WO2019080854A1 - 一种便于回收控制的介入器械输送装置 - Google Patents

一种便于回收控制的介入器械输送装置

Info

Publication number
WO2019080854A1
WO2019080854A1 PCT/CN2018/111565 CN2018111565W WO2019080854A1 WO 2019080854 A1 WO2019080854 A1 WO 2019080854A1 CN 2018111565 W CN2018111565 W CN 2018111565W WO 2019080854 A1 WO2019080854 A1 WO 2019080854A1
Authority
WO
WIPO (PCT)
Prior art keywords
interventional instrument
strip
floating
delivery device
outer sheath
Prior art date
Application number
PCT/CN2018/111565
Other languages
English (en)
French (fr)
Inventor
张志飞
訾振军
曾敏
龚全钢
Original Assignee
杭州启明医疗器械有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from CN201810509283.0A external-priority patent/CN108371571B/zh
Application filed by 杭州启明医疗器械有限公司 filed Critical 杭州启明医疗器械有限公司
Priority to CN201890001318.3U priority Critical patent/CN216318209U/zh
Publication of WO2019080854A1 publication Critical patent/WO2019080854A1/zh

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2427Devices for manipulating or deploying heart valves during implantation
    • A61F2/2436Deployment by retracting a sheath
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2427Devices for manipulating or deploying heart valves during implantation
    • A61F2/243Deployment by mechanical expansion
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2412Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
    • A61F2/2418Scaffolds therefor, e.g. support stents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/962Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
    • A61F2/966Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod

Definitions

  • the present invention relates to the field of medical devices, and more particularly to a delivery device for implanting a prosthetic heart valve into the heart.
  • Heart valve disease is one of the most common heart diseases in China, mainly caused by rheumatic fever.
  • valve degeneration including calcification and mucus degeneration
  • metabolic disorders Damage is also increasing in our country; in addition, congenital valvular disease is also a common cause of heart disease.
  • a considerable number of high-risk diseases of valvular heart disease such as severe valvular insufficiency, elderly patients who are unsuitable for surgical valve replacement surgery, advanced tumors, and valvular insufficiency, require new minimally invasive interventional procedures.
  • Invasive heart valves are inspired by surgical heart valve replacement surgery.
  • percutaneous valve intervention has emerged and has been successfully applied to humans since 2000. From experimental research to small-scale clinical parallel research, valvular disease intervention may break through the technical "bottleneck" and rapidly achieve a wide range of clinical applications, once again becoming the focus of interventional cardiology.
  • the prosthetic heart valve stent is compressed and delivered to the human body through a delivery device.
  • the compressed valve stent is usually elastic, and exerts a large force on the compression catheter when in a compressed state. These excessive forces are difficult to slow the valve stent. Accurate release often leads to excessive friction between the valve support and the inner wall of the blood vessel.
  • the Chinese patent publication No. CN101953725 discloses a prosthetic heart valve stent which is composed of an aortic stent, a valve stent, an outflow tract stent and a connecting ear.
  • the connecting ear can be engaged to In the stent fixation assembly of the delivery device, the slow release of the valve stent is accomplished by the engagement of the attachment ears and the constriction of the outer sheath during release of the valve support.
  • the concentric force of the engaging valve stent connecting ear is small, and in the later stage of the valve stent releasing process, the connecting ear is easily ejected from the delivery device stent fixing assembly, so that the valve stent is completely released. At this time, if problems such as positioning deviation are found, it cannot be recovered in time, and can only be replaced by surgery.
  • U.S. Patent No. 5,683,451 discloses a delivery device and method for controlled release of a valve support, which reduces the delivery and release of the valve by means of a track in the delivery device.
  • the above-described invention reduces the friction between the valve support and the delivery catheter when the body elastically expands the friction caused by the delivery catheter.
  • the valve stent after the release of the valve stent cannot be adjusted in position or secondary, which not only requires strict control accuracy during surgery. High, and there are certain risks.
  • the present invention provides a delivery device capable of fastening a proximally released proximal end during release of an interventional instrument to prevent the interventional instrument connection from abruptly disengaging from the mounting position prior to confirmation of release or further retraction of the adjustment position, When the interventional device confirms the release, the joint is smoothly released and released stably.
  • An interventional instrument delivery device for facilitating recovery control comprises a loading assembly and an outer sheath tube sleeved outside the loading assembly, the loading assembly having a positioning portion cooperating with the interventional instrument connection portion, the outer sheath tube and the positioning portion
  • auxiliary limiting member having:
  • the auxiliary limiting member applies a force to the interventional instrument connecting portion under the restraint of the outer sheath tube to prevent the interventional instrument connecting portion from being disengaged from the positioning portion;
  • the urging force of the auxiliary stopper is released, and the interventional instrument connection portion is allowed to be disengaged from the positioning portion.
  • the axial direction of the present invention can be understood as the direction in which the loading assembly or the outer sheath tube extends. Since the loading assembly and the outer sheath tube are of a bendable structure, the axial direction is understood to be the axial direction at which the relevant component is located.
  • Corresponding said radial direction is perpendicular to the axial direction of the respective portion, for example, as the radial direction of the loading assembly or the outer sheath tube at the location where the auxiliary limiting member is located.
  • the outer sheath tube and the positioning portion are understood to be in the radial direction.
  • the force mainly comes from the restraint of the outer sheath tube.
  • the auxiliary limiting member Based on the fitting relationship of the outer sheath tube in the outer periphery of the positioning portion, the auxiliary limiting member applies a force to the corresponding portion of the interventional instrument connecting portion to maintain the interventional instrument connection portion and the positioning. Departmental cooperation.
  • the locking of the connecting portion of the interventional instrument relative to the positioning portion generally relies on the tight tolerance of the outer sheath tube and the positioning portion to provide a radial binding force to the connecting portion, so that the interventional instrument connecting portion is assembled on the positioning portion;
  • the material used in the positioning part is hard
  • the connecting part of the interventional device is a thin and hard material
  • the outer sheath tube has a relatively soft material.
  • the outer sheath tube and the positioning part are tightly matched, but Between the sheath tube and the interventional instrument, it is inevitable that there is a matching gap due to the processing technology, or the outer sheath tube itself is deformed under the external tension of the interventional instrument, and the gap is inevitable, and these gaps will become the interventional instrument during the delivery process.
  • the main reason for the slippage of the connecting portion is that the interventional device connecting portion is separated from the positioning portion in an unexpected situation, and the invention compensates the gap between the outer sheath tube and the interventional device by the auxiliary limiting member, and strengthens and ensures The stability of the locked state.
  • the auxiliary limiting member when viewed from the radial position, is located between the outer sheath tube and the interventional instrument connecting portion, effectively filling the radial gap between the outer sheath tube and the interventional instrument connecting portion, reinforcing and reinforcing the outer sheath tube The binding and tightening tendency of the interventional instrument connection by the auxiliary limiting member in the radial direction.
  • the connecting portion pushes the auxiliary limiting member radially outward to be separated from the positioning portion, the auxiliary limiting member is pushed by the connecting portion to abut against the inner wall of the outer sheath tube, and the inner wall of the outer sheath tube reacts to the auxiliary limit.
  • the positional member provides a corresponding tightening force, and the tightening force is transmitted to the connecting portion via the auxiliary limiting member to prevent the connecting portion from being disengaged from the positioning portion, thereby enhancing the stability and firmness of the connection between the connecting portion of the interventional instrument and the positioning portion, and preventing the intervention.
  • the instrument connection portion is out of the positioning portion before the interventional device is completely released and cannot be controlled, and after the interventional device portion is released, the release position or the effect is not satisfactory, the interventional device can be pulled back to the outer sheath tube for secondary positioning or returning. Withdrawal provides a strong, stable pull.
  • the auxiliary limiting member also acts as a spacer, and the filling of the gap does not or rarely increases the radial dimension of the delivery system when the valve is implanted; The reinforcement of the connection between the loading components is enhanced, and the connection performance is more stable.
  • the auxiliary limiting member is offset from the projection area of the positioning portion on the outer sheath axis.
  • the outer sheath tube When the outer sheath tube is retracted proximally relative to the positioning portion until the positioning portion is no longer restrained, it also means that the force of the tightening force transmitted to the interventional instrument connection portion via the auxiliary limiting member disappears, that is, the auxiliary limiting member In the unlocked state, the interventional instrument is allowed to disengage from the positioning portion.
  • the projection regions of the outer sheath tube and the positioning portion on the outer sheath tube axis are correspondingly displaced from each other by at least partial overlap.
  • auxiliary limiting members there are a plurality of auxiliary limiting members, and different auxiliary limiting members enter the locked state simultaneously or sequentially.
  • auxiliary limiting members there are a plurality of auxiliary limiting members, and different auxiliary limiting members are switched from the locked state to the released state simultaneously or sequentially.
  • the outer sheath has a pre-release state that completely encases the interventional instrument, a semi-released state of the exposed portion of the interventional instrument, and a fully exposed release state of the interventional instrument relative to the loading assembly;
  • the outer sheath tube is in a pre-release and semi-release state, the auxiliary limit member is in a locked state; or the auxiliary limit member is in a locked state only when the outer sheath tube is in a semi-release state.
  • the loading assembly comprises a core tube assembly
  • the core tube assembly is provided with a mounting head
  • the positioning portion is located on the outer peripheral wall of the mounting head
  • the auxiliary limiting member provides a force to the interventional device only in the locked state.
  • the loading assembly function is combined with the outer sheath tube to carry the interventional instrument in the body cavity or blood vessel until the lesion site.
  • the core tube assembly will extend proximally and connect the operating handle (control handle), the same outer sheath
  • the proximal end of the tube is also coupled to the operating handle such that axial relative movement between the loading assembly and the sheath tube can be controlled at the proximal end to effect release and retrieval of the interventional instrument.
  • the positioning portion is located on the outer peripheral wall of the mounting head, i.e., as a part of the mounting head, and the mounting heads may be integrally formed or separately fixed to each other.
  • the mounting head is a unitary structure or a split structure.
  • the split structure is adopted, at least two, for example, 2 to 4 split ends are arranged, and the split ends are arranged around each other and are gathered together, and the split ends are directly fixed on the core tube assembly or connected to the core tube assembly through the connecting member, and connected through
  • the splitting head is allowed to swing in a certain extent in the radial direction.
  • a positioning portion is disposed on each of the split heads, and the plurality of connecting portions on the interventional instrument cooperate with the corresponding positioning portions.
  • At least a portion of the interventional instrument connection portion is a connection ear that cooperates with the positioning portion, and in the locked state, the auxiliary limit member fills a radial gap between the outer sheath tube and the attachment ear.
  • the shape of the connecting ear is not strictly limited, and at least has an axially constraining structure with the positioning portion.
  • the positioning portion is at least partially radially open, and the connecting ear is in contact with the mounting head via the open portion, and the axial direction is abutted.
  • the bit structure interacts, and the force of the auxiliary limiter just keeps the axial limit structure interaction.
  • the auxiliary limiting member allows the radial movement of the connecting ear in the unlocked state (at least having a component of the radially outward movement) to release the axial limit between the positioning portion and the positioning portion.
  • the relative position of the mounting head in the loading assembly is fixed.
  • the distal end side of the core tube assembly is further provided with a guide head between which the interventional instrument mounting position for receiving the interventional instrument is located.
  • the interventional instrument mounting position is used to mount an interventional instrument (eg, an interventional prosthetic heart valve) that is adapted to the length of the interventional instrument.
  • an interventional instrument eg, an interventional prosthetic heart valve
  • the radially outer side of the auxiliary limiting member abuts against the inner wall of the outer sheath tube, and the radially inner side of the auxiliary limiting member abuts against the connecting ear.
  • the auxiliary limiting member functions as a gap compensation.
  • the outer sheath tube, the auxiliary limiting member, the connecting ear and the mounting head are sequentially abutted.
  • the force provided by the auxiliary limiting member in the locked state limits the radial movement of the connecting ear relative to the positioning portion.
  • the positioning portion has an open area that allows the connecting ear to change the radial position, and in the locked state, the auxiliary limiting member is blocked in the open area.
  • the outer sheath tube travels through the body, especially when bending occurs, and the radial gap between the outer cover tube and the connecting ear is increased, and the tendency of the connecting ear to be separated from the positioning portion by the open area is more obvious, and the auxiliary limiting member blocks the opening.
  • the zone understood that the partial or integral part of the auxiliary stop is in the open zone) can limit the radial movement of the blocking lug, maintaining the fit of the positioning portion.
  • the open area can also be understood that the positioning portion is exposed to the outer periphery of the mounting head, and has a radial thickness and a circumferential shape.
  • the interventional instrument connection portion gradually approaches and fits over the positioning portion via the open region.
  • the auxiliary limiting member completely closes or partially closes the open area.
  • the connecting ear may have the same shape as the open area, or the connecting ear only occupies a part of the open area, the partially closed open area is understood to be a part or the whole of the auxiliary limiting member on the radial moving path of the connecting ear, At least the radial movement of the connecting ears can be blocked.
  • the auxiliary limiting member when the auxiliary limiting member extends in the axial direction, at least part of the auxiliary limiting member passes through the open area, and the portion corresponds to the shape of the open area.
  • the shape of the auxiliary limiting member completely shields the open area.
  • the portion where the interventional instrument connecting portion cooperates with the positioning portion is provided with an axial limiting structure that interacts in the locked state, and in the unlocked state, the interventional instrument is allowed to move relative to the positioning portion to release the axial limit.
  • the mounting head can limit the axial relative position of the interventional instrument, so that the portable interventional instrument can be transported in the body. At the same time, during the recovery process, the interventional instrument needs to be pulled back relative to the outer sheath tube, that is, re-enter the outer sheath tube and return to the loading state. .
  • the size and shape of the auxiliary limiting member are not strictly limited, and there may be multiple places where the interventional instrument is in contact with the auxiliary limiting member, but the present invention focuses on applying a force to hold the interventional instrument on the positioning portion, and maintaining the interventional instrument and the positioning portion. Axial limit relationship.
  • the force has at least a radial component force, and in the locked state, the radial component force prevents the interventional instrument connection from moving outwardly, and the interventional instrument connection portion is inwardly abutted against the mounting head.
  • the interventional instrument connection has a tendency to abut radially against the mounting head, in order to further stabilize the state, the radial component provided by the auxiliary limiting member will strengthen the connection to the interventional instrument Limiting or restraining, that is, reinforcing the interventional instrument connection to the mounting head.
  • the force has at least a radial component, and in the locked state, the interventional instrument connection abuts against the outer circumference of the mounting head by the radial component.
  • the axial overlap length between the auxiliary stopper and the interventional instrument connecting portion is 0.3 to 2 cm.
  • Sufficient overlap length can ensure radial force, maintain the coordination relationship between the connecting part of the interventional instrument and the positioning part, and avoid the failure of the mating relationship due to unintended deformation of the component.
  • the radial force is related to the presence of the outer sheath tube, and when the outer sheath tube is disengaged from the interventional device, the radial force is correspondingly relieved.
  • the auxiliary limiting member and the interventional instrument connecting portion are freely slidably engaged in the axial direction.
  • the auxiliary limiting member mainly provides a radial force, it is allowed to freely slide with the interventional instrument connection portion in the axial direction, and there is no mutual restriction structure.
  • the auxiliary limiting member is located radially outside the interventional instrument.
  • the auxiliary limiting member has the same number of positioning portions, and the circumferential positions are in one-to-one correspondence.
  • the auxiliary stop has a smooth surface and/or a lubricating coating at the location where the interventional instrument connection is mated.
  • the auxiliary limiting member is a polytetrafluoroethylene material.
  • the auxiliary limiter contacts the outer circumference of the interventional instrument connection and/or the outer circumference of the mounting head in the radial direction.
  • the connecting portion may be higher than, equal to, or lower than the outer wall of the mounting head of the peripheral portion, and the auxiliary limiting member may directly contact the outer periphery of the connecting portion of the interventional instrument to apply a force, or only from the radial thickness (the connecting ear is lower than its own elasticity)
  • the auxiliary limiting member only contacts the outer circumference of the mounting head in the radial direction.
  • the auxiliary limiter only contacts the outer circumference of the interventional instrument connection.
  • the positioning portion has sufficient radial depth and the auxiliary limiting member only contacts the outer circumference of the interventional instrument, it can penetrate deeper inward along with the interventional instrument, that is, the auxiliary limiting member also sinks into the positioning portion to avoid external The local outer diameter of the sheath is too large.
  • said auxiliary stop member is a floating stop strip associated with the loading assembly, the floating stop strip being sheathed by the outer sheath tube to provide a force applied to the interventional instrument.
  • the floating stop strip can swing freely relative to the interventional instrument or core tube assembly when the interventional instrument is not loaded or without the sheath of the outer sheath or rely solely on its own material strength to maintain the relative position and posture.
  • the floating limit strips may be one or more spaced in the circumferential direction.
  • the circumferential wrap angle is less than 360 degrees, and the circumferential wrap angle is used for all the floating limit strips. And less than 360 degrees to facilitate radial movement to directly release the connecting ears.
  • the proximal end of the floating limit strip is connected to the loading assembly, and the distal end of the floating limit strip is floating relative to the loading assembly.
  • the floating arrangement is understood to be that there is no direct or indirect connection between the distal end of the floating limit strip and the loading assembly.
  • the distal end of the floating limit strip can be freely radial relative to the loading assembly, regardless of the action of the outer sheath tube. swing.
  • the positioning portion is a positioning protrusion or a positioning groove.
  • the connecting ear sleeve is disposed on the positioning protrusion or embedded in the corresponding positioning groove.
  • the floating limit bar is laminated. Attached to the ear to maintain the fit between the connecting ear and the positioning portion.
  • the connecting portion is disposed at the proximal end of the interventional instrument, and the proximal end of the connecting portion is a connecting ear that cooperates with the mounting head.
  • the connecting ear can generally adopt a T shape, an L shape, a ring shape, etc.
  • the positioning portion can be The positioning slot of the T-shaped or L-shaped receiving body, or the snap-in protruding head or the like is adopted, so that the axial position of the interventional instrument connecting ear after loading is limited to the positioning portion.
  • the shape of the connecting ear itself can be used. The prior art is not the focus of the improvement of the present invention.
  • the positioning portion adopts a positioning protrusion or a positioning groove, or a combination of the two.
  • a protruding head is arranged at the bottom of the positioning groove, and the corresponding shape of the connecting ear can enhance the positioning effect.
  • the positioning portion is a positioning groove, and in a locked state, a portion of the floating limiting strip that fits with the positioning groove is partially or completely sunk into the positioning groove.
  • the radial thickness of the floating limiting strip is not less than a position where the floating limiting strip does not cooperate with the positioning slot.
  • the positioning groove extends axially through the mounting head.
  • the axial through region of the positioning groove is closed by the floating limit strip.
  • the floating limit strip has at least a part of an overlapping area with the positioning portion in the circumferential direction.
  • the positioning portion is a positioning protrusion.
  • the radial thickness at the portion where the floating limiting strip cooperates with the positioning protrusion is not greater than the position where the floating limiting bar does not cooperate with the positioning protrusion.
  • the floating limit strip is hollowed out or recessed at a portion where the positioning tab cooperates with the positioning protrusion.
  • the hollow or recess can just accommodate or avoid the positioning protrusion, and the shape of the hollow or the recess can be the same as the positioning protrusion or the area is slightly larger and the positioning protrusion.
  • a fixed guiding strip extending on the inner wall of the outer sheath tube and extending in the axial direction.
  • the position of the fixed guiding strip in the state before the outer sheath tube corresponds to the position of the interventional instrument.
  • One side of the fixed guide strip is fixed to the inside of the tubular housing at the distal end of the outer sheath tube (in the direction away from the operator in the conveying device), and the fixed guiding strip is arranged to extend along the axial direction of the tubular housing.
  • the interventional instrument is in direct contact with the fixed guide strip located in the tubular casing of the outer sheath tube, and the smooth orbit provided by the fixed guide strip is used for rapid and precise regulation of the interventional instrument.
  • the fixed guide strip and the inner wall of the outer sheath tube may be partially or completely fixedly connected, or a plurality of fixed points spaced apart. Since the fixed guide strip needs to reciprocate with the outer sheath tube, the shaft of the fixed guide strip is preferably used. At least two ends are fixed to the inner wall of the outer sheath tube to avoid spatial interference caused by the tilting movement.
  • the outer sheath tube bundles the interventional device, and the fixed guide strip is closely attached to the interventional instrument.
  • the fixed guide strip provides a smooth track between the outer tubular tubular housing and the interventional instrument (near the side of the interventional instrument), reducing contact friction and facilitating the release and control of the interventional instrument.
  • the fixed guide strip and the auxiliary limiter are alternately arranged in the circumferential direction.
  • the fixed guide strips and the auxiliary limit members are alternately arranged in the circumferential direction to avoid mutual interference.
  • the floating limit strip changes the radial position by partial or integral deformation in a state in which the outer sheath is lost, allowing the interventional instrument connection to move radially outward from the positioning portion.
  • the floating stop strip is restrained by the outer sheath tube to maintain the cooperation between the connecting portion and the positioning portion before the insertion device is loaded into the outer sheath tube until the outer sheath tube is completely released; the outer sheath tube is retracted, and the connecting ear is gradually released.
  • the floating limit strip is gradually released from the outer sheath tube.
  • the connecting portion is completely released and disengaged from the mounting head, the floating limit strip can swing freely, and the released floating limit strip no longer applies radial to the connecting ear.
  • the pressing force that is, after the interventional instrument is in good position, the outer sheath tube will continue to retract, and the connecting portion and the floating limiting strip will be released. At this time, the floating limiting strip of the outer sheath tube is released, and the connecting portion has an infinite position. There is no secondary interference with the interventional device that causes the interventional instrument to shift.
  • the radial pressure of the floating limit strip on the joint disappears synchronously with the withdrawal of the outer sheath, and does not cause new interference to the well-released valve.
  • the floating limiting strip is deformable at least in the radial direction, and the binding of the connecting portion is released by the deformation of the corresponding portion. Since the floating limiting strip is wrapped by the outer sheath tube to provide a radial force, the floating limiting strip loses the outer sheath. When the tube is in a restrained state, the radial position is changed. When the radial position is changed, it is not strictly required that the moving path is radial, but at least has a radially outward component to prevent the connecting ear from coming off the positioning portion to realize the release of the interventional instrument.
  • the partial or integral deformation of the floating limiting strip is a memory deformation or a predetermined deformation.
  • the floating stop strip is a deformable structure, the deformable structure employing an elastic material and/or a hinge mechanism.
  • the floating limit bar When the floating limit bar enters the release state based on changing the radial or circumferential position, a part of the auxiliary connecting piece is fixedly connected with respect to the sheath core assembly or the mounting head, and in order to obtain a local radial or circumferential position, the floating limit strip is At least a portion is a deformable structure.
  • the proximal end of the floating limiting strip is fixedly connected to at least one of the following places:
  • the fixed position of the starting end of the floating limit strip is close to the mounting head, at the tail end of the mounting head (in the direction of the conveyor close to the operator) or the core tube assembly connected to the tail, through the outer sheath tube before the operation
  • the interventional instrument and the floating stop strip are converged such that the radially constraining strip of the floating stop strip rests against the periphery of the interventional instrument.
  • the floating limiting strips are arranged at intervals in the circumferential direction, and the proximal end sides of the plurality of floating limiting strips are connected as a fixing ring, and the fixing ring is fixed to at least one of the core tube assembly and the mounting head .
  • the floating limit strip has the same number of positioning portions, and the circumferential positions are in one-to-one correspondence.
  • the positioning slot ensures that the floating limit bar does not shift during the converging and releasing process.
  • the proximal end portion of the floating limit strip is tightly fastened to the positioning groove and the connecting ear embedded therein under the outer sheath tube.
  • the quick release and the fall of the interventional instrument are prevented by the squeeze fastening action of the floating limit strip in the positioning groove.
  • the distal end of the floating stop strip extends at least to a position corresponding to the connecting ear.
  • the connecting ears are covered to achieve the binding of the radial movement of the connecting ear, and the end of the floating limiting strip can further extend distally.
  • the farthest end of the floating limit strip is aligned with the farthest end of the mounting head or does not exceed the farthest end of the mounting head or slightly beyond the farthest end of the mounting head.
  • the floating limit strip When the floating limit strip has a minimum length, the floating limit strip can cover at least the connecting ear. To further ensure the compression effect, the end of the floating stop strip may extend further to the distal end side of the mounting head or slightly beyond the distal end side of the mounting head, for example over 1 cm less than or equal to the length.
  • the floating limit strip When the floating limit strip has the maximum length, the floating limit strip as a whole can ensure the bundle is in the outer sheath tube, and the end of the floating limit strip is flush with the distal end side of the interventional instrument inside the outer sheath tube, and the floating limit strip at this time
  • the length can wrap the entire interventional instrument, and the floating limit strip acts as a slide rail to ensure that the outer sheath tube can be pushed forward and retracted along the slide rail without directly contacting the interventional instrument.
  • the positioning groove is axially penetrated.
  • a portion of the floating limiting strip and the positioning groove is partially or completely sunk into the positioning groove.
  • the floating limiting strip extends distally via the positioning slot.
  • the positioning slot is not only axially penetrated, but the radial outer side is also open, that is, has a radial opening, and the floating limiting strip is not strictly limited to be completely inside the radial opening. Allowing a portion to be outside the radial opening, for example, the floating limiting strip has a T-shaped cross section, the T-shaped bottom end extends into the positioning groove for blocking the connecting ear, and the T-shaped top dimension is limited by the radial opening, so On the outside of the radial opening, only the cooperation with the inner wall of the outer sheath tube can be ensured, and the cooperation with the connecting lug can also be achieved.
  • the axial through region of the positioning groove is closed by the floating limit strip.
  • the width of the floating limiting strip may be the same as or slightly wider than the radial opening of the axial through-region, so that the radial opening is completely closed, even if the width is smaller than the width of the radial opening, the gap is at least not at least
  • the width of the floating limiting strip is preferably the same as the radial opening of the axial through-region, and the floating limit strip can be further prevented from shifting.
  • the floating limit strip sinks into a portion of the locating groove to contact or abut the connecting ear inwardly in the radial direction.
  • the floating limit strip can block the connecting ears
  • the thickness (radial size) of the two and the depth of the positioning groove can have different matching relationships.
  • the floating limit strip Stacked on the outer wall of the connecting ear, if the thickness of the floating limiting strip and the connecting ear is greater than the depth of the positioning groove, the floating limiting strip abuts the connecting ear radially inward, and vice versa, and does not produce obvious
  • the tightening force can ensure the limit of the floating limit strip and the connecting ear.
  • the abutting relationship can be used to ensure that the limit is maintained when the axial force is too large or the outer sheath tube is locally deformed.
  • the floating limiting strip is radially higher than or higher than the outer wall of the mounting head.
  • the floating limit strip is not lower than the outer wall of the mounting head in the radial direction, so as to avoid unnecessary gap between the floating limit strip and the inner wall of the outer sheath tube, so that the inner wall of the outer sheath tube is close to the floating limit strip, and the connecting ear is connected Press in the positioning part of the mounting head.
  • the floating limit strip extends along a straight line or a curve at a portion where the connecting lug fits.
  • the width of the floating limiting strip can be appropriately narrowed when extending along the curve, and it is easier to bend outward to release the connecting ear when the interventional instrument is released to avoid the connecting ear.
  • the hysteresis of prolapse When the two sides of the floating limiting strip are opposite to the corresponding sides of the positioning groove, the width of the floating limiting strip can be appropriately narrowed when extending along the curve, and it is easier to bend outward to release the connecting ear when the interventional instrument is released to avoid the connecting ear. The hysteresis of prolapse.
  • the positioning portion has an open area for allowing the connecting ear to change a radial position, and in the locked state, the floating limiting strip is blocked in the open area;
  • the radially inner side of the floating limiting strip abuts or gap fits with the outer side of the connecting ear radial direction.
  • the gap for allowing the radial movement of the connecting ear is smaller than the radial stroke required for the connecting ear to be disengaged from the positioning portion.
  • the floating stop strip can still ensure that the necessary force is applied to limit the movement of the connecting ear when it is moved radially outward.
  • the floating limiting strip extends at an equal width or a unequal width at a portion where the connecting lug fits; the floating limiting strip extends at an equal or unequal thickness at a portion where the connecting lug fits.
  • the portion of the floating limiting strip that cooperates with the connecting ear can be set to a unequal width and/or an unequal thickness whether extending along a straight line or a curved line, and the local strength is adjusted by the change of the width and the thickness, and the limit and release connection are taken into consideration. ear.
  • the end of the floating limit strip has a smooth outer peripheral surface.
  • the floating limit strip is radially expanded with the release of the interventional instrument.
  • the end has a smooth outer contour, such as a spherical crown or an edge round. .
  • the end of the floating limiting strip is a round head structure.
  • the floating limit strips are evenly arranged 2, 3 or 4 in the circumferential direction.
  • each of the floating limit strips is equal in length or unequal length.
  • the distal positions of the floating limiting strips are not completely identical; wherein the distal end of the at least one floating limiting strip extends to be flush with the distal end side of the mounting head; the distal end of the at least one floating limiting strip extends to The distal end side of the interventional instrument mounting position.
  • the floating limiting strips are three equal lengths and are all elongated structures.
  • the floating limit strip is hollow or solid.
  • the floating limit strip is a solid flat strip shape.
  • the flat strip-like structure has a small radial footprint in the installation position of the interventional instrument, which is advantageous for reducing the outer diameter after compression.
  • the size of the floating limiting strip is: length 10mm-80mm, width 1-2mm, thickness 0.2-0.5mm.
  • the floating stop strip is secured to the attached component by gluing, bundling, locking, welding or integration.
  • One end of the floating limiting strip is a starting end, the other end is an end, and the middle part is an extending part, and the starting end is located at a connecting end of the tail end or the tail part of the mounting head and the core tube assembly for bonding, binding, locking Fastened, welded or integrated to the connected parts.
  • the floating limiting strip extends distally along the starting end. In the natural state, the starting end of the floating limiting strip is fixed, and the extending section and the end are axially stretched open along the core tube assembly.
  • the distal end of the floating stop strip is at least partially axially superposed on the attachment ear.
  • the distal end of the floating limit bar axially overlaps the connecting ear and the mounting head.
  • the distal end of the floating limit strip axially overlaps the connecting lug and the entire mounting head.
  • the distal end of the floating stop strip extends beyond the distal end of the mounting head to the largest diameter portion of the interventional instrument.
  • At least one of the portion of the floating stop strip that mates with the outer sheath tube and the portion that mates with the interventional instrument has a smooth surface and/or has a lubricating coating.
  • the floating limit strip is a polytetrafluoroethylene material.
  • the auxiliary limiting member is a fixed limiting strip extending in the axial direction, and at least a portion of the fixed limiting strip is fixedly connected with respect to the outer sheath tube.
  • the fixed limiting strip is attached to the inner wall of the outer sheath tube, and is separated from the outer sheath tube by a split fixing manner or an integral structure.
  • the fixed limit strips can be multiple strips, and the intervals are distributed on the inner peripheral wall of the outer sheath tube.
  • the outer sheath tube not only serves to connect the fixed limit strips, but also provides the binding force.
  • the fixed stop strip enters the unlocked state as the outer sheath is further retracted to axially disengage from the interventional instrument.
  • the fixed limit strip of the unlocked state has a relative axial displacement with the interventional instrument. At least a portion of the fixed stop strip is variable relative to the axial position of the mounting head to switch the locked, unlocked state.
  • the axially opposite position between the fixed limit strip and the outer sheath tube can be maintained at all times, and can also be connected by a deformable member, and the axial positions of the two are changed within a predetermined range.
  • the fixed limit strip changes axial position by axial sliding.
  • a traction member may be provided, which is directly or indirectly connected to the proximal operating handle to control the movement of the fixed limiting strip.
  • the fixed limiting strips are plural, and the axial separation order between the fixed limiting strips and the interventional instrument is synchronous or asynchronous.
  • the number of fixed limit strips may be multiple, and the number and position of the connecting ears of the interventional instrument are also corresponding thereto.
  • the axial movement of the fixed limit strips can release the binding of the corresponding connecting ears one by one or one by one, that is, the connections are also determined.
  • the order in which the ears are released. Not only that, the non-synchronous release can avoid simultaneous release, the joint ear suddenly and simultaneously radially outwardly expand the body tissue.
  • the fixed limit strip is fixedly connected to the distal end of the outer sheath tube, and the fixed limit strip avoids the positioning portion in a state before the outer sheath tube is released.
  • the fixed limiting strip can extend the entire insertion instrument mounting position in the axial direction, or can be disposed only at the distal end, and the fixed limiting strip is disposed at the distal end, and of course, no radial force is applied to the interventional instrument, which can be reduced.
  • the outer diameter of other parts ensures flexibility.
  • the fixed limit strip does not contact the mounting head, and the fixed limit strip can be contacted with the mounting head just after the beginning of release or release, so that the fixed limit strip can be shortened at least, without Emphasize that the length is the same as or longer than the insertion position of the interventional instrument.
  • the direct contact strip can directly contact the interventional instrument to play the slide rail and guide, ensuring that the outer sheath tube can be pushed forward and retracted along the slide rail without directly contacting the interventional instrument.
  • the fixed limiting strip is fixedly connected to the distal end of the outer sheath tube, and the fixed limiting strip enters the locked state when the outer sheath tube is in a semi-release state;
  • the fixed limit strip enters the unlocked state as the outer sheath is further retracted to axially disengage from the interventional instrument.
  • the fixing strip is fixed to the inner wall of the sheath by means of bonding, welding or integration.
  • the distal end and the proximal end of the fixed stop strip have a beveled structure that gradually abuts toward the inside of the outer sheath tube. Guided by the beveled structure to slide along the outer wall of the interventional instrument to avoid axial steric hindrance with the interventional instrument due to the presence of angularities.
  • the interventional instrument connection portion is a connection ear that cooperates with the positioning portion, and the positioning portion is a positioning protrusion or a positioning groove.
  • the connection ear sleeve is disposed on the positioning protrusion or embedded In the corresponding positioning groove, in the locked state, the fixed limiting strip is laminated on the connecting ear to maintain the cooperation between the connecting ear and the positioning portion.
  • the proximal end of the interventional instrument is generally provided with a connecting ear that cooperates with the mounting head.
  • the connecting ear can generally adopt a T shape, an L shape, a ring shape, etc.
  • the positioning portion can adopt a T shape and an L shape.
  • the positioning groove, or the snap-in lug or the like, is such that the axial position of the interventional instrument is limited to the positioning portion after loading.
  • the prior art can be used for the shape of the connecting ear itself, which is not the focus of improvement of the present invention. .
  • the positioning portion adopts a positioning protrusion or a positioning groove, or a combination of the two.
  • a protruding head is arranged at the bottom of the positioning groove, and the corresponding shape of the connecting ear can enhance the positioning effect.
  • the positioning portion is a positioning groove.
  • the portion where the fixed limiting strip cooperates with the positioning groove is partially or completely sunk into the positioning groove.
  • the radial thickness of the fixing limiting strip is not less than the position where the fixed limiting strip does not cooperate with the positioning groove.
  • the positioning groove axially penetrates the mounting head, and in the locked state, the axial through region of the positioning groove is closed by the fixing limiting strip.
  • the fixed limiting strip has at least a part of an overlapping area with the positioning portion in the circumferential direction.
  • the fixed limiting strips are a plurality of strips, and the distal ends of the fixed limiting strips are adjacent to the distal end of the outer sheath tube or flush with the distal end of the outer sheath tube.
  • the fixed limiting strips are a plurality of strips, and the proximal ends of the fixed limiting strips are flush with each other or the axial positions are staggered.
  • the floating of the present invention means that one end is fixed, and the other end can be oscillated at least in the radial direction without external restraint, and the circumferential offset is generally allowed due to the limitation of the strength of the material itself.
  • a fixed guide strip is also provided which is located on the inner wall of the outer sheath tube and extends in the axial direction.
  • the outer sheath tube is laminated on the outer circumference of the interventional instrument in a state before release.
  • the auxiliary limiting member for example, a floating limiting strip or a fixed limiting strip
  • the fixed guiding strip are alternately arranged in the circumferential direction.
  • the distribution of the fixed guide strips is staggered with the positioning grooves on the mounting head, which also means that the floating limit strips and the fixed guide strips are staggered.
  • the distal ends of the auxiliary stoppers are identical or staggered in axial position to the distal end side of the fixed guide strip.
  • the fixed guide strips are evenly arranged 2, 3 or 4 in the circumferential direction.
  • each of the fixed guide strips is equal in length or unequal length.
  • the fixed guide strips are three of equal lengths and are all elongated structures.
  • the fixed guide strip is a hollow or solid structure.
  • the fixed guide strip is in the form of a solid flat strip.
  • the flat strip-like structure has a small radial footprint in the installation position of the interventional instrument, which is advantageous for reducing the outer diameter after compression.
  • the fixed guide strip has a size of 10 mm to 80 mm in length, 1-2 mm in width, and 0.2-0.5 mm in thickness.
  • the fixed guide strip has a length of 60 mm to 80 mm.
  • the shape and size of the floating limiting strip and the fixed guiding strip are mutually independent, and may be, for example, a long solid or hollow structure; the cross-sectional shape thereof is preferably flat, in order to reduce the overall diameter of the distal end of the outer sheath tube.
  • the dimension is the thickness direction of the flat shape, that is, the radial direction of the outer sheath tube.
  • the contact area with the outer sheath tube is reduced, thereby reducing the relative friction between the two, and the floating limit strip and the fixed guide strip are also appropriately selected in size.
  • the fixed guide strip fixes the inner wall of the outer sheath tube by means of bonding, binding, locking, welding or integration.
  • the portion of the fixed guide strip that mates with the interventional instrument has a smooth surface and/or has a lubricating coating.
  • the fixed guide strip is a polytetrafluoroethylene material.
  • the material of the floating limiting strip and the fixed guiding strip can be selected independently of each other, and is preferably made of a biocompatible material with better elasticity, and the specific material can be selected by using the prior art.
  • a floating guide strip is further disposed between the outer sheath tube and the loading assembly, the proximal end of the floating guide strip is connected to the loading assembly, and the distal end of the floating guide strip is floating relative to the loading assembly.
  • the loading assembly comprises a core tube assembly having a mounting head thereon, the positioning portion being on an outer peripheral wall of the mounting head, the proximal end of the floating guide strip and at least one of the following Fixed connection:
  • the floating guide strip is laminated on the outer circumference of the interventional instrument, and the floating guide strip and the auxiliary limiting member (for example, the floating limiting strip or the fixed limiting strip) are alternately arranged in the circumferential direction.
  • the floating guide strip and the auxiliary limiting member for example, the floating limiting strip or the fixed limiting strip
  • the floating guide strip can also be used in combination with a fixed limit strip.
  • the material and size of the floating guide strip can be referred to the floating limit strip.
  • the floating guide strips are plural, and each of the floating guide strips is equal in length or unequal length.
  • the distal end of the core tube assembly is provided with a guiding head, the distal end of which extends to the guiding head portion.
  • the floating guide strip or the fixed guide strip has a suitable elasticity and a minimum dynamic friction factor, polytetrafluoroethylene (PTFE) is preferably used.
  • PTFE polytetrafluoroethylene
  • the outer sheath tube is withdrawn, and the interventional device is in contact with the interventional instrument during the withdrawal process, in order to prevent the position of the interventional instrument from being changed again during the withdrawal process, more preferably, in the interventional instrument or the outer sheath tube
  • the outer surface of the auxiliary movement limiter, the floating guide strip or the fixed guide strip of the relative movement is as smooth as possible or a lubricating coating is provided on the surface, and the lubricating coating material may be a hydrophilic monomer or a high molecular polymer having lubricating properties.
  • DMAA N,N-dimethylacryloyl
  • AAm acrylamide
  • NDP N-vinylpyrrolidone
  • PVA polyvinyl alcohol
  • PAAm polyacrylamide
  • PEG polyethylene glycol
  • the invention adopts the auxiliary limiting member to further strengthen the limitation of the insertion of the interventional device, and is more advantageous for the recovery of the interventional device.
  • Figure 1a is a schematic structural view of a conveying device of the present invention
  • Figure 1b is a schematic view showing the structure of the distal end portion of Figure 1a;
  • FIG. 2a is a schematic structural view of another embodiment of a conveying device of the present invention.
  • Figure 2b is a schematic view showing the structure of the distal end portion of Figure 2a;
  • Figure 3a is a schematic structural view of a locking portion
  • Figure 3b is a schematic structural view of the end of the floating limiting strip in Figure 3a;
  • 4a to 4g are schematic diagrams showing filling positions of a floating limiting strip in a radial gap in different embodiments
  • Figure 5a is a partial release state diagram of the interventional instrument
  • Figure 5b is a state diagram of the release of the interventional floating stop strip during partial release of the heart valve
  • Figure 5c is a state diagram of the interventional device when fully released
  • FIG. 6 is a schematic structural view of a floating limit strip according to an embodiment
  • Figure 7a is a schematic view showing the structure of the outer sheath tube before release in another embodiment
  • Figure 7b is a schematic view showing the structure of the outer sheath tube in the semi-release state of Figure 7a;
  • Figure 7c is a schematic view of the outer sheath of Figure 7a in a released state (the proximal end of the interventional instrument has not been radially opened);
  • Figure 7d is a schematic view showing the structure in which the proximal end of the interventional instrument of Figure 7c has been radially opened, but the floating limit strip has not been reset;
  • FIG. 7e is a schematic structural view of the floating limit strip after resetting in FIG. 7d;
  • Figure 8a is a schematic view showing the structure of the outer sheath tube before release in another embodiment
  • Figure 8b is a schematic view showing the structure of the outer sheath tube of Figure 8a when it is released by about one-half;
  • Figure 8c is a schematic view showing the structure of the outer sheath of Figure 8a when it is released about three quarters;
  • Figure 8d is a schematic view of the structure of the outer sheath tube of Figure 8a after complete release;
  • Figure 8e is a schematic structural view of the floating limit bar of Figure 8d;
  • Figure 9a is a schematic view showing the structure of the outer wall of the outer sheath tube when a fixed guide strip is assembled
  • Figure 9b is a schematic cross-sectional view of the outer sheath tube of Figure 9a;
  • Figure 10a is a front view of the interventional instrument when fully assembled before the floating limit strip and the fixed guide strip are assembled;
  • Figure 10b is a state diagram of the complete release of the interventional instrument when the floating stop strip and the fixed guide strip are assembled (relative to Figure 10a, a portion of the outer sheath tube is removed);
  • Figure 11a is a schematic view of the mating portion of the connecting ear and the mounting head
  • Figure 11b is a schematic view of the connecting ear of Figure 11a after being pressed against the floating limit strip;
  • 11c-11d are schematic structural views of a mounting head in different embodiments.
  • 11e-11h are schematic structural views of a floating limit bar in different embodiments.
  • Figure 12a is a schematic view showing another matching portion of the connecting ear and the mounting head
  • FIG. 12b to 12d are schematic views of the connecting ear of FIG. 12a being pressed against different shapes of floating limit strips;
  • 13a to 13d are schematic views of another type of connecting ear pressed against different lengths of floating limit strips
  • 13e is a schematic diagram of the cooperation of the floating limiting strip and the connecting ear in another embodiment
  • 13f to 13i are schematic structural views of a floating limit bar in different embodiments.
  • 14a to 14d are schematic views of the floating limit strips at different radial positions when the connecting ears are annular;
  • 15a to 15c are schematic views of the distal end portion of the outer sheath tube in different states when the fixed limit strip is used;
  • 15d to 15f are schematic views showing the state in which the connecting ear is pressed when the limiting strip is fixed with different lengths
  • 16a to 16c are schematic views of the distal end portion of the outer sheath tube when the limit strips are fixed with different lengths;
  • 17a-17b are schematic diagrams showing the filling position of the fixed limiting strip in the radial gap in different embodiments
  • Figure 18 is a schematic cross-sectional view of the outer sheath tube when the fixed limit strip is combined with the fixed guide strip;
  • Figure 19 is a schematic view showing the structure of the conveying device of the present invention with a floating guide bar.
  • proximal end refers to one end of the delivery device in the direction of the operator, and the distal end is the end that is away from the operator in the direction of the delivery device.
  • interventional instrument is exemplified by the interventional heart valve.
  • the interventional instrument delivery device of the present embodiment includes a loading assembly and an outer sheath tube 5 that is sleeved over the loading assembly.
  • the loading assembly and the proximal end of the outer sheath tube 5 are coupled to an operating handle 6.
  • the loading assembly comprises a guiding head 2, a mounting head 3 and a core tube assembly 7, wherein the guiding head 2 and the mounting head 3 are each fixed to a core tube assembly 7, the guiding head 2 being located at the most distal end of the core tube assembly 7, the core tube assembly 7
  • the distal end side is also sleeved with a mounting head 3, between which the guiding head 2 and the mounting head 3 are in the position of the interventional instrument;
  • the outer sheath tube 5 is located at the periphery of the insertion position of the interventional instrument and is axially slidable, the core tube assembly 7 and the outer tube
  • the proximal end of the sheath 5 is connected to the operating handle 6, and the axial sliding of the outer sheath 5 relative to the core tube assembly 7 is achieved by operating the handle 6.
  • the inner tube 4 is disposed as needed, and may be omitted in other embodiments.
  • the inner tube 4 is sleeved on the core tube assembly 7 and located on the proximal end side of the mounting head 3.
  • the inner tube 4 generally does not move axially with the outer sheath tube 5,
  • the inner tube can also be considered as a coating layer covering the outer surface of the core tube assembly 7.
  • the core tube assembly 7 may be a single component or may be composed of two or more segments, each segment being connected and fixed by welding, a connector or a connector, and the insertion portion or the connection portion is preferably located in the mounting head 3 to ensure the connection.
  • the strength and appearance are smooth.
  • the floating limit strip 1 as an auxiliary stopper in Fig. 1a is three of equal lengths, arranged in order in the circumferential direction, and naturally stretched in a released state without the outer sheath tube 5 being bound.
  • different portions of the floating limiting strip 1 can be divided into a proximal end 103, an extension 102 and a distal end 101 according to the position, and the starting end 103 is fixed to the core tube assembly 7. It is also on the proximal side of the mounting head 3, although it is of course also possible to fix the starting end 103 to the mounting head 3.
  • the slot 1b is a positioning groove
  • the proximal end of the connecting portion of the interventional heart valve is a connecting ear
  • the position and shape of the positioning groove can be matched with the connecting ear, and the positioning is performed in the figure.
  • the slot has three axial positions staggered, such as the positioning slot 31 and the positioning slot 33 in the figure.
  • the positioning groove adopts an axial through structure, and has extended wings on both sides to match the T-shaped connecting ears.
  • the proximal end 103 of the floating limit strip can be fixed by bonding, bundling, locking, welding, and integration.
  • the adhesive material is selected from biocompatible corrosion resistant adhesives.
  • the binding material uses a flexible, corrosion-resistant binding line.
  • Figure 1a, Figure 1b, Figure 2a, Figure 2b shows the delivery device (the interventional heart valve is omitted in each figure, that is, the floating limit bar 1 is in the no-load state), and the floating limit bar has a locked state after the intervention of the heart valve is loaded.
  • the floating limit strip exerts a force on the interventional instrument connection under the restraint of the outer sheath tube, for example, preventing the interventional heart valve connecting ear from coming off the positioning groove; the floating limit strip also has a release state, that is, when the interventional instrument begins to enter When the state is released, the force applied by the outer sheath tube to the interventional instrument connection by the floating limit strip is released, for example, the outer sheath tube is withdrawn, and when the interventional heart valve is released, the outer sheath tube is connected to the interventional heart valve through the floating limit strip. The force of the ear is released and the valve stent radially expands the connecting ear away from the positioning slot.
  • the floating limit strip of the embodiment is slightly longer than that of FIG. 1a and FIG. 1b.
  • the interventional instrument delivery device of the embodiment includes the guiding head 2, the core tube assembly 7, and the floating The limit strip 1, the mounting head 3, the inner tube 4, and the outer sheath tube 5 and the operating handle 6.
  • the positioning portion on the mounting head 3 is a positioning groove. In the figure, there are three positioning grooves and the axial positions are staggered, for example, the positioning groove 31 and the positioning groove 33 in the figure, and the other positioning groove is not blocked due to the viewing angle relationship.
  • the proximal end of the connecting portion of the interventional heart valve is a connecting ear, and the number of connecting ears is three, and each connecting ear cooperates with a corresponding positioning groove.
  • the different parts of the floating limit strip 1 can be divided into a proximal end 13 at the proximal end, an extension 12 and a distal end 11 at the distal end.
  • the starting end 13 is fixed to the core tube assembly 7 and is installed.
  • the proximal end side of the head and tail portion 32, as seen in the figure, is located between the inner tube 4 and the mounting head tail portion 32.
  • the outer periphery of the mounting head 3 is provided with a positioning groove, and the positioning groove needs to cooperate with the connecting ear of the interventional instrument, so that the position and shape of the positioning groove can be matched with the connecting ear, and the positioning groove has three positions and the axial positions are staggered, for example, The positioning groove 31 and the positioning groove 33 are shown in the middle, and the other positioning groove is not blocked due to the viewing angle relationship.
  • the positioning groove can be an axial through structure.
  • the connecting ear radially expands out of the positioning groove, so the positioning groove is open radially outward, that is, has a radial opening.
  • the positioning groove is axially penetrated, and has extended wings on both sides to match the T-shaped connecting ears.
  • the floating limiting strip 1 extends distally, it passes through the axial through portion of the corresponding positioning groove and extends to the interventional device.
  • the floating stop strip 1 in Figure 2 On the distal side of the mounting position, the floating stop strip 1 in Figure 2 is in a loaded state and the end 11 extends axially to the outer circumference of the guide head 2.
  • the distal end when the floating limiting strip is flattened in the axial direction, the distal end extends to the position of the guiding head 2, and when combined with the interventional instrument, it can serve as a sliding rail between the interventional instrument and the outer sheath tube, and serves as a guiding function.
  • the distal end of the floating stop strip is curved outwardly and radially outwardly (see Figure 2a) without the sheath of the outer sheath.
  • the floating limit strip can be pre-formed and radially expanded in the state in which the outer sheath is released.
  • the starting end of the floating limiting strip is fixed on the mounting head or the core tube assembly on the proximal side of the mounting head, and the lock made of alloy material can be connected to the mounting head or the proximal end of the mounting head by welding.
  • the starting end is tightened by a locking bolt.
  • the starting end 103 of the floating limiting strip 1 is clamped in a stainless steel (material 306) locking buckle 14, which is only illustrated in the figure.
  • the partial extension 102, the buckle 14 is welded to the mounting head 3 or the core tube assembly 7.
  • the floating limit strip 1 is a long solid or hollow structure.
  • a solid flat strip is used, and the end 101 can adopt a curved outer edge structure in order to avoid corners (see Fig. 3b).
  • Each floating limit strip 1 has a length of 10 mm to 80 mm, a width of 1-2 mm, and a thickness of 0.2-0.5 mm. When the floating limit strip 1 has the maximum length, the floating limit strip 1 as a whole can ensure the constriction in the outer sheath tube 5.
  • the positioning portion of the outer wall of the mounting head 3 is a positioning groove.
  • the connecting ears are located in corresponding positioning slots, for example, the connecting ears 81 are located in the corresponding positioning slots 33.
  • the floating limit strip 1 is filled in the radial gap 53 of the outer sheath tube 5 and the connecting lug 81, and the radially outer side of the floating limiting strip 1 abuts against the inner wall of the outer sheath tube 5, and the floating limiting strip 1 The radially inner side abuts against the outer side of the connecting lug 81.
  • the floating limit strip 1 functions as a gap compensation.
  • the outer sheath tube 5, the floating limit strip 1, the connecting lug 83 and the mounting head 3 are sequentially abutted or adjacent, and the binding force provided by the outer sheath tube 5 is passed.
  • the floating limit strip 1 provides a force to the connecting lug 81 to restrict the connecting lug 81 from coming out of the positioning groove 33.
  • the thickness of the connecting lug 81 in FIG. 4a substantially matches the depth of the positioning groove 33. After the connecting lug 81 is placed in the positioning groove 33, the outer side of the connecting lug 81 is substantially flush with the outer wall of the mounting head 3, and the inner diameter of the outer sheath tube 5 and the mounting head. 3 There is a radial gap 53 between the outer walls, and the floating limit strip 1 does not sink into the positioning groove 33 in the radial direction, but just fills the radial gap 53.
  • the floating limiting strip 1a is blocked in the open area 36, and the floating limiting strip 1a is smaller than the circumferential span.
  • the open area 36 is a partially enclosed open area.
  • the thickness of the connecting ear 81 is smaller than the depth of the positioning groove 33, that is, after the connecting ear 81 is placed in the positioning groove 33, the radial gap 53 is larger, but the floating limit bar 1 is played.
  • the effect of the gap compensation is that even if the connecting ear 81 is slightly separated from the groove bottom of the positioning groove 33, it is still limited by the floating limiting strip 1 and cannot completely escape the positioning groove 33.
  • the floating limit strip 1 functions as a gap compensation, that is, the total radial thickness of the connecting ear 81 and the floating limiting strip 1 is greater than the radial gap 53. Since the floating limiting strip 1 is on the outer side, the connecting ear 81 cannot be completely removed. The positioning groove 33 can be pulled out of the positioning groove 33 only after the outer sheath tube 5 is removed.
  • the thickness of the connecting ear 81 is smaller than the depth of the positioning groove 33, that is, after the connecting ear 81 is placed in the positioning groove 33, the radial gap 53 is larger, and the thickness of the floating limiting bar 1 is larger than the radial direction.
  • the gap 53 is such that the floating limit strip 1 is sunk into the positioning groove 33 by the restraining portion of the outer sheath tube 5, thereby functioning as a gap compensation, so that the connecting lug 81 cannot be pulled out of the positioning groove 33.
  • the loading assembly is traversed in the body along with the outer sheath tube.
  • the loading assembly is eccentrically displaced relative to the outer sheath tube 5.
  • the upper radial gap 53 is significantly larger than the upper portion.
  • the insertion instrument ears 81a are placed in the corresponding positioning grooves 33a, and in the locked state, the floating limit bars 1a are filled in the radial direction of the outer sheath tube 5 and the connecting ears 81a.
  • the gap 53 is partially sunk into the positioning groove 33, and the radially outer side of the floating limiting strip 1 abuts against the inner wall of the outer sheath tube 5, and the radially inner side of the floating limiting strip 1 abuts against the outer side of the connecting lug 81.
  • the positioning groove 33a has an open area 36 for allowing the connecting ear to change the radial position.
  • the floating limiting strip 1a In the locked state, the floating limiting strip 1a is blocked in the open area 36, and the floating limiting strip 1a is equal to the open area 36 in the circumferential span, that is, completely The closed open area 36 has a better limit effect.
  • the connecting lug 81a is located in the corresponding positioning groove 33a, and the total radial thickness of the connecting lug 81a and the floating limiting strip 1a is equal to the depth of the positioning groove 33a, that is, The floating limiting strip 1a is completely sunk into the positioning groove 33a, and the outer sheath tube 5 is wrapped around the outer circumference of the floating limiting strip 1a, and the floating limiting strip 1a completely fills the radial gap between the outer sheath tube 5 and the connecting ear 81a, and The floating limit strip 1a completely closes the open area of the positioning groove 33a in the circumferential span.
  • the connecting lug 81a is located in the corresponding positioning groove 33a.
  • the floating limiting strip 1a is filled in the radial direction of the outer sheath tube 5 and the connecting lug 81a.
  • the positioning groove 33a has an open area for allowing the connecting ear to change the radial position, and the floating limiting strip 1a is blocked in the open area in the locked state.
  • the floating limit strip 1a is equal to the open area in the circumferential span, that is, the completely closed open area, and has a better limit effect.
  • the inner side of the radial limiting strip 1a in the radial direction cooperates with the outer side of the radial direction of the connecting lug 81a, and the gap 54 which allows the radial movement of the connecting lug 81a is smaller than the radial stroke required for the connecting lug 81a to come out of the positioning groove 33a.
  • the floating limit strip 1a can still ensure that the necessary force is applied to the limit when the connecting ear 81a moves radially outwardly away from the positioning groove 33a.
  • the floating limit strip 1 in order to ensure that the floating limit strip 1 has a small dynamic friction factor, is made of a PTFE material; each floating limit in the figure The strip 1 is 15 mm long, and the width is adapted to the width of the positioning groove of the mounting head 3, and the thickness is 0.5 mm.
  • the valve support 8 in the interventional heart valve has three T-shaped connecting ears 81.
  • the positioning groove is axially penetrated on the basis of the T-shape, that is, a cross shape, in order to ensure the limit
  • the axial effect of the positioning groove is completely closed by the corresponding floating limit strip 1 , that is, the width of the floating limit strip 1 is adapted to the width of the axial through area, and if the through area does not extend along the same width of the axis, then the floating limit
  • the width of the strip 1 corresponds at least to the narrowest portion of the through region to ensure partial or complete sinking into the positioning groove.
  • the outer side of the floating limit strip 1 may be slightly higher than the outer peripheral surface of the mounting head 3 to reduce the outer circumference of the mounting head 3. Surface and outer sheath tube 5 Friction.
  • the floating limit strip 1 encloses the valve support 8 together in the outer sheath tube 5; that is, the outer sheath tube has a pre-release state in which the interventional instrument is completely wrapped, and before the release state The floating limit bar is locked.
  • the outer sheath tube 5 is along the floating limit strip 1 (the floating limit strip is in the outer sheath 5, and thus is not shown) Smoothly retracting, at this time, the floating limit bar 1 is in a locked state: when the connecting ear 81 is in the outer sheath tube 5, due to the restraint of the outer sheath tube 5, the floating limiting strip 1 acts on the connecting ear 81 to prevent the connecting ear 81 pops up.
  • the valve stent 8 can be pulled back into the outer sheath tube 5 through the forward outer sheath tube 5, that is, the arrow M in the opposite direction, for recovery and secondary release.
  • the present invention can achieve stable recovery of the valve relative to the prior art, so that when the release position is unsatisfactory during valve release, it can be retracted into the sheath for secondary positioning or retraction.
  • the stable back tension is the key to whether the valve support can be re-received into the outer sheath 5. Since the floating limit strip 1 functions as a gasket, the connecting ear 81 can be stably placed in the positioning groove 33, along with the core. The movement of the tube assembly provides a powerful resilience to the valve support that allows the valve support to be withdrawn into the outer sheath.
  • the floating limit bar is still locked.
  • the outer sheath tube 5 is continued to be retracted along the arrow M, and the end 101 and the extension portion 102 of the floating limit strip 1 are no longer bound by the outer sheath tube 5.
  • the end 101 and the extension 102 of the floating limiting strip 1 are deployed with the deployment of the valve support 8.
  • the floating limiting strip 1 is in the unlocked state, that is, no force is applied to the connecting ear 81, thereby completing the valve support 8.
  • the floating limit strip 1 has a short axial length and the end is flush with the distal end of the mounting head 3.
  • the floating limit strip 1 fills a gap between the connecting ear of the valve support 8 and the outer sheath tube 5, and between the outer sheath tube 5 and the mounting head 3 or provides a smooth track to reduce the relative friction when the two contacts are in contact with each other.
  • the direct force of the doctor's operation can be reduced by the contact with the floating limit strip 1 during the forward and retraction of the tube 5, thereby achieving precise control of the release and recovery of the valve support 8.
  • the floating limiting strip 1 is three solid strips and is made of PTFE material.
  • the starting end of the floating limiting strip 1 is fixed to the proximal end of the mounting head 3 by means of bonding, and the floating limiting strip
  • the end 101 of the first end 101 is flush with the distal end of the mounting head 3, that is, at least the mating portion of the connecting ear and the positioning slot can be completely covered and restrained in the positioning slot, and the width of the floating limiting strip 1 and the width of the axially extending region of the positioning slot 33 are Consistent, thickness 0.5mm.
  • the outer sheath 5 has a pre-release state that completely encases the interventional instrument 8, a semi-released state of the exposed portion of the interventional instrument 8, and a fully exposed release state of the interventional instrument 8.
  • the outer sheath tube 5 is in a state before being released and in a half-release state, and the floating limit strip 1 is in a locked state.
  • Fig. 7a shows the pre-release state of the outer sheath tube 5.
  • the proximal end of the valve holder 8 has a connecting lug 81.
  • the outer periphery of the mounting head 3 is provided with a positioning groove 33, and the connecting lug 81 received in the positioning groove 33 is received by the floating limiting strip 1
  • the pressure, the valve support 8 and the floating limit strip 1 are both bound by the outer sheath tube 5.
  • the floating limit strip 1 extends for a length corresponding to the distal end position of the mounting head 3, and its end can only resist the connecting ears embedded inside the positioning groove of the mounting head.
  • the length of the floating limit strip 1 can also extend to the central portion of the axial direction of the valve support 8, for example, no more than the valve is completely The maximum dimension of the axial direction of the valve when released.
  • Fig. 7c the outer sheath tube 5 is withdrawn, and the projection regions of the outer sheath tube 5 and the positioning groove 33 on the outer sheath tube axis are mutually displaced, and the connecting rod 81 is no longer bound by the floating limiting strip 1, meaning that the floating limit is passed.
  • the force of the conduction of the strip 1 to the valve support 8 disappears, that is, the floating limit strip 1 is in the unlocked state, allowing the valve holder 8 to be disengaged from the positioning groove 33, and the connecting ear in Fig. 7c has not yet been radially opened, but is already in the path. The state of being bounced.
  • the locking state in the present invention refers to the state in which the interventional instrument connection portion is held in cooperation with the positioning portion.
  • the interventional instrument may be assembled on the positioning portion; and the release state means that the interventional instrument connection portion can be detached.
  • the positioning portion but does not specifically refer to the complete release of the interventional device, only the connection portion that cooperates with the positioning portion is in a disengageable state, and the other portions that are not engaged with the positioning portion may have been partially or completely released and radially expanded. .
  • the connecting ear 81 pushes the radially deformable floating limiting strip 1 to radially open, and the floating limiting strip 1 also rotates outward.
  • the floating limiting strip 1 can be oriented toward the mounting head 3. Close to reset.
  • the outer sheath tube 5 has a pre-release state that completely encases the interventional instrument 8, a semi-released state of the exposed portion of the interventional instrument 8, and a fully exposed release state of the interventional instrument 8.
  • the outer sheath tube 5 is in a state before being released and in a half-release state, and the floating limit strip 1 is in a locked state.
  • Fig. 8a shows the pre-release state of the outer sheath tube 5.
  • the proximal end of the valve holder 8 has a connecting lug 81.
  • the outer periphery of the mounting head 3 is provided with a positioning groove 33, and the connecting lug 81 received in the positioning groove 33 is received by the floating limiting strip 1
  • the pressure, the valve support 8 and the floating limit strip 1 are both bound by the outer sheath tube 5.
  • the floating limit strip 1 extends for a length corresponding to the distal end position of the mounting head 3, and its end can only resist the connecting ears embedded inside the positioning groove of the mounting head.
  • Figs. 8b to 8c when the valve stent 8 is delivered to the human body and released, the outer sheath tube 5 is withdrawn, and the valve stent 8 is gradually released to different stages, the attachment ears 81 of the valve stent 8 are embedded in the mounting head.
  • the force of the converging force in the groove 33 and at the beginning of the floating limit strip 1 is firmly restrained in the positioning groove 33, so as to avoid the premature complete release of the stent by releasing the expansion force exerted by the valve holder 8 on the connecting ear end.
  • FIG. 8d the outer sheath tube 5 is withdrawn, and the projection area of the outer sheath tube 5 and the positioning groove 33 on the outer sheath tube axis is partially overlapped and transferred to each other, and then the connecting rod 81 is no longer bound by the floating limiting strip 1 .
  • the connecting lug 81 pushes the radially deformable floating limiting strip 1 to radially open, and then the floating limiting strip 1 abuts against the mounting head 3 in abutment.
  • the floating limiting strips 1 are arranged at intervals of three in the circumferential direction, and the proximal end sides of the plurality of floating limiting strips are connected as a fixing ring 104, which is close to the mounting head.
  • the end side core tube assembly or mounting head is fixed.
  • each of the floating limit strips 1 is slightly turned outwards, and can also be extended flat in the axial direction.
  • the distal inner wall of the outer sheath tube 5 is further provided with a fixed guide strip 51.
  • the inner wall of the outer side of the outer sheath tube 5 is also provided with a fixed guide.
  • the strips 51, the fixed guide strips 51 are three of equal lengths, are evenly arranged in the circumferential direction, and are fixed to the inner surface of the distal tubular casing of the outer sheath tube 5 to provide a smooth track between the valve holder 8 and the outer sheath tube 5.
  • each fixed guide strip 51 is staggered with the positioning groove on the mounting head 3 (ie, the circumferential distribution of the floating limiting strip 1).
  • the positioning groove On the mounting head 3 (ie, the circumferential distribution of the floating limiting strip 1).
  • the fixed guide strip 51 is a solid flat strip having a length of 10 mm to 80 mm, a width of 1-2 mm, and a thickness of 0.2-0.5 mm.
  • the length of the fixed guide strip 51 corresponds to the axial length of the valve holder 8 by about 60 mm.
  • the fixing guide bar 51 fixes the inner wall of the outer sheath tube 5 by means of bonding, bundling, locking, welding or integration.
  • the fixing guide strip 51 is made of PTFE material, and the portion matching the interventional instrument 8 has a smooth surface and/or Has a lubricating coating.
  • the fixed guide strip 51 is integrally formed with the inner wall of the outer sheath tube 5, which is a rib projecting into the outer sheath tube 5, having a smooth surface and/or having a lubricating coating.
  • FIG. 10a shows the release state of the interventional instrument when the floating stop strip and the fixed guide strip are assembled, for clarity, between the connecting ears 81 of the valve support 8 and the floating limit strip 1
  • the outer sheath 5 is retracted to the floating limit strip completely exposed, and the joint ear has not yet been radially opened, but is already in a state in which it can be radially opened.
  • the outer sheath tube 5 When the valve support 8 is released, the outer sheath tube 5 is slid in contact with the valve support 8 through the fixed guide strip 51, and the outer sheath tube 5 can be withdrawn with a small frictional force to achieve the gradual release of the stent.
  • the outer sheath 5 When the outer sheath 5 is retracted to the position of the mounting head 3, only the connecting lug of the valve stent 8 is constricted within the outer sheath 5.
  • the fixed guide strip 51 is completely disengaged from the valve holder 8, and the floating stopper strip 1 is pressed against the connecting ear by the constriction of the outer sheath tube 5.
  • the outer sheath tube 5 is continuously withdrawn, and the converging force of the floating limit strip 1 on the connecting ear is gradually withdrawn, and the connecting ear is gradually released.
  • the outer sheath tube 5 is filled with the smooth rail and the gap provided by the fixed guide strip 51 and the floating limiting strip 1 to reduce the friction between the outer sheath tube 5 and the compressed valve stent, which is beneficial to the release of the valve stent or Re-enter the income sheath.
  • the following embodiments are mainly for the length and shape of the floating limiting strip, and the manner in which the connecting ear and the mounting head are combined.
  • the other components may be combined with or combined with at least one of the foregoing embodiments.
  • the connecting ear 81 is T-shaped, and the positioning portion on the mounting head 3 is a positioning groove 33.
  • the connecting ear 81 is embedded in the corresponding positioning groove 33, and the floating limiting strip 1 is restrained by the outer sheath tube on the connecting ear 81 to prevent the connecting ear 81 from coming out of the positioning groove 33.
  • the connecting ear is released. 81 limit.
  • a suitable depth of the positioning groove 33 allows the positioning groove 33 to be embedded (sinked) in the radial direction of the connecting lug 81.
  • the floating limiting strip 1 and the connecting ears 81 can be stacked in the positioning groove 33, and the suitable depth of the positioning groove 33 (the depth is the sum of the thickness of the connecting ear and the floating limiting strip) makes the locking state
  • the lower floating limit strip 1 is radially higher than the outer wall of the mounting head 3.
  • the connecting ear 81 is omitted in FIG. 11, and the positioning groove 33 is T-shaped, and the left side is the distal end in the figure.
  • the positioning groove 33 is open to the distal end in the axial direction, and the proximal end side is closed.
  • the floating limit strip 1 must be extended from the outer side of the outer peripheral portion 3a of the mounting head 3 to the distal end, and the connecting lug 81 is laminated. At the outer peripheral portion 3a, the floating restricting strip 1 increases the overall outer diameter of the transfer assembly.
  • the positioning groove 33 is open to the distal end in the axial direction.
  • the outer circumference of the mounting head 3 is also correspondingly grooved to form a through-region 3b connected to the positioning groove 33, That is, the positioning groove 33 is a through structure in the axial direction, and the floating limiting strip 1 can be sunk into the through-region 3b and extend distally until the laminated connecting lug 81, and the overall outer diameter of the transfer assembly is not additionally increased.
  • the floating limit strip 1 in order to cope with the non-axially through positioning groove, in order to minimize the overall outer diameter of the transfer assembly, the floating limit strip 1 is not equally thickly extended, in the floating limit strip.
  • the inner side of the radial direction is provided with a relief groove 105 which is matched with the non-penetrating area of the positioning groove 33, that is, the outer peripheral portion 3a of the mounting head 3, since the floating limiting strip 1 has a thinner portion at the opening avoidance groove 105.
  • the thickness can be appropriately reduced to increase the outer diameter of the transfer assembly.
  • the floating limiting strip 1 since the T-shape can form an axial limit between the connecting ear and the positioning groove, if the floating limiting strip 1 obtains the effect of sufficient lamination, the floating limiting strip 1 is not
  • the equal-width extension that is, the floating limit strip 1 has the same shape as the positioning slot opening at the portion that cooperates with the positioning groove.
  • the floating limiting strip 1 is provided with external convex portions 106 on both sides thereof. Completely close the positioning slot opening.
  • the proximal end sides of the plurality of floating stop strips 1 are integrally formed to form a retaining ring 104 that is secured to the core tube assembly or mounting head.
  • the plurality of floating limiting strips 1 may also adopt a manner of avoiding the grooves 105, and correspondingly, at the distal ends of the floating limiting strips 1, a boss 107 for laminating the connecting ears is formed.
  • the proximal end sides of the plurality of floating stop strips 1 are integrally formed to form a retaining ring 104 that is secured to the core tube assembly or mounting head.
  • the outer convex portion 106 may also be used in the plurality of floating limiting strips 1 to completely close the corresponding positioning slot opening.
  • the connecting ear 81 is U-shaped, and the U-shaped opening side is connected to the valve holder 8 and the U-shaped opening is closed.
  • the positioning portion on the mounting head 3 is a positioning protrusion 34, and the connecting ear 81 utilizes U.
  • the structure is hung on the positioning protrusion 34 to realize axial positioning.
  • the outer periphery of the positioning head 34 that is, the outer wall of the mounting head 3 is provided with a settling groove 35, and the connecting ear 81
  • the stacking is carried out in the settling tank 35, and the outer wall of the mounting head 3 can be realized in the radial direction.
  • the floating limiting strip 1 and the connecting lug 81 can be stacked in the settling tank 35.
  • the suitable depth of the settling tank 35 (the depth can be the sum of the thickness of the connecting lug and the floating limiting strip) makes the locking
  • the floating limit strip 1 in the state is radially higher than the outer wall of the mounting head 3.
  • the floating limiting strip 1 is a bifurcated structure, i.e., U-shaped, the unbranched portion is fixed to the outside of the mounting head 3, and the bifurcation portion extends distally until it is laminated outside the connecting lug 81.
  • the floating stop strip 1 is a single strip-like structure that also extends distally until it is laminated on the outside of the attachment ears 81.
  • the floating stop strip 1 is a bifurcated mechanism, but adopts a V-shaped or Y-shaped shape, and the unbranched portion is fixed to the outside of the mounting head 3, and the branching portion extends distally until it is laminated on the outside of the connecting lug 81.
  • FIG. 13a to 13d a schematic view of the structure in which the connecting ears are pressed against the floating limit bars 1 of different lengths is shown.
  • the outer sheath tube 5 binds the floating limiting strip 1
  • the connecting ear 81 is positioned outside the mounting head, and the positioning portion on the mounting head is used to position the protruding head 34 as an example, and the floating limiting strip 1 is The distal end is at least partially laminated to the attachment ear 81.
  • 13a shows that the distal end side of the floating stop strip 1 is laminated on the connecting lug 81.
  • the distal end side of the floating limiting strip 1 has not yet extended to the positioning tab 34, only a small portion of the connecting lug 81 is laminated.
  • Figure 13b shows that the distal end side of the floating limiting strip 1 is laminated on the connecting lug 81.
  • the distal end side of the floating limiting strip 1 completely covers at least the positioning portion on the mounting head in the axial direction, that is, over the positioning tab 34, the distal end side of the mounting head 3 is reached, and the connecting lug 81 and the entire mounting head 3 are laminated axially toward the distal end side.
  • Fig. 13c shows that the distal end side of the floating stop strip 1 is laminated on the connecting lug 81, and the distal end side of the floating limiting strip 1 passes over the mounting head in the axial direction.
  • Figure 13d shows that the distal end side of the floating limiting strip 1 is laminated on the connecting ear 81.
  • the distal end side of the floating limiting strip 1 passes axially across the mounting head, reaching the portion where the diameter of the interventional heart valve is the largest, and the valve stent is loaded. After being restrained by the outer sheath tube, the outer diameter of the interventional heart valve is substantially uniform, so the portion with the largest diameter can be understood as the portion with the largest diameter in the released state.
  • the positioning portion on the mounting head 3 is a positioning boss 34
  • the valve holder 8 has an annular connecting lug 81
  • the connecting lug 81 is sleeved on the positioning boss 34 by an annular structure.
  • the positioning groove 33 is disposed on the outer circumference of the mounting head 3, and the positioning protrusion 34 is located in the positioning groove 33, and the positioning groove 33 can also be regarded as a sinking groove on the outer circumference of the positioning protrusion 34.
  • the outer sheath tube 5 restricts the connecting lug 81 to the state in which it is engaged with the positioning boss 34 by the floating stopper strip 1.
  • the floating limiting strip 1 can be engaged with the outer peripheral portion 3a by means of the escape groove 105.
  • the floating limiting strip 1 not only has the escape groove 105, but also has a relief groove 108 (recessed radially outward), and the relief groove 108 and the positioning protrusion 34 in the locked state. Correspondingly, it is avoided that the outer circumference of the positioning boss 34 is excessively raised.
  • the positioning groove 33 is substantially T-shaped, and can better accommodate the annular connecting ears 81.
  • the corresponding floating limiting strips 1 are provided with external convex portions 106 on both sides.
  • the opening of the positioning groove 33 can be completely closed.
  • the floating limiting strip 1 is also provided with the escape groove 108 corresponding to the position of the positioning protrusion 34.
  • the annular connecting lug 81 can be better adapted.
  • the corresponding floating limiting strip 1 is provided with outer convex portions 106 on both sides, and the floating limiting strip 1 is also disposed.
  • the hollow portion 109 corresponding to the position of the positioning boss 34 forms an annular shape at the periphery of the hollow portion 109, substantially conforming to the shape of the connecting lug 81, and completely presses the connecting lug 81.
  • a plurality of (may be two or three, etc., the number corresponding to the connecting ears), the proximal side of the floating limiting strip 1 is connected as a unitary structure to form a fixing ring 104, the fixing ring The 104 is fixed to the core tube assembly or the mounting head, and the plurality of floating limit strips 1 are provided with a hollowed-out area 109 corresponding to the position of the positioning boss 34.
  • the positioning portion on the mounting head 3 is a positioning boss 34, and the annular connecting lug 81 is sleeved on the positioning boss 34.
  • the outer sheath tube 5 passes the floating limit.
  • the strip 1 limits the connecting lug 81 to the state in which the positioning tab 34 is engaged.
  • the floating limiting strip 1 is prevented from being excessively raised on the outer periphery of the positioning tab 34, and the floating limiting strip 1 is disposed.
  • the positioning boss 34 is positioned corresponding to the escape groove 108.
  • the floating limit strip 1 is filled in the radial gap 53 of the outer sheath tube 5 and the connecting lug 81 to limit the connection of the ears.
  • the mounting head 3 undergoes significant eccentricity when the loading assembly and the outer sheath tube are turned.
  • the radial gap 53 in the upper portion of the figure is significantly larger than the lower portion, and the radial gap 53 in the upper portion is too large, which may cause the connecting ear.
  • 81 is disengaged from the positioning boss 34, but since the lower radial gap is compressed and reduced, the lower connecting lug 81a is firmly engaged with the positioning tab 34a on the floating limiting strip 1a, and the valve bracket is locked as a whole.
  • the auxiliary limiting member adopts a fixed limiting strip and further describes the fixed limiting strip, and the relationship between the other components and the fixed limiting strip can be adopted or combined without obvious contradiction. At least one of the foregoing embodiments.
  • the positioning portion on the mounting head 3 is a positioning boss 34, and the annular connecting lug 81 is sleeved on the positioning boss 34.
  • the outer sheath tube 5 passes the floating limit.
  • the strip 1 limits the connecting lug 81 to the state in which the positioning tab 34 is engaged.
  • the floating limiting strip 1 is prevented from being excessively raised on the outer periphery of the positioning tab 34, and the floating limiting strip 1 is disposed.
  • the positioning boss 34 is positioned corresponding to the escape groove 108.
  • the floating limit strip 1 is filled in the radial gap 53 of the outer sheath tube 5 and the connecting lug 81 to limit the connection of the ears.
  • the floating limit strip 1 In the locked state, the radially inner side of the floating limiting strip 1 cooperates with the radial outer side clearance of the connecting lug 81, and the gap 54 for allowing the radial movement of the connecting lug 81 is smaller than the radial stroke required for the connecting lug 81 to come out of the positioning boss 34. Then, the floating limit strip 1 can still ensure that when the connecting ear 81 moves radially outwardly away from the positioning boss 34, the necessary force is provided for limiting.
  • the auxiliary limiting member is a fixed limiting strip 52 extending in the axial direction, and the fixing limiting strip 52 is integrally fixed to the inner wall of the outer sheath tube 5.
  • the fixing limiting strip 52 is integrally fixed to the inner wall of the outer sheath tube 5.
  • it is fixed to the inner wall of the outer sheath tube by bonding, welding or integration.
  • the material of the fixed limiting strip 52 is made of a fixed guiding strip or a floating limiting strip as described above.
  • the number of the fixing limiting strips 52 is three (only one is shown in the figure), and the circumference of each fixed limiting strip is The position is adapted to the position of the positioning portion on the mounting head 3 to limit the attachment of the ear.
  • the fixed limiting strip 52 is only distributed on the distal part of the outer sheath tube and extends in the axial direction. When the outer sheath tube is in the state before release, that is, completely wrapping the insertion device mounting position, the fixing limiting strip 52 avoids the positioning portion of the mounting head 3. .
  • the fixed limiting strip 52 is in the locked state.
  • the fixed limiting strip 52 is further withdrawn from the outer sheath tube 5 to be axially separated from the valve support 8, i.e., the connecting ear 81 Exposed to the outer sheath tube, of course, the force between the fixed limiting strip 52 and the connecting ear 81 has been released, and the connecting ear 81 moves radially outward from the mounting head, at which time the fixed limiting strip 52 enters the unlocked state.
  • the shape of the connecting ear 81 and the positioning portion on the mounting head 3 can be referred to the form of FIGS. 11a to 12d.
  • the connecting ear 81 is T-shaped, and the positioning portion on the mounting head 3 is a positioning groove. After the valve is loaded, the connecting ear 81 is embedded in the corresponding positioning groove, and the fixed limiting strip 52 is folded on the connecting ear 81 in the locked state. Upper to prevent the connecting ears 81 from coming out of the positioning groove.
  • the suitable depth of the positioning groove (the depth is the thickness of the connecting lug) is such that it is equal in height to the outer wall of the mounting head 3 in the radial direction of the connecting lug.
  • the connecting ear 81 is U-shaped, the U-shaped opening side is connected to the valve support, and the U-shaped opening is closed.
  • the positioning portion on the mounting head 3 is a positioning convex head, and the connecting ear 81 is hung on the positioning convex head by a U-shaped structure.
  • the axial positioning can be realized.
  • the outer wall of the mounting head 3, that is, the outer wall of the mounting head 3 is provided with a settling groove, and the connecting ear 81 is stacked in the settling groove, in the radial direction.
  • the contour can be achieved with the outer wall of the mounting head 3.
  • the connecting ears 81 have three and different axial positions.
  • the binding of the corresponding connecting ears is released one by one, that is, the connecting ears are released one by one.
  • the fixed limit bar is switched from the locked state to the released state.
  • a plurality of fixed limiting strips are disposed on the inner wall of the same outer sheath tube 5, and the lengths of the plurality of fixed limiting strips are different.
  • the fixed limiting strips 52a are only distributed in the outer sheath tube. 5 distal portion, and extending in the axial direction, when the outer sheath tube 5 is in the state before release, that is, completely wrapping the insertion device mounting position, the fixed limiting strip 52 avoids the positioning portion of the mounting head 3, and the connecting ear 81a mainly depends on the outer sheath tube 5 binding force limit.
  • the fixed limit strip 52b and the axial length of the insertion position of the interventional instrument are substantially the same.
  • the proximal end of the fixed limit strip 52b and the outer circumference of the mounting head 3 cooperate with the limit connection ear 81b, and the longer fixed limit strip 52b is outside.
  • the inner wall of the sheath 5 acts as a slide rail and guide between the valve support 8, and the outer sheath tube 5 is pushed forward and retracted without directly contacting the interventional instrument.
  • the fixed limiting strip 52a has different lengths, and the distal end side is flush, and the proximal side axial position is staggered.
  • the connecting ear 81b is completely released.
  • the rest is limited to the fixed limit strip 52b, and the connecting ear 81a only when the outer sheath tube 5 is retracted until the proximal end side of the fixed limiting strip 52a contacts the connecting ear 81a, that is, the fixed limiting strip 52a enters the locked state. .
  • Different fixed limit bars enter the locked state.
  • the length of the fixed stop strips 52 can vary.
  • the fixed limiting strip 52 is only distributed at a portion of the distal end of the outer sheath tube 5 and extends in the axial direction.
  • the fixed limiting strip 52 avoids installation. The positioning portion of the head 3.
  • the fixed limit strip 52 and the axial length of the insertion position of the interventional instrument are substantially the same.
  • the proximal end of the fixed limit strip 52 and the outer circumference of the mounting head cooperate with the limit connection ear, and the longer fixed limit strip 52
  • the inner wall of the outer sheath tube 5 and the valve support 8 serve as a slide rail and guide, and the outer sheath tube 5 is pushed forward and retracted without directly contacting the interventional instrument.
  • the fixed stop strip 52 has a length of about 2/3 of the length of the valve support 8, and extends proximally from the distal end of the outer sheath tube 5, in the state before the outer sheath tube 5 is released, that is, the fully wrapped interventional instrument mounting position. At this time, the fixed limit bar 52 avoids the positioning portion of the mounting head 3.
  • the longer fixed stop strip 52 acts as a slide rail and guide between the inner wall of the outer sheath tube 5 and the valve support 8, and the outer sheath tube 5 is pushed forward and retracted without direct contact with the interventional instrument.
  • the insertion ear 81 is in the corresponding positioning groove 33 after the insertion of the interventional instrument.
  • the fixed limiting strip 52 is filled in the radial direction of the outer sheath 5 and the connecting ear 81.
  • the radially outer side of the fixed limiting strip 52 abuts against the inner wall of the outer sheath tube 5 and is integrally connected or fixedly connected, and the radially inner side of the fixing limiting strip 52 and the connecting ear 81 The outer side is abutted.
  • the positioning slot 33 has an open area 36 that allows the connecting ear to change the radial position.
  • the fixed limiting strip 52 is blocked in the open area 36, and the fixed limiting strip 52 is smaller than the open area 36 in the circumferential span, ie, the portion Closed open area 36.
  • the attachment ears 81 are located in the corresponding positioning slots 33, and the total radial thickness of the attachment ears 81 and the fixed stop strips 52 is equal to the depth of the positioning slots 33, ie
  • the fixed limiting strip 52 is completely sunk into the positioning groove 33, and the outer sheath tube 5 is wrapped around the outer circumference of the fixed limiting strip 52, and the fixing limiting strip 52 completely fills the radial gap between the outer sheath tube 5 and the connecting ear 81, and
  • the fixed stop strip 52 completely encloses the open area 36 of the positioning groove 33 in the circumferential span.
  • the fixed limiting strip 52 can be used in various manners with the aforementioned fixed guiding strip 51.
  • the fixed limiting strip 52 and the fixed guiding strip 51 are each three, and are spaced apart in the circumferential direction (the different passages in the figure)
  • the dense diagonal regions respectively express the fixed limit strip 52 or the fixed guide strip 51).
  • the loading assembly includes a core tube assembly having a guide head 2 and a mounting head 3 mounted thereon, the core tube assembly being located near the mounting head 3
  • a floating limiting strip 1 is fixed on the end side portion, and a floating guiding strip 9 is further disposed between the outer sheath tube and the loading assembly.
  • the floating guiding strip 9 and the limiting strip 1 are arranged at three intervals, and the floating guiding is visible in the figure.
  • the strip 9a and the floating guide strip 9b, the other floating guide strip are not obscured by the angle of view.
  • each floating guide strip 9 is fixed to the outer peripheral wall of the mounting head 3, and the distal end 92 of the floating guide strip 9 extends toward the guiding head 2 until it is on the outer circumference of the guiding head 2.
  • the proximal end 91 of the floating guide strip 9 can also be fixedly attached to the core tube assembly and on the proximal side of the mounting head 3.
  • the floating guide strip 9 can provide a smooth track, reduce the relative friction between the interventional heart valve and the outer sheath tube, and reduce the direct force of the doctor during the forward and retraction of the outer sheath tube, thereby realizing the intervention. Precise control of heart valve release and recovery.
  • the floating guide strip 9 is longer than the limit strip 1 , that is, the distal end 91 of the floating guide strip 9 passes over the distal end of the limiting strip 1 .
  • the floating guide strip 9 and the limiting strip 1 may also wait. Long, or shorter than limit bar 1.
  • each floating guide strip 9 is equal in length, and each of the limiting strips 1 is also equal in length. In other embodiments, the floating guide strips 9 and the respective limiting strips 1 may not be equal in length.
  • the floating guide bar can be used in combination with the aforementioned fixed guide bar, floating limit bar and fixed limit bar.
  • the material of the floating guide bar and the shape of the cross-section can be referred to the floating limit.
  • the embodiment of the present invention is a description of the interventional heart valve as an implant. It can be understood by those skilled in the art that the delivery device disclosed in the present invention can implant other implants into the body as a carrier in addition to the interventional heart valve. Corresponding location.

Landscapes

  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Public Health (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Transplantation (AREA)
  • Veterinary Medicine (AREA)
  • Mechanical Engineering (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)

Abstract

一种便于回收控制的介入器械输送装置,包括装载组件以及滑动套设在装载组件外的外鞘管(5),装载组件中带有与介入器械配合的定位部,在外鞘管(5)与装载组件之间设有辅助限位件,辅助限位件具有:锁定状态,辅助限位件在外鞘管(5)的束缚下对介入器械施加作用力以阻止介入器械脱离定位部;释锁状态,辅助限位件解除作用力以容许介入器械脱离定位部。该介入器械输送装置能够在介入器械释放过程中紧固最后释放的近端侧,防止介入器械在确认释放前或需进一步回撤调整位置过程中突然脱离安装位,同时外鞘管在介入器械回收时能提供稳定的轴向支撑和扩张力。

Description

一种便于回收控制的介入器械输送装置 技术领域
本发明涉及医疗器械领域,更具体地,本发明涉及一种将人工心脏瓣膜植入到心脏的输送装置。
背景技术
心脏瓣膜疾病是我国最常见的心脏病之一,其中主要为风湿热导致的瓣膜损害;近年来随着人口老龄化的发展,瓣膜退行性变(包括钙化和粘液变性等)以及代谢障碍性瓣膜损害在我国也日益增多;此外,先天性瓣膜病也是心脏病的常见病因之一。相当多的心脏瓣膜病的高危病例如严重瓣膜关闭不全、高龄不适于外科换瓣手术、晚期肿瘤并瓣膜关闭不全的患者等,需要新的创伤小的介入方法治疗。介入心脏瓣膜是在外科心脏瓣膜置换手术的启发下发展的,近几年来,经皮瓣膜介入术应运而生并于2000年后相继应用与人类取得了成功。从实验研究发展到小规模临床并行的研究阶段,瓣膜病介入可能突破技术上的“瓶颈”,迅速实现广泛的临床应用,再次成为介入性心脏病学领域的关注焦点。
现有技术中,人工心脏瓣膜支架压缩后通过输送装置输送到人体内,压缩的瓣膜支架通常具有弹性,处于压缩状态时对压缩导管施加很大的力,这些过大的力难以使瓣膜支架缓慢而精确的释放,往往导致瓣膜支架与血管内壁的过度摩擦。
公开号为CN101953725的中国专利文献公开了一种人工心脏瓣膜支架,由主动脉支架、瓣膜支架、流出道支架和连接耳组成,心脏瓣膜压缩至输送装置内时,所述连接耳能够卡合到输送装置的支架固定组件中,在瓣膜支架释放过程中通过连接耳的卡合和外鞘管的收束完成瓣膜支架的缓慢释放。然而,现有技术中卡合瓣膜支架连接耳的收束力较小,在瓣膜支架释放过程后期,连接耳极易从输送装置支架固定组件中弹出,使瓣膜 支架完全释放。此时,若发现定位偏差等问题,便无法及时进行回收,只能通过外科手术置换。
为克服瓣膜支架在植入人体释放过程中存在的上述问题,美国专利US5683451公开了一种瓣膜支架控制释放的递送装置和方法,通过在输送装置内设置轨道的方法,减少在输送和释放瓣膜假体时弹性扩张对输送导管造成的摩擦力,上述发明减小了瓣膜支架与输送导管之间的摩擦。然而,瓣膜支架在释放过程中因弹力过大而突然完全释放的问题仍无法解决,释放就位后的瓣膜支架无法实现位置的调整或二次就位,这样不仅对手术时的控制精度要求极高,而且也存在一定的风险。
发明内容
本发明提供了一种输送装置,能够在介入器械释放过程中紧固最后释放的近端侧,防止介入器械连接部在确认释放前或需进一步回撤调整位置过程中突然脱离安装位,同时在介入器械确认释放时连接部顺利解脱,稳定释放。
一种便于回收控制的介入器械输送装置,包括装载组件以及滑动套设在装载组件外的外鞘管,所述装载组件中带有与介入器械连接部配合的定位部,在外鞘管与定位部之间还设有辅助限位件,该辅助限位件具有:
锁定状态,辅助限位件在外鞘管的束缚下对介入器械连接部施加作用力、以阻止介入器械连接部脱离定位部;
释锁状态,所述辅助限位件的作用力解除、容许介入器械连接部脱离定位部。
本发明所述的轴向可理解为装载组件或外鞘管的延伸方向,由于装载组件和外鞘管为可弯曲结构,因此轴向应理解为相关部件所处位置的轴向。
相应的所述径向垂直于相应部位的轴向,例如可理解为辅助限位件所处部位处,装载组件或外鞘管的径向。
由于辅助限位件未必在所有状态均与外鞘管或定位部相接触,因此所述的外鞘管与定位部之间,可理解为径向方向上。
所述作用力主要来自外鞘管的束缚,基于外鞘管处于定位部的外周的配合关系,通过辅助限位件施加作用力至介入器械连接部的相应部位,以保持介入器械连接部与定位部的配合关系。
释锁状态,外鞘管对辅助限位件的束缚力解除时,通过辅助限位件施加在连接部上的作用力也随即解除、容许介入器械连接部脱离定位部。
现有技术中介入器械连接部相对定位部的锁定一般依靠外鞘管与定位部的紧公差配合提供对连接部的径向束缚力,以使介入器械连接部装配在定位部上;一般情况下,定位部采用的材料较硬、介入器械连接部为径向厚度较薄较硬的材料,而外鞘管采用有相对较软的材料,设计时外鞘管与定位部为紧公差配合,但是外鞘管与介入器械之间因加工工艺难免有配合间隙、或外鞘管本身在弯曲、或介入器械的外涨作用下产生形变等原因难免出现配合间隙,这些间隙都会成为介入器械在输送过程或释放过程或重新回收过程中,连接部滑脱的主要原因,导致在非预期情况下介入器械连接部脱离定位部,本发明通过辅助限位件补偿外鞘管与介入器械的间隙,加强并保证锁定状态的稳定性。整体而言,从径向位置看,辅助限位件位于外鞘管与介入器械连接部之间时,有效填塞外鞘管与介入器械连接部在径向上的间隙,加强、增固外鞘管在径向上通过辅助限位件对介入器械连接部的束缚、束紧趋势。
当连接部径向向外推动辅助限位件欲脱离定位部时,辅助限位件受连接部的推动会相应的抵靠外鞘管的内壁,此时外鞘管的内壁会反作用于辅助限位件即提供相应的束紧力,该束紧力经由辅助限位件传导至连接部,以阻止连接部脱离定位部,加强介入器械连接部与定位部连接的稳定、牢固性,防止在介入器械连接部在介入器械完全释放前脱离定位部而无法控制,以及在介入器械部分释放后,释放位置或效果不理想的情况下,为介入器械可被重新拉回外鞘管内二次定位或回撤提供强有力的、稳定的拉力。
介入器械装载进外鞘管内后,辅助限位件也起到了垫片的作用,对间隙的填补不会或极少的增加瓣膜植入时输送系统的径向尺寸;是对现有介入器械和装载组件间连接配合的加固增强,连接性能更加稳定。
以下还提供了若干可选方式,但并不作为对上述总体方案的额外限定,仅仅是进一步的增补或优选,在没有技术或逻辑矛盾的前提下,各可选方式可单独针对上述总体方案进行组合,还可以是多个可选方式之间进行组合。
作为优选,辅助限位件在释锁状态下,外鞘管与定位部在外鞘管轴线上的投影区域相互错位。
当外鞘管相对于定位部向近端回撤,直至不再束缚定位部时,也意味着束紧力经由辅助限位件向介入器械连接部传导的作用力消失,即辅助限位件处在释锁状态,容许介入器械脱离定位部。
作为优选,辅助限位件由锁定状态转入释锁状态时,外鞘管与定位部在外鞘管轴线上的投影区域也相应的由至少部分重叠转入相互错位。
作为优选,所述辅助限位件有多个,不同的辅助限位件同时或先后进入锁定状态。
作为优选,所述辅助限位件有多个,不同的辅助限位件同时或先后由锁定状态转入释放状态。
作为优选,相对于装载组件,所述外鞘管具有完全包裹介入器械的释放前状态、暴露部分介入器械的半释放状态以及完全暴露介入器械的释放状态;
所述外鞘管处于释放前以及半释放状态下,所述辅助限位件均处于锁定状态;或仅在外鞘管处于半释放状态下,所述辅助限位件处在锁定状态。
作为优选,所述装载组件包括芯管组件,芯管组件上设有安装头,所述定位部处在安装头的外周壁,所述辅助限位件仅在锁定状态提供作用力施加在介入器械连接部与定位部配合的部位。
装载组件功能是与外鞘管组合承载介入器械在体腔或血管内穿行直至病灶部位,为了便于在近端操控,芯管组件会向近端延伸并连接操作手柄(控制手柄),同理外鞘管的近端也与操作手柄相连,使得在近端可以控制装载组件和外鞘管之间轴向相对运动,以实施介入器械的释放和回收。
所述定位部处在安装头的外周壁即作为安装头上的一部分,安装头可 以是一体结构或分体相互固定。
所述安装头为整体结构或分体结构。采用分体结构时,包括至少两个,例如2~4个分头,各分头环绕排布,相互聚拢,各分头直接固定在芯管组件上或通过连接件方式连接在芯管组件上,通过连接件方式时,若没有外鞘管的束缚,则容许个分头在径向上有一定幅度的摆动。
每个分头上均设置定位部,介入器械上多处连接部与相应的定位部配合。
作为优选,介入器械连接部的至少一部分为与所述定位部相配合的连接耳,锁定状态下,辅助限位件填充外鞘管与连接耳的径向间隙。
连接耳的形状并没有严格限制,至少与定位部之间具有相互配合的轴向限位结构,定位部至少局部径向开放,连接耳经由开放部位与安装头贴靠,贴靠后轴向限位结构相互作用,而辅助限位件的作用力恰可以保持轴向限位结构相互作用。辅助限位件在释锁状态下容许连接耳径向向外运动(至少具有径向向外运动的分量)解除与定位部之间的轴向限位。
作为优选,所述安装头在装载组件中的相对位置是固定的。
作为优选,芯管组件的远端侧还设有引导头,引导头和安装头之间为用于容纳介入器械的介入器械安装位。
介入器械安装位用于安装介入器械(例如介入人工心脏瓣膜),介入器械安装位的长度应与介入器械的长度相适应。
作为优选,锁定状态下,辅助限位件的径向外侧与外鞘管内壁贴靠,辅助限位件的径向内侧与所述连接耳贴靠。
辅助限位件起到了间隙补偿的作用,锁定状态下,外鞘管、辅助限位件、连接耳和安装头依次靠紧。
所述辅助限位件在锁定状态提供的作用力,限制连接耳相对定位部径向移动。
作为优选,所述定位部具有容许连接耳改变径向位置的开放区,锁定状态下,所述辅助限位件阻挡在该开放区。
外鞘管在体内穿行,尤其在发生弯曲时,与安装头或连接耳之间的径向间隙加大,连接耳由开放区脱离定位部的趋势更明显,而辅助限位件阻 挡在该开放区(理解为辅助限位件的局部或整体处在开放区)可限制阻挡连接耳的径向运动,保持以定位部的配合。
所述开放区也可理解定位部暴露在安装头外周的区域,有径向厚度也有周向形状,装载时介入器械连接部经由开放区逐渐接近并贴合在定位部。
作为优选,锁定状态下,所述辅助限位件完全封闭或部分封闭开放区。
由于连接耳可以是与开放区形状相同,也可能是连接耳只占开放区的一部分,因此部分封闭开放区应理解为辅助限位件的局部或整体处在连接耳的径向运动路径上,至少可以阻挡连接耳的径向运动。
作为优选,所述辅助限位件沿轴向延伸时,辅助限位件的至少局部经过开放区,该局部与开放区形状相应。
即锁定状态下,所述辅助限位件的形状完全遮蔽所述开放区。
作为优选,介入器械连接部与定位部配合的部位设有在锁定状态下相互作用的轴向限位结构,且在释锁状态下容许介入器械相对定位部运动解除轴向限位。
安装头可限制介入器械的轴向相对位置,便于携带介入器械在体内输送,同时,在回收过程中,也需要拉紧介入器械相对外鞘管回撤,即重新进入外鞘管中回复装载状态。辅助限位件尺寸,形状没有严格限制,介入器械与辅助限位件相接触的部位可能有多处,但本发明重点在于施加作用力将介入器械保持在定位部上,保持介入器械与定位部的轴向限位关系。
作为优选,所述作用力至少具有径向分力,锁定状态下,该径向分力阻碍所述介入器械连接部向径外移动,加强所述介入器械连接部向内贴靠安装头。
若仅在外鞘管的包裹下,所述介入器械连接部具有径向向内贴靠安装头的趋势,为了进一步稳定该状态,辅助限位件提供的径向分力会加强对介入器械连接部的限位或束缚作用,即加强所述介入器械连接部装配在安装头上。
作为优选,所述作用力至少具有径向分力,锁定状态下,所述介入器械连接部在该径向分力的作用下贴靠在安装头的外周。
作为优选,锁定状态下,辅助限位件与介入器械连接部之间的轴向重叠长度为0.3~2cm。
足够的重叠长度可保证径向作用力,维系介入器械连接部与定位部之间的配合关系,避免由于部件非预期的形变导致配合关系失效。
外鞘管在释放状态下,辅助连接件施加在介入器械连接部上的径向作用力解除。
径向作用力与外鞘管的存在是相关的,当外鞘管脱离介入器械时,径向作用力相应解除。
作为优选,辅助限位件与介入器械连接部之间,在轴向上自由滑动配合。
由于辅助限位件主要是提供径向的作用力,在轴向上则容许与介入器械连接部自由滑动,并不存在相互限位的结构。
作为优选,锁定状态下,在辅助限位件与介入器械连接部的接触部位处,所述辅助限位件均处在介入器械径向的外部。
作为优选,所述辅助限位件与定位部数量相同,且周向位置一一对应。
作为优选,所述辅助限位件与介入器械连接部配合的部位处具有光滑表面和/或具有润滑涂层。
作为优选,所述辅助限位件为聚四氟乙烯材料。
作为优选,锁定状态下,辅助限位件在径向上接触介入器械连接部外周和/或安装头的外周。
连接部可能高于、等于或低于周边部位的安装头外壁,辅助限位件可直接接触介入器械连接部外周施加作用力,或仅从径向厚度上看(连接耳由于自身弹性即使低于周边部位的安装头外壁,但仍有可能略向外扩展),辅助限位件在径向上仅接触安装头的外周。
作为优选,锁定状态下,辅助限位件仅接触介入器械连接部的外周。
定位部若具有足够的径向深度,辅助限位件仅接触介入器械的外周的情况下,则可随同介入器械沿径向向内深入,即辅助限位件也沉入定位部中,避免外鞘管局部外径过大。
作为优选,所述辅助限位件为与装载组件相连的浮动限位条,浮动限 位条受外鞘管包束提供向介入器械施加的作用力。
浮动限位条在介入器械没有装载时或没有外鞘管束缚的情况下相对于介入器械或芯管组件而言可以自由摆动或仅依靠自身的材料强度保持相对位置以及姿态。
所述浮动限位条可以是一个或在周向上间隔排布有多个,就每个浮动限位条而言周向上包角小于360度,就所有浮动限位条而言周向上包角之和小于360度,以便于径向运动而直接释放连接耳。
作为优选,浮动限位条的近端与装载组件相连,浮动限位条的远端相对装载组件浮动设置。
浮动设置可理解为浮动限位条的远端与装载组件之间并没有直接或间接的连接,在不考虑外鞘管的作用时,浮动限位条的远端可以相对装载组件在径向上自由摆动。
作为优选,所述定位部为定位凸头或定位槽,锁定状态下,连接耳套设在定位凸头上或嵌装在相应的定位槽内,锁定状态下,所述浮动限位条叠压在连接耳上以保持连接耳与定位部之间的配合。
为了控制介入器械的轴向位置,连接部设在介入器械的近端,连接部的近端为与安装头配合的连接耳,连接耳一般可以采用T形、L形、环形等,定位部可以采用接纳T形、L形的定位槽,或卡入环形的凸头等,使介入器械连接耳在装载后轴向位置受限于定位部,具体实施例中,就连接耳本身形状而言可采用现有技术,其并非本发明改进的重点。
定位部采用定位凸头或定位槽,或两者结合,例如在定位槽的槽底设置凸头,配合连接耳的相应形状可以增强定位效果。
作为优选,所述定位部为定位槽,锁定状态下,所述浮动限位条与定位槽配合的部位处,径向部分或全部沉入定位槽内。
作为优选,所述浮动限位条与定位槽配合的部位处,浮动限位条的径向厚度不小于浮动限位条未与定位槽配合的部位处。
即浮动限位条在厚度方向上,至少一半沉入定位槽内。
作为优选,所述定位槽轴向贯通所述安装头。
作为优选,锁定状态下,所述定位槽的轴向贯通区域被浮动限位条所封闭。
作为优选,所述浮动限位条在周向上与所述定位部至少存在一部分重叠区域。
所述定位部为定位凸头,锁定状态下,所述浮动限位条与定位凸头配合的部位处的径向厚度,不大于浮动限位条未与定位凸头配合的部位处。
作为优选,所述浮动限位条与定位凸头配合的部位处为镂空或凹陷。
镂空或凹陷可恰好容置或避让定位凸头,镂空或凹陷的形状可以是与定位凸头相一致或面积略大与定位凸头。
作为优选,还设有位于外鞘管内壁且沿轴向延伸的固定导向条,外鞘管在释放前状态下,固定导向条的位置与介入器械位置相应。
固定导向条的一面固定于外鞘管远端(沿输送装置远离操作者方向)管状壳体内部,固定导向条沿管状壳体的轴向延伸布置。在外鞘管收束与释放介入器械过程中,介入器械与位于外鞘管管状壳体内的固定导向条直接接触,通过固定导向条提供的光滑轨道进行介入器械的快速、精准调控。
固定导向条与外鞘管内壁之间可以是接触部分或全部固定相连,或采用间隔分布的多个固定点,由于固定导向条需要随外鞘管往复运动,因此作为优选,固定导向条的轴向两端至少与外鞘管内壁固定,以避免产生翻翘造成运动时的空间干涉。
手术前外鞘管收束介入器械,固定导向条与介入器械紧贴。在随后的介入器械释放中,固定导向条在外鞘管管状壳体与介入器械之间(靠近介入器械的一面)提供光滑轨道,减少接触摩擦,便于介入器械的释放与控制。
作为优选,所述固定导向条与辅助限位件沿周向交替布置。
固定导向条与辅助限位件沿周向交替布置可避免相互干涉。
作为优选,所述浮动限位条在失去外鞘管束缚状态下,通过局部或整体形变的方式改变径向位置,容许介入器械连接部径向向外运动脱离定位部。
外鞘管开始回撤释放介入器械时,随着浮动限位条逐渐暴露于外鞘 管,浮动限位条施加在介入器械连接部上的作用力逐渐解除。
在介入器械装载进外鞘管内至被完全释放出外鞘管前,所述浮动限位条受外鞘管束缚保持连接部与定位部之间的配合;外鞘管回撤,逐渐释放连接耳的过程中,浮动限位条也逐渐被释放出外鞘管,在连接部完全释放并脱离安装头时,浮动限位条可以自由摆动,被释放的浮动限位条对连接耳不再施加径向的压紧力,即确定介入器械就位良好后,外鞘管将继续回撤,将释放连接部和浮动限位条,此时释放出外鞘管的浮动限位条对连接部已无限位作用,不会对介入器械造成二次干扰导致介入器械的移位。
浮动限位条对连接部的径向压力随外鞘管的回撤而同步消失,不会对已释放良好的瓣膜造成新的干扰。
所述浮动限位条至少在径向上可形变,通过对应部位的形变解除对连接部的束缚,由于浮动限位条受外鞘管包裹提供径向作用力,因此浮动限位条在失去外鞘管束缚状态下改变径向位置,改变径向位置时并不严格要求其运动路径是沿径向的,但至少具有径向向外的分量,以避让连接耳脱离定位部实现介入器械的释放。
所述浮动限位条的局部或整体形变,为记忆形变或预定型形变。
作为优选,所述浮动限位条的至少一部分为可形变结构,该可形变结构采用弹性材料和/或铰链机构。
浮动限位条基于改变径向或周向位置进入释锁状态时,辅助连接件的一部分相对于鞘芯组件或安装头固定连接,为了获得局部的径向或周向位置,浮动限位条的至少一部分为可形变结构。
作为优选,所述浮动限位条的近端与以下各处中的至少一处固定连接:
a)固定连接在所述安装头上;
b)固定连接在所述芯管组件上,且处在所述安装头的近端侧。
例如浮动限位条起始端的固定位置靠近安装头,处在安装头近端(沿输送装置靠近操作者方向)的尾部或与该尾部相连的芯管组件上,在手术前通过外鞘管对介入器械以及浮动限位条进行收束,使得浮动限位条径向内敛帖靠在介入器械外周。
作为优选,所述浮动限位条在周向上间隔布置多个,多个浮动限位条的近端侧连接为一固定环,该固定环与芯管组件和安装头中的至少一者相固定。
作为优选,所述浮动限位条与定位部数量相同,且周向位置一一对应。
定位槽可保证浮动限位条在收束与释放过程中不会偏移。
介入器械装载后浮动限位条的近端部位在外鞘管包裹下紧扣定位槽及内嵌其中的连接耳。在外鞘管后撤释放介入器械过程中,通过浮动限位条在定位槽的挤压紧固作用,防止介入器械的快速释放及脱落。在介入器械释放过程发现定位偏差时,可以前推外鞘管,对已释放的介入器械进行压缩和回收,此时连接耳被浮动限位条和外鞘管紧紧包裹,有效保证了介入器械的安全控制及二次定位。
作为优选,所述浮动限位条的远端至少延伸至与所述连接耳相应的位置。
即至少覆盖部分连接耳,以实现对连接耳径向运动的束缚,在此基础上浮动限位条的末端还可以进一步朝远端延伸。
作为优选,所述浮动限位条的最远端与安装头最远端对齐或不超过安装头最远端或略超过安装头最远端。
所述浮动限位条具有最小长度时,浮动限位条至少可以覆盖所述连接耳。为了进一步保证压紧效果,浮动限位条的末端可进一步延伸至安装头的远端侧或略微超过安装头的远端侧,例如超过长度小于等于1cm。当浮动限位条具有最大长度时,浮动限位条整体均能保证收束在外鞘管内,且浮动限位条末端与外鞘管内部的介入器械远端侧齐平,此时浮动限位条的长度能够包裹整个介入器械,浮动限位条起到了滑轨作用,保证外鞘管能够沿滑轨前推和回撤而不直接接触介入器械。
作为优选,所述定位槽轴向贯通,锁定状态下,所述浮动限位条与定位槽配合的部位处,部分或全部沉入定位槽内。
所述浮动限位条经由定位槽向远端延伸,定位槽不仅轴向贯通,径向的外侧也是开放的,即具有径向开口,浮动限位条并不严格限制完全处在径向开口内侧,容许有部分处在径向开口的外侧,例如浮动限位条截面为 T形,T形底端伸入定位槽用于阻挡连接耳,而T形顶部尺寸受限于径向开口,因此处在径向开口的外侧,这样仅可以保证与外鞘管内壁的配合,也能够兼顾与连接耳的配合。
作为优选,锁定状态下,所述定位槽的轴向贯通区域被浮动限位条所封闭。
为了防止连接耳脱出,浮动限位条的宽度可以与轴向贯通区域的径向开口相同或略宽,实现对径向开口的完全封闭,即使宽度小于径向开口的宽度,其缝隙至少不至于连接耳的脱出,浮动限位条的宽度优选与轴向贯通区域的径向开口相同,可进一步防止浮动限位条偏移。
作为优选,所述浮动限位条沉入定位槽的部分,在径向上向内接触或抵紧连接耳。
浮动限位条尽管可以阻挡连接耳,但两者的厚度(径向尺寸),以及定位槽的深度可具有不同的匹配关系,在外鞘管包覆接触安装头外周的情况下,浮动限位条叠置在连接耳的外壁,若浮动限位条与连接耳的厚度和大于定位槽的深度,浮动限位条在径向上向内抵紧连接耳,反之则接触而已,并不会产生明显的束紧力,但都可以保证浮动限位条与对连接耳的限位,作为进一步的优选,采用抵紧关系,可保证在轴向力过大或外鞘管局部形变时仍保持限位。
作为优选,锁定状态下,所述浮动限位条在径向上与安装头的外壁等高或高于安装头的外壁。
浮动限位条在径向上不低于安装头的外壁,可以避免浮动限位条与外鞘管内壁之间产生不必要的间隙,使得外鞘管内壁紧贴浮动限位条,并将连接耳压紧在安装头的定位部内。
作为优选,所述浮动限位条与连接耳配合的部位处沿直线或曲线延伸。
浮动限位条两侧边与定位槽相应侧相抵时,沿曲线延伸时浮动限位条宽度可适当变窄,在介入器械释放时更易于折弯向外翻翘以释放连接耳,避免连接耳脱出的迟滞。
作为优选,所述定位部具有容许连接耳改变径向位置的开放区,锁定 状态下,所述浮动限位条阻挡在该开放区;
浮动限位条径向的内侧与连接耳径向的外侧相贴靠或间隙配合,其间隙配合时,容许连接耳径向运动的间隙小于连接耳脱出定位部所需的径向行程。
浮动限位条仍可以保证在连接耳径向向外运动预脱离定位部时,提供必要的作用力进行限位。
作为优选,所述浮动限位条与连接耳配合的部位处等宽或不等宽延伸;所述浮动限位条与连接耳配合的部位处等厚或不等厚延伸。
所述浮动限位条与连接耳配合的部位无论是沿直线或曲线延伸,均能够设置为不等宽和/或不等厚,通过宽度、厚度的变化调节局部强度,兼顾限位与释放连接耳。
作为优选,所述浮动限位条的末端具有光滑的外周面。
使用过程中所述浮动限位条随介入器械的释放而径向展开,为防止展开后的末端刺伤血管内壁,因此末端采用光滑的外轮廓,例如类似于球冠或边缘倒圆角等形式。
作为优选,所述浮动限位条的末端为圆头结构。
作为优选,所述浮动限位条沿周向均匀排布2、3或4根。
作为优选,各浮动限位条等长或不等长。
作为优选,各浮动限位条的远端位置不完全相同;其中至少一浮动限位条的远端延伸至与安装头的远端侧相平齐;至少一浮动限位条的远端延伸至介入器械安装位的远端侧。
作为优选,所述浮动限位条为等长的3根,且均为长条状结构。
作为优选,所述浮动限位条空心或实心结构。
作为优选,所述浮动限位条为实心的扁条状。
采用扁条状结构在介入器械安装位的径向占用空间小,利于减小压缩后的外径。
作为优选,所述浮动限位条的尺寸为:长度10mm-80mm,宽度1-2mm,厚度0.2-0.5mm。
作为优选,所述浮动限位条采用粘合、捆绑、锁扣、焊接或一体化的 方式固定在所连接的部件上。
所述浮动限位条一端为起始端,另一端为末端,中间部位为延伸段,所述起始端位于安装头近端的尾部或尾部与芯管组件的连接部位,以粘合、捆绑、锁扣、焊接或一体化方式固定在所连接的部件上。浮动限位条沿起始端向远端延伸,在自然状态下,所述浮动限位条起始端固定,延伸段及末端沿芯管组件轴向舒展打开。
作为优选,在介入器械装载后,所述浮动限位条远端头轴向至少部分叠压在所述连接耳上。
作为优选,所述浮动限位条远端头轴向上叠压连接耳和安装头。
作为优选,所述浮动限位条远端头轴向上叠压连接耳和整个安装头。
作为优选,所述浮动限位条远端头超过安装头远端至介入器械的直径最大部位。
作为优选,所述浮动限位条与外鞘管配合的部位,以及与介入器械配合的部位中,至少有一处具有光滑表面和/或具有润滑涂层。
作为优选,所述浮动限位条为聚四氟乙烯材料。
作为优选,所述辅助限位件为沿轴向延伸的固定限位条,固定限位条的至少一部分相对于外鞘管固定连接。
作为优选,所述固定限位条贴覆固定在外鞘管的内壁,与外鞘管之间为分体固定方式或一体结构方式。
固定限位条可以为多条,间隔的分布在外鞘管的内周壁,外鞘管既起到了连接各固定限位条的作用,也提供了束缚力。
作为优选,从锁定状态起,所述固定限位条随外鞘管进一步回撤至与介入器械轴向分离时,进入释锁状态。
即相对于锁定状态,释锁状态的固定限位条与介入器械之间具有相对轴向位移。固定限位条的至少局部相对于安装头的轴向位置可变,以切换锁定、释锁状态。另外固定限位条与外鞘管之间既可以轴向相对位置始终保持不变,还可以采用可形变部件连接,且两者轴向位置在预定范围内改变。
作为优选,所述固定限位条采用轴向滑动的方式改变轴向位置。
为了改变辅助限位件的轴向相对位置可设置牵引部件,直接或间接的与近端的操作手柄连接,以控制固定限位条的运动。
作为优选,所述固定限位条为多个,各固定限位条与介入器械之间的轴向分离顺序为同步或不同步。
固定限位条可以是多个,介入器械的连接耳的数量以及位置也与其相应,固定限位条轴向运动的同时可逐个或逐批解除对相应连接耳的束缚,即也决定了各连接耳的释放顺序。不仅如此,非同步释放可避免同时释放时,连接耳突然同时径向外扩弹伤体内组织。
作为优选,所述固定限位条固定连接在外鞘管的远端,且在外鞘管处于释放前状态下,固定限位条避让所述定位部。
固定限位条可沿轴向布满整个介入器械安装位,还可以仅布置在远端,固定限位条布置在远端时,,当然也没有向介入器械施加径向作用力,可以减小其他部位的外径尺寸,保证柔顺性。
外鞘管在释放前状态时,固定限位条与安装头并没有接触,可以是刚开始释放或释放一段后固定限位条才与安装头接触,这样固定限位条至少可以缩短一部分,无需强调其长度与介入器械安装位相同或更长。
另外固定限位条与介入器械直接接触还可以起到滑轨和导向作用,保证外鞘管能够沿滑轨前推和回撤而不直接接触介入器械。
作为优选,所述固定限位条固定连接在外鞘管的远端,且在外鞘管处于半释放状态下固定限位条进入锁定状态;
从锁定状态起,固定限位条随外鞘管进一步回撤至与介入器械轴向分离时,进入释锁状态。
即随着介入器械的暴露于外鞘管,固定限位条施加在介入器械上的作用力逐渐解除。
只有伴随外鞘管的回撤进入半释放状态时,固定限位条才移动至安装头部位,向介入器械施加径向作用力,此时介入器械已经有部分释放,便于在体内评测就位情况,决定是否需要回收。
作为优选,所述固定限位条采用粘合、焊接或一体化的方式固定在鞘管内壁。
作为优选,所述固定限位条的远端以及近端具有朝外鞘管内部逐渐贴靠的斜面结构。通过斜面结构的导向,以便沿介入器械外壁滑动,避免由于存在棱角而产生与介入器械的轴向位阻。
作为优选,介入器械连接部的至少一部分为与所述定位部相配合的连接耳,所述定位部为定位凸头或定位槽,锁定状态下,连接耳套设在定位凸头上或嵌装在相应的定位槽内,锁定状态下,所述固定限位条叠压在连接耳上以保持连接耳与定位部之间的配合。
为了控制介入器械的轴向位置,在介入器械的近端一般设有与安装头配合的连接耳,连接耳一般可以采用T形、L形、环形等,定位部可以采用接纳T形、L形的定位槽,或卡入环形的凸头等,使介入器械在装载后轴向位置受限于定位部,本发明中就连接耳本身形状而言可采用现有技术,其并非本发明改进的重点。
定位部采用定位凸头或定位槽,或两者结合,例如在定位槽的槽底设置凸头,配合连接耳的相应形状可以增强定位效果。
作为优选,所述定位部为定位槽,锁定状态下,所述固定限位条与定位槽配合的部位处,径向部分或全部沉入定位槽内。
所述固定限位条与定位槽配合的部位处,固定限位条的径向厚度不小于固定限位条未与定位槽配合的部位处。
即固定限位条在厚度方向上,至少一半沉入定位槽内。
作为优选,所述定位槽轴向贯通所述安装头,锁定状态下,所述定位槽的轴向贯通区域被固定限位条所封闭。
作为优选,所述固定限位条在周向上与所述定位部至少存在一部分重叠区域。
作为优选,所述固定限位条为多条,各固定限位条远端邻近外鞘管的远端,或与外鞘管的远端平齐。
作为优选,所述固定限位条为多条,各固定限位条近端相互平齐或轴向位置交错分布。
本发明浮动是指一端固定,而另一端在没有外部束缚的情况下,至少可以在径向上摆动,而由于自身材料强度的限制,一般也容许发生周向的 偏移。
作为优选,还设有位于外鞘管内壁且沿轴向延伸的固定导向条,外鞘管在释放前状态下,固定导向条叠压在介入器械的外周。
作为优选,所述辅助限位件(例如浮动限位条或固定限位条)与固定导向条沿周向交替布置。
各固定导向条的分布与安装头上的定位槽交错排列,也意味着与浮动限位条与固定导向条交错排列。
作为优选,所述辅助限位件的远端与固定导向条的远端侧的轴向位置相同或交错布置。
作为优选,所述固定导向条沿周向均匀排布2、3或4根。
作为优选,各固定导向条等长或不等长。
作为优选,所述固定导向条为等长的3根,且均为长条状结构。
作为优选,所述固定导向条为空心或实心结构。
作为优选,所述固定导向条为实心的扁条状。
采用扁条状结构在介入器械安装位的径向占用空间小,利于减小压缩后的外径。
作为优选,所述固定导向条的尺寸为:长度10mm-80mm,宽度1-2mm,厚度0.2-0.5mm。
作为优选,所述固定导向条的长度60mm-80mm。
本发明中,所述浮动限位条、固定导向条的形状以及尺寸相互独立设置,例如可以是长条的实心或空心结构;其截面形状优选为扁平,为了减少外鞘管远端整体的径向尺寸,扁平形状的厚度方向即外鞘管的径向。
为了便于控制支架的释放与回收,减少与外鞘管的接触面积,从而减少两者之间的相对摩擦,浮动限位条、固定导向条也相应的有适宜尺寸的选择。
作为优选,所述固定导向条采用粘合、捆绑、锁扣、焊接或一体化的方式固定外鞘管内壁。
作为优选,所述固定导向条与介入器械配合的部位具有光滑表面和/或具有润滑涂层。
作为优选,所述固定导向条为聚四氟乙烯材料。
本发明中,所述浮动限位条、固定导向条的材质可以相互独立的选取,作为优选采用弹性较好的生物相容性材料制成,具体材料的选用可以采用现有技术。
作为优选,在所述外鞘管与装载组件之间还设有浮动导向条,所述浮动导向条的近端与装载组件相连,所述浮动导向条的远端相对装载组件浮动设置。
作为优选,所述装载组件包括芯管组件,芯管组件上设有安装头,所述定位部处在安装头的外周壁,所述浮动导向条的近端与以下各处中的至少一处固定连接:
a)固定连接在所述安装头上;
b)固定连接在所述芯管组件上,且处在所述安装头的近端侧。
作为优选,外鞘管在释放前状态下,浮动导向条叠压在介入器械的外周,浮动导向条与辅助限位件(例如浮动限位条或固定限位条)沿周向交替布置。
浮动导向条还可以与固定限位条结合使用,所述浮动导向条的材质和尺寸,可参照浮动限位条。
作为优选,所述浮动导向条为多根,各浮动导向条等长或不等长。
作为优选,所述芯管组件的远端带有引导头,所述浮动导向条的远端延伸至引导头部位。
为保证辅助限位件、浮动导向条或固定导向条具有适宜的弹性和最小的动摩擦因数,优选地,可选用聚四氟乙烯(PTFE)。介入器械在人体内释放时,外鞘管后撤,后撤过程中会与介入器械接触摩擦,为防止后撤过程中再次改变介入器械位置,更优选的,在与介入器械或外鞘管有相对运动的辅助限位件、浮动导向条或固定导向条的外表面尽可能光滑或在表面设置润滑涂层,润滑涂层材料可选用具有润滑特性的亲水性单体或高分子聚合物,如N,N-二甲基丙烯酰(DMAA)、丙烯酰胺(AAm)、N-乙烯基吡咯烷酮(NVP)、聚乙烯醇(PVA)、聚丙烯酰胺(PAAm)、聚乙二醇(PEG)等,通过偶联剂或化学方法将上述润滑涂层材料附着到相应部位的外表 面。
本发明采用辅助限位件进一步加强加入介入器械的限位,更有利于介入器械的回收。
附图说明
图1a为本发明输送装置的结构示意图;
图1b为图1a中远端部位的结构示意图;
图2a为本发明输送装置另一实施方式的结构示意图;
图2b为图2a中远端部位的结构示意图;
图3a为锁扣部位的结构示意图;
图图3b为图3a中浮动限位条末端处的结构示意图;
图4a~图4g为不同实施方式下,浮动限位条在径向间隙中的填充位置示意图;
图5a为介入器械部分释放状态图;
图5b为介入浮动限位条在心脏瓣膜释放过程部分释放的状态图;
图5c为介入器械完全释放时的状态图;
图6为采用一实施方式浮动限位条时的结构示意图;
图7a为另一实施方式中在外鞘管处于释放前的结构示意图;
图7b为图7a中外鞘管处于半释放状态的结构示意图;
图7c为图7a中外鞘管处于释放状态的结构示意图(图中介入器械的近端尚未径向弹开);
图7d为图7c中介入器械的近端已经径向弹开,但浮动限位条尚未复位时的结构示意图;
图7e为图7d中浮动限位条复位后的结构示意图;
图8a为另一实施方式中在外鞘管处于释放前的结构示意图;
图8b为图8a中外鞘管释放约二分之一时的结构示意图;
图8c为图8a中外鞘管释放约四分之三时的结构示意图;
图8d为图8a中外鞘管完全释放后的结构示意图;
图8e为图8d中浮动限位条的结构示意图;
图9a为外鞘管内壁装配有固定导向条时的结构示意图;
图9b为图9a中外鞘管的截面示意图;
图10a为装配有浮动限位条和固定导向条时的介入器械完全释放前状态图;
图10b为装配有浮动限位条和固定导向条时的介入器械完全释放前状态图(相对图10a,去除了部分外鞘管);
图11a为连接耳与安装头相配合部位的示意图;
图11b为图11a的连接耳受压于浮动限位条后的示意图;
图11c~图11d为不同实施方式中,安装头的结构示意图;
图11e~图11h为不同实施方式中,浮动限位条的结构示意图;
图12a为另一种连接耳与安装头相配合部位的示意图;
图12b~图12d为图12a的连接耳受压于不同形状浮动限位条的示意图;
图13a~图13d为另一种连接耳受压于不同长度浮动限位条的示意图;
图13e为另一实施方式中浮动限位条与连接耳的配合示意图;
图13f~图13i为不同实施方式中,浮动限位条的结构示意图;
图14a~图14d为连接耳为环形时,浮动限位条处在不同径向位置的示意图;
图15a~图15c为采用固定限位条时,外鞘管不同状态下远端部位的示意图;
图15d~图15f为采用不同长度固定限位条时,连接耳受压状态示意图;
图16a~图16c为为采用不同长度固定限位条时,外鞘管远端部位的示意图;
图17a~图17b为不同实施方式下,固定限位条在径向间隙中的填充位置示意图;
图18为固定限位条结合固定导向条时外鞘管的截面示意图;
图19为本发明输送装置带有浮动导向条时的结构示意图。
具体实施方式
下面将结合附图和实施例对本发明进行详细说明。应当理解,此处所描述的具体实施例仅用以解释本发明,并不用于限定本发明。文中所述近端是指沿输送装置靠近操作者方向的一端,所述远端为沿输送装置远离操作者方向的一端,实施例中介入器械以介入心脏瓣膜为例。
参见图1a,本实施例介入器械输送装置,包括装载组件以及滑动套设在装载组件外的外鞘管5,装载组件以及外鞘管5的近端连接有操作手柄6。
装载组件包括引导头2、安装头3和芯管组件7,其中引导头2和安装头3均固定在芯管组件7上,引导头2位于芯管组件7的最远端,芯管组件7远端侧还套设有安装头3,引导头2和安装头3之间为介入器械安装位;外鞘管5处在介入器械安装位的外围且可轴向滑动,芯管组件7和外鞘管5的近端均与操作手柄6相连,通过操作手柄6可实现外鞘管5相对于芯管组件7的轴向滑动。
另外内管4根据需要设置,在其他实施方式中也可以省略,内管4套在芯管组件7上且位于安装头3近端侧,内管4一般并不随外鞘管5轴向运动,当芯管组件采用不锈钢制成时,内管也可以认为是覆膜在芯管组件7外表面的覆膜层。
芯管组件7可以单一部件,也可以是由两段或多段组成,各段通过焊接、插接件或连接件衔接固定连成,插接部位或连接部位优选位于安装头3内,以保证连接强度和外表的光滑。
图1a中作为辅助限位件的浮动限位条1为等长的三根,在周向上依次排布,在没有外鞘管5束缚的情况下处于释放状态自然伸展。参见图1b,浮动限位条1的不同部位根据所处位置可分为处在近端的起始端103、延伸段102和处在远端的末端101,起始端103固定于芯管组件7上且处在安装头3的近端侧,当然也可以将起始端103固定在安装头3上。图1b中所示安装头3的外周的定位部为定位槽,与之配合的介入心脏瓣膜的连接部的近端为连接耳,定位槽位置以及形状均可与连接耳相匹配,图中定位槽有三个且轴向位置交错布置,例如图中的定位槽31和定位槽33,介入心脏瓣膜释放时,支架膨胀带动连接耳径向外扩展脱离定位槽,因此定 位槽径向外侧是开放的,即具有径向开口。定位槽径向外侧开放可理解全开放或半开放,即支架膨胀带来的径向扩张使得连接耳能够从定位槽处解脱。
图中定位槽采用轴向贯通结构,两侧带有扩展的翼部,以配合T形的连接耳,浮动限位条1从近端向远端延伸时经过对应定位槽的轴向贯通部位。
浮动限位条的近端起始端103可采用粘合、捆绑、锁扣、焊接、一体化方式进行固定。粘合材料选用具有生物相容性的抗腐蚀胶联剂。捆绑材料选用柔韧性强、耐腐蚀的绑线。
图1a、图1b,图2a、图2b所示输送装置(各图中省略介入心脏瓣膜,即浮动限位条1处在空载状态),介入心脏瓣膜装载后,浮动限位条具有锁定状态,即浮动限位条在外鞘管的束缚下对介入器械连接部施加作用力,例如:阻止介入心脏瓣膜连接耳脱离定位槽;浮动限位条还具有释锁状态,即当介入器械处开始进入释放状态时,外鞘管通过浮动限位条对介入器械连接部施加的作用力解除,例如:外鞘管回撤,释放介入心脏瓣膜时,外鞘管通过浮动限位条对介入心脏瓣膜连接耳的作用力解除,同时瓣膜支架径向扩展连接耳从定位槽脱离。
参见图2a以及图2b,在另一实施方式中,相对于图1a以及图1b,本实施例浮动限位条略长,本实施例介入器械输送装置包括引导头2、芯管组件7、浮动限位条1、安装头3、内管4,以及外鞘管5和操作手柄6。安装头3上的定位部为定位槽,图中定位槽有三个且轴向位置交错布置,例如图中的定位槽31和定位槽33,另一定位槽由于视角关系受遮挡未显示。介入心脏瓣膜的连接部的近端为连接耳,连接耳数量为三个,各连接耳与相应的定位槽配合。
浮动限位条1的不同部位根据所处位置可分为处在近端的起始端13、延伸段12和处在远端的末端11,起始端13固定于芯管组件7上且处在安装头尾部32的近端侧,图中可见位于内管4与安装头尾部32之间。安装头3的外周带有定位槽,定位槽需要与介入器械的连接耳配合,因此定位槽位置以及形状均可与连接耳相匹配,图中定位槽有三个且轴向位置交错 布置,例如图中显示的定位槽31和定位槽33,另一定位槽由于视角关系受遮挡未显示。
定位槽可为轴向贯通结构,介入器械释放时连接耳径向外扩脱离定位槽,因此定位槽径向外侧是开放的,即具有径向开口。图中定位槽轴向贯通,两侧带有扩展的翼部,以配合T形的连接耳,浮动限位条1向远端延伸时经过对应定位槽的轴向贯通部位,并延伸至介入器械安装位的远端侧,图2中的浮动限位条1处在装载状态,末端11沿轴向延伸至引导头2的外周。
图2b中,浮动限位条在沿轴向展平时,远端延伸至引导头2部位,在与介入器械相配合时可兼做介入器械与外鞘管之间的滑轨,起到导向作用,作为优选,在没有外鞘管的束缚下,浮动限位条的远端径向上向外弯曲扩展(图2a可见)。以便于介入器械的释放,减少非预期的径向阻挡。例如浮动限位条可以进行预定型,在外鞘管释放状态下径向外扩。
各实施例中浮动限位条的起始端固定在安装头上或安装头近端侧的芯管组件上,可通过焊接方式将合金材料制成的锁扣连接在安装头上或安装头近端侧的芯管组件上,再通过锁扣箍紧起始端,例如参见图3a,浮动限位条1的起始端103箍紧于不锈钢(材质为306)的锁扣14中,图中仅示意了部分延伸段102,锁扣14以焊接的方式连接在安装头3或芯管组件7上。
浮动限位条1为长条状的实心或空心结构,本实施例中采用实心的扁条,末端101为了避免棱角可采用弧形的外缘结构(参见图3b)。
每根浮动限位条1长为10mm-80mm,宽1-2mm,厚0.2-0.5mm。当浮动限位条1具有最大长度时,浮动限位条1整体均能保证收束在外鞘管5内。
参见图4a~图4f,安装头3外壁的定位部为定位槽,介入器械装载后各连接耳处在位置相应的定位槽中,例如图中连接耳81处在位置相应的定位槽33中。
在锁定状态下,浮动限位条1填充在外鞘管5与连接耳81的径向间隙53中,浮动限位条1的径向外侧与外鞘管5内壁贴靠,浮动限位条1的径向内 侧与连接耳81的外侧贴靠。
浮动限位条1起到了间隙补偿的作用,锁定状态下,外鞘管5、浮动限位条1、连接耳83和安装头3依次靠紧或相邻,外鞘管5提供的束缚力通过浮动限位条1提供作用力至连接耳81上,限制连接耳81脱出定位槽33。
图4a中连接耳81的厚度与定位槽33的深度大致匹配,即连接耳81置入定位槽33后,连接耳81外侧与安装头3外壁大致平齐,而外鞘管5内径与安装头3外壁之间带有径向间隙53,浮动限位条1在径向上并没有沉入定位槽33,但恰好填充了径向间隙53。
以其中一定位槽33a为例,具有容许连接耳改变径向位置的开放区36,锁定状态下,浮动限位条1a阻挡在该开放区36,且浮动限位条1a在周向跨度上小于开放区36,即部分封闭开放区。
参见图4b,在另一实施方式中,连接耳81的厚度小于定位槽33的深度,即连接耳81置入定位槽33后,径向间隙53较大,但由于浮动限位条1起到了间隙补偿的作用,即使连接耳81稍脱离定位槽33的槽底,仍会受限于浮动限位条1而无法彻底脱出定位槽33。
浮动限位条1起到了间隙补偿的作用,即连接耳81与浮动限位条1的径向总厚度大于径向间隙53,由于浮动限位条1处在外侧,因此连接耳81无法彻底脱出定位槽33,只有撤去外鞘管5的束缚后,连接耳81才可以脱出定位槽33。
参见图4c,在另一实施方式中,连接耳81的厚度小于定位槽33的深度,即连接耳81置入定位槽33后,径向间隙53较大,浮动限位条1厚度大于径向间隙53,因此浮动限位条1受外鞘管5的束缚部分沉入定位槽33,起到了间隙补偿的作用,使连接耳81无法脱出定位槽33。
参见图4d,在另一实施方式中,装载组件连同外鞘管在体内穿行,在发生转折时,装载组件会相对于外鞘管5发生偏心错位,图中可见上部的径向间隙53明显大于图中下部的径向间隙53,但尽管连接耳81稍脱离定位槽33的槽底,仍会受限于浮动限位条1而无法彻底脱出定位槽33。
参见图4e,在另一实施方式中,介入器械装载后连接耳81a处在位置相应的定位槽33a中,在锁定状态下,浮动限位条1a填充在外鞘管5与连接 耳81a的径向间隙53中,且部分沉入定位槽33,浮动限位条1的径向外侧与外鞘管5内壁贴靠,浮动限位条1的径向内侧与连接耳81的外侧贴靠。
定位槽33a具有容许连接耳改变径向位置的开放区36,锁定状态下,浮动限位条1a阻挡在该开放区36,且浮动限位条1a在周向跨度上等于开放区36,即完全封闭开放区36,具有更佳的限位效果。
参见图4f,在另一实施方式中,介入器械装载后连接耳81a处在位置相应的定位槽33a中,连接耳81a与浮动限位条1a的径向总厚度等于定位槽33a的深度,即浮动限位条1a完全沉入定位槽33a中,而外鞘管5包紧在浮动限位条1a外周,浮动限位条1a将外鞘管5与连接耳81a的径向间隙完全充满,且浮动限位条1a在周向跨度上完全封闭定位槽33a的开放区。
参见图4g,在另一实施方式中,介入器械装载后连接耳81a处在位置相应的定位槽33a中,在锁定状态下,浮动限位条1a填充在外鞘管5与连接耳81a的径向间隙53中,且部分沉入定位槽33,与图4e的实施例相同的是定位槽33a具有容许连接耳改变径向位置的开放区,锁定状态下,浮动限位条1a阻挡在该开放区,优选为且浮动限位条1a在周向跨度上等于开放区,即完全封闭开放区,具有更佳的限位效果。本实施方式中浮动限位条1a径向的内侧与连接耳81a径向的外侧间隙配合,容许连接耳81a径向运动的间隙54小于连接耳81a脱出定位槽33a所需的径向行程,则浮动限位条1a仍可以保证在连接耳81a径向向外运动预脱离定位槽33a时,提供必要的作用力进行限位。
在另一实施例中,结合图5a和图5b,为保证浮动限位条1具有较小的动摩擦因数,浮动限位条1选用聚四氟乙烯材料制造而成;图中每根浮动限位条1长15mm,宽度与安装头3的定位槽宽度相适应,厚度0.5mm,当浮动限位条1处于收束状态时,三根浮动限位条1沿轴向装配在定位槽内并朝远端进一步延伸,介入心脏瓣膜中的瓣膜支架8带有三个T形的连接耳81,为了输送装置整体排气需要,定位槽在T形的基础上轴向贯通,即呈十字状,为了保证限位效果,定位槽的轴向贯通区域被相应的浮动限位条1完全封闭,即浮动限位条1宽度与轴向贯通区域宽度相适应,若贯通区域并非沿轴线等宽延伸,那么浮动限位条1宽度至少是与贯通区域最 窄部位相应,以保证部分或完全沉入定位槽,浮动限位条1的外侧可略高于安装头3的外周面,以减小安装头3的外周面与外鞘管5内壁之间的摩擦。
当瓣膜支架8装载到输送装置上时,浮动限位条1包裹着瓣膜支架8一同收束于外鞘管5内;即外鞘管具有完全包裹介入器械的释放前状态下,释放前状态下浮动限位条处于锁定状态。
在瓣膜支架8释放的过程中,如图5a所示,沿着箭头M方向,外鞘管5沿着浮动限位条1(图中浮动限位条处于外鞘5内,因而未画出)顺滑回撤,此时浮动限位条1处于锁定状态:连接耳81处于外鞘管5内时,由于外鞘管5的束缚,浮动限位条1作用在连接耳81上,防止连接耳81的弹出。
接着,如图5b所示,随着外鞘管5的进一步沿着箭头M方向回撤,浮动限位条1的远端的末端101脱离外鞘管5的束缚,延伸段102和瓣膜支架的连接耳仍处于外鞘管5内,此时延伸段102作用在连接耳81上,给予了瓣膜支架的连接耳81一个径向压力,使得瓣膜支架的连接耳被牢牢抓住,克服了支架在自膨胀释放过程中产生的巨大膨胀力,牢固卡合在支架安装头3的定位槽33内,避免其脱离安装头的定位部而完全释放的风险。此时如若发现瓣膜释放位置不准确,可通过前行外鞘管5,即箭头M反方向,使得瓣膜支架8被重新拉回外鞘管5内,进行回收与二次释放。在这里本发明相对现有技术,能实现瓣膜的稳定回收,以便于瓣膜释放过程中发现释放位置不理想时,能够收回至鞘管内进行二次定位或收回。稳固的后拉力是瓣膜支架能否重新收入外鞘管5内的关键,由于浮动限位条1起到了垫片的作用,保证了连接耳81能稳定的置于定位槽33内,随着芯管组件的移动给瓣膜支架提供有力的回收力,使瓣膜支架回撤至外鞘管内。
在释放过程中,尽管暴露部分介入器械(即外鞘管处在半释放状态),而浮动限位条仍处于锁定状态。
最后,当确定当前的释放位置准确时,如图5c所示,继续沿着箭头M回撤外鞘管5,浮动限位条1的末端101和延伸段102不再受外鞘管5 的束缚,浮动限位条1的末端101和延伸段102随瓣膜支架8的展开而展开,此时浮动限位条1处于释锁状态,即不施加作用力至连接耳81上,从而完成瓣膜支架8的释放,完全释放时,浮动限位条对连接耳的径向压力随外鞘管5的回撤而同步消失,不会对已释放良好的瓣膜支架造成新的干扰,可有效防止瓣膜支架的移位。
参见图6,在其他实施方式中,浮动限位条1轴向长度较短,末端与安装头3远端齐平。
浮动限位条1在瓣膜支架8的连接耳与外鞘管5之间、以及外鞘管5与安装头3之间填补间隙或提供平滑轨道,减少两两接触时的相对摩擦力,在外鞘管5前推和回撤过程中可通过与浮动限位条1的接触减小医生操作时的直接作用力,从而实现对瓣膜支架8释放与回收的精确控制。
图6中浮动限位条1为三根实心长条状,且由聚四氟乙烯材料制成,浮动限位条1起始端通过粘合方式固定在安装头3的近端尾部,浮动限位条1的末端101与安装头3远端齐平,即至少可将连接耳与定位槽的配合部位完全覆盖并限制在定位槽内,浮动限位条1宽度与定位槽33轴向贯通区域的宽度一致,厚度0.5mm。
结合图7a~图7e,结合前述,在另一实施方式中,外鞘管5具有完全包裹介入器械8的释放前状态、暴露部分介入器械8的半释放状态以及完全暴露介入器械8的释放状态;外鞘管5处于释放前以及半释放状态下,浮动限位条1均处于锁定状态。
图7a显示了外鞘管5的释放前状态,瓣膜支架8近端具有连接耳81,安装头3外周设有定位槽33,容纳在定位槽33中的连接耳81被浮动限位条1抵压,瓣膜支架8以及浮动限位条1均受到外鞘管5的束缚。浮动限位条1延伸的长度与安装头3远端位置相当,其末端仅能抵压嵌入安装头定位槽内部的连接耳。
在图7b中,当瓣膜支架8输送到人体并释放时,外鞘管5后撤,瓣膜支架8逐步释放。此时,瓣膜支架8的连接耳81由于嵌入到安装头的定位槽33内且受浮动限位条1起始端的收束力作用牢牢束缚在定位槽33 内,避免已释放瓣膜支架8对连接耳端施加的外扩力而使支架过早的完全释放。
采用较短尺寸的浮动限位条1,可避免对支架正常释放的影响和不必要的束缚,浮动限位条1的长度也可以延伸至瓣膜支架8轴向的中部区域,例如不超过瓣膜完全释放时瓣膜轴向的最大尺寸处。
在图7c中,外鞘管5后撤,外鞘管5与定位槽33在外鞘管轴线上的投影区域相互错位,不再通过浮动限位条1束缚连接耳81,意味着经由浮动限位条1向瓣膜支架8传导的作用力消失,即浮动限位条1处在释锁状态,容许瓣膜支架8脱离定位槽33,图7c中连接耳尚未径向弹开,但已经处在可以径向弹开的状态。
本发明中的锁定状态,指将介入器械连接部保持在与定位部相配合的状态,具体而言,可以是介入器械装配在定位部上;而释锁状态,指介入器械连接部已经可以脱离定位部,但并不特指介入器械完全释放,仅仅是与定位部配合的连接部处在可以解除的状态,至于其他并没与定位部配合的部位,可能已经部分或全部释放并径向扩张。
图7d中,连接耳81推动可径向形变的浮动限位条1径向弹开,浮动限位条1也随之外翻,在图7e中,浮动限位条1可朝安装头3方向贴靠复位。
结合图8a~图8d,结合前述,在另一实施方式中,外鞘管5具有完全包裹介入器械8的释放前状态、暴露部分介入器械8的半释放状态以及完全暴露介入器械8的释放状态;外鞘管5处于释放前以及半释放状态下,浮动限位条1均处于锁定状态。
图8a显示了外鞘管5的释放前状态,瓣膜支架8近端具有连接耳81,安装头3外周设有定位槽33,容纳在定位槽33中的连接耳81被浮动限位条1抵压,瓣膜支架8以及浮动限位条1均受到外鞘管5的束缚。浮动限位条1延伸的长度与安装头3远端位置相当,其末端仅能抵压嵌入安装头定位槽内部的连接耳。
在图8b~图8c中,当瓣膜支架8输送到人体并释放时,外鞘管5后撤,瓣膜支架8逐步释放至不同阶段时,瓣膜支架8的连接耳81由于嵌入到 安装头的定位槽33内且受浮动限位条1起始端的收束力作用牢牢束缚在定位槽33内,避免已释放瓣膜支架8对连接耳端施加的外扩力而使支架过早的完全释放。
在图8d中,外鞘管5后撤,外鞘管5与定位槽33在外鞘管轴线上的投影区域由部分重叠转入相互错位后,不再通过浮动限位条1束缚连接耳81,连接耳81推动可径向形变的浮动限位条1径向弹开,之后浮动限位条1朝安装头3方向贴靠复位。参见图8e,在优选的实施方式中,浮动限位条1在周向上间隔布置3条,且多个浮动限位条的近端侧连接为一固定环104,该固定环104与安装头近端侧的芯管组件或安装头相固定。图中各浮动限位条1略向外翻翘,也可沿轴向平置延伸。
参见图9a和图9b,在其他实施方式中,外鞘管5的远端内壁还设有固定导向条51。
图中除示意了浮动限位条1、引导头2、安装头3、内管4、外鞘管5、瓣膜支架8外,在外鞘管5远端包裹压缩支架的一段内壁还设有固定导向条51,固定导向条51为等长的三条,沿周向均匀排布,且固定于外鞘管5远端管状壳体内表面,在瓣膜支架8与外鞘管5之间提供光滑轨道。
各固定导向条51的周向位置与安装头3上的定位槽(即浮动限位条1的周向分布)交错排列,当外鞘管5收束瓣膜支架8时,固定导向条近端紧靠安装头3,位置与定位槽一一交错。
固定导向条51为实心的扁条,长度10mm-80mm,宽度1-2mm,厚度0.2-0.5mm,本实施例中固定导向条51的长度与瓣膜支架8轴向长度相应约60mm。
固定导向条51采用粘合、捆绑、锁扣、焊接或一体化的方式固定外鞘管5内壁,固定导向条51为聚四氟乙烯材料,与介入器械8配合的部位具有光滑表面和/或具有润滑涂层。在最佳实现方式下,固定导向条51与外鞘管5的内壁一体形成,固定导向条51为向外鞘管5内凸出的凸棱,具有光滑表面和/或具有润滑涂层。
固定导向条可以与不同长度的浮动限位条相配合,包括但不限于图1a、图2a所示长度的浮动限位条。具体而言结合图10a、10b,图10a显 示了装配有浮动限位条和固定导向条时的介入器械释放状态图,为了清楚显示瓣膜支架8的连接耳81与浮动限位条1之间的结构,在图10b中外鞘管5回撤至浮动限位条完全暴露,此时连接耳尚未径向弹开,但已经处在可以径向弹开的状态。
当瓣膜支架8释放时,外鞘管5通过固定导向条51与瓣膜支架8接触滑动,可在摩擦力很小的情况下回撤外鞘管5实现支架的逐步释放。当外鞘管5回撤到安装头3的位置时,瓣膜支架8仅有连接耳被收束在外鞘管5内。此时,固定导向条51与瓣膜支架8完全脱离,浮动限位条1通过外鞘管5的收束紧压在连接耳上。继续回撤外鞘管5,浮动限位条1对连接耳的收束力逐渐撤销,连接耳逐步释放。综上,外鞘管5通过通过固定导向条51、浮动限位条1提供的光滑轨道和间隙填塞,减少了外鞘管5和压缩状态的瓣膜支架间的摩擦力,有利于瓣膜支架释放或重新回撤收入鞘管内。
以下各实施方式主要针对浮动限位条的长度和形状,以及连接耳与安装头的配合方式做进一步的说明,有关其他部件可以采用或结合前述各实施方式中的至少一种。
参见图11a和图11b,连接耳81为T形,安装头3上的定位部为定位槽33,瓣膜支架8装载后,连接耳81嵌装在形状相应的定位槽33内,浮动限位条1受外鞘管的束缚叠压在连接耳81上,以防止连接耳81从定位槽33中脱出,在支架释过程中,当外鞘管完全脱离浮动限位条1时,才解除连接耳81的限位。
定位槽33的适宜深度(深度不小于连接耳的厚度)使得在连接耳81径向上可以嵌入(沉入)定位槽33内。
在其他优选的实施方式中,浮动限位条1以及连接耳81都可以叠置在定位槽33中,定位槽33的适宜深度(深度为连接耳与浮动限位条厚度之和)使得锁定状态下的浮动限位条1径向上与安装头3的外壁等高。
参见图11c,可视为在图11中省略连接耳81,可见定位槽33为T形,图中左侧为远端,定位槽33在轴向上朝远端开放,而近端侧封闭,使得浮动 限位条1必须从安装头3的外周部位3a外侧向远端延伸,再叠压连接耳81,在外周部位3a处,浮动限位条1会增加转载组件的整体外径。
在另一改进的实施方式中,参见图11d,定位槽33在轴向上朝远端开放,在近端侧,安装头3的外周也相应开槽形成与定位槽33相连的贯通区3b,即定位槽33在轴向上为贯通结构,浮动限位条1可沿沉入贯通区3b并向远端延伸直至叠压连接耳81,转载组件的整体外径没有额外增加。
在另一改进的实施方式中,参见图11e,在应对非轴向贯通的定位槽时,为了尽可能减少转载组件的整体外径,浮动限位条1并非等厚延伸,在浮动限位条1径向的内侧设有避让槽105,该避让槽105与定位槽33的非贯通区,即安装头3的外周部位3a相配合,由于浮动限位条1在开设避让槽105部位具有较薄的厚度,可适当减少转载组件的外径的增加。
在另一改进的实施方式中,参见图11f,由于T形可在连接耳与定位槽之间形成轴向限位,若浮动限位条1获得充分叠压的效果,浮动限位条1并非等宽延伸,即浮动限位条1在与定位槽配合的部位上,具有与定位槽开口相同的形状,例如为了适应T形,浮动限位条1两侧边设有外凸部106,可以完全封闭定位槽开口。
在另一改进的实施方式中,参见图11g,多个浮动限位条1的近端侧连接为一体结构形成固定环104,该固定环104与芯管组件或安装头相固定。多个浮动限位条1内也可以采用避让槽105的方式,相应的在浮动限位条1的远端形成叠压连接耳的凸台107。
在另一改进的实施方式中,参见图11h,多个浮动限位条1的近端侧连接为一体结构形成固定环104,该固定环104与芯管组件或安装头相固定。多个浮动限位条1内也可以采用外凸部106的方式,完全封闭相应的定位槽开口。
参见图12a~图12d,连接耳81为U形,U形开口一侧与瓣膜支架8相连,且将U形开口封闭,安装头3上的定位部为定位凸头34,连接耳81利用U形结构挂在定位凸头34上,可实现轴向定位,为了避免连接耳81过于径向外凸,在定位凸头34的外周即安装头3的外壁,设有沉降槽35,连接耳81叠置在沉降槽35中,在径向上与安装头3的外壁可实现等高。
在其他优选的实施方式中,浮动限位条1以及连接耳81都可以叠置在沉降槽35中,沉降槽35的适宜深度(深度可为连接耳与浮动限位条厚度之和)使得锁定状态下的浮动限位条1径向上与安装头3的外壁等高。
图12b中,浮动限位条1为分叉结构,即U形,未分叉部位固定在安装头3的外部,分叉部位向远端延伸直至叠压在连接耳81外侧。
图12c中,浮动限位条1为单根条状结构,同样也向远端延伸直至叠压在连接耳81外侧。
图12d中,浮动限位条1为分叉机构,但采用V形或Y形,未分叉部位固定在安装头3的外部,分叉部位向远端延伸直至叠压在连接耳81外侧。
参见图13a~图13d,显示了连接耳受压于不同长度的浮动限位条1的结构示意图。介入心脏瓣膜装载状态时,外鞘管5束缚浮动限位条1,将连接耳81定位安装头的外部,安装头上的定位部以定位凸头34的方式为例,浮动限位条1的远端侧至少部分叠压在连接耳81上。
图13a可见浮动限位条1的远端侧叠压在连接耳81上,浮动限位条1的远端侧尚未延伸至定位凸头34,仅仅叠压连接耳81的小部分区域。
图13b可见浮动限位条1的远端侧叠压在连接耳81上,浮动限位条1的远端侧在轴向上至少将安装头上的定位部完全覆盖,即越过了定位凸头34,到达了安装头3的远端侧,轴向上朝远端一侧叠压连接耳81和整个安装头3。
图13c可见浮动限位条1的远端侧叠压在连接耳81上,浮动限位条1的远端侧在轴向上越过安装头。
图13d可见浮动限位条1的远端侧叠压在连接耳81上,浮动限位条1的远端侧在轴向上越过安装头,到达了介入心脏瓣膜直径最大的部位,瓣膜支架装载后由于受外鞘管束缚,介入心脏瓣膜的外径基本一致,因此直径最大的部位可理解为释放状态下直径最大的部位。
参见图13e,在另一改进的实施方式中,安装头3上的定位部为定位凸头34,瓣膜支架8带有环形的连接耳81,连接耳81利用环形结构套在定位凸头34上,为了防止转载组件外径的额外增加,安装头3外周仍设置定位 槽33,定位凸头34位于定位槽33内,也可视为定位槽33为处在定位凸头34外周的沉降槽。
锁定状态下外鞘管5通过浮动限位条1将连接耳81限制在与定位凸头34相配合的状态。
若定位槽33近端为非贯通槽,即安装头3的外周部位3a封闭了定位槽33近端,浮动限位条1可采用避让槽105的方式与外周部位3a配合。
参见图13f,在另一改进的实施方式中,浮动限位条1不仅带有避让槽105,还设有避让槽108(朝径向外侧凹陷),锁定状态下避让槽108与定位凸头34位置相应,避免在定位凸头34的外周过于隆起。
参见图13g,在另一改进的实施方式中,定位槽33大致为T形,可更好的适应环形的连接耳81,相应的浮动限位条1在两侧边设有外凸部106,可以完全封闭定位槽33开口,为了进一步避免在定位凸头34的外周过于隆起,浮动限位条1也设置了与定位凸头34位置相应的避让槽108。
参见图13h,在另一改进的实施方式中,可更好的适应环形的连接耳81,相应的浮动限位条1在两侧边设有外凸部106,浮动限位条1也设置了与定位凸头34位置相应的镂空区109,外凸部106在镂空区109外围构成环形,基本与连接耳81形状适配,完全抵压连接耳81。
参见图13i,在另一实施方式中,多个(可以是两个或三个等,数量与连接耳相应)浮动限位条1的近端侧连接为一体结构形成固定环104,该固定环104与芯管组件或安装头相固定,多个浮动限位条1设置了与定位凸头34位置相应的镂空区109。
参见图14a,在另一改进的实施方式中,安装头3上的定位部为定位凸头34,环形的连接耳81套在定位凸头34上,锁定状态下外鞘管5通过浮动限位条1将连接耳81限制在与定位凸头34相配合的状态,为了避让定位凸头34,避免在浮动限位条1在定位凸头34的外周过于隆起,浮动限位条1设置了与定位凸头34位置相应的避让槽108。浮动限位条1填充在外鞘管5与连接耳81的径向间隙53中,以限位连接耳。
参见图14b,当瓣膜支架输送到人体并释放时,外鞘管5后撤,连接耳81径向外扩力加大,已具有脱离定位凸头34的趋势,但浮动限位条1 填充在外鞘管5与连接耳81的径向间隙53中,且受外鞘管5束缚将连接耳81保持在与定位凸头34配合的状态。
参见图14c,在装载组件以及外鞘管发生转折时,安装头3会发生明显的偏心,例如图中上部的径向间隙53明显大于下部,上部的径向间隙53过大,可能导致连接耳81脱离定位凸头34,但由于下部径向间隙反而被压缩减小,因此下部的连接耳81a反而在浮动限位条1a的作用牢牢配合在定位凸头34a上,整体上锁定了瓣膜支架。以下各实施方式中,辅助限位件采用固定限位条并对固定限位条做进一步的阐述,有关其他部件以及与固定限位条之间的关系,在没有明显矛盾前提下可以采用或结合前述各实施方式中的至少一种。
参见图14d,在另一改进的实施方式中,安装头3上的定位部为定位凸头34,环形的连接耳81套在定位凸头34上,锁定状态下外鞘管5通过浮动限位条1将连接耳81限制在与定位凸头34相配合的状态,为了避让定位凸头34,避免在浮动限位条1在定位凸头34的外周过于隆起,浮动限位条1设置了与定位凸头34位置相应的避让槽108。浮动限位条1填充在外鞘管5与连接耳81的径向间隙53中,以限位连接耳。锁定状态下,浮动限位条1径向的内侧与连接耳81径向的外侧间隙配合,容许连接耳81径向运动的间隙54小于连接耳81脱出定位凸头34所需的径向行程,则浮动限位条1仍可以保证在连接耳81径向向外运动预脱离定位凸头34时,提供必要的作用力进行限位。
参见图15a,本实施例中辅助限位件为沿轴向延伸的固定限位条52,固定限位条52整体上固定在外鞘管5的内壁。例如采用粘合、焊接或一体化的方式固定在外鞘管内壁。
固定限位条52的材质采用如前述的固定导向条或浮动限位条的材质,本实施例中固定限位条52数量为三条(图中仅示意了一条),各固定限位条的周向位置与安装头3上的定位部位置相适应,用以限位连接耳。
固定限位条52仅分布在外鞘管远端的局部,且沿轴向向延伸,在外鞘管处于释放前状态即完全包裹介入器械安装位时,固定限位条52避让安装头3的定位部。
参见图15b,随着外鞘管的后侧,在外鞘管处于半释放状态下,瓣膜支架8的远端部分已经释放展开,而此时固定限位条52(图中仅示意了一条)随外鞘管相对于瓣膜支架8沿轴向自由滑动后移动至连接耳81部位,并径向施力将连接耳81保持在与安装头相配合的状态,可防止连接耳81脱出定位部,以便于回收。
图15b中,固定限位条52处在锁定状态,参见图15c,从锁定状态起,固定限位条52随外鞘管5进一步回撤至与瓣膜支架8轴向分离时,即连接耳81暴露于外鞘管,当然固定限位条52与连接耳81之间的作用力已经解除,连接耳81径向向外运动脱离安装头,此时固定限位条52进入释锁状态。
本实施例中,连接耳81以及安装头3上定位部的形状可参照图11a至图12d的形式。
例如连接耳81为T形,安装头3上的定位部为定位槽,瓣膜装载后,连接耳81嵌装在形状相应的定位槽内,锁定状态下固定限位条52叠压在连接耳81上,以防止连接耳81从定位槽中脱出。
定位槽的适宜深度(深度为连接耳的厚度)使得在连接耳径向上与安装头3的外壁等高。
还例如连接耳81为U形,U形开口一侧与瓣膜支架相连,且将U形开口封闭,安装头3上的定位部为定位凸头,连接耳81利用U形结构挂在定位凸头上,可实现轴向定位,为了避免连接耳81过于径向外凸,在定位凸头的外周即安装头3的外壁,设有沉降槽,连接耳81叠置在沉降槽中,在径向上与安装头3的外壁可实现等高。
在其他实施方式中连接耳81有三个且轴向位置各不相同,固定限位条轴向运动的同时逐个解除对相应连接耳的束缚,即各连接耳逐个释放。固定限位条先后由锁定状态转入释放状态。
参见图15d~图5f,在另一实施方式中,同一外鞘管5的内壁设置多条固定限位条,且多条固定限位条长度不同,例如固定限位条52a仅分布在外鞘管5远端的局部,且沿轴向延伸,在外鞘管5处于释放前状态即完全包裹介入器械安装位时,固定限位条52避让安装头3的定位部,连接耳81a主要依靠外鞘管5的束缚力限位。
而固定限位条52b与介入器械安装位的轴向长度基本一致,锁定状态下,固定限位条52b近端与安装头3外周配合限位连接耳81b,较长的固定限位条52b在外鞘管5的内壁与瓣膜支架8之间起到滑轨和导向作用,外鞘管5前推和回撤而不直接接触介入器械。
即固定限位条52a,固定限位条52b长度不同,且远端侧平齐,近端侧轴向位置交错,在释放时,随着外鞘管5的后侧,连接耳81b除了彻底释放以外,其余都受限于固定限位条52b,而连接耳81a只有外鞘管5回撤至固定限位条52a近端侧与连接耳81a接触时,即固定限位条52a才进入锁定状态。不同的固定限位条先后进入锁定状态。
参见图16a~图16c,在不同的实施方式中,固定限位条52的长度可以不同。
图16a中,固定限位条52仅分布在外鞘管5远端的局部,且沿轴向延伸,在外鞘管5处于释放前状态即完全包裹介入器械安装位时,固定限位条52避让安装头3的定位部。
图16b中,固定限位条52与介入器械安装位的轴向长度基本一致,锁定状态下,固定限位条52近端与安装头外周配合限位连接耳,较长的固定限位条52在外鞘管5的内壁与瓣膜支架8之间起到滑轨和导向作用,外鞘管5前推和回撤而不直接接触介入器械。
图16c中,固定限位条52长度大约为瓣膜支架8长度的2/3,且由外鞘管5远端起朝近端延伸,在外鞘管5处于释放前状态即完全包裹介入器械安装位时,固定限位条52避让安装头3的定位部。较长的固定限位条52在外鞘管5的内壁与瓣膜支架8之间起到滑轨和导向作用,外鞘管5前推和回撤而不直接接触介入器械。
参见图17a,在另一实施方式中,介入器械装载后连接耳81处在位置相应的定位槽33中,在锁定状态下,固定限位条52填充在外鞘管5与连接耳81的径向间隙53中,但并没有沉入定位槽33,固定限位条52的径向外侧与外鞘管5内壁贴靠且一体结构或固定连接,固定限位条52的径向内侧与连接耳81的外侧贴靠。
定位槽33具有容许连接耳改变径向位置的开放区36,锁定状态下,固 定限位条52阻挡在该开放区36,且固定限位条52在周向跨度上小于开放区36,即部分封闭开放区36。
参见图17b,在另一实施方式中,介入器械装载后连接耳81处在位置相应的定位槽33中,连接耳81与固定限位条52的径向总厚度等于定位槽33的深度,即固定限位条52完全沉入定位槽33中,而外鞘管5包紧在固定限位条52外周,固定限位条52将外鞘管5与连接耳81的径向间隙完全充满,且固定限位条52在周向跨度上完全封闭定位槽33的开放区36。
固定限位条52可以与前述的固定导向条51以各种方式配合使用,例如图18中,固定限位条52和固定导向条51各为三条,在周向上间隔分布(图中通过不同疏密的斜线区分别表达固定限位条52或固定导向条51)。
参见图19(图中省略外鞘管),在另一实施方式中,装载组件包括芯管组件,芯管组件上安装有引导头2和安装头3,在芯管组件处在安装头3近端侧的部位上固定有浮动限位条1,外鞘管与装载组件之间还设有浮动导向条9,浮动导向条9以及限位条1均有三条且间隔布置,图中可见浮动导向条9a以及浮动导向条9b,另一浮动导向条受视图角度影响遮蔽未见。
各浮动导向条9的近端91固定在安装头3的外周壁,浮动导向条9的远端92朝引导头2延伸,直至处在引导头2的外周。在其他实施方式中,浮动导向条9的近端91还可以固定连接在芯管组件上,且处在安装头3的近端侧。
浮动导向条9可提供平滑轨道,减少介入心脏瓣膜与外鞘管之间接触时的相对摩擦力,在外鞘管前推和回撤过程中减小医生操作时的直接作用力,从而实现对介入心脏瓣膜释放与回收的精确控制。
本实施例中浮动导向条9长于限位条1,即浮动导向条9的远端91越过限位条1的远端,在其他实施方式中,浮动导向条9和限位条1也可以等长,或短于限位条1。
本实施例中各浮动导向条9等长,各限位条1也等长,在其他实施方式中,各浮动导向条9之间以及各限位条1之间也可以不等长。
在没有逻辑或技术矛盾的情况下,浮动导向条可以与前述的固定导向条、浮动限位条、固定限位条以各种方式配合使用,浮动导向条材质和截 面形状尺寸,可参照浮动限位条实施。
本发明实施例为以介入心脏瓣膜为植入体所作的描述,本领域技术人员可以理解的是本发明公开的输送装置除介入心脏瓣膜外还可以将其他植入体作为载体置入到身体的相应位置。
以上实施例的各技术特征可以进行任意的组合,为使描述简洁,未对上述实施例中的各个技术特征所有可能的组合都进行描述,然而,只要这些技术特征的组合不存在矛盾,都应当认为是本说明书记载的范围。
本领域的技术人员可以对本发明进行各种改动和变型而不脱离本发明的精神和范围。显然这些改动和变型均应属于本发明要求的保护范围保护内。此外,尽管本说明书中使用了一些特定的术语,但这些术语只是为了方便说明,并不对本发明构成任何特殊限制。

Claims (70)

  1. 一种便于回收控制的介入器械输送装置,包括装载组件以及滑动套设在装载组件外的外鞘管,其特征在于,所述装载组件中带有与介入器械连接部配合的定位部,在外鞘管与定位部之间还设有辅助限位件,该辅助限位件具有:
    锁定状态,辅助限位件在外鞘管的束缚下对介入器械连接部施加作用力、以阻止介入器械连接部脱离定位部;
    释锁状态,所述辅助限位件的作用力解除、容许介入器械连接部脱离定位部。
  2. 如权利要求1所述的便于回收控制的介入器械输送装置,其特征在于,所述辅助限位件在释锁状态下,外鞘管与定位部在外鞘管轴线上的投影区域相互错位。
  3. 如权利要求2所述的便于回收控制的介入器械输送装置,其特征在于,所述辅助限位件由锁定状态转入释锁状态时,外鞘管与定位部在外鞘管轴线上的投影区域也相应的由至少部分重叠转入相互错位。
  4. 如权利要求1所述的便于回收控制的介入器械输送装置,其特征在于,所述辅助限位件有多个,不同的辅助限位件同时或先后进入锁定状态。
  5. 如权利要求1所述的便于回收控制的介入器械输送装置,其特征在于,所述辅助限位件有多个,不同的辅助限位件同时或先后由锁定状态转入释放状态。
  6. 如权利要求1所述的便于回收控制的介入器械输送装置,其特征在于,相对于装载组件,所述外鞘管具有完全包裹介入器械的释放前状态、暴露部分介入器械的半释放状态以及完全暴露介入器械的释放状态;
    所述外鞘管处于释放前以及半释放状态下,所述辅助限位件均处于锁定状态;或仅在外鞘管处于半释放状态下,所述辅助限位件处在锁定状态。
  7. 如权利要求1所述的便于回收控制的介入器械输送装置,其特征在于,所述装载组件包括芯管组件,芯管组件上设有安装头,所述定位部处 在安装头的外周壁,所述辅助限位件仅在锁定状态提供作用力施加在介入器械连接部与定位部配合的部位。
  8. 如权利要求7所述的便于回收控制的介入器械输送装置,其特征在于,所述介入器械连接部的至少一部分为与所述定位部相配合的连接耳,锁定状态下,辅助限位件填充外鞘管与连接耳的径向间隙。
  9. 如权利要求7所述的便于回收控制的介入器械输送装置,其特征在于,所述安装头在装载组件中的相对位置是固定的。
  10. 如权利要求7所述的便于回收控制的介入器械输送装置,其特征在于,所述芯管组件的远端侧还设有引导头,引导头和安装头之间为用于容纳介入器械的介入器械安装位。
  11. 如权利要求8所述的便于回收控制的介入器械输送装置,其特征在于,锁定状态下,所述辅助限位件的径向外侧与外鞘管内壁贴靠,辅助限位件的径向内侧与所述连接耳贴靠。
  12. 如权利要求8所述的便于回收控制的介入器械输送装置,其特征在于,所述定位部具有容许连接耳改变径向位置的开放区,锁定状态下,所述辅助限位件阻挡在该开放区。
  13. 如权利要求12所述的便于回收控制的介入器械输送装置,其特征在于,锁定状态下,所述辅助限位件完全封闭或部分封闭开放区。
  14. 如权利要求7所述的便于回收控制的介入器械输送装置,其特征在于,介入器械连接部与定位部配合的部位设有在锁定状态下相互作用的轴向限位结构,且在释锁状态下容许介入器械相对定位部运动解除轴向限位。
  15. 如权利要求7所述的便于回收控制的介入器械输送装置,其特征在于,所述作用力至少具有径向分力,锁定状态下,该径向分力阻碍所述介入器械连接部向径外移动,加强所述介入器械连接部向内贴靠安装头。
  16. 如权利要求1所述的便于回收控制的介入器械输送装置,其特征在于,辅助限位件与介入器械连接部之间,在轴向上自由滑动配合。
  17. 如权利要求1所述的便于回收控制的介入器械输送装置,其特征 在于,锁定状态下,在辅助限位件与介入器械连接部的接触部位处,所述辅助限位件均处在介入器械径向的外部。
  18. 如权利要求1所述的便于回收控制的介入器械输送装置,其特征在于,所述辅助限位件与定位部数量相同,且周向位置一一对应。
  19. 如权利要求1所述的便于回收控制的介入器械输送装置,其特征在于,所述辅助限位件与介入器械连接部配合的部位处具有光滑表面和/或具有润滑涂层。
  20. 如权利要求19所述的便于回收控制的介入器械输送装置,其特征在于,所述辅助限位件为聚四氟乙烯材料。
  21. 如权利要求1所述的便于回收控制的介入器械输送装置,其特征在于,锁定状态下,辅助限位件仅接触介入器械连接部的外周。
  22. 如权利要求8所述的便于回收控制的介入器械输送装置,其特征在于,所述辅助限位件为与装载组件相连的浮动限位条,浮动限位条受外鞘管包束提供向介入器械施加的作用力。
  23. 如权利要求22所述的便于回收控制的介入器械输送装置,其特征在于,浮动限位条的近端与装载组件相连,浮动限位条的远端相对装载组件浮动设置。
  24. 如权利要求22所述的便于回收控制的介入器械输送装置,其特征在于,所述定位部为定位凸头或定位槽,锁定状态下,连接耳套设在定位凸头上或嵌装在相应的定位槽内,锁定状态下,所述浮动限位条叠压在连接耳上以保持连接耳与定位部之间的配合。
  25. 如权利要求24所述的便于回收控制的介入器械输送装置,其特征在于,所述定位部为定位槽,锁定状态下,所述浮动限位条与定位槽配合的部位处,径向部分或全部沉入定位槽内。
  26. 如权利要求25所述的便于回收控制的介入器械输送装置,其特征在于,所述浮动限位条与定位槽配合的部位处,浮动限位条的径向厚度不小于浮动限位条未与定位槽配合的部位处。
  27. 如权利要求24所述的便于回收控制的介入器械输送装置,其特征 在于,所述定位槽轴向贯通所述安装头。
  28. 如权利要求27所述的便于回收控制的介入器械输送装置,其特征在于,锁定状态下,所述定位槽的轴向贯通区域被浮动限位条所封闭。
  29. 如权利要求22所述的便于回收控制的介入器械输送装置,其特征在于,所述浮动限位条在周向上与所述定位部至少存在一部分重叠区域。
  30. 如权利要求22所述的便于回收控制的介入器械输送装置,其特征在于,所述定位部为定位凸头,锁定状态下,所述浮动限位条与定位凸头配合的部位处的径向厚度,不大于浮动限位条未与定位凸头配合的部位处。
  31. 如权利要求30所述的便于回收控制的介入器械输送装置,其特征在于,所述浮动限位条与定位凸头配合的部位处为镂空或凹陷。
  32. 如权利要求1所述的便于回收控制的介入器械输送装置,其特征在于,还设有位于外鞘管内壁且沿轴向延伸的固定导向条,外鞘管在释放前状态下,固定导向条的位置与介入器械位置相应。
  33. 如权利要求32所述的便于回收控制的介入器械输送装置,其特征在于,所述固定导向条与辅助限位件沿周向交替布置。
  34. 如权利要求22所述的便于回收控制的介入器械输送装置,其特征在于,所述浮动限位条在失去外鞘管束缚状态下,通过局部或整体形变的方式改变径向位置,容许介入器械连接部径向向外运动脱离定位部。
  35. 如权利要求34所述的便于回收控制的介入器械输送装置,其特征在于,所述浮动限位条的至少一部分为可形变结构,该可形变结构采用弹性材料和/或铰链机构。
  36. 如权利要求22所述的便于回收控制的介入器械输送装置,其特征在于,所述浮动限位条的近端与以下各处中的至少一处固定连接:
    a)固定连接在所述安装头上;
    b)固定连接在所述芯管组件上,且处在所述安装头的近端侧。
  37. 如权利要求22所述的便于回收控制的介入器械输送装置,其特征在于,所述浮动限位条在周向上间隔布置多个,多个浮动限位条的近端侧 连接为一固定环,该固定环与芯管组件和安装头中的至少一者相固定。
  38. 如权利要求24所述的便于回收控制的介入器械输送装置,其特征在于,所述浮动限位条的远端至少延伸至与所述连接耳相应的位置。
  39. 如权利要求22所述的便于回收控制的介入器械输送装置,其特征在于,所述浮动限位条的最远端与安装头最远端对齐或不超过安装头最远端或略超过安装头最远端。
  40. 如权利要求25所述的便于回收控制的介入器械输送装置,其特征在于,所述浮动限位条沉入定位槽的部分,在径向上向内接触或抵紧连接耳。
  41. 如权利要求22所述的便于回收控制的介入器械输送装置,其特征在于,锁定状态下,所述浮动限位条在径向上与安装头的外壁等高或高于安装头的外壁。
  42. 如权利要求22所述的便于回收控制的介入器械输送装置,其特征在于,所述定位部具有容许连接耳改变径向位置的开放区,锁定状态下,所述浮动限位条阻挡在该开放区。
  43. 如权利要求22所述的便于回收控制的介入器械输送装置,其特征在于,所述浮动限位条与连接耳配合的部位处等宽或不等宽延伸;所述浮动限位条与连接耳配合的部位处等厚或不等厚延伸。
  44. 如权利要求22所述的便于回收控制的介入器械输送装置,其特征在于,所述浮动限位条的末端为圆头结构。
  45. 如权利要求22所述的便于回收控制的介入器械输送装置,其特征在于,各浮动限位条等长或不等长。
  46. 如权利要求22所述的便于回收控制的介入器械输送装置,其特征在于,各浮动限位条的远端位置不完全相同;其中至少一浮动限位条的远端延伸至与安装头的远端侧相平齐;至少一浮动限位条的远端延伸至介入器械安装位的远端侧。
  47. 如权利要求22所述的便于回收控制的介入器械输送装置,其特征在于,所述浮动限位条为实心的扁条状。
  48. 如权利要求22所述的便于回收控制的介入器械输送装置,其特征在于,所述浮动限位条的尺寸为:长度10mm-80mm,宽度1-2mm,厚度0.2-0.5mm。
  49. 如权利要求7所述的便于回收控制的介入器械输送装置,其特征在于,所述辅助限位件为沿轴向延伸的固定限位条,固定限位条的至少一部分相对于外鞘管固定连接。
  50. 如权利要求49所述的便于回收控制的介入器械输送装置,其特征在于,所述固定限位条贴覆固定在外鞘管的内壁,与外鞘管之间为分体固定方式或一体结构方式。
  51. 如权利要求49所述的便于回收控制的介入器械输送装置,其特征在于,从锁定状态起,所述固定限位条随外鞘管进一步回撤至与介入器械轴向分离时,进入释锁状态。
  52. 如权利要求49所述的便于回收控制的介入器械输送装置,其特征在于,所述固定限位条采用轴向滑动的方式改变轴向位置。
  53. 如权利要求49所述的便于回收控制的介入器械输送装置,其特征在于,所述固定限位条为多个,各固定限位条与介入器械之间的轴向分离顺序为同步或不同步。
  54. 如权利要求49所述的便于回收控制的介入器械输送装置,其特征在于,所述固定限位条固定连接在外鞘管的远端,且在外鞘管处于释放前状态下,固定限位条避让所述定位部。
  55. 如权利要求54所述的便于回收控制的介入器械输送装置,其特征在于,所述固定限位条固定连接在外鞘管的远端,且在外鞘管处于半释放状态下固定限位条进入锁定状态;
    从锁定状态起,固定限位条随外鞘管进一步回撤至与介入器械轴向分离时,进入释锁状态。
  56. 如权利要求49所述的便于回收控制的介入器械输送装置,其特征在于,介入器械连接部的至少一部分为与所述定位部相配合的连接耳,所述定位部为定位凸头或定位槽,锁定状态下,连接耳套设在定位凸头上或 嵌装在相应的定位槽内,锁定状态下,所述固定限位条叠压在连接耳上以保持连接耳与定位部之间的配合。
  57. 如权利要求56所述的便于回收控制的介入器械输送装置,其特征在于,所述定位部为定位槽,锁定状态下,所述固定限位条与定位槽配合的部位处,径向部分或全部沉入定位槽内。
  58. 如权利要求57所述的便于回收控制的介入器械输送装置,其特征在于,所述定位槽轴向贯通所述安装头,锁定状态下,所述定位槽的轴向贯通区域被固定限位条所封闭。
  59. 如权利要求49所述的便于回收控制的介入器械输送装置,其特征在于,所述固定限位条为多条,各固定限位条远端邻近外鞘管的远端,或与外鞘管的远端平齐。
  60. 如权利要求49所述的便于回收控制的介入器械输送装置,其特征在于,所述固定限位条为多条,各固定限位条近端相互平齐或轴向位置交错分布。
  61. 如权利要求1所述的便于回收控制的介入器械输送装置,其特征在于,还设有位于外鞘管内壁且沿轴向延伸的固定导向条,外鞘管在释放前状态下,固定导向条叠压在介入器械的外周。
  62. 如权利要求61所述的便于回收控制的介入器械输送装置,其特征在于,所述辅助限位件的远端与固定导向条的远端侧的轴向位置相同或交错布置。
  63. 如权利要求61所述的便于回收控制的介入器械输送装置,其特征在于,所述固定导向条为等长的3根,且均为长条状结构。
  64. 如权利要求61所述的便于回收控制的介入器械输送装置,其特征在于,所述固定导向条为实心的扁条状。
  65. 如权利要求61所述的便于回收控制的介入器械输送装置,其特征在于,所述固定导向条的尺寸为:长度10mm-80mm,宽度1-2mm,厚度0.2-0.5mm。
  66. 如权利要求61所述的便于回收控制的介入器械输送装置,其特征 在于,所述固定导向条与介入器械配合的部位具有光滑表面和/或具有润滑涂层。
  67. 如权利要求1所述的便于回收控制的介入器械输送装置,其特征在于,在所述外鞘管与装载组件之间还设有浮动导向条,所述浮动导向条的近端与装载组件相连,所述浮动导向条的远端相对装载组件浮动设置。
  68. 如权利要求67所述的便于回收控制的介入器械输送装置,其特征在于,所述装载组件包括芯管组件,芯管组件上设有安装头,所述定位部处在安装头的外周壁,所述浮动导向条的近端与以下各处中的至少一处固定连接:
    a)固定连接在所述安装头上;
    b)固定连接在所述芯管组件上,且处在所述安装头的近端侧。
  69. 如权利要求68所述的便于回收控制的介入器械输送装置,其特征在于,外鞘管在释放前状态下,浮动导向条叠压在介入器械的外周,浮动导向条与辅助限位件沿周向交替布置。
  70. 如权利要求67所述的便于回收控制的介入器械输送装置,其特征在于,所述芯管组件的远端带有引导头,所述浮动导向条的远端延伸至引导头部位。
PCT/CN2018/111565 2017-10-24 2018-10-24 一种便于回收控制的介入器械输送装置 WO2019080854A1 (zh)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN201890001318.3U CN216318209U (zh) 2017-10-24 2018-10-24 一种便于回收控制的介入器械输送装置

Applications Claiming Priority (6)

Application Number Priority Date Filing Date Title
CN201710999545 2017-10-24
CN201710999545.1 2017-10-24
CN201810509283.0A CN108371571B (zh) 2017-10-24 2018-05-24 一种便于操控的介入心脏瓣膜的输送系统
CN201810509283.0 2018-05-24
CN201810940914 2018-08-17
CN201810940914.4 2018-08-17

Publications (1)

Publication Number Publication Date
WO2019080854A1 true WO2019080854A1 (zh) 2019-05-02

Family

ID=66246184

Family Applications (4)

Application Number Title Priority Date Filing Date
PCT/CN2018/111573 WO2019080857A1 (zh) 2017-10-24 2018-10-24 一种便于控制的介入器械输送装置
PCT/CN2018/111567 WO2019080855A1 (zh) 2017-10-24 2018-10-24 一种便于回收的介入器械输送装置以及介入器械输送方法
PCT/CN2018/111569 WO2019080856A1 (zh) 2017-10-24 2018-10-24 一种便于控制的介入器械输送装置以及介入器械输送方法
PCT/CN2018/111565 WO2019080854A1 (zh) 2017-10-24 2018-10-24 一种便于回收控制的介入器械输送装置

Family Applications Before (3)

Application Number Title Priority Date Filing Date
PCT/CN2018/111573 WO2019080857A1 (zh) 2017-10-24 2018-10-24 一种便于控制的介入器械输送装置
PCT/CN2018/111567 WO2019080855A1 (zh) 2017-10-24 2018-10-24 一种便于回收的介入器械输送装置以及介入器械输送方法
PCT/CN2018/111569 WO2019080856A1 (zh) 2017-10-24 2018-10-24 一种便于控制的介入器械输送装置以及介入器械输送方法

Country Status (7)

Country Link
US (2) US11406499B2 (zh)
EP (1) EP3701910A4 (zh)
JP (1) JP7189950B2 (zh)
CN (5) CN214073757U (zh)
BR (1) BR112020008158A2 (zh)
CA (1) CA3097180A1 (zh)
WO (4) WO2019080857A1 (zh)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN116172756A (zh) * 2022-12-20 2023-05-30 杭州启明医疗器械股份有限公司 带释放位置提示的介入器械输送系统

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN116965975A (zh) * 2017-10-24 2023-10-31 杭州启明医疗器械股份有限公司 一种人工心脏瓣膜输送系统
KR102543906B1 (ko) * 2021-07-01 2023-06-16 (재)예수병원유지재단 스텐트 림커버 캡처 기구

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5683451A (en) * 1994-06-08 1997-11-04 Cardiovascular Concepts, Inc. Apparatus and methods for deployment release of intraluminal prostheses
CN101953725A (zh) * 2010-04-19 2011-01-26 杭州启明医疗器械有限公司 人造瓣膜置换装置及支架
CN102258402A (zh) * 2010-05-25 2011-11-30 微创医疗器械(上海)有限公司 一种心脏瓣膜输送系统及其输送装置
CN102961198A (zh) * 2012-10-31 2013-03-13 普霖医疗科技(广州)有限公司 一种覆膜支架输送器及其输送方法
CN204814284U (zh) * 2015-07-27 2015-12-02 上海纽脉医疗科技有限公司 一种人工心脏瓣膜输送装置
CN207871029U (zh) * 2017-10-24 2018-09-18 杭州启明医疗器械有限公司 一种介入心脏瓣膜的可调弯输送系统
CN108652791A (zh) * 2017-10-24 2018-10-16 杭州启明医疗器械有限公司 一种介入心脏瓣膜可重复定位的输送装置

Family Cites Families (21)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7815670B2 (en) * 2006-07-11 2010-10-19 Boston Scientific Scimed, Inc. Method of loading a medical endoprosthesis through the side wall of an elongate member
US8192351B2 (en) * 2007-08-13 2012-06-05 Paracor Medical, Inc. Medical device delivery system having integrated introducer
CN102076281B (zh) * 2008-06-30 2014-11-05 波顿医疗公司 用于腹主动脉瘤的系统和方法
US8137398B2 (en) * 2008-10-13 2012-03-20 Medtronic Ventor Technologies Ltd Prosthetic valve having tapered tip when compressed for delivery
US8876892B2 (en) * 2010-04-21 2014-11-04 Medtronic, Inc. Prosthetic heart valve delivery system with spacing
US9629719B2 (en) * 2010-04-23 2017-04-25 Medtronic, Inc. Delivery systems and methods of implantation for prosthetic heart valves
US9561102B2 (en) * 2010-06-02 2017-02-07 Medtronic, Inc. Transcatheter delivery system and method with controlled expansion and contraction of prosthetic heart valve
JP5664040B2 (ja) 2010-09-08 2015-02-04 株式会社カネカ ステントデリバリーカテーテル、アウターシャフトの製造方法、および、ステントデリバリーカテーテルの製造方法
US20120095542A1 (en) * 2010-10-15 2012-04-19 Cook Incorporated Intraluminal medical device
WO2014011888A1 (en) * 2012-07-12 2014-01-16 Boston Scientific Scimed, Inc. Low profile heart valve delivery system and method
CN102764165B (zh) * 2012-08-13 2015-01-07 宁波健世生物科技有限公司 经皮主动脉或主动脉瓣膜支架输送系统
US9649212B2 (en) 2012-08-30 2017-05-16 Biotronik Ag Release device for releasing a medical implant from a catheter and catheter comprising a release device
CN103190968B (zh) * 2013-03-18 2015-06-17 杭州启明医疗器械有限公司 一种支架以及具有该支架的安装稳固的人造瓣膜置换装置
CN106170269B (zh) * 2014-02-21 2019-01-11 爱德华兹生命科学卡迪尔克有限责任公司 用于瓣膜替代品的受控部署的递送装置
CN104055604B (zh) * 2014-07-07 2016-06-01 宁波健世生物科技有限公司 一种带锚定装置的心脏瓣膜植入器械
EP3738551A1 (en) * 2015-05-14 2020-11-18 Edwards Lifesciences Corporation Heart valve sealing devices and delivery devices therefor
CN106333774B (zh) * 2015-07-14 2019-05-31 先健科技(深圳)有限公司 管腔支架输送系统
US10265169B2 (en) * 2015-11-23 2019-04-23 Edwards Lifesciences Corporation Apparatus for controlled heart valve delivery
EP3644902B1 (en) 2017-06-30 2024-05-22 Edwards Lifesciences Corporation Lock and release mechanisms for trans-catheter implantable devices
CN108371571B (zh) * 2017-10-24 2019-11-05 杭州启明医疗器械股份有限公司 一种便于操控的介入心脏瓣膜的输送系统
CN108371570B (zh) * 2017-10-24 2023-10-31 杭州启明医疗器械股份有限公司 一种操作稳定的介入心脏瓣膜可回收输送系统

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5683451A (en) * 1994-06-08 1997-11-04 Cardiovascular Concepts, Inc. Apparatus and methods for deployment release of intraluminal prostheses
CN101953725A (zh) * 2010-04-19 2011-01-26 杭州启明医疗器械有限公司 人造瓣膜置换装置及支架
CN102258402A (zh) * 2010-05-25 2011-11-30 微创医疗器械(上海)有限公司 一种心脏瓣膜输送系统及其输送装置
CN102961198A (zh) * 2012-10-31 2013-03-13 普霖医疗科技(广州)有限公司 一种覆膜支架输送器及其输送方法
CN204814284U (zh) * 2015-07-27 2015-12-02 上海纽脉医疗科技有限公司 一种人工心脏瓣膜输送装置
CN207871029U (zh) * 2017-10-24 2018-09-18 杭州启明医疗器械有限公司 一种介入心脏瓣膜的可调弯输送系统
CN108652791A (zh) * 2017-10-24 2018-10-16 杭州启明医疗器械有限公司 一种介入心脏瓣膜可重复定位的输送装置

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN116172756A (zh) * 2022-12-20 2023-05-30 杭州启明医疗器械股份有限公司 带释放位置提示的介入器械输送系统
CN116172756B (zh) * 2022-12-20 2023-10-31 杭州启明医疗器械股份有限公司 带释放位置提示的介入器械输送系统

Also Published As

Publication number Publication date
US20220362019A1 (en) 2022-11-17
WO2019080856A1 (zh) 2019-05-02
CN116725741A (zh) 2023-09-12
JP2021500190A (ja) 2021-01-07
WO2019080855A1 (zh) 2019-05-02
EP3701910A4 (en) 2021-08-11
BR112020008158A2 (pt) 2020-11-03
CN214073757U (zh) 2021-08-31
CN111655197B (zh) 2023-07-04
WO2019080857A1 (zh) 2019-05-02
CN214484739U (zh) 2021-10-26
CN216318209U (zh) 2022-04-19
EP3701910A1 (en) 2020-09-02
US11406499B2 (en) 2022-08-09
CA3097180A1 (en) 2019-05-02
US20200315796A1 (en) 2020-10-08
JP7189950B2 (ja) 2022-12-14
CN111655197A (zh) 2020-09-11

Similar Documents

Publication Publication Date Title
CN108378960B (zh) 一种介入心脏瓣膜的可调弯输送系统
CN108371570B (zh) 一种操作稳定的介入心脏瓣膜可回收输送系统
EP2152339B1 (en) Cannula insertion devices, systems, and methods including a compressible member
WO2019080854A1 (zh) 一种便于回收控制的介入器械输送装置
US8747448B2 (en) Stent graft delivery system
US20160051800A1 (en) Vascular conduit device and system for implanting
US20230050824A1 (en) Device for securing heart valve leaflets
US6860876B2 (en) Versatile interventional coronary guiding catheter
US8911454B2 (en) Suturing device
CN209770591U (zh) 一种可重复定位的介入器械输送装置
CN108652791B (zh) 一种介入心脏瓣膜可重复定位的输送装置
CN109692057B (zh) 一种便于回收控制的介入器械输送装置
CN218922889U (zh) 用于心脏瓣环修复的植入物和植入物的输送装置
WO2023029726A1 (zh) 具有穿线环的锚定组件、植入物及经导管缩环系统
CN214414866U (zh) 内窥镜用多发处理装置
JP2018537168A (ja) 外科クリップ及びその留置制御
CN117281663A (zh) 瓣膜夹合装置及瓣膜修复系统
JPWO2019188741A1 (ja) カテーテル組立体

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 18871130

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 18871130

Country of ref document: EP

Kind code of ref document: A1