WO2020259358A1 - Dispositif de blocage de flux sanguin veineux coronaire - Google Patents

Dispositif de blocage de flux sanguin veineux coronaire Download PDF

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Publication number
WO2020259358A1
WO2020259358A1 PCT/CN2020/096475 CN2020096475W WO2020259358A1 WO 2020259358 A1 WO2020259358 A1 WO 2020259358A1 CN 2020096475 W CN2020096475 W CN 2020096475W WO 2020259358 A1 WO2020259358 A1 WO 2020259358A1
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WO
WIPO (PCT)
Prior art keywords
catheter
balloon
blocking device
blood flow
venous blood
Prior art date
Application number
PCT/CN2020/096475
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English (en)
Chinese (zh)
Inventor
李金山
郑帅
李丽
王旭东
张文超
崔建培
Original Assignee
北京康瑞迪医疗科技有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 北京康瑞迪医疗科技有限公司 filed Critical 北京康瑞迪医疗科技有限公司
Publication of WO2020259358A1 publication Critical patent/WO2020259358A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord

Definitions

  • the invention relates to the field of medical equipment, in particular to a cardiac coronary venous blood flow blocking device.
  • the coronary circulation is to provide the heart itself with the nutrients and oxygen it needs, and to transport away metabolic waste. It is a circulation in which blood flows directly from the coronary arteries at the base of the aorta to the capillary network inside the myocardium and finally flows from the veins back to the right atrium and right ventricle, and then enters the lungs for exchange and flows into the left atrium and left ventricle.
  • coronary artery stenosis or obstruction can cause myocardial ischemia, hypoxia or necrosis.
  • Acute myocardial infarction is myocardial necrosis caused by acute and persistent ischemia and hypoxia of coronary arteries.
  • the disease is most common in Europe and the United States. About 1.5 million people in the United States suffer from myocardial infarction each year. China has shown a significant upward trend in recent years, with at least 500,000 new cases each year, and at least 2 million current cases.
  • the present invention provides a cardiac coronary venous blood flow blocking device, which helps to solve the problem of no reflow of myocardium after coronary blood flow is restored in patients with acute myocardial infarction.
  • a cardiac coronary venous blood flow blocking device comprising:
  • a first catheter, the proximal connection part of the first catheter is connected to the filling mechanism;
  • the first balloon has an accommodating space inside the first balloon, the first balloon communicates with the distal end of the first catheter, and the filling mechanism makes the first The balloon is in an inflated state.
  • the filling mechanism includes:
  • a cavity, the cavity has an accommodation space inside;
  • the piston is located in the accommodating space of the cavity and slides along the length of the accommodating space of the cavity.
  • the blocking device further includes:
  • a vacuuming mechanism which vacuums the blocking device.
  • the blocking device further includes:
  • a second catheter the second catheter is located in the first catheter, and the proximal end of the second catheter extends to the outside of the first catheter, and a filling mechanism is connected to the proximal end of the second catheter;
  • the distal end of the second catheter extends to the outside of the distal end of the first balloon;
  • a second balloon, the second balloon is located at the distal end of the second catheter and communicates with the inside of the second catheter;
  • the filling mechanism makes the second balloon in a filling state through the second catheter.
  • the blocking device further includes:
  • the perfusion pipe has an extracorporeal perfusion inlet and an intracorporeal perfusion outlet, the perfusion pipe is located in the first catheter, the extracorporeal perfusion inlet extends to the outside of the proximal port of the first catheter, and the intracorporeal perfusion outlet Extending to the outside of the distal end of the first catheter.
  • the blocking device further includes:
  • the pressure monitoring unit is used to monitor the blood pressure of the coronary veins of the heart.
  • the invention provides a heart coronary venous blood flow blocking device. Compared with the prior art, it has the following beneficial effects:
  • the first balloon is placed in the cardiac coronary vein through an operation, and the filling mechanism uses the first catheter to contact the first balloon. After filling, the accommodating space inside the first balloon is filled so that the diameter of the first balloon becomes larger, so as to block the end of the coronary vein close to the right atrium, so that the blood flow of the vein cannot return to the right atrium.
  • Normal myocardial cell blood flows out, so the blood pressure in the blocked area increases. Under pressure, the blood in the vein will flow back into the venous microcirculation of the myocardium.
  • the ischemic myocardial area is fully perfused to ensure the blood supply of the myocardium.
  • Figure 1 is a schematic structural diagram of an embodiment of the present invention
  • FIG. 2 is a schematic diagram of the structure of the first balloon in the contracted state of the embodiment of the present invention.
  • FIG. 3 is a schematic structural diagram of the first balloon in the inflated state of the embodiment of the present invention.
  • FIG. 4 is a schematic diagram of the structure of the second balloon in the contracted state of the embodiment of the present invention.
  • Fig. 5 is a schematic structural diagram of a second balloon in a contracted state according to an embodiment of the present invention.
  • the "far” and “near” are all referred to the operator.
  • the “distal end” of the first catheter refers to the end of the first catheter away from the operator, while the “proximal end” of the first catheter refers to the end of the first lumen near the operator.
  • the embodiments of the present application provide a cardiac coronary venous blood flow blocking device to solve the technical problem of no reflow phenomenon after the blood flow of the occluded epicardial blood vessel of the patient with acute myocardial infarction is restored;
  • the first balloon is placed in the coronary vein of the heart by surgery, and the filling mechanism uses the first catheter to inflate the first balloon so that the diameter of the first balloon becomes larger, thereby blocking the end of the coronary vein close to the right atrium , So that the venous blood flow can not return to the right atrium, under pressure, the blood in the vein will reflow into the venous microcirculation of the myocardium, the ischemic myocardial area is fully perfused to ensure the blood supply of the myocardium.
  • a cardiac coronary venous blood flow blocking device the blocking device includes a first catheter 2 and a first balloon 1, wherein the proximal connection part of the first catheter 2 has a filling mechanism 4 ,
  • the first balloon 1 has an accommodating space inside, the first balloon 1 is in communication with the distal end of the first catheter 2, and the filling mechanism 4 passes through the first catheter 2 to make the first balloon 1 appear Full state.
  • FIG. 2 is the contracted state of the first balloon 1
  • FIG. 3 is the filled state of the first balloon 1.
  • the first balloon 1 in the inflated state blocks the vein, thereby blocking the end of the coronary vein close to the right atrium, so that the blood flow of the vein cannot return to the right
  • the atrium, under pressure, the blood in this vein will infiltrate the venous microcirculation of the myocardium, and the ischemic myocardial area will be fully perfused to ensure the blood supply of the myocardium.
  • the present invention provides a cardiac coronary venous blood flow blocking device, which is placed in a vein and pushes the blood in the vein back into the myocardium, avoiding the inability to continuously supply blood to the myocardium due to the clogging of the arterial microvessels, resulting in myocardial ischemia , The blood is pushed back from the vein to the myocardium to ensure the blood supply of the myocardium and avoid myocardial necrosis caused by no-reflow phenomenon.
  • the filling mechanism 4 includes a cavity 401 and a piston 402.
  • the cavity 401 has an accommodation space inside, and the piston 402 is located in the accommodation space of the cavity 401 and extends along It slides along the length of the housing space of the cavity 401.
  • the piston 402 pushes the gas or liquid in the cavity 401 to the first catheter 2 so that the first balloon 1 is filled.
  • a sealing ring 4021 is provided on the side of the piston 402, and the sealing ring 4021 slides along the inner wall of the cavity 401.
  • a motor 403 may also be provided, and the piston 402 is driven by the motor 403 to generate a reciprocating motion in the cavity 401 to inflate and contract the first balloon 1.
  • the blocking device further includes a vacuuming mechanism 5, and the vacuuming mechanism 5 vacuumizes the blocking device.
  • the device needs to be evacuated before working.
  • the embodiment of the present invention also provides a connection structure.
  • a three-way valve 201 is provided at the proximal end of the first catheter 2, and the vacuuming mechanism 5 and the filling mechanism 4 are respectively connected through the three-way valve 201. It should be noted that in specific implementation, other connection methods can also be selected according to needs.
  • the blocking device further includes a second catheter 701 and a second balloon 7.
  • the second catheter 701 is located in the first catheter 2, and the proximal end of the second catheter 701 extends To the outside of the first catheter 2, the proximal end of the second catheter 701 is connected with a filling mechanism 4; the distal end of the second catheter 701 extends to the outside of the first balloon 1, and the second catheter 701
  • the inside of the balloon 7 communicates with the distal end of the second tube 701; the filling mechanism 4 makes the second balloon 7 in an inflated state through the second tube 701.
  • the filling mechanism 4 connected to the second tube 701 and the filling mechanism 4 connected to the first tube 2 may adopt the same structure, and the proximal end of the second tube 701 may also be connected to the vacuuming mechanism 5.
  • the blocking device when the arterial blockage causes myocardial ischemia, the blocking device is placed in the coronary vein of the heart by surgery, the filling mechanism fills the first balloon through the first catheter, and the accommodation space inside the first balloon It is filled so that the first balloon is in an inflated state.
  • the first balloon in the inflated state forms a blood block to the vein, preventing the blood in the vein from flowing to the right atrium, so that it is blocked to the pressure of the blood in the vein in the myocardium
  • the filling mechanism fills the second balloon through the second catheter, and the accommodating space inside the second balloon is filled, so that the second balloon is in a filled state, due to the second balloon in the filled state Forming blood squeeze on the veins, so that the blood in the veins is pushed back into the myocardium, so that the ischemic area is fully perfused to ensure the blood supply of the myocardium.
  • Multi-balloons block the veins in sections, increase the pressure of venous blood, promote the reverse push of venous blood back to the myocardium, fully ensure that the myocardial ischemic area is fully perfused, and prevent myocardial ischemic necrosis.
  • the blocking device further includes a perfusion pipe 3 having an in vitro perfusion inlet and an in vivo perfusion outlet, and the drug release pipe 3 is located in the first catheter 2 ,
  • the extracorporeal perfusion inlet extends to the outside of the proximal port of the first catheter 2
  • the intracorporeal perfusion outlet extends to the outside of the first balloon 1, and the drug is administered through the drug release tube 3 for drug assistance treatment.
  • the blocking device further includes a pressure monitoring unit 601, which is used to monitor the blood pressure of the heart vein, and the pressure monitored by the pressure monitoring unit 601 passes through the pressure monitoring unit.
  • the pipeline 6 is transmitted to the outside of the human body.
  • the pressure monitoring unit pipeline 6 can be set in the first catheter 2 to monitor the pressure of the venous blood in real time to prevent excessive pressure difference between the blocked vein and the artery during the blocking process. Damage to the heart muscle.
  • the first balloon is placed in the coronary vein of the heart through an operation.
  • the filling mechanism fills the first balloon through the first catheter, and gas or liquid enters the first balloon.
  • the accommodating space inside the balloon makes the first balloon in an inflated state.
  • the first balloon in the inflated state blocks the veins, prevents the blood in the coronary veins from flowing to the right ventricle, and increases the pressure of the venous blood.
  • the blood in the veins is pushed back to the myocardium, so that the myocardial ischemic area can get sufficient venous blood perfusion, and prevent myocardial ischemia from causing necrosis.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Reproductive Health (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • External Artificial Organs (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un dispositif de blocage de flux sanguin veineux coronaire, se rapportant au domaine de l'équipement médical. Le dispositif de blocage comprend un premier cathéter (2) et un premier ballonnet (1). Une partie de raccordement d'extrémité proche du premier cathéter (2) est reliée à un mécanisme de remplissage (4). Le premier ballonnet (1) enferme un espace de réception et est en communication avec une extrémité éloignée du premier cathéter (2). Le mécanisme de remplissage (4) remplit le premier ballonnet (1) au moyen du premier cathéter (2). Le dispositif de blocage de flux sanguin veineux coronaire est placé dans une veine pour pousser le sang dans la veine vers l'arrière dans le muscle cardiaque, ce qui permet de remédier au problème d'alimentation sanguine discontinue du muscle cardiaque en raison de l'obstruction des microvaisseaux artériels qui entraîne ainsi une ischémie myocardique. Le sang est poussé pour s'écouler vers l'arrière depuis la veine vers le muscle cardiaque, assurant ainsi l'alimentation en sang du muscle cardiaque, et empêchant la nécrose myocardique provoquée par un phénomène de non-reflux.
PCT/CN2020/096475 2019-06-28 2020-06-17 Dispositif de blocage de flux sanguin veineux coronaire WO2020259358A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CN201910577330.XA CN110353752B (zh) 2019-06-28 2019-06-28 心脏冠状静脉血流阻断装置
CN201910577330.X 2019-06-28

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WO2020259358A1 true WO2020259358A1 (fr) 2020-12-30

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Publication number Priority date Publication date Assignee Title
CN110353753A (zh) * 2019-06-28 2019-10-22 北京康瑞迪医疗科技有限公司 心脏冠状静脉灌注系统及其控制方法
CN110353752B (zh) * 2019-06-28 2021-05-25 北京康瑞迪医疗科技有限公司 心脏冠状静脉血流阻断装置

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CN109331266A (zh) * 2018-10-17 2019-02-15 杨清 静脉心脏辅助装置及应用其的介入治疗设备
CN110353752A (zh) * 2019-06-28 2019-10-22 北京康瑞迪医疗科技有限公司 心脏冠状静脉血流阻断装置

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Publication number Priority date Publication date Assignee Title
US20120296368A1 (en) * 2005-07-29 2012-11-22 Cvdevices, Llc Devices and methods for controlling blood perfusion pressure
CN102939124A (zh) * 2010-04-30 2013-02-20 雅培心脏血管系统股份有限公司 用于防止或减少再灌注损伤的具有膨胀和收缩管腔的导管
CN104185492A (zh) * 2011-12-22 2014-12-03 米拉科尔医疗系统有限责任公司 用于治疗心脏组织的系统和方法
CN105377268A (zh) * 2013-03-15 2016-03-02 克利夫兰临床医学基金会 用于治疗心肌梗塞的sdf-1的逆行递送
CN109331266A (zh) * 2018-10-17 2019-02-15 杨清 静脉心脏辅助装置及应用其的介入治疗设备
CN110353752A (zh) * 2019-06-28 2019-10-22 北京康瑞迪医疗科技有限公司 心脏冠状静脉血流阻断装置

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