catheter provided with the helical configuration adjustment mechanism shown in FIG. 12 and before and after adjustment according to an embodiment of the present invention.
  • the multi-electrode ablation catheter can be used in conjunction with a guiding catheter or a guide wire as needed. , and has perfusion liquid perfusion function;
  • Figure 16 is a schematic view showing a multi-pole ablation catheter of an annular ring configuration adjusting mechanism according to an embodiment of the present invention
  • Figure 17 is a view showing the left side of the line e-e in Figure 16;
  • Figure 18 is a schematic view showing the unfolded state of the intraoperative multistage catheter
  • Figure 19 shows a schematic diagram of the ground state of an intraoperative multistage catheter. Description of the reference numerals
  • FIG. 1 illustrates a multi-electrode ablation catheter with a perfusion fluid perfusion function and a perfusion fluid perfusion function, including a distal section 1, a body section 4, and at least a portion of a circumferential configuration that are sequentially connected, in accordance with an embodiment of the present invention.
  • the circumferential configuration of the distal section 1 can be reversibly changed to a lower profile configuration, such as being straightened, under the action of an external force, such as insertion into the lumen of the guiding catheter or via the access guidewire 22. , to get into the vessel more smoothly and deliver it to the target location.
  • the circumferential configuration can take a variety of forms, for example, the distal segment 1 can be in a helical configuration or an annular configuration, with the one or more annular rings in the helical configuration or annular configuration to form the circumferential configuration. .
  • an annular configuration the distal end of the distal section 1 is provided with (e.g., attached) an annular ring, which is preferably of adjustable diameter.
  • the distal section 1 is first taken as an example of a spiral configuration, but those skilled in the art know that other forms of circumferentially extending circumferential configuration that can be changed to a lower profile configuration by an external force are also available.
  • the various configurations that are applicable in the case where the distal section 1 is of the helical configuration can also be applied correspondingly to the case where at least part of the distal section 1 is of other forms of circumferential configuration.
  • At least one electrode 2 for ablation of the target point is arranged on the distal section, each electrode 2 being at least partially arranged circumferentially around the distal section.
  • the respective electrodes 2 may be fixedly arranged around the circumference of the distal section, whereby various loops may be employed, for example, a ring electrode 201 provided with a boss in the middle section as shown in Fig. 3 and as shown in Figs. 5A-5C Straight ring electrode 209 and the like.
  • the individual electrodes 2 can also be partially annular.
  • the electrode 2 may be provided with at least one perfusion hole 3, and during ablation in the body, for example, radiofrequency ablation of the renal artery denervation, perfusion fluid perfusion may be performed via a perfusion mechanism, the perfusion mechanism being configured as follows: body segment and control handle a perfusate channel is provided therein; the distal segment includes a perfusate lumen 102 (shown in FIG.
  • each electrode 2 and perfusate lumen 102 having an opening in a sidewall of the perfusate lumen 102; and each electrode 2 and perfusate lumen 102 Cavities are formed therebetween (such as perfusate cavities 202 and 208 as shown in Figures 4 and 6), each perfusion hole 3 via the perfusate chamber 202, corresponding opening (opening 21 as shown in Figures 4 and 6) 1 and 221), the perfusate lumen 102, the perfusate channel is fluidly connected to a source of perfusion fluid external to the catheter.
  • the perfusate can be delivered from the perfusate source via the perfusate channel, the perfusate lumen 102 and the opening to the perfusate chamber 202, where it accumulates, and the electrode 2 is absorbed from the inner wall during accumulation.
  • the heat when filled, ejects the perfusate from the perfusion hole 3, scouring and cooling the outer wall of the electrode, thereby more effectively cooling the electrode 2 and efficiently removing heat from the entire portion thereof, thereby being able to be on the electrode 2 Enter more energy to ensure the depth of electrode ablation.
  • the distal section 1 of the helical configuration may be a multi-lumen tube, and the perfusion fluid lumen 102 is one of the chambers, and each of the other chambers may respectively contain a desired component, such as a guide wire, a wire pull wire, and a temperature sensing wire.
  • a desired component such as a guide wire, a wire pull wire, and a temperature sensing wire.
  • One or more of the various components, such as wires and temperature sensing wires, can also be housed in the same cavity without affecting the respective operations.
  • the multi-lumen tube can be made of a block copolymer of polyurethane, polyether and polyamide, nylon or the like, and the number of cavities of the multi-lumen tube is 1-6, preferably the number of cavities is 2-5.
  • the multi-lumen tube can be shaped by the heat treatment of the NITI shaped wire or the polymeric material of the multi-lumen tube to maintain the helical shape of the distal section 1.
  • the heat treatment temperature is 100 ° C - 140 ° C, and the heat treatment time is 30 minutes.
  • the distal section 1 of the helical configuration of the multi-polar ablation catheter according to the present invention is prepared from a multi-lumen tube.
  • One of the lumens of the multilumen tube is a guidewire lumen.
  • the guidewire lumen is adapted to pass through the guidewire, i.e., the distal segment 1 of the helical configuration of the catheter can be changed by the guidewire to be in a grounded or expanded state, and the distal section of the helical configuration can be passed through the guidewire. Delivery to the specified target position can effectively avoid damage to the vessel by the spiral catheter and improve the safety of the operation.
  • the distal section 1 of the helical configuration of the multi-polar ablation catheter according to the present invention is prepared from a multi-lumen tube.
  • One of the multi-lumen tubes is a wire lumen.
  • One end of the pull wire is fixed on the distal section 1 of the catheter, passes through the wire lumen of the distal section 1 of the spiral configuration, enters the wire tube cavity in the main body section of the catheter, and is then fixedly connected to the control handle, and the pull wire is controlled by the handle.
  • the movement in the lumen to achieve a change in the helical diameter and bending deflection of the distal section 1 of the helical configuration of the catheter, the bending deflection angle being 0-180°, preferably the bending deflection angle being 0-90°, the wire can be But not limited to nickel-titanium alloy wire, stainless steel wire, polyurethane wire, polyether wire, Preparation of materials such as block copolymer yarns of polyamide.
  • the multipolar ablation catheter according to the present invention may be helical multipolar ablation.
  • the multi-polar ablation catheter can increase saline perfusion function; the multi-polar ablation catheter can be used to change the spiral shape of the spiral catheter to a ground state or a deployed state by a guide wire; the multi-pole ablation catheter can simultaneously increase saline perfusion and can be used for a saline infusion
  • the spiral shape of the spiral catheter is changed to a ground state or an expanded state; the multi-pole ablation catheter can also increase the function of the adjustable circle.
  • the invention introduces the application in a multi-electrode ablation catheter by taking a four-lumen tube as an example.
  • the diameter of the multi-lumen tube is 0.9-3.0 mm, and the four chambers are the guide wire lumen 103, the wire lumen 104, and the perfusion fluid lumen 102. And the wire lumen 105.
  • a pull wire 12 is fixed in the cable lumen 104, and the pull wire 12 can control the change in the diameter of the spiral of the distal section 1 of the catheter through the handle function 5. Moreover, the pull wire 12 can also control the bending deflection of the catheter distal section 1 by the handle function 5 by the different coupling positions of the distal end of the wire 12 on the distal section 1 of the catheter.
  • the pull wire 12 may be prepared from materials such as, but not limited to, nitinol wire, stainless steel wire, polyurethane wire, polyether wire, block copolymer yarn of polyamide.
  • a guide wire 22 can be introduced into the guide lumen 103 in the catheter.
  • the multi-pole ablation catheter described in the patent can be used in conjunction with the guide wire 22, and can be used to change the spiral shape of the spiral catheter to the ground state through the guide wire 22 ( See Figure 19) or the expanded state (see Figure 18).
  • the guidewire 22 is first routinely advanced into the renal artery via the femoral artery and the multi-polar ablation catheter is then delivered along the guidewire 22 to the target site of the renal artery vessel.
  • a schematic view of the front and rear of the multi-electrode ablation catheter leading into the guide wire 22 is shown in FIG.
  • the number of electrodes 2 disposed on the distal section of the helical configuration may be from 1 to 15, preferably from 4 to 10.
  • the electrode 2 can be made of a material such as platinum-rhodium alloy, gold, silver, platinum, copper, stainless steel, etc.
  • the perfusion hole 3 on the electrode 2, as shown in the perfusion hole D in FIGS. 4 and 6, can be mechanically required as needed.
  • a wire 13 is connected to each of the electrodes 2, and a heat sensor for sensing the temperature of the electrode at the time of discharge ablation is provided in the vicinity of the electrode 2.
  • the heat sensor is connected to the temperature sensing wire 14 in the wire lumen 105, and the wire 13 and the temperature sensing wire 14 pass through
  • the distal section 1 and the body section 4 of the helical configuration are then connected to the tail line socket 7 at the proximal end of the control handle 6, for respectively transmitting electrical signals and/or pulsed RF energy and temperature feedback signals, thereby greatly enhancing the ablation Safety of use of the catheter.
  • the main body section 4 of the multi-electrode ablation catheter is composed of a braided wire and a polymer material prepared from a polymer material, and the braided wire comprises a nickel-titanium wire, a stainless steel wire, a polyurethane wire, a polyether wire, and a block copolymer wire of a polyamide.
  • the braided filaments may be a single layer of braided silk or a multi-layer braided filament; the polymeric material is selected from the group consisting of polyurethane, polyether and polyamide block copolymers, nylon, and the like.
  • Control handle 6 for the operator to hold can be polypropylene (PP), polyethylene (PE), silicone, rubber, polyoxymethylene (POM), polyvinyl chloride (PVC), copolyester (PETG), polystyrene ( HIPS), acrylonitrile-butadiene-styrene plastic (ABS) and other materials are prepared, connected to the main body section 1, for various control of the catheter.
  • the proximal end of the control handle 6 can have a tail cable socket 7 for connecting the radio frequency meter through a matching tail wire.
  • the proximal end of the control handle 6 can be provided with a connector conduit 9 that connects the Luer connector 8 and the Luer connector 10, respectively.
  • the Luer connector 8 is used for fluid connection to the perfusion solution 11, and the perfusate 11 enters the multi-electrode ablation catheter from the Luer connector 8, and sequentially passes through the connector catheter 9, and the perfusion fluid channel in the control handle 6 (not shown) Entering the body segment 4, and then, as shown in Fig.
  • the perfusate can be selected as a safe coolant for the human body, such as cold saline.
  • the helical configuration of the distal section 1 is superimposed on a circle having a diameter of 3-30 mm. All of the electrodes 2 are evenly distributed over one week of the spiral configuration. When the number of the electrodes 2 is four, it appears in Fig. 2 that the electrodes 2 are evenly divided. The cloth is placed on the circumference of the circle with an adjacent angle of 90 °. Preferably, the perfusion holes 3 are evenly distributed on the surface of each of the electrodes 2 in the circumferential direction. When the number of the electrodes 2 exceeds 4, the electrodes 2 are evenly distributed on the circumference of the circle. As seen in Fig.
  • Figure 3 shows a schematic view of a ring electrode 201 having a boss.
  • the ring-shaped electrode 201 having a boss includes a bottom portion 204, a boss portion 207, and an excessive portion 205 connecting the two, and a filling hole 203 distributed on the boss portion 207, and the filling hole 203 can penetrate the boss portion
  • the side wall of the 207, the side wall of the boss portion 207 and the perfusate tube lumen 102 form a perfusate chamber 202 as shown in FIG. 4, whereby each of the perfusion holes 203 passes through the perfusate chamber 202, the corresponding opening ( The opening 21 1 ) shown in Fig. 4, the perfusate lumen 102, the perfusate channel are fluidly connected to a perfusion fluid source external to the catheter for perfusion using the delivered perfusate.
  • the number of the filling holes 203 on the ring electrode 201 having the boss is at least one, and the number of the filling holes 203 on the ring electrode 201 having the boss shown in FIG. 3 is six, and is divided into two rows, each of which is distributed.
  • the rows are evenly distributed with three infusion holes 203 in the circumferential direction, and the two rows of perfusion holes 203 are staggered, as shown in FIG.
  • the perfusate can be effectively infused into each region of the electrode surface via the respective perfusion holes, thereby effectively achieving the cooling and cooling effect of the electrodes.
  • the number and number of rows of the filling holes 203 of the ring-shaped electrode 201 having the boss shown in FIG. 3 are only examples, and the number of the filling holes 203 may be any one of 2-40, and the number of rows may be 2- Any number in the 6 rows.
  • the diameter of the perfusion hole 203 is 0.02-0.5 mm, and preferably, the diameter of the perfusion hole is 0.08-0.2 mm. Fig.
  • FIG. 5A shows a schematic view of a distribution of a perforated hole of a straight cylindrical electrode and its surface.
  • the ring electrode 209 is provided with two rows of filling holes 210, and each row is uniformly distributed with three filling holes 210 in the circumferential direction, and the two rows of filling holes 210 are staggered.
  • Fig. 5B shows a schematic view of another straight cylindrical electrode and a perfusion hole distribution on its surface.
  • the annular electrode 214 is provided with two rows of filling holes 210, and each row is uniformly distributed with four filling holes 210 in the circumferential direction, and the two rows of filling holes 210 are staggered.
  • Figure 5C shows still another straight ring electrode and its surface perfusion Schematic diagram of pore distribution.
  • the ring electrode 213 is provided with three rows of filling holes 210, and each row is uniformly distributed with three filling holes 210 in the circumferential direction.
  • the filling holes 210 of any two adjacent rows of the three rows of filling holes 210 are staggered. .
  • the adjacent rows of perfusion holes 210 are circumferentially offset by 60 degrees such that the first and third rows of perfusion holes 210 are circumferentially aligned.
  • the perfusion holes on the ring electrodes shown in Figures 5A-5C are arranged as an example of the invention, and an arrangement of other numbers of perfusion holes in 2-40 may be taken as needed.
  • the perfusion holes on the respective electrodes are arranged in one or more rows, the perfusion holes in the single row are evenly arranged in the circumferential direction, and the perfusion holes in the adjacent rows are staggered so that the electrodes can be separated from the plurality of longitudinal positions.
  • the perfusate is evenly sprayed at a plurality of angular positions in the circumferential direction to evenly remove heat from the electrodes.
  • the diameter of the perfusion hole is correspondingly reduced.
  • the number of the perfusion holes on the ring electrode is 4-20, and is arranged in one or more rows.
  • the perfusion hole on the ring electrode can be prepared by mechanical hole formation, electric spark hole formation, laser hole formation, etc., the perfusion hole has a diameter of 0.02 mm to 0.5 mm, and preferably, the perfusion hole has a diameter of 0.08-0.2. Mm.
  • Figure 4 shows a schematic representation of the manner of attachment between the ring electrode shown in Figure 3 and the distal section of the catheter and the flow path of the perfusate.
  • the ring electrode 201 having the boss is fixed to the multi-lumen tube 101, and the bottom portion 204 of the ring electrode having the boss is in contact with the multi-lumen tube 101, and the contact portions thereof are sealed and fixed by heat welding, glue or mechanical means.
  • the boss portion 207 forms a perfusate chamber 202 with the multi-lumen tube 101.
  • the perfusion fluid lumen 102 in the multi-lumen tube 101 has an opening 21 on the side wall thereof, and the perfusate 1 1 enters the multi-electrode ablation catheter from the Luer connector 8 (shown in FIG. 1) through the multi-electrode ablation catheter.
  • the perfusate channel (not shown in Figure 1) enters the perfusate lumen 102 in the distal section 1 (multi-lumen tube 101) of the helical configuration, and the perfusate 1 1 enters the multilumen tube along the direction indicated by arrow "A" 101, after the opening 21 1 on the side wall of the perfusion fluid lumen 102, the perfusate 1 1 is divided into two directions, a portion continues to flow distally along the perfusion fluid lumen 102, as indicated by the arrow "C"; A portion enters the cavity 202 via the sidewall opening 21 1 along the direction of the arrow "B".
  • the liquid 1 1 is filled with the perfusate chamber 202, and flows out from the six perfusion holes 203 on the ring electrode 201 having the bosses, as indicated by an arrow "D" in FIG.
  • the perfusate 1 1 continuously enters the perfusate chamber 202 and flows out or ejects from the perfusion hole 203 after filling the perfusate chamber 202, and the perfusate 1 1 continuously flows from the inner wall of the ring electrode 201 during accumulation in the perfusate chamber 202.
  • FIG. 6 shows a schematic representation of the manner in which the straight ring electrode is secured to the distal section of the catheter and the perfusate flow path.
  • the straight ring electrode 209 has a substantially straight cylindrical shape except for the edges (shown by oblique lines) on both sides, and is fixedly coupled to the multi-lumen tube 101.
  • the both side edges of the ring electrode 209 are sealed and fixed to the multi-lumen tube 101 by glue or thermal connection, so that the middle portion (the inner wall) of the ring electrode 209 and the perfusate tube lumen 102 in the multi-lumen tube 101 (the outer wall) A perfusate chamber 208 is formed between them.
  • the perfusate 1 1 continuously absorbs heat from the inner wall of the ring electrode 209 during the accumulation of the perfusate chamber 208, and can flush and cool the outer wall of the ring electrode 209 after flowing out or ejecting from the perfusion hole 206, thereby enabling
  • the inside and the outside of the ring electrode 209 having a straight cylinder sufficiently absorb heat, which can effectively lower the temperature of the ring electrode 209 having a straight cylinder, can increase the discharge ablation power, increase the ablation depth, and reduce the risk of scarring on the electrode surface.
  • Figure 7 is a schematic illustration of the multi-electrode ablation catheter of Figure 1 before and after accessing the guidewire.
  • the multi-electrode ablation catheter has a perfusion fluid perfusion function, can be used with a guide catheter of a suitable size on the market, or can be used with a guide wire of a suitable size on the market to deliver the multi-electrode ablation catheter to the human body.
  • Multi-electrode ablation catheter access guide After the wire 22, the body of the guide wire 22 provides a supporting force to stretch the distal section 1 of the helical configuration of the multi-electrode ablation catheter in an expanded state (see Figure 18). As shown in the dotted line in Figure 7.
  • the guide wire 22 enters the multi-electrode ablation catheter from the Luer connector 10 and then enters a guidewire channel (not shown) in the multi-electrode ablation catheter.
  • the distal end of the guidewire channel is provided with an opening for the distal end of the guide wire.
  • the surface of the guidewire 22 has an ultra-slip coating that allows the guidewire 22 to pass smoothly within the guidewire channel within the multi-electrode ablation catheter.
  • the multi-electrode ablation catheter can be used to change the helical configuration of the distal section 1 of the catheter into a ground state or a deployed state through the guide wire 22, and the multi-electrode ablation catheter can be successfully passed through the femoral artery through the blood to the human body through the guide wire.
  • the target position of the vessel can effectively avoid the damage of the vessel to the vessel in the distal section 1 of the spiral configuration, and improve the safety of the operation.
  • target locations include, but are not limited to, renal artery blood vessels, pulmonary artery blood vessels, and the like.
  • the distal end of the guide wire 22 is provided with a flexible sheath 21 which is very compliant, and can smoothly enter the human vessel without damaging the vascular tissue.
  • the proximal end 23 of the guidewire can be secured so that the guidewire 22 can be positioned after it enters the body's vasculature.
  • FIG. 8 shows a cross-sectional view of Figure 7 taken along line bb.
  • the multi-lumen tube 101 comprises four chambers, a perfusate tube chamber 102, a guide tube lumen 103, a pull tube lumen 104 and a lead lumen 105.
  • the perfusate lumen 102 is used as a part of the perfusate flow path for transmitting the perfusate;
  • the guidewire lumen 103 is for guiding the guide wire to guide the multi-electrode ablation catheter to the target position of the human vessel
  • a pull wire 12 is fixed in the pull tube lumen 104 for controlling a change in the diameter of the spiral of the distal section of the catheter and a change in the bending deflection angle of the distal end of the catheter.
  • the pull wire 12 may be selected from, but not limited to, a nickel-titanium alloy wire, a stainless steel wire, a polyurethane.
  • FIG. 9 illustrates a multi-electrode that can be used in conjunction with a guiding catheter in accordance with an embodiment of the present invention.
  • the illustrated multi-polar ablation catheter comprises a distal section of the catheter in a helical configuration
  • the multi-polar ablation catheter can be used in conjunction with a guiding catheter that first reaches a target point of the human vessel, and the multi-polar ablation catheter fixes the multi-polar ablation catheter after the guiding catheter reaches the target position. Withdrawing the guiding catheter, the distal segment 1 of the multipolar ablation catheter is restored to the helical configuration, ie, the ground state (see Figure 19), and the ablation electrode 2 on the distal segment 1 of the helical configuration abuts the target on the vessel Point location. The target position can then be extracted and the pulsed RF energy delivered to achieve the discharge ablation function. As shown in FIG.
  • an adjustable loop common handle multi-pole ablation catheter has a pull-tab 12 (see FIG. 8) in the handle function member 5, and the pull-wire 12 controls the distal section of the catheter in a spiral configuration by the handle function 5.
  • the diameter of the spiral ring is the same as the bending deflection angle.
  • 10 is a schematic view showing a multi-pole ablation catheter that can be passed through a guidewire in accordance with an embodiment of the present invention.
  • the illustrated multi-polar ablation catheter comprises a catheter distal section 1, ablation electrode 2, catheter body section 4, handle function 5, functional handle 6, tailline socket 7, and luer connector 10.
  • the multi-polar ablation catheter contains a guidewire channel (not shown).
  • the guidewire 22 can extend the distal section 1 of the helical configuration into a deployed state (see Figure 18).
  • the guide wire 22 reaches the target position in the vessel, and then after the multi-electrode ablation catheter reaches the target position along the guide wire 22, the guide wire 22 is withdrawn, and the distal segment 1 returns to a helical configuration, so that the electrode abuts the target point. position.
  • the target position can then be extracted and the pulsed RF energy delivered to achieve the discharge ablation function.
  • Figure 1 1 shows a schematic view of a multi-electrode ablation catheter having a saline perfusion function comprising a distal section 1 in a helical configuration, a plurality of electrodes 2 arranged around a distal segment 1, 2 electrodes 2, in accordance with an embodiment of the present invention.
  • the body section 4 and the control handle 6 are provided with a perfusate channel (not shown), and the perfusate from the perfusate source passes through the luer connector 8 and enters the distal section 1 of the spiral configuration through the perfusate channel.
  • FIG. 12 is a schematic illustration of a multi-electrode ablation catheter obtained before and after conditioning with the addition of a mechanism for adjusting the helical configuration of the distal section of the multi-electrode ablation catheter based on the multi-electrode ablation catheter of Figure 11.
  • the multi-electrode ablation catheter comprises a distal section 1 of a helical configuration, an electrode 2, a perfusion orifice 3, a body section 4, a handle function 5, a control handle 6, a tail socket 7, a luer 8 and a connector conduit 9.
  • the handle function member 5 is used for controlling the diameter of the spiral configuration of the distal segment 1, facilitating the multi-electrode ablation catheter to adjust the size of the spiral ring, so that the multi-electrode ablation catheter can easily enter the vessel in the human body, and the electrode can be Effectively abuts the vessel wall. As shown in FIG.
  • a handle function member 5 on a multi-pole ablation catheter of a bendable type guideable ribbon saline infusion function has a pull wire 12 (see FIG. 8), and the pull wire 12 is realized by the handle function member 5.
  • the distal section 1 of the helical configuration is also projected in the axial direction on a circumference 17 (see dotted line).
  • the diameter of the helical configuration of the distal section 1 can be reduced or increased by the handle function 5 as desired.
  • the diameter of the spiral configuration is small to facilitate the multi-electrode ablation catheter to enter the human vessel, and when adjusted, the distal segment 1 of the helical configuration is facilitated to abut the vessel wall in the vessel, ie, the multi-lumen tube
  • the electrode 2 on 101 can effectively abut the target on the vessel wall.
  • FIG. 12 can be filled with perfusate from the perfusion fluid source from the Luer connector 8 and the connector catheter 9, and the perfusate finally flows out from the perfusion hole 3 on the electrode 2, effectively reducing the electrode. 2 and the temperature of the target tissue can increase the ablation power and increase the ablation depth to the tissue. 14 and FIG. 15 respectively show a multi-electrode ablation catheter provided with the helical configuration adjustment mechanism shown in FIG.
  • the multi-electrode ablation catheter shown in Figure 14 can be used in conjunction with a guiding catheter
  • the multi-electrode ablation catheter shown in Figure 15 can be used not only in conjunction with a guiding catheter, but also in conjunction with a guidewire, and has a perfusion fluid perfusion function.
  • FIG. 9 only a multi-electrode ablation catheter that can be used in conjunction with a guiding catheter is illustrated by using FIG. 9, but it is to be understood that the above-mentioned multi-electrode ablation catheters that can be used in conjunction with the guidewire can be combined with appropriate specifications. Guide catheters are used in conjunction.
  • the operator can select one to assist the multi-electrode ablation catheter for delivery positioning based on the surgical needs and the suitability and cost of the guidewire and guide catheter of a suitable size.
  • the various structures that are applicable in the case where the distal segment 1 is in the helical configuration, in particular the wire-related structure and the wire-related structure, can also be applied separately or in combination to at least part of the distal segment 1 in other forms of circumferential configuration.
  • a plurality of electrodes 2 for ablation are arranged on the annular ring of the annular configuration.
  • FIG. 16 shows a schematic view of a multi-electrode ablation catheter with an adjustable annular ring attached to the distal end of the distal segment 1 and a plurality of ablation electrodes 2 distributed over the annular ring, in accordance with an embodiment of the present invention, A schematic diagram in which the annular ring is reduced is shown by a broken line.
  • the connection between the annular ring and the distal end of the catheter may be disposed at the edge of the annular ring.
  • the connection between the annular ring and the distal end of the catheter may also be disposed at the center of the annular ring.
  • the shape of the annular ring of the illustrated embodiment is shown in the broken lines in Figs. 16 and 17.
  • the number of electrodes in this embodiment is 10, which is more suitable for ablation of a human lumen with a larger vessel diameter.
  • the annular ring of this embodiment can adjust the size of the ring, and can cooperate with the guiding catheter to enter the human vessel, especially the pulmonary vein mouth, the pulmonary artery mouth, the renal artery mouth, and the pulmonary vein, the pulmonary artery, the renal artery blood vessel and the like, and the ablation is not only improved. Ablation efficiency, this adjustable size of the annular ring can more effectively abut the ablation electrode to the target site, ensuring ablation.
  • the design of the multi-electrode ablation catheter to which the adjustable annular ring is connected at the distal end can be combined with various aspects in addition to the scheme given in this embodiment. Any one or two of the guide wire pulling mechanism and the infusion mechanism in the embodiment shown in the embodiment are used in combination.
  • the distal section is a multi-lumen tube, wherein one lumen houses a guidewire, the access of the guidewire causes the distal section to include an annular loop, and the withdrawal of the guidewire causes the distal section
  • the return configuration is also the original configuration with the annular ring attached to the distal end.
  • the diameter and bending deflection adjustment mechanism of the annular ring is similar to the adjustment mechanism for the helical configuration associated with Figures 12-15 above, and is also achieved as follows: the pull wire 12 is received in the pull tube lumen 104 of the multi-lumen tube 101, and Coupled to the handle function 5 on the control handle 6, the pull wire 12 controls the diameter and bending deflection angle of the adjustable annular ring of the distal section 1 by the handle function 5.
  • the invention is not limited to the specific details described in the detailed description.
  • the invention provides a catheter for in vivo treatment, in addition to intracardiac ablation for arrhythmia and renal artery ablation to sympathetic treatment of hypertension, and is also suitable for discharge ablation of other intracardiac and/or intravascular vessels. surgery.

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Abstract

A multi-electrode ablation catheter which includes, connected in sequence, a distal portion (1), a main body portion (4) and a control handle (6); the distal portion (1) can, at least partially, reversibly change into a circumferential configuration having a lower contour configuration, the upper portion of which is provided with a plurality of electrodes (2) used for ablation. Perfusion fluid channels are provided in the main body portion (4) and in the control handle (6); the distal portion (1) includes a perfusion fluid lumen (102), a lateral wall of which perfusion fluid lumen (102) is provided with an opening. Each electrode (2) is provided with at least one perfusion aperture (203), each electrode (2) at least partially surrounds the circumferentially affixed arrangement of the distal portion (1) and forms a perfusion fluid chamber (202) between itself and a perfusion fluid lumen (102). Each perfusion aperture (203) is fluidly connected to a perfusion fluid source by means of a cavity, a corresponding opening, a perfusion fluid lumen (102), and a perfusion fluid channel. The distal portions (1) of the plurality of ablation catheters can be helical in form, thus being able to use a plurality of electrodes (2) to engage in the ablation of a plurality of targets, forming a desired shape of ablation; in addition, the electrode (2) and catheter inner cavity can be effectively used to form a coolant liquid perfusion flow path, efficiently removing heat from the electrode (2).

Description

多电极消融导管 技术领域  Multi-electrode ablation catheter
本发明涉及一种多电极消融导管, 用于在人体脉管内对靶部位进 行多电极放电消融, 特别涉及一种可用于肾动脉去神经治疗和肺动脉 射频消融的多电极消融导管。 背景技术  The present invention relates to a multi-electrode ablation catheter for multi-electrode discharge ablation of a target site within a human vessel, and more particularly to a multi-electrode ablation catheter for use in renal artery denervation therapy and pulmonary artery radiofrequency ablation. Background technique
顽固性高血压又称难治性高血压, 是指采用 3种或 3种以上降压 药物 (包括一种利尿剂) 治疗仍不能控制的高血压。 最新的动物及临 床实验数据证明: 采用经皮导管对肾脏交感神经进行射频消融的方法 可以持久有效地降低高血压。 该方法具有导管介入手段, 可以利用射频能量对肾动脉部位的交 感神经进行阻抗式加热, 可减弱其活性甚至使其传导功能丧失。 该方 法不仅可以有效治疗顽固性高血压, 而且具有微创、 无明显并发症等 优点。 业界把这种方法视为突破性进展, 被认为是治疗顽固性高血压 的新方法。 传统的电极为了达到较深的消融深度, 临床上会使用较高的消融 功率, 这样易在靶点表面形成局部高温, 易促成血栓、 焦痂, 从而影 响安全性和有效性, 延长手术时间, 增加病人的痛苦。 为了能够达到更深的消融深度, 可以在射频消融的同时, 在射频 电极的周围均匀地喷洒灌注液, 这样可以使电极达到更高的功率, 同 时不会快速增加其温度, 在保证治疗效果的同时, 还可以防止靶点表 面形成局部高温, 减少结痂和形成血栓的概率, 提高手术的安全性和 有效性。 当前远侧段为螺旋形的电极消融导管, 鉴于其能够顺畅地递送进 入脉管至靶部位并形成围绕脉管内壁的所需形状的消融, 受到重视。 本领域技术人员开发了如下多种远侧段为螺旋形的电极消融导管。 公开号为 CN102198015A的中国发明专利申请公开了一种可伸缩 螺旋叠环式电极导管, 导管与配套的鞘协同使用, 导管的远端为螺旋 叠环式, 可以通过中芯芯杆的伸缩来控制螺旋叠环的收缩与展开, 该 方法的中芯芯杆需要有一定的硬度, 才能控制螺旋叠环的收缩与展开。 中芯芯杆与鞘之间存在空隙, 容易在此处形成血栓。 该申请中的导管 不具有灌注液灌注功能, 不能有效地冷却电极和降低电极表面结痂风 险, 不能保证有足够的消融深度。 公开号为 CN201469401U的中国实用新型专利申请公开了一种螺 旋状环肾动脉肾交感神经射频电极导管, 其中的电极为连续的螺旋型, 该电极过大, 不能有效地保证消融深度。 电极远端无特殊保护措施, 在导管进入肾动脉血管时容易引起肾动脉穿孔, 风险高。 且无灌注液 灌注功能, 结痂风险高。 公开号为 CN102488552A的中国发明专利申请公开了一种可操控 螺旋形电极导管, 与公开号为 CN102198015A 的中国发明专利申请类 似, 该导管也通过中芯芯杆来控制导管的收缩, 同样无灌注液灌注, 不能有效冷却电极。 中芯芯杆与导管的主体之间存在空隙, 芯杆与导 管主体间相互运动, 容易引起血栓。 公开号为 CN 1549694 A的中国发明专利申请公开了一种螺旋形电 生理导管, 其具有螺旋形状的远侧段, 可以在该远侧段上布置多个电 极, 该远侧段通过其中延伸的芯构件来设置其螺旋构型, 且能够可逆 地变形为较低轮廓构型, 以便在脉管中顺利递送, 但是: 其仅仅提到 了可以根据温度数据的反馈来使用冷却液, 没有公开具体的灌注液灌 注机构, 且在远侧段上的电极优选螺旋线圈, 显然, 电极本身无法成 为冷却液灌注流路的一部分, 无法从电极的各处带走热量; 此外, 该 电生理导管只能与导引导管协同使用来使远侧段变形为较低轮廓构型 进而顺利在脉管中递送, 但是与导引导管协同使用时, 其会增加总的 外周直径, 在纤细的脉管中会增加递送难度并增加病人的不适。 公开号为 CN101309651A的中国发明专利申请公开了一种多电极 消融导管, 适用于脉管口位置的放电消融, 该导管可以控制电极与靶 点位置的贴靠程度, 但是部分结构中具有的中心芯杆与导管主体存在 间隙, 容易引起血栓; 该导管也不具有灌注液灌注的功能。 公开号为 US 2013/0304062 A1的美国专利申请公开了一种用于消 融的螺旋型导管, 通过收缩丝控制该导管螺旋形态的变化, 并且可以 通过盐水灌注, 有效冷却消融电极。 导管内部有 6 个腔, 使得导管整 体尺寸偏大, 达到 2.8mm。 肾动脉射频消融导管作为导管消融肾动脉去交感神经术 ( Catheter-based renal sympathetic denervation, RDN) 治疗顽固性高血 压最为关键, 不可或缺的工具。 临床研究表明, 为使 RDN获得最佳的 消融终点的有效性及安全性, 肾动脉射频消融导管需要外径偏小, 能 够进行多点消融, 并且具有冷盐水灌注的功能, 还需要可以与导丝、 导引鞘等配合, 可调弯功能以及游走血管内的安全性。 已有的专利大 多只具有其中的单一功能、 少部分功能。 因此, 需要提供一种多电极消融导管, 其远侧段能够可逆地在螺 旋构型与较低轮廓构型之间改变, 以便于顺利地在脉管中递送, 及利 用远侧段上布置的多个电极对脉管内壁的多个靶点处进行消融, 形成 期望形状的消融; 且该导管还具有灌注液灌注机构, 其能够有效地利 用电极和导管的内腔来形成冷却液灌注流路, 由此从电极各处高效地 带走热量; 此外, 该导管可以视应用情况灵活地选择与导引导管、 导 丝、 导引鞘协同使用以在脉管中顺利递送; 另外该导管还可以利用控 制手柄经由拉线来调节螺旋构型的圈大小, 使得在需要进入脉管中时 可以调小螺旋构型的直径, 而在到达靶点附近时可以调大螺旋构型的 直径, 使得电极紧密贴靠各个靶点。 另外, 该导管还可以利用控制手 柄经由拉线来调节导管远侧段的弯曲偏转, 使得在需要时, 可以通过 远侧段弯曲偏转调节进入脉管到达靶点位置。 另外, 该导管还可以利 用控制手柄的鲁尔接口通入导丝使得在需要时可以通过导丝改变导管 远侧段呈基态 (周向构型, 例如螺旋构型或环形构型) 和展开态 (较 低轮廓构型) , 使得在需要时经过脉管到达靶点。 另外, 有时候需要 将消融的靶点严格限制在纵向的窄带内, 这就需要远侧段的远端连接 有直径可调的环形圈的多电极消融导管, 其也能够顺利地在脉管中递 送, 能利用环形圈上布置的多个电极对脉管内壁近似落在一圈上的多 个靶点处进行消融, 形成期望形状为环形的消融。 发明内容 Refractory hypertension, also known as refractory hypertension, refers to the use of three or more antihypertensive drugs (including a diuretic) to treat hypertension that is still uncontrollable. The latest animal and clinical trial data demonstrate that radiofrequency ablation of the renal sympathetic nerve using a percutaneous catheter can permanently and effectively reduce hypertension. The method has a catheter intervention method, and the sympathetic nerve of the renal artery can be heated by the RF energy, which can weaken its activity and even lose its conduction function. The method can not only effectively treat refractory hypertension, but also has the advantages of minimally invasive and no obvious complications. The industry sees this approach as a breakthrough and is considered a new way to treat refractory hypertension. In order to achieve a deeper ablation depth, the traditional electrode uses a higher ablation power in the clinic, which is easy to form a local high temperature on the surface of the target, which is easy to cause thrombosis and eschar, which affects safety and effectiveness, and prolongs the operation time. Increase the suffering of the patient. In order to achieve deeper ablation depth, the perfusion solution can be evenly sprayed around the RF electrode at the same time as the RF ablation, so that the electrode can reach higher power without increasing the temperature rapidly, while ensuring the therapeutic effect. It can also prevent local high temperature from forming on the target surface, reduce the probability of scarring and thrombosis, and improve the safety and effectiveness of the operation. The current distal segment is a spiral electrode ablation catheter that is valued in view of its ability to smoothly deliver aspiration into the vessel to the target site and to form a desired shape around the vessel's inner wall. Those skilled in the art have developed a variety of electrode ablation catheters having a distal segment that is helical. The Chinese Patent Application Publication No. CN102198015A discloses a retractable spiral stacking-type electrode catheter which is used in conjunction with a matching sheath. The distal end of the catheter is a spiral stack ring type, which can be controlled by the expansion and contraction of the core core rod. The shrinkage and unfolding of the spiral stack, the core of the method requires a certain hardness to control the shrinkage and unfolding of the spiral stack. There is a gap between the core mandrel and the sheath, which easily forms a thrombus there. The catheter in this application does not have a perfusion fluid perfusion function, does not effectively cool the electrode and reduces the risk of scarring on the electrode surface, and does not guarantee sufficient ablation depth. The Chinese Utility Model Patent Application Publication No. CN201469401U discloses a spiral-loop renal artery renal sympathetic nerve RF electrode catheter in which the electrode is a continuous spiral type, and the electrode is too large to effectively ensure the ablation depth. There is no special protective measure at the distal end of the electrode. When the catheter enters the renal artery, it is easy to cause perforation of the renal artery, and the risk is high. And no perfusion fluid perfusion function, the risk of scarring is high. The Chinese Patent Application Publication No. CN102488552A discloses a steerable spiral electrode catheter similar to the Chinese invention patent application disclosed in CN102198015A, which also controls the contraction of the catheter through the core mandrel, and also has no perfusate. Perfusion, can not effectively cool the electrode. There is a gap between the core rod and the main body of the catheter, and the core rod and the catheter body move with each other, which is liable to cause thrombus. Chinese Patent Application Publication No. CN 1549694 A discloses a spiral electrophysiological catheter having a helically shaped distal section on which a plurality of electrodes can be disposed, the distal section extending therethrough The core member is configured to have its helical configuration and can be reversibly deformed into a lower profile configuration for smooth delivery in the vessel, but: it only mentions that coolant can be used based on feedback of temperature data, without specific disclosure The perfusion fluid infusion mechanism, and the electrode on the distal segment is preferably a spiral coil, obviously, the electrode itself cannot be The part of the flow path for the coolant is incapable of removing heat from the electrodes; in addition, the electrophysiological catheter can only be used in conjunction with the guiding catheter to deform the distal section into a lower profile and thus smoothly in the vessel Medium delivery, but when used in conjunction with a guiding catheter, it increases the total peripheral diameter, which increases the difficulty of delivery and increases patient discomfort in the thin vessel. The Chinese Patent Application Publication No. CN101309651A discloses a multi-electrode ablation catheter suitable for discharge ablation at the position of a vascular orifice, which can control the adhesion of the electrode to the target position, but has a central core in a part of the structure. There is a gap between the rod and the catheter body, which is easy to cause a thrombus; the catheter also does not have the function of perfusion fluid perfusion. U.S. Patent Application Publication No. US 2013/0304062 A1 discloses a spiral-type catheter for ablation, the change in the helical shape of the catheter is controlled by the contraction wire, and the ablation electrode can be effectively cooled by saline infusion. There are 6 chambers inside the tube, making the overall size of the tube too large, reaching 2.8mm. The renal artery radiofrequency ablation catheter is the most critical and indispensable tool for the treatment of refractory hypertension by Catheter-based renal sympathetic denervation (RDN). Clinical studies have shown that in order to obtain the best ablation end point for the effectiveness and safety of RDN, renal artery radiofrequency ablation catheters require a small outer diameter, can perform multiple ablation, and have the function of cold saline perfusion, but also need to be able to guide The silk, the guiding sheath and the like cooperate to adjust the bending function and the safety inside the blood vessel. Most of the existing patents only have a single function and a small part of the functions. Accordingly, it is desirable to provide a multi-electrode ablation catheter having a distal section that is reversibly changeable between a helical configuration and a lower profile configuration for smooth delivery in the vessel, and utilizing placement on the distal section a plurality of electrodes ablate at a plurality of target points of the inner wall of the vessel to form a desired shape of ablation; and the catheter further has a perfusate perfusion mechanism capable of effectively utilizing the inner cavity of the electrode and the catheter to form a coolant perfusion flow path Thereby, the heat is efficiently removed from all parts of the electrode; in addition, the catheter can be flexibly selected for use in conjunction with the guiding catheter, the guide wire, and the guiding sheath for smooth delivery in the vessel depending on the application; in addition, the catheter can be utilized Control The handle adjusts the size of the loop of the spiral configuration via a pull wire, so that the diameter of the spiral configuration can be adjusted when it is required to enter the vessel, and the diameter of the spiral configuration can be adjusted when the vicinity of the target is reached, so that the electrodes are closely attached. Rely on each target. In addition, the catheter can also adjust the bending deflection of the distal section of the catheter via a pull wire using a control handle such that the distal vessel bend deflection can be adjusted to enter the vessel position by the distal segment bending deflection. In addition, the catheter can also be guided into the guide wire by means of the Luer interface of the control handle so that the distal section of the catheter can be changed to a ground state (circumferential configuration, such as a helical configuration or a ring configuration) and an expanded state by a guide wire when needed. The low profile configuration) allows the vessel to reach the target when needed. In addition, it is sometimes necessary to strictly limit the target of ablation within the longitudinal narrow band, which requires a multi-electrode ablation catheter with a diameter-adjustable annular ring attached to the distal end of the distal segment, which can also be smoothly in the vessel. Delivery, a plurality of electrodes disposed on the annular ring can be used to ablate at a plurality of targets on the inner wall of the vessel that are approximately one turn, forming a desired shape of ablation. Summary of the invention
本发明提供了一种多电极消融导管, 包括顺序连接的远侧段、 主 体段和控制手柄, 所述远侧段的至少部分为周向构型, 该周向构型能 够可逆地改变为较低轮廓构型, 且其上布置有多个消融用的电极, 其 特征在于: 主体段和控制手柄中设有灌注液通道; 所述远侧段包括灌 注液管腔, 所述灌注液管腔的侧壁上有开口; 以及各个电极开有至少 一个灌注孔, 围绕所述远侧段的周向固定布置, 且与灌注液管腔之间 形成空腔, 各灌注孔经由所述空腔、 相应的开口、 所述灌注液管腔、 所述灌注液通道流体连接到导管外部的灌注液源。 利用该多电极消融 导管, 可以根据需要来调节远侧段的螺旋构型, 例如多电极导管要进 入脉管中时, 可以将其改变为较低轮廓构型便于顺利进入脉管和其中 的递送; 而当已经递送到靶点位置时, 可以恢复远侧段的螺旋构型以 贴靠侧壁上的靶点位置实施消融, 保证消融深度且避免对周边组织的 损伤; 并且, 可以利用远侧段上布置的多个电极对脉管内壁的多个靶 点处进行消融, 形成期望形状的消融; 且该导管还具有灌注液灌注机 构, 其能够有效地利用电极和导管的内腔来形成冷却液灌注流路, 由 此从电极各处, 包括内壁和外壁, 高效地带走热量。 所述周向构型可以采取多种形式。 优选的两种形式为: 所述远侧 段为螺旋构型, 或者所述远侧段为环形构型。 优选地, 所述各个电极均匀地分布在呈现周向构型的所述远侧段 部分的一周上。 由此, 可以利用尺寸较小的各个电极形成所需的消融 形状。 优选地, 各个电极上的灌注孔以一排或多排布置, 单排内的灌注 孔沿周向均匀布置, 且相邻排的灌注孔呈交错排列。 由此, 可以将灌 注液经由如此分布的各个灌注孔有效地灌注到电极表面的各个区域, 从而有效地实现电极的冷却降温效果。 优选地, 所述远侧段为多腔管, 该多腔管可依靠 NITI定型丝或者 该多腔管的高分子材质本身进行热处理定型以保持所述远侧段的螺旋 构型或环形构型。热处理温度为 100°C— 140°C,热处理时间为 30分钟一 60 分钟。 优选地, 热处理参数为: 110°C、 30 分钟。 该多腔管的构造 便于利用各个腔分别容纳所需构件以避免构件之间的互相干扰。 为节 省空间计, 在确保一些构件不会互相干扰的情况下, 例如导线和温度 感应线, 也可以将它们一同容纳在同一个腔内。 优选地, 所述控制手柄的近侧设有连接件导管, 该所述连接件导 管上设有第一鲁尔接头, 所述灌注液通道经由所述连接件导管和第一 鲁尔接头连接到灌注液源。 优选地, 所述灌注孔通过机械成孔、 电火花成孔、 激光成孔中的 一种方式来制备。 优选地, 所述灌注孔的直径为 0.02mm-0.5mm, 且灌 注孔的数量为 2-40个。 本发明还提供一种多电极消融导管, 包括顺序连接的远侧段、 主 体段和控制手柄, 所述远侧段上布置有多个消融用的电极, 其特征在 于, 所述远侧段为环形构型, 且所述电极布置在所述环形构型的环形 圈上。 这种设有环形圈的远端段的设计, 适应靶点的纵向延伸严格受 限的情况, 需要在脉管中递送时可以缩小环形圈的直径, 而在需要紧 密贴靠脉管内壁时可以扩大环形圈的直径。 优选地, 上述两种多电极消融导管的所述远侧段为多腔管, 其中 一腔内容纳拉线, 所述控制手柄耦联到所述拉线, 在控制手柄的调节 下, 螺旋构型或环形圈的直径大小改变或者所述远侧段的弯曲偏转角 度改变。 由此, 可以根据需要来利用控制手柄准确和方便地调节螺旋 构型或环形圈的直径, 例如多电极导管要进入脉管中时, 可以调小直 径便于顺利进入脉管和其中的递送; 而当递送到靶点部位而螺旋构型 或环形圈的直径小于脉管的内径导致没有贴紧脉管的侧壁时, 可以调 大直径以紧密贴靠侧壁上的靶点位置, 保证消融深度且避免对周边组 织的损伤。 优选地, 上述两种多电极消融导管的所述远侧段为多腔管, 其中 一腔内容纳导丝, 导丝的通入使得远侧段伸直, 导丝的回撤使得远侧 段回复构型, 例如回复螺旋构型或回复环形构型。 由此, 该多电极消 融导管可以与市面上的适合规格的导丝配合使用, 以实施方便的递送。 优选地, 所述控制手柄的近侧设有第二鲁尔接头, 所述导丝经由所述 第二鲁尔接头通入导管, 由此, 可以对导丝进行灵活的操控。 本发明还提供一种多电极消融导管, 包括顺序连接的远侧段、 主 体段和控制手柄, 所述远侧段为螺旋构型, 能够可逆地改变为较低轮 廓构型, 且其上布置有多个消融用的电极, 其特征在于: 所述远侧段 为多腔管, 其中一腔内容纳导丝, 导丝的通入使得远侧段伸直, 导丝 的回撤使得远侧段回复螺旋构型。 由此, 该远侧段为螺旋构型的多电 极消融导管可以与市面上的适合规格的导丝配合使用, 以实施方便的 递送。 本发明此外还提供一种多电极消融导管,包括顺序连接的远侧段、 主体段和控制手柄, 所述远侧段为螺旋构型, 能够可逆地改变为较低 轮廓构型, 且其上布置有多个消融用的电极, 其特征在于: 所述远侧 段为多腔管, 其中一腔内容纳拉线, 所述控制手柄耦联到所述拉线, 在控制手柄的调节下, 螺旋构型的直径大小改变或者所述远侧段的弯 曲偏转角度改变。 该新型多极消融导管可以与导引导丝配合将消融导管输送到靶点 位置, 也可以与导引导丝及导引鞘配合将消融导管输送到靶点位置。 此外, 多极消融导管还具有盐水灌注功能, 每个消融电极上规格分布 一定数量的灌注孔, 能够有效地灌注电极, 降低电极问题并且降低电 极表面结痂风险。 附图说明 The present invention provides a multi-electrode ablation catheter comprising a distal section, a body section and a control handle that are sequentially connected, at least a portion of the distal section being a circumferential configuration that can be reversibly changed to a lower profile configuration And a plurality of electrodes for ablation disposed thereon, wherein: the body segment and the control handle are provided with a perfusate channel; the distal segment comprises a perfusion fluid lumen, and the perfusion fluid lumen is on the side wall An opening; and each of the electrodes is provided with at least one perfusion hole, disposed circumferentially around the distal segment, and forming a cavity with the perfusate lumen, each perfusion hole via the cavity, a corresponding opening, The perfusate lumen, the perfusate channel is fluidly coupled to a source of perfusion fluid external to the catheter. With the multi-electrode ablation catheter, the helical configuration of the distal segment can be adjusted as desired, for example, when the multi-electrode catheter is to enter the vessel, it can be changed to a lower profile configuration for smooth access to the vessel and delivery therein. And when it has been delivered to the target site, the helical configuration of the distal segment can be restored to ablate against the target location on the sidewall, ensuring ablation depth and avoiding damage to surrounding tissue; and, the distal side can be utilized a plurality of electrodes disposed on the segment ablate at a plurality of target points of the inner wall of the vessel to form a desired shape of ablation; and the catheter further has a perfusate perfusion mechanism capable of effectively utilizing the lumen of the electrode and the catheter to form a cooling The liquid is perfused into the flow path, thereby efficiently removing heat from all parts of the electrode, including the inner and outer walls. The circumferential configuration can take a variety of forms. Two preferred forms are: the distal segment is in a helical configuration, or the distal segment is in an annular configuration. Preferably, the respective electrodes are evenly distributed over a week of the distal segment portion that presents a circumferential configuration. Thereby, each of the smaller-sized electrodes can be used to form a desired ablation shape. Preferably, the perfusion holes on the respective electrodes are arranged in one or more rows, the perfusion holes in the single row are evenly arranged in the circumferential direction, and the perfusion holes in the adjacent rows are staggered. Thereby, the perfusate can be effectively infused into the respective regions of the electrode surface via the respective perfusion holes thus distributed, thereby effectively achieving the cooling and cooling effect of the electrodes. Preferably, the distal segment is a multi-lumen tube, which can be heat-treated according to the NITI shaped wire or the polymer material of the multi-lumen tube to maintain the spiral configuration or the annular configuration of the distal segment. . The heat treatment temperature is from 100 ° C to 140 ° C, and the heat treatment time is from 30 minutes to 60 minutes. Preferably, the heat treatment parameters are: 110 ° C, 30 minutes. The configuration of the multi-lumen tube facilitates the use of the respective chambers to accommodate the desired components, respectively, to avoid mutual interference between the members. To save space, it is also possible to accommodate some components together in the same cavity, while ensuring that some components do not interfere with each other, such as wires and temperature sensing wires. Preferably, a proximal side of the control handle is provided with a connector conduit, the connector conduit is provided with a first luer connector, and the perfusate channel is connected to the first luer connector via the connector conduit and the first luer connector Prime fluid source. Preferably, the perfusion hole is prepared by one of mechanical hole formation, electric spark hole formation, and laser hole formation. Preferably, the perfusion hole has a diameter of 0.02 mm to 0.5 mm, and the number of perfusion holes is 2 to 40. The invention also provides a multi-electrode ablation catheter comprising a distal section, a main connection a body segment and a control handle, the distal segment is provided with a plurality of electrodes for ablation, wherein the distal segment is in an annular configuration, and the electrode is disposed on the annular ring of the annular configuration . The design of the distal segment with the annular ring is adapted to the strict limitation of the longitudinal extension of the target, and the diameter of the annular ring can be reduced when it is delivered in the vessel, and can be closely attached to the inner wall of the vessel. Increase the diameter of the annular ring. Preferably, the distal section of the two multi-electrode ablation catheters is a multi-lumen tube, wherein one cavity has a nanowire, the control handle is coupled to the cable, under the adjustment of the control handle, the spiral configuration or The diameter of the annular ring changes or the bending deflection angle of the distal segment changes. Thereby, the diameter of the spiral configuration or the annular ring can be adjusted accurately and conveniently using the control handle as needed. For example, when the multi-electrode catheter is to enter the vessel, the diameter can be adjusted to facilitate smooth access to the vessel and delivery therein; When delivered to the target site and the diameter of the helical configuration or annular ring is smaller than the inner diameter of the vessel, so that the side wall of the vessel is not in close contact, the diameter can be adjusted to closely abut the target position on the sidewall to ensure the depth of ablation. And to avoid damage to the surrounding tissue. Preferably, the distal section of the two types of multi-electrode ablation catheters is a multi-lumen tube, wherein one lumen contains a guide wire, the access of the guide wire causes the distal section to straighten, and the withdrawal of the guidewire causes the distal section Restore configuration, such as returning a spiral configuration or returning a circular configuration. Thus, the multi-electrode ablation catheter can be used in conjunction with a commercially available guidewire to facilitate convenient delivery. Preferably, the control handle is provided with a second luer connector on the proximal side, and the guide wire is guided into the catheter via the second luer, whereby the guide wire can be flexibly manipulated. The present invention also provides a multi-electrode ablation catheter comprising a distal section, a body section and a control handle that are sequentially connected, the distal section being of a helical configuration, capable of reversibly changing to a lower profile configuration, and being disposed thereon There are multiple electrodes for ablation, characterized in that: the distal segment is a multi-lumen tube, wherein one cavity contains a guide wire, the access of the guide wire makes the distal segment straight, and the withdrawal of the guide wire makes the distal side The segment returns to the helical configuration. Thus, the multi-electrode ablation catheter in which the distal section is in a helical configuration can be used in conjunction with a commercially available guidewire to facilitate convenient delivery. The present invention further provides a multi-electrode ablation catheter comprising a distal section, a body section and a control handle that are sequentially connected, the distal section being in a helical configuration, capable of reversibly changing to a lower profile configuration, and on which Arranging a plurality of electrodes for ablation, wherein: the distal segment is a multi-lumen tube, wherein a cavity has a nanowire, the control handle is coupled to the wire, and under the adjustment of the control handle, the spiral structure The size of the diameter of the type changes or the angle of deflection of the distal section changes. The novel multi-polar ablation catheter can be coupled to the guidewire to deliver the ablation catheter to the target site, or can be coupled to the guidewire and the introducer sheath to deliver the ablation catheter to the target site. In addition, the multi-polar ablation catheter has a saline perfusion function, and a certain number of perfusion holes are distributed on each ablation electrode, which can effectively perfuse the electrode, reduce the electrode problem and reduce the risk of scarring on the electrode surface. DRAWINGS
为了更清楚地描述本发明的技术方案, 下面将结合附图作简要介 绍。 显而易见, 这些附图仅是本申请记载的一些具体实施方式。 根据 本发明的包括但不限于以下这些附图。 在下文中, 以远离操作者靠近 靶点的一侧为远侧, 靠近操作者的一侧则为近侧。 较低轮廓构型或展开态则表示更接近直线型的构型, 例如小直径 的螺旋构型或可调环形圈相较大直径的螺旋构型或可调环形圈分别是 低轮廓构型, 螺旋构型在拉伸 (包括伸直) 状态下的构型相较原始螺 旋构型是低轮廓构型。 周向构型或基态表示沿着周向延伸的构型, 其 具有多种形式, 例如远侧段为螺旋构型或环形构型。 环形构型表示直 部与环形圈连接而成的构型, 环形圈的数量和位置可以根据需要确定。 在远侧段为螺旋构型的情况下, 呈现周向构型的所述远侧段部分的一 周表示该螺旋构型一个螺距的螺旋部分, 而在所述远侧段为环形构型 的情况下, 呈现周向构型的所述远侧段部分的一周表示一个所述环形 圈。 环形电极则表示该电极为沿着轴向两头开口且中空的回转体, 该 回转体可以是直筒的, 也可以具有起伏的周缘, 还可以根据需要在远 近两侧进行倒角。 此外, 术语 "流体连接" 表示以可以传输流体的方 式连接, 例如两个 "流体连接" 的部件, 表示流体可以在两个部件之 间流动传输。 图 1 示出根据本发明一实施例的多电极消融导管, 其可通入导丝 也具备灌注液灌注功能; In order to more clearly describe the technical solution of the present invention, a brief description will be made below with reference to the accompanying drawings. It is obvious that these drawings are only some of the specific embodiments described herein. In accordance with the present invention, including but not limited to the following figures. Hereinafter, the side far from the operator close to the target is the far side, and the side close to the operator is the near side. A lower profile configuration or an unfolded state indicates a configuration that is closer to a straight line, such as a small diameter spiral configuration or an adjustable annular ring phase with a larger diameter spiral configuration or an adjustable annular ring, respectively, a low profile configuration. The configuration of the helical configuration in the stretched (including straightened) state is a lower profile configuration than the original helical configuration. The circumferential configuration or ground state represents a configuration that extends in the circumferential direction and has a variety of forms, such as a distal configuration of a helical configuration or a toroidal configuration. The annular configuration represents a configuration in which the straight portion is connected to the annular ring, and the number and position of the annular ring can be determined as needed. Where the distal segment is of a helical configuration, a week of the distal segment portion exhibiting a circumferential configuration represents a helical portion of the helical configuration of one pitch, and wherein the distal segment is of a circular configuration, A week of the distal segment portion that presents a circumferential configuration represents one of the annular rings. The ring electrode means that the electrode is a hollow rotating body which is open at both ends in the axial direction, and the rotating body may be a straight cylinder, or may have an undulating circumference, and may be chamfered on both sides as far as necessary. Furthermore, the term "fluid connection" means connected in such a way as to transfer fluid, for example two "fluidly connected" components, indicating that fluid can be transported between two components. 1 illustrates a multi-electrode ablation catheter that can be passed through a guidewire and also has a perfusion fluid perfusion function, in accordance with an embodiment of the present invention;
图 2 示出图 1沿 a-a线向左看到的图示;  Figure 2 shows an illustration of Figure 1 taken to the left along the a-a line;
图 3 示出一种具有凸台的环形电极的示意图;  Figure 3 shows a schematic view of a ring electrode having a boss;
图 4 示出图 3所示的环形电极与导管的远侧段之间的固定方式以 及灌注液流路的示意图;  Figure 4 is a view showing the manner of fixing between the ring electrode shown in Figure 3 and the distal section of the catheter and the flow path of the perfusate;
图 5A示出一种直筒的环形电极及其表面的灌注孔分布的示意图; 图 5B 示出另一种直筒的环形电极及其表面的灌注孔分布的示意 图;  Figure 5A is a schematic view showing the distribution of a perforated hole of a straight ring electrode and its surface; Figure 5B is a schematic view showing the distribution of a perforation hole of another straight ring electrode and its surface;
图 5C 示出又一种直筒的环形电极及其表面的灌注孔分布的示意 图;  Figure 5C shows a schematic view of a further straight ring electrode and a perfusion hole distribution on its surface;
图 6示出直筒的环形电极与导管的远侧段之间的固定方式以及灌 注液流路的示意图;  Figure 6 is a view showing the manner of fixing the straight ring electrode and the distal section of the catheter and the flow path of the infusion solution;
图 7示出图 1所示的多电极消融导管通入导丝前后的示意图; 图 8示出图 7沿着 b-b线的剖面图;  Figure 7 is a schematic view of the multi-electrode ablation catheter of Figure 1 before and after the introduction of the guide wire; Figure 8 is a cross-sectional view of Figure 7 taken along line b-b;
图 9示出根据本发明一实施例的可与导引导管协同使用的多电极 消融导管的示意图;  9 shows a schematic view of a multi-electrode ablation catheter that can be used in conjunction with a guiding catheter, in accordance with an embodiment of the present invention;
图 10 示出根据本发明一实施例的可与导丝协同使用的多电极消 融导管的示意图;  Figure 10 shows a schematic view of a multi-electrode ablation catheter that can be used in conjunction with a guidewire in accordance with an embodiment of the present invention;
图 1 1 示出根据本发明一实施例的具有灌注液灌注功能的多电极 消融导管的示意图;  Figure 1 1 shows a schematic view of a multi-electrode ablation catheter having a perfusion fluid perfusion function, in accordance with an embodiment of the present invention;
图 12示出在图 1 1所示的多电极消融导管的基础上添加用于对多 电极消融导管的远侧段的螺旋构型进行调节的机构所得的多电极消融 导管和调节前后的示意图; Figure 12 shows the addition of a multi-electrode ablation for the adjustment of the helical configuration of the distal section of the multi-electrode ablation catheter based on the multi-electrode ablation catheter shown in Figure 11. Schematic diagram of the catheter and before and after adjustment;
图 13 示出图 12中沿 c-c线向左看到的图示;  Figure 13 is a view showing the left side of the line c-c in Figure 12;
图 14 示出根据本发明一实施例的设置有图 12所示的螺旋构型调 节机构的多电极消融导管及调节前后的示意图, 该多电极消融导管与 导引导管协同使用;  Figure 14 is a view showing a multi-electrode ablation catheter provided with the helical configuration adjustment mechanism shown in Figure 12 and before and after adjustment according to an embodiment of the present invention, the multi-electrode ablation catheter being used in conjunction with a guiding catheter;
图 15示出本发明一实施例的设置有图 12所示的螺旋构型调节机 构的多电极消融导管及调节前后的示意图, 该多电极消融导管可以视 需要与导引导管或导丝协同使用, 且具有灌注液灌注功能;  15 is a schematic view of a multi-electrode ablation catheter provided with the helical configuration adjustment mechanism shown in FIG. 12 and before and after adjustment according to an embodiment of the present invention. The multi-electrode ablation catheter can be used in conjunction with a guiding catheter or a guide wire as needed. , and has perfusion liquid perfusion function;
图 16 示出本发明一实施例的环形圈构型调节机构的多极消融导 管及调节前后的示意图;  Figure 16 is a schematic view showing a multi-pole ablation catheter of an annular ring configuration adjusting mechanism according to an embodiment of the present invention;
图 17示出图 16中沿 e-e线向左看到的图示;  Figure 17 is a view showing the left side of the line e-e in Figure 16;
图 18示出术中多级导管展开态示意图; 以及  Figure 18 is a schematic view showing the unfolded state of the intraoperative multistage catheter;
图 19示出术中多级导管基态示意图。 附图标记的说明  Figure 19 shows a schematic diagram of the ground state of an intraoperative multistage catheter. Description of the reference numerals
1 多电极消融导管的远侧段  1 distal segment of a multi-electrode ablation catheter
2 消融电极  2 ablation electrode
3 灌注孔  3 filling hole
4 多电极消融导管的主体段  4 main body segment of multi-electrode ablation catheter
5 手柄功能件  5 handle function
6 功能手柄  6 function handle
7 尾线插座  7 tail cable socket
8 鲁尔接头  8 luer connector
9 连接件导管  9 connector conduit
10 鲁尔接头  10 luer connector
1 1 灌注液  1 1 perfusate
12 拉线  12 pull line
13 导线  13 wire
14 温度感应线  14 temperature sensing line
16 圆周 17 圆周 16 circumference 17 circumference
21 导丝弹性段  21 guide wire elastic section
22 导丝  22 guide wire
23 导丝近端  23 guide wire proximal end
101 多腔管  101 multi-lumen tube
102 灌注液管腔  102 perfusate lumen
103 导丝管腔  103 guide wire lumen
104 拉线管腔  104 pull tube lumen
105 导线管腔  105 wire lumen
106 具有凸台的电极底部与多腔管连接部  106 electrode bottom with boss and multi-lumen tube connection
107 具有凸台的电极底部与多腔管平滑处  107 electrode bottom with boss and smoothing of multi-lumen tube
108 环形电极与多腔管平滑处  108 ring electrode and multi-lumen tube smoothing
201 具有凸台的环形电极  201 ring electrode with boss
202 灌注液腔  202 perfusate cavity
203 灌注孔  203 filling hole
204 具有凸台的环形电极的底部  204 bottom of ring electrode with boss
205 具有凸台的环形电极的过度部  205 over-extension of the ring electrode with a boss
206 灌注孔  206 filling hole
207 具有凸台的环形电极的凸台部  207 boss portion of a ring electrode having a boss
208 灌注液腔  208 perfusate cavity
209 直筒的环形电极  209 straight ring electrode
210 灌注孔  210 filling hole
21 1 具有凸台的环形电极下多腔管侧壁开口  21 1 Multi-lumen tube side opening under the ring electrode with boss
212 环形电极下多腔管侧壁开口  212 ring electrode under the multi-lumen tube side opening
213 一种直筒环形电极  213 a straight ring electrode
214 一种直筒环形电极 具体实施方式  214 a straight ring electrode embodiment
为了进一步理解本发明, 下面将结合实施例对本发明的优选方案 进行描述。 这些描述只是举例说明本发明的特征和优点, 而非限制本 发明的保护范围。 图 1 示出了根据本发明一实施例的一种可通导丝且带灌注液灌注 功能的多电极消融导管, 其包括顺序连接的至少部分为周向构型的远 侧段 1、 主体段 4和控制手柄 6, 其中, 远侧段 1的周向构型能够在外 力的作用下, 诸如插入导引导管的腔内或者经由通入导丝 22来可逆地 改变为较低轮廓构型, 例如被伸直, 以便更顺利地进入脉管并递送到 靶点位置。 该周向构型可以采取多种形式, 例如, 所述远侧段 1 可以 为螺旋构型或环形构型, 利用该螺旋构型或环形构型中的一个或多个 环形圈来构成所述周向构型。 作为环形构型的一个示例, 所述远侧段 1 的远端上设有 (例如连接有) 一个环形圈, 该环形圈优选是直径可调 的。 以下先以远侧段 1 为螺旋构型为例来进行说明, 但本领域技术人 员知道, 其他形式的能够在外力作用下改变为较低轮廓构型的沿周向 延伸的周向构型也是可用的, 以下在远侧段 1 为螺旋构型情况下适用 的各种结构也能够相应适用于远侧段 1 的至少部分为其他形式的周向 构型的情况。 该远侧段上布置有至少一个用于对靶点进行消融的电极 2, 各个 电极 2至少部分地围绕所述远侧段的周向固定布置。 各个电极 2可以 围绕所述远侧段的周向固定布置, 由此可以采取各种环形, 例如, 如 图 3所示的中段设有凸台的环形电极 201和如图 5A-5C所示的直筒的 环形电极 209等。 按照具体应用情况, 各个电极 2也可以采用部分的 环形。 其中, 电极 2上可以开有至少一个灌注孔 3, 在体内进行消融例 如进行肾动脉去神经射频消融的同时, 可以经由灌注机构进行灌注液 灌注, 所述灌注机构构成如下: 主体段和控制手柄中设有灌注液通道; 所述远侧段包括灌注液管腔 102 (如图 8所示) , 所述灌注液管腔 102 的侧壁上有开口; 以及各个电极 2与灌注液管腔 102之间形成空腔(如 图 4和图 6所示的灌注液腔 202 和 208 ) , 各灌注孔 3经由所述灌注 液腔 202、 相应的开口 (如图 4和图 6所示的开口 21 1和 221 ) 、 所述 灌注液管腔 102、 所述灌注液通道流体连接到导管外部的灌注液源。 通 过利用该灌注机构, 可以将灌注液从灌注液源经由所述灌注液通道、 灌注液管腔 102和开口输送到灌注液腔 202, 并在其中蓄积起来, 在蓄 积的期间从内壁吸收电极 2的热量, 充满时从灌注孔 3喷出灌注液, 对电极的外壁进行冲刷和冷却, 从而能够更有效地对电极 2 进行冷却 并从其各处高效地带走热量, 由此可以在电极 2 上输入更大功率的能 量, 从而可以保证电极消融的深度。 所述螺旋构型的远侧段 1可以为多腔管, 灌注液管腔 102为其中 的一腔, 其他各个腔中可以分别容纳所需的部件, 例如导丝、 导线拉 线和温度感应线中的一种或多种, 也可以在不影响各自操作的情况下, 将多种部件例如导线和温度感应线容纳在相同的腔内。 该多腔管可由 聚氨酯、 聚醚和聚酰胺的嵌段共聚物、 尼龙等材料制备, 多腔管的腔 的数量为 1-6个, 优选地腔的数量为 2-5个。 该多腔管可依靠 NITI定 型丝或者该多腔管的高分子材质本身进行热处理来定型, 以保持远侧 段 1的螺旋形状。热处理温度为 100°C— 140°C,热处理时间为 30分钟一In order to further understand the present invention, the preferred embodiments of the present invention will be described below in conjunction with the embodiments. These descriptions are merely illustrative of the features and advantages of the present invention and are not intended to be limiting The scope of protection of the invention. 1 illustrates a multi-electrode ablation catheter with a perfusion fluid perfusion function and a perfusion fluid perfusion function, including a distal section 1, a body section 4, and at least a portion of a circumferential configuration that are sequentially connected, in accordance with an embodiment of the present invention. Controlling the handle 6, wherein the circumferential configuration of the distal section 1 can be reversibly changed to a lower profile configuration, such as being straightened, under the action of an external force, such as insertion into the lumen of the guiding catheter or via the access guidewire 22. , to get into the vessel more smoothly and deliver it to the target location. The circumferential configuration can take a variety of forms, for example, the distal segment 1 can be in a helical configuration or an annular configuration, with the one or more annular rings in the helical configuration or annular configuration to form the circumferential configuration. . As an example of an annular configuration, the distal end of the distal section 1 is provided with (e.g., attached) an annular ring, which is preferably of adjustable diameter. Hereinafter, the distal section 1 is first taken as an example of a spiral configuration, but those skilled in the art know that other forms of circumferentially extending circumferential configuration that can be changed to a lower profile configuration by an external force are also available. The various configurations that are applicable in the case where the distal section 1 is of the helical configuration can also be applied correspondingly to the case where at least part of the distal section 1 is of other forms of circumferential configuration. At least one electrode 2 for ablation of the target point is arranged on the distal section, each electrode 2 being at least partially arranged circumferentially around the distal section. The respective electrodes 2 may be fixedly arranged around the circumference of the distal section, whereby various loops may be employed, for example, a ring electrode 201 provided with a boss in the middle section as shown in Fig. 3 and as shown in Figs. 5A-5C Straight ring electrode 209 and the like. Depending on the application, the individual electrodes 2 can also be partially annular. Wherein, the electrode 2 may be provided with at least one perfusion hole 3, and during ablation in the body, for example, radiofrequency ablation of the renal artery denervation, perfusion fluid perfusion may be performed via a perfusion mechanism, the perfusion mechanism being configured as follows: body segment and control handle a perfusate channel is provided therein; the distal segment includes a perfusate lumen 102 (shown in FIG. 8) having an opening in a sidewall of the perfusate lumen 102; and each electrode 2 and perfusate lumen 102 Cavities are formed therebetween (such as perfusate cavities 202 and 208 as shown in Figures 4 and 6), each perfusion hole 3 via the perfusate chamber 202, corresponding opening (opening 21 as shown in Figures 4 and 6) 1 and 221), the perfusate lumen 102, the perfusate channel is fluidly connected to a source of perfusion fluid external to the catheter. Pass With the perfusion mechanism, the perfusate can be delivered from the perfusate source via the perfusate channel, the perfusate lumen 102 and the opening to the perfusate chamber 202, where it accumulates, and the electrode 2 is absorbed from the inner wall during accumulation. The heat, when filled, ejects the perfusate from the perfusion hole 3, scouring and cooling the outer wall of the electrode, thereby more effectively cooling the electrode 2 and efficiently removing heat from the entire portion thereof, thereby being able to be on the electrode 2 Enter more energy to ensure the depth of electrode ablation. The distal section 1 of the helical configuration may be a multi-lumen tube, and the perfusion fluid lumen 102 is one of the chambers, and each of the other chambers may respectively contain a desired component, such as a guide wire, a wire pull wire, and a temperature sensing wire. One or more of the various components, such as wires and temperature sensing wires, can also be housed in the same cavity without affecting the respective operations. The multi-lumen tube can be made of a block copolymer of polyurethane, polyether and polyamide, nylon or the like, and the number of cavities of the multi-lumen tube is 1-6, preferably the number of cavities is 2-5. The multi-lumen tube can be shaped by the heat treatment of the NITI shaped wire or the polymeric material of the multi-lumen tube to maintain the helical shape of the distal section 1. The heat treatment temperature is 100 ° C - 140 ° C, and the heat treatment time is 30 minutes.
60分钟。 优选地, 热处理参数为: 110°C、 30分钟。 根据本发明所述的多极消融导管的螺旋构型的远侧段 1 由多腔管 制备而成。 该多腔管其中一个腔为导丝管腔。 该导丝管腔用于通过导 丝, 即可以通过导丝用于改变导管的螺旋构型的远侧段 1 呈基态或展 开态, 并可通过导丝将该螺旋构型的远侧段 1 输送到指定靶点位置, 可以有效避免螺旋导管对脉管的损伤, 提高手术的安全。 根据本发明所述的多极消融导管的螺旋构型的远侧段 1 由多腔管 制备而成。 该多腔管其中一个腔为拉线管腔。 拉线的一端固定在导管 的远侧段 1,经过螺旋构型的远侧段 1的拉线管腔后进入导管主体段内 的拉线管腔, 然后连接固定到控制手柄上, 通过手柄控制拉线在拉线 管腔内的运动来实现对导管螺旋构型的远侧段 1 的螺旋直径与弯曲偏 转改变, 弯曲偏转角度为 0— 180° , 优选地弯曲偏转角度为 0— 90° , 该拉线丝可以由但不限于镍钛合金丝、 不锈钢丝、 聚氨酯丝、 聚醚丝、 聚酰胺的嵌段共聚物丝等材料制备。 根据本发明所述的多极消融导管可以为螺旋型多极消融。 该多极 消融导管可以增加盐水灌注功能; 该多极消融导管可以通过导丝用于 改变螺旋导管的螺旋外形呈基态或展开态; 该多极消融导管可同时增 加盐水灌注和通过导丝用于改变螺旋导管的螺旋外形呈基态或展开 态; 该多极消融导管还可以增加可调圈功能。 本发明以四腔管为例介绍在多电极消融导管中的应用情况, 多腔 管的直径为 0.9-3.0mm, 该四腔为导丝管腔 103、 拉线管腔 104、 灌注 液管腔 102和导线管腔 105。 所述拉线管腔 104 内固定有拉线 12, 拉 线 12可以通过手柄功能件 5来控制导管的远侧段 1的螺旋直径变化。 而且, 通过拉线 12远端在导管的远侧段 1上的不同耦联位置, 该拉线 12还可以通过手柄功能件 5来控制导管远侧段 1 的弯曲偏转。 也就是 说, 通过拉线 12远端在导管远侧段 1的一个耦联位置, 可以控制导管 远侧段 1的直径大小变化, 而通过拉线 12远端在导管远侧段 1的另一 个耦联位置, 可以控制导管远侧段 1 的弯曲偏转; 这两种控制都可通 过手柄功能件 5 的操作来实现。 该拉线可以由但不限于镍钛合金丝、 不锈钢丝、 聚氨酯丝、 聚醚丝、 聚酰胺的嵌段共聚物丝等材料制备。 导管中的导丝管腔 103 内可以通入导丝 22, 该发明专利所述的多极消 融导管可以与导丝 22匹配使用, 可以通过导丝 22用于改变螺旋导管 的螺旋外形呈基态 (见图 19 ) 或展开态 (见图 18 ) 将多极消融导管递 送到人体脉管内的靶点位置。 例如, 先将导丝 22经由股动脉例行进入 肾动脉血管内, 然后将该多极消融导管沿导丝 22递送到肾动脉血管的 靶点位置。 多电极消融导管通入导丝 22前后的示意图见图 7。 该螺旋构型的远侧段上布置的电极 2可以为 1 -15个, 优选电极个 数为 4-10个。 电极 2可以由铂铱合金、 金、 银、 铂金、 铜、 不锈钢等 材料制备, 电极 2上的灌注孔 3, 如图 4和图 6所示中的灌注孔 D所 示, 可以视需要通过机械成孔、 电火花成孔、 激光成孔中的一种方式 来制备。 各个电极 2上连接有导线 13, 电极 2附近设置有用于感知放 电消融时电极的温度的热传感器, 该热传感器连接到导线管腔 105 中 的温度感应线 14, 导线 13和温度感应线 14经过螺旋构型的远侧段 1 和主体段 4后连接到控制手柄 6近端的尾线插座 7上, 分别用于传递 电信号和 /或脉冲射频能量以及温度反馈信号, 从而可以大大提高该消 融导管的使用安全性。 多电极消融导管的主体段 4为编织丝与高分子材料制备而成的管 材构成, 该编织丝包含镍钛丝、 不锈钢丝、 聚氨酯丝、 聚醚丝、 聚酰 胺的嵌段共聚物丝中的一种或多种, 且编制丝可以为单层编织丝或多 层编制丝; 该高分子材料选自聚氨酯、 聚醚和聚酰胺的嵌段共聚物、 尼龙等材料。控制手柄 6供术者握持,可由聚丙烯(PP),聚乙烯(PE)、 硅胶、 橡胶、 聚甲醛(POM)、 聚氯乙烯(PVC ) 、共聚聚酯(PETG) 、 聚苯乙烯 (HIPS ) 、 丙烯腈-丁二烯 -苯乙烯塑料 (ABS ) 等材料制备, 与主体段 1 相连, 用于对导管进行各种控制。 控制手柄 6近端可有尾 线插座 7, 该尾线插座 7用于通过配套尾线连接射频仪。 控制手柄 6近 端可设有连接件导管 9,该连接件导管 9分别连接鲁尔接头 8和鲁尔接 头 10。 所述鲁尔接头 8用于流体连接到灌注液 11, 灌注液 11从鲁尔 接头 8进入多电极消融导管内, 依次经过连接件导管 9、 控制手柄 6内 灌注液通道 (图中未标示) 进入主体段 4, 然后, 参见图 4所示, 进入 螺旋构型的远侧段 1 中的灌注液管腔 102, 接着灌注液 11经过多腔管 侧壁开口 211后进入灌注液腔 202, 最后从灌注孔 203喷射出去, 中段 具有凸台的环形电极 201 中的灌注液腔 202中充满灌注液 11, 并且不 断喷射出去, 带走大量的热量, 能够有效带走电极的能量, 降低电极 的温度, 也降低了电极表面结痂的风险。 灌注液可以选择对人体安全 的冷却液, 例如冷盐水等。 如图 2所示, 从图 1 中沿轴向向左看去, 远侧段 1 的螺旋构型叠 置在圆上, 该圆的直径为 3-30mm。 所有电极 2均匀地分布在螺旋构型 的一周上。 当电极 2的数量为 4个时, 在图 2中看来, 电极 2均匀分 布在圆的周缘上, 相邻两者夹角为 90 ° 。 优选地, 灌注孔 3沿周向均 匀地分布在各个电极 2的表面上。 当电极 2的数量超过 4个时, 电极 2 也均匀地分布在圆的周缘上, 在图 2 中看来, 电极 2之间的夹角可以 为多种, 通过 360° /电极 2的数量得到其度数, 其中典型的角度包括 72° 、 60° 、 45 ° 和 40 ° 等。 以上所述的角度为典型的角度, 但本发 明所述情况不限以上所述的几种情况, 依然适用于类似的其他角度。 图 3示出一种具有凸台的环形电极 201 的示意图。 所述具有凸台 的环形电极 201包括底部 204、 凸台部 207和连接两者的过度部 205, 以及分布在凸台部 207上的灌注孔 203,该灌注孔 203可以贯通凸台部60 minutes. Preferably, the heat treatment parameters are: 110 ° C, 30 minutes. The distal section 1 of the helical configuration of the multi-polar ablation catheter according to the present invention is prepared from a multi-lumen tube. One of the lumens of the multilumen tube is a guidewire lumen. The guidewire lumen is adapted to pass through the guidewire, i.e., the distal segment 1 of the helical configuration of the catheter can be changed by the guidewire to be in a grounded or expanded state, and the distal section of the helical configuration can be passed through the guidewire. Delivery to the specified target position can effectively avoid damage to the vessel by the spiral catheter and improve the safety of the operation. The distal section 1 of the helical configuration of the multi-polar ablation catheter according to the present invention is prepared from a multi-lumen tube. One of the multi-lumen tubes is a wire lumen. One end of the pull wire is fixed on the distal section 1 of the catheter, passes through the wire lumen of the distal section 1 of the spiral configuration, enters the wire tube cavity in the main body section of the catheter, and is then fixedly connected to the control handle, and the pull wire is controlled by the handle. The movement in the lumen to achieve a change in the helical diameter and bending deflection of the distal section 1 of the helical configuration of the catheter, the bending deflection angle being 0-180°, preferably the bending deflection angle being 0-90°, the wire can be But not limited to nickel-titanium alloy wire, stainless steel wire, polyurethane wire, polyether wire, Preparation of materials such as block copolymer yarns of polyamide. The multipolar ablation catheter according to the present invention may be helical multipolar ablation. The multi-polar ablation catheter can increase saline perfusion function; the multi-polar ablation catheter can be used to change the spiral shape of the spiral catheter to a ground state or a deployed state by a guide wire; the multi-pole ablation catheter can simultaneously increase saline perfusion and can be used for a saline infusion The spiral shape of the spiral catheter is changed to a ground state or an expanded state; the multi-pole ablation catheter can also increase the function of the adjustable circle. The invention introduces the application in a multi-electrode ablation catheter by taking a four-lumen tube as an example. The diameter of the multi-lumen tube is 0.9-3.0 mm, and the four chambers are the guide wire lumen 103, the wire lumen 104, and the perfusion fluid lumen 102. And the wire lumen 105. A pull wire 12 is fixed in the cable lumen 104, and the pull wire 12 can control the change in the diameter of the spiral of the distal section 1 of the catheter through the handle function 5. Moreover, the pull wire 12 can also control the bending deflection of the catheter distal section 1 by the handle function 5 by the different coupling positions of the distal end of the wire 12 on the distal section 1 of the catheter. That is, by the distal end of the pull wire 12 at a coupling position of the distal section 1 of the catheter, the change in the diameter of the distal section 1 of the catheter can be controlled, while the other end of the distal section 1 of the catheter is coupled via the distal end of the cable 12 The position can control the bending deflection of the distal section 1 of the catheter; both of these controls can be achieved by operation of the handle function 5. The pull wire may be prepared from materials such as, but not limited to, nitinol wire, stainless steel wire, polyurethane wire, polyether wire, block copolymer yarn of polyamide. A guide wire 22 can be introduced into the guide lumen 103 in the catheter. The multi-pole ablation catheter described in the patent can be used in conjunction with the guide wire 22, and can be used to change the spiral shape of the spiral catheter to the ground state through the guide wire 22 ( See Figure 19) or the expanded state (see Figure 18). Deliver the multipolar ablation catheter to the target site within the human vessel. For example, the guidewire 22 is first routinely advanced into the renal artery via the femoral artery and the multi-polar ablation catheter is then delivered along the guidewire 22 to the target site of the renal artery vessel. A schematic view of the front and rear of the multi-electrode ablation catheter leading into the guide wire 22 is shown in FIG. The number of electrodes 2 disposed on the distal section of the helical configuration may be from 1 to 15, preferably from 4 to 10. The electrode 2 can be made of a material such as platinum-rhodium alloy, gold, silver, platinum, copper, stainless steel, etc. The perfusion hole 3 on the electrode 2, as shown in the perfusion hole D in FIGS. 4 and 6, can be mechanically required as needed. One way to make holes, spark holes, and laser holes To prepare. A wire 13 is connected to each of the electrodes 2, and a heat sensor for sensing the temperature of the electrode at the time of discharge ablation is provided in the vicinity of the electrode 2. The heat sensor is connected to the temperature sensing wire 14 in the wire lumen 105, and the wire 13 and the temperature sensing wire 14 pass through The distal section 1 and the body section 4 of the helical configuration are then connected to the tail line socket 7 at the proximal end of the control handle 6, for respectively transmitting electrical signals and/or pulsed RF energy and temperature feedback signals, thereby greatly enhancing the ablation Safety of use of the catheter. The main body section 4 of the multi-electrode ablation catheter is composed of a braided wire and a polymer material prepared from a polymer material, and the braided wire comprises a nickel-titanium wire, a stainless steel wire, a polyurethane wire, a polyether wire, and a block copolymer wire of a polyamide. One or more, and the braided filaments may be a single layer of braided silk or a multi-layer braided filament; the polymeric material is selected from the group consisting of polyurethane, polyether and polyamide block copolymers, nylon, and the like. Control handle 6 for the operator to hold, can be polypropylene (PP), polyethylene (PE), silicone, rubber, polyoxymethylene (POM), polyvinyl chloride (PVC), copolyester (PETG), polystyrene ( HIPS), acrylonitrile-butadiene-styrene plastic (ABS) and other materials are prepared, connected to the main body section 1, for various control of the catheter. The proximal end of the control handle 6 can have a tail cable socket 7 for connecting the radio frequency meter through a matching tail wire. The proximal end of the control handle 6 can be provided with a connector conduit 9 that connects the Luer connector 8 and the Luer connector 10, respectively. The Luer connector 8 is used for fluid connection to the perfusion solution 11, and the perfusate 11 enters the multi-electrode ablation catheter from the Luer connector 8, and sequentially passes through the connector catheter 9, and the perfusion fluid channel in the control handle 6 (not shown) Entering the body segment 4, and then, as shown in Fig. 4, enters the perfusate lumen 102 in the distal section 1 of the helical configuration, and then the perfusate 11 passes through the multilumen tube sidewall opening 211 and enters the perfusate lumen 202, finally The perfusion liquid cavity 202 in the annular electrode 201 having the boss in the middle section is filled with the perfusate 11 and continuously ejected, taking away a large amount of heat, which can effectively remove the energy of the electrode and lower the temperature of the electrode. , also reduces the risk of scarring on the electrode surface. The perfusate can be selected as a safe coolant for the human body, such as cold saline. As seen in Figure 2, looking axially to the left in Figure 1, the helical configuration of the distal section 1 is superimposed on a circle having a diameter of 3-30 mm. All of the electrodes 2 are evenly distributed over one week of the spiral configuration. When the number of the electrodes 2 is four, it appears in Fig. 2 that the electrodes 2 are evenly divided. The cloth is placed on the circumference of the circle with an adjacent angle of 90 °. Preferably, the perfusion holes 3 are evenly distributed on the surface of each of the electrodes 2 in the circumferential direction. When the number of the electrodes 2 exceeds 4, the electrodes 2 are evenly distributed on the circumference of the circle. As seen in Fig. 2, the angle between the electrodes 2 can be various, and the number of 360° / electrode 2 is obtained. Its degrees, typical angles include 72°, 60°, 45 °, and 40 °. The angles described above are typical angles, but the present invention is not limited to the above-described cases, and is still applicable to similar other angles. Figure 3 shows a schematic view of a ring electrode 201 having a boss. The ring-shaped electrode 201 having a boss includes a bottom portion 204, a boss portion 207, and an excessive portion 205 connecting the two, and a filling hole 203 distributed on the boss portion 207, and the filling hole 203 can penetrate the boss portion
207的侧壁, 凸台部 207的侧壁与灌注液管腔 102之间形成如图 4所示 的灌注液腔 202 , 由此各灌注孔 203经由所述灌注液腔 202、 相应的 开口 (如图 4所示的开口 21 1 ) 、 所述灌注液管腔 102、 所述灌注液通 道流体连接到导管外部的灌注液源, 以利用输送的灌注液进行灌注。 所述具有凸台的环形电极 201上的灌注孔 203的数量为至少 1个, 图 3 所述的具有凸台的环形电极 201上的灌注孔 203数量为 6个, 分成两 排分布, 每一排沿周向均匀分布 3个灌注孔 203, 该两排灌注孔 203呈 交错排列, 如图 3 所示。 可以将灌注液经由各个灌注孔有效地灌注到 电极表面的各个区域, 从而有效地实现电极的冷却降温效果。 图 3 所 示的具有凸台的环形电极 201 的灌注孔 203数量和排数仅为示例, 所 述的灌注孔 203 的数量可以为 2-40个中的任一数量, 排数可以为 2-6 排中的任一数量。 所述灌注孔 203 的直径为 0.02-0.5mm, 优选地, 所 述灌注孔的直径为 0.08-0.2mm。 图 5A示出一种直筒的环形电极及其表面的灌注孔分布的示意图。 所述环形电极 209上开有两排灌注孔 210,每一排沿周向均匀分布 3个 灌注孔 210, 该两排灌注孔 210呈交错排列。 图 5B示出另一种直筒的 环形电极及其表面的灌注孔分布的示意图。 所述环形电极 214 上开有 两排灌注孔 210, 每一排沿周向均匀分布 4个灌注孔 210, 该两排灌注 孔 210呈交错排列。 图 5C示出又一种直筒的环形电极及其表面的灌注 孔分布的示意图。 所述环形电极 213上开有三排灌注孔 210, 每一排沿 周向均匀分布 3个灌注孔 210,该三排灌注孔 210中的任两个相邻的排 的灌注孔 210 间呈交错排列。 如图 5C 中所示, 相邻排的灌注孔 210 之间沿周向错开 60度, 使得第一排和第三排的灌注孔 210在周向上是 对齐的。 图 5A-5C所示的环形电极上的灌注孔排列为本发明的示例, 也可 以按需采取 2-40个中的其他数量的灌注孔的排列。 优选地, 各个电极 上的灌注孔以一排或多排布置, 单排内的灌注孔沿周向均匀布置, 且 相邻排的灌注孔呈交错排列, 这样可以在多个纵向位置上从电极周向 的多个角度位置均匀地喷出灌注液, 以从电极各处均匀地带走热量。 环形电极上随着灌注孔数量的增加, 相应减小灌注孔直径。 反之, 环 形电极上随着灌注孔直径的增加, 相应减少灌注孔数量。 优选地, 环 形电极上灌注孔的数量为 4-20个, 分成一排或多排排列。 可通过机械 成孔、 电火花成孔、 激光成孔等方式制备环形电极上的灌注孔, 所述 灌注孔的直径为 0.02mm-0.5mm, 优选地, 所述灌注孔的直径为 0.08-0.2mm。 图 4示出图 3所示的环形电极与导管的远侧段之间的固定方式以 及灌注液流路的示意图。 具有凸台的环形电极 201 与多腔管 101 固定 到一起, 具有凸台的环形电极的底部 204与多腔管 101 接触, 两者接 触部位通过热焊接、胶水或者机械方式实现两者密封固定,凸台部 207, 具体是其内壁, 与多腔管 101之间形成灌注液腔 202 。其中多腔管 101 中的灌注液管腔 102的侧壁上有开口 21 1,灌注液 1 1从鲁尔接头 8 (如 图 1 所示) 进入多电极消融导管, 经过多电极消融导管中的灌注液通 道 (图 1中未标示) 进入螺旋构型的远侧段 1 (多腔管 101 ) 中的灌注 液管腔 102, 灌注液 1 1沿着箭头 " A"指示的流向进入多腔管 101, 经 过灌注液管腔 102的侧壁上的开口 21 1后, 灌注液 1 1分成两个方向, 一部分继续沿着灌注液管腔 102向远侧流动, 如箭头 " C "所示; 另一 部分则沿着箭头 " B " 指示的流向经由侧壁开口 21 1进入腔 202。 灌注 液 1 1注满灌注液腔 202, 从具有凸台的环形电极 201上的 6个灌注孔 203上流出, 如图 4中的箭头 " D "所示。 灌注液 1 1 不断进入灌注液 腔 202 , 并在充满灌注液腔 202 后从灌注孔 203流出或喷出, 灌注液 1 1在灌注液腔 202中蓄积的过程中持续地从环形电极 201 的内壁吸收 热量, 而从灌注孔 203流出或喷出后能够对环形电极 201 的外壁进行 冲刷冷却, 由此能够从具有凸台的环形电极 201 的内部和外部充分地 吸收热量, 能够有效地降低具有凸台的环形电极 201 的温度, 可以增 加放电消融功率, 提高消融深度, 并降低电极表面结痂风险。 图 6示出直筒的环形电极与导管的远侧段之间的固定方式以及灌 注液流路的示意图。 该直筒的环形电极 209 除了两侧的边缘 (斜线所 示) 外基本呈直筒形, 与多腔管 101 连接固定到一起。 通过胶水或热 连接的方式, 将环形电极 209 的两侧边缘与多腔管 101 密封固定, 使 环形电极 209的中部 (的内壁) 与多腔管 101中的灌注液管腔 102 (的 外壁) 之间形成灌注液腔 208。 与图 4所示情况类似地, 灌注液 1 1进 入灌注液管腔 102后, 沿着箭头 " A"指示的方向流动, 在灌注液管腔 102侧壁上的开口 212处分成两个方向:一部分沿着灌注液管腔 102继 续向远侧流动, 如图 6中的箭头" C "所示, 另一部分经由侧壁开口 212 沿着箭头 " B "指示的方向流入灌注液腔 208, 灌注液注满灌注液腔 208 后, 从环形电极 209上的灌注孔 206流出, 如图 6中的箭头" D "所示。 灌注液 1 1在灌注液腔中 208蓄积的过程中持续地从环形电极 209的内 壁吸收热量, 而从灌注孔 206流出或喷出后能够对环形电极 209 的外 壁进行冲刷冷却, 由此能够从具有直筒的环形电极 209 的内部和外部 充分地吸收热量, 能够有效地降低具有直筒的环形电极 209 的温度, 可以增加放电消融功率, 提高消融深度, 并降低电极表面结痂风险。 图 7示出图 1所示的多电极消融导管通入导丝前后的示意图。 所 述多电极消融导管具有灌注液灌注功能, 可以与市面上适合规格的导 引导管配合使用, 也可以与市面上适合规格的导丝配合使用, 来将多 电极消融导管输送到人体内脉管的靶点部位。 多电极消融导管通入导 丝 22后, 导丝 22 的主体提供支撑力, 将多电极消融导管的螺旋构型 的远侧段 1撑直, 呈展开态 (见图 18 ) 。 如图 7中的虚线图所示。 导 丝 22从鲁尔接头 10进入多电极消融导管, 然后进入多电极消融导管 内的导丝通道 (图中未标示出) , 导丝通道的远端设有开口可供导丝 的远端通出。 导丝 22 的表面具有超滑涂层, 使得导丝 22能够在多电 极消融导管内的导丝通道内顺畅通过。 这样, 多电极消融导管可以通 过导丝 22用于改变螺旋构型的导管远侧段 1呈基态或展开态, 并可通 过导丝将多电极消融导管成功地通过股动脉经血液逆行进入人体内脉 管的靶点位置, 可以有效避免螺旋构型的导管远侧段 1对脉管的损伤, 提高手术的安全。 这些靶点位置包括但不限于肾动脉血管、 肺动脉血 管等。 在导丝 22进入脉管时, 导丝 22远端设有柔顺性非常好的导丝 弹性段 21, 可以很顺利的进入人体脉管内, 且不会损伤脉管组织。 导 丝的近端 23可以被固定, 以便导丝 22进入人体脉管后进行定位。 在 螺旋构型的远侧段 1在人体内脉管的靶点处定位后, 夹持导丝近端 23 回撤导丝 22,使螺旋构型的远侧段 1回复成螺旋形状或基态(见图 19), 以便电极 2有效地贴靠在脉管内的靶点位置。 图 8示出图 7沿着 b-b线的剖面图。 如图 8所示, 多腔管 101包 含四个腔, 分别为灌注液管腔 102、 导丝管腔 103、 拉线管腔 104和导 线管腔 105。 其中, 所述灌注液管腔 102作为灌注液流路的一部分, 用 于传输灌注液; 导丝管腔 103 用于通入导丝, 以导引多电极消融导管 到达人体脉管的靶点位置; 拉线管腔 104内固定有拉线 12, 用于控制 导管远侧段的螺旋直径大小变化以及导管远端的弯曲偏转角度变化, 拉线 12可以选自但不限于镍钛合金丝、 不锈钢丝、 聚氨酯丝、聚醚丝、 聚酰胺的嵌段共聚物丝等材料; 导线管腔 105内容纳导线 13和温度感 应线 14, 导线 13和温度感应线 14依次经过主体段 4和控制手柄 6后 连接固定到尾线插座 7 对应的引脚上, 以便传递电信号和输送射频脉 冲能量。 图 9示出根据本发明一实施例的可与导引导管协同使用的多电极 消融导管的示意图。 所示的多极消融导管包含螺旋构型的导管远侧段The side wall of the 207, the side wall of the boss portion 207 and the perfusate tube lumen 102 form a perfusate chamber 202 as shown in FIG. 4, whereby each of the perfusion holes 203 passes through the perfusate chamber 202, the corresponding opening ( The opening 21 1 ) shown in Fig. 4, the perfusate lumen 102, the perfusate channel are fluidly connected to a perfusion fluid source external to the catheter for perfusion using the delivered perfusate. The number of the filling holes 203 on the ring electrode 201 having the boss is at least one, and the number of the filling holes 203 on the ring electrode 201 having the boss shown in FIG. 3 is six, and is divided into two rows, each of which is distributed. The rows are evenly distributed with three infusion holes 203 in the circumferential direction, and the two rows of perfusion holes 203 are staggered, as shown in FIG. The perfusate can be effectively infused into each region of the electrode surface via the respective perfusion holes, thereby effectively achieving the cooling and cooling effect of the electrodes. The number and number of rows of the filling holes 203 of the ring-shaped electrode 201 having the boss shown in FIG. 3 are only examples, and the number of the filling holes 203 may be any one of 2-40, and the number of rows may be 2- Any number in the 6 rows. The diameter of the perfusion hole 203 is 0.02-0.5 mm, and preferably, the diameter of the perfusion hole is 0.08-0.2 mm. Fig. 5A shows a schematic view of a distribution of a perforated hole of a straight cylindrical electrode and its surface. The ring electrode 209 is provided with two rows of filling holes 210, and each row is uniformly distributed with three filling holes 210 in the circumferential direction, and the two rows of filling holes 210 are staggered. Fig. 5B shows a schematic view of another straight cylindrical electrode and a perfusion hole distribution on its surface. The annular electrode 214 is provided with two rows of filling holes 210, and each row is uniformly distributed with four filling holes 210 in the circumferential direction, and the two rows of filling holes 210 are staggered. Figure 5C shows still another straight ring electrode and its surface perfusion Schematic diagram of pore distribution. The ring electrode 213 is provided with three rows of filling holes 210, and each row is uniformly distributed with three filling holes 210 in the circumferential direction. The filling holes 210 of any two adjacent rows of the three rows of filling holes 210 are staggered. . As shown in Fig. 5C, the adjacent rows of perfusion holes 210 are circumferentially offset by 60 degrees such that the first and third rows of perfusion holes 210 are circumferentially aligned. The perfusion holes on the ring electrodes shown in Figures 5A-5C are arranged as an example of the invention, and an arrangement of other numbers of perfusion holes in 2-40 may be taken as needed. Preferably, the perfusion holes on the respective electrodes are arranged in one or more rows, the perfusion holes in the single row are evenly arranged in the circumferential direction, and the perfusion holes in the adjacent rows are staggered so that the electrodes can be separated from the plurality of longitudinal positions. The perfusate is evenly sprayed at a plurality of angular positions in the circumferential direction to evenly remove heat from the electrodes. As the number of perfusion holes increases on the ring electrode, the diameter of the perfusion hole is correspondingly reduced. Conversely, as the diameter of the perfusion hole increases on the ring electrode, the number of perfusion holes is correspondingly reduced. Preferably, the number of the perfusion holes on the ring electrode is 4-20, and is arranged in one or more rows. The perfusion hole on the ring electrode can be prepared by mechanical hole formation, electric spark hole formation, laser hole formation, etc., the perfusion hole has a diameter of 0.02 mm to 0.5 mm, and preferably, the perfusion hole has a diameter of 0.08-0.2. Mm. Figure 4 shows a schematic representation of the manner of attachment between the ring electrode shown in Figure 3 and the distal section of the catheter and the flow path of the perfusate. The ring electrode 201 having the boss is fixed to the multi-lumen tube 101, and the bottom portion 204 of the ring electrode having the boss is in contact with the multi-lumen tube 101, and the contact portions thereof are sealed and fixed by heat welding, glue or mechanical means. The boss portion 207, specifically the inner wall thereof, forms a perfusate chamber 202 with the multi-lumen tube 101. The perfusion fluid lumen 102 in the multi-lumen tube 101 has an opening 21 on the side wall thereof, and the perfusate 1 1 enters the multi-electrode ablation catheter from the Luer connector 8 (shown in FIG. 1) through the multi-electrode ablation catheter. The perfusate channel (not shown in Figure 1) enters the perfusate lumen 102 in the distal section 1 (multi-lumen tube 101) of the helical configuration, and the perfusate 1 1 enters the multilumen tube along the direction indicated by arrow "A" 101, after the opening 21 1 on the side wall of the perfusion fluid lumen 102, the perfusate 1 1 is divided into two directions, a portion continues to flow distally along the perfusion fluid lumen 102, as indicated by the arrow "C"; A portion enters the cavity 202 via the sidewall opening 21 1 along the direction of the arrow "B". Perfusion The liquid 1 1 is filled with the perfusate chamber 202, and flows out from the six perfusion holes 203 on the ring electrode 201 having the bosses, as indicated by an arrow "D" in FIG. The perfusate 1 1 continuously enters the perfusate chamber 202 and flows out or ejects from the perfusion hole 203 after filling the perfusate chamber 202, and the perfusate 1 1 continuously flows from the inner wall of the ring electrode 201 during accumulation in the perfusate chamber 202. The heat is absorbed, and the outer wall of the ring electrode 201 can be flushed and cooled after flowing out or ejected from the filling hole 203, whereby heat can be sufficiently absorbed from the inside and the outside of the ring electrode 201 having the boss, and the convexity can be effectively reduced. The temperature of the ring electrode 201 of the stage can increase the discharge ablation power, increase the ablation depth, and reduce the risk of scarring on the electrode surface. Figure 6 shows a schematic representation of the manner in which the straight ring electrode is secured to the distal section of the catheter and the perfusate flow path. The straight ring electrode 209 has a substantially straight cylindrical shape except for the edges (shown by oblique lines) on both sides, and is fixedly coupled to the multi-lumen tube 101. The both side edges of the ring electrode 209 are sealed and fixed to the multi-lumen tube 101 by glue or thermal connection, so that the middle portion (the inner wall) of the ring electrode 209 and the perfusate tube lumen 102 in the multi-lumen tube 101 (the outer wall) A perfusate chamber 208 is formed between them. Similar to the situation shown in Figure 4, after the perfusate 1 1 enters the perfusate lumen 102, it flows in the direction indicated by arrow "A" and is split into two directions at the opening 212 in the side wall of the perfusate lumen 102: A portion continues to flow distally along the perfusate lumen 102, as indicated by arrow "C" in Figure 6, and another portion flows into the perfusate chamber 208 via the sidewall opening 212 in the direction indicated by arrow "B", the perfusate After filling the perfusate chamber 208, it flows out of the perfusion hole 206 on the ring electrode 209, as indicated by the arrow "D" in FIG. The perfusate 1 1 continuously absorbs heat from the inner wall of the ring electrode 209 during the accumulation of the perfusate chamber 208, and can flush and cool the outer wall of the ring electrode 209 after flowing out or ejecting from the perfusion hole 206, thereby enabling The inside and the outside of the ring electrode 209 having a straight cylinder sufficiently absorb heat, which can effectively lower the temperature of the ring electrode 209 having a straight cylinder, can increase the discharge ablation power, increase the ablation depth, and reduce the risk of scarring on the electrode surface. Figure 7 is a schematic illustration of the multi-electrode ablation catheter of Figure 1 before and after accessing the guidewire. The multi-electrode ablation catheter has a perfusion fluid perfusion function, can be used with a guide catheter of a suitable size on the market, or can be used with a guide wire of a suitable size on the market to deliver the multi-electrode ablation catheter to the human body. Target site. Multi-electrode ablation catheter access guide After the wire 22, the body of the guide wire 22 provides a supporting force to stretch the distal section 1 of the helical configuration of the multi-electrode ablation catheter in an expanded state (see Figure 18). As shown in the dotted line in Figure 7. The guide wire 22 enters the multi-electrode ablation catheter from the Luer connector 10 and then enters a guidewire channel (not shown) in the multi-electrode ablation catheter. The distal end of the guidewire channel is provided with an opening for the distal end of the guide wire. Out. The surface of the guidewire 22 has an ultra-slip coating that allows the guidewire 22 to pass smoothly within the guidewire channel within the multi-electrode ablation catheter. In this way, the multi-electrode ablation catheter can be used to change the helical configuration of the distal section 1 of the catheter into a ground state or a deployed state through the guide wire 22, and the multi-electrode ablation catheter can be successfully passed through the femoral artery through the blood to the human body through the guide wire. The target position of the vessel can effectively avoid the damage of the vessel to the vessel in the distal section 1 of the spiral configuration, and improve the safety of the operation. These target locations include, but are not limited to, renal artery blood vessels, pulmonary artery blood vessels, and the like. When the guide wire 22 enters the vessel, the distal end of the guide wire 22 is provided with a flexible sheath 21 which is very compliant, and can smoothly enter the human vessel without damaging the vascular tissue. The proximal end 23 of the guidewire can be secured so that the guidewire 22 can be positioned after it enters the body's vasculature. After the distal segment 1 of the helical configuration is positioned at the target of the vessel in the human body, the guide wire proximal end 23 is pulled back to withdraw the guide wire 22, causing the distal segment 1 of the helical configuration to return to a helical or ground state ( See Figure 19) so that the electrode 2 effectively abuts the target position within the vessel. Figure 8 shows a cross-sectional view of Figure 7 taken along line bb. As shown in Fig. 8, the multi-lumen tube 101 comprises four chambers, a perfusate tube chamber 102, a guide tube lumen 103, a pull tube lumen 104 and a lead lumen 105. Wherein, the perfusate lumen 102 is used as a part of the perfusate flow path for transmitting the perfusate; the guidewire lumen 103 is for guiding the guide wire to guide the multi-electrode ablation catheter to the target position of the human vessel A pull wire 12 is fixed in the pull tube lumen 104 for controlling a change in the diameter of the spiral of the distal section of the catheter and a change in the bending deflection angle of the distal end of the catheter. The pull wire 12 may be selected from, but not limited to, a nickel-titanium alloy wire, a stainless steel wire, a polyurethane. Wire, polyether wire, polyamide block copolymer wire and the like; the wire lumen 105 contains the wire 13 and the temperature sensing wire 14, the wire 13 and the temperature sensing wire 14 are sequentially connected through the main body segment 4 and the control handle 6 Connect to the corresponding pin on the tail socket 7 to transfer electrical signals and deliver RF pulse energy. Figure 9 illustrates a multi-electrode that can be used in conjunction with a guiding catheter in accordance with an embodiment of the present invention. Schematic diagram of an ablation catheter. The illustrated multi-polar ablation catheter comprises a distal section of the catheter in a helical configuration
1、 消融电极 2、 导管主体段 4、 手柄功能件 5、 功能手柄 6和尾线插座 7。 所述多极消融导管能够与导引导管配合使用, 导引导管先到达人体 脉管的靶点位置处, 所述多极消融导管通过导引导管到达靶点位置后, 固定多极消融导管, 回撤导引导管, 多极消融导管的远侧段 1 回复螺 旋构型即基态后 (见图 19 ) , 螺旋构型的导管远侧段 1上的消融电极 2贴靠到脉管上的靶点位置。 然后可以对靶点位置进行信号提取, 以及 输送脉冲射频能量, 实现放电消融功能。 如图 14所示, 一种可调圈普 通多极消融导管上的手柄功能件 5内有拉线 12 (见图 8 ) , 拉线 12通 过手柄功能件 5来控制螺旋构型的导管远侧段 1 的螺旋圈的直径大小 与弯曲偏转角度。 图 10 为示出根据本发明一实施例的一种可通导丝的多极消融导 管的示意图。 所示的多极消融导管包含螺旋构型的导管远侧段 1、 消融 电极 2、 导管主体段 4、 手柄功能件 5、 功能手柄 6、 尾线插座 7和鲁 尔接头 10。 所述多极消融导管内含有导丝通道 (图中未标示) , 多极 消融导管内通入导丝 22后, 导丝 22可将螺旋构型的远侧段 1撑直呈 展开态 (见图 18 ) 。 导丝 22到达脉管中的靶点位置, 然后多电极消融 导管沿着导丝 22到达靶点位置后, 回撤导丝 22, 远侧段 1回复成螺旋 构型, 使得电极贴靠靶点位置。 然后可以对靶点位置进行信号提取, 以及输送脉冲射频能量, 实现放电消融功能。 图 1 1 示出根据本发明一实施例的具有盐水灌注功能的多电极消 融导管的示意图, 其包含螺旋构型的远侧段 1、 围绕远侧段 1布置的多 个电极 2、 各个电极 2上的灌注孔 3、 主体段 4、 手柄功能件 5、 控制 手柄 6、 尾线插座 7、 鲁尔接头 8和连接件导管 9。 所述主体段 4和控 制手柄 6 内设有灌注液通道 (图中未标示) , 来自灌注液源的灌注液 经过鲁尔接头 8后, 通过灌注液通道进入螺旋构型的远侧段 1, 然后进 入电极 2的内壁与灌注液管腔 102的灌注液腔 202 内 (见图 4 ) , 最 后经过灌注孔 203流出电极 2, 灌注液 1 1能够从内部和外部高效地带 走电极 2上的热量, 从而可以增加电极 2上的功率, 增加靶点位置的 消融深度。 图 12示出在图 1 1所示的多电极消融导管的基础上添加用于对多 电极消融导管的远侧段的螺旋构型进行调节的机构所得的多电极消融 导管和调节前后的示意图。 该多电极消融导管包含螺旋构型的远侧段 1、 电极 2、 灌注孔 3、 主体段 4、 手柄功能件 5、 控制手柄 6、 尾线插 座 7、 鲁尔接头 8和连接件导管 9。 其中所述手柄功能件 5用于控制远 侧段 1 的螺旋构型的直径大小, 便于多电极消融导管调节螺旋圈的大 小, 以便多电极消融导管能够方便进入人体内脉管, 以及使得电极能 够有效地贴靠到脉管壁上。 如图 15所示, 一种可调弯型可通导丝带盐 水灌注功能的多极消融导管上的手柄功能件 5内有拉线 12 (见图 8 ) , 拉线 12通过手柄功能件 5来实现对螺旋构型的远侧段 1的螺旋直径大 小以及弯曲偏转角度的变化。如图 13所示,图 12中沿 c-c线向左看到, 螺旋构型的远侧段 1在轴向上投影在同一圆周 16上, 电极 2的投影均 匀地分布于圆周 16上, 灌注孔 3按一定规律排列在电极 2上。 利用手柄功能件 5调节远侧段 1 的螺旋构型的直径后, 螺旋构型 的远侧段 1在轴向上也投影在一个圆周 17 (参见虚线所示) 上。 可以 根据需要利用手柄功能件 5将远侧段 1的螺旋构型的直径调小或调大。 螺旋构型的直径调小后便于多电极消融导管进入人体脉管, 而调大后 则便于螺旋构型的远侧段 1 在人体内脉管中贴靠到脉管壁上, 即多腔 管 101 上的电极 2可以有效地贴靠到脉管壁上的靶点。 进行放电消融 时, 图 12所示的多电极消融导管可以从灌注液源从鲁尔接头 8和连接 件导管 9灌入灌注液, 灌注液最后从电极 2上的灌注孔 3流出, 有效 降低电极 2 和靶点组织的温度, 可以提高消融功率, 增加对组织的消 融深度。 图 14和图 15分别示出了据本发明两个实施例的设置有图 12所示 的螺旋构型调节机构的多电极消融导管及调节前后的示意图, 其中, 图 14所示的多电极消融导管可以与导引导管协同使用, 而图 15所示 的多电极消融导管不仅可以与导引导管协同使用, 还可以与导丝协同 使用, 且具有灌注液灌注功能。 上文中仅仅以图 9为例示出了一种可与导引导管协同使用的多电 极消融导管, 但需要知道, 上文中那些可以与导丝协同使用的多电极 消融导管, 都可以与合适规格的导引导管协同使用。 操作者可以根据 手术需求以及合适规格的导丝和导引导管的适用性和成本等, 来选择 一种来协助多电极消融导管进行递送定位。 以上在远侧段 1 为螺旋构型情况下适用的各种结构, 尤其是导丝 相关的结构和拉线相关的结构也能够分别或结合地适用于远侧段 1 的 至少部分为其他形式的周向构型的情况, 例如远侧段 1 为环形构型的 情况, 此情况下, 多个消融用的电极 2 布置在所述环形构型的环形圈 上。 以下以远侧段 1 的远端处连接有一个可调环形圈的一种环形构型 为例进行说明。 图 16示出了根据本发明一实施例的远侧段 1的远端处连接有一个 可调环形圈且多个消融用的电极 2 分布在所述环形圈上的多电极消融 导管的示意图, 其中以虚线示出环形圈调小后的示意图。 本实施例中, 环形圈与导管的远端的连接处可以设置在环形圈的边缘, 此外, 环形 圈与导管的远端的连接处也可以设置在环形圈的中心, 此连接方式也 在本发明的范围内。 图示实施例的环形圈调小后的形状见图 16 和 17 中虚线所示。 该实施例中的电极数量为 10个, 更加适合与脉管直径较 大的人体管腔的消融。 该实施例的环形圈可以调节其环形大小, 可以 配合导引导管进入到人体脉管内, 特别是肺静脉口、 肺动脉口、 肾动 脉口、 以及肺静脉、 肺动脉、 肾动脉血管等部分进行消融, 不仅提高 消融效率, 环形圈的这种可调大小的设计可以更加有效地将消融电极 贴靠到靶点部位, 保证消融效果。 此外, 远端处连接有可调的环形圈 的多电极消融导管的设计除了该实施例给出的方案外, 还可以与各种 实施例所示方案中的导丝牵引机构和灌注机构中的任一种或两种组合 地使用。 就导丝牵引机构而言, 所述远侧段为多腔管, 其中一腔内容 纳导丝, 导丝的通入使得远侧段包括环形圈伸直, 导丝的回撤使得远 侧段回复构型也就是远端连接有环形圈的原始构型。 该环形圈的直径 与弯曲偏转调节机制与上文中与图 12-15 相关的对于螺旋构型的调节 机制类似,也是如下实现的:拉线 12容纳在多腔管 101的拉线管腔 104 中, 并耦联到控制手柄 6上的手柄功能件 5, 拉线 12通过手柄功能件 5来控制远侧段 1的可调环形圈的直径大小与弯曲偏转角度变化。 本发明不局限于具体实施方式中所描述的具体内容。 本发明所提 供的一种体内治疗的导管除了心脏内消融治疗心律失常和肾动脉内消 融去交感神经治疗高血压用途外, 也适合于其他心内和 /或血管内等人 体脉管的放电消融手术。 以上实施例的说明只是用于帮助理解本发明的核心思想。 应当指 出, 对于本领域的普通技术人员而言, 在不脱离本发明原理的前提下, 还可以对本发明进行若干改进和修饰, 但这些改进和修饰也落入本发 明权利要求请求保护的范围内。 1. Ablation electrode 2, catheter body section 4, handle function member 5, function handle 6 and tail line socket 7. The multi-polar ablation catheter can be used in conjunction with a guiding catheter that first reaches a target point of the human vessel, and the multi-polar ablation catheter fixes the multi-polar ablation catheter after the guiding catheter reaches the target position. Withdrawing the guiding catheter, the distal segment 1 of the multipolar ablation catheter is restored to the helical configuration, ie, the ground state (see Figure 19), and the ablation electrode 2 on the distal segment 1 of the helical configuration abuts the target on the vessel Point location. The target position can then be extracted and the pulsed RF energy delivered to achieve the discharge ablation function. As shown in FIG. 14, an adjustable loop common handle multi-pole ablation catheter has a pull-tab 12 (see FIG. 8) in the handle function member 5, and the pull-wire 12 controls the distal section of the catheter in a spiral configuration by the handle function 5. The diameter of the spiral ring is the same as the bending deflection angle. 10 is a schematic view showing a multi-pole ablation catheter that can be passed through a guidewire in accordance with an embodiment of the present invention. The illustrated multi-polar ablation catheter comprises a catheter distal section 1, ablation electrode 2, catheter body section 4, handle function 5, functional handle 6, tailline socket 7, and luer connector 10. The multi-polar ablation catheter contains a guidewire channel (not shown). After the guidewire 22 is introduced into the multi-polar ablation catheter, the guidewire 22 can extend the distal section 1 of the helical configuration into a deployed state (see Figure 18). The guide wire 22 reaches the target position in the vessel, and then after the multi-electrode ablation catheter reaches the target position along the guide wire 22, the guide wire 22 is withdrawn, and the distal segment 1 returns to a helical configuration, so that the electrode abuts the target point. position. The target position can then be extracted and the pulsed RF energy delivered to achieve the discharge ablation function. Figure 1 1 shows a schematic view of a multi-electrode ablation catheter having a saline perfusion function comprising a distal section 1 in a helical configuration, a plurality of electrodes 2 arranged around a distal segment 1, 2 electrodes 2, in accordance with an embodiment of the present invention. The upper perfusion hole 3, the main body section 4, the handle function 5, the control handle 6, the tail cable socket 7, the luer connector 8, and the connector conduit 9. The body section 4 and the control handle 6 are provided with a perfusate channel (not shown), and the perfusate from the perfusate source passes through the luer connector 8 and enters the distal section 1 of the spiral configuration through the perfusate channel. Then, it enters the inner wall of the electrode 2 and the perfusate chamber 202 of the perfusate lumen 102 (see FIG. 4), and finally flows out of the electrode 2 through the perfusion hole 203, and the perfusate 1 can be efficiently taken from the inside and the outside. The heat on the electrode 2 is moved, so that the power on the electrode 2 can be increased, and the ablation depth of the target position can be increased. Figure 12 is a schematic illustration of a multi-electrode ablation catheter obtained before and after conditioning with the addition of a mechanism for adjusting the helical configuration of the distal section of the multi-electrode ablation catheter based on the multi-electrode ablation catheter of Figure 11. The multi-electrode ablation catheter comprises a distal section 1 of a helical configuration, an electrode 2, a perfusion orifice 3, a body section 4, a handle function 5, a control handle 6, a tail socket 7, a luer 8 and a connector conduit 9. Wherein the handle function member 5 is used for controlling the diameter of the spiral configuration of the distal segment 1, facilitating the multi-electrode ablation catheter to adjust the size of the spiral ring, so that the multi-electrode ablation catheter can easily enter the vessel in the human body, and the electrode can be Effectively abuts the vessel wall. As shown in FIG. 15, a handle function member 5 on a multi-pole ablation catheter of a bendable type guideable ribbon saline infusion function has a pull wire 12 (see FIG. 8), and the pull wire 12 is realized by the handle function member 5. The helical diameter of the distal section 1 of the helical configuration and the change in the bending deflection angle. As shown in Fig. 13, in Fig. 12, as seen to the left along the cc line, the distal section 1 of the helical configuration is projected on the same circumference 16 in the axial direction, and the projection of the electrode 2 is evenly distributed on the circumference 16, the perfusion hole 3 is arranged on the electrode 2 according to a certain regularity. After adjusting the diameter of the helical configuration of the distal section 1 by means of the handle function 5, the distal section 1 of the helical configuration is also projected in the axial direction on a circumference 17 (see dotted line). The diameter of the helical configuration of the distal section 1 can be reduced or increased by the handle function 5 as desired. The diameter of the spiral configuration is small to facilitate the multi-electrode ablation catheter to enter the human vessel, and when adjusted, the distal segment 1 of the helical configuration is facilitated to abut the vessel wall in the vessel, ie, the multi-lumen tube The electrode 2 on 101 can effectively abut the target on the vessel wall. When performing discharge ablation, the multi-electrode ablation catheter shown in Fig. 12 can be filled with perfusate from the perfusion fluid source from the Luer connector 8 and the connector catheter 9, and the perfusate finally flows out from the perfusion hole 3 on the electrode 2, effectively reducing the electrode. 2 and the temperature of the target tissue can increase the ablation power and increase the ablation depth to the tissue. 14 and FIG. 15 respectively show a multi-electrode ablation catheter provided with the helical configuration adjustment mechanism shown in FIG. 12 according to two embodiments of the present invention, and a schematic view before and after adjustment, wherein The multi-electrode ablation catheter shown in Figure 14 can be used in conjunction with a guiding catheter, while the multi-electrode ablation catheter shown in Figure 15 can be used not only in conjunction with a guiding catheter, but also in conjunction with a guidewire, and has a perfusion fluid perfusion function. . In the above, only a multi-electrode ablation catheter that can be used in conjunction with a guiding catheter is illustrated by using FIG. 9, but it is to be understood that the above-mentioned multi-electrode ablation catheters that can be used in conjunction with the guidewire can be combined with appropriate specifications. Guide catheters are used in conjunction. The operator can select one to assist the multi-electrode ablation catheter for delivery positioning based on the surgical needs and the suitability and cost of the guidewire and guide catheter of a suitable size. The various structures that are applicable in the case where the distal segment 1 is in the helical configuration, in particular the wire-related structure and the wire-related structure, can also be applied separately or in combination to at least part of the distal segment 1 in other forms of circumferential configuration. In the case of the type, for example, the case where the distal section 1 is of the annular configuration, in this case, a plurality of electrodes 2 for ablation are arranged on the annular ring of the annular configuration. Hereinafter, an annular configuration in which an adjustable annular ring is connected at the distal end of the distal section 1 will be described as an example. Figure 16 shows a schematic view of a multi-electrode ablation catheter with an adjustable annular ring attached to the distal end of the distal segment 1 and a plurality of ablation electrodes 2 distributed over the annular ring, in accordance with an embodiment of the present invention, A schematic diagram in which the annular ring is reduced is shown by a broken line. In this embodiment, the connection between the annular ring and the distal end of the catheter may be disposed at the edge of the annular ring. In addition, the connection between the annular ring and the distal end of the catheter may also be disposed at the center of the annular ring. Within the scope of the invention. The shape of the annular ring of the illustrated embodiment is shown in the broken lines in Figs. 16 and 17. The number of electrodes in this embodiment is 10, which is more suitable for ablation of a human lumen with a larger vessel diameter. The annular ring of this embodiment can adjust the size of the ring, and can cooperate with the guiding catheter to enter the human vessel, especially the pulmonary vein mouth, the pulmonary artery mouth, the renal artery mouth, and the pulmonary vein, the pulmonary artery, the renal artery blood vessel and the like, and the ablation is not only improved. Ablation efficiency, this adjustable size of the annular ring can more effectively abut the ablation electrode to the target site, ensuring ablation. In addition, the design of the multi-electrode ablation catheter to which the adjustable annular ring is connected at the distal end can be combined with various aspects in addition to the scheme given in this embodiment. Any one or two of the guide wire pulling mechanism and the infusion mechanism in the embodiment shown in the embodiment are used in combination. In the case of a guidewire traction mechanism, the distal section is a multi-lumen tube, wherein one lumen houses a guidewire, the access of the guidewire causes the distal section to include an annular loop, and the withdrawal of the guidewire causes the distal section The return configuration is also the original configuration with the annular ring attached to the distal end. The diameter and bending deflection adjustment mechanism of the annular ring is similar to the adjustment mechanism for the helical configuration associated with Figures 12-15 above, and is also achieved as follows: the pull wire 12 is received in the pull tube lumen 104 of the multi-lumen tube 101, and Coupled to the handle function 5 on the control handle 6, the pull wire 12 controls the diameter and bending deflection angle of the adjustable annular ring of the distal section 1 by the handle function 5. The invention is not limited to the specific details described in the detailed description. The invention provides a catheter for in vivo treatment, in addition to intracardiac ablation for arrhythmia and renal artery ablation to sympathetic treatment of hypertension, and is also suitable for discharge ablation of other intracardiac and/or intravascular vessels. surgery. The above description of the embodiments is merely for helping to understand the core idea of the present invention. It should be noted that those skilled in the art can make several improvements and modifications to the present invention without departing from the principles of the present invention, but such modifications and modifications are also within the scope of the claims of the present invention. .

Claims

权 利 要 求 Rights request
1. 一种多电极消融导管, 包括顺序连接的远侧段、 主体段和控制 手柄, 所述远侧段的至少部分为周向构型, 该周向构型能够可逆地改 变为较低轮廓构型, 且其上布置有多个消融用的电极, 其特征在于: 主体段和控制手柄中设有灌注液通道; 1. A multi-electrode ablation catheter comprising a distal segment, a main body segment and a control handle connected in sequence, at least part of the distal segment being in a circumferential configuration, the circumferential configuration being reversibly changeable to a lower profile configuration, and A plurality of ablation electrodes are arranged on it, which is characterized by: the main body section and the control handle are provided with perfusion fluid channels;
所述远侧段包括灌注液管腔, 所述灌注液管腔的侧壁上有开口; 以及 The distal section includes a perfusate lumen with an opening on a side wall; and
各个电极开有至少一个灌注孔, 各个电极至少部分地围绕所述远 侧段的周向固定布置, 且与灌注液管腔之间形成空腔, 各灌注孔经由 所述空腔、 相应的开口、 所述灌注液管腔、 所述灌注液通道流体连接 到导管外部的灌注液源。 Each electrode has at least one perfusion hole. Each electrode is at least partially fixedly arranged around the circumference of the distal section, and forms a cavity with the perfusion fluid lumen. Each perfusion hole passes through the cavity and the corresponding opening. , the perfusate lumen, and the perfusate channel are fluidly connected to a perfusate source outside the catheter.
2. 根据权利要求 1所述的多电极消融导管, 其特征在于, 所述远 侧段为螺旋构型, 或者所述远侧段为环形构型。 2. The multi-electrode ablation catheter according to claim 1, wherein the distal section is in a spiral configuration, or the distal section is in a ring configuration.
3. 根据权利要求 1所述的多电极消融导管, 其特征在于, 所述各 个电极均匀地分布在呈现周向构型的所述远侧段部分的一周上。 3. The multi-electrode ablation catheter according to claim 1, wherein each of the electrodes is evenly distributed around the distal section in a circumferential configuration.
4. 根据权利要求 1所述的多电极消融导管, 其特征在于, 各个电 极上的灌注孔以一排或多排布置, 单排内的灌注孔沿周向均匀布置, 且相邻排的灌注孔呈交错排列。 4. The multi-electrode ablation catheter according to claim 1, wherein the perfusion holes on each electrode are arranged in one or more rows, the perfusion holes in a single row are evenly arranged circumferentially, and the perfusion holes in adjacent rows are arranged evenly in the circumferential direction. The holes are arranged in a staggered pattern.
5. 根据权利要求 2所述的多电极消融导管, 其特征在于, 所述远 侧段为多腔管, 所述多腔管依靠 NITI定型丝或者该多腔管的高分子材 质本身进行热处理定型来保持所述远侧段的螺旋构型或环形构型。 5. The multi-electrode ablation catheter according to claim 2, wherein the distal section is a multi-lumen tube, and the multi-lumen tube relies on NITI shaping wire or the polymer material of the multi-lumen tube itself for heat treatment and shaping. to maintain the helical or annular configuration of the distal segment.
6. 根据权利要求 5所述的多电极消融导管, 其特征在于, 所述热 处理的温度为 100°C— 140°C, 时间为 30分钟一 60分钟。 6. The multi-electrode ablation catheter according to claim 5, characterized in that the temperature of the heat treatment is 100°C-140°C, and the time is 30 minutes-60 minutes.
7. 根据权利要求 6所述的多电极消融导管, 其特征在于, 所述热 处理的温度为 1 10°C, 时间为 30分钟。 7. The multi-electrode ablation catheter according to claim 6, wherein the heat treatment temperature is 110°C and the time is 30 minutes.
8. 根据权利要求 1所述的多电极消融导管, 其特征在于, 所述控 制手柄的近侧设有连接件导管, 该所述连接件导管上设有第一鲁尔接 头, 所述灌注液通道经由所述连接件导管和第一鲁尔接头连接到灌注 液源。 8. The multi-electrode ablation catheter according to claim 1, wherein a connector conduit is provided on the proximal side of the control handle, a first Luer connector is provided on the connector conduit, and the perfusion fluid The channel is connected to a source of perfusate via the connector conduit and the first luer connector.
9. 根据权利要求 1所述的多电极消融导管, 其特征在于, 所述灌 注孔通过机械成孔、 电火花成孔、 激光成孔中的一种方式来制备。 9. The multi-electrode ablation catheter according to claim 1, wherein the perfusion hole is prepared by one of mechanical hole forming, electric spark hole forming, and laser hole forming.
10. 根据权利要求 1 所述的多电极消融导管, 其特征在于, 所述 灌注孔的直径为 0.02mm-0.5mm, 且灌注孔的数量为 2-40个。 10. The multi-electrode ablation catheter according to claim 1, characterized in that the diameter of the perfusion holes is 0.02mm-0.5mm, and the number of perfusion holes is 2-40.
1 1. 一种多电极消融导管, 包括顺序连接的远侧段、 主体段和控 制手柄, 所述远侧段上布置有多个消融用的电极, 其特征在于, 所述 远侧段为环形构型, 且所述电极布置在所述环形构型的环形圈上。 1 1. A multi-electrode ablation catheter, including a distal section, a main body section and a control handle connected in sequence, with a plurality of ablation electrodes arranged on the distal section, characterized in that the distal section is annular. configuration, and the electrodes are arranged on the annular ring of the annular configuration.
12. 根据权利要求 1或 1 1所述的多电极消融导管, 其特征在于, 所述远侧段为多腔管, 其中一腔内容纳拉线, 所述控制手柄耦联到所 述拉线, 在控制手柄的调节下, 螺旋构型或环形圈的直径大小改变或 者所述远侧段的弯曲偏转角度改变。 12. The multi-electrode ablation catheter according to claim 1 or 11, wherein the distal section is a multi-lumen tube, one of the lumens contains a pull wire, and the control handle is coupled to the pull wire. Under the adjustment of the control handle, the diameter of the spiral configuration or annular ring changes or the bending deflection angle of the distal segment changes.
13. 根据权利要求 1或 1 1所述的多电极消融导管, 其特征在于, 所述远侧段为多腔管, 其中一腔内容纳导丝, 导丝的通入使得远侧段 伸直, 导丝的回撤使得远侧段回复构型。 13. The multi-electrode ablation catheter according to claim 1 or 11, characterized in that the distal section is a multi-lumen tube, one of which contains a guide wire, and the introduction of the guide wire straightens the distal section. , the retraction of the guidewire causes the distal segment to return to its configuration.
14. 根据权利要求 12所述的多电极消融导管, 其特征在于, 所述 远侧段为多腔管, 其中一腔内容纳导丝, 导丝的通入使得远侧段伸直, 导丝的回撤使得远侧段回复构型。 14. The multi-electrode ablation catheter according to claim 12, wherein the distal section is a multi-lumen tube, one of which contains a guide wire, and the introduction of the guide wire straightens the distal section. Retraction of the guidewire allows the distal segment to return to configuration.
15. 一种多电极消融导管, 包括顺序连接的远侧段、 主体段和控 制手柄, 所述远侧段为螺旋构型, 能够可逆地改变为较低轮廓构型, 且其上布置有多个消融用的电极, 其特征在于: 所述远侧段为多腔管, 其中一腔内容纳导丝, 导丝的通入使得远侧段伸直, 导丝的回撤使得 远侧段回复螺旋构型。 15. A multi-electrode ablation catheter, including a distal segment, a main body segment, and a control handle connected in sequence. The distal segment is in a spiral configuration and can be reversibly changed to a lower profile configuration, and multiple devices are arranged on it. An electrode for ablation, characterized in that: the distal segment is a multi-lumen tube, one of which contains a guide wire, the introduction of the guide wire causes the distal segment to straighten, and the withdrawal of the guide wire causes the distal segment to recover Spiral configuration.
16. 根据权利要求 15所述的多电极消融导管, 其特征在于, 所述 控制手柄的近侧设有第二鲁尔接头, 所述导丝经由所述第二鲁尔接头 通入导管。 16. The multi-electrode ablation catheter according to claim 15, wherein a second Luer connector is provided on the proximal side of the control handle, and the guide wire passes into the catheter through the second Luer connector.
17. 一种多电极消融导管, 包括顺序连接的远侧段、 主体段和控 制手柄, 所述远侧段为螺旋构型, 能够可逆地改变为较低轮廓构型, 且其上布置有多个消融用的电极, 其特征在于: 所述远侧段为多腔管, 其中一腔内容纳拉线, 所述控制手柄耦联到所述拉线, 在控制手柄的 调节下, 螺旋构型的直径大小改变或者所述远侧段的弯曲偏转角度改 变。 17. A multi-electrode ablation catheter, including a distal segment, a main body segment, and a control handle connected in sequence. The distal segment is in a spiral configuration and can be reversibly changed to a lower profile configuration, and multiple devices are arranged on it. An electrode for ablation, characterized in that: the distal section is a multi-lumen tube, one of which contains a pull wire, the control handle is coupled to the pull wire, and under the adjustment of the control handle, the diameter of the spiral configuration The size changes or the bending deflection angle of the distal segment changes.
18. 根据权利要求 17所述的多电极消融导管, 其特征在于, 所述 各个电极均匀地分布在所述螺旋构型的一周上。 18. The multi-electrode ablation catheter according to claim 17, wherein the electrodes are evenly distributed around the spiral configuration.
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