WO2020155978A1 - 球囊导管及电生理系统 - Google Patents

球囊导管及电生理系统 Download PDF

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Publication number
WO2020155978A1
WO2020155978A1 PCT/CN2019/129030 CN2019129030W WO2020155978A1 WO 2020155978 A1 WO2020155978 A1 WO 2020155978A1 CN 2019129030 W CN2019129030 W CN 2019129030W WO 2020155978 A1 WO2020155978 A1 WO 2020155978A1
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WIPO (PCT)
Prior art keywords
balloon
layer
double
temperature measuring
measuring element
Prior art date
Application number
PCT/CN2019/129030
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English (en)
French (fr)
Inventor
赵乾成
梁波
奚云珠
蒋佳强
孙毅勇
Original Assignee
上海微创电生理医疗科技股份有限公司
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.)
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Priority claimed from CN201910182459.0A external-priority patent/CN109646106B/zh
Application filed by 上海微创电生理医疗科技股份有限公司 filed Critical 上海微创电生理医疗科技股份有限公司
Priority to US17/427,497 priority Critical patent/US20220008111A1/en
Priority to EP19912505.5A priority patent/EP3919011A4/en
Publication of WO2020155978A1 publication Critical patent/WO2020155978A1/zh

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00214Expandable means emitting energy, e.g. by elements carried thereon
    • A61B2018/0022Balloons
    • A61B2018/0025Multiple balloons
    • A61B2018/00255Multiple balloons arranged one inside another
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345Vascular system
    • A61B2018/00351Heart
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577Ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00642Sensing and controlling the application of energy with feedback, i.e. closed loop control
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00696Controlled or regulated parameters
    • A61B2018/00714Temperature
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00791Temperature
    • A61B2018/00797Temperature measured by multiple temperature sensors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00791Temperature
    • A61B2018/00815Temperature measured by a thermistor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00791Temperature
    • A61B2018/00821Temperature measured by a thermocouple
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A61B2018/0212Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques using an instrument inserted into a body lumen, e.g. catheter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A61B2018/0231Characteristics of handpieces or probes
    • A61B2018/0262Characteristics of handpieces or probes using a circulating cryogenic fluid
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M2025/1043Balloon catheters with special features or adapted for special applications
    • A61M2025/1075Balloon catheters with special features or adapted for special applications having a balloon composed of several layers, e.g. by coating or embedding

Definitions

  • the invention relates to the technical field of medical devices, in particular to a balloon catheter and an electrophysiological system.
  • Atrial fibrillation patients with atrial fibrillation have a high risk of stroke.
  • atrial fibrillation occurs, the atrium beats irregularly and quickly, and the contraction function is lost.
  • the blood is prone to stagnate in the atrium to form a thrombus.
  • the thrombus falls off and enters the brain with the artery. Stroke.
  • the interventional catheter is used to apply energy to the pulmonary vein for ablation, thereby isolating the pulmonary vein potential and achieving the therapeutic effect.
  • Hypertension has the characteristics of high incidence, low awareness and great harm. Experimental data has proved that hypertension is related to the high excitability of the patient's renal sympathetic nerves. Blocking renal sympathetic nerve by ablation can not only lower blood pressure, but also affect chronic organ-specific diseases caused by excessive activation of sympathetic nerve.
  • Cryoballoon ablation can be used for ablation.
  • Cryo-balloon ablation is based on anatomical considerations, using the contact between the balloon and the tissue for freezing, and has the characteristics of one-time and continuous.
  • a cryoablation balloon catheter is used, a balloon is arranged at the distal end of the catheter, and a freezing device is connected to the proximal end.
  • the surgeon places the cryoablation balloon catheter percutaneously into the heart cavity, reaches the pulmonary vein opening, and fills the balloon, adjusts the outer wall of the balloon to contact the myocardial tissue, and then enters the fluid into the cryoablation balloon catheter
  • the tube sprays the frozen liquid directly to the inner surface of the balloon, and the frozen liquid is quickly vaporized and absorbed heat under the influence of the heat conduction of the myocardial temperature, so that the myocardial tissue in contact with the balloon is cooled to produce cryoablation.
  • myocardial tissue can form an effective ablation focus only when the low temperature reaches a sufficient time.
  • the cryoablation balloon catheter is equipped with a temperature measuring element, and the temperature measuring element is placed in the middle of the balloon to monitor the ball
  • the internal temperature of the balloon is then used to estimate the temperature of the balloon surface.
  • the prior art has tried to set a temperature measuring element on the surface of the balloon to monitor the temperature of the balloon surface, but this requires high operability. However, there is no effective method in the prior art to integrate the temperature measuring element. Fixing on the surface of the balloon can prevent the expansion and contraction of the balloon from being affected.
  • the purpose of the present invention is to provide a balloon catheter and an electrophysiological system.
  • the temperature measuring element By arranging the temperature measuring element in the interlayer of the double-layer balloon, the measurement accuracy of the balloon surface temperature is improved. Attached to the inner balloon or outer balloon to ensure that the temperature measuring element will not be displaced during normal ablation, and the adsorption member and the temperature measuring element can also be displaced relative to the balloon as the balloon deforms, thereby avoiding The balloon is restrained when it expands and contracts, thereby improving the operability of detecting temperature on the balloon surface.
  • a balloon catheter provided by the present invention includes:
  • At least one temperature measuring element arranged in the space between the inner layer balloon and the outer layer balloon;
  • At least one adsorbent is not only connected to the temperature measuring element, but also to the inner layer balloon or the outer layer balloon, so that the temperature measuring element is attached to the inner layer balloon or The outer balloon;
  • the adsorption member when the double-layer balloon is deformed, can be displaced relative to the inner layer balloon or the outer layer balloon connected to the adsorption member, and the temperature measuring element is also It can be displaced relative to the inner layer balloon or the outer layer balloon connected to the adsorbent.
  • the adsorption member is a physical adsorption member, which is connected to the temperature measurement element in a physical adsorption manner, so that the temperature measurement element is relative to the adsorption member when the double-layer balloon is deformed. Displacement occurs, and at the same time, the adsorption member is also connected to the inner balloon or the outer balloon in a physical adsorption manner, so that the adsorption member can be relative to the inner balloon or the outer balloon when the double-layer balloon is deformed.
  • the inner layer balloon or the outer layer balloon connected with the adsorbing member is displaced, and the temperature measuring element can also be relative to the inner layer balloon or the outer layer balloon connected with the adsorbing member.
  • the capsule is displaced.
  • the maximum displacement of the adsorbent relative to the inner balloon or the outer balloon connected to the adsorbent does not exceed the total displacement after expansion. 15% of the outer diameter of the double-layer balloon.
  • the adsorption member includes a base layer and a physical adsorption layer provided on the base layer;
  • a part of the physical adsorption layer is physically adsorbed to the temperature measuring element, another part of the physical adsorption layer is physically adsorbed to one of the inner balloon and the outer balloon, and the base layer is used for Prevent the other of the inner layer balloon and the outer layer balloon from being adsorbed with the physical adsorption layer.
  • the material of the physical adsorption layer is a soft jelly whose performance state remains unchanged before and after use.
  • the material of the physical adsorption layer is silica gel or hydrogel
  • the base layer is a membrane made of a polymer material, and one surface of the membrane is coated with the physical adsorption layer.
  • At least one end of the adsorption member is fixed to one end of the double-layer balloon.
  • one end of the adsorption member is fixed to the proximal end of the double-layer balloon, and the other end of the adsorption member is fixed to the distal end of the double-layer balloon; and the adsorption member is located on the double-layer balloon.
  • the part between the proximal end and the distal end of the layer balloon is in adsorption connection with the temperature measuring element, and is also in adsorption connection with the inner layer balloon or the outer layer balloon;
  • the length of the adsorption member is greater than the length of the unilateral contour line from the proximal end to the distal end of the expanded double-layer balloon.
  • the width of the adsorption member is greater than or equal to the maximum width of the temperature measurement element, so that the temperature measurement element is not exposed outside the adsorption member in its width direction.
  • the adsorption member extends from one end of the temperature measurement element to the other end of the temperature measurement element, so as to attach the entire temperature measurement element to the inner layer balloon or the outer layer ball bag.
  • the thickness of the suction member is less than 100 microns, and the width of the suction member ranges from 0.2 mm to 3.0 mm.
  • the temperature measuring element includes opposite ends and a main body located between the opposite ends;
  • At least one end of the temperature measuring element is fixed to one end of the double-layer balloon, and at least a part of the main body of the temperature measuring element is attached to the inner balloon or The outer balloon.
  • At least a part of the main body portion is attached to the inner balloon or the outer balloon through a plurality of the adsorbents.
  • thermometers there are a plurality of the temperature measuring elements, which are distributed at different positions in the space between the inner layer balloon and the outer layer balloon.
  • the temperature measuring element is a linear temperature sensor, at least one end of the linear temperature sensor is fixed to one end of the double-layer balloon, and the linear temperature sensor is along The double-layer balloon is arranged in the direction from the proximal end to the distal end.
  • the adsorption member extends from the proximal end of the double-layer balloon to the distal end of the double-layer balloon to attach the entire linear temperature sensor to the inner balloon Or the outer balloon.
  • the suction member is elongated.
  • the parts of the temperature measuring element located at the proximal and distal ends of the double-layer balloon are in an untensioned state, and the temperature measuring element
  • the expanded length is greater than the length of the unilateral contour line from the proximal end to the distal end of the expanded double-layer balloon.
  • the linear temperature sensor is a thermocouple temperature sensor or a thermal resistance temperature sensor.
  • the temperature measurement element includes a first wire, a second wire, and a temperature measurement module, the first wire and the second wire are connected, and the measurement is provided between the first wire and the second wire.
  • a temperature module, the temperature measurement module is used to convert temperature information into electrical information, and the first wire and the second wire are used to transmit the electrical information;
  • the temperature measurement module is attached to the inner balloon or the outer balloon through the adsorbent, and/or, at least one of the first wire and the second wire Part of the section is attached to the inner layer balloon or the outer layer balloon through the adsorbent.
  • the catheter body includes an outer tube and a core rod arranged in the outer tube, the distal end of the core rod extends out of the outer tube; the distal end of the double-layer balloon and the core rod The rod is connected, and the proximal end of the double-layer balloon is connected with the outer tube.
  • the catheter body further includes a fluid delivery tube, which is arranged between the core rod and the outer tube, and the fluid delivery tube is further provided with a fluid ejection port facing the surface of the inner balloon, It is used to inject frozen fluid into the inner layer balloon, and the fluid ejection port is located in the hemisphere of the double-layer balloon near the distal end of the double-layer balloon.
  • the present invention provides an electrophysiological system, comprising any one of the balloon catheter, ablation energy output device and control device, the ablation energy output device is connected with the balloon catheter, The ablation medium is provided to the balloon catheter; the control device is used for controlling the ablation energy output device to adjust the temperature of the ablation medium according to the temperature information detected by the temperature measuring element, so that the double-layer ball The temperature of the capsule surface is within the preset ablation temperature range.
  • the balloon catheter and electrophysiological system provided by the present invention have the following advantages:
  • the balloon catheter of the present invention includes a double-layer balloon, and the double-layer balloon has a sandwich.
  • at least A temperature measuring element therefore, during actual ablation, more accurate temperature information of the lesion can be obtained through the temperature measuring element, thereby improving the ablation effect.
  • the balloon catheter of the present invention uses an adsorbent to attach the temperature measuring element to the surface of the balloon.
  • the adsorption capacity of the adsorbent makes the double-layer balloon When the balloon expands or contracts, the adsorbent can be displaced relative to the balloon along with the deformation of the balloon surface material, and because the temperature measuring element is attached to the inner balloon or the outer balloon through the adsorbent, It also enables the temperature measuring element to be displaced relative to the balloon or the adsorbent, so that the temperature measuring element can better comply with the expansion or contraction of the balloon, and will not affect the expansion and contraction of the balloon, thereby ensuring The effectiveness and operability of balloon surface temperature monitoring.
  • the double-layer balloon can shrink uniformly, the diameter of the double-layer balloon passing through the outer sheath after contraction is also reduced; at the same time, because the balloon can expand uniformly, the double-layer balloon can It forms good contact with the target tissue, so that the temperature measuring element can obtain the temperature information of the lesion more accurately and improve the ablation effect.
  • the adsorption member of the present invention is preferably a physical adsorption member, so that the temperature measuring element is physically adsorbed to the surface of the balloon through the physical adsorption layer, and the physical adsorption will not produce substances harmful to the balloon, making the balloon The strength will not be affected, ensuring the safety during balloon surgery, and the physical adsorption is surface-to-surface contact adsorption. Compared with local dispensing and fixation, the contact area is large, and it is not easy to cause the temperature measuring element to fall off, ensuring the intraoperative Reliability of temperature measurement.
  • the maximum displacement of the adsorbent relative to the double-layer balloon is preferably not more than 15% of the outer diameter of the double-layer balloon after expansion, so as to prevent adsorption Excessive displacement of the parts and temperature measurement elements relative to the balloon ultimately ensures the effectiveness of balloon surface temperature monitoring. More preferably, at least one end of the adsorption member is preferably fixed to one end of the double-layer balloon, so as to further prevent the adsorption member from generating large axial displacement.
  • the minimum width of the adsorption member is preferably greater than or equal to the maximum width of the temperature measurement element, so that the temperature measurement element is not exposed to the adsorption member in its width direction, thereby preventing the temperature measurement element from being separated
  • the adsorbent makes the temperature monitoring on the surface of the balloon more operability.
  • the temperature measuring elements are preferably multiple, and they are distributed in different positions in the sandwich of the double-layer balloon, so that the target tissue in contact with the balloon can be measured at multiple points, which can better confirm the ball The contact state between the capsule and the target tissue, thereby further improving the ablation effect.
  • the catheter body of the present invention also includes a fluid delivery tube, and the fluid delivery tube is provided with a fluid ejection port for ejecting frozen liquid into the inner balloon to achieve cryoablation, and the fluid ejection port is preferably It is located in the hemisphere of the double-layer balloon close to the distal end of the double-layer balloon, so that freezing energy can be used more efficiently and energy saving.
  • Figure 1 is a schematic diagram of the balloon being restrained during expansion in an embodiment of the present invention
  • Figure 2 is a front view of a balloon catheter in an embodiment of the present invention.
  • Figure 3 is a left side view of the balloon catheter shown in Figure 2;
  • Figure 4 is a schematic diagram of the distal end of the balloon catheter in an embodiment of the present invention.
  • Fig. 5 is a schematic diagram of a suction member in an embodiment of the present invention.
  • FIG. 6 is a schematic diagram of a temperature measuring element in an embodiment of the present invention, wherein the temperature measuring element is a thermocouple temperature sensor;
  • FIG. 7 is a schematic diagram of a temperature measuring element in an embodiment of the present invention, wherein the temperature measuring element is a thermistor temperature sensor;
  • Figure 8 is a working flow chart of the electrophysiological system in an embodiment of the present invention.
  • Figure 9 is a schematic diagram of cardiac ablation performed by the electrophysiological system in an embodiment of the present invention.
  • Fig. 10 is a schematic diagram of renal artery ablation performed by the electrophysiological system in an embodiment of the present invention.
  • FIG. 11 is a flowchart of cryoablation performed by the electrophysiological system in an embodiment of the present invention.
  • 100-Balloon catheter 110-Double-layer balloon; 111-Outer layer balloon; 112-Inner layer balloon; 113-Sandwich layer; 120-Temperature measuring element; 121-First wire; 122-Second wire; 123 -Temperature measurement module; 130-conduit body; 131-fluid conveying pipe fittings; 132-spiral structure; 133-outer pipe; 134-core rod; 135-soft head; 136-development mark; 140-adsorption part; 141-base layer; 142-physical adsorption layer; 150-control handle; 151-electrical input and output interface; 152-fluid input interface; 153-inner cavity interface;
  • the prior art has tried to install a temperature measuring element on the surface of the balloon to monitor the temperature of the balloon surface.
  • it has tried to install an optical fiber or a flexible printed sensor on the surface of the balloon. Poor performance, poor compliance with the balloon, and difficult to fix, and there are problems such as broken temperature measurement elements, uneven balloon expansion and contraction, etc. Therefore, the operability of setting temperature measurement elements on the balloon surface is not high .
  • the inventors tried to monitor the temperature of the balloon surface by installing a temperature measuring element between the interlayer of the double-layer balloon (here, the interlayer is the space sandwiched between the inner and outer balloon).
  • liquid glue is used to fix the temperature measuring element on the surface of the balloon.
  • the temperature measuring element and the balloon surface form a fixed connection at the glue bonding position, so that the balloon and the temperature measuring element cannot be displaced relative to each other, as shown in Figure 1, when the balloon is expanded Because of the poor ductility of the temperature measuring element 1 (usually composed of a sensor and a metal wire, or a flexible circuit board containing a sensor), the temperature measuring element 1 cannot comply with the expansion of the balloon 2. In this case, the temperature measurement The element 1 either restrains the balloon 2 and prevents the balloon 2 from expanding uniformly, thereby forming a depression on the surface of the balloon, for example, in the area enclosed by the dashed line, or drawing marks in the area enclosed by the dashed line, thereby causing damage to the balloon. It will reduce the accuracy of the temperature measurement of the balloon surface. Not only that, the temperature measuring element 1 is also prone to the risk of breakage, which will cause the temperature measuring element 1 to fail and affect ablation.
  • the glue is composed of a variety of chemical components.
  • the glue is cured to achieve adhesion to the substrate, but when the glue is cured, the chemical components will enter the surface of the bonded substrate.
  • the influence of the chemical composition on the substrate is negligible, but for a thin-walled substrate, such as a balloon with a thickness of 20-60 microns, if the chemical composition enters the balloon
  • the surface layer will affect the strength of the balloon and reduce the safety of balloon surgery.
  • the inventor has also tried to fix the temperature measuring element on the surface of the balloon by means of partial glue dispensing.
  • this method directly leads to a large thickness and high hardness of the balloon at the glue dispensing position, and the glue is incompatible with each other.
  • the balloon is tightly bonded to form a whole, which ultimately results in a large difference in strength between the area of the balloon without glue and the area of the balloon with glue, which will cause the balloon to deform during normal ablation (see Figure 1, that is In the balloon area of the glue, the balloon cannot expand normally, showing a collapsed state), affecting ablation.
  • uneven contraction will also occur (that is, the area of the balloon provided with glue will contract to form a raised skeleton), which will affect the delivery and recovery of the balloon.
  • the balloon will reach through the vein.
  • the outer sheath needs to be used as a channel, and uneven contraction will significantly increase the difficulty of passing the outer sheath.
  • the small contact area for local dispensing may easily cause the temperature measuring element to fall off or shift from the balloon, thereby affecting the reliability of the catheter during surgery.
  • the present invention provides a balloon catheter, which includes a catheter body, a double-layer balloon, at least one temperature measuring element, and at least one adsorbent; wherein, the catheter body includes an outer tube and is disposed on the outer tube.
  • the distal end of the core rod extends out of the outer tube;
  • the double-layer balloon is arranged at the distal end of the catheter body, and the double-layer balloon includes an inner layer balloon and a coating
  • the outer layer balloon of the inner layer balloon, the distal end of the double-layer balloon is connected with the core rod, and the proximal end of the double-layer balloon is connected with the outer tube;
  • the temperature measuring element is arranged In the interlayer formed by the inner layer balloon and the outer layer balloon; the adsorbent is not only connected to the temperature measuring element, but also connected to the inner layer balloon or the outer layer balloon.
  • the temperature measuring element is attached to the inner balloon or the outer balloon through the adsorption member.
  • the adsorbent can be displaced relative to the inner balloon or the outer balloon connected to the adsorbent, and make the measurement
  • the temperature element can also be displaced relative to the inner balloon or the outer balloon connected to the adsorbent.
  • the maximum displacement of the adsorption member and the temperature measuring element relative to the balloon is very small, and basically does not affect the temperature measurement, so the effectiveness of the balloon surface temperature monitoring can be ensured.
  • the temperature information of the outer surface of the double-layer balloon can be detected by the temperature measuring element in the interlayer of the double-layer balloon to obtain more accurate temperature information of the lesion, thereby improving the ablation effect.
  • the temperature measuring element is attached to the surface of the balloon by the adsorbent.
  • the balloon when the balloon is not deformed, it can ensure that the temperature measuring element and the balloon remain relatively static; on the other hand, when the balloon is deformed, the adsorbent can A certain amount of displacement is generated relative to the balloon connected to it, so that the temperature measuring element can also generate a certain amount of displacement relative to the balloon, so that the temperature measuring element can better comply with the expansion and contraction of the balloon, and avoid This solves the problem of uneven expansion or contraction of the balloon due to restraint, and ultimately improves the operability of balloon surface temperature monitoring, and also improves the reliability of balloon surface temperature monitoring. Not only that, the balloon shrinks uniformly. The diameter of the balloon catheter passing through the outer sheath tube is also reduced, thereby facilitating the realization of interventional surgery and improving the success rate of surgery.
  • proximal and distal refer to the relative position, relative position, and direction of components or actions relative to each other from the perspective of the doctor using the product, although “proximal” and “distal” are not limiting sexual, but “proximal” usually refers to the end of the product that is close to the doctor during normal operation, while “distal” usually refers to the end that first enters the patient's body.
  • proximal usually refers to the end of the product that is close to the doctor during normal operation
  • distal usually refers to the end that first enters the patient's body.
  • the singular forms “a”, “an” and “the” include plural referents unless the content clearly dictates otherwise.
  • the term “or” is generally used in the meaning including “and/or”, unless the content clearly dictates otherwise.
  • the term “circumferential” generally refers to the direction around the axis of the double-layer balloon.
  • an embodiment of the present invention provides a balloon catheter 100, including: a double-layer balloon 110, a temperature measuring element 120, a catheter body 130, and an adsorbent 140; the double-layer balloon 110 is disposed on the catheter The distal end of the body 130 and a part of the catheter body 130 are located in the double-layer balloon 110 for ejecting an ablation medium to the double-layer balloon 110.
  • the ablation medium here includes, but is not limited to, frozen liquid.
  • the catheter body 130 specifically includes an outer tube 133 and a core rod 134, the core rod 134 is arranged in the outer tube 133, and the distal end of the core rod 134 extends out of the outer tube 133 and is connected to the distal end of the double-layer balloon 110 , And the proximal end of the double-layer balloon 110 is connected to the outer tube 133.
  • the double-layer balloon 110 specifically includes an outer layer balloon 111 and an inner layer balloon 112.
  • the outer layer balloon 111 is wrapped around the inner layer balloon 112, and the outer layer balloon 111 and the inner layer Both the proximal and distal ends of the balloon 112 are fixed on the catheter body 130.
  • Both the outer balloon 111 and the inner balloon 112 can be expanded.
  • a frozen liquid is sprayed into the inner cavity of the inner balloon 112 through the distal end of the catheter body 130, and the frozen liquid instantly vaporizes and expands after absorbing the heat of the human tissue , So that the inner balloon 112 is expanded.
  • the outer balloon 111 expands under the action of the inner balloon 112.
  • the material of the double-layer balloon 110 may be selected from polymer materials such as polyester, polyurethane, thermoplastic elastomer, polyethylene or polyolefin copolymer, or may be selected from many of these materials. kind of combination.
  • the temperature measuring element 120 is at least one and is arranged in the interlayer 113 formed by the inner balloon 112 and the outer balloon 111. Since the temperature measuring element 120 can detect the temperature information of the area adjacent to the temperature measuring element 120, and the temperature measuring element 120 is arranged in the interlayer 113 formed by the inner balloon 112 and the outer balloon 111, the inner balloon The distance between 112 and the outer layer balloon 111 and the outer surface of the double-layer balloon 110 is relatively close. Therefore, when the temperature information detected by the temperature measuring element 120 is used to estimate the temperature information on the outer surface of the double-layer balloon 110, it can be estimated The accuracy of the temperature information on the outer surface of the double-layered balloon 110 is improved, thereby improving the ablation effect.
  • the temperature measuring element 120 is attached to the inner balloon 112 or the outer balloon 111 through the adsorbing member 140.
  • the member 140 is attached to the outer surface of the inner layer balloon 112, so that the temperature measuring element 120 can monitor the temperature at a designated position on the double-layer balloon 110.
  • the adsorption capacity of the adsorption member 140 allows the adsorption member 140 to follow the expansion or contraction of the double-layer balloon 110.
  • the deformation of the surface material of the connected balloon produces displacement relative to the double-layer balloon 110, and since the temperature measuring element 120 is attached to the inner layer balloon 112 or the outer layer balloon 111 through the adsorbing member 140, The temperature measuring element 120 can also be displaced relative to the double-layer balloon 110 or the adsorbing member 140.
  • the displacement here is usually small (in general, the maximum is not more than 5mm), which basically does not affect the temperature measurement, and
  • the temperature measuring element 120 and the adsorption member 140 may also have a relative displacement.
  • the double-layer balloon 110 is constrained during expansion or contraction, so that the double-layer balloon 110 can expand and contract uniformly, so that the operability of the double-layer balloon is improved, and the surface temperature of the balloon will not be affected by the uneven expansion of the double-layer balloon.
  • the monitoring of the temperature measurement element will not cause the temperature measurement element 120 to break and fail due to its poor ductility.
  • the double-layer balloon 110 shrinks uniformly, which also reduces the diameter of the balloon catheter 100 through the outer sheath, thereby facilitating the implementation of interventional surgery and improving the success rate of the surgery.
  • the adsorption member 140 can limit the temperature measuring element 120 to remain stationary relative to the double-layer balloon 110, so that the temperature measuring element 120 can be positioned on the double-layer balloon. Perform temperature monitoring without shifting.
  • the displacement of the adsorbent 140 relative to the double-layer balloon 110 enables the temperature measuring element 120 to conform to the expansion of the double-layer balloon, which not only avoids the need for double-layer balloon expansion.
  • the influence of the expansion of the capsule also reduces the risk of the temperature measuring element 120 breaking due to its poor ductility.
  • the displacement of the adsorbent 140 relative to the double-layer balloon 110 is also used to enable the temperature measuring element 120 to conform to the contraction of the double-layer balloon, so that the double-layer balloon 110 can be smoothly contracted. Through the outer sheath.
  • the adsorption member 140 is preferably a physical adsorption member, that is, is connected to the temperature measuring element 120 and the inner balloon 112 by physical adsorption, or the adsorption member 140 is preferably physically adsorbed to the temperature measurement.
  • the element 120 and the outer balloon 111 are connected. Therefore, physical adsorption is used to realize the effect that the adsorption member 140 and the temperature measuring element 120 can be displaced relative to the double-layer balloon 110 when the double-layer balloon 110 is expanded and contracted.
  • the adsorption member 140 is physically adsorbed to the temperature measurement element 120, the adsorption member 140 can be displaced relative to the temperature measurement element 120 when the double-layer balloon 110 is deformed.
  • the surface is physically adsorbed, so that when the double-layer balloon 110 is deformed, the adsorption member 140 can also be displaced relative to the surface of the balloon connected to the adsorption member 140, and finally the temperature measuring element 120 can also be relatively Displacement occurs on the surface of the balloon connected with the suction member.
  • the adsorption member 140 preferably includes a base layer 141 and a physical adsorption layer 142 disposed on the base layer 141.
  • the physical adsorption layer 142 can be directly coated on a surface of the base layer 141.
  • a part of the physical adsorption layer 142 on the adsorption member 140 is physically adsorbed to the temperature measuring element 120, and another part of the physical adsorption layer 142 is physically adsorbed to the inner balloon 112 or the outer balloon 111.
  • the adsorption member 140 is an adhesive tape provided with a physical adsorption layer 142 on the surface, and the temperature measuring element 120 is directly pasted on the balloon surface by using the adhesive tape to realize the connection between the temperature measuring element 120 and the balloon surface.
  • the effect that physical adsorption can achieve is that when the surface of the balloon connected to the adsorption member 140 is not deformed, the physical adsorption layer 142 can be firmly bonded to the surface of the balloon and the temperature measuring element 120, and when When the balloon surface expands or contracts, the physical adsorption layer 142 will slide relative to the expansion or contraction of the balloon surface material, so that neither the adsorption member 140 nor the temperature measuring element 120 affects the balloon expansion and contraction.
  • the material of the physical adsorption layer 142 is preferably a soft jelly that does not change the performance state of the material before and after use, such as soft jelly such as silica gel and hydrogel, but not Limited to this, other soft gels that can achieve similar functions are also applicable.
  • soft jelly such as silica gel and hydrogel
  • other soft gels that can achieve similar functions are also applicable.
  • the hardness of the selected material before and after use the formation of adsorption with the surface of the substrate to be bonded is after use
  • its hardness remains unchanged, such as silica gel and balloon Before and after the surface is adsorbed, it always maintains a soft state without changing its hardness.
  • the physical adsorption described in the present invention is different from chemical adsorption in which the performance state of the material changes before and after use.
  • chemical adsorption for example, the use of glue that changes the performance state of the material before and after use. Before and after the glue is bonded to the balloon surface, its performance state changes significantly, from the liquid state before use. It is solid, and the glue after use is also harder. Therefore, if the glue is bonded to the surface of the balloon, relative displacement between the balloon and the fixed element will not be generated and a fixed connection will be formed, which will affect the performance of the balloon. Expansion and contraction.
  • the temperature measuring element 120 and the adsorbing member 140 are arranged in the sandwich 113 of the two-layer balloon 110, and it is not easy to fall off. This is because the sandwich 113 not only has the outer balloon 111 as protection, but the sandwich 113 is basically in a vacuum state. Therefore, when the double-layer balloon 110 contacts and slides with human tissues, the interlayer 113 is basically not affected by external forces, which can avoid the problem of sliding of the adsorbent 140 due to insufficient physical adsorption and adhesion.
  • the maximum displacement of the adsorbent 140 relative to the double-layer balloon 110 is set to preferably not exceed the double-layer balloon after expansion. 15% of the outer diameter of 110.
  • the outer diameter of the double-layer balloon 110 after expansion is 28 mm, and the maximum displacement of the adsorbent 140 relative to the double-layer balloon 110 does not exceed 4.2 mm.
  • the adsorption member 140 and the double-layer balloon 110 are relatively static. At this time, more vividly, there should be several points and double layers on the adsorption member 140. Corresponding points on the surface of the balloon 110 overlap, and there is no relative displacement between these points. Then, when the double-layer balloon 110 is expanded, the adsorption member 140 is displaced relative to the double-layer balloon 110, so that the adsorption member 140 is Several points are also displaced relative to the corresponding points on the surface of the double-layer balloon.
  • the present invention defines the displacement of the two originally overlapping points before and after expansion as the displacement of the adsorbent 140 relative to the double-layer balloon 110, and the displacement of the adsorbent 140 relative to the double-layer balloon 110
  • the maximum displacement of the balloon 110 is limited to not more than 15% of the outer diameter of the double-layer balloon 110 after expansion.
  • the first point on the adsorbent 140 and the second point on the outer surface of the inner balloon 112 are overlapped before the double-layer balloon 110 is expanded as an illustration to further illustrate the displacement of the present invention.
  • the first point coincides with the second point; and when the double-layer balloon 110 is expanded, the first point is displaced relative to the second point, and there is no In the case of overlap, at this time, the distance between the first point and the second point along the outer surface of the expanded inner balloon 112 is defined as the displacement of the first point relative to the second point.
  • the displacement of the suction member 140 relative to the double-layer balloon 110 is realized in the above-mentioned manner.
  • the maximum displacement of the adsorbent 140 relative to the double-layer balloon 110 is generally related to the selected expansion characteristics of the double-layer balloon 110, that is, those skilled in the art can choose to have A balloon with corresponding expansion characteristics meets this requirement, so that the maximum displacement of the adsorbent 140 relative to the double-layer balloon 110 does not exceed 15% of the outer diameter of the double-layer balloon 110 after expansion.
  • the advantage that can be achieved is that when the double-layer balloon expands, the relative position of the adsorbent 140 is reduced.
  • this technical effect is a further technical effect achieved under the premise that the maximum displacement of the adsorbent does not exceed 15% of the outer diameter of the expanded double-layer balloon.
  • the displacement is not limited in direction.
  • the base layer 141 is preferably a film made of a polymer material, such as a film made of polyimide or polyester material, which is used to isolate the physical adsorption layer 142 from the material that is not connected to the adsorption member 140.
  • the inner balloon 112 or the outer balloon 111 for example, when the adsorbent 140 is connected to the inner balloon 112, the base layer 141 is used to isolate the physical adsorption layer 142 and the outer balloon 111, or the adsorbent 140 and the outer balloon When 111 is connected, the base layer 141 is used to isolate the physical adsorption layer 142 and the inner balloon 112, so as to prevent the outer balloon 111 or the inner balloon 112 and the physical adsorption layer 142 from being adsorbed to affect the expansion and contraction of the balloon.
  • the adsorption member 140 is composed of a film and a soft jelly arranged on one side of the film.
  • the temperature measuring element 120 is first placed in, for example, the inner balloon 112. Then, the adsorption member 140 is directly pasted on the temperature measuring element 120 and the inner balloon 112 to form physical adsorption.
  • the thickness of the adsorption member 140 is less than 100 microns, and the width ranges from 0.2 mm to 3 mm. The width range is capable of fully adsorbing the temperature measuring element 120, and the narrower the better, so as to reduce the The effect of balloon expansion.
  • the thickness of the base layer 141 can be less than 50 microns, and the thickness of the physical adsorption layer 142 can be less than 75 microns.
  • At least one end of the adsorbing member 140 is preferably fixed to one end of the double-layer balloon 110, so as to prevent the adsorbing member 140 from having a large axial displacement when the double-layer balloon expands and contracts. .
  • one end of the adsorption member 140 is fixed to the proximal or distal end of the double-layer balloon 110.
  • one end of the adsorbent 140 is fixed to the proximal end of the double-layer balloon 110, while the other end is fixed to the distal end of the double-layer balloon 110, as shown in FIGS.
  • the part of the adsorbent 140 located at the proximal and distal ends of the double-layer balloon 110 is not only physically adsorbed to the temperature measuring element 120, but also to the inner balloon 112 or the outer balloon. 111 physical adsorption.
  • fixing of one end of the adsorbing member and the double-layer balloon means that one end of the adsorbing member and the double-layer balloon always remain relatively static without displacement.
  • the The two ends of the adsorption member 140 may not be fixed to the double-layer balloon, and the entire adsorption member 140 is physically adsorbed to the temperature measuring element 120 and the double-layer balloon 110.
  • the adsorption member 140 extends from one end of the temperature measuring element 120 to the other end of the temperature measuring element 120, so as to attach the entire temperature measuring element 120 to the inner balloon 112 or the Outer balloon 111.
  • the adsorbent 140 extends from the proximal end of the double-layer balloon 110 to the distal end of the double-layer balloon 110, so that the entire temperature measuring element 120 is moved along the axial direction of the balloon. Attached to the inner layer balloon 112 or the outer layer balloon 111, the temperature measuring element 120 can be better attached to the inner layer balloon 112 or the outer layer balloon 111, thereby keeping the inner layer balloon 112 or the outer layer balloon ⁇ 111 ⁇ Bag 111.
  • the length of the part of the adsorbent 140 at the proximal and distal ends of the double-layer balloon should ensure a certain amount of elongation, so as not to The balloon is constrained by the suction member 140 when it is expanded.
  • the minimum length of the suction member 140 (here, the initial length of the suction member 140 without being stretched) is greater than along the expanded double layer
  • the length of the unilateral contour line from the proximal end to the distal end of the balloon 110 is to avoid that the length of the suction member 140 is too short to affect the expansion of the balloon.
  • the suction member 140 may be a long strip, so that only one suction member 140 can cover the temperature measuring element 120 in the axial direction of the balloon, so that the temperature measuring element 120 can be attached more firmly.
  • the suction member 140 may also have other shapes, such as a square, a rectangle, and the like.
  • the adsorbing member 140 can either attach the entire temperature measuring element 120 to the balloon, or attach a part of the temperature measuring element 120 to the balloon.
  • the width of the suction member 140 is preferably greater than or equal to the width of the temperature measuring element 120, so that the temperature measuring element 120 is not exposed to the suction member 140 in its width direction, so that the suction member 140 is conveniently placed on the double layer.
  • the balloon can completely cover the temperature measuring element 120 in the circumferential direction.
  • the adsorption member 140 and the temperature measuring element 120 may both have a non-equal width structure.
  • the minimum width of the adsorption member 140 is greater than or equal to the maximum width of the temperature measurement element 120, so that The temperature measuring element 120 is not exposed outside the adsorption member 140 in its width direction.
  • it may only be that the minimum width of the portion of the adsorption member 140 covering the temperature measurement element 120 is greater than or equal to the maximum width of the temperature measurement element 120, that is, the adsorption member 140 does not cover the temperature measurement element 120
  • the width of the part may also be smaller than the width of the temperature measuring element 120.
  • the minimum length of the adsorption member 140 is consistent with the length of the temperature measuring element 120.
  • the temperature measuring element 120 is a linear temperature sensor, and the linear temperature The sensor is in an untensioned state before the balloon is expanded, so that the minimum length of the adsorbent 140 is the same as the length of the temperature measuring element 120 after expansion. This way, it can ensure that the adsorbent 140 is in the axial direction of the double-layer balloon. It can cover the entire temperature measuring element 120, and on the other hand, it can also ensure that the adsorbent 140 has a certain amount of elongation when the balloon is expanded without restricting the expansion of the balloon.
  • one temperature measuring element 120 may also be connected to the double-layer balloon through a plurality of adsorbents 140, such as A plurality of adsorption members 140 are arranged at intervals along the length direction of the temperature measuring element 120, so that multiple sections of the temperature measuring element 120 can be connected.
  • the temperature measuring element 120 includes two opposite ends and a main body located between the two ends. Wherein, at least one end of the temperature measuring element 120 is fixed to one end of the double-layer balloon 110. For example, in some embodiments, one end of the temperature measuring element 120 is fixed to the proximal or distal end of the double-layer balloon 110. In some embodiments, as shown in FIGS.
  • one end of the temperature measuring element 120 is fixed to the proximal end of the double-layer balloon 110, while the other end is fixed to the distal end of the double-layer balloon 110, and
  • the temperature measuring element 120 is located at least a part of the main body at the proximal and distal ends of the double-layer balloon 110, and is physically adsorbed on the inner balloon 112 or the outer balloon 111 by the adsorbing member 140 Therefore, the suction member 140 further restricts the temperature measuring element 120 from generating excessive displacement in the circumferential direction of the balloon.
  • the temperature measuring element 120 is preferably linear, which is preferably arranged along the axial direction of the double-layer balloon 110, that is, the linear temperature sensor is along the It is arranged in the direction from the proximal end to the distal end. More preferably, when the double-layer balloon 110 is not expanded, the temperature measuring element 120 is located at the proximal and distal ends of the double-layer balloon 110 in an unexpanded state.
  • the expanded length of the temperature measuring element 120 is greater than the unilateral contour line along the direction from the proximal end to the distal end of the expanded double-layer balloon 110
  • the temperature measuring element 120 has a certain degree of straightening, which can effectively prevent the temperature measuring element 120 from breaking, and the physical adsorption layer 142 will not affect the straightening of the temperature measuring element 120 , So that the temperature measuring element 120 is more difficult to break.
  • the temperature measuring element 120 is preferably multiple, and the plurality of temperature measuring elements 120 are distributed at different positions in the interlayer 113, preferably, evenly distributed around the central axis of the inner balloon 112. In this embodiment, since multiple temperature measuring elements 120 are provided, temperature information at multiple locations can be detected by the temperature measuring elements 120.
  • the outer surface of the double-layer balloon 110 is usually spherical, and the irregular cylindrical structure of the lesion usually cannot be completely matched at one time, that is, the outer surface of the double-layer balloon 110 cannot be in good contact with the lesion. The matching of the double-layer balloon 110 and the lesion will directly affect the effect of the ablation operation.
  • the double-layer balloon 110 can be judged according to the temperature information at the multiple positions detected by the multiple temperature measuring elements 120 in the double-layer balloon 110 with the balloon catheter 100 in this embodiment. The contact with the balloon at the corresponding position and further evaluation of the ablation effect.
  • the balloon catheter 100 in this embodiment does not require multiple imaging, that is, the patient will not be repeatedly exposed to X-rays. The irradiation will not affect the health of the patient, at the same time it can improve the efficiency of the operation and reduce the risk of the operation.
  • the linear temperature measuring element 120 may be a thermocouple temperature sensor. Or referring to FIG. 7, the linear temperature measuring element 120 may also be a thermistor temperature sensor.
  • the temperature measurement element 120 may include a first wire 121, a second wire 122 and a temperature measurement module 123.
  • the first wire 121 and the second wire 122 can be arranged in parallel or intersecting.
  • the temperature measurement module 123 is arranged between the first wire 121 and the second wire 122, and the temperature measurement module 123 forms a temperature measurement point for sensing temperature information.
  • the temperature measurement module 123 is also used to convert temperature information into electrical information, and the first wire 121 and the second wire 122 are used to transmit the electrical information.
  • the first wire 121 is a copper wire
  • the second wire 122 is a constantan wire
  • the temperature measurement module 123 is welded to a section of the first wire 121 and a section of the second wire 122 through the first wire 121
  • the temperature information is converted into electrical information at the welding place with the second wire 122, and the electrical information is transmitted through the first wire 121 and the second wire 122, thereby realizing the temperature information detection at the welding place of the first wire 121 and the second wire 122
  • the temperature information is detected by the thermocouple formed at the welding place of the first wire 121 and the second wire 122.
  • the temperature measurement module 123 may also be a thermistor, and the first wire 121 and the second wire 122 are electrically connected to the thermistor, respectively.
  • the first wire 121 and the second wire 122 are in a twisted state.
  • the linear thermocouple temperature sensor or the thermal resistance temperature sensor is selected as the temperature measuring element, because the linear thermocouple temperature sensor or the thermal resistance temperature sensor is relatively soft and not easy to break.
  • the temperature measurement module 123 has a proximal side and a distal side, and the proximal side is connected to the first wire 121 and the second wire 122, and the two wires pass through the third wire ( Figure (Not marked in) through the catheter body 130 to connect to the electrical input/output interface 151 on the control handle 150, so as to output the temperature information of the temperature measurement to the outside.
  • the third wire may be an extension of the first wire 121 and the second wire 122 and connected to the electrical input/output interface 151; or it may be different from the first wire 121 and the An independent third wire of the second wire 122 is connected to the electrical input/output interface 151 after connecting the first wire 121 and the second wire 122, that is, one end of the third wire is connected to the The first wire 121 is connected to the second wire 122, and the other end of the third wire is connected to the electrical input/output interface 151, wherein there may be two third wires to respectively connect to the first wire.
  • At least one wire is connected to the distal side of the temperature measurement module 123, and the at least one wire is used for fixing to the distal end of the double-layer balloon 110.
  • the present invention is not limited to the distal side connecting wire, but may be Other flexible bodies.
  • the temperature measurement module 123 is physically adsorbed to the surface of the balloon through the adsorption member 140, and the proximal end of at least one of the first wire 121 and the second wire 122 is fixed on the double layer
  • the first wire 121, the second wire 122 and the temperature measuring module 123 are all arranged in the interlayer 113 formed by the inner balloon 112 and the outer balloon 111. Since the adsorbing member 140 is physically adsorbed to the double-layer balloon 110 and the temperature measurement module 123, the temperature measurement module 123 can be relative to the double-layer balloon 110 and the temperature measurement module 123 during balloon expansion and contraction.
  • the adsorption member 140 is displaced, so that the temperature measuring module 123 can adapt to the expansion and contraction of the double-layer balloon 110, and the temperature measuring module 123 will not break and fail due to its poor ductility.
  • the first wire 121 and the second wire 121 The wires 122 are all in an untightened state and can be straightened when the balloon is expanded, and will not affect the expansion of the balloon.
  • a part of the first wire 121 and/or the second wire 122 may also be physically adsorbed on the inner balloon 112 or the outer balloon 111 through the adsorbing member 140, In this way, a part of the first wire 121 and/or the second wire 122 can move relative to the double-layer balloon 110 during the balloon expansion and contraction process, and will not form a fixed node, so that it will not affect the double-layer balloon.
  • the restraint is generated, and the temperature measuring module 123 is not fixedly connected to the balloon, so the balloon will not be restrained.
  • the entire first wire 121 and/or the second wire 122 can also be physically adsorbed to the inner balloon 112 or the outer balloon through the adsorption member 140 111, so that the entire first wire 121 and/or the second wire 122 can move relative to the double-layer balloon 110 during the balloon expansion and contraction process, and will not form a fixed node, so that it will not affect the double-layer balloon.
  • the balloon is bound, and the temperature measuring module 123 is not fixedly connected to the balloon, so the balloon will not be restrained.
  • the first wire 121 and the second wire 122 are fixedly connected to the double-layer balloon 110 at the proximal end, and the entire length of the first wire 121 and the second wire 122 includes a temperature measurement module 123, all are physically adsorbed by the adsorption member 140 and the double-layer balloon 110.
  • the temperature measurement can also be made
  • the module 123 is not physically attached to the double-layer balloon 110, and this method also does not affect the expansion and contraction of the balloon.
  • the temperature measuring element 120 may also be in other forms, such as an optical fiber or a flexible printed sensor, which is not limited in the present invention.
  • the temperature measuring modules 123 are distributed in different circumferential directions of the double-layer balloon 110, that is, at least One temperature measurement module 123, more preferably, the projections of all the temperature measurement modules 123 in the same circumferential direction are arranged at intervals in the circumferential direction.
  • the temperature measurement modules 123 can be spaced along the circumferential direction of the balloon. The arrangement is preferably evenly arranged, and the distance between the temperature measuring modules 123 and the balloon center can be different.
  • the temperature measuring element 120 can also be provided in other ways.
  • at least one temperature measuring element 120 is provided on the section of the catheter body 130 located in the inner layer balloon 112.
  • the temperature measuring element 120 is used to obtain temperature information inside the balloon, and the at least one temperature measuring element 120 on the catheter body 130 is also connected to the electrical input/output interface 151 on the control handle 150 through a wire.
  • different temperature measuring elements 120 can be connected to the same electrical input/output interface 151, and different data channels can be set in the electrical input/output interface 151, so that each temperature measuring element 120 transmits data through different data channels.
  • the catheter body 130 is a non-rigid structure and can be bent arbitrarily.
  • the material of the catheter body 130 is preferably a polymer material, such as Thermoplastic Polyurethanes (TPU), block polyetheramide resin (Pebax) or nylon with metal braided wires, or a metal braided tube .
  • TPU Thermoplastic Polyurethanes
  • Pebax block polyetheramide resin
  • nylon with metal braided wires or a metal braided tube .
  • the proximal end of the catheter body 130 is provided with a control handle 150, the control handle 150 is arranged on the outer tube 133, and the control handle 150 can be specifically used to manipulate and control the bending state of the catheter body 130.
  • the control handle 150 is provided with an electrical input and output interface 151, and the proximal end of the temperature measuring element 120 passes through the catheter body 130 and is connected to the electrical input and output interface 151 to facilitate the transmission of the detected temperature information to an external device .
  • the control handle 150 may further include: at least one fluid input interface 152; at least one fluid output interface (not shown); and at least one cavity interface 153.
  • the lumen interface 153 is used for inserting guide wires, mapping catheters, and delivering contrast agents.
  • the fluid input interface 152 is in fluid communication with the fluid delivery tube 131 and is used for inputting the ablation medium provided from the outside into the balloon catheter 100.
  • the fluid output interface is used to discharge ablation media or other media in the double-layer balloon.
  • the catheter body 130 also includes a fluid conveying pipe 131, which is also penetrated through the outer tube 133, and is specifically arranged between the outer pipe 133 and the core rod 134, and the fluid conveying pipe 131 is also provided with an
  • the fluid ejection port (not labeled) on the surface of the inner balloon is used to eject the ablation medium X into the inner balloon 112, and the ablation medium here is not limited to a frozen fluid.
  • the fluid ejection port is located in the hemisphere of the double-layer balloon 110 close to the distal end of the double-layer balloon, so as to be closer to the pulmonary vein orifice to be ablated, so as to utilize freezing energy more efficiently and save energy.
  • the refrigerating fluid is carbon dioxide or nitrous oxide.
  • the fluid delivery tube 131 specifically includes a spiral structure 132 at the distal end and a longitudinally extending portion in fluid communication with the spiral structure 132, and the longitudinally extending portion passes through the catheter body 130 and the fluid input interface 152. connection.
  • the spiral structure 132 is preferably provided with a plurality of fluid ejection ports, and the multiple fluid ejection ports are used to eject the ablation medium in different directions.
  • the core rod 134 is a hollow structure and can be movably arranged in the outer tube 133, and the core rod 134 can be moved in the outer tube 133 by adjusting the control handle 150 to complete the double-layer balloon 110 out of the sheath, release and insertion The sheath is withdrawn.
  • the proximal end of the core rod 134 is communicated with the lumen interface 153 on the control handle 150, and is used to deliver related equipment such as a guide wire, a mapping catheter or a contrast fluid.
  • the catheter body 130 also includes a fluid discharge pipe, which is arranged between the core rod 134 and the outer tube 133 to discharge the fluid in the double-layer balloon.
  • the distal end of the core rod 134 protruding from the double-layer balloon 110 is preferably provided with a soft head 135.
  • the soft head 135 is made of relatively soft material to avoid damage to the tissue.
  • the distal end of the core rod 134 is provided with a developing mark 136, and the material of the developing mark 136 is a metal developing material.
  • the doctor can use the developing device to confirm the double-layer balloon 110 through the developing mark 136. The position relative to the outer sheath.
  • an embodiment of the present invention also provides an electrophysiological system, including: a balloon catheter 100, an ablation energy output device 200, and a control device 300, wherein the ablation energy output device 200 is in fluid communication with the balloon catheter 100 to provide
  • the catheter 100 provides an ablation medium.
  • the control device 300 is connected to the ablation energy output device 200, and the ablation energy output device 200 is connected to the balloon catheter 100.
  • the control device 300 may also be connected to the ablation energy output device 200 and the balloon catheter 100 respectively.
  • the control device 300 and the ablation energy output device 200 may be integrated in the same device. The present invention does not limit this.
  • the control device 300 is used to control the ablation energy output device 200 to adjust the temperature of the ablation medium (such as the temperature of the frozen liquid) according to the temperature information detected by the temperature measuring element 120, so that the surface of the double-layer balloon The temperature is within the preset ablation temperature range.
  • the electrophysiological system includes, but is not limited to, cryoablation of target tissue, and the target tissue may be a heart cavity or a renal artery, etc., which is not specifically limited.
  • the electrophysiological system can be applied to the treatment of the heart cavity, and the balloon catheter 100 can be inserted into the heart cavity in an interventional manner to ablate the pulmonary vein A and realize the treatment of arrhythmia.
  • the electrophysiological system can also be applied to the renal artery, and the balloon catheter 100 is inserted into the renal artery ostium B through intervention, and the renal artery C is ablated to adjust the blood pressure of the renal artery.
  • Step one S1 connect the control handle 150 of the balloon catheter 100 to the ablation energy output device 200.
  • Step two S2 insert the balloon catheter 100 into the corresponding target tissue that needs ablation, such as into the cylindrical tissue inside the heart cavity, that is, into the pulmonary vein ostium.
  • step S3 the double-layer balloon 110 is filled and the ablation medium (ie, frozen liquid) is released to the double-layer balloon 110.
  • the ablation medium ie, frozen liquid
  • Step 4 S4, adjust the position of the double-layer balloon 110 in the cylindrical tissue.
  • Step 5 S5 Analyze the temperature of the outer surface of the double-layer balloon 110 based on the temperature information detected by the plurality of temperature measuring elements 120.
  • Step 6 S6 Determine the contact between the double-layer balloon 110 and the cylindrical tissue. If the double-layer balloon 110 is in good contact with the cylindrical tissue, proceed to the next step. If the double-layer balloon 110 is in poor contact with the cylindrical tissue Then return to step four S4.
  • Step 7 S7, start cryoablation.
  • Step 8 S8 Analyze the temperature of the outer surface of the double-layer balloon 110 based on the temperature information detected by the multiple temperature measuring elements 120 to confirm the ablation effect.
  • Step 9 S9 verify the ablation result.
  • Step 10 S10 end the ablation operation.
  • the control device 300 analyzes and determines the contact between the double-layer balloon 110 and the target tissue according to the temperature information detected by the balloon catheter 100, and controls the ablation energy output device 200 to adjust the ablation temperature of the ablation medium accordingly. .
  • the control device 300 specifically includes a refrigeration control unit.
  • the ablation energy output device 200 specifically includes a refrigeration unit, a fluid source and a fluid output channel.
  • the fluid source is in communication with a fluid output channel, and the fluid output channel is used to output the fluid in the fluid source to the balloon catheter 100.
  • the fluid output channel is connected to the fluid input interface 152 on the control handle 150 through which The interface inputs the ablation medium to the balloon catheter 100.
  • the refrigeration unit is arranged on the fluid output channel, and is used for cooling the fluid conveyed in the fluid output channel.
  • the refrigeration unit may be a compressor or other refrigeration device, and the present invention does not specifically limit its structure.
  • the refrigeration unit is used to communicate with the refrigeration control unit to control the working state of the refrigeration unit through the refrigeration control unit.
  • the refrigeration control unit is used to control the operation of the refrigeration unit according to the received cryoablation instruction, so that the fluid output channel provides the balloon catheter 100 with refrigerated liquid.
  • a cryoablation button may be provided on the control handle 150 or the computer interface. When the operator activates the cryoablation button, the cryoablation command is issued to the refrigeration control unit 110.
  • the computer interface can be set on the control device 300 or the ablation energy output device 200.
  • the cooling control unit sends a cooling signal to the cooling unit, and the cooling unit performs cooling according to the received cooling signal.
  • the refrigeration control unit controls the refrigeration unit to adjust its refrigeration temperature according to the temperature information fed back by the multiple temperature measuring elements 120, so as to control the temperature of the balloon surface within the preset cryoablation temperature range Inside.
  • the working process of the electrophysiological system implementing cryoablation specifically includes:
  • Step 401 the fluid source outputs fluid to the fluid output channel
  • Step 402 the refrigeration control unit controls the refrigeration of the refrigeration unit
  • Step 403 After cooling, make the fluid reach a preset cooling temperature
  • Step 404 Inject frozen liquid to the inner balloon; here, steps 401, 402, 403, and 404 can actually be performed at the same time, that is, the frozen liquid is sprayed to the inner surface of the balloon while the refrigeration is set up;
  • Step 405 During the refrigeration process, the refrigeration control unit controls the refrigeration temperature of the refrigeration unit in real time according to the temperature information fed back by the temperature measuring element 120;
  • Step 406 The temperature of the balloon surface reaches the temperature required for cryoablation (for example, -40°C to -60°C), and after maintaining it for a period of time (for example, 120 to 180 seconds), the cryoablation can be ended.
  • the temperature required for cryoablation for example, -40°C to -60°C
  • a period of time for example, 120 to 180 seconds
  • the doctor determines whether to perform the next cryoablation according to the actual effect of cryoablation.
  • the double-layer balloon needs to be warmed to body temperature naturally in the body in advance (step 407) before the next cryoablation can be performed.
  • the temperature measuring element in the present invention can also be selected as optical fiber or flexible printed sensors, and these sensors can also be physically adsorbed on The surface of the balloon does not restrict the expansion and contraction of the balloon, but due to the problems of these sensors, the use of linear temperature measuring elements is better.
  • a soft non-metallic wire can be used to fix the temperature measurement module, for example, at least one braided node is formed on the surface of the balloon, and the temperature measurement module can be embedded in the braided node.

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Abstract

一种球囊导管(100)及电生理系统,旨在提高在双层球囊(110)的表面精确监测球囊表面温度的可操作性。球囊导管(100)包括导管本体(130)、双层球囊(110)、至少一个测温元件(120)和至少一个吸附件(140),测温元件(120)设置在内层球囊(112)和外层球囊(111)所形成的夹层(113)中,吸附件(140)既与测温元件(120)吸附连接,又同时与内层球囊(112)或外层球囊(111)吸附连接,测温元件(120)通过吸附件(140)贴附于内层球囊(112)或外层球囊(111),并且当双层球囊(110)产生形变时,吸附件(140)能够相对于与吸附件(140)连接的内层球囊(112)或外层球囊(111)产生位移,并使得测温元件(120)也能够相对于与吸附件(140)连接的内层球囊(112)或外层球囊(111)产生位移。

Description

球囊导管及电生理系统 技术领域
本发明涉及医疗器械技术领域,具体涉及一种球囊导管及电生理系统。
背景技术
房颤患者具有很高的脑卒中风险,当房颤时,心房不规律地快速跳动,失去了收缩功能,血液容易在心房内淤滞而形成血栓,血栓脱落,随动脉进入脑中,即发生脑卒中。通过介入导管对肺静脉施以能量进行消融,从而隔离肺静脉电位,可以达到治疗的效果。高血压具有发病率高、知晓率低、危害大的特点。实验数据已证明高血压与患者的肾交感神经兴奋性偏高有关。通过消融阻断肾交感神经,不但能够使血压下降,并且还能够对交感神经过度激活造成的慢性器官特异性疾病产生影响。
可以采用冷冻球囊消融的方式进行消融。冷冻球囊消融基于解剖学考虑,利用球囊与组织的接触进行冷冻,且具有一次性、连续性等特点。具体的,采用冷冻消融球囊导管,在导管的远端设置球囊,近端连接冷冻设备。手术过程中,术者将冷冻消融球囊导管经皮穿刺入路放置进入心腔,到达肺静脉口,并使球囊充盈,调整球囊外壁与心肌组织接触,进而冷冻消融球囊导管内进液管将冷冻液体直接向球囊内表面喷射,冷冻液受心肌温度传导热影响迅速气化吸热,使与球囊接触的心肌组织降温产生冷冻消融。一般的,心肌组织只有在低温达到足够的时间,才能形成有效的消融灶,为此,冷冻消融球囊导管的内部配置有测温元件,测温元件被置于球囊中间,用于监测球囊内部温度,进而通过该内部温度去估算球囊表面的温度,但是估算得到的球囊表面温度与实际温度可能存在较大偏差,导致球囊表面温度的准确性低,从而直接影响消融效果。
现有技术曾尝试在球囊表面设置测温元件来监测球囊表面的温度,但这样做需要较高的操作性,而现有技术中尚无一种有效的方法,既能将测温元件固定在球囊表面,又能够避免球囊的扩张和收缩受到影响。
发明内容
本发明的目的在于提供一种球囊导管及电生理系统,通过将测温元件设置在双层球囊的夹层中,提高了球囊表面温度的测量精度,同时通过吸附件将测温元件贴附于内层球囊或外层球囊,可确保正常消融时测温元件不会发生移位,并且吸附件和测温元件还能够随球囊的变形而相对于球囊产生位移,从而避免了球囊扩张和收缩时受到束缚,由此提高在球囊表面检测温度的可操作性。
为实现上述目的,本发明提供的一种球囊导管,包括:
导管本体;
双层球囊,设置于所述导管本体的远端,且所述双层球囊包括内层球囊和包覆所述内层球囊的外层球囊;
至少一个测温元件,设置在所述内层球囊和所述外层球囊之间的空间中;以及
至少一个吸附件,既与所述测温元件吸附连接,又与所述内层球囊或所述外层球囊吸附连接,从而将所述测温元件贴附于所述内层球囊或所述外层球囊;
其中,当所述双层球囊产生形变时,所述吸附件能够相对于与该吸附件连接的所述内层球囊或所述外层球囊产生位移,并使得所述测温元件也能够相对于与该吸附件连接的所述内层球囊或所述外层球囊产生位移。
可选的,所述吸附件为一物理吸附件,以物理吸附的方式与所述测温元件连接,以使所述测温元件在所述双层球囊产生形变时相对于所述吸附件产生位移,同时所述吸附件还以物理吸附的方式与所述内层球囊或所述外层球囊连接,以使所述吸附件在所述双层球囊产生形变时能够相对于与该吸附件连接的所述内层球囊或所述外层球囊产生位移,并使得所述测温元件也能够相对于与该吸附件连接的所述内层球囊或所述外层球囊产生位移。
可选的,当所述双层球囊产生形变时,所述吸附件相对于与该吸附件连接的所述内层球囊或所述外层球囊的最大位移量不超过扩张后的所述双层球囊的外径的15%。
可选的,所述吸附件包括基层以及设置在所述基层上的物理吸附层;
所述物理吸附层的一部分与所述测温元件物理吸附,所述物理吸附层的另一部分与所述内层球囊和所述外层球囊中的一个物理吸附,同时所述基层用于防止所述内层球囊和所述外层球囊中的另一个与所述物理吸附层相吸附。
可选的,所述物理吸附层的材质为使用前后性能状态不变的软质胶状物。
可选的,所述物理吸附层的材质为硅胶或水凝胶,且所述基层为由高分子材料制成的膜,所述膜的一个表面涂覆形成有所述物理吸附层。
可选的,所述吸附件的至少一端与所述双层球囊的一端固定。
可选的,所述吸附件的一端与所述双层球囊的近端固定,所述吸附件的另一端与所述双层球囊的远端固定;并且所述吸附件位于所述双层球囊的近端和远端之间的部分与所述测温元件吸附连接,同时还与所述内层球囊或所述外层球囊吸附连接;
其中,所述吸附件的长度大于沿着扩张后的所述双层球囊的近端到远端的单侧轮廓线的长度。
可选的,所述吸附件的宽度大于或等于所述测温元件的最大宽度,以使所述测温元件在其宽度方向上未暴露在所述吸附件之外。
可选的,所述吸附件自所述测温元件的一端延伸至所述测温元件的另一端,以将整个所述测温元件贴附于所述内层球囊或所述外层球囊。
可选的,所述吸附件的厚度在100微米以下,且所述吸附件的宽度范围为0.2mm~3.0mm。
可选的,所述测温元件包括相对两端以及位于该相对两端之间的主体部;
其中,所述测温元件的至少一端与所述双层球囊的一端固定,且所述测温元件的所述主体部的至少一部分通过所述吸附件贴附于所述内层球囊或所述外层球囊。
可选的,所述主体部的至少一部分通过多个所述吸附件贴附于所述内层球囊或所述外层球囊。
可选的,所述测温元件为多个,且分布在所述内层球囊和所述外层球囊 之间的空间中的不同位置。
可选的,所述测温元件为呈线状的温度传感器,所述呈线状的温度传感器的至少一端与所述双层球囊的一端固定,且所述呈线状的温度传感器沿着所述双层球囊的近端到远端的方向布置。
可选的,所述吸附件自所述双层球囊的近端延伸至所述双层球囊的远端,以将整个所述呈线状的温度传感器贴附于所述内层球囊或所述外层球囊。
可选的,所述吸附件呈长条状。
可选的,在所述双层球囊未扩张的情况下,所述测温元件位于所述双层球囊的近端和远端的部分处于未张紧的状态,且所述测温元件展开后的长度大于沿着扩张后的所述双层球囊的近端到远端的单侧轮廓线的长度。
可选的,所述呈线状的温度传感器为热电偶温度传感器或热电阻温度传感器。
可选的,所述测温元件包括第一导线、第二导线和测温模块,所述第一导线和第二导线相连接,所述第一导线和第二导线之间设置有所述测温模块,所述测温模块用于将温度信息转换为电信息,所述第一导线和所述第二导线用于传递所述电信息;
其中,所述测温模块通过所述吸附件贴附于所述内层球囊或所述外层球囊,和/或,所述第一导线和所述第二导线中的至少一个的至少部分区段通过所述吸附件贴附于所述内层球囊或所述外层球囊。
可选的,所述导管本体包括外管和设置于所述外管中的芯杆,所述芯杆的远端伸出所述外管;所述双层球囊的远端与所述芯杆连接,所述双层球囊的近端与所述外管连接。
可选的,所述导管本体还包括流体输送管件,设置于所述芯杆和所述外管之间,所述流体输送管件上还设置有朝向所述内层球囊表面的流体喷射口,用于向所述内层球囊的内部喷射冷冻流体,且所述流体喷射口位于所述双层球囊靠近所述双层球囊的远端的半球内。
为实现上述目的,本发明提供的一种电生理系统,包括任一项所述的球囊导管、消融能量输出装置和控制装置,所述消融能量输出装置与所述球囊 导管相连通,用于向所述球囊导管提供消融介质;所述控制装置用于根据所述测温元件检测到的温度信息控制所述消融能量输出装置调整所述消融介质的温度,以使所述双层球囊表面的温度在预设的消融温度范围内。
与现有技术相比,本发明提供的球囊导管及电生理系统具有以下的优点:
第一、本发明的球囊导管包括一个双层球囊,且该双层球囊具有一夹层,为了准确检测双层球囊外表面的温度信息,在双层球囊的夹层中设置了至少一个测温元件,因此,在实际消融时,通过该测温元件可获得更为准确的病灶的温度信息,从而改善消融效果。进而为了避免双层球囊的扩张与收缩受到测温元件的影响,本发明的球囊导管利用吸附件将测温元件贴附于球囊表面上,通过吸附件的吸附能力,使得双层球囊在扩张或收缩时,所述吸附件能够随球囊表面材料的形变而相对于球囊产生位移,而由于测温元件通过吸附件贴附于内层球囊或外层球囊上,进而也使得测温元件也能够相对于球囊或吸附件产生位移,从而使测温元件能较好的顺应球囊的扩张或收缩,不会对球囊的扩张和收缩造成影响,由此可确保球囊表面温度监测的有效性和可操作性。同时还带来了其它效果:由于双层球囊可以均匀收缩,因此也减小了双层球囊收缩后通过外鞘管的直径;同时也因为球囊可以均匀扩张,使得双层球囊可以与目标组织形成良好的接触,使得测温元件能够更准确的获取病灶的温度信息,改善消融效果。
第二、本发明的吸附件较佳地为一物理吸附件,以通过物理吸附层将测温元件物理吸附到球囊表面,而物理吸附不会产生对球囊不利的物质,使得球囊的强度不会受到影响,确保了球囊术中的安全性,而且物理吸附为面-面接触吸附,相比于局部点胶固定,接触面积大,不容易造成测温元件脱落,确保了术中温度测量的可靠性。
第三、当双层球囊产生形变时,所述吸附件相对于所述双层球囊的最大位移量优选不超过扩张后的所述双层球囊的外径的15%,从而防止吸附件和测温元件相对于球囊产生过大的位移,最终确保球囊表面温度监测的有效性。更优选的,所述吸附件的至少一端优选与双层球囊的一端固定,进一步防止吸附件产生较大的轴向位移。
第四、所述吸附件的最小宽度优选大于或等于所述测温元件的最大宽度,使得所述测温元件在其宽度方向上未暴露在所述吸附件之外,从而防止测温元件脱离吸附件,使在球囊表面监测温度的可操作性更高。
第五、所述测温元件较佳地为多个,并在双层球囊的夹层中不同位置分布,这样能对与球囊接触的目标组织进行多点测温,可以更好的确认球囊与目标组织的接触状态,从而进一步改善消融效果。
第六、本发明的导管本体还包括流体输送管件,且流体输送管件上设置有流体喷射口,用于向内层球囊的内部喷射冷冻液体,从而实现冷冻消融,且流体喷射口较佳地位于双层球囊靠近双层球囊的远端的半球内,这样可更高效地利用冷冻能量,节约能源。
附图说明
为了更清楚地说明本发明实施例或现有技术中的技术方案,下面将对实施例或现有技术描述中所需要使用的附图作简单地介绍,显而易见地,下面描述中的附图仅仅是本发明的一些实施例,对于本领域普通技术人员来讲,在不付出创造性劳动的前提下,还可以根据这些附图获得其他的附图。
图1是本发明一实施例中的球囊扩张时受到束缚的示意图;
图2是本发明一实施例中的球囊导管的主视图;
图3是图2所示的球囊导管的左视图;
图4是本发明一实施例中的球囊导管之远端的示意图;
图5是本发明一实施例中的吸附件的示意图;
图6是本发明一实施例中的测温元件的示意图,其中测温元件为热电偶温度传感器;
图7是本发明一实施例中的测温元件的示意图,其中测温元件为热敏电阻温度传感器;
图8是本发明一实施例中的电生理系统的工作流程图;
图9是本发明一实施例中的电生理系统进行心脏消融的示意图;
图10是本发明一实施例中的电生理系统进行肾动脉消融的示意图;
图11是本发明一实施例中的电生理系统进行冷冻消融的流程图。
其中:
1-测温元件;2-球囊;
100-球囊导管;110-双层球囊;111-外层球囊;112-内层球囊;113-夹层;120-测温元件;121-第一导线;122-第二导线;123-测温模块;130-导管本体;131-流体输送管件;132-螺旋结构;133-外管;134-芯杆;135-软头;136-显影标识;140-吸附件;141-基层;142-物理吸附层;150-控制手柄;151-电性输入输出接口;152-流体输入接口;153-内腔接口;
200-消融能量输出装置;
300-控制装置。
具体实施方式
如背景技术所述,现有技术曾尝试在球囊表面设置测温元件来监测球囊表面的温度,例如曾尝试在球囊表面设置光纤或柔性印刷传感器,但均因为这些测温元件自身延展性差,对球囊的顺应性不好,且不易固定,而出现了测温元件断裂,球囊扩张和收缩不均匀等问题,因此,在球囊表面设置测温元件的可操作性并不高。为此,发明人曾尝试在双层球囊的夹层(在此,夹层为夹于内层球囊和外层球囊之间的空间)之间设置测温元件来监测球囊表面的温度,并同时利用液态胶水将测温元件固定在球囊表面,但是,发明人发现,这样做还是存在一些问题:
第一、液态胶水固化后,使测温元件和球囊表面在胶水粘结位置处形成固定连接,使得球囊和测温元件无法发生相对位移,进而如图1所示,在球囊扩张时,因为测温元件1的自身延展性差(一般由传感器和金属导线组成,或者含传感器的柔性线路板组成),导致测温元件1无法顺应球囊2的扩张,在这种情况下,测温元件1要么束缚球囊2,使球囊2无法均匀扩张,从而在球囊表面例如虚线圈出的区域形成凹陷,要么在虚线圈出的区域勒出痕迹,从而对球囊造成损伤,而且还会降低球囊表面温度测量的准确性,不仅于此,测温元件1还容易发生断裂的风险,导致测温元件1失效,进而影响消融。
第二、胶水由多种化学成分组成,实际使用时,胶水通过固化实现与基材的粘接,但胶水固化时化学成分会进入被粘接的基材表层。对于一定厚度的基材来说,化学成分的进入对基材产生的影响可以忽略不计,但是对于薄壁的基材而言,例如20~60微米厚的球囊,若化学成分进入球囊的表层,则会影响球囊的强度,降低球囊术中的安全性。
除了上述问题以外,发明人还曾尝试采用局部点胶的方式将测温元件固定在球囊表面,但是,这种做法直接导致球囊在点胶位置处厚度大、硬度高,而胶水又与球囊紧紧粘合而形成一体,最终导致无胶水的球囊区域与有胶水的球囊区域的强度差异很大,进而在正常消融时,造成球囊变形(参阅图1,即在设置有胶水的球囊区域,球囊无法正常扩张,呈现塌陷状态),影响消融。同样的,球囊收缩时也会因此产生不均匀的收缩(即设置有胶水的球囊区域后收缩,形成凸起的骨架),从而影响球囊的输送和回收,例如球囊在经静脉到达心腔时,需要使用外鞘管作为通道,而收缩不均会显著增加通过外鞘管的难度。除此之外,局部点胶的接触面积小,容易造成测温元件从球囊上脱落或者发生移位,从而影响导管在术中的可靠性。
基于此,本发明提出了一种球囊导管,其包括导管本体、双层球囊、至少一个测温元件和至少一个吸附件;其中,所述导管本体包括外管和设置于所述外管中的芯杆,所述芯杆的远端伸出所述外管;所述双层球囊设置于所述导管本体的远端,且所述双层球囊包括内层球囊和包覆所述内层球囊的外层球囊,所述双层球囊的远端与所述芯杆连接,所述双层球囊的近端与所述外管连接;所述测温元件设置在所述内层球囊和所述外层球囊所形成的夹层中;所述吸附件既与所述测温元件吸附连接,又同时与所述内层球囊或所述外层球囊吸附连接,从而通过所述吸附件将所述测温元件贴附于所述内层球囊或所述外层球囊。实际应用时,当所述双层球囊扩张或者收缩时,所述吸附件可相对于与该吸附件连接的所述内层球囊或所述外层球囊产生位移,并使得所述测温元件也可相对于与该吸附件连接的所述内层球囊或所述外层球囊产生位移。当然,本发明中吸附件和测温元件相对于球囊所产生的最大位移量很小,基本上对温度测温不会造成影响,因此可确保球囊表面温度监测 的有效性。
由此,利用双层球囊之夹层中的测温元件检测双层球囊的外表面的温度信息,可获得较为准确的病灶的温度信息,从而改善消融效果。同时利用吸附件将测温元件贴附于球囊表面,一方面当球囊没有发生变形时,可确保测温元件与球囊保持相对静止,另一方面当球囊发生变形时,吸附件可相对于与其连接的球囊产生一定的位移量,由此也使得测温元件也可相对于球囊产生一定的位移量,从而使得测温元件能够较好的顺应球囊的扩张和收缩,避免了球囊因受到束缚而导致扩张或收缩不均匀的问题,最终提高了球囊表面温度监测的可操作性,同时也提高了球囊表面温度监测的可靠性,不仅于此,球囊收缩均匀也减小了球囊导管通过外鞘管的直径,从而有利于实现介入手术,提高手术的成功率。
为使本发明的内容更加清楚易懂,以下结合说明书附图对本发明做进一步说明。当然本发明并不局限于该具体实施例,本领域的技术人员所熟知的一般替换也涵盖在本发明的保护范围内。其次,本发明利用示意图进行了详细的表述,但这些示意图仅为了便于详述本发明实例,不应对此作为本发明的限定。
本文中,“近端”和“远端”是从使用产品的医生角度来看相对于彼此的元件或动作的相对方位、相对位置、方向,尽管“近端”和“远端”并非是限制性的,但是“近端”通常指该产品在正常操作过程中靠近医生的一端,而“远端”通常是指首先进入患者体内的一端。如在本说明书和所附权利要求中所使用的,单数形式“一”、“一个”以及“该”包括复数对象,除非内容另外明确指出外。如在本说明书和所附权利要求中所使用的,术语“或”通常是以包括“和/或”的含义而进行使用的,除非内容另外明确指出外。此外,术语“周向”通常指的是围绕双层球囊的轴线的方向。
参考图2至图4,本发明实施例提供一种球囊导管100,包括:双层球囊110、测温元件120、导管本体130和吸附件140;所述双层球囊110设置于导管本体130的远端,并使得导管本体130的一部分位于所述双层球囊110内,用于向双层球囊110喷射消融介质,这里的消融介质包括但不限于冷冻 液体。
所述导管本体130具体包括外管133和芯杆134,所述芯杆134设置在外管133内,且所述芯杆134的远端伸出外管133并与双层球囊110的远端连接,而双层球囊110的近端则与外管133连接。
所述双层球囊110具体包括外层球囊111和内层球囊112,所述外层球囊111包覆在所述内层球囊112外,所述外层球囊111和内层球囊112的近端和远端皆固定于导管本体130上。所述外层球囊111和内层球囊112均可扩张,例如通过导管本体130的远端向内层球囊112的内腔喷射冷冻液体,冷冻液体在吸收人体组织热量后瞬间气化扩张,从而使得内层球囊112发生扩张。所述内层球囊112扩张时,所述外层球囊111在所述内层球囊112的作用下扩张。本实施例中,所述双层球囊110的材料可选自聚酯类、聚氨酯类、热塑性弹性体、聚乙烯或聚烯烃共聚物等高分子材料,或者也可以选自这些材料中的多种组合。
所述测温元件120至少为一个并设置在所述内层球囊112和外层球囊111所形成的夹层113中。由于测温元件120可检测与测温元件120临近的区域的温度信息,而测温元件120又设置在所述内层球囊112和外层球囊111形成的夹层113中,内层球囊112和外层球囊111之间与双层球囊110的外表面的距离较近,因此通过测温元件120检测的温度信息估算双层球囊110的外表面的温度信息时,可使估算的双层球囊110的外表面的温度信息的准确度提高,进而可改善消融效果。
本发明的较佳实施例中,所述测温元件120通过所述吸附件140贴附于内层球囊112或者外层球囊111,例如在图4中,所述测温元件120通过吸附件140贴附于内层球囊112的外表上,从而使得测温元件120能够在双层球囊110上指定的位置进行温度的监测。而为了使测温元件120能够顺应双层球囊110的扩张和收缩,通过所述吸附件140的吸附能力,当双层球囊110扩张或者收缩时,所述吸附件140能够随着与之连接的球囊表面材料的变形相对于双层球囊110产生位移,而由于所述测温元件120通过所述吸附件140贴附于内层球囊112或者外层球囊111上,进而也使得测温元件120也能够相 对于双层球囊110或吸附件140产生位移,当然这里的位移量通常较小(一般情况下最大不超过5mm),基本上对温度测量不会造成影响,且测温元件120与吸附件140也可能产生相对位移。
因此,通过吸附件140和双层球囊110的相对位移,吸附件140和测温元件120的相对位移,以及测温元件120和双层球囊110的相对位移,最终避免了双层球囊110扩张或收缩时受到约束,使双层球囊110可以均匀扩张和均匀收缩,使双层球囊的操作性能提高,同时也不会因为双层球囊的不均匀扩张而影响球囊表面温度的监测,也不会因为测温元件120自身延展性能差而造成测温元件断裂失效。同时,双层球囊110收缩均匀,也减小了球囊导管100通过外鞘管的直径,从而有利于介入手术的实施,提高手术成功率。
应了解的是,当双层球囊110正常消融时,通过吸附件140可限定测温元件120相对于双层球囊110保持静止状态,从而测温元件120可在双层球囊上指定位置进行温度的监测而不会发生移位。然而消融之前,在双层球囊110扩张过程中,通过吸附件140相对于双层球囊110的位移,使测温元件120可顺应双层球囊的扩张,这样不仅避免了对双层球囊扩张的影响,而且也降低了测温元件120因自身延展性差而断裂的风险。类似的,在双层球囊110收缩过程中,亦利用吸附件140相对于双层球囊110的位移,使测温元件120能够顺应双层球囊的收缩,使双层球囊110能够顺利通过外鞘管。
进一步的,所述吸附件140优选为一物理吸附件,即以物理吸附的方式与测温元件120以及内层球囊112连接,或者,所述吸附件140优选以物理吸附的方式与测温元件120以及外层球囊111连接。从而利用物理吸附,实现吸附件140和测温元件120在双层球囊110扩张和收缩时皆可相对于双层球囊110产生位移的效果。具体来说,由于所述吸附件140与测温元件120物理吸附,使得吸附件140在双层球囊110产生形变时能够相对于测温元件120产生位移,同时由于吸附件140还与球囊表面物理吸附,从而使得所述吸附件140在所述双层球囊110产生形变时也能够相对于与该吸附件140连接的球囊表面产生位移,最终使得所述测温元件120也能够相对于与该吸附件连接的球囊表面产生位移。
需要说明的是,这里的物理吸附区别于化学吸附,物理吸附仅依靠吸附材料与被吸附的基材表面之间的作用力实现物理粘接,且当被吸附的基材表面相对于吸附材料产生形变时,吸附材料能够相对于被吸附的基材表面产生微小的滑动。
更进一步的,参考图5,所述吸附件140优选包括基层141和设置在基层141上的物理吸附层142。所述物理吸附层142可直接涂覆在基层141的一表面上。实际应用时,所述吸附件140上的一部分物理吸附层142与测温元件120物理吸附,而另一部分物理吸附层142则与内层球囊112或外层球囊111物理吸附。举例来说,所述吸附件140为一表面设置有物理吸附层142的胶带,利用胶带将测温元件120直接粘贴在球囊表面上,即可实现测温元件120和球囊表面的连接。应了解的是,物理吸附所能实现的效果是,当与吸附件140连接的球囊表面未发生变形时,物理吸附层142能够与球囊表面和测温元件120牢固的粘接,而当球囊表面产生延展或者收缩时,物理吸附层142会随着球囊表面材料的延展或收缩产生相对滑动,从而使得吸附件140和测温元件120皆不会影响球囊的扩张和收缩。
本发明实施例中,所述物理吸附层142的材料优选为在使用前后,材料的性能状态不会发生变化的软质胶状物,比如硅胶、水凝胶等软质胶状物,但不限于此,其他可实现类似功能的软质胶状物也可适用。具体来说,若要形成物理吸附,则所选用的材料在使用之前和使用之后(与被粘结的基材表面形成吸附即为使用之后),其硬度保持不变,比如硅胶在与球囊表面吸附的前后,其始终保持软质状态而硬度不曾改变。因此,本发明中所述的物理吸附区别于使用前后材料的性能状态发生变化的化学吸附。就化学吸附而言,例如选用使用前后材料的性能状态会发生变化的胶水,胶水在与球囊表面粘接之前和粘接之后,其性能状态便发生了明显的变化,由使用之前的液态转变为固态,同时使用之后的胶水也更硬,由此若将胶水与球囊表面进行粘接,则使球囊和被固定的元件之间无法产生相对位移而形成固定连接,从而影响球囊的扩张和收缩。当然,物理吸附不仅能够实现上述效果,而且物理吸附也不会产生对球囊有不利影响的物质,从而对于薄壁的双层球囊而言,物理 吸附不会对球囊的强度造成损伤,可确保球囊术中的安全性。另外,将测温元件120和吸附件140设置在两层球囊110的夹层113中,也不容易脱落,这是因为夹层113不仅有外层球囊111作为保护,而且夹层113基本处于真空状态,因此,当双层球囊110与人体组织接触和滑动时,夹层113基本上不会受到外力的影响,这样可避免吸附件140因为物理吸附粘接力不足而产生滑动的问题。
进一步的,本发明实施例中,当所述双层球囊产生形变时,所述吸附件140能够相对于双层球囊110产生的最大位移量设置为优选不超过扩张后的双层球囊110的外径的15%,例如扩张后的双层球囊110的外径为28mm,则吸附件140能够相对于双层球囊110产生的最大位移量不超过4.2mm。
具体来说,在双层球囊110扩张之前,所述吸附件140与双层球囊110相对静止,此时,更为形象地来说,所述吸附件140上应存在若干点与双层球囊110表面上相对应的若干点重合,且这些点之间无相对位移,进而当双层球囊110发生扩张,吸附件140便相对于双层球囊110产生位移,使得吸附件140上若干点也相对于双层球囊表面上对应点产生位移。因此,本发明将原本重合的两个点在扩张前后所产生的位移量定义为,所述吸附件140相对于双层球囊110所产生的位移量,并且将吸附件140上相对于双层球囊110所产生的最大位移量限定为不超过扩张后的双层球囊110的外径的15%。
为便于理解,以吸附件140上第一点与内层球囊112外表面上第二点,在双层球囊110扩张之前相重合作为示意,来进一步说明本发明所述的位移量。在双层球囊110未扩张时,所述第一点与第二点相重合;进而当双层球囊110发生扩张,所述第一点相对于所述第二点产生位移而出现了不重合的情况,此时,将第一点与第二点在沿着扩张后的内层球囊112外表面的距离定义为第一点相对于第二点所产生的位移量。并且无论吸附件140与双层球囊110的两端固定还是一端固定,所述吸附件140相对于双层球囊110的位移量均以上述方式实现。
应知晓的是,所述吸附件140能够相对于双层球囊110所产生的最大位移量通常与所选择的双层球囊110的膨胀特性有关,也就是说,本领域技术 人员可选择具有相应膨胀特性的球囊来满足这一要求,使吸附件140相对于双层球囊110所产生的最大位移量不会超过扩张后的双层球囊110的外径的15%。此外,应理解的是,在以下描述中,若将吸附件140与双层球囊110的一端或两端固定,所能实现的优点是在双层球囊扩张时,减小吸附件140相对于双层球囊110所产生的位移,该技术效果是在吸附件的最大位移量不超过扩张后的双层球囊的外径的15%的前提下所进一步取得的技术效果。另外,还应理解的是,所述位移量不作方向上的限定。
进一步的,所述基层141较佳地为由高分子材料制成的薄膜,例如聚酰亚胺或者聚酯材料制成的薄膜,其用于隔离物理吸附层142和没有与吸附件140连接的内层球囊112或外层球囊111,例如吸附件140与内层球囊112连接时,基层141用于隔离物理吸附层142和外层球囊111,或者吸附件140与外层球囊111连接时,基层141用于隔离物理吸附层142和内层球囊112,从而防止外层球囊111或者内层球囊112与物理吸附层142发生吸附而影响球囊的扩张和收缩。
在一示范性的实施例中,所述吸附件140由薄膜和设置在薄膜一侧表面上的软质胶状物构成,实际应用时,首先将测温元件120放置在例如内层球囊112的外表面上,之后将吸附件140直接粘贴在测温元件120和内层球囊112上形成物理吸附即可。可选的,所述吸附件140的厚度在100微米以下,且宽度范围为0.2mm~3mm,该宽度范围以能够完全吸附住测温元件120的前提下,越窄越好,以减小对球囊扩张的影响。其中,所述基层141的厚度可选在50微米以下,所述物理吸附层142的厚度可选在75微米以下。
进一步的,在本发明实施例中,所述吸附件140的至少一端优选与双层球囊110的一端固定,以避免吸附件140在双层球囊扩张和收缩时产生较大的轴向位移。在一些实施例中,所述吸附件140的一端与双层球囊110的近端或远端固定。在一些实施例中,所述吸附件140的一端与双层球囊110的近端固定,同时另一端与与双层球囊110的远端固定,如图3和图4所示,此时,所述吸附件140位于所述双层球囊110的近端和远端的部分既与所述测温元件120物理吸附,同时又与所述内层球囊112或所述外层球囊111物理 吸附。这里,还应知晓的是,所谓吸附件的一端与双层球囊的固定,指的是吸附件的一端与双层球囊始终保持相对静止而不会产生位移,当然实际应用时,所述吸附件140的两端也可不与双层球囊固定,而使整个吸附件140与测温元件120及双层球囊110物理吸附。
更进一步的,所述吸附件140自所述测温元件120的一端延伸至测温元件120的另一端,以便将整个所述测温元件120贴附于所述内层球囊112或所述外层球囊111。例如图3和图4所示,所述吸附件140自所述双层球囊110的近端延伸至双层球囊110的远端,以便于将整个测温元件120沿球囊的轴向贴附于内层球囊112或外层球囊111,测温元件120能够更好地贴附于内层球囊112或外层球囊111,从而保持在内层球囊112或外层球囊111上。此外当所述吸附件140的两端均与双层球囊110固定时,所述吸附件140位于双层球囊的近端和远端的部分的长度应确保有一定的伸长量,以免球囊在扩张时受到吸附件140的束缚,较佳地,所述吸附件140的最小长度(在此即所述吸附件140未经过拉伸的、初始长度)大于沿着扩张后的双层球囊110的近端到远端的单侧轮廓线的长度,以避免吸附件140的长度过短影响球囊的扩张。
在一些实施例中,所述吸附件140可以为长条状,便于仅通过一个吸附件140在球囊的轴向上整体覆盖测温元件120,使测温元件120的贴附更牢靠。在其他实施例中,所述吸附件140也可以为其他形状,如正方形、长方形等。所述吸附件140既可以将整个测温元件120贴附于球囊上,也可以将测温元件120的局部贴附于球囊上。并且,所述吸附件140的宽度优选大于或等于所述测温元件120的宽度,以使测温元件120在其宽度方向上未暴露在吸附件140之外,从而便于吸附件140在双层球囊的周向上能够完全覆盖住测温元件120。其中,所述吸附件140和所述测温元件120均可以为非等宽度结构,此时,优选的,所述吸附件140的最小宽度大于或等于所述测温元件120的最大宽度,以使测温元件120在其宽度方向上未暴露在吸附件140之外。在此,可以仅仅是所述吸附件140覆盖所述测温元件120的部分的最小宽度大于或等于所述测温元件120的最大宽度,即所述吸附件140不覆盖所述测温 元件120的部分的宽度也可以较所述测温元件120的的宽度小。
在一示范性的实施例中,所述吸附件140的最小长度与测温元件120的长度相一致,例如所述测温元件120为呈线状的温度传感器,且所述呈线状的温度传感器在球囊扩张之前处于未张紧的状态,使吸附件140的最小长度与测温元件120展开后的长度一致即可,这样一方面可确保吸附件140在双层球囊的轴向上能够覆盖整个测温元件120,另一方面也可确保吸附件140在球囊扩张时具有一定的伸长量而不会束缚球囊的扩张。当然,本发明不限定一个测温元件120通过一个吸附件140与双层球囊连接,在其他实施例中,一个测温元件120也可通过多个吸附件140与双层球囊连接,如沿着测温元件120的长度方向间隔布置多个吸附件140,这样可对测温元件120的多个区段进行连接。
进一步的,所述测温元件120包括相对的两端以及位于该两端之间的主体部。其中,所述测温元件120的至少一端与双层球囊110的一端固定,例如在一些实施例中,所述测温元件120的一端与双层球囊110的近端或远端固定,在一些实施例中,如图3和图4所示,所述测温元件120的一端与双层球囊110的近端固定,同时另一端与双层球囊110的远端固定,并且所述测温元件120位于所述双层球囊110的近端和远端的所述主体部的至少一部分,通过吸附件140物理吸附在所述内层球囊112或所述外层球囊111上,从而进一步通过吸附件140限定测温元件120在球囊的周向上产生过大的位移。
继续参考图3和图4,所述测温元件120较佳地呈线状,其优选沿着双层球囊110的轴向布置,即线状的温度传感器沿着所述双层球囊的近端到远端的方向布置,更优选的,在双层球囊110未发生扩张时,所述测温元件120位于所述双层球囊110的近端和远端的主体部处于未张紧的状态,且在双层球囊110扩张后,所述测温元件120展开后的长度大于沿着扩张后的所述双层球囊110的近端到远端的方向的单侧轮廓线的长度,这样当球囊扩张时,所述测温元件120有一定程度的伸直,这样可有效避免测温元件120发生断裂,而且物理吸附层142也不会影响测温元件120的伸直,使测温元件120更不容易断裂。
所述测温元件120优选为多个,多个所述测温元件120在所述夹层113中的不同位置分布,优选地,围绕内层球囊112的中轴线均匀分布。本实施例中,由于设置有多个测温元件120,因此可通过测温元件120检测多个位置处的温度信息。此外,在消融手术中,双层球囊110的外表面通常呈圆球形,与病灶不规则的筒状结构通常不能一次完全匹配,即双层球囊110的外表面不能与病灶良好接触。而双层球囊110与病灶的匹配情况,将直接影响消融手术的效果,因此,在消融手术中需要确认双层球囊110与病灶是否完全接触。由于人体组织的血液循环,双层球囊110与组织接触不良的部分的外表面被血液冲刷,温度显著高于双层球囊110与组织接触良好的部分的温度,因此双层球囊110与组织的不同接触情况会导致双层球囊110相应的接触点处的温度不一致。于是,可通过本实施例中的球囊导管100分布在双层球囊110中的多个测温元件120检测的多个位置处的温度信息,根据检测到的温度信息判断双层球囊110在相应位置处与球囊的接触情况,并进一步评估消融效果。相较于现有技术中,通过X光观察造影剂判断病灶是否完全被球囊完全阻隔的方式而言,本实施例中的球囊导管100无需多次造影,即病人不会反复受到X光的照射,也不会因此影响病人的健康,同时可提高手术效率,降低手术风险。
参考图6,所述呈线状的测温元件120可以是热电偶温度传感器。或者参考图7,所述呈线状的测温元件120还可以是热敏电阻温度传感器。
如图6所示,在本实施例中,所述测温元件120可包括第一导线121、第二导线122和测温模块123。所述第一导线121和第二导线122可平行设置,也可相交设置。所述第一导线121和第二导线122之间设置有所述测温模块123,所述测温模块123形成一个测温点,用于感测温度信息。所述测温模块123还用于将温度信息转换为电信息,所述第一导线121和第二导线122用于传递所述电信息。例如,所述第一导线121为铜线,所述第二导线122为康铜线,所述测温模块123与一段第一导线121和一段第二导线122焊接在一起,通过第一导线121和第二导线122焊接处将温度信息转换为电信息,并通过第一导线121和第二导线122将电信息传递出去,进而可实现第一导线 121和第二导线122焊接处的温度信息检测,通过第一导线121和第二导线122在焊接处形成的热电偶检测温度信息。
如图7所示,在其他实施例中,所述测温模块123也可以为热敏电阻,所述第一导线121和第二导线122分别与所述热敏电阻电连接。所述第一导线121和第二导线122呈对绞的状态。在本实施例中,选用呈线状的热电偶温度传感器或热电阻温度传感器作为测温元件,原因是:线状的热电偶温度传感器或热电阻温度传感器较柔软,不易发生断裂。
继续参考图6和图7,所述测温模块123具有近端侧和远端侧,所述近端侧连接第一导线121和第二导线122,该两根导线进而通过第三导线(图中未标记出)穿过导管本体130与控制手柄150上的电性输入输出接口151连接,从而将测温的温度信息向外输出。其中,所述第三导线可以是所述第一导线121和所述第二导线122的延伸部分而与所述电性输入输出接口151连接;也可以是不同于所述第一导线121和所述第二导线122的一独立的第三导线,连接所述第一导线121和所述第二导线122后与所述电性输入输出接口151连接,即所述第三导线的一端与所述第一导线121和所述第二导线122连接,所述第三导线的另一端与所述电性输入输出接口151连接,其中,所述第三导线可以为两根,以分别连接所述第一导线121和所述电性输入输出接口151以及所述第二导线122和所述电性输入输出接口151。优选的,所述测温模块123的远端侧连接有至少一根导线,该至少一根导线用于与双层球囊110的远端固定,本发明不限于远端侧连接导线,也可是其他柔性体。
进一步的,本发明一实施例中,仅所述测温模块123通过吸附件140与球囊表面物理吸附,而第一导线121和第二导线122中的至少一个近端固定在所述双层球囊110的近端,所述第一导线121、第二导线122和测温模块123均设置在所述内层球囊112和外层球囊111形成的夹层113中。由于所述吸附件140与所述双层球囊110及测温模块123物理吸附,因此在球囊扩张和收缩过程中,所述测温模块123可相对于所述双层球囊110和所述吸附件140产生位移,由此使测温模块123能顺应双层球囊110的扩张和收缩,而且测温模块123也不会因自身延展性差而断裂失效,同时第一导线121和第二 导线122均处于未收紧状态而在球囊扩张时可伸直,也不会影响球囊的扩张。
在另一示范性的实施例中,还可将所述第一导线121和/或第二导线122的一部分区段通过吸附件140物理吸附在内层球囊112或外层球囊111上,从而使第一导线121和/或第二导线122的一部分区段在球囊扩张与收缩过程中可相对于双层球囊110活动,不会形成固定结点,从而不会对双层球囊产生束缚,而且测温模块123也没有与球囊固定连接,故也不会约束球囊。
在其他示范性实施例中,参考图3和图4,还可将整根所述第一导线121和/或第二导线122通过吸附件140物理吸附在内层球囊112或外层球囊111上,从而使整根第一导线121和/或第二导线122在球囊扩张与收缩过程中可相对于双层球囊110活动,不会形成固定结点,从而不会对双层球囊产生束缚,而且测温模块123也没有与球囊固定连接,故也不会约束球囊。例如,所述第一导线121和第二导线122皆在近端与所述双层球囊110固定连接,而且在所述第一导线121和第二导线122的整个长度上,包括测温模块123,皆通过吸附件140与双层球囊110物理吸附。然而在其他实施例中,在通过吸附件140将所述第一导线121和/或第二导线122物理吸附在内层球囊112或外层球囊111的同时,还可以使得所述测温模块123处未与所述双层球囊110物理吸附连接,此方式同样也不会影响球囊的扩张和收缩。
当然,在其他实施例中,所述测温元件120也可以是其他形式,例如光纤或柔性印刷传感器,本发明对此不做限制。
进一步的,当所述测温元件120为多个时,优选至少一部分所述测温模块123在所述双层球囊110的不同周向上分布,即双层球囊的不同圆周上分布有至少一个测温模块123,更优选的,所有所述测温模块123在同一周向上的投影沿周向间隔设置,例如图3所示,可将六个测温模块123沿球囊的周向间隔布置,优选均匀布置,且这些测温模块123与球囊中心的距离可不同。
进一步的,除了在双层球囊的夹层113中设置测温元件120以外,还可以其他方式设置测温元件120,例如,在导管本体130位于内层球囊112内的区段上设置至少一个测温元件120,用于获取球囊内部的温度信息,且位于导管本体130上的所述至少一个测温元件120亦通过导线与控制手柄150上的 电性输入输出接口151连接。当然不同的测温元件120可连接同一个电性输入输出接口151,且在该电性输入输出接口151中可设置不同的数据通道,使各测温元件120通过不同的数据通道传送数据。
接下去将对导管本体130的结构做进一步的说明。
参考图2,所述导管本体130为非刚性结构,可任意弯曲。所述导管本体130的材料优选为高分子材料,如带有金属编织丝的热塑性聚氨酯弹性体橡胶(Thermoplastic polyurethanes,TPU)、嵌段聚醚酰胺树脂(Pebax)或尼龙,也可以是金属编织管。优选的,所述导管本体130的近端设置有控制手柄150,所述控制手柄150设置在外管133上,所述控制手柄150具体可用于操纵和操控导管本体130的弯曲状态。
所述控制手柄150上设置有电性输入输出接口151,所述测温元件120的近端穿过导管本体130与电性输入输出接口151连接,以便于将检测到的温度信息向外部设备传送。所述控制手柄150还可包括:至少一个流体输入接口152;至少一个流体输出接口(未图示);以及至少一个内腔接口153。所述内腔接口153用来插入导丝、标测导管、输送造影剂等器械。所述流体输入接口152与流体输送管件131流体连通,用于将外部提供的消融介质输入球囊导管100。所述流体输出接口用于排出双层球囊内的消融介质或其他介质。
进一步的,所述导管本体130还包括流体输送管件131,亦穿设在外管133中,并具体设置于外管133和芯杆134之间,并且所述流体输送管件131上还设置有朝向所述内层球囊表面的流体喷射口(未标示),用于向所述内层球囊112的内部喷射消融介质X,这里的消融介质不限于为冷冻流体。优选的,所述流体喷射口位于所述双层球囊110靠近双层球囊之远端的半球内,以便于更靠近待消融的肺静脉口,从而更高效地利用冷冻能量,节约能源。更优选的,所述冷冻流体为二氧化碳或一氧化二氮。
进一步的,如图2所示,所述流体输送管件131具体包括远端的螺旋结构132和与螺旋结构132流体连通的纵向延伸部分,所述纵向延伸部分穿过导管本体130与流体输入接口152连接。所述螺旋结构132上优选设置有多 个流体喷射口,多个流体喷射口用于朝不同的方向喷射消融介质。
进一步的,所述芯杆134为中空结构且可活动地设置在外管133内,且通过调节控制手柄150可使芯杆134在外管133内移动,以完成双层球囊110出鞘释放和入鞘回撤。所述芯杆134的近端与控制手柄150上的内腔接口153相连通,用来输送相关器械如导丝、标测导管或造影液等。所述导管本体130还包括流体排放管道,设置于所述芯杆134和外管133之间,用于排出双层球囊内的流体。此外,所述芯杆134伸出双层球囊110的远端较佳地设置有软头135,所述软头135的材质较软,用于避免对组织造成损伤。优选的,所述芯杆134的远端设置有显影标识136,所述显影标识136的材料为金属显影材料,术中,医生可借助于显影设备,通过显影标识136可确认双层球囊110相对于外鞘管的位置。
进一步的,本发明实施例还提供一种电生理系统,包括:球囊导管100、消融能量输出装置200和控制装置300,其中消融能量输出装置200与球囊导管100流体连通,以向球囊导管100提供消融介质。在一些实施例中,控制装置300与消融能量输出装置200连接,而消融能量输出装置200又与球囊导管100连接。在另一些实施例中,控制装置300也可以分别与消融能量输出装置200和球囊导管100连接。在还有一些实施例中,控制装置300与消融能量输出装置200可整合在同一设备中。本发明对此不做限制。
所述控制装置300用于根据所述测温元件120检测到的温度信息控制所述消融能量输出装置200调整消融介质的温度(如冷冻液体的温度),以使所述双层球囊表面的温度在预设的消融温度范围内。所述电生理系统包括但不限于对目标组织进行冷冻消融,而目标组织可以是心腔或肾动脉等,具体不作限制。
例如图9所示,可将电生理系统应用于心腔治疗,将球囊导管100通过介入方式置入心腔内部,以对肺静脉A进行消融,实现心律失常的治疗。或者如图10所示,也可将电生理系统应用于肾动脉,将球囊导管100通过介入方式置于入肾动脉口部B,对肾动脉C进行消融,以此调节肾动脉血压。
进一步的,以肺静脉的冷冻消融为例,结合图8和图9对电生理系统的 工作原理做进一步的说明。
步骤一S1,将球囊导管100的控制手柄150与消融能量输出装置200连接。
步骤二S2,将球囊导管100插入相应需要进行消融手术的目标组织中,如插入到心腔内部的筒状组织中,即插入肺静脉口。
步骤三S3,双层球囊110充盈,并向双层球囊110释放消融介质(即冷冻液体)。
步骤四S4,调整双层球囊110在筒状组织中的位置。
步骤五S5,通过多个测温元件120检测的温度信息分析双层球囊110的外表面的温度。
步骤六S6,判断双层球囊110与筒状组织的接触情况,若双层球囊110与筒状组织的接触良好则进行下一步骤,若双层球囊110与筒状组织的接触不良则返回步骤四S4。
步骤七S7,开始冷冻消融。
步骤八S8,通过多个测温元件120检测的温度信息分析双层球囊110的外表面的温度,确认消融效果。
步骤九S9,验证消融结果。
步骤十S10,结束消融手术。
其中,所述控制装置300根据所述球囊导管100检测的温度信息分析和判断所述双层球囊110与目标组织的接触情况,并据此控制消融能量输出装置200调整消融介质的消融温度。
在一实施例中,所述控制装置300具体包括制冷控制单元。所述消融能量输出装置200具体包括制冷单元、流体源和流体输出通道。所述流体源与流体输出通道连通,流体输出通道进而用于向球囊导管100输出所述流体源中的流体,例如所述流体输出通道与控制手柄150上的流体输入接口152连接,通过该接口向球囊导管100输入消融介质。所述制冷单元设置于流体输出通道上,用于对流体输出通道中输送的流体进行制冷。所述制冷单元可以是压缩机或其它制冷装置,本发明对其结构不作具体限定。所述制冷单元用 于与制冷控制单元通讯连接,以通过制冷控制单元控制制冷单元的工作状态。更进一步来说,所述制冷控制单元用于根据接收到冷冻消融的指令,控制制冷单元工作,使流体输出通道向球囊导管100提供冷冻液体。本发明实施例中,可在控制手柄150或电脑界面上设置冷冻消融按钮,当操作者启动冷冻消融按钮时,即向制冷控制单元110发出冷冻消融的指令。其中电脑界面可以设置在控制装置300或消融能量输出装置200上。在一非限制性的操作中,所述制冷控制单元向制冷单元发出一制冷信号,制冷单元根据接收到的所述制冷信号进行制冷。
进一步的,在冷冻消融时,所述制冷控制单元根据多个测温元件120反馈回的温度信息,控制制冷单元调节其制冷温度,以此控制球囊表面的温度在预设的冷冻消融温度范围内。
更详细来说,如图11所示,所述电生理系统实施冷冻消融的工作过程具体包括:
步骤401:流体源向流体输出通道输出流体;
步骤402:制冷控制单元控制制冷单元制冷;
步骤403:经过制冷后,使流体到达预设的制冷温度;
步骤404:向内层球囊喷射冷冻液体;这里,步骤401、402、403、404实际上可同时进行,即开设制冷的同时向球囊内表面喷射冷冻液体;
步骤405:制冷过程中,制冷控制单元实时根据测温元件120反馈回的温度信息,控制制冷单元的制冷温度;
步骤406:球囊表面的温度到达冷冻消融所需的温度(例如是-40℃~-60℃),并维持一段时间后(例如是120~180秒),即可结束冷冻消融。
完成一次冷冻消融后,根据实际冷冻消融的效果,医生确定是否进行下一次的冷冻消融。但是,应知晓的是,每次冷冻消融后,双层球囊需要事先在体内自然复温到体温(步骤407),才可实施下一次的冷冻消融。
最后,本发明较佳实施例如上所述,但不限于上述实施例所公开的范围,例如本发明中的测温元件还可选用光纤或柔性印刷传感器,这些传感器亦可通过吸附件物理吸附在球囊表面,也不会对球囊的扩张和收缩造成束缚,但 是由于这些传感器自身存在的一些问题,线状的测温元件的使用效果更好。另外,还可采用柔软的非金属线对测温模块进行固定,例如在球囊表面上形成至少一个编织节点,所述测温模块可嵌在所述编织节点中。
上述描述仅是对本发明较佳实施例的描述,并非对本发明范围的任何限定,本发明领域的普通技术人员根据上述揭示内容做的任何变更、修饰,均属于权利要求书的保护范围。

Claims (23)

  1. 一种球囊导管,其特征在于,包括:
    导管本体;
    双层球囊,设置于所述导管本体的远端,且所述双层球囊包括内层球囊和包覆所述内层球囊的外层球囊;
    至少一个测温元件,设置在所述内层球囊和所述外层球囊之间的空间中;以及
    至少一个吸附件,既与所述测温元件吸附连接,又与所述内层球囊或所述外层球囊吸附连接,从而将所述测温元件贴附于所述内层球囊或所述外层球囊;
    其中,当所述双层球囊产生形变时,所述吸附件能够相对于与该吸附件连接的所述内层球囊或所述外层球囊产生位移,并使得所述测温元件也能够相对于与该吸附件连接的所述内层球囊或所述外层球囊产生位移。
  2. 根据权利要求1所述的球囊导管,其特征在于,所述吸附件为一物理吸附件,以物理吸附的方式与所述测温元件连接,以使所述测温元件在所述双层球囊产生形变时能够相对于所述吸附件产生位移,同时所述吸附件还以物理吸附的方式与所述内层球囊或所述外层球囊连接,以使所述吸附件在所述双层球囊产生形变时能够相对于与该吸附件连接的所述内层球囊或所述外层球囊产生位移,并使得所述测温元件也能够相对于与该吸附件连接的所述内层球囊或所述外层球囊产生位移。
  3. 根据权利要求2所述的球囊导管,其特征在于,当所述双层球囊产生形变时,所述吸附件相对于与该吸附件连接的所述内层球囊或所述外层球囊的最大位移量不超过扩张后的所述双层球囊的外径的15%。
  4. 根据权利要求2所述的球囊导管,其特征在于,所述吸附件包括基层以及设置在所述基层上的物理吸附层;
    所述物理吸附层的一部分与所述测温元件物理吸附,所述物理吸附层的另一部分与所述内层球囊和所述外层球囊中的一个物理吸附,同时所述基层 用于防止所述内层球囊和所述外层球囊中的另一个与所述物理吸附层相吸附。
  5. 根据权利要求4所述的球囊导管,其特征在于,所述物理吸附层的材质为使用前后性能状态不变的软质胶状物。
  6. 根据权利要求5所述的球囊导管,其特征在于,所述物理吸附层的材质为硅胶或水凝胶,且所述基层为由高分子材料制成的膜,所述膜的一个表面涂覆形成有所述物理吸附层。
  7. 根据权利要求1-6中任一项所述的球囊导管,其特征在于,所述吸附件的至少一端与所述双层球囊的一端固定。
  8. 根据权利要求7所述的球囊导管,其特征在于,所述吸附件的一端与所述双层球囊的近端固定,所述吸附件的另一端与所述双层球囊的远端固定;并且所述吸附件位于所述双层球囊的近端和远端之间的部分与所述测温元件吸附连接,同时还与所述内层球囊或所述外层球囊吸附连接;
    其中,所述吸附件的长度大于沿着扩张后的所述双层球囊的近端到远端的单侧轮廓线的长度。
  9. 根据权利要求1-6中任一项所述的球囊导管,其特征在于,所述吸附件的宽度大于或等于所述测温元件的最大宽度,以使所述测温元件在其宽度方向上未暴露在所述吸附件之外。
  10. 根据权利要求9所述的球囊导管,其特征在于,所述吸附件自所述测温元件的一端延伸至所述测温元件的另一端,以将整个所述测温元件贴附于所述内层球囊或所述外层球囊。
  11. 根据权利要求9所述的球囊导管,其特征在于,所述吸附件的厚度在100微米以下,且所述吸附件的宽度范围为0.2mm~3.0mm。
  12. 根据权利要求1-6中任一项所述的球囊导管,其特征在于,所述测温元件包括相对两端以及位于该相对两端之间的主体部;
    其中,所述测温元件的至少一端与所述双层球囊的一端固定,且所述测温元件的所述主体部的至少一部分通过所述吸附件贴附于所述内层球囊或所述外层球囊。
  13. 根据权利要求12所述的球囊导管,其特征在于,所述主体部的至少一部分通过多个所述吸附件贴附于所述内层球囊或所述外层球囊。
  14. 根据权利要求12所述的球囊导管,其特征在于,所述测温元件为多个,且分布在所述内层球囊和所述外层球囊之间的空间中的不同位置。
  15. 根据权利要求1-6中任一项所述的球囊导管,其特征在于,所述测温元件为呈线状的温度传感器,所述呈线状的温度传感器的至少一端与所述双层球囊的一端固定,且所述呈线状的温度传感器沿着所述双层球囊的近端到远端的方向布置。
  16. 根据权利要求15所述的球囊导管,其特征在于,所述吸附件自所述双层球囊的近端延伸至所述双层球囊的远端,以将整个所述呈线状的温度传感器贴附于所述内层球囊或所述外层球囊。
  17. 根据权利要求16所述的球囊导管,其特征在于,所述吸附件呈长条状。
  18. 根据权利要求15所述的球囊导管,其特征在于,在所述双层球囊未扩张的情况下,所述测温元件位于所述双层球囊的近端和远端的部分处于未张紧的状态,且所述测温元件展开后的长度大于沿着扩张后的所述双层球囊的近端到远端的单侧轮廓线的长度。
  19. 根据权利要求15所述的球囊导管,其特征在于,所述呈线状的温度传感器为热电偶温度传感器或热电阻温度传感器。
  20. 根据权利要求15所述的球囊导管,其特征在于,所述测温元件包括第一导线、第二导线和测温模块,所述第一导线和第二导线相连接,所述第一导线和第二导线之间设置有所述测温模块,所述测温模块用于将温度信息转换为电信息,所述第一导线和所述第二导线用于传递所述电信息;
    其中,所述测温模块通过所述吸附件贴附于所述内层球囊或所述外层球囊,和/或,所述第一导线和所述第二导线中的至少一个的至少部分区段通过所述吸附件贴附于所述内层球囊或所述外层球囊上。
  21. 根据权利要求1或2所述的球囊导管,其特征在于,所述导管本体包括外管和设置于所述外管中的芯杆,所述芯杆的远端伸出所述外管;所述 双层球囊的远端与所述芯杆连接,所述双层球囊的近端与所述外管连接。
  22. 根据权利要求21所述的球囊导管,其特征在于,所述导管本体还包括流体输送管件,设置于所述芯杆和所述外管之间,所述流体输送管件上还设置有朝向所述内层球囊表面的流体喷射口,用于向所述内层球囊的内部喷射冷冻流体,且所述流体喷射口位于所述双层球囊靠近所述双层球囊的远端的半球内。
  23. 一种电生理系统,其特征在于,包括消融能量输出装置、控制装置和如权利要求1至22中任一项所述的球囊导管,所述消融能量输出装置与所述球囊导管相连通,用于向所述球囊导管提供消融介质;所述控制装置用于根据所述测温元件检测到的温度信息控制所述消融能量输出装置调整所述消融介质的温度,以使所述双层球囊表面的温度在预设的消融温度范围内。
PCT/CN2019/129030 2019-01-31 2019-12-27 球囊导管及电生理系统 WO2020155978A1 (zh)

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