WO2021020767A1 - Dispositif d'élimination de thrombus - Google Patents

Dispositif d'élimination de thrombus Download PDF

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Publication number
WO2021020767A1
WO2021020767A1 PCT/KR2020/009148 KR2020009148W WO2021020767A1 WO 2021020767 A1 WO2021020767 A1 WO 2021020767A1 KR 2020009148 W KR2020009148 W KR 2020009148W WO 2021020767 A1 WO2021020767 A1 WO 2021020767A1
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WIPO (PCT)
Prior art keywords
stent body
blood clot
removal device
cell
clot removal
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PCT/KR2020/009148
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English (en)
Korean (ko)
Inventor
민지영
민성우
쿠이 노-추단
Original Assignee
주식회사 엔벤트릭
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Publication of WO2021020767A1 publication Critical patent/WO2021020767A1/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
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00902—Material properties transparent or translucent
    • A61B2017/00915—Material properties transparent or translucent for radioactive radiation
    • A61B2017/0092—Material properties transparent or translucent for radioactive radiation for X-rays
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22094—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for crossing total occlusions, i.e. piercing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2212—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B2017/320733—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a flexible cutting or scraping element, e.g. with a whip-like distal filament member

Definitions

  • the present application relates to a blood clot removal device, and more particularly, to a blood clot removal device used for mechanical thrombectomy.
  • Ischemic vascular disease which is one of the vascular diseases, occurs because blood vessels are blocked or a strong stricture occurs in the blood vessels, thereby reducing blood flow. Therefore, for the treatment of ischemic vascular disease, it is most important to remove blood clots from the blood vessels of the patient.
  • dissolving blood clots by injecting a thrombolytic agent into a vein was a typical treatment method, but recently, a method of removing blood clots using a device that mechanically removes blood clots from blood vessels such as a stent retriever has emerged.
  • An object of the present invention is to provide a blood clot removal device that has sufficient radiation force to be combined with a blood clot during initial deployment and prevents excessive increase in radiation force due to its shape deformation during the blood clot removal process.
  • Another object of the present invention is to provide a blood clot removal device in which not only an excessive increase in radiation force due to shape deformation, but also excessive length deformation during a blood clot removal process is suppressed.
  • a structure including a plurality of cells having corners-
  • the plurality of cells include a first cell and a second cell having different coupling profiles from each other, and the coupling profile of a specific cell is the A blood clot removal device comprising a specific cell and a coupling type of a coupling between a corner of the specific cell and a neighboring cell, and a full wire operatively coupled to the structure, wherein the first The cell has a first coupling profile, the coupling type of all the couplings included in the first coupling profile is a first coupling type, and the first coupling type is each of two different cells connected to each other.
  • the ring type is a second coupling type
  • the second coupling type is formed by two struts each forming two corners and each individually included in two different cells connected to each other, the two struts It is possible to provide an apparatus for removing blood clots intertwined with each other.
  • connection between adjacent cells of the stent body included in the blood clot removal device is provided in a non-fixed form, excessive increase in radiation force due to a shape change of the stent body during the blood clot removal process is prevented, The friction applied to the blood vessel wall is minimized, so that damage to the blood vessel wall can be prevented.
  • an anti-stretching mechanism such as an anti-stretching wire or a cell of an anti-stretching structure suppresses excessive deformation of the stent body, thereby preventing the separation or fragmentation of the thrombus that is bound to the thrombus removal device or captured during the thrombus removal process. So the reperfusion rate can be improved.
  • FIG. 1 is a diagram illustrating that a conventional blood clot removal device is deformed according to a blood vessel diameter during a blood clot removal process.
  • FIG. 2 is a diagram illustrating a connection form between cells that may be provided on a stent body of a blood clot removal device according to an embodiment of the present specification.
  • FIG. 3 is another diagram illustrating a connection form between cells that may be provided on a stent body of a blood clot removal device according to an embodiment of the present specification.
  • FIG. 4 is a diagram illustrating an example in which a specific connection type is provided to a stent body of a blood clot removal device according to an exemplary embodiment of the present specification.
  • FIG. 5 is a diagram illustrating that the blood clot removal device according to FIG. 4 is modified according to a blood vessel structure during a blood clot removal process.
  • 6 to 11 are examples of coupling profiles of cells of a stent body of a blood clot removal device according to an embodiment of the present specification.
  • FIGS. 12 to 16 are diagrams illustrating an arrangement between a plurality of specific connection types provided to a stent body of a blood clot removal device according to an embodiment of the present specification.
  • FIG. 17 is a partially enlarged view of a blood clot removal device according to an embodiment of the present specification.
  • FIG. 18 is a diagram illustrating an example of a fixture used to manufacture a blood clot removal device according to an embodiment of the present specification.
  • 19 to 21 are photographs of a blood clot removal device according to an embodiment of the present specification.
  • FIG. 22 is a diagram illustrating an example of a blood clot removal device according to an embodiment of the present specification.
  • FIG. 23 is an exploded view of the blood clot removal device according to FIG. 22.
  • FIG. 24 is a diagram illustrating another example of a blood clot removal device according to an embodiment of the present specification.
  • FIG. 25 is an exploded view of the blood clot removal device according to FIG. 24.
  • 26 is a diagram illustrating another example of a blood clot removal device according to an embodiment of the present specification.
  • FIG. 27 is an exploded view of the blood clot removing device according to FIG. 26.
  • FIG. 28 is a photograph of an example implementation of a blood clot removal device according to an embodiment of the present specification.
  • 29 is an enlarged photograph of an implementation example of a blood clot removal device according to an embodiment of the present specification.
  • FIG. 30 is an exploded view of the blood clot removing device according to FIG. 28.
  • 31 and 32 are diagrams illustrating another implementation example of a blood clot removal device according to an embodiment of the present specification.
  • FIG 33 is a diagram illustrating a modified example of a blood clot removal device according to an embodiment of the present specification.
  • FIG. 34 is a diagram illustrating another modified example of a blood clot removal device according to an embodiment of the present specification.
  • 35 is a diagram illustrating another modified example of a blood clot removal device according to an embodiment of the present specification.
  • 36 to 38 are diagrams illustrating yet another modified example of a blood clot removal device according to an embodiment of the present specification.
  • 39 is a diagram illustrating an example of a blood clot removal device according to another embodiment of the present specification.
  • 40 and 43 are diagrams illustrating an example of a blood clot removing device according to another embodiment of the present specification.
  • 44 and 45 are perspective views and exploded views of different states of a blood clot removing device according to another embodiment of the present specification.
  • 46 and 47 are side views of different states of an apparatus for removing blood clots according to still another embodiment of the present specification.
  • FIG. 48 is a modified example of a blood clot removing device according to another embodiment of the present specification.
  • 49 is a diagram illustrating an example of a blood clot removing device according to another embodiment of the present specification.
  • a structure including a plurality of cells having corners- The plurality of cells includes a first cell and a second cell having different coupling profiles from each other, and the coupling profile of a specific cell is the A blood clot removal device comprising a specific cell and a coupling type of a coupling between a corner of the specific cell and a neighboring cell, and a full wire operatively coupled to the structure, wherein the first The cell has a first coupling profile, the coupling type of all the couplings included in the first coupling profile is a first coupling type, and the first coupling type is each of two different cells connected to each other.
  • the ring type is a second coupling type
  • the second coupling type is formed by two struts each forming two corners and each individually included in two different cells connected to each other, the two struts It provides a device for removing blood clots, which are intertwined with each other.
  • the corners of the plurality of cells may include two longitudinal corners and two circumferential corners, and at least one circumferential corner of the second cell may correspond to a second coupling type.
  • the rest of the corners of the second cell may correspond to the first coupling type.
  • the second coupling type may be formed by two struts intertwined once with each other, and the second coupling type may be formed by two struts intertwined with each other twice.
  • a blood clot removal device comprising a strut structure including a plurality of cells including a first cell and a second cell, and a pull wire operatively coupled to the structure
  • the first cell has four corners, all corners are fixedly coupled to the corners of neighboring cells
  • the second cell has four corners, and at least one of the corners is neighboring due to the struts being woven.
  • a blood clot removal device is provided that is non-fixedly coupled to at least one of the corners of one cell, and the rest of the corners are fixedly connected to the corners of neighboring cells.
  • a strut structure-the strut forms a border of a plurality of cells forming the surface of the structure and crosses each other to form a junction-and is operatively connected to the structure ( operatively coupled) full wire, wherein the junction comprises at least one first junction and at least one second junction, the first junction formed by two crossed struts attached to each other, the second junction It provides a blood clot removal device formed by twisted two crossed struts.
  • One of the two junctions facing each other and adjacent to the second junction may be a first junction.
  • All of the at least one second junction may be disposed on the same line parallel to an axis in a longitudinal direction of the blood clot removal device.
  • one of the at least one second junction and the other of the at least one second junction may be disposed at different longitudinal positions, and one of the at least one second junction and The other one of the at least one second joint may be disposed at a different circumferential position.
  • the blood clot removal device is fixedly connected to a first point and a second point of the blood clot removal device, further comprising a wire extending therebetween, wherein the wire is the first point And a distance between the second points may be prevented from having a value greater than the length of the wire.
  • the length of the wire may be greater than a distance between the first point and the second point when the blood clot removing device is in a no-load state.
  • the wire extends between the proximal end and the distal end of the structure and may be located along a central axis of the structure.
  • the blood clot removal device may further include an internal stent extending between the proximal end and the distal end of the structure and positioned inside the structure.
  • the present specification relates to a blood clot removal device.
  • the blood clot removal device is a device used to treat vascular diseases, and the blood clot removal device can remove blood vessels from blood vessels in a mechanical manner.
  • a blood clot removal device is used to remove a blood clot from a blood vessel in order to restore the blocked or decreased blood flow due to a blood clot sticking to the blood vessel wall, and is mainly used for the treatment of cerebrovascular diseases such as ischemic stroke.
  • a clot removal device is commonly called a stent retriever because it has a structural feature similar to a conventional stent inserted into the body to prevent blood vessel occlusion or stenosis, and is medically referred to as a mechanical blood clot removal device ( It is also called mechanical thrombectomy device).
  • a process of removing a blood clot using a blood clot removal device may be described as follows.
  • a location where blood flow is blocked in a user's blood vessel is detected, and then the guide wire is moved to the location.
  • the guide wire is placed in the vicinity of the blood clot, it is guided by the guide wire and moves the catheter to the vicinity of the clot.
  • a stent retriever, or blood clot removal device is inserted into the body using the catheter in earnest.
  • the blood clot removal device may move to the vicinity of the blood clot along the inside of the tube-shaped catheter in a compressed configuration.
  • the clot-removal device When the clot-removal device reaches the vicinity of the blood clot, the clot-removal device is fixed in place, the catheter is retrieved, and the clot-removal device is released from the catheter.
  • the blood clot removal device since the blood clot removal device is manufactured using a material of high elasticity such as Nitinol or a nitinol-based memory alloy, the blood clot removal device from the catheter expands and changes its shape to a deployed configuration. , During this dilation process, it engages with the thrombus located nearby.
  • the blood clot removal device After the blood clot removal device is sufficiently well coupled with the blood clot, the blood clot in the blood vessel is removed and reperfusion is performed by collecting the blood clot from the body together with the blood clot removal device through a pull wire.
  • the blood clot removal device is a device used for mechanical thrombectomy, and specifically, is a device that holds a blood clot located in a blood vessel to restore blood flow and recovers it outside the body.
  • the blood clot removal device is advantageously designed to have high radiation when it is initially deployed because it is combined with the blood clot in the process of expanding out of the catheter after being inserted into the blood vessel.
  • a blood clot removal device having a high radiation power is a blood clot removal device into the blood vessel. It can be difficult to compress enough to be inserted into the interior of the carrying catheter.
  • the blood clot removal device must be deformed according to the structure of the blood vessel in the process of being recovered from the body after carrying the blood clot, but the blood clot removal device having a high radiation force is difficult to deform or the radiation force is excessively increased through the deformation. May be.
  • the blood clot removal device is designed to have a high radiation force when deployed, and that the difference in radiation force between the compressed state and the deployed state is not large.
  • the conventional blood clot An open structure, such as a seam, an open cut, or a slit, was also provided for the removal device.
  • the blood clot removal device 10 includes a stent body 11 and a pull wire 12, and a slit, which is an example of an open structure, is formed in the stent body 11.
  • the slit is provided on the side of the stent body 11 of the blood clot removal device, and the slit may be implemented in a shape in which the side of the stent body 11 is cut along the length direction.
  • the stent body 11 including a slit having a cut shape as shown in FIG. 1 when an external force is applied to the blood clot removal device, the circumferential surfaces of the stent body 11 separated through the incision surface overlap each other (A1-A1 By using ⁇ ), problems that may occur when the diameter of the stent body 11 is reduced may be somewhat solved.
  • the stent body 11 including an open structure can prevent an increase in radiation force due to a change in diameter through overlapping of the circumferential surfaces, and accordingly, the stent body 11 of FIG. 1 is inserted into the catheter. It can be easily compressed in the process, and deformation according to various vascular structures can be easily performed in the recovery process.
  • the blood clot removing device 11 While the blood clot removing device 11 has an open structure, it may have an advantage according to a change in diameter, but a disadvantage due to a cut shape may also occur. For example, when the blood clot removal device 11 passes through a blood vessel of a wide diameter in the recovery process, the diameter D2 of the stent body 11 increases accordingly, so that the stent body 11 with the slit therebetween.
  • the separated circumferential surface may have a gap between them (A2-A2' cut plane), and a blood clot carried by the stent body 11 may be separated or leaked through the open side, and the end of the opened circumferential surface It can damage it.
  • the stent body 11 may be deformed to fit the blood vessel structure, and the separated circumferential surface is opened accordingly, and the blood clot is separated from the stent body 11 Or leak.
  • the blood clot removal device is a blood clot removal device that has a small difference in radiation force before and after shape deformation. More specifically, the stent body of the blood clot removal device is opened to solve this problem. It is a blood clot removal device that does not include a part but is designed so that a part of the stent body can overlap, so that the radiation force does not increase excessively even after the shape of the stent body is deformed by external force.
  • the blood clot removal device may be designed to minimize a difference in radiation force of the stent body before and after shape deformation by an external force, and this may be possible by overlapping portions of the stent body with each other.
  • the stent body of the blood clot removal device may be a strut structure formed by connecting at least one or more struts to each other, and the stent body may include a plurality of cells formed through struts, and the plurality of cells are adjacent cells and Can be connected to each other. At this time, some of the plurality of cells may be non-fixedly connected with neighboring cells, and when the stent body is compressed into the hollow of the catheter or passes through a vessel having a narrow diameter or a curved section of a blood vessel, it is non-fixed. The connected two adjacent cells overlap each other so that the shape change of the stent body can be easily performed.
  • the radiation force of the stent body may increase through a change in the shape of the stent body, but the stent body of the blood clot removal device according to the present embodiments excessively increases the radiation force through overlapping of the cells described above. Can be prevented.
  • non-fixedly connecting the two cells is distinguished from the conventional slit separating the two cells, and the stent body of the blood clot removal device according to the present embodiments does not open the side of the stent body. It is possible to prevent a blood clot from being separated from the stent body or leaking out when passing through a blood vessel having a wide diameter or passing through a curved section of a blood vessel.
  • the non-fixed form exemplified through the present specification may be a form of intertwining struts of two adjacent cells, but a non-fixed connection between two adjacent struts or two adjacent cells other than intertwining. It should be construed as including a variety of structures and forms.
  • the thrombus removal device is a device used for mechanical thrombus removal for reperfusion of blood vessels, and an increase in radiation force due to shape deformation may be prevented.
  • the blood clot removal device may include a stent body and a full wire, and some of the struts or cells of the stent body may be connected in a non-fixed form.
  • the stent body is an element that directly bears blood clots
  • the full wire is a configuration that applies a recovery force to the stent body
  • the non-fixedly coupling type formed on the stent body is the stent body. It is to minimize the increase in radiation force due to the deformation of the shape.
  • the stent body is accommodated in the catheter in a compressed state, and the catheter is released from the catheter after reaching the treatment point, that is, the point where the blood clot is located in the blood vessel, and expands to a deployed state. Then, a blood clot may be removed during or after the inflation process, and the pull wire collects the stent body carrying the clot out of the body together with the clot to remove the blood clot.
  • the stent body of the blood clot removal device includes a non-fixed connection formed between struts or cells, and through this, the stent body is easily compressed in the process of being inserted into the catheter to be transported into the blood vessel.
  • the radiation force of the stent body is maintained within a certain range, thereby preventing damage to the blood vessel wall and stably recovering the blood clot in the blood vessel.
  • the stent body may be provided as a highly elastic mesh framework capable of shape deformation.
  • the stent body is enclosed in a catheter from the outside of the body and moves through the blood vessel to the treatment point, and then escapes from the catheter and binds to or captures a thrombus.
  • the catheter is very different in size to contain and to bind to or capture a thrombus. Therefore, it needs to be transformed in shape. Therefore, the stent body is a highly elastic structure that can be transformed into a deployed configuration suitable for carrying a blood clot by self-expansion when it is removed from the catheter from a compressed configuration compressed to be contained in the catheter. Is provided.
  • the stent body may be provided as a mesh-based structure formed by struts of a high elastic material.
  • the strut has a linear structure, and a material having high elasticity including mainly Nitinol or a nitinol-based memory-shaped alloy may be used.
  • the stent body may be manufactured to have a hollow tube-shaped mesh structure using such a high elastic material strut.
  • the strut may form a stent body by forming an edge of the cell constituting the mesh structure.
  • the stent body provided as a mesh-based structure made of a highly elastic material can be compressed/expanded, it can be inserted into the catheter in a compressed state, and when it is out of the catheter, it can expand itself and reach a deployed state.
  • the stent body may be manufactured by first forming a shape in an deployed state with a strut made of a material such as nitinol and heating it at a high temperature to memorize the shape in the deployed state.
  • the stent body manufactured as described above is made of a highly elastic material, so it is easy to compress, and when external force is removed from the compressed state, it has the property of restoring to a memorized shape at high temperature, and accordingly, it can expand with radiation and reach an unfolded state.
  • the strut is used as a term in terms of elements constituting the stent body, and should be interpreted as not referring to the number of physical strands.
  • the number of physical strands of the strut will be expressed using the term strand.
  • the cell constituting the mesh structure of the stent body is in the shape of a diamond having four edges, the cell may be expressed as consisting of four struts regardless of whether it is actually formed of one strand or multiple strands. have.
  • the entire stent body is made through a bottom-up manufacturing technique in which a single strand is twisted. May be expressed as a single-strand structure.
  • the distinction between the strut and the strand is not necessarily clear, and for convenience of description, they may be mixed within a range that is obvious to those skilled in the art.
  • the stent body may selectively include a structure for attracting blood clots into the stent body, that is, a clot inviting structure.
  • Blood clots are largely classified into soft clots and hard clots, depending on their hardness.
  • vascular occlusion or vascular stenosis occurs when embolus in blood clumps to form a clot, which gradually hardens as time passes, and grows from a lead thrombosis to a menstrual thrombosis.
  • the strut can penetrate into the blood clot relatively easily during the self-expansion process of the stent body, so it is highly likely to be combined with the stent body, whereas a menstrual thrombosis with high hardness is a stent body when the radiation force of the stent body is insufficient.
  • the shape of the stent may not be combined with the stent body, and in this case, acupuncture points may partially distort the shape of the stent body.
  • the primary thrombus structure may be understood as a configuration for increasing a blood vessel reperfusion rate for blood vessel occlusion caused by acupuncture points that are not easily bonded to the stent body described above.
  • the first thrombus structure may be provided in various forms, and some examples thereof will be described below.
  • the stent body may have an opening through which a blood clot can pass through a direction toward the outside of the body in the longitudinal direction of the stent body (hereinafter, referred to as'proximal direction').
  • the stent body may have a cell (hereinafter referred to as'enlarged cell') formed to a size sufficient to serve as a passage through which blood clots located outside the stent body can move entirely into the stent body. have.
  • the stent body may be provided in a multi-segment form formed by connecting a plurality of segments having a single mesh structure, and may be provided in a structure having a gap formed between the segment and the segment. have.
  • blood clots have been divided into acupuncture points and blood clots, but this is only for convenience of explanation of the initial structure of a blood clot.
  • blood clots are not classified into conjunctival and menstrual thrombosis based on a specific hardness value, and with regard to the description of thrombus binding and thrombus capture, which will be described later, thrombus binding must be performed only for strep thrombosis, and thrombus capture is not possible.
  • a thrombus can be combined with the stent body.
  • the stent body can carry blood clots.
  • the stent body may combine with or capture a blood clot using a mesh structure or a clot inviting structure, and accordingly, a blood clot removal device may carry the blood clot.
  • the stent body may be combined with a blood clot through struts forming the stent body dig up a blood clot located nearby.
  • the stent body may capture a thrombus by receiving a thrombus located outside the stent body into the stent body through the above-described thrombus primary structure.
  • the strut penetrates the inside of the blood clot and the blood clot is bonded to the stent body, it is referred to as'clot engagement', and the reception of the blood clot inside the stent body is referred to as'clot capturing'. do.
  • the state in which the blood clot binding or the clot capture is performed by the stent body will be expressed as the clot removal device holding the blood clot.
  • the full wire can transmit a transverse force to the stent body.
  • One end of the pull wire may be directly or indirectly connected to the stent body, and the other end may be directly or indirectly connected to a user or a robotic surgical device performing thrombectomy.
  • the pull wire may receive a pulling force or a pushing force from a user or a robotic surgical device through the other end, and transmit the force to the stent body through one end.
  • the transverse force may be primarily a recovery force, but this is not necessarily the case.
  • the pull wire transfers some force to the stent body in the opposite direction of the recovery force. You can also pass it on.
  • the stent body is accommodated in the catheter, inserted from the outside of the body into a blood vessel inside the body, and is recovered out of the blood vessel through manipulation of a pull wire after holding a blood clot.
  • the shape of the stent body specifically its diameter It can vary in this wide range.
  • the shape deformation of the stent body is caused by the external force being applied to the stent body or the external force is removed.
  • an external force load
  • resistance or stress may occur inside the stent body.
  • buckling may occur in the strut of the stent body or the radiation force of the stent body may increase.
  • the non-fixed connection type is one of the coupling types that connects two adjacent cells of the stent body, and can be formed by intertwining or intertwisting struts forming the rim of the two adjacent cells. . Since the non-fixed connection type allows overlapping of cells, and the shape deformation of the stent body is performed through this, the increase in buckling or radiation force caused by the shape deformation may be limited compared to the case where overlapping of cells is not allowed. .
  • FIG. 2 is a diagram illustrating a connection form between cells that may be provided on a stent body of a blood clot removal device according to an embodiment of the present specification.
  • the coupling between two adjacent cells among a plurality of cells included in the stent body may be connected through a fixedly coupling type or a non-fixed connection type, wherein the'fixed' connection type is an external force
  • the'fixed' connection type is an external force
  • This may mean a connection type in which the positional relationship between the two cells is not changed
  • the'non-fixed' connection type may mean a connection relationship in which the positional relationship between the two cells is changed by an external force.
  • the term'coupling' refers to a connection between one cell and an adjacent cell.
  • the stent body of the blood clot removal device according to the present embodiment may have a plurality of couplings.
  • Each coupling may be provided in a different connection type, and a coupling provided in a fixed connection form is a'fixed coupling 1400', and a coupling provided in a non-fixed connection form is a'non-fixed connection'. It may be referred to as'coupling 1500'.
  • junction or junction link (link, linkage, or linking) or connection may be used interchangeably with respect to the coupling for convenience of description as needed, which is a comprehensive couple It should be understood to refer to a ring.
  • the two cells connected through the fixed coupling 1400 can be fixed in an abutting state, and their positional relationship does not change, so the shape of the stent body is deformed (specifically, it may mean a change in the diameter of the stent body).
  • Silver may be performed through deformation of the cell, and accordingly, the shape of the cell may be deformed to be elongated as shown in FIG. 2 or to be deformed by buckling generated by an external force.
  • the two cells connected through the non-fixed coupling 1500 may have a flexible positional relationship therebetween, and the no-load state (here, the'no-load state' means a state in which no external force is applied. ), two cells are in contact with each other, but in a load state (here,'load state' means a state in which an external force is applied), the two cells move closer together by the external force, so that at least a part of the two cells overlap.
  • the shape transformation of the stent body (which may specifically mean a change in the diameter of the stent body) by a non-fixed connection type can be performed through overlapping of cells rather than deformation of the cells, and accordingly, the shape of the cell is relatively original. Can be kept similar to
  • the static coupling 1400 does not change the positional relationship between two adjacent cells, it may be referred to as a'static coupling', and the non-stationary coupling 1500 can determine the positional relationship between two adjacent cells. As it fluctuates, it may also be referred to as'dynamic coupling'.
  • the non-stationary coupling 1500 may also be referred to as a free diameter, or a free diameter mechanism, based on its effect of reducing the difference in radiative force with a change in diameter.
  • the change in shape of the stent body through the non-fixed coupling 1500 is possible until two adjacent cells connected through the non-fixed coupling 1500 and the fixed connection form 1400 overlap each other, and the two cells overlap.
  • the shape of the stent body may be changed by changing the shape of the cell as described in the fixed coupling 1400. Therefore, the shape deformation of the stent body through the non-fixed coupling 1500 is performed only in a limited range, and the effect thereof is the size and shape of the two cells connected by the non-fixed coupling 1500, and the central axis of the stent body 1100 It may appear differently depending on the angle formed.
  • the above-described non-stationary coupling 1500 may be provided in different forms depending on the number of times of intertwining or intertwisting, for example, a single loop in which two struts are intertwined once each other. It may be provided in the form of a double loop or double loops intertwined with each other.
  • the shape of a single ring is shown in the'non-fixed coupling 1500' of FIG. 2, and has been described through the above description.
  • the boundary of two adjacent cells that is, struts may contact each other through a fixed or non-fixed connection type, and at this time, a point in contact with the strut of another cell in each cell is a contact point. May be referred to as.
  • the number of contact points located in each cell may be one or more, and the number of contact points may vary according to a connection type and the presence or absence of an external force.
  • each cell may have one contact point 1405.
  • the contact point 1405 of the two cells connected through the fixed coupling 1400 may not change its position due to an external force.
  • the contact point 1405 of the fixed coupling 1400 is the outer surface of the strut forming the rim of each cell (the surface facing the inner region of the cell from the strut forming the rim of the cell is the inner surface, and the opposite surface Can be defined as the outer surface).
  • two cells connected through the non-fixed coupling 1500 may change the position of the contact point 1505 according to an external force, and contact through one point in a no-load state, but contact through two points in a load state. have.
  • each contact point 1505 is on the inner surface of the strut forming the edge of the cell. Can be located.
  • the position of the contact point 1505 changes as the two cells move, and the two cells may each have two contact points 1505.
  • the two contact points 1505 located in one cell may be positioned in different directions on the strut forming the edge of the cell, and more specifically, one of the two contact points 1505 is in the inner direction of the stent body. And the other may be located in the outer direction of the stent body. This positional relationship may be due to the fact that the struts of the two adjacent cells are connected to each other in a twisted form, that is, arm-in-arm.
  • the border of the cell formed by the strut may include a corner and an edge, where the corner is near a point connected to another adjacent cell among the borders of the cell (based on the no-load state). It may refer to a predetermined area, and the edge of the cell extending between the corner and the corner may be referred to as an edge.
  • the contact point of the two cells connected through the fixed coupling (1400) can be located at the corner, and the contact point of the two cells connected through the non-fixed coupling (1500) is located at the corner in the no-load state, but the corner in the state where external force is applied. Can be located in
  • the position of the contact point described above is not fixed as an example described above, and the position may be changed according to the intention of the designer or the direction of the external force applied to the stent body.
  • a non-fixed coupling 1500 between two adjacent cells is located at a corner, and two corners abutting each other in a no-load state may be spaced apart from each other by an external force.
  • Each spaced corner is moved to the inside of the facing cell, and a range in which each corner can be moved may be an inner area of the facing cell. According to the movement of each corner, the two cells may overlap, and accordingly, shape deformation of the stent body may be performed.
  • the corners of the two adjacent cells are spaced apart, so that at least some of the two adjacent cells may overlap.
  • the overlapped region may be defined as a co-shared cell 1510.
  • the area of the shared cell 1510 may be included in the area of two adjacent cells with the non-fixed coupling 1500 interposed therebetween, and as the external force applied to the stent body increases, the area occupied by the shared cell 1510 may increase. . However, since the region of the shared cell 1510 is dependent on the region of two adjacent cells connected through the non-fixed coupling 1500, it may not be larger than one of the two adjacent cells.
  • non-fixed coupling 1500 has been described mainly to be provided between cells disposed along the circumference, this is not necessarily the case, and may be provided between cells disposed along the length direction.
  • FIG. 3 is another diagram illustrating a connection form between cells that may be provided on a stent body of a blood clot removal device according to an embodiment of the present specification.
  • coupling between at least two adjacent cells among cells of the stent body may be provided as a non-fixed coupling 1500 in a longitudinal direction.
  • the longitudinal non-fixed coupling 1500 connects two adjacent cells in the lengthwise direction, but by not fixing their positions, it is possible to allow the two adjacent cells to overlap in the lengthwise direction, and in the area where the two cells overlap.
  • a shared cell 1510 may be formed.
  • the non-fixed coupling 1500 provided between two adjacent cells disposed along the circumference mainly performs diameter reduction of the stent body by overlapping two radially adjacent cells, whereas between two adjacent cells disposed along the length direction.
  • the provided non-fixed coupling 1500 may perform partial length reduction of the stent body by overlapping two adjacent cells in the length direction.
  • a portion of the stent body uses compression force and the other portion uses tensile force based on the longitudinal section of the stent body.
  • the stent body can be deformed due to this.
  • the diameter of the stent body located in the curve section of the blood vessel is reduced under the influence of this force, thereby causing fragmentation of the blood clot or the separation of the blood clot.
  • a non-fixed connection form is provided between two adjacent cells of the stent body, the length of a portion of the stent body subjected to compression force by overlapping the two adjacent cells may be reduced, and the stent body may be deformed to fit the shape of the curve section. have. Since the compressive force acting on the stent body is resolved through the overlapping of the cells, the stent body having a non-fixed connection type may be prevented from reducing its diameter in the curve section.
  • the blood clot removal device includes a stent body and a full wire, and a coupling between at least two adjacent cells among cells of the stent body may be provided in a non-fixed connection form.
  • FIG. 4 is a diagram illustrating an example in which a specific connection type is provided to a stent body of a blood clot removal device according to an embodiment of the present specification
  • FIG. 5 is a diagram showing an example in which the blood clot removal device according to FIG. 4 is modified according to a blood vessel structure during a blood clot removal process It is a drawing showing what has been done.
  • the blood clot removal device 1000 may include a stent body 1100 and a full wire 1300, and at least one of the couplings included in the stent body 1100 May be a non-stationary coupling 1500.
  • the stent body 1100 is provided as a mesh structure in which cells are disposed on the outer surface of the hollow formed by the strut, and can hold the blood clot by combining with the blood clot through the mesh structure or by capturing the blood clot therein. I can.
  • the mesh structure may be formed including a plurality of cells 1103 formed by the struts 1101. Specifically, the strut forms the rim of the cell 1103, the cell 1103 may be formed by the strut 1101 constituting the rim, and the strut 1101 forms a plurality of cells 1103 so that the stent
  • the overall mesh structure of the body 1100 may be formed.
  • the cell 1103 is shown to be in the shape of a diamond, but the size or shape of the cell 1103 is the degree to which it is combined with the blood clot, the radiation force of the stent body 1100, the flexibility of the blood clot removal device 1000, etc. It may have an effect, so it can be properly designed in consideration of these factors.
  • the shape or size between the individual cells 1103 does not necessarily have to be the same.
  • some cells 1103 may be provided in the form of the above-described expanded cells for inviting blood clots.
  • the stent body 1100 having the above-described mesh structure may be manufactured through various manufacturing methods, and examples of manufacturing methods include laser cutting, micro machining, and electrical discharge machining (EDM). , Braiding, etc., and other examples include mechanical locks, welding, soldering (soldering), brazing (brazing), adhesive molding ), there may be a method of connecting the struts through crimping, etc.
  • the mechanical engagement may include twisting, knitting, webbing, mesh, or intertwining, but is not limited to these examples.
  • the stent body 1100 since the stent body 1100 is finally completed as a mesh structure using a strut, the stent body 1100 may be referred to as a strut structure.
  • the strut structure should be interpreted as a generic term including all of the stent body 1100 in the form of a metal wire form manufactured from the strut as well as the stent body 1100 in the form of cutting a metal tube. .
  • the stent body 1100 may include a material for securing visibility of the blood clot removal device 1000 during the blood clot removal process. Since mechanical thrombus removal is usually performed in the body, it is impossible for the user to visually check the location, operation, and shape of the thrombus removal device 1000, and visibility is achieved using X-rays or similar transparent light. Efforts to secure are being attempted.
  • the stent body 1100 may be made of a material including platinum, a platinum iridium alloy, or other material having high visibility under fluoroscopy to provide visual feedback to the user, and these visible materials may be used in the stent body 1100. Visibility can be secured in a form coated on the surface, inserted into the interior of the strut 1101, a form in which an object such as a marker providing visibility is attached to the stent body 1101, or a combination thereof.
  • the stent body 1100 may have a proximal end located on the side of the pull wire 1300 and a distal end located on the opposite side thereof.
  • a portion close to the proximal end may be a proximal portion
  • a portion close to the distal end side may be a dital portion
  • a portion located between the proximal portion and the distal portion may be a body portion. have.
  • the proximal portion of the stent body 1100 is a portion at which the strut forming the stent body 1100 starts to progress, and may be a portion receiving a force such as a recovery force from the pull wire 1300.
  • the strut 1101 may be gathered at one point at the proximal end, and at the proximal portion, the distal direction, that is, in a direction away from the pull wire 1300 according to the length direction of the stent body 1100, goes from the proximal end to a point. As the gathered struts 1101 spread out, the diameter of the stent body 1100 may gradually increase.
  • the pull wire 1300 may be directly or indirectly connected to the proximal end or a point of the proximal part, through which the proximal part transmits force for movement or manipulation of the stent body 1100 from the pull wire 1300 I can receive it.
  • the body portion of the stent body 1100 is a portion extending from the proximal portion, and may be a portion substantially carrying a blood clot.
  • the body portion may have a hollow tube shape, and an outer surface thereof may have a mesh structure including a cell formed by a strut.
  • the body portion can be combined with the blood clot through such a mesh structure, and the blood clot can be captured in the inner space thereof.
  • the body portion is illustrated in a simple hollow cylinder shape, but the body portion may be implemented in various shapes other than the body portion.
  • FIG. 4 shows that the diameter of the body portion is constant throughout the body portion, but it is possible that the diameter of the body portion differs at different points in the longitudinal direction.
  • FIG. 4 shows that the diameter of the body portion is constant throughout the body portion, but it is possible that the diameter of the body portion differs at different points in the longitudinal direction.
  • FIG. 4 shows that the diameter of the body portion is constant throughout the body portion, but it is possible that the diameter of the body portion differs at different points in the longitudinal direction.
  • FIG. 4 shows that the diameter of the body portion is constant throughout the body portion, but it is possible that the diameter of the
  • the body portion may have a multi-segment type in which the body portion has a plurality of segments. Since a description of the multi-segment stent body 1100 will be described later, a detailed description thereof will be omitted.
  • the distal portion of the stent body 1100 is a portion extending from the body portion.
  • the distal portion may simply form the distal end of the stent body, but may play a role of finally preventing the blood clot from being separated from the end of the stent body 1100 in the process of recovering the stent body 1100.
  • the distal portion may be provided in a closed end type as shown in FIG. 4.
  • the struts 1101 gather as the struts 1101 proceed in the distal direction again, as shown in FIG. 4, so that the diameter of the stent body 1100 may decrease.
  • the struts 1101 may be gathered at a point at the distal end of the distal portion.
  • the struts 1101 do not necessarily have to be assembled at the distal end, and may not have to gradually decrease in diameter from the distal portion toward the distal direction.
  • the distal part of the closed form prevents the separation or leakage of a thrombus or fragmented thrombus held by the thrombus removal device 1000 at the end of the stent body 1100 during the blood clot removal device 1000 is recovered It can re-engaging with clots that become
  • FIG. 4 shows the distal part in a closed form
  • the distal part may be an open end type.
  • the open distal portion may be interpreted as a part of the body. Since the open distal portion minimizes the influence of the stent body 1100 on the blood flow, the stent body 1100 in the recovery process can be moved quickly.
  • the stent body 1100 having an open distal portion is relatively easily deformed in shape compared to the stent body 1100 having a closed distal portion, and thus it is somewhat advantageous for passage through a curved section of a blood vessel or a narrow diameter section.
  • the open distal portion may also be provided in a form that gradually decreases in diameter, such as a closed distal portion.
  • the pull wire 1300 may receive a force for manipulating the blood clot removal device 1000 from a user or a surgical robot, and may transmit it to the stent body.
  • the pull wire 1300 is made of a material having high tensile strength and can perform instructions transmitted from the outside of the body, and the material of the pull wire 1300 is mainly nickel titanium alloy or stainless steel. However, it is not limited thereto.
  • the pull wire 1300 may receive force from a user or a surgical robot through one end or a portion close to the one end.
  • a portion of the pull wire 1300 is generally extended to the outside of the body, but the pull wire 1300 does not necessarily have to directly contact the user or the surgical robot, and the driving part of the user or the surgical robot indirectly as needed. Since it is also possible to be connected to the back, a part of the pull wire 1300 does not necessarily have to extend outside the body.
  • the full wire 1300 may transmit a force to the stent body 1100 through the other end or a portion close to the other end.
  • a portion of the pull wire 1300 may be directly or indirectly connected to the stent body 1100.
  • the pull wire 1300 may be connected to the proximal end of the stent body 1100 as shown in FIG. 4.
  • the full wire 1300 does not necessarily have to be directly attached to the proximal end, and is connected to the stent body 1100 through another medium in the middle, or connected to the stent body 1100 through a portion other than the proximal end. It is also possible.
  • Figure 4 shows that the pull wire 1300 is connected to the proximal end on a central axis extending in the longitudinal direction of the stent body 1100 along the center of the cross section of the stent body 1100. It is obvious that it can be appropriately deformed according to the shape of the proximal part of 1100).
  • Various modifications to the connection relationship between the stent body 1100 and the pull wire 1300 are examples described through the various drawings attached to the present specification and may be sufficiently understood by those skilled in the art, and thus a detailed description thereof will be omitted.
  • a user or a surgical robot can operate the blood clot removal device through the pull wire 1300.
  • the stent body 1100 may be moved within the blood vessel according to the manipulation of the pull wire 1300. Specifically, by pulling the pull wire 1300, a recovery force is applied to the stent body 1100, and through this, the blood clot removal device 1000 carrying the blood clot can be recovered outside the body.
  • the above-described push-and-fluff technique may also be performed through manipulation of a pull wire.
  • the non-fixed coupling 1500 is one of a form that connects two adjacent cells 1103 of the stent body 1100 and may be intertwined or twisted together.
  • the non-fixed coupling 1500 changes the positional relationship between the two adjacent cells 1103, so that the stent body (
  • the shape change of the 1100 in detail, the diameter change may be performed. After the inner regions of the two adjacent cells 1103 are sufficiently overlapped, the diameter change may be performed through the shape change of the cell 1103.
  • the shape change of the stent body 1100 provided with the non-fixed coupling 1500 may be freely performed, and an increase in buckling or radiation force according to the shape change of the stent body 1100 may be limited.
  • a shared cell 1510 may be formed in a region where two adjacent cells 1103 connected through the non-fixed coupling 1500 overlap, and the shape of the shared cell 1510 may not be excessively deformed.
  • the shape of the other cell 1103 located within the length section of the stent body 1100 in which the shared cell 1510 is located due to the influence of the shared cell 1510 is compared with the length section where only the fixed coupling 1400 is located. It can be kept similar to its original shape.
  • the contact point 1505 of may be located. In this case, the contact point 1505 may be located at a corner of each cell 1103.
  • the two corners that abut the inner surface may be spaced apart from each other, and the two cells 1103 connected through the non-fixed coupling 1500 overlap each other, and each cell is in a different direction. It may have two contact points 1505 located at.
  • the above-described shared cell 1510 may be formed in an area where the two cells overlap.
  • the shape of the cell 1103 located in the same length section as the shared cell 1510 is the original shape than that of the other cells 1103. Can be maintained.
  • the stent body 1100 is shown to include one non-fixed coupling, but this is only an example, and two or more non-fixed couplings may be provided to the stent body 1100. It is self-evident.
  • the coupling profile refers to a connection type between the cell 1103 and all neighboring cells 1103, and the coupling profile of one cell 1103 is It may be determined whether the connection type of the coupling of the cell 1103 is fixed or non-fixed.
  • the cell 1103 may include a maximum of four non-static couplings 1500, and the coupling profile of the cell 1103 May be determined according to including only the fixed coupling 1400, including one non-stationary coupling 1500, or including two or three or more.
  • the coupling profile can be treated differently depending on whether it is provided between the two cells.
  • the coupling profile includes a first coupling profile including only the fixed connection type and a second couple including at least one non-fixed connection type.
  • a ring profile may be included, and the cell 1103 of the stent body 1100 may include a first cell having a first coupling profile and a second cell having a second coupling profile.
  • the number of second cells may be determined according to the number of non-stationary coupling 1500, but this is not necessarily the case, and the number of second cells varies depending on whether the non-fixed coupling 1500 is formed in duplicate in one cell. I can.
  • the number of second cells is twice the number of non-fixed couplings 1500, whereas a plurality of non-fixed couples When the ring 1500 is overlapped with one cell, the number of second cells may be less than twice the number of the non-stationary coupling 1500.
  • two adjacent cells of the stent body 1100 are connected through one non-fixed coupling 1500 to each become a second cell having a second coupling profile, and a non-fixed coupling to one of these second cells. If another adjacent cell is connected by providing an additional ring 1500, the number of second cells may be minimized, and the number of second cells may be one more than the number of non-stationary coupling 1500. have.
  • the number of second cells having a second coupling profile is one more than the number of second connection types, depending on the number of second connection types provided to the stent body 1100 and their positions, to twice that number. It could have a value between
  • the behavior of the stent body 1100 may vary according to the number of first and second cells of the stent body 1100, and the larger the number of second cells, the more free the stent body 1100 can be deformed.
  • the second connection type is to connect two radially adjacent cells of the stent body, the more the second cells are, the easier the diameter change of the stent body is performed, and the second connection type is two adjacent cells in the length direction of the stent body. In the case of connecting the stent body, as the number of second cells increases, the flexibility of the stent body may be improved.
  • 6 to 11 are examples of coupling profiles of cells of a stent body of a blood clot removal device according to an embodiment of the present specification.
  • one of the cells 1103 of the stent body 1100 is connected to two cells adjacent to each other in length of the stent body 1100 and two cells adjacent to each other in a circumferential shape.
  • At least two of the four couplings formed therebetween may be provided as a non-stationary coupling 1500.
  • the corresponding cell 1103 may have a coupling profile including two non-fixed connection types or three non-fixed connection types, and may have a coupling profile including only non-fixed connection types.
  • two of the corners of the cell 1103 are located at different positions in the circumferential direction and the other two are located at different positions in the longitudinal direction, respectively. It may be referred to as a corner (circumferential corner) and a longitudinal corner (longitudinal corner).
  • the two non-fixed couplings 1500 face each other at the circumferential corners of the cell 1103 as shown in FIG. 6. It can be positioned to be seen, and may be positioned to face each other in the longitudinal corner of the cell 1103 as shown in FIG. 7, and the circumferential corner and the longitudinal direction of the cell 1103 as shown in FIG. One can also be placed in each upper corner.
  • a shared cell 1510 may be formed in the region.
  • two shared cells 1510 may be formed in the cell 1103 provided with the two non-fixed couplings 1500, and the case where one non-fixed coupling 1500 is provided to the cell 1103 In comparison, two shared cells 1510 formed in an inner region of one cell 1103 may not be able to freely increase in size due to influences on each other.
  • three non-fixed couplings 1500 are provided in one cell 1103, three non-fixed couplings 1500 are provided with two circumferential corners of the cell 1103 as shown in FIG. It may be located at the longitudinal corner of the cell 1103, as shown in FIG. 10, may be located at one circumferential corner and two longitudinal corners of the cell 1103.
  • the non-fixed coupling 1500 may be located at all corners of the cell 1103 as shown in FIG. 11.
  • the two cells 1103 connected through each non-stationary coupling 1500 may move toward each other and overlap, and a cell having three non-stationary couplings 1500
  • a maximum of three shared cells 1510 may be formed in an inner region of 1103, and a maximum of four shared cells 1510 may be formed in an inner region of the cell 1103 having four non-fixed coupling 1500.
  • the increase in size may be limited due to influences on each other.
  • the arrangement of the plurality of non-stationary couplings 1500 provided in different cells 1103 may be varied.
  • a plurality of non-stationary couplings 1500 may be provided in consideration of the free diameter area ratio.
  • a region in which diameter change is free through the non-fixed coupling 1500 among the entire regions of the stent body 1100 may be referred to as a free diameter region, and among the entire regions of the stent body 1100
  • the ratio of the free diameter region may be referred to as the ratio of Free Diameter region.
  • the non-fixed coupling 1500 may be provided between two rows of the stent body 1100, and may be positioned one after another in each row, so that the non-fixed coupling 1500 may be continuously positioned from the proximal end to the distal end.
  • the free diameter area ratio may be 100%, and the non-fixed coupling 1500 may prevent an increase in radiation force with respect to the entire length of the stent body 1100.
  • the non-fixed coupling 1500 is disposed to be positioned in one of two consecutive columns between two rows of the stent body 1100, thereby changing the lengthwise direction of the fixed coupling 1400 and the stent body 1100. They can be arranged alternately along the way. In this case, the free diameter area ratio may be 50%, and the effect of the non-fixed coupling 1500 may be low compared to the above-described example.
  • the term'row' refers to a position to which the cells 1103 consecutive in the length direction of the stent body 1100 belong when viewing the stent body 1100 in a two-dimensional development view, and also in the three-dimensional mesh structure. It may mean a position to which the cells 1103 continuing in the length direction belong.
  • the term'column' refers to the location of the cells 1103 that are continuous in the vertical direction of the stent body 1100 in a two-dimensional developed view, and a three-dimensional mesh On the structure, it can coincide with the circumferential direction.
  • the plurality of non-fixed couplings 1500 may be disposed in various combinations defined by a position in the length direction or a direction in a cross section of the stent body 1100 of the blood clot removal device 1000.
  • FIGS. 12 to 16 are diagrams illustrating an arrangement between a plurality of specific connection types provided to a stent body of a blood clot removal device according to an embodiment of the present specification.
  • the plurality of non-fixed couplings 1500 are arranged according to a position in the longitudinal direction or a direction in the cross section of the stent body 1100 may be described in detail with reference to the drawings.
  • the plurality of non-fixed couplings 1500 may be disposed at different positions in the length direction of the stent body 1100.
  • the plurality of non-fixed couplings 1500 may be positioned consecutively in the longitudinal direction as shown in FIG. 12, or may be positioned spaced apart in the longitudinal direction as shown in FIG. 13.
  • two non-fixed couplings 1500 may be formed at a position closest to the maximum in the longitudinal direction, and at this time, each free diameter region by the two non-fixed couplings 1500 Can be partially overlapped.
  • the plurality of non-fixed couplings 1500 are arranged in succession, overlapping or spaced apart in the longitudinal direction, thereby determining the free diameter area ratio of the non-fixing coupling 1500 to the stent body, and increasing the radiation force of the stent body 1100 May be restricted or permitted as appropriate.
  • the plurality of non-fixed couplings 1500 may be disposed in different radial directions from the center of the stent body 1100 when viewed from the longitudinal section of the stent body 1100.
  • the plurality of non-fixed couplings 1500 provided at radially different positions may have different effects depending on positions in the longitudinal direction.
  • the free diameter region of the two non-fixed couplings 1500 may be the same as in FIG. 12, but shared
  • the location where the cell 1510 is formed may be different from that of FIG. 12.
  • each non-fixed coupling when an external force is applied to the stent body 1100 Two shared cells 1510 generated by 1500 may be located on a straight line parallel to the central axis of the stent body 1100.
  • the two non-fixed couplings 1500 are located in different radial directions as shown in FIG. 15, the two shared cells 1510 generated thereby may be located in different radial directions of the stent body 1100. As a result, the stent body 1100 may be twisted as a whole.
  • the stent body 1100 may be re-engaged with the captured blood clots, and a blood clot removal device ( 1000), the success rate of clot capture could be improved.
  • a non-fixed coupling 1500 when the stent body 1100 is provided with a non-fixed coupling 1500 in the form according to FIG. 16, a plurality of non-fixed couplings 1500 are disposed on the circumference of the stent body 1100 As a result, it can act as an overlap within a specific length section.
  • two shared cells 1510 may be formed at radially different positions within a specific length section.
  • the diameter change of the corresponding length section can be easily performed compared to other sections of the stent body 1100, but if the effect is excessive, the stent body ( 1100) can interfere with its original radiation. Since the number of non-fixed couplings 1500 located on the circumference of the circumference may affect the ability of the stent body 1100 to capture blood clots, it is designed differently according to the shape or size of the cells 1103 of the stent body 1100. It may have to be.
  • the plurality of non-fixed couplings 1500 when the plurality of non-fixed couplings 1500 are disposed in different radial directions, their disposition may be symmetrical to each other.
  • the two non-fixed couplings 1500 may be disposed to face each other around a central axis of the stent body 1100.
  • the three non-fixed couplings 1500 may be arranged in a form that forms an angle of 120 degrees to each other from the central axis of the stent body 1100.
  • a plurality of non-fixed couplings 1500 are spaced apart as much as possible in the length direction or are arranged at a certain distance. It can be advantageous.
  • a plurality of non-fixed couplings 1500 are formed at the maximum angle on the longitudinal section of the stent body 1100. It may be advantageous if they are arranged to be spaced apart or so that the angles made to each other are constant.
  • the method of forming the non-stationary coupling 1500 may vary depending on the manufacturing process of the stent body 1100.
  • the stent body 1100 may be manufactured by a top-down process in which a tube-shaped metal is cut to form a structure, and the connection between the struts 1101 of the initial stent body 1100 All of silver may be formed as a fixed coupling 1400. At this time, the strut 1101 of one cell 1103 of the two adjacent cells 1103 is cut, and one strut 1101 is connected after looping the strut 1101 of the other cell 1103. A non-stationary coupling 1500 may be formed between two adjacent cells 1103.
  • connection of the two cut struts 1101 is laser welding, mechanical locks, crimping, adhesive method, molding or injection overmolding, shrink tube. ), soldering (soldering), brazing (brazing), swaging (swaging), or through various methods not mentioned.
  • the cut strut 1101 may be referred to as a disconnected strut 1590, and various forms of the separated strut 1590 may be provided.
  • two separating struts 1590 may be provided in a straight shape and partially overlap each other.
  • the two separating struts 1590 may be stably connected to each other through portions that are in contact with each other and overlap, and structural stability may be secured as the area to be connected increases.
  • the two separating struts 1590 may be provided in a stepped form and may be engaged with each other.
  • a protruding portion may be formed on the strut 1101 of the stent body 1100, so the width of the two separating struts 1590 can be adjusted through a step to be connected to each other.
  • the width of the separating strut 1590 may be formed to be the same as the width of the other struts 1101. As the two separate struts 1590 connected in this way become integrated with the other struts 1101, there may be an advantage in the process of inserting the stent body 1100 into the catheter or the process of recovering the stent body 1100 out of the body.
  • the separating struts 1590 of the stent body 1100 according to the present example may be provided in a stepped form and may be engaged with each other.
  • the separating struts 1590 are stably connected through the surfaces in contact with each other, and have a width of about half the width of the other struts 1101, so that the widths of the two separating struts 1590 are different from each other. It can have substantially the same value as the width.
  • the separation strut 1590 is preferably formed at the edge rather than the corner of the cell 1103, which may be because the corner portion where the coupling is formed is greatly affected by an external force.
  • the stent body 1100 may be manufactured by a bottom-up process in which a metal wire is deformed or formed to form a structure.
  • the order of manufacturing the wire-based stent body 1100 may vary.
  • the stent body 1100 may be manufactured by forming and connecting a wire, forming a two-dimensional pattern, and then wrapping it again to form a three-dimensional pattern.
  • a fixture may be used in the forming process of the wire, and each 2D pattern and 3D pattern may be formed through thermoforming.
  • the dynamic coupling 1500 may be formed by weaving or twisting wires in the process of creating a two-dimensional pattern.
  • the stent body 1100 may be manufactured by winding a wire around a cylindrical fixture to form a three-dimensional pattern.
  • the three-dimensional pattern may be formed through thermoforming, and the non-fixed coupling 1500 may be formed by weaving or twisting wires in the process of creating a three-dimensional pattern.
  • FIG. 18 is a diagram illustrating an example of a fixture used to manufacture a blood clot removal device according to an embodiment of the present specification.
  • the fixture is cylindrical and can be used to form a three-dimensional pattern.
  • the fixture is illustrated as including a protruding post, but may be provided in a form including a groove, and the wire may be formed into a specific shape through the post or groove.
  • the coupling between the metal wires may be formed through various methods.
  • the plurality of couplings formed on one stent body 1100 may be formed by the same method, but may be formed by using two or more methods.
  • the coupling may be non-fixedly formed through various mechanical engagements such as knitting, webbing, and meshing. Through this, the coupling between the metal wires may be provided in a non-fixed form.
  • Non-fixed coupling 1500 may be formed as the fixed coupling 1400 through a separate process.
  • Non-fixed coupling 1500 can be used for laser welding, mechanical locks, crimping, adhesive method, molding or injection overmolding, shrink tube, It can be fixed by soldering, brazing, swaging, or various methods not mentioned.
  • crimping, molding, or swaging may be made of metal, and may include the same material as the stent body 1100.
  • a coupling such as crimping, molding, or swaging includes a metal material
  • the visibility of the stent body 1100 may be improved by adding a radiopaque material thereto.
  • the stent body 1100 including the non-fixed coupling 1500 is a two-dimensional pattern or a three-dimensional pattern by intertwining wires as shown in FIGS. 19 to 21, and fixed coupling by fixing some couplings. It can be manufactured by forming with (1400).
  • FIG. 19 is a two-dimensional pattern formed by using a wire-based manufacturing method
  • FIG. 20 is a three-dimensional pattern formed by wrapping the two-dimensional pattern of FIG. 19, which is formed by connecting both sides of the two-dimensional pattern. I can.
  • Crimping is a method of connecting wires using a separate material, and the size of the coupling may vary depending on the size of the material used for crimping.
  • 21 is a two-dimensional pattern or a three-dimensional pattern formed by using a wire-based manufacturing method, at least some of the coupling between the wires was formed through an adhesive.
  • the size of the adhesive is slightly larger, but it may be desirable to have a smaller size of the adhesive to prevent damage to the vessel wall.
  • the coupling profile of the cell 1103 is provided in two types, one including only the fixed coupling 1400 and one including the one non-fixed coupling 1500, respectively.
  • the non-fixed coupling 1500 of is provided between two adjacent cells 1103 along the circumference of the circumference, it may be provided in other forms with reference to the above description.
  • FIG. 22 is a diagram illustrating an example of a blood clot removal device according to an embodiment of the present specification
  • FIG. 23 is an exploded view of the blood clot removal device according to FIG. 22.
  • the non-fixed coupling 1500 is continuously positioned along the length direction of the stent body 1100 by providing one for each row of the stent body 1100, and the stent body ( By being disposed between the two rows of 1100, all are located in the same direction from the central axis of the stent body 1100.
  • the free diameter area ratio may be 100%, and an increase in radiation force for the entire stent body 1100 in a load state is suppressed. Can be.
  • the diameter change can be performed by overlapping the two cells connected through the non-fixed coupling 1500, thereby reducing the compressive force generated in the stent body 1100.
  • buckling of the strut 1101 can be prevented, and an increase in radiation force due to a reduction in diameter can be prevented.
  • FIG. 24 is a diagram illustrating another example of a blood clot removal device according to an embodiment of the present specification
  • FIG. 25 is an exploded view of the blood clot removal device according to FIG. 24.
  • the non-fixed coupling 1500 according to the present example is provided in one of two rows consecutively arranged on the stent body 1100, and thus may be alternately arranged with the fixed coupling 1400.
  • the free diameter area ratio may be 50%.
  • the non-fixed coupling 1500 when the free diameter ratio is less than 100%, it may be advantageous to arrange the non-fixed coupling 1500 at equal intervals in order to generate the effect evenly in the longitudinal direction, that is, the non-fixed coupling 1500 may be an odd number. When arranged in rows or even rows, it may be preferable that the fixed coupling 1400 be arranged in even or odd rows.
  • FIG. 26 is a diagram illustrating another example of a blood clot removal device according to an embodiment of the present specification
  • FIG. 27 is an exploded view of the blood clot removal device according to FIG. 26.
  • one non-fixed coupling 1500 according to the present example is provided for each column of the stent body 1100, but a non-fixed coupling 1500 is provided between cells arranged in different rows. By being formed, it can be located radially differently.
  • the free diameter area is the same as compared to FIGS. 22 and 23, but the area where the cells overlap may be radially spaced apart, and accordingly, the stent body
  • the shape deformation of 1100 may appear different from those of FIGS. 24 and 25.
  • the non-fixed coupling 1500 is disposed at equal intervals, and in FIGS. 26 and 27, 90 degrees to each other with respect to the central axis of the stent body 1100 It is arranged to form an angle.
  • FIG. 28 and 29 are photographs of an implementation example of a blood clot removal device according to an embodiment of the present specification
  • FIG. 30 is an exploded view of the blood clot removal device according to FIG. 28
  • 31 and 32 are diagrams illustrating another example of implementation of a blood clot removal device according to an embodiment of the present specification.
  • the stent body 1100 includes two types of cells 1103, through which flexibility or radiation force of the stent body may be different.
  • the stent body 1100 may alternately include a row in which the first cell 1104 is disposed and a row in which the second cell 1105 is disposed, through which the first cell 1104 and the second cell
  • the 1105 may be disposed along a spiral extending along the circumference of the stent body 1100.
  • an angle formed by a virtual straight line connecting the first cells 1104 arranged along a spiral on the deployed stent body 1100 with respect to the central axis of the stent body 1100 may be less than 90 degrees.
  • the radiation force of the stent body 1100 may appear differently depending on the size, shape or arrangement of the cells 1103, if the stent body 1100 includes two types of cells 1103 as shown in FIGS. 28 to 32 Compared with the case of including one type of cell 1103, the original radiation force of the stent body 1100 may be different in the no-load state. In addition, since the two types of cells 1103 are formed in the stent body 1100, the degree to which the stent body 1100 is deformed in a load state may be changed, and accordingly, an increase in radiation force may be different.
  • each row in which the first cell 1104 is located is located spaced apart by a predetermined distance, so that the two first cells 1104 connected by non-stationary coupling overlap.
  • This can be different. For example, if two cells connected through the non-fixed coupling 1500 are on the same circumference, the two cells may be completely overlapped by an external force, but are spaced apart as shown in FIGS. 28 to 30. In this case, even if an external force is applied, the two cells may not completely overlap.
  • a separating strut 1590 may be formed in the cell 1103 provided with the non-fixed coupling 1500. Separation struts 1590 are provided in the form of engaging with each other as shown in FIG. 17, and the width of the engaging portion is provided narrower than that of the other struts 1101, so that the struts having different widths after the two separation struts 1590 are connected ( 1101) can be made to have substantially the same width.
  • the separation strut 1590 may be connected through a shrink tube or laser welding.
  • the connection of the separation strut 1590 may be formed in the shape as shown in FIG. 31 according to the size of the contraction tube.
  • a portion where the two separation struts 1590 contact may be attached as shown in FIG. 32, and each end of the separation strut 1590 needs to be rounded. have.
  • an external force in the longitudinal direction may act on the stent body, and the length may be increased according to the following force.
  • the thrombus may become fragmented, or may be dislodged or leaked from the stent body. have.
  • the blood clot removal device of the present specification may further include an anti-stretching mechanism that prevents shape deformation of the stent body in addition to the non-fixed coupling 1500.
  • the anti-stretching mechanism is a configuration that suppresses deformation of a blood clot removal device, particularly a stent body, and may be a structure that prevents or limits deformation of the length of the stent body.
  • the anti-stretching mechanism may prevent or limit an increase in the length of the stent body due to a lateral force acting on the stent body (a force acting in the length direction of the stent body according to the recovery force and the force in the opposite direction).
  • the anti-stretching mechanism can prevent or limit the change in diameter or deformation of the cell by suppressing the increase in the length of the stent body.
  • the anti-stretching mechanism may be provided in various forms.
  • the anti-stretching mechanism may be provided in the form of a wire fixed to two points of the blood clot removal device (hereinafter referred to as'anti-stretching wire').
  • the anti-stretching mechanism may be provided in the form of a stent (hereinafter referred to as'anti-stretching stent') formed inside the blood clot removal device.
  • the anti-stretching mechanism is provided in the form of a strut crossing the inside of the cell of the stent body (hereinafter referred to as'anti-stretching strut') or in the form of a cell containing such strut (hereinafter referred to as an anti-stretching cell).
  • the anti-stretching mechanism should be interpreted as including various structures and shapes that limit excessive deformation of the stent body by external force.
  • FIG 33 is a diagram illustrating a modified example of a blood clot removal device according to an embodiment of the present specification.
  • an anti-stretching mechanism in the form of an anti-stretching wire may be provided in the blood clot removal device 1000 according to the present example.
  • the anti-stretching wire 1600 may be provided as a wire having a predetermined length attached to at least two points of the blood clot removing device 1000.
  • the anti-stretching wire 1600 may fix the distance between two points of the blood clot removal device 1000 or prevent the distance between the two points from increasing by more than a certain amount, thereby preventing excessive deformation of the stent body 1100. I can.
  • the anti-stretching wire 1600 is provided with a material with relatively low elasticity (for example, a nickel-titanium alloy, stainless steel, or a metal or polymer having similar mechanical properties to these), and accordingly, the length deformation caused by an external force It may have robust properties, but not necessarily.
  • the anti-stretch wire 1600 may be provided as a single strand wire as well as a multi-strand wire as needed.
  • Two points at which the anti-stretching wire 1600 is connected to the blood clot removal device 1000 may be mainly disposed in a direction parallel to or close to the length direction of the stent body, and accordingly, the anti-stretching wire is attached to the stent body.
  • tension mainly in the longitudinal direction the length deformation of the stent body can be restrained, and the diameter deformation and the cell shape deformation can be suppressed based on the suppression of the length deformation.
  • the lateral force applied to the stent body 1100 in the process of recovering the blood clot removal device through the pull wire 1300 after the stent body 1100 is deployed in the blood vessel may induce an increase in the length of the stent body 1100.
  • the deformation-resistant anti-stretching wire 1600 has a distance between both ends of the stent body 1100 in a state where both ends are fixed to the proximal and distal ends of the stent body 1100 is equal to or greater than the length of the anti-stretch wire 1600 You can counter the increase in Through this, the anti-stretching wire 1600 may prevent a length change of the stent body 1100.
  • the anti-stretching wire 1600 is additionally provided to the stent body 1100 on which the non-fixed coupling 1500 is formed, so that the stretching by the anti-stretching wire 1600 is prevented and the non-fixed coupling 1500
  • An effect of preventing an increase in radiation force may be applied to the stent body 1100 at the same time.
  • the length increase is limited by the anti-stretching wire 1600
  • the stress is relieved through the non-fixed coupling 1500 to prevent buckling of the strut 1101 and an increase in the radiation force of the stent body 1100.
  • the anti-stretching wire 1600 provided in the form of FIG. 33 is shown to be fixed to the proximal end and the distal end of the stent body 1100, each of which ends are disposed on the central axis of the stent body 1100,
  • the anti-stretching wire 1600 may be connected to the stent body 1100 on any two points, and may be connected at any two points of the blood clot removal device 1100 other than the stent body 1100.
  • the length of the anti-stretching wire 1600 is the same as the total length of the stent body 1100 in the unloaded state, but this is not necessarily the case.
  • the length of the anti-stretching wire 1600 may be less than the total length.
  • the anti-stretching wire 1600 is used to allow some degree of length deformation of the stent body 1100. It is also possible to provide longer than the entire length of the stent body 1100.
  • the length deformation of the stent body 1100 continues until the anti-stretching wire 1600 becomes taut, and thereafter, the increase in the length of the stent body 1100 may be terminated due to the tension of the anti-stretching wire 1600. have.
  • the anti-stretching wire 1600 may be disposed on the central axis of the stent body 1100 as shown in FIG. 33, but may be located close to the surface of the stent body 1100.
  • the anti-stretching wire 1600 since the anti-stretching wire 1600 does not cross the inner space of the stent body 1100, the stent body 1100 invites a blood clot to its inner space or a blood clot in the inner space. It has an advantageous advantage to capture.
  • both ends of the anti-stretching wire 1600 are on the extension direction of the pull wire 1300 in order to allow the pull wire 1300 to act on the same line as the recovery force and the tension applied to the stent body 1100. It can also be placed.
  • the anti-stretching wire 1600 may be formed in a partial length section of the stent body 1100 to act, and when the anti-stretching wire 1600 acts on the proximal and distal portions of the stent body 1100, its effects May appear differently.
  • the anti-stretching effect may appear differently, and if the angle is too large, the anti-stretching efficiency decreases.
  • an eccentricity or the like is applied to the stent body 1100 so that unwanted behavior may occur in the stent body 1100 or unwanted shape deformation may occur.
  • the anti-stretching wire 1600 may be provided as a plurality of the blood clot removing device 1100, and the length of the stent body 1100 of the blood clot removing device 1000 It can be arranged by various combinations defined by the position on the direction or the direction on the cross section.
  • the plurality of anti-stretching wires 1600 may be disposed on different radial directions from the center of the stent body 1100 when viewed from the longitudinal section of the stent body 1100.
  • the plurality of anti-stretching wires 1600 are disposed on different radial directions, the more symmetrical their arrangements are, the more equally the effect may occur.
  • the plurality of anti-stretching wires 1600 may be disposed at different positions in the length direction of the stent body 1100.
  • the area of the stent body 1100 in which the anti-stretching effect is generated by each of the anti-stretching wires 1600 is referred to as a covering region
  • the plurality of anti-stretching wires 1600 are partially or entirely overlapped.
  • the shape, a shape in which the start and end of the covering regions of the adjacent anti-stretching wires 1600 coincide, the covering regions of the adjacent anti-stretching wires 1600 are spaced apart from each other, or a combination thereof.
  • the effect of resisting length deformation may be stronger than when using a single anti-stretching wire 1600, and when adjacent covering areas are spaced apart from each other, the stent body is allowed to change in length between the covering areas. There may be an effect of increasing the flexibility and elasticity of (1600).
  • the anti-stretching wire 1600 may be designed in consideration of the covering ratio.
  • 33 illustrates that the covering ratio is 100%, but according to an embodiment, when a partial length section of the stent body 1100 is covered, the covering ratio may be less than 100%.
  • FIG. 34 is a diagram illustrating another modified example of a blood clot removal device according to an embodiment of the present specification.
  • an anti-stretching mechanism in the form of an anti-stretching stent may be provided in the apparatus 1000 for removing blood clots according to the present example.
  • the anti-stretching stent 1700 may be provided as an inner stent positioned along a central axis in the longitudinal direction between the proximal end and the distal end of the stent body 1100.
  • the anti-stretching stent 1700 may support the entire stent body 1100 and prevent an excessive increase in distance between both ends of the stent body 1100.
  • the anti-stretch stent 1700 may be provided as a mesh structure provided inside the stent body 1100. Since the anti-stretching stent 1700 may be deformed in its shape, an increase in the length of the stent body 1100 may be allowed until the length of the anti-stretching stent 1700 is maximized.
  • the anti-stretching stent 1700 may be made of a material having a strength similar to or greater than that of the stent body 1100, and through this, the radial force of the anti-stretching stent 1700 is the radial force of the stent body 1100 Can be designed larger.
  • blood flow may flow through the space inside the anti-stretching stent 1700, and reperfusion of blood vessels may be formed.
  • the anti-stretching stent 1700 is additionally provided to the stent body 1100 on which the non-fixed coupling 1500 is formed, thereby preventing the stretching by the anti-stretching stent 1700 and the effect of forming reperfusion and the non-fixing coupling ( 1500) may be applied to the stent body 1100 at the same time.
  • the anti-stretching stent 1700 may be deformed through a separate manipulation, thereby enhancing engagement between the stent body 1100 and the blood clot.
  • the anti-stretching stent 1700 may radially expand inside the stent body 1100 to engage a blood clot accommodated in the stent body 1100.
  • the anti-stretching stent 1700 includes a plurality of baskets, and moves the blood clots accommodated in the stent body 1100 by moving the basket in the longitudinal direction, or additional engagement between the blood clots and the stent body 1100 Can provide.
  • the anti-stretching stent 1700 includes a configuration that extends in a radially outward direction, and by manipulating it, additional engagement between the blood clot and the stent body 1100 may be provided.
  • the deformation of the anti-stretching stent 1700 can be manipulated through a separate button.
  • 35 is a diagram illustrating another modified example of a blood clot removal device according to an embodiment of the present specification.
  • an anti-stretching mechanism in the form of an anti-stretching strut may be provided to the apparatus 1000 for removing blood clots according to the present example.
  • the anti-stretch strut 1800 may be provided as a strut having a predetermined length formed inside the cell 1103. In this case, the anti-stretch strut 1800 may be the same as or different from the strut forming the edge of the cell 1103.
  • the anti-stretch strut 1800 may be provided as a strut having a predetermined length attached to at least two points of an edge of the cell.
  • the anti-stretching strut 1800 may fix the distance between two points of the cell 1103 or prevent the distance between the two points from increasing by a certain amount or more, thereby suppressing the deformation of the cell 1103.
  • the cell 1103 in which the deformation is suppressed by including the anti-stretching strut 1800 may be an anti-stretching cell 1803, and the cell structure to which the anti-stretching strut 1800 is attached is an anti-stretching cell structure. stretching cell structure).
  • the anti-stretching strut 1800 or the anti-stretching cell structure When an increase in the length of the anti-stretching cell 1803 is suppressed by the anti-stretching strut 1800 or the anti-stretching cell structure, as a result, the length deformation of the stent body 1100, which is a mesh structure formed of the cells 1103, is suppressed and the stent A reduction in the diameter of the body 1100 or deformation of the shape of the cell 1103 may be controlled.
  • a longitudinal lateral force acts over the entire stent body 1100, and accordingly, a tensile force along the length direction may also act on the cell 1103.
  • the anti-stretch strut 1800 may resist tensile force to maintain the shape of the cell 1103, and the shape of the cell 1103 may be maintained, thereby limiting the deformation of the entire stent body 1100.
  • the anti-stretching mechanism provided by the anti-stretching strut 1800 can suppress not only an increase in the length of the cell 1103 but also a decrease in the length. This may be because the shape deformation of the cell 1103 is suppressed by the anti-stretch strut 1800 supporting the edge of the cell 1103 even if a compressive force acts on the cell 1103.
  • an anti-stretching cell 1803 and, in detail, an anti-stretching strut 1800 are additionally provided to the stent body 1100 on which the non-fixed coupling 1500 is formed, so that the stent body 1100 is provided with the anti-stretching cell 1803.
  • the stretching prevention effect and the radiation force increase prevention effect for the non-fixed coupling 1500 may be simultaneously applied. Through this, while the diameter of the stent body 1100 is reduced by a radial external force, the shape deformation of the cell 1103 is limited, and an increase in the radiation force of the stent body 1100 can be prevented.
  • the anti-stretching cell 1803 when the anti-stretching cell 1803 is provided to the stent body 1100 on which the non-fixed coupling 1500 is formed, the anti-stretching cell 1803 and the non-fixed coupling 1500 It may be provided in the same row, or may be provided in different rows. However, since the anti-stretching cell 1803 includes an anti-stretching strut 1800 that traverses its inner region, when the non-fixed coupling 1500 is provided to the anti-stretching cell 1803, the anti-stretching strut 1800 is The overlap of may be limited within a certain range.
  • the anti-stretch strut 1800 is installed in the cell 1103 through both corners along the length direction of the diamond-shaped cell 1103, and the stent body 1100 is under no-load condition. It is shown to have the same length as the distance between the corners of the cell 1103 in the lower deployed state, but this is only an example, and the connection point between the anti-stretch strut 1800 and the cell 1103 or the anti-stretch strut ( It is obvious that the length of 1800) can be varied in various ways.
  • the anti-stretching strut 1800 is at least a certain distance in the length direction of the stent body 1100 among the edges of the cell 1103. It may be desirable to be designed to connect spaced locations.
  • a virtual straight line connecting the two ends of the anti-stretch strut 1800 is at least 45 degrees or less from the length direction of the stent body 1100 It may be desirable to achieve, but in contrast to this, if it is desired to prevent diameter deformation of the stent body 1100, it may be preferable that the virtual straight line forms an angle of at least 45 degrees or more with the length direction of the stent body 1100. have.
  • the anti-stretching strut 1800 may be used as a cell among the corners of the cell 1103. 1103) may be arranged in a point symmetrical position or a line symmetrical position with respect to the center.
  • the length of the anti-stretch strut 1800 is the same as the distance on the edge of the cell 1103 to which the two ends of the anti-stretch strut 1800 are connected, but this is not necessarily the case, and the cell 1103 has a shape In order to allow deformation within a certain range, the length of the anti-stretch strut 1800 may be provided longer than the distance on the rim of the cell 1103 connecting the two ends.
  • the number of anti-stretching cells 1803 provided with the anti-stretching strut may be plural. As the number of anti-stretching cells 1803 increases, the length deformation of the stent body 1100 and the corresponding diameter deformation and shape deformation may be suppressed, and the flexibility of the stent body 1100 may decrease, so the number of anti-stretching cells Needs to be properly designed.
  • the anti-stretching cell may be disposed in consideration of the covering ratio.
  • the covering ratio may mean a ratio of an area (ie, a covering area) to which the anti-stretching effect by the anti-stretching cell 1803 is applied among the entire area of the stent body 1100.
  • the anti-stretching cell 1803 may be arranged such that the covering ratio by the anti-stretching cell 1803 is 30% to 100%.
  • the anti-stretching effect may be different depending on the position.
  • the anti-stretching cells 1803 may be positioned at an equal distance.
  • the anti-stretching cells 1803 may be arranged such that the spacing between the rows to which the anti-stretching cells 1803 belongs are relatively even, and the angle formed from each other on the longitudinal section of the stent body 1100 is maximally separated or the angle formed from each other is It can be arranged to be constant.
  • the anti-stretching effect of the anti-stretching cells 1803 is distributed throughout the stent body 1100, and thus it can be uniformly operated.
  • 36 to 38 are diagrams illustrating yet another modified example of a blood clot removal device according to an embodiment of the present specification.
  • the stent body 1100 may include a first cell 1104 and a second cell 1105.
  • a non-stationary coupling 1500 may be provided between the two rows formed of the first cell 1104, and an anti-stretching strut 1800 may be provided in the first cell 1104.
  • the stent body 1100 according to the present example includes two cells having different shapes-a first cell 1104 and a second cell 1105 -, the flexibility or radiation force of the stent body is compared to the case of including one cell. This may appear differently, and details may be described with reference to the above-described contents.
  • the anti-stretching cell 1803 is continuously located along the length direction of the stent body 1100, and is disposed along the row of the stent body 1100, so that the center of the stent body 1100 They can all be located in the same direction from the axis.
  • the non-fixed coupling 1500 and the anti-stretching cell 1803 may be respectively disposed on a straight line parallel to the central axis of the stent body 1100, and accordingly, the anti-stretching cell 1803 in the stent body 1100
  • the stretching prevention effect and the radiation force increase prevention effect for the non-fixed coupling 1500 may be simultaneously applied.
  • one anti-stretching cell 1803 is provided in each row of the stent body 1100, and is positioned at a 90 degree angle with respect to the central axis of the stent body 1100. Can be arranged. Since the anti-stretching cell 1803 is arranged to form a certain angle with respect to the central axis of the stent body 1100, the anti-stretching effect by the anti-stretching cell 1803 may be equally generated in the radial direction of the stent body 1100 .
  • each row in which the first cell 1104 is located is located spaced apart by a predetermined distance
  • the anti-stretching cells 1803 provided in each other row are arranged at a predetermined distance in the longitudinal direction.
  • the lengthwise position of the anti-stretching cell 1803 of FIG. 37 may be further separated from the anti-stretching cell 1803 of FIG. 36. Through this, the anti-stretching effect by the anti-stretching cell 1803 of FIG. 37 may be equally generated in the length direction of the stent body 1100.
  • the anti-stretching effect by the anti-stretching cell 1803 and the effect of preventing an increase in radiation force to the non-fixed coupling 1500 may be simultaneously applied to the stent body 1100, but the effect occurs.
  • the position to do may be different from FIG. 36.
  • the anti-stretching cells 1803 according to the present example are provided in a plurality of rows of the stent body 1100, and are arranged to be spaced apart maximally so that the effect is equally generated in the longitudinal direction or the radial direction. I can.
  • the anti-stretching cells 1803 of each row are alternately positioned with the cells 1103 to which the anti-stretching strut 1800 is not provided, and a full wire 1300 of the anti-stretching cells 1803 arranged in each row.
  • the four closest to the stent body 1100 are arranged so as to form 90 degrees to each other, and the four anti-stretch cells 1803 arranged in each row are located in the center and the farthest from the pull wire 1300.
  • the four located can be arranged according to the above pattern.
  • the plurality of anti-stretching cells 1803 may be evenly positioned throughout the stent body 1100.
  • the distal portion of the stent body of the blood clot removal device may be provided in a closed or open form.
  • the blood clot carried by the blood clot removal device 1000 may be separated from the blood clot removal device 1000 through the open distal terminal.
  • thrombosis may occur depending on the arrangement of the struts at the distal end.
  • a basket 1900 (not shown) may be selectively provided on the distal side of the stent body 1100 to prevent the blood clot from being separated.
  • the basket 1900 may have a profile that is connected to the distal end of the stent body 1100 and decreases in diameter as it moves away from the distal end of the stent body 1100. Through this, the basket 1900 may prevent the blood clot entering the stent body 1100 from escaping or prevent the blood clot from escaping along the longitudinal direction of the stent body 1100.
  • the basket 1900 may be manufactured using a material having high elasticity such as nitinol or a nitinol-based memory alloy, and if necessary, may include a material having high visibility under fluoroscopy.
  • the basket 1900 may be separately manufactured through a method such as braiding and then connected to the stent body 1100, and may be manufactured integrally with the stent body 1100.
  • the proximal end having a wide diameter among the baskets 1900 is generally connected to the distal end of the stent body 1100, but this is not necessarily the case, and at one position of the basket 1900 in addition to the proximal end of the basket 1900 It may be connected to the stent body 1100, through which the proximal end of the basket 1900 may have a diameter wider than the diameter of the stent body 1100, and even when the stent body 1100 is not completely in close contact with the blood vessel wall, I will be able to contact you.
  • the blood clot removal device 1100 of the example or an example to be described later through the present specification may include a basket 1900, and when the blood clot removal device 1100 includes a basket 1900, the stent body 1100 The end of the anti-stretching wire 1600 or the anti-stretching stent 1700 located on the central axis of) may be connected to the basket 1900.
  • the stent body of the blood clot removal device has a single segment shape, but the stent body may have a multi-segment shape.
  • the segment may be understood as a unit that refers to a mesh structure forming a stent body, and thus, the single segmented stent body means a stent body formed with a single mesh structure, and the multisegmented stent body It may mean a stent body including a plurality of mesh structures. That is, the multi-segment may have a shape in which the stent body has a plurality of mesh structures spaced apart from each other.
  • the multi-segment stent body may have a bridge connecting a plurality of mesh structures and mesh structures to each other.
  • the bridge may be a straight wire or strut each of which ends are connected to two adjacent mesh structures.
  • FIG. 17 to be described later shows that the segments are connected by two bridges, but it is also possible to have one or three or more bridges.
  • the bridge may be advantageously arranged symmetrically as viewed from the longitudinal section of the stent body 11 in order to prevent the two segments connecting to each other from twisting.
  • the bridge is connected to two adjacent segments, respectively.
  • the bridge can be connected to the segment through the end of the segment, as well as to the segment at other points.
  • the bridge connects two segments through the rear end of the segment disposed in the proximal direction among the two adjacent segments and the front end of the segment disposed in the distal direction, but the segment must be connected through the corresponding point. It is not something to do.
  • the multi-segment stent body described above has an advantage in terms of the first thrombus compared to the single-segment stent body.
  • the multi-segment stent body includes a bridge connecting adjacent mesh structures, and such a bridge may form a mouse structure on the stent body.
  • the mouth structure may mean a structure in which an opening of a relatively large size formed by a bridge is formed unlike a cell of a mesh structure having a relatively close opening.
  • the opening formed by the mouse structure generally has a size larger than the size of the blood clot, so that the blood clot flows into the inner space of the stent body through the opening to reverse blood inlet.
  • the mouse structure of the present specification may refer to a region in which a bridge is located between a segment and a segment, and a space sufficient for thrombus to enter the stent body may be formed between the bridges.
  • the stent body having the above-described mouse structure can perform thrombus invitation.
  • the mouse structure has an advantage in attracting acupuncture points, which are difficult to penetrate into the stent body, as shown in FIG. 39 to be described later.
  • it is not excluded that inviting yeonhyeoljeon from the function of the mouse structure.
  • the mouse structure is not to be understood as including an expanded cell from a mechanical point of view, but it should be understood as a generic term including an expanded cell from a functional point of view depending on the context.
  • the space between the bridges may be referred to as an expansion cell, or inlet, which is larger than other cells of the stent body, and the size of the inlet may be determined by the length of the bridge and the diameter of the segment.
  • the size and shape of the inlet may be deformed by reducing the diameter of the segment.
  • 39 is a diagram illustrating an example of a blood clot removal device according to another embodiment of the present specification.
  • the stent body 1100 of the blood clot removal device 1000 includes two segments 1110 and 1130, a bridge 1123 connecting the two segments 1110 and 1130, and two It may include a mouth structure 1120 formed between the segments 1110 and 1130.
  • the segments 1110 and 1130 may be provided as a mesh structure by struts.
  • the bridge 1123 may be provided in the form of a wire whose both ends are connected to the distal portion of the mesh structure on the proximal direction side and the proximal portion of the mesh structure on the distal direction side and extend between both ends, and the central axis of the stent body 1100 It can be disposed on different radial directions from.
  • the bridge 1123 may form a mouth structure 1120 between the two segments.
  • the above-described blood clot removal device 1000 may be disposed and deployed at the treatment point, and the blood clot in the vicinity of the treatment point is formed in the mouse structure during the deployment process or the recovery process of the stent body 1100 through the pull wire 1300 after being deployed ( It may be invited into the stent body 1100 through 1120.
  • 40 and 43 are diagrams illustrating an example of a blood clot removing device according to another embodiment of the present specification.
  • the non-fixed coupling 1500 is continuously positioned along the length direction of the stent body 1100 by being provided to each segment of the stent body 1100, respectively.
  • the static coupling 1500 may be located in the same direction from the central axis of the stent body 1100. Through this, even if an external force is applied to the stent body 1100, an excessive increase in the radiation force may be prevented by the non-fixed coupling 1500 located in each segment.
  • the free diameter area may have to be calculated excluding the mouse structure.
  • the free diameter area may be a mesh structure area in which the non-fixed coupling is located, and the free diameter area ratio is the length ratio of the total free diameter area to the total length of the mesh structures excluding the mouse structure. Can be defined.
  • the non-fixed coupling 1500 is provided in the form of FIGS. 40 and 41, the free diameter area ratio accordingly may be calculated as 100%.
  • the non-fixed coupling 1500 is provided to each segment of the stent body 1100 and is continuously positioned along the length direction of the stent body 1100, and each remarks
  • the static coupling 1500 may be located on a different radial direction from the central axis of the stent body 1100.
  • the multi-segment type is a dual segment type
  • the present invention is not limited thereto, and the stent body is a triple segment type or a quadruple segment type. May be provided. Even when the number of segments of the stent body is different from the mentioned example, the arrangement and effect of the non-fixed coupling 1500 of the present specification will be sufficiently understood by those skilled in the art through the above-described examples.
  • the arrangement of the non-fixed coupling 1500 provided on the multi-segment stent body 1100 may be variously extended with reference to the single-segment stent body 1100 described above in addition to FIGS. 40 to 43 Is self-explanatory.
  • each segment 1110, 1130 of the stent body 1100 of the blood clot removal device 1000 according to the present example is increased in length. Accordingly, the shape may be deformed, and accordingly, the size of the entrance of the mouse structure 1120 may be deformed, and the blood clot invitation may not be smoothly performed. Therefore, in a blood clot removal device using a multi-segment stent body, it may be desirable to apply an overall anti-stretching effect to the segments constituting the stent body, and various types of anti-stretching mechanisms as described above may be used for the blood clot removal device. Can be provided to
  • the anti-stretching mechanism when provided as an anti-stretching wire, the position of the anti-stretching wire may be limited in relation to the bridge.
  • an anti-stretching wire may be provided so that a covering region is disposed on each segment.
  • one or more anti-stretching wires may be provided, and each of the anti-stretching wires may simultaneously cover one segment or a plurality of segments.
  • an anti-stretching wire may be provided in a blood clot removal device having a multi-segment stent body in consideration of the position of the bridge.
  • the anti-stretching wire can be placed in line with the bridge connecting the two adjacent segments so as not to obscure the mouth of the mouth structure.
  • the size of the mouth of the mouth structure formed by the bridge connecting adjacent segments can be determined by the anti-stretching wire, so if the anti-stretching wire is located on a different line from the bridge, the mouth of the mouth structure can be reduced. have.
  • the covering ratio of the anti-stretching wire provided to the stent body in the form of a multi-segment may be calculated excluding the mouse structure portion.
  • the covering area may be a mesh structure area in which an anti-stretching effect is generated by the anti-stretching wire, and the covering ratio is the length of the entire covering area to the total length of the mesh structures excluding the mouse structure. It can be defined as the ratio of
  • the blood clot removal device may include a plurality of stent bodies.
  • the independent stent body may mean a single mesh structure or a set of mesh structures forming a unibody.
  • the independent stent body may mean a mesh structure or a group thereof that is not connected to another mesh structure.
  • a plurality of mesh structures are connected to each other through a bridge or the like, even if there are a plurality of mesh structures, this may be interpreted as a single stent body.
  • the plurality of mesh structures should be interpreted as being a plurality of stent bodies.
  • the mesh structure that is not connected to each other may mean that a recovery force applied to move one of the mesh structures is not transmitted to the other mesh structure. Therefore, in general, it is difficult to transmit force between the plurality of stent bodies, and individual full wires may be connected to the plurality of stent bodies.
  • the mesh structures connected to different full wires may be understood as different stent bodies.
  • a mesh structure that is not connected to each other may mean a mesh structure that can operate independently of each other.
  • each mesh structure is connected to different pull wires and relative movement between the mesh structures is possible according to manipulation of a plurality of pull wires, this may be understood as a non-connected mesh structure.
  • this should still be understood as a mesh structure independent of each other.
  • mesh structures that do not operate substantially integrally due to the recovery force through the pull wire, etc. can be understood as separate stent bodies even if they are connected by simple struts, strings, wires, etc. will be.
  • a plurality of pull wires are manipulated in the same manner by a single user in a form in which a plurality of pull wires are fastened to each other and the plurality of mesh structures are integrally moved, this may be understood as a separate stent body.
  • a multi-body type of blood clot removal device will be described based on a blood clot removal device (dual-body type blood clot removal device) including two stent bodies.
  • a blood clot removal device dual-body type blood clot removal device
  • the number of stent bodies in the multi-body type blood clot removal device does not necessarily have to be two.
  • FIGS. 44 and 45 are perspective views and exploded views of different states of a blood clot removal device according to another embodiment of the present specification
  • FIGS. 46 and 47 are different views of a blood clot removal device according to another embodiment of the present specification. It is a side view of the state.
  • FIGS. 44 and 46 are diagrams illustrating that the blood clot removing device 1000 is in a first state
  • FIGS. 45 and 47 are diagrams illustrating that the thrombus removing device 1000 is in a second state.
  • the blood clot removal device 1000 may include two stent bodies 1100A and 1100B-hereinafter referred to as (1100).
  • Each stent body 1000 may include a segment and a mouse structure.
  • Each stent body 1100 is connected to the full wire 1300 and operated independently, so that a positional relationship between the two stent bodies 1100 may be changed.
  • the blood clot removal device 1000 may be transformed into a shape suitable for capturing a stroma or a form suitable for capturing a menstrual thrombosis.
  • the blood clot removal device 1000 may be deformed between a first state and a second state.
  • the first state may be in a form suitable for engaging with a thrombus. Accordingly, when the blood clot removing device 1000 is in the first state, the blood clot removing device 1000 may be referred to as operating in a clot engaging mode. In addition, since the binding of the stent body 1100 and the thrombus mainly relates to a stent, it may be referred to as a soft-clot mode. As will be described later, in the thrombus coupling mode of the thrombus removal device 1000, the two stent bodies 1100 are staggered with a mouse structure and a mesh structure, so that the mouse structure of one stent body 1100 is different. Since it may be implemented by being closed due to the mesh structure of 1100, the blood clot removal device 1000 may be referred to as having a closed configuration with respect to the blood clot collecting device 1000 in the first state.
  • the second state may be a form suitable for inviting and capturing a blood clot. Accordingly, it may be referred to as operating in a clot inviting mode or in a clot capturing mode when the blood clot removing device 1000 is in the second state.
  • the stent body 1100 and the invitation and acceptance of blood clots mainly relate to acupuncture points, this may be referred to as a hard-clot mode.
  • two stent bodies 1100 are arranged so that the arrangement of the mouse structure and the mesh structure are aligned to each other (correspoing to each other).
  • the mouse structure of (1100) and the mouse structure of the stent body (1100) that are different from each other can be implemented by opening the opening of the mouse structure, the blood clot is removed when the blood clot collecting device 1000 is in the second state.
  • the device 1000 may be referred to as having an open configuration.
  • thrombosis mode excludes binding of acupoints, or conversely, the term thrombosis mode does not exclude binding of thrombosis. It should be noted in advance that the invitation is not excluded or, conversely, the clot capture mode does not exclude the binding of the clot.
  • the two stent bodies 1000 may include a first stent body 1100A and a second stent body 1100B.
  • Both the first stent body 1100A and the second stent body 1100B may be the multi-segment stent body 1000 described above.
  • the first stent body may include three segments and two mouse structures.
  • the three segments may include a first segment 1110A, a second segment 1130A, and a third segment 1150A, which are arranged in a near order from the proximal.
  • the two mouse structures include a first mouse 1120A positioned in the first segment 1110A and the second segment 1130A, and a second positioned between the second segment 1130A and the third segment 1150A. It may include a mouse 1140A.
  • the second stent body 1100B may include two segments and one mouse structure as shown in FIG. 44.
  • the two segments may include a fifth segment 1110B and a sixth segment 1130B, which are arranged in a near order from the proximal.
  • the mouse structure may include a fifth mouse 1120B positioned between the fifth segment 1110B and the sixth segment 1130B.
  • both the first stent body 1100A and the second stent body 1100B have a multi-segment shape, but both stent bodies 1100 must have a multi-segment shape. It's not just that.
  • the dual-body type thrombus removal device 1000 is a stent body of an appropriate shape in order to perform a function of opening/closing the opening of the mouse structure according to the positional relationship between the two stent bodies 1100. It can have (1100), which can be implemented in various forms.
  • one of the two stent bodies 1100 may be provided in a multi-segment form, and thus may include at least one mouse structure.
  • the other stent body 1100 of the two stent bodies 1100 may have segments equal to or larger than the number of mouse structures of any one stent body.
  • the first stent body 1100A is provided as a triple segment stent body having two mouse structures
  • the two stent body 1100B is provided as a double-segment stent body 1100 having two segments equal to the number of mouse structures of the first stent body 1100A.
  • the other stent body 1100 may be provided in the form of a triple segment.
  • the other stent body 1100 may be provided in the form of a single segment.
  • both stent bodies 1100 may be provided in the form of a double segment or a triple segment.
  • the dual-body type thrombus removal device 1000 of the present specification includes one stent body 1100 provided in a multi-segment form and another stent body 1100 provided in a multi-segment form or a single segment form.
  • the number of segments of the other stent body 1100 should be equal to or greater than the number of mouse structures of any one stent body 1100. In general, since the number of mouse structures is one less than the number of segments, the dual-body type thrombus removal device 1000 of the present specification may be equal to or different from the number of segments of the two stent bodies 1100.
  • the length of the corresponding mouse and the segment of the two stent bodies are substantially the same. It may be desirable.
  • one of the two stent bodies 1100 may be located inside the other. This is also shown in Figures 45 and 46.
  • the second stent body 1100B may be located inside the first stent body 1100A, or conversely, the first stent body 1100A may be located inside the second stent body 1100B.
  • the second stent body 1100B may be inserted into the first stent body 1100A or the first stent body 1100A may be inserted into the second stent body 1100B.
  • the second stent body 1100B is positioned inside the first stent body 1100A.
  • one stent body 1100 is inserted into the other stent body, but in the first state to be described later, the mesh structure of the first stent body 1100A and the mesh structure of the second stent body 1100B are single.
  • the diameter of the two stent bodies 1100 is substantially the same, or the diameter of the stent body 1100 inserted inside is smaller than the diameter of the stent body 1100 disposed outside, but is almost It could be a similar number.
  • the circumferential surface of the first stent body 1100A and the circumferential surface of the second stent body 1100B may extend on substantially the same surface, and the mesh structures of the two stent bodies 1100 are alternately arranged (first State), it can behave like a single mesh structure.
  • two pull wires 1300A and 1300B-hereinafter referred to as 1300- may be included in the blood clot removal device 1000 according to the present example.
  • the first pull wire 1300A may be connected to the first stent body 1100A
  • the second pull wire 1300B may be connected to the second stent body 1100B. Accordingly, force can be transmitted to each stent body 1100.
  • the two pull wires 1300 may be selectively coupled. In a state in which the coupling between the two pull wires 1300 is released, each pull wire 1300 can be independently manipulated. In addition, when the two pull wires 1300 are coupled to each other, the two pull wires 1300 may be integrally operated. Accordingly, in a state in which the two pull wires 1300 are uncoupled, the user can independently manipulate the two stent bodies 1100, and in the state in which the two pull wires 1300 are coupled, the user can operate the two stent bodies ( 1100) can be operated integrally.
  • the user may use the pull wire 1300 in a state in which the coupling is released to the relative position of the two stent bodies 1100. Can be adjusted.
  • the user may use the pull wire 1300 coupled to each other.
  • the two stent bodies 1100 can be moved integrally. Of course, it is not necessary to combine the two pull wires 1300 in order to move the two stent bodies 1100 integrally.
  • the pull wire ( 1300) can achieve the same effect as manipulating in the combined state.
  • inputting the same operation to two uncoupled pull wires 1300 compared to physically coupled pull wires 1300 may cause an error by the user. It may be advantageous to move the two stent bodies 1100 integrally.
  • the two pull wires 1300 may be physically coupled, and may be implemented in the form of, for example, a locking mechanism.
  • one of the two pull wires 1300 may be provided as a hollow wire, and the other may be inserted into any one.
  • the locking structure may release the coupling between the two pull wires 1300 by applying pressure to the hollow wire from the outside and coupling the two wires by friction between the two pull wires 1300 or releasing the pressure.
  • the locking device can be operated by a user or a robot
  • two pull wires 1300 are disposed adjacent to each other along side surfaces in the length direction of each other, and two pull wires at a point where the two pull wires 1300 overlap in the length direction of the two pull wires 1300 ( It is also possible to implement a locking structure in the form of fastening or releasing the fastening 1300).
  • the blood clot removal device 1000 may optionally further include an anti-rotating mechanism.
  • the rotation preventing structure may prevent relative rotation between the two stent bodies 1100.
  • the arrangement relationship between the bridges of the mouse structures included in the two stent bodies 1100 may be changed, and accordingly, the size of the opening of the mouse structure may be changed.
  • the rotation preventing structure prevents relative rotation of the two stent bodies 1100, thereby maintaining a constant relative positional relationship between the bridges of the two stent bodies 1100, thereby maintaining a constant size of the opening of the mouse structure.
  • the rotation preventing structure may indirectly prevent relative rotation between the two stent bodies 1100 by preventing rotation between the two pull wires 1300.
  • the rotation preventing structure for preventing rotation between the two pull wires 1300 is formed on the inner diameter surface of the pull wire 1300 provided in a hollow shape and the outer diameter surface of the pull wire 1300 inserted therein. It can be provided in a pattern that is complementary to each other and suppresses relative rotation. Specifically, the rotation preventing structure may be provided in a square or cross-sectional pattern formed on the inner diameter surface of the outer pull wire 1300 and the outer diameter surface of the inner pull wire 1300.
  • the blood clot removal device 1000 may be in the first state or the second state according to the relative positional relationship between the two stent bodies 1100.
  • the two stent bodies 1100 are arranged such that the opening of the mouth structure of one stent body 1100 is closed by the segment of the other stent body 1100. I can. Specifically, as the segments (or mouse structures) of the two stent bodies 1100 are arranged alternately with each other, the blood clot removal device 1000 may have a first state.
  • At least one of the segments of the second stent body 1100B is disposed to correspond to at least one of the mouse structures of the first stent body 1100A, so that the mouse structure may be closed by the segment.
  • the mouse structure of the first stent body 1100A may be covered by the segment of the second stent body 1100B, and the mouse structure of the second stent body 1100B is the first stent body 1100A ) Can be obscured by segments. Accordingly, the openings of the mouse structures are closed, and the two stent bodies 1100 may have a shape similar to that of forming one mesh structure.
  • the two stent bodies 1100 can be combined with blood clots through a cell structure or a mesh structure from the most distal point to the most distal point. Can facilitate the binding of blood clots.
  • the two stent bodies 1100 When the blood clot removal device 1000 is in the second state, the two stent bodies 1100 may be disposed so that the mouse structures overlap each other. Specifically, as the segments (or mouse structures) of the two stent bodies 1100 are arranged at positions corresponding to each other, the blood clot removal device may have a second state.
  • the mouse structure of the first stent body 1100A may be opened by the mouse structure of the second stent body 1100B
  • the mouse structure of the second stent body 1100B is the first stent body 1100A. It can be opened by the mouse structure. Accordingly, the openings of the mouse structures are opened, and the blood clot removal device 1000 may have a shape similar to a single stent body 1100 in a multi-segment shape having a mouse structure in appearance.
  • thrombus invitation may be facilitated through the mouse structure.
  • the blood clot removal device 1000 may perform state transformation between the first state or the second state according to the relative movement of the two stent bodies.
  • a state transformation between the first state and the second state is achieved by manipulating any one pull wire 1300 to move any one of the two stent bodies 1100. Can be done.
  • the blood clot removal device 1000 may initially have a first state.
  • the blood clot removal device 1000 may have a first state when the opening area of the mouth structure of the first stent body 1100A is covered by a segment of the second stent body 1100B. That is, the first mouse 1120A is disposed to correspond to the fifth segment 1110B, the second mouse 1140A is disposed to correspond to the sixth segment 1130B, and the fifth mouse 1120B of the second stent body 1100B As is disposed to correspond to the second segment 1130A of the first stent body 1100A, the blood clot removal device may have a first state.
  • the first stent body 1100A is not manipulated, and only the second pull wire 1300B is operated.
  • the stent body 1100B may be moved in the proximal direction in the longitudinal direction of the stent body.
  • the blood clot removal device 1000 may have a second state.
  • the spacing between the struts 1101 may be adjusted.
  • the strut 1101 in contact with the thrombus in the thrombus removal device 1000 is It can be located densely. Through this, the strut 1101 of the blood clot removal device 1000 may be easily combined with the blood clot.
  • the segment of the first stent body 1100A and the segment of the second stent body 1100B have an interference reduction mechanism for preventing mechanical interference between the first stent body 1100A and the second stent body 1100B ( interference reduction mechanism).
  • interference reduction mechanism for preventing mechanical interference between the first stent body 1100A and the second stent body 1100B
  • the segment of one stent body 1100A may not be provided in a protruding form, and the proximal end of the segment of the second stent body 1100B may not be provided in a protruding form.
  • FIG. 48 is a modified example of a blood clot removing device according to another embodiment of the present specification.
  • a basket 1900 may be selectively included in the blood clot removal device 1000 of the present example.
  • the basket may be disposed at the distal end of at least one stent body 1100 of the two stent bodies 1100, and preferably may be connected to the stent body 1100 disposed outside of the two stent bodies 1100.
  • the basket 1900 may prevent blood clots captured through the mouse structure from escaping through the distal end of the stent body 1100.
  • the basket 1900 blood clots introduced mainly through the second mouse 1140A can be prevented from leaking to the outside, and the blood clots introduced through the first mouse 1120A or the fifth mouse 1120B When it moves within the stent body 1100, it is possible to prevent its outflow.
  • the- It may be advantageous to form the distal end of the stent body 1100 in a closed configuration-where the basket 1900 is not provided.
  • 49 is a diagram illustrating an example of a blood clot removing device according to another embodiment of the present specification.
  • the non-fixed coupling 1500 may be provided in the cell 1103 of each segment of the first stent body 1100A and the second stent body 1100B. Through this, when an external force is applied to the stent body 1100, an excessive increase in the radiation force of the stent body 1100 may be prevented by the non-fixed coupling 1500 located in each segment.
  • deformation of the blood clot removal device 1000 may be limited due to interference between the two stent bodies 1100.
  • the non-fixed coupling 1500 of FIG. 49 is disposed in the form of FIGS. 40 and 41, but may be disposed to be located in different radial directions as shown in FIGS. 42 and 43, and in addition, referring to the above-described example. It may be arranged in various forms.
  • the blood clot removal device 1000 including the plurality of stent bodies 1100 described above and capable of deforming between the first state and the second state according to the positional relationship between the stent bodies 1100, one stent body Unlike the blood clot removal device 1000 having 1100, length deformation may occur not only in the recovery process but also in the process of relatively moving the stent body 1100 for state transformation.
  • the above-described blood clot removal device 1000 uses a mouse structure and segment having substantially the same length, so that a segment of one stent body 1100 closes or opens the mouse of the other stent body 1100, It may be important to keep the length ratio between the segment and the mouse structure constant.
  • the mouse structure formed by a bridge that is provided in the form of a wire and has almost no length deformation due to lateral force maintains a substantially constant length even when a force in the longitudinal direction such as a recovery force is applied, but the segment formed by the mesh structure is Since length deformation easily occurs due to the force in the longitudinal direction, the length of the segment becomes larger than the length of the mouse structure during the recovery process or the relative movement between the two stent bodies 1100, so even if the mouse and the segment are placed at the corresponding positions, a part of the mouse structure Is likely to be obscured by segments.
  • a blood clot removal device including a plurality of stent bodies 1100 and capable of deforming between the first state and the second state according to the positional relationship between the stent bodies 1100 may preferably include an anti-stretching mechanism.
  • the anti-stretching mechanism may be provided in various forms as described above, and an example in which various types of anti-stretching mechanisms are provided to the blood clot removal device may be described through the above description.
  • the anti-stretching mechanism may be advantageously provided to each of the two stent bodies 1100. This is because when a lateral force for state transformation is applied to only one stent body 1100 to the blood clot removal device 1000 including a plurality of stent bodies 1100, the length of the segments of the stent body 1100 increases. , This is because the length of the segment is larger than the length of the mouse structure, and due to this, the entrance of the mouse structure may be partially opened or cannot be opened, and it may be impossible for the blood clot removal device 1000 to reach the second state. to be.
  • the anti-stretching mechanism may be arranged to minimize interference between the two stent bodies 1100 moving between the first state and the second state, and part of the thrombus removal device 1000 overlapping each other in the second state May be arranged to have the same shape.
  • the mode for carrying out the present invention may include the best mode for carrying out the above-described invention, and related matters have been described in the best mode for carrying out the invention.

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Abstract

La présente invention concerne un dispositif d'élimination de thrombus comprenant : une structure constituée d'une pluralité de cellules qui présentent des angles ; et un fil de traction relié de manière fonctionnelle à la structure. Une première cellule présente un premier profil d'accouplement, le type d'accouplement de tous les accouplements compris dans le premier profil d'accouplement constitue un premier type d'accouplement, le premier type d'accouplement est formé par deux angles respectivement inclus dans deux cellules différentes reliées l'une à l'autre, et les deux angles sont fixés l'un à l'autre. Une seconde cellule présente un second profil d'accouplement, le type d'accouplement d'au moins un des accouplements inclus dans le second profil d'accouplement est un second type d'accouplement, le second type d'accouplement étant formé par deux entretoises qui sont respectivement incluses dans deux cellules différentes formant deux angles et reliées l'une à l'autre, les deux entretoises étant entrelacées.
PCT/KR2020/009148 2019-07-29 2020-07-10 Dispositif d'élimination de thrombus WO2021020767A1 (fr)

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US201962880008P 2019-07-29 2019-07-29
US62/880,008 2019-07-29
US201962897654P 2019-09-09 2019-09-09
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US201962924335P 2019-10-22 2019-10-22
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PCT/KR2020/009145 WO2021020765A1 (fr) 2019-07-29 2020-07-10 Dispositif d'élimination de thrombus et procédé d'élimination de thrombus l'utilisant
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US20230062684A1 (en) * 2021-08-28 2023-03-02 Sheri Albers Intravascular thrombectomy device and process for treating acute ischemic stroke
CN114869407A (zh) * 2022-06-17 2022-08-09 惠州市顺美医疗科技有限公司 一种取栓装置
WO2024050511A1 (fr) * 2022-09-02 2024-03-07 Merit Medical Systems, Inc. Dispositifs d'embolisation comprenant des fils tressés, leurs procédés de fabrication et d'utilisation

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