WO2015169075A1 - 一种血管内异物捕捞装置及其捕捞方法 - Google Patents

一种血管内异物捕捞装置及其捕捞方法 Download PDF

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WO2015169075A1
WO2015169075A1 PCT/CN2014/090863 CN2014090863W WO2015169075A1 WO 2015169075 A1 WO2015169075 A1 WO 2015169075A1 CN 2014090863 W CN2014090863 W CN 2014090863W WO 2015169075 A1 WO2015169075 A1 WO 2015169075A1
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micro
guide wire
microwire
magnetic
foreign body
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PCT/CN2014/090863
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French (fr)
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张凌云
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张凌云
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/50—Instruments, other than pincettes or toothpicks, for removing foreign bodies from the human body
    • A61B17/52—Magnets

Definitions

  • the invention relates to the technical field of medical instruments, in particular to an intravascular foreign body fishing device and a fishing method thereof.
  • the fishing device is particularly suitable for use in an intravascular interventional operation, in which a surgical material such as a spring coil is dislodged and blocks a normal blood vessel. Safe and easy to remove such intravascular foreign bodies, to avoid cerebral infarction caused by vascular occlusion.
  • An intracranial aneurysm is a common cerebrovascular disease with extremely high mortality and disability.
  • intracranial aneurysms there are two treatment methods for intracranial aneurysms, namely, surgical clipping or intravascular interventional embolization.
  • surgical clipping or intravascular interventional embolization After the invention of the electrolytic coil in 1991, the latter has now become an important method for the treatment of intracranial aneurysms. At present, it has become the treatment of choice for most patients with aneurysms in developed countries such as Europe and the United States, and has been rapidly developed in China.
  • the types of instruments that have been reported for the capture of intravascular foreign bodies such as detached coils are mainly micro-lasso, micro-clamps, screw-opener-type catchers, and stent-type catchers:
  • the design of the micro-lasso is similar to the set of horses. After the lasso extends from the outer casing, the lasso ring is opened. After the target enters the lasso ring, the lasso ring can be tightened to capture the target, but the lasso The circle is difficult to fully open in the small intracranial distal blood vessels. If the displaced foreign bodies are densely packed, it is difficult to be trapped, and the fishing has a large chance;
  • Micro-clamp design is mainly used for foreign body fishing in peripheral large blood vessels, and occasionally used to capture foreign bodies in the intracranial large and middle arteries, but its complex mechanical design leads to its end stiffness, which is more vulnerable to fragile cerebrovascular damage. Large, and requires a large space to fully open, the same is not applicable to the end of the thin cerebrovascular;
  • the design principle of the spiral bottle opener is similar to the cork bottle opener.
  • the main purpose is to catch the blood clot in the artery. It can only be applied to the large internal carotid artery and the proximal end of the middle cerebral artery in the brain. The end is also stiffer and is not suitable for small cerebrovascular vessels at the distal end;
  • the stent-shaped fishing device originated from the design of the intravascular stent. It is applied to the fishing of foreign bodies in the blood vessel because it is similar to the trawling shape. However, just as the trawling damages the riverbed ecosystem, the stent is inevitably dragged in the blood vessel. It can damage vulnerable vascular endothelial cells and even directly cause vascular occlusion. Moreover, the mechanical design of the end is complicated and rigid, and the passage is poor, requiring a large space to operate. If the operation is improper, once the foreign body such as the coil is pushed into the smaller artery, it will not be able to be caught, causing permanent damage.
  • the present invention aims to provide an intravascular foreign body fishing device and a fishing method thereof, which can safely and easily take out intravascular foreign bodies such as surgical materials that are displaced and detached, thereby avoiding vascular clogging. Cerebral infarction and other conditions.
  • an intravascular foreign body fishing device which is composed of an A micro-guide wire and a B micro-guide wire, wherein the A micro-guide ribbon has magnetic properties, and the B micro-guide wire has ferromagnetism but is itself non-magnetic.
  • a micro-wire and B micro-wire are matched to become fishing devices.
  • the magnetic portion of the A micro-guide ribbon is at the end thereof, or in a region near the end but not at the end, in principle, only a partial region of the end of the A micro-wire or near the end is required. It is magnetic and can attract B microwires.
  • the end of the A microwire or near the end but not reaching the end region is a magnetized metal material, or itself contains a magnetic substance, or is a magnetic coating.
  • the B microwire material may preferably be a commonly used nickel-containing alloy wire material.
  • the present invention also provides a method for fishing by using the above-mentioned intravascular foreign body fishing device, comprising the following steps:
  • the significant effect of the invention is that since the device used is a micro-guide wire, it can smoothly pass through a narrow area and an intravascular foreign body; based on the safety and ease of operation of the micro-wire, a guide wire end portion is provided. It is magnetic and can be used together with another guide wire to easily and safely catch foreign objects such as coils displaced in the blood vessel, which reduces the uncertainty of the operation of the common method; and, because the guide wire is fine and soft, The traditional method reduces damage to the vessel wall.
  • the two guide wires are entangled after rotation, the foreign matter in the blood vessel can be firmly grasped, the stability of the operation is good, the operation level of the doctor is relatively low, and it is more suitable for popularization, and is suitable for all interventional procedures. Small blood vessels.
  • Figure 1 is a schematic view showing the displacement of the coil into the artery of the tumor-bearing artery.
  • FIG. 2 is a schematic view of the A microwire of the present invention after passing through a coil.
  • Fig. 3 is a schematic view showing the A micro guide wire and the B micro guide wire of the present invention passing through the coil.
  • FIG. 4 is a schematic view of the A microwire and the B microwire of the present invention passing through a coil and rotating.
  • FIG. 5 is a schematic structural view of an A micro-guide wire according to Embodiment 1 of the present invention.
  • Figure 6 is a schematic view showing the structure of an A microwire according to Embodiment 2 of the present invention.
  • an intravascular foreign body fishing device is composed of an A microwire 5 and a B microwire 4, wherein the A microwire 3 is magnetic with a section 1 to 2 cm near the end thereof.
  • the B microwire 4 is made of nickel titanium alloy, and the A microwire 3 and the B microwire 4 are matched into a fishing device.
  • Example 1 was repeated, as shown in Fig. 6, except that the magnetic portion of the A microwire 3 was at its end.
  • the fishing method comprises the following steps:
  • the intravascular foreign body fishing device of the invention is stable, simple, safe, stable in operation, small in damage to blood vessels, greatly reduces the uncertainty in operation, and is suitable for all small blood vessels that can be reached by interventional surgery.

Abstract

一种血管内异物捕捞装置，由A微导丝（3）和B微导丝（4）组成，其中A微导丝（3）带有磁性，B微导丝（4）具有铁磁性但其本身为非磁性，A微导丝（3）和B微导丝（4）配套成为捕捞装置。一种利用血管内异物捕捞装置进行捕捞的方法，包括：首先将A微导丝（3）穿过移位的异物缝隙；之后，将B微导丝（4）穿过移位的异物的其它缝隙；然后，使A微导丝（3）末端吸引B微导丝（4）末端并同时旋转两根微导丝，使其将移位的异物缠绕袢住；最后将两根微导丝同时退出，将异物从血管内拖出。

Description

一种血管内异物捕捞装置及其捕捞方法 技术领域
本发明涉及医疗器械技术领域，具体涉及一种血管内异物捕捞装置及其捕捞方法，该捕捞装置特别适用于血管内介入手术中，弹簧圈等手术材料移位脱落而堵塞正常血管的情况，可安全简便地取出此类血管内异物，避免血管堵塞引发脑梗死等情况。
背景技术
颅内动脉瘤是一种常见的脑血管病，具有极高的死亡率和致残率。目前颅内动脉瘤的治疗方式有两种，即外科手术夹闭或者血管内介入栓塞。1991年电解弹簧圈发明以后，后者目前已成为治疗颅内动脉瘤的重要方法。目前已经成为欧美等发达国家大多数动脉瘤患者的首选治疗方法，在我国也很快得到发展普及。
虽然介入栓塞颅内动脉瘤以其微创、住院时间短、恢复快为特色，但是弹簧圈等手术材料移位脱落而堵塞正常血管的情况也偶尔发生，这样就给手术带来很大风险。一旦发生，就极易导致动脉内形成血栓甚至载瘤动脉闭塞造成脑梗死。
已经报道的用于捕捞脱落弹簧圈等血管内异物的器械类型主要有微套索、微夹钳，螺旋开瓶器状捕捞器、支架状捕捞器等四种类型：
1.微套索的设计类似于套马索，套索从外套管伸出后即打开套索圈，待目标进入套索圈后，收紧套索圈即可抓获目标，但是这种套索圈在细小的颅内远端血管内很难充分打开，如果移位的异物团聚密集，则很难被套住，捕捞带有较大的偶然性；
2.微夹钳设计主要应用于外周大血管内异物捕捞，偶尔也被用于在颅内大、中动脉内捕捞异物，但是其复杂的机械设计导致其末端僵硬，对脆弱的脑血管损伤较大，而且需要较大空间才能充分打开，同样不适用于末端纤细的脑血管；
3.螺旋开瓶器状捕捞器设计原理类似软木塞开瓶器，主要目的是捕捞动脉中的血栓，在大脑中仅能应用于较大的颈内动脉、大脑中动脉近端等区域，其末端同样较为僵硬，并不适用于远端细小的脑血管；
4.支架状捕捞器起源于血管内支架设计，因其类似于拖网状而被应用于捕捞血管内异物，但就像拖网对河床生态系统损害极大一样，支架在血管内拖动时不可避免会损伤脆弱的血管内皮细胞，甚至直接导致血管痉挛闭塞。而且，其末端机械设计复杂且僵硬，通过性差，需要较大空间才能操作，若操作不当一旦将弹簧圈等异物推入更小的动脉则将无法捕捞，造成永久伤害。
近年来，介入治疗动脉瘤手术数量增长迅速，发生的弹簧圈等手术材料脱落事件的数量也相应逐渐增多，但从目前医疗技术看来，尚无理想的捕捞器械。
发明内容
针对上述技术问题，本发明旨在提供一种血管内异物捕捞装置及其捕捞方法，该捕捞装置及捕捞方法可安全简便地取出移位脱落的手术材料之类的血管内异物，避免血管堵塞引发脑梗死等情况。
本发明解决问题的技术方案是：一种血管内异物捕捞装置，由A微导丝和B微导丝组成，其中A微导丝带有磁性，B微导丝具有铁磁性但其本身为非磁性，A微导丝和B微导丝配套成为捕捞装置。
上述技术方案中，所述A微导丝带有磁性的部位在其末端，或者在靠近末端但未到达末端的一段区域，原则上只需保证A微导丝末端或者靠近末端的部位的局部区域带有磁性，能够吸引B微导丝即可。
上述技术方案中，所述A微导丝末端或靠近末端但未到达末端区域为已磁化的金属材料，或本身含有磁性物质，或者为磁性涂层。
上述技术方案中，B微导丝材料可以优选为常用的含镍合金导丝材料。
相应的，本发明还提供利用上述血管内异物捕捞装置进行捕捞的方法，包括如下步骤：
a)在血管内将A微导丝穿过移位的异物缝隙；
b)将B微导丝穿过移位的异物的其它缝隙；
c)使带磁性的A微导丝末端吸引B微导丝末端并同时旋转两根微导丝，使其将移位的异物缠绕袢住；
d)将两根微导丝同时退出，将异物从血管内拖出。
本发明的显著效果是：由于所用的器材为微导丝，所以其更能顺利的穿过狭小区域以及血管内异物；基于微导丝的安全性和易操作性，使一根导丝末端部位带有磁性，并与另一根导丝配合使用，可简便、安全的捕捞血管内移位的弹簧圈等异物，降低了普通方法操作的不确定性；并且，由于导丝细且柔软，较之传统方法减轻了对血管壁的损害。
同时，由于两根导丝旋转后缠绕，可牢牢的抓取血管内异物，其操作的稳定性好，对医生的操作水平要求相对较低，更适合普及推广，适用于所有介入手术能够到达的细小血管。
附图说明
下面结合附图对本发明作进一步描述。
图1为弹簧圈移位进入载瘤动脉堵塞血管示意图。
图2为本发明的A微导丝穿过弹簧圈后的示意图。
图3为本发明的A微导丝和B微导丝均穿过弹簧圈后的示意图。
图4为本发明的A微导丝和B微导丝均穿过弹簧圈并旋转后的示意图。
图5为本发明实施例1的A微导丝结构示意图。
图6为本发明实施例2的A微导丝结构示意图。
图中，1-血管，2-弹簧圈，3-A微导丝，4-B微导丝。
具体实施方式
实施例1
如图1～4所示，一种血管内异物捕捞装置，由A微导丝3和B微导丝4组成，其中A微导丝3在靠近其末端1～2厘米处的一段带有磁性(如图5所示)，B微导丝4由镍钛合金制成，A微导丝3和B微导丝4配套成为捕捞装置。
实施例2
重复实施例1，如图6所示，所不同的是A微导丝3带有磁性的部位在其末端。
当使用本发明提供的血管内异物捕捞装置时，其捕捞方法包括如下步骤：
a)在血管1内将A微导丝3穿过移位的弹簧圈2缝隙；
b)将B微导丝4穿过移位的弹簧圈2的其它缝隙；
c)使带磁性的A微导丝3末端吸引B微导丝4末端，同时旋转两根微导丝，使其将移位的弹簧圈2缠绕袢住；
d)将两根微导丝同时退出，将弹簧圈2从血管内拖出。
本发明的血管内异物捕捞装置抓取异物稳固、简便、安全，操作稳定性好，对血管的损伤小，大大降低了操作中的不确定性，且适用于所有介入手术能够到达的细小血管。
上述只是对本发明的优选实施例进行了图示和描述，但是本发明的保护范围并不局限于此，任何在本发明揭露的技术范围内可轻易想到的变化或替换，都应涵盖在本发明的保护范围之内。

Claims (8)

  1. 一种血管内异物捕捞装置，其特征在于：由A微导丝和B微导丝组成，其中A微导丝带有磁性，B微导丝具有铁磁性但其本身为非磁性，A微导丝和B微导丝配套成为捕捞装置。
  2. 根据权利要求1所述的血管内异物捕捞装置，其特征在于：A微导丝带有磁性的部位在其末端。
  3. 根据权利要求1所述的血管内异物捕捞装置，其特征在于：A微导丝带有磁性的部位在靠近末端但未到达末端的一段区域。
  4. 根据权利要求2或3所述的血管内异物捕捞装置，其特征在于：A微导丝末端或靠近末端但未到达末端区域为已磁化的金属材料。
  5. 根据权利要求2或3所述的血管内异物捕捞装置，其特征在于：A微导丝末端或靠近末端但未到达末端区域本身含有磁性物质。
  6. 根据权利要求2或3所述的血管内异物捕捞装置，其特征在于：A微导丝末端或靠近末端但未到达末端区域的磁性物质为磁性涂层。
  7. 根据权利要求1所述的血管内异物捕捞装置，其特征在于：B微导丝材料为含镍合金。
  8. 一种利用如权利要求1～7中任一项所述的血管内异物捕捞装置进行捕捞的方法，其特征在于包括如下步骤：
    a)在血管内将A微导丝穿过移位的异物缝隙；
    b)将B微导丝穿过移位的异物的其它缝隙；
    c)使带磁性的A微导丝末端吸引B微导丝末端并同时旋转两根微导丝，使其将移位的异物缠绕袢住；
    d)将两根微导丝同时退出，将异物从血管内拖出。
PCT/CN2014/090863 2014-05-09 2014-11-12 一种血管内异物捕捞装置及其捕捞方法 WO2015169075A1 (zh)

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CN103932764B (zh) * 2014-05-09 2016-08-24 张凌云 一种血管内异物捕捞装置
CN108186079A (zh) 2018-02-12 2018-06-22 中南大学湘雅二医院 一种微型电控磁力清洁系统及其方法
CN110200685B (zh) * 2019-06-28 2024-02-27 刘存发 圈套式血管异物取出器

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