WO2021052486A1 - 便于定位的介入器械及加工方法和介入系统 - Google Patents

便于定位的介入器械及加工方法和介入系统 Download PDF

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Publication number
WO2021052486A1
WO2021052486A1 PCT/CN2020/116324 CN2020116324W WO2021052486A1 WO 2021052486 A1 WO2021052486 A1 WO 2021052486A1 CN 2020116324 W CN2020116324 W CN 2020116324W WO 2021052486 A1 WO2021052486 A1 WO 2021052486A1
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WO
WIPO (PCT)
Prior art keywords
stent
friction
positioning according
interventional
convenient
Prior art date
Application number
PCT/CN2020/116324
Other languages
English (en)
French (fr)
Inventor
齐均
訾振军
曾敏
Original Assignee
杭州启明医疗器械股份有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 杭州启明医疗器械股份有限公司 filed Critical 杭州启明医疗器械股份有限公司
Priority to EP20866830.1A priority Critical patent/EP4032500A4/en
Publication of WO2021052486A1 publication Critical patent/WO2021052486A1/zh
Priority to US17/693,980 priority patent/US20220257397A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/04Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06Blood vessels
    • A61F2/07Stent-grafts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12168Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
    • A61B17/12177Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure comprising additional materials, e.g. thrombogenic, having filaments, having fibers or being coated
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2412Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
    • A61F2/2418Scaffolds therefor, e.g. support stents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2427Devices for manipulating or deploying heart valves during implantation
    • A61F2/2436Deployment by retracting a sheath
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831Material properties
    • A61B2017/00858Material properties high friction, non-slip
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/962Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
    • A61F2/966Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/962Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
    • A61F2/966Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
    • A61F2002/9665Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod with additional retaining means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2210/00Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0076Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof multilayered, e.g. laminated structures
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0008Fixation appliances for connecting prostheses to the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0021Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in coefficient of friction
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0039Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in diameter

Definitions

  • the present invention relates to the technical field of medical devices, in particular to an interventional device, a processing method and an interventional system.
  • anchors are provided on the periphery of the stent of the interventional device for positioning or attachments to fill the gap with adjacent tissues.
  • the placement of anchors may bring safety hazards, and the attachments will further Increasing the diameter of the interventional device, especially in the self-expanding interventional device, the increase of the diameter brings inconvenience to the loading, and the passability of the intervention into the body will be greatly reduced.
  • the present application provides an interventional device that is convenient for positioning and a processing method.
  • the interventional devices that are easy to locate in this application include:
  • a stent is a frame structure with a hollow area and has an axis in space, the stent has a radially compressed loading state and a radially expanded release state;
  • a closed film connected to the bracket and a position corresponding to at least a part of the hollow area, in the loaded state, the outer peripheral surface of the bracket surrounds to form a storage space, and the closed film is located in the storage space;
  • the friction-increasing component is connected with the closed film.
  • the friction-increasing component extends to the outside of the stent for friction positioning with the adjacent tissue at the implantation site of the interventional instrument.
  • the inside of the stent is an axial channel, and in the released state, the axial channel remains through, or a leaflet that can change the through state of the axial channel is provided in the stent.
  • valve leaflets correspond to the aortic valve, pulmonary valve, mitral valve, tricuspid valve or venous valve according to the use position of the interventional instrument, and the stent has a shape suitable for the use position.
  • the stent is spherically expanded or self-expandable.
  • the bracket is made by pipe cutting or weaving as a whole, or made by combining pipe cutting and weaving.
  • the stent is provided with an auxiliary positioning structure that interacts with adjacent tissues, and the auxiliary positioning structure includes at least one of the following methods:
  • the stent has a radially undulating corrugated structure
  • the outer surface of the bracket is provided with anti-skid patterns.
  • the stent expands circumferentially during the release process, and the sealing membrane is linked with the circumferential expansion of the stent to drive the friction-increasing component to change the radial position.
  • the positions of the stent on both sides of the hollow area are linkage edges, and the closing film is connected to at least the linkage edges.
  • the linkage on both sides of the hollow area The sides move away from each other to drive the closed film to expand and push the friction-increasing component radially outward.
  • the closed film is an inner closed film that is attached to the inner wall of the stent.
  • At least a part of the area of the closed film is a driving part corresponding to the hollow area.
  • the driving part is folded, and at least a part of the friction-increasing component is wrapped by the folded driving part.
  • the edge of the driving part abuts against the radial inner side of the stent; or the edge of the driving part abuts against the inner edge of the hollow area.
  • the sealing membrane is located on the radial inner side of the stent as a whole.
  • the sealing film protrudes beyond the outer peripheral surface of the bracket at the position where the friction-increasing component is connected.
  • the sealing membranes are distributed or continuously distributed in the circumferential direction of the stent.
  • the sealing membrane is continuously distributed in the circumferential direction of the stent, and is circumferentially closed.
  • the closed membrane is connected to the stent by stitching or winding.
  • the closed film completely shields or partially shields the corresponding hollow area.
  • the material of the sealing membrane is a biological membrane or an artificial membrane, and the sealing membrane covers part or all of the inner wall of the stent.
  • the friction increasing component is one or more wire bodies.
  • the wire body is a single-stranded wire, a cored wire or a twisted multi-stranded wire.
  • the thread body is made of polyester material.
  • the wire body has a flat strip shape.
  • the friction increasing component includes:
  • An anchor portion connected to the closed membrane
  • the support part located outside the closed membrane in the radial direction of the stent
  • An outer convex portion extending from the support portion to the outside of the stent and used for frictional positioning with adjacent tissues;
  • the anchoring portion, the supporting portion and the outer convex portion each independently adopt one or more wire bodies, or at least one wire body is shared between the two.
  • both the support portion and the outer convex portion are directly connected to the anchor portion or one of the two is directly connected to the anchor portion, and the other It is indirectly connected to the anchoring part.
  • friction-increasing components there are multiple friction-increasing components, and in the released state, the friction-increasing components are distributed along the circumference of the bracket, and each friction-increasing component corresponds to the position of the corresponding hollow area.
  • the friction-increasing component is divided into multiple groups along the circumferential direction of the stent, and adjacent groups are arranged in a staggered manner in the axial direction of the stent.
  • one axial end of the bracket is an inflow end, and the other end is an outflow end, and the friction-increasing component is arranged on a side adjacent to the inflow end.
  • one or more friction-increasing parts are arranged in the same hollow area.
  • At least a part of the area of the closed film is a driving part corresponding to the hollow area
  • the friction-increasing component has an anchoring part and is connected to the driving part through the anchoring part.
  • the anchoring portion penetrates the closed film via a connecting hole, and the part of the anchoring portion located inside the closed film restricts the friction-increasing component to escape through the closed film.
  • the anchoring portion penetrates the closing film through a connecting hole, and a part of the anchoring portion located inside the closing film is provided with an anchoring head blocked by the connecting hole.
  • the anchoring head is an integral structure with the rest of the anchoring portion or is a separately configured limiter.
  • the anchoring portion is one or more U-shaped, the two arms of each U-shaped penetrating through the closing membrane through the corresponding connecting holes, and the two arms intersect at the inner side of the driving portion to form a U-shaped bottom,
  • the two arms are wound on the outside of the driving part to form a supporting part, and at least one of the two arms is further extended from the supporting part to form an outer convex part.
  • the winding manner is that the two arms are knotted or knotted with each other on the outside of the driving part, or knotted with other U shapes.
  • the anchoring portion penetrates the closed membrane perpendicularly.
  • the same anchoring portion corresponds to two or more connecting holes, and at least two connecting holes are arranged along the axial direction of the stent.
  • At least a part of the closed membrane is a driving part corresponding to the hollow area, one end of the friction-increasing part is connected to the driving part, and the other end is located outside the closed membrane in the radial direction of the stent and formed Support part.
  • the friction-increasing component further includes an outer convex portion extending from the supporting portion to the outside of the stent for friction positioning with adjacent tissues.
  • the friction-increasing component is a wire body, and the supporting portion is formed by winding the wire body; or the friction-increasing component is a plurality of wire bodies, and the supporting portion is formed between multiple wire bodies. Are formed by entwining each other; the wire body is further extended from the supporting portion to form the outer convex portion.
  • the supporting part has a higher rigidity relative to the outer convex part.
  • the supporting portion adopts a locally reinforced wire body to improve rigidity.
  • the local reinforcement adopts at least one of tying the thread body, thickening the thread body, and changing the material of the thread body.
  • the outer convex portion includes one or more thread ends, and at least one thread head increases in diameter at one end close to the closing film to form the support part; or at least one thread head is opposite to the material at the end close to the closing film The material at the end away from the closed membrane has higher rigidity.
  • the support part is a separately configured part, and is a separate structure from other parts of the friction increasing part.
  • the support portion is a gasket or a sleeve, and the outer convex portion penetrates the support portion or is in contact with the support portion.
  • the support parts in all friction-increasing parts in the same hollowed-out area are integrated, or the supporting parts in different friction-increasing parts in the same hollowed-out area are configured independently.
  • the support parts in the friction-increasing parts in different hollow areas are configured independently.
  • the driving part is folded, and the supporting part is wrapped by the folded driving part and is located in the storage space.
  • the outer convex portion is a thread end of the wire body and/or a coil surrounded by the wire body.
  • the number of the thread ends is one or multiple divergent, and the number of coils is one or more.
  • each thread head is the same or at least two thread heads have different directions.
  • the end of the thread head far away from the support portion is a free end, which is further enlarged compared to other parts of the thread head; the expansion adopts a method of twisting or local hot melt deformation.
  • the outer convex part is wrapped and wrapped by the folded driving part, and is located in the storage space.
  • the application also provides a processing method for an interventional device, the interventional device including a stent, the stent is a frame structure with a hollow area and has a spatial axis, the stent has a radially compressed loading state, and a diameter To the unfolded released state;
  • the processing method includes implementation in any order:
  • step S100 a closing film is installed on the stent, and the closing film is connected to the stent and the position corresponds to at least a part of the hollow area.
  • the outer peripheral surface of the stent In the loaded state, the outer peripheral surface of the stent is surrounded to form a storage space. In the storage space; when the stent changes its state, it is pulled and deformed by the stent;
  • step S200 a friction-increasing component is installed on the sealing membrane, and in a released state, the friction-increasing component extends to the outside of the stent for friction positioning with the adjacent tissue at the implantation site of the interventional device.
  • the sealing film is an inner sealing film that is attached to the inner wall of the stent, and the inner sealing film is attached to the inner side of the stent during installation and stitched and fixed.
  • the friction-increasing component is a wire body.
  • one end of the wire body is inserted from the outside of the stent through the closed membrane into the inside of the stent, and then the end that enters the inside of the stent is removed from the same hollow area.
  • Other parts pass through the inner sealing membrane and return to the outside of the stent, and are knotted with other parts of the outside of the stent.
  • At the knotted part there is at least one thread extending to the outside of the stent for friction positioning with adjacent tissues.
  • the present application also provides an interventional system, including a sheath assembly, a control handle, and an interventional instrument.
  • the sheath assembly has opposite distal and proximal ends.
  • the interventional instrument is loaded on the distal end of the sheath assembly.
  • the control handle is connected to the proximal end of the sheath assembly, and the control handle can release the interventional instrument by driving the sheath assembly, and the interventional instrument is the interventional instrument that is convenient for positioning as described above in this application.
  • the interventional device of the present application is provided with friction-increasing components and its installation position is improved.
  • a friction positioning method is provided, and adverse effects on loading are avoided to the greatest extent, and potential safety hazards are eliminated as much as possible.
  • Figure 1 is a schematic structural diagram of an interventional device in a released state in an embodiment
  • FIG. 2 is a schematic diagram of the structure of the interventional device in a loaded state in an embodiment
  • Fig. 3 is a schematic diagram of the storage space position on the cross section of the interventional instrument in an embodiment
  • Figure 4 is a schematic diagram of the frictional positioning of the interventional instrument (partial) and adjacent tissues in a released state in an embodiment
  • Figure 5 is a schematic structural diagram of an interventional device used as a vascular stent in an embodiment
  • Figure 6 is a schematic structural diagram of an interventional device processed by a tube cutting method in an embodiment
  • Fig. 7 is a schematic diagram of a structure with barbs on the bracket of the interventional instrument in an embodiment
  • FIG. 8 is a schematic structural diagram with anti-skid patterns on the bracket of the interventional device in an embodiment
  • Fig. 9 is a schematic structural diagram of a corrugated structure on the stent of the interventional device in an embodiment
  • Figure 10 is a schematic diagram of the movement of the friction-increasing component driven by the closed membrane of the interventional device
  • Figure 11 is a schematic diagram of the radial positional relationship between the sealing membrane and the stent in an embodiment
  • Figure 12 is a schematic diagram of the radial positional relationship between the sealing membrane of the interventional device and the stent in an embodiment
  • Figure 13 is a schematic diagram of the radial positional relationship between the sealing membrane of the interventional device and the stent (corresponding to Figure 11) in an embodiment
  • FIG. 14 is a schematic diagram of the radial positional relationship between the sealing membrane of the interventional device and the stent (corresponding to FIG. 12) in an embodiment
  • Figure 15 is a schematic structural diagram of an interventional device with a closed membrane protruding from the stent in an embodiment
  • 16 is a schematic diagram of the layout of the driving part of the interventional instrument in an embodiment
  • Figure 17 is a schematic diagram of the layout of the driving part of the interventional instrument in an embodiment
  • 18 is a schematic diagram of the structure of the friction-increasing component of the interventional device in an embodiment
  • 19 is a schematic diagram of the structure when the friction-increasing component of the interventional device in an embodiment adopts a wire body;
  • 20 is a schematic diagram of the structure of the friction-increasing component of the interventional device in an embodiment
  • Figure 21 is a schematic diagram of the structure of the friction-increasing component of the interventional device in an embodiment
  • Figure 22 is a schematic diagram of the distribution of friction-increasing components of an interventional device in an embodiment
  • Figure 23 is a schematic diagram of the distribution of friction-increasing components of an interventional device in an embodiment
  • Figure 24 is a schematic diagram of the distribution of friction-increasing components of an interventional device in an embodiment
  • Figure 25 is a schematic diagram of the connection of the anchoring head of the interventional device in an embodiment
  • Figure 26 is a schematic diagram of the connection of the anchoring head of the interventional device in an embodiment
  • Figure 27 is a schematic diagram of the anchoring head connection of an interventional instrument in an embodiment
  • Figure 28 is a schematic diagram of the structure of the friction-increasing component of the interventional device in an embodiment
  • Figure 29 is a side view of the friction increasing component of Figure 28;
  • FIG. 30 is a schematic diagram of the structure of the support portion of the interventional instrument in an embodiment
  • Figure 31 is a schematic diagram of the structure of the support part of the interventional instrument in an embodiment
  • FIG. 32 is a schematic diagram of the structure of the support portion of the interventional device in an embodiment
  • Figure 33 is a schematic diagram of the structure of the support portion of the interventional instrument in an embodiment
  • Figure 34 is a schematic diagram of the structure of the support portion of the interventional instrument in an embodiment
  • 35 is a schematic diagram of the structure of the support part of the interventional instrument in an embodiment
  • Figure 36 is a schematic diagram of the structure of the support portion of the interventional instrument in an embodiment
  • Figure 37 is a schematic diagram of the structure of the friction-increasing component of the interventional device in an embodiment
  • FIG. 38 is a side view of the friction-increasing component of FIG. 37;
  • FIG. 39 is a schematic diagram of the structure of the friction-increasing component of an interventional device in an embodiment;
  • Figure 40 is a schematic diagram of the structure of the friction-increasing component of the interventional device in an embodiment
  • Figure 41 is a schematic diagram of the structure of the friction-increasing component of the interventional device in an embodiment
  • Figure 42 is a schematic diagram of the structure of the friction-increasing component of the interventional device in an embodiment
  • FIG. 43 is a schematic structural diagram of an intervention system in an embodiment of this application.
  • Figure 44 is a schematic view of the structure of the sheath core assembly in Figure 43;
  • Figure 45 is a schematic diagram of the compressed state before the interventional device is released.
  • Figure 46 is a schematic diagram of the structure of the distal end partially expanded during the release of the interventional instrument.
  • Closure membrane 21, valve leaflet; 22, closure membrane edge; 23, driving part; 231, driving part edge; 24, connecting hole;
  • Friction-increasing parts 31. Anchor part; 32. Support part; 33. Outer convex part; 311. U-shaped two arms; 332. Twisting zone; 333. Hot melt zone;
  • Sheath core assembly 91. Core tube; 92. Lock; 93. Guide head.
  • a component when a component is said to be “connected” with another component, it can be directly connected to the other component or there may also be a central component. When a component is considered to be “installed on” another component, it can be directly installed on another component or a centered component may exist at the same time.
  • one of the embodiments of this application provides an interventional instrument that is convenient for positioning, including:
  • the stent 1 is a frame structure with a hollow area 11 and has a spatial axis.
  • the stent 1 has a radially compressed loading state (shown in Figure 2) and a radially expanded release state (shown in Figure 1 );
  • the closing film 2 is connected to the stent 1 and the position corresponds to at least a part of the hollow area 11.
  • the outer peripheral surface of the stent 1 surrounds to form a storage space, and the closing film 2 is in the storage space;
  • the friction-increasing part 3 is connected with the closed membrane 2.
  • a radially compressible structure is used to facilitate loading and transportation. After reaching a predetermined position in the body, it can be released by expansion of the ball or its own elasticity.
  • the side close to the operator is the proximal end.
  • the side that enters the body close to the lesion is the distal end.
  • the sealing film 2 can be made of biocompatible materials, which can cover at least part of the corresponding hollow area 11.
  • the sealing film 2 in the loaded state is in the storage space, for example, the outer ring in Figure 3 is The storage space boundary 12, the closed film 2 is folded in the area surrounded by the storage space boundary 12, and does not extend to the outside thereof, and will not affect the outer diameter of the stent 1.
  • the closed film 2 and the stent 1 The relative radial relationship is not strictly limited, and it can be inside the stent, or flush with the radial position of the sidewall of the stent, or even partially protruding outside the stent.
  • the friction-increasing component 3 is connected to the closed film 2, and the friction-increasing component 3 in the loaded state can be extended into the storage space along with the closed film 2. As part or even all of the friction-increasing component 3 is in the storage space, it can reduce the need for brackets. Due to the influence of the outer circumference, the difficulty of loading is avoided as much as possible, which is particularly important for self-expanding stents.
  • the friction-increasing component 3 itself is concerned, biocompatible materials can be used.
  • the friction-increasing component 3 preferably has a certain degree of elasticity, so that it can be better in the released state. Keep tightly attached to the adjacent tissue 4.
  • the friction-increasing component 3 in the released state, extends to the outside of the stent for friction positioning with the adjacent tissue 4 where the interventional device is implanted.
  • the direct connection between the friction-increasing component 3 and the bracket 1 should be reduced to avoid the restriction on the degree of freedom.
  • the friction-increasing component 3 extends to the outside of the stent.
  • the friction-increasing component 3 is filled or tensioned between the stent 1 and the adjacent tissue 4, and the positioning effect is further improved by increasing the friction.
  • the stent 1 is roughly mesh-shaped and made of stainless steel or nickel-titanium alloy.
  • the interior of the stent 1 is an axial channel.
  • the axial channel in the released state, the axial channel is kept through, or a stent 1 is provided with a The valve leaflet that changes the through state of the axial passage, such as the valve leaflet 21 in FIG. 1.
  • the interventional device only plays a supporting role and does not need to control and interfere with the blood flow, the axial channel can always be kept through in the released state. If the blood flow direction is required to be controlled, for example, to prevent backflow, a valve can be set in the stent
  • the lobes which are commonly single-leaf, two-leaf or three-leaf lobes, are fixed in the stent by stitching or bonding to interfere with the opening and closing of the axial channel or the degree of opening and closing.
  • valve leaflets can be configured according to the use position of the interventional device.
  • the valve leaflets correspond to the aortic valve, pulmonary valve, mitral valve, tricuspid valve or venous valve according to the use position of the interventional device.
  • the bracket has a shape suitable for the use position.
  • the stent also has corresponding shape characteristics to adapt to the surrounding tissues.
  • the stent 1 and valve leaflet 21 are adapted to it.
  • the stent 1 is a blood vessel stent, and the inside of the stent 1 is covered with a sealing film 2, and a friction-increasing component 3 is provided on the sealing film 2.
  • the stent is a ball-expandable type, and in a preferred embodiment, the stent is a self-expanding type.
  • the self-expanding stent its loading space is limited and it is more sensitive to the outer diameter change in the loaded state.
  • the method of setting a covering on the outer periphery of the stent to increase the friction force will inevitably increase the outer diameter in the loaded state.
  • Reprinting brings inconvenience and greatly reduces the flexibility of the mounting part of the stent, making it difficult to pass more complicated paths in the body. Therefore, in the self-expanding stent, the friction-increasing component method adopted in this application has more prominent advantages.
  • the stent as a whole is made by pipe cutting or braiding, or a combination of pipe cutting and braiding.
  • the stent 1 is made by pipe cutting as a whole.
  • the stent 1 is in a loaded state, and there is still a gap between the inner wall of the stent 1 after radial compression and the sheath core in the delivery system.
  • a radial gap, and the closed film of the present application and the friction-increasing component (at least a part) are accommodated in the radial gap.
  • the bracket can be further improved in different embodiments.
  • the stent 1 is provided with an auxiliary positioning structure that interacts with adjacent tissues.
  • the auxiliary positioning structure is provided with barbs 13 on the stent 1.
  • the barbs 13 can be arranged along the circumference of the stent 1. There are multiple ones. In the released state, the barbs 13 can anchor adjacent tissues to prevent the interventional instrument from shifting.
  • the stent 1 is provided with an auxiliary positioning structure that interacts with adjacent tissues.
  • the auxiliary positioning structure is provided with anti-skid patterns 14 on the stent 1.
  • the anti-skid patterns 14 can be arranged in the circumferential direction of the stent 1. Partially or completely, at least one section of the axial direction is provided with anti-slip patterns 14 which can be processed simultaneously during the cutting of the stent. In the released state, the anti-slip patterns 14 can act on adjacent tissues to increase friction and prevent the interventional device from shifting.
  • the stent 1 is provided with an auxiliary positioning structure that interacts with adjacent tissues.
  • the auxiliary positioning structure is provided with a corrugated structure 15 on the stent 1, and the corrugated structure 15 has at least radial undulations. It can be arranged on part or all of the stent 1 in the circumferential direction. At least one section of the axial direction is provided with a corrugated structure 15.
  • the corrugated structure 15 can be obtained by heat setting. In the released state, the corrugated structure 15 can act on adjacent tissues to increase friction and prevent The interventional device is displaced.
  • the sealing membrane and the stent are linked, and at the same time, the friction-increasing component is provided with a radially outward expansion force, so that the friction-increasing component is attached to the adjacent tissue outwards to obtain sufficient friction.
  • the material of the sealing membrane is biofilm or artificial membrane, covering part or all of the inner wall of the stent.
  • woven membranes are preferably used. Since the woven membrane itself has a fiber gap, when the friction-increasing component directly or indirectly passes through the fiber gap, the structural damage to the woven film itself can be reduced, and the dragging of the friction-increasing component can be avoided. When the film is closed, the closed film is torn due to local damage or stress concentration. Specifically, the existing technology can be used in terms of the weaving method itself.
  • the stent 1 expands circumferentially during the release process, and the sealing membrane 2 is linked with the circumferential expansion of the stent 1 to drive the friction-increasing component 3 to change the radial position.
  • the parts of the stent 1 on both sides of the hollow area are the linkage edges, and the closing membrane 2 is at least connected to the linkage edges.
  • the closing membrane 2 is closed on both sides of the stent circumference.
  • the membrane edge 22 is fixedly connected to the linkage edge of the stent 1.
  • the linkage edges on both sides of the hollow area are far away from each other, that is, the circumferential expansion of the stent 1 will tighten the sealing membrane 2 and connect to the increase of the sealing membrane 2.
  • the friction part 3 moves radially outward in the direction of arrow A until it abuts against adjacent tissues.
  • the sealing membrane 2 is an inner sealing membrane that abuts against the inner wall of the stent.
  • the closed film 2 is at least partially folded, and at least a part of the friction-increasing component 3 is wrapped by the folded part of the closed film 2.
  • the closed film 2 is in the storage space as a whole, if the friction-increasing parts 3 are all wrapped by the folded part of the closed film 2, it can also be regarded as the friction-increasing part 3 is also in the storage space as a whole, which is a feasible way
  • One is that a part of the friction-increasing component 3 is wrapped by the folded part of the closed film 2, and the other part slightly extends to the outside of the stent, but the part outside the stent is generally only a small part of the friction-increasing component 3, and will not increase significantly. The difficulty of loading interventional instruments.
  • the area of the closure membrane is large, it will cover part of the hollow area inside the stent, and it will inevitably cover the frame part of the stent.
  • the closure membrane itself is connected to the stent, it is usually stitched on the frame part of the stent, so in order to reduce the radial
  • at least a part of the area of the closed film is a driving part corresponding to the hollow area, and the friction-increasing component is connected to the corresponding driving part.
  • the driving part is folded, and at least a part of the friction-increasing component is wrapped by the folded driving part.
  • the stent 1 is distributed with a plurality of hollow areas 11, the closed film 2 is an inner closed film that covers the inner wall of the stent 1, and the closed film 2 passes through the binding wire 5 (only part of the binding wire is shown) It is sewn on the frame of the stent 1, and the part of the closed film 2 corresponding to one of the hollow areas in the figure is the drive part 23.
  • the friction-increasing component (not shown in the figure) is arranged on the drive part 23. Of course, only Indicates the part of the bracket, the location and number of friction-increasing parts and the settings according to requirements. Since the closing film 2 is an inner closing film, the edge of the driving portion 23 in this embodiment is abutted against the radial inner side of the stent.
  • the stent 1 is distributed with a plurality of hollow areas 11, and the closed membranes 2 are distributed at intervals, that is, the driving part 23 corresponding to each hollow area 11 is independent, and the wires 5 are respectively tied (shown only partially The binding thread) is stitched on the frame strip of the stent 1, but the driving part 23 is not attached to the inner side of the stent, but the edge of the driving part 23 is attached to the edge 16 of the hollow area where it is located.
  • the closure membrane 2 in the released state, according to the tight state of the closure membrane 2, in different embodiments, the closure membrane 2 is on the radial inner side of the stent as a whole. See Figure 15. In another embodiment, in the released state , The sealing film 2 protrudes beyond the outer peripheral surface of the bracket at the position where the friction increasing member is connected (the driving part 23).
  • the covered films on the stent are all the above-mentioned closed membranes.
  • the distribution area of the sealing film relative to the stent can be located at different positions in the axial and circumferential directions of the stent.
  • the sealing film is distributed or continuously distributed in the circumferential direction of the stent.
  • the closure membranes 2 are continuously distributed in the circumferential direction of the stent 1
  • the closure membranes are distributed in the circumferential direction of the stent 1 at intervals, and the driving part 23 is arranged at every other cell in the figure.
  • the sealing membrane is continuously distributed in the circumferential direction of the stent and is circumferentially closed. It is convenient to ensure the connection and its own strength, and in addition, a better sealing effect can be obtained
  • the closed film completely shields or partially shields the corresponding hollow area.
  • the closed film 2 completely shields the corresponding hollow area 11.
  • the stent 1 is distributed with multiple hollow areas 11, the closed film 2 is an inner closed film that covers the inner wall of the stent 1, and the closed film 2 is bound by a binding wire 5 (only partially shown Thread) is stitched on the frame part of the stent 1.
  • the part of the closed film 2 corresponding to one of the hollow areas in the figure is the drive part 23.
  • the friction-increasing component (not shown in the figure) is arranged on the drive part 23, but the drive part 23 does not completely cover the hollow area 11, and the driving part edge 231 is also in the hollow area 11. Since the driving part 23 is fixed to the bracket 1 on both sides in the circumferential direction, it can still drive the friction-increasing component to change the radial position. The role of.
  • the friction-increasing component 3 is one or more wire bodies.
  • the wire body itself is not the focus of improvement in this application.
  • the wire body is a single-stranded wire, a cored wire, or a twisted multi-stranded wire.
  • the surface of the thread body should have a certain roughness. This can be obtained by surface treatment of the thread body, or a suitable material can be selected.
  • the thread body is made of polyester material. .
  • the thread body has a certain degree of elasticity, which is particularly suitable for the use of the interventional device in the biological body.
  • the surrounding tissue of the interventional device (if there is no obvious calcification) also has a certain degree of elasticity, which can be realized with the friction-increasing component.
  • Mutual adaptive deformation in a common use scenario, taking the aortic valve as an example, its inner circumference is relatively smooth and prone to peripheral leakage.
  • the use of the interventional device with friction-increasing components of this application not only further guarantees the positioning effect, but also Directly or indirectly reduce the risk of weekly leakage.
  • the winding and fixing between the wires is simple and easy, which can save additional connecting pieces or locking pieces.
  • the cross-sectional shape of the wires also has a certain influence on the firmness of winding and fixing.
  • the line body is a flat strip.
  • the friction-increasing component 3 may include an anchor portion 31 connected to the closure membrane 2; the closure membrane 2 is located in the radial direction of the stent 1 The outer support portion 32; the outer convex portion 33 extending from the support portion 32 to the outside of the stent 1 for frictional positioning with adjacent tissues.
  • the specific arrangement of the anchor portion 31, the support portion 32, and the convex portion 33 can be seen in the figure. All three adopt the wire structure, because the wires are easy to intertwined and overlapped. Therefore, the number of wires included in the friction-increasing component 3 as a whole is not strictly limited.
  • the anchoring portion 31, the supporting portion 32, and the outer convex portion 33 each independently adopt one or more wire bodies, or at least one wire body is shared between the two.
  • the figure is only a schematic illustration, and there is no strict restriction on the specific threading method of the wire body relative to the closed film 2.
  • the supporting portion 32 and the outer convex portion 33 Both are directly connected to the anchor portion 31.
  • the supporting portion 32 omits a specific winding manner, of course, the supporting portion 32 may also be formed by partial bonding or thermal melting.
  • the support portion 32 and the anchor portion 31 In terms of the connection relationship between the support portion 32 and the outer convex portion 33 and the anchor portion 31, according to the extension path of the wire body, the support portion 32 and the anchor portion 31 It is directly connected, and the outer convex portion 33 is indirectly connected to the anchor portion 31 through the supporting portion 32.
  • the supporting portion 32 omits a specific winding manner, of course, the supporting portion 32 may also be formed by partial bonding or thermal melting.
  • the stent 1 is covered with an inner sealing film, and there are multiple friction-increasing components 3 distributed on the inner sealing film.
  • the friction-increasing components 3 are distributed along the circumference of the stent 1, and each The friction-increasing component 3 corresponds to the position of the corresponding hollow area.
  • friction-increasing parts 3 are provided on the inner closed membrane corresponding to each hollow area of the circle, which is also regarded as the friction-increasing parts 3 being continuously distributed in the circumferential direction.
  • the stent 1 is covered with an inner sealing film, and there are multiple friction-increasing components 3 distributed on the inner sealing film.
  • the friction-increasing components 3 are distributed along the circumference of the stent 1, and each The friction-increasing component 3 corresponds to the position of the corresponding hollow area.
  • the inner sealing film is provided with friction-increasing parts 3 corresponding to every other hollow area in the circle, which is also regarded as the friction-increasing parts 3 distributed at intervals in the circumferential direction.
  • the stent 1 is covered with an inner sealing film, and there are multiple friction-increasing components 3 distributed on the inner sealing film.
  • the friction-increasing components 3 are divided into multiple groups along the circumference of the stent.
  • the two friction-increasing components 3 can be regarded as a group, and the adjacent groups are arranged in a staggered axial direction of the stent, that is, the axial positions of the two adjacent boxes are different, so that the increase in the adjacent groups during loading
  • the friction parts 3 are arranged staggered in the axial direction to avoid mutual extrusion and interference.
  • one axial end of the stent 1 is the inflow end, and the other end is the outflow end, and the friction-increasing component 3 is provided On the side adjacent to the inflow end (also can be combined with Figure 22 ⁇ Figure 24 or other related drawings).
  • One or more friction-increasing parts can be arranged in the same hollow area. When multiple friction-increasing parts are arranged, they can be arranged in the rear circumferential direction along the axis of the bracket, preferably in the axial direction, and are independent of each other.
  • At least a part of the area of the closed film is a driving part corresponding to the hollow area, and the friction-increasing component has an anchoring part and is connected with the driving part through the anchoring part.
  • the anchoring part is mainly used to provide a connection point to be fixedly connected with the closure membrane to prevent the friction-increasing component 3 from falling off.
  • the anchoring part can be attached and fixed on the outside of the closure membrane. See Figure 25.
  • the stent 1 Covered with a closed film 2 the anchoring portion 31 of the friction-increasing component is attached and fixed to the outside of the closed film 2, and the remaining parts extend outward in the radial direction.
  • the anchoring portion 31 penetrates the sealing membrane 2 through the connecting hole 24, which can play a better connection role and increase the connection strength.
  • the connecting holes corresponding to the same anchoring portion 31 are 1 to 3. A.
  • One to three different embodiments can also be seen in Fig. 26, Fig. 21 and Fig. 20 respectively.
  • the anchoring portion 31 of FIG. 21 is approximately U-shaped and penetrates the closed membrane 2 through two connecting holes.
  • the anchoring portion 31 of FIG. 22 is approximately W-shaped (or viewed as two U-shaped parts merged), connected via three The hole penetrates the closed membrane 2.
  • the anchoring portion 31 preferably penetrates the sealing film 2 vertically to avoid the hidden danger of tearing caused by oblique penetration, especially when the sealing film 2 has a certain thickness, the effect is more obvious.
  • the anchoring portion 31 penetrates the closure membrane 2 via the connecting hole 24, and the part of the anchoring portion 31 located inside the closure membrane 2 escapes through the restricting friction-increasing member of the closure membrane 2.
  • the part of the anchoring portion 31 inside the sealing membrane 2 is provided with an anchoring head blocked by the connecting hole 24, and the anchoring head is swollen and can be blocked by the connecting hole 24.
  • the anchoring head and the rest of the anchoring portion 31 are an integral structure or a separately configured limiter.
  • the anchoring head itself may be an integral structure with the wire body.
  • the anchoring head is formed by knotting the wire body.
  • the anchoring head may be The limit piece connected with the line body.
  • the anchoring portion 31 is U-shaped
  • the two U-shaped arms 311 penetrate the closure membrane 2 through the corresponding connecting holes 24, and the U-shaped two arms 311 are in the driving part of the closure membrane 2
  • the insides of the U-shaped arms meet to form a U-shaped bottom.
  • the two U-shaped arms 311 are wound on the outside of the driving part of the closure film 2 to form the supporting portion 32.
  • At least one of the U-shaped two arms 311 is further extended from the supporting portion 32 to form a convex ⁇ 33.
  • one or more wire bodies can be used for the overall friction-increasing component, preferably one wire body, which is convenient for processing and avoids redundant connection operations.
  • the U-shaped anchor portion 31 corresponds to the two connection holes. 24.
  • the two connecting holes 24 are arranged along the axial direction of the stent.
  • the same anchoring portion 31 corresponds to two or more connecting holes 24, at least two or all of the connecting holes 24 are arranged along the axial direction of the stent, and all connecting holes 24 on the same driving portion are preferably arranged along the axial direction of the stent (the view can be Understand as expanded state).
  • the two arms 311 with a U-shaped winding manner are knotted or knotted on the outside of the driving part 23.
  • the knotting method is at least not easy to loosen. For example, when the two are wound and knotted, they are wound around each other at least twice. Tightening, that is, forming the supporting portion 32 at the knotted portion, can reduce the shaking of the outer convex portion 33 in the released state, and maintain sufficient tension for adjacent tissues.
  • At least a part of the area of the closed film is a driving part corresponding to the hollow area, and one end of the friction-increasing part is connected to the driving part. Connected, the other end is located outside the closed membrane in the radial direction of the stent and forms a support part. After the stent is released, the support portion can extend radially outward under the action of its own elasticity or a predetermined shape.
  • the friction-increasing component further includes an outer convex part extending from the support part to the outside of the stent for friction positioning with the adjacent tissue.
  • the supporting part has a higher rigidity than the convex part.
  • the support part adopts a method of locally strengthening the wire body to increase the rigidity.
  • the increase in rigidity can be regarded as compared to the direct extension of the anchoring portion to form an outer convex portion, the way to increase the rigidity can rely on the change of the wire itself or with the aid of additional components.
  • the interventional device includes a stent, the stent is covered with a closed film 2, and friction-increasing parts distributed on the closed film 2.
  • the friction-increasing part is a linear structure and includes an anchoring part connected to the closed film 2. 31; the support portion 32 outside the closure membrane 2; the outer convex portion 33 extending from the support portion 32 to the outside and used for friction and positioning with adjacent tissues.
  • the material of the wire body at the support portion 32 is changed, and the rigidity is higher.
  • the convex portion 33 plays a further supporting role.
  • the interventional device includes a stent, the stent is covered with a closed film 2, and friction-increasing components distributed on the closed film 2.
  • the friction-increasing component is a wire structure, including an anchor connected to the closed film 2.
  • the rigidity of the outer convex part 33 plays a further supporting role.
  • the interventional device includes a stent.
  • the stent is covered with a closed film 2 and friction-increasing components distributed on the closed film 2.
  • the friction-increasing component is a wire structure, including a connection
  • the way of knotting correspondingly obtains higher rigidity, and further supports the outer convex portion 33.
  • the friction-increasing component has a wire body, and the two strands extending from the U-shaped anchor portion 31 are knotted to form a supporting portion 32, and the outer convex portion adopts a split and bifurcation method to form a divergent structure.
  • the ends of the strands are the same or different.
  • the friction-increasing component in FIG. 34 is composed of two wire bodies, the anchor portion 31 and the supporting portion 32 are both formed by knotting the two wires, and the outer convex portion adopts the way of splitting and bifurcation to form a diverging structure. .
  • the friction-increasing component in FIG. 35 is a wire body
  • the supporting portion 32 is formed by knotting the wire body itself
  • the outer convex portion adopts a split and bifurcation method to form a diverging structure.
  • the supporting part may be a separately configured component, and the anchoring part and the outer convex part are of separate structures.
  • the interventional instrument includes a stent.
  • the stent is covered with a closed film 2 and friction-increasing components distributed on the closed film 2.
  • the friction-increasing component is a linear structure and includes an anchor portion 31 connected to the closed film 2; The support portion 32 outside the membrane 2; the outer protrusion 33 extending from the support portion 32 to the outside and used for frictional positioning with adjacent tissues, wherein the support portion 32 is a gasket, which is higher than the outer protrusion 33 and the support portion 32
  • the anchoring portion 31 sequentially penetrates the gasket of the closure membrane 2 and further extends to form an outer convex portion 33.
  • the supporting portion 32 can also be a sleeve.
  • the anchoring portion 31 sequentially penetrates the sleeve of the closure film 2 and further extends to form an outer convex portion 33.
  • the supporting portion 32 is clamped and limited to the closure film 2 and the outer convex portion. Between 33.
  • the support parts in the friction-increasing parts in different hollow areas are configured independently.
  • the support parts in all friction-increasing parts in the same hollow area are integrated, or the supporting parts in different friction-increasing parts in the same hollow area are independently configured.
  • the supporting parts in the non-hollowed area are arranged independently, it is possible to prevent the supporting parts from wrapping the outer wall of the frame of the bracket. Because the supporting parts have high rigidity, if the loading state is on the periphery of the bracket, it will inevitably have an adverse effect on the loading. Therefore, it is further preferred In the embodiment, when the bracket is in the loaded state, the driving part is folded, and the supporting part is wrapped by the folded driving part and is located in the storage space (for the specific position relationship, please refer to the schematic diagram of FIG. 3). In a further preferred embodiment, in the loaded state, the outer convex portion is wrapped by the folded driving portion and is located in the storage space.
  • the end of the thread end of the outer protrusion away from the support portion is a free end, and the free end is further enlarged compared with other parts of the thread end; see Fig. 37, outer protrusion 33
  • the swelling of the swelling adopts an open-twisting method, that is, an open-twisting area 332 is formed, and the expansion of the outer convex portion 33 can also adopt a local hot-melt deformation method, that is, a hot-melting area 333 is formed.
  • the inner side of the stent of the interventional device is stitched with an inner sealing film.
  • the drive part 23 of the inner sealing film is formed with a friction increasing component 3 in a linear manner.
  • the driving part 23 is provided with a plurality of connecting holes, the wire body forms a roundabout stitch on the inner and outer sides of the driving part 23 through each connecting hole, forming the anchor part 31 and the outer convex part 33, and the outer convex part 33 is close to the driving part.
  • the outside part of 23 forms the support part 32 by knotting the thread body.
  • the friction-increasing component 3 includes a plurality of units. In the figure, the friction-increasing component is three wire bodies, which are respectively wound and formed into a knot. As far as each unit is concerned, the relevant structures in Fig. 30 to Fig. 36 can be independently adopted.
  • the units that is, the connecting holes, are arranged in sequence along the axial direction of the stent.
  • the number of wire bodies in the friction-increasing component 3 that is, the number of units, can also be increased or decreased accordingly. See FIG. 39.
  • the friction-increasing component 3 includes two units, and the friction-increasing component in the figure is two wire bodies. They are wound and knotted separately, and the relevant structures in Figure 30 to Figure 36 can be used independently for each unit.
  • the part of the friction-increasing component outside the support will not collapse as a whole, and the friction-increasing component can be formed on the basis of the linear structure with multiple continuous knots to form the support part.
  • the inner side of the stent of the interventional device is stitched with a closed film 2, that is, an internal closed film is used.
  • a closed film 2 that is, an internal closed film is used.
  • the drive part of the internal closed film is in a linear manner.
  • a friction-increasing component is formed.
  • the friction-increasing component is a linear structure, including an anchoring portion 31 connected to the closure membrane 2; a support portion 32 located outside the closure membrane 2; extending outward from the support portion 32 for friction with adjacent tissues Positioning of the convex portion 33.
  • the friction-increasing component is a wire body
  • the U-shaped anchor portion 31 passes through the closed film 2 through the connecting hole on the closed film 2, and the two extended strands are knotted to form a supporting portion. 32.
  • the knotted thread further extends to form an outer convex portion 33, and the end of the outer convex portion 33 forms a divergent structure by splitting and bifurcation.
  • a continuous knotting method is adopted.
  • the number of knots is 4. In other embodiments, the number can be increased or decreased accordingly. For example, in another embodiment of FIG. 41, the number of knots is 8 Times.
  • the outer convex portion may not be provided.
  • the inner side of the stent of the interventional device is stitched with a sealing membrane 2, that is, an internal sealing membrane is adopted.
  • a friction increasing component is formed on the driving part of the inner sealing membrane in a linear manner.
  • the friction increasing component is a linear structure and includes an anchoring portion 31 connected to the sealing membrane 2; a support part located outside the sealing membrane 2 32.
  • the U-shaped anchoring portion 31 passes through the sealing film 2 through the connecting hole on the sealing film 2, and the two stretched strands are knotted multiple times to form a supporting portion 32.
  • the knotted thread ends There is no obvious outward extension, that is, no convex part changed by obvious rigidity is formed.
  • An embodiment of the present application also provides a processing method of an interventional device.
  • the interventional device can adopt any one or a combination of the above-mentioned embodiments.
  • the interventional device includes a stent, and the stent is a frame structure with a hollow area and has a On an axis in space, the stent has a radially compressed loaded state and a radially expanded released state;
  • the processing method includes implementation in any order:
  • Step S100 install a closing film on the stent, the closing film is connected to the stent and the position corresponds to at least a part of the hollow area, in the loaded state, the outer peripheral surface of the stent surrounds to form a storage space, and the closing film is in the storage space; the stent changes state During the process, it is deformed by the stent;
  • step S200 a friction-increasing component is installed on the sealing membrane.
  • the friction-increasing component extends to the outside of the stent for friction positioning with adjacent tissues at the implantation site of the interventional device.
  • the sealing film is an inner sealing film that is attached to the inner wall of the stent, and the inner sealing film is attached to the inner side of the stent and fixed by stitching during installation.
  • the friction-increasing component is a wire body.
  • one end of the wire body is inserted from the outer side of the stent through the inner sealing membrane into the inner side of the stent, and then the end is penetrated and sealed from other parts of the same hollow area.
  • the membrane returns to the outside of the stent and is knotted with other parts of the outside of the stent.
  • At the knotted part at least one thread end extends to the outside of the stent for friction positioning with adjacent tissues.
  • an embodiment of the present application also discloses an interventional system, including a sheath assembly, a control handle 6 and an interventional instrument 7.
  • the sheath assembly has opposite distal and proximal ends, and the interventional instrument 7 is loaded.
  • the control handle 6 is connected to the proximal end of the sheath assembly.
  • the control handle can release the interventional instrument 7 by driving the sheath assembly.
  • the interventional instrument 7 can be the interventional instrument of the foregoing embodiments.
  • the sheath tube assembly includes a sheath tube 8 and a sheath core assembly 9, wherein the sheath tube 8 is slidably fitted to the outer periphery of the sheath core assembly 9.
  • the sheath core assembly 9 includes a core tube 91 and a lock 92 fixed to the core tube and used for connecting the interventional instrument 7.
  • the distal end of the core tube 91 further extends out of the lock 92 and is fixed with a guide head 93.
  • the distal end of the guide head 93 has a round head structure with a convergent shape to facilitate the penetration and travel in the body.
  • the position between the guide head 93 and the lock 92 is used as the loading position of the interventional instrument 7, and the compressed interventional instrument 7 is in this position. Cooperate with the lock 92 in position limit.
  • the interventional system may further include a catheter 61 that is relatively fixed to the control handle 6, and the catheter 61 is used to establish a channel to prevent the sheath 8 from damaging tissues in the body when the sheath 8 reciprocates.
  • the interventional instrument 7 is loaded on the sheath core assembly 9 and enters the body together with the catheter 61 under the sheath tube 8, and the rear sheath tube 8 can slide and retract proximally relative to the sheath core assembly 9 under the drive of the control handle 6, then the intervention The device 7 is gradually exposed and released.

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Abstract

公开了一种便于定位的介入器械,包括:支架(1),支架(1)为带有镂空区(11)的框架结构且具有空间上的一轴线,支架(1)具有径向压缩的装载状态,以及径向展开的释放状态;封闭膜(2),与支架(1)相连且位置与至少部分镂空区对应,装载状态下,支架(1)的外周面围拢形成收纳空间,封闭膜(2)处在该收纳空间内;增摩部件(3),与封闭膜(2)相连。该介入器械通过设置增摩部件(3)并对其安装位置进行了改进,一方面提供了摩擦定位的方式,另外最大限度避免了对装载的不利影响,尽可能的消除安全隐患。还同时公开了相应的加工方法和介入系统。

Description

便于定位的介入器械及加工方法和介入系统 技术领域
本发明涉及医疗器械技术领域,特别是涉及一种介入器械及加工方法和介入系统。
背景技术
常见的介入器械例如瓣膜或血管支架,主要靠金属支架的径向支撑力在血管或脏器内定位,但金属支架的外周一般比较光滑,在血流的冲击下一旦发生位移不仅影响效果还存在安全隐患。某些患者在介入器械植入位的邻近组织有钙化情况,组织弹性不佳,定位问题尤为凸显。
为了解决定位问题,现有技术中,在介入器械的支架外周设置锚刺进行定位或设置附着物以填塞与邻近组织的间隙,但设置锚刺可有能带来安全隐患,而附着物会进一步增加介入器械的直径,尤其在自膨式介入器械中,直径的增加给装载带来不便,向体内介入时的通过性也会大大降低。
技术问题
为了进一步提高介入器械在体内的定位效果,同时尽可能的避免增加介入器械的装载难度,本申请提供一种便于定位的介入器械及加工方法。
技术解决方案
本申请便于定位的介入器械,包括:
支架,所述支架为带有镂空区的框架结构且具有空间上的一轴线,所述支架具有径向压缩的装载状态,以及径向展开的释放状态;
封闭膜,与所述支架相连且位置与至少部分镂空区对应,装载状态下,所述支架的外周面围拢形成收纳空间,所述封闭膜处在该收纳空间内;
增摩部件,与所述封闭膜相连。
以下还提供了若干可选方式,但并不作为对上述总体方案的额外限定,仅仅是进一步的增补或优选,在没有技术或逻辑矛盾的前提下,各可选方式可单独针对上述总体方案进行组合,还可以是多个可选方式之间进行组合。
可选的,释放状态下,所述增摩部件伸向支架外侧用于与介入器械植入位的邻近组织摩擦定位。
可选的,所述支架的内部为轴向通道,在释放状态下,所述轴向通道保持贯通,或在所述支架内设置有可改变所述轴向通道贯通状态的瓣叶。
可选的,所述瓣叶依据介入器械使用位置相应的为主动脉瓣、肺动脉瓣、二尖瓣、三尖瓣或静脉瓣,所述支架具有与使用位置相适应的形状。
可选的,所述支架为球扩型或自膨型。
可选的,所述支架整体上采用管材切割方式制成或采用编织方式制成,或采用管材切割与编织相结合的方式制成。
可选的,所述支架设置有与邻近组织相作用的辅助定位结构,该辅助定位结构至少包括以下方式之一:
所述支架带有径向起伏的波纹结构;
所述支架上带有倒刺;
所述支架的外表面带有防滑纹。
可选的,所述支架在释放过程中周向扩展,所述封闭膜与所述支架的周向扩展联动,带动所述增摩部件改变径向位置。
可选的,在支架周向上,所述支架处在镂空区两侧的部位为联动边,所述封闭膜至少连接至所述联动边,所述支架在释放过程中,镂空区两侧的联动边相互远离带动所述封闭膜展开,并径向外推所述增摩部件。
可选的,所述封闭膜为贴靠在支架内壁的内封闭膜。
可选的,所述封闭膜的至少一部分区域为与镂空区相对应的驱动部,装载状态下,所述驱动部折叠,所述增摩部件的至少一部分被折叠的驱动部包裹。
可选的,所述驱动部的边缘贴靠在支架径向内侧;或所述驱动部的边缘贴靠在镂空区的内缘处。
可选的,释放状态下,所述封闭膜整体上均处在支架径向内侧。
可选的,释放状态下,所述封闭膜在连接有所述增摩部件的位置处外凸越过支架外周面。
可选的,所述封闭膜在支架周向上间隔分布或连续分布。
可选的,所述封闭膜在支架周向上连续分布,且周向封闭。
可选的,所述封闭膜采用缝缀或缠绕的方式与所述支架相连。
可选的,所述封闭膜将所对应的镂空区完全遮蔽或部分遮蔽。
可选的,所述封闭膜的材质为生物膜或人造膜,所述封闭膜覆盖支架内壁的局部或全部。
可选的,所述增摩部件为一根或多根线体。
可选的,所述线体为单股线、包芯线或加捻的多股线。
可选的,所述线体为涤纶材料。
可选的,所述线体为扁条状。
可选的,所述增摩部件包括:
连接于所述封闭膜的锚定部;
在支架径向上处在封闭膜外侧的支撑部;
由所述支撑部向支架外侧延伸、用于与邻近组织摩擦定位的外凸部;
所述锚定部、支撑部和外凸部三者各自独立的采用一根或多根线体,或其中两者之间共用至少一根线体。
可选的,根据线体的延伸路径,所述支撑部和所述外凸部两者均与所述锚定部直接相连或两者中的一者与所述锚定部直接相连,另一者与所述锚定部间接相连。
可选的,所述增摩部件为多个,释放状态下,所述增摩部件沿支架周向分布,且各增摩部件与相应的镂空区位置对应。
可选的,所述增摩部件沿支架周向分为多组,且相邻组之间在支架轴向上错位布置。
可选的,所述支架的轴向一端为流入端,另一端为流出端,所述增摩部件设置在邻近所述流入端的一侧。
可选的,同一镂空区内设置一个或多个增摩部件。
可选的,所述封闭膜的至少一部分区域为与所述镂空区相对应的驱动部,所述增摩部件具有锚定部,且通过该锚定部与所述驱动部相连。
可选的,所述锚定部经由连接孔贯穿所述封闭膜,所述锚定部处在封闭膜内侧的部分通过所述封闭膜的限制所述增摩部件脱出。
可选的,所述锚定部通过一个连接孔贯穿所述封闭膜,所述锚定部处在封闭膜内侧的部分设有受阻于所述连接孔的锚定头。
可选的,所述锚定头与所述锚定部的其余部分一体结构或为单独配置的限位件。
可选的,所述锚定部为一个或多个U形,各U形的两臂经由相应的连接孔贯穿所述封闭膜,所述两臂在驱动部内侧相交汇形成U形的底部,所述两臂在驱动部外侧采用缠绕方式形成支撑部,所述两臂的至少一者由所述支撑部进一步延伸形成外凸部。
可选的,所述缠绕方式为所述两臂在驱动部外侧相互打结或自身打结或与其他U形之间相互打结。
可选的,所述锚定部垂直贯穿于所述封闭膜。
可选的,同一锚定部对应两个或以上的连接孔,至少两个连接孔沿支架轴向排列。
可选的,所述封闭膜的至少一部分区域为与所述镂空区相对应的驱动部,所述增摩部件一端与所述驱动部相连,另一端在支架径向上处在封闭膜外侧并形成支撑部。
可选的,所述增摩部件还包括由所述支撑部向支架外侧延伸、用于与邻近组织摩擦定位的外凸部。
可选的,所述增摩部件为一根线体,所述支撑部由该线体自身缠绕形成;或所述增摩部件为多根线体,所述支撑部由多根线体之间相互缠绕形成;所述线体由所述支撑部进一步延伸形成所述外凸部。
可选的,相对于外凸部、所述支撑部具有更高的刚度。
可选的,所述支撑部采用线体局部加强的方式以提高刚度。
可选的,所述局部加强的方式采用线体打结、线体增粗、线体材质变化中的至少一种。
可选的,所述外凸部包括一根或多根线头,至少一根线头在贴近封闭膜的一端直径增大形成所述支撑部;或至少一根线头在贴近封闭膜的一端的材质相对于远离封闭膜的一端的材质具有更高的刚度。
可选的,所述支撑部为单独配置的部件,且与所述增摩部件的其他部位为分体结构。
可选的,所述支撑部为垫片或套管,所述外凸部贯穿所述支撑部或与所述支撑部相互贴靠。
可选的,同一镂空区内所有增摩部件中的支撑部为一体结构,或同一镂空区内不同增摩部件中的支撑部各自独立配置。
可选的,不同镂空区内的增摩部件中的支撑部各自独立配置。
可选的,所述驱动部折叠,所述支撑部被折叠的驱动部包裹,且位于所述收纳空间内。
可选的,所述外凸部为所述线体的线头和/或所述线体围成的线圈。
可选的,所述线头为一根或发散的多根,所述线圈为一个或多个。
可选的,各线头的轴向指向相同或至少两个线头的指向不同。
可选的,所述线头远离支撑部的一端为自由端,该自由端与所述线头的其他部位相比进一步膨大;所述膨大采用开捻或局部热熔形变的方式。
可选的,装所述驱动部折叠,所述外凸部被被折叠的驱动部包裹,包裹,且位于所述收纳空间内。
本申请还提供了介入器械的加工方法,所述介入器械包括支架,所述支架为带有镂空区的框架结构且具有空间上的一轴线,所述支架具有径向压缩的装载状态,以及径向展开的释放状态;所述加工方法包括以任意次序实施的:
步骤S100,在所述支架上安装封闭膜,所述封闭膜与所述支架相连且位置与至少部分镂空区对应,装载状态下,所述支架的外周面围拢形成收纳空间,所述封闭膜处在该收纳空间内;在支架改变状态的过程中受支架牵引而形变;
步骤S200,在所述封闭膜上安装增摩部件,释放状态下,所述增摩部件伸向支架外侧用于与介入器械植入位的邻近组织摩擦定位。
可选的,步骤S100中,所述封闭膜为贴靠在支架内壁的内封闭膜,安装时将所述内封闭膜贴覆在支架内侧并缝缀固定。
可选的,步骤S200中,所述增摩部件为线体,安装时将所述线体的一端由支架外侧贯穿所述封闭膜进入支架内侧,再将进入支架内侧的一端从同一镂空区的其他部位贯穿所述内封闭膜回到支架外侧、并与支架外侧的其他部分线体相互打结,在打结部位至少有一根线头伸向支架外侧用于与邻近组织摩擦定位。
本申请还提供一种介入系统,包括鞘管组件、控制手柄和介入器械,所述鞘管组件具有相对的远端和近端,所述介入器械装载于所述鞘管组件的远端,所述控制手柄连接于所述鞘管组件的近端,所述控制手柄可通过驱动所述鞘管组件释放所述介入器械,所述介入器械为本申请上文所述的便于定位的介入器械。
有益效果
本申请的介入器械,通过设置增摩部件并对其安装位置进行了改进,一方面提供了摩擦定位的方式,另外最大限度避免了对装载的不利影响,尽可能的消除安全隐患。
附图说明
图1为一实施例中释放状态下的介入器械结构示意图;
图2为一实施例中装载状态下的介入器械结构示意图;
图3为一实施例中介入器械横截面上收纳空间位置的示意图;
图4为一实施例中释放状态下的介入器械(局部)与邻近组织摩擦定位的示意图;
图5为一实施例中作为血管支架的介入器械结构示意图;
图6为一实施例中采用管材切割方式加工的介入器械结构示意图;;
图7为一实施例中介入器械的支架上带有倒刺的结构示意图;
图8为一实施例中介入器械的支架上带有防滑纹的结构示意图;
图9为一实施例中介入器械的支架上带有波纹结构的结构示意图;
图10为介入器械封闭膜驱动增摩部件运动的原理示意图;
图11为一实施例中封闭膜与支架径向位置关系的示意图;
图12为一实施例中介入器械的封闭膜与支架径向位置关系的示意图;
图13为一实施例中介入器械的封闭膜与支架径向位置关系(与图11对应)的示意图;
图14为一实施例中介入器械的封闭膜与支架径向位置关系(与图12对应)的示意图;
图15为一实施例中介入器械的封闭膜外凸于支架的结构示意图;
图16为一实施例中介入器械的驱动部分布示意图;
图17为一实施例中介入器械的驱动部分布示意图;
图18为一实施例中介入器械的增摩部件结构示意图;
图19为一实施例中介入器械的增摩部件采用线体时的结构示意图;
图20为一实施例中介入器械的增摩部件结构示意图;
图21为一实施例中介入器械的增摩部件结构示意图;
图22为一实施例中介入器械的增摩部件分布示意图;
图23为一实施例中介入器械的增摩部件分布示意图;
图24为一实施例中介入器械的增摩部件分布示意图;
图25为一实施例中介入器械的锚定头连接示意图;
图26为一实施例中介入器械的锚定头连接示意图;
图27为一实施例中介入器械的锚定头连接示意图;
图28为一实施例中介入器械的增摩部件结构示意图;
图29为图28的增摩部件侧视图;
图30为一实施例中介入器械的支撑部结构示意图;
图31为一实施例中介入器械的支撑部结构示意图;
图32为一实施例中介入器械的支撑部结构示意图;
图33为一实施例中介入器械的支撑部结构示意图;
图34为一实施例中介入器械的支撑部结构示意图;
图35为一实施例中介入器械的支撑部结构示意图;
图36为一实施例中介入器械的支撑部结构示意图;
图37为一实施例中介入器械的增摩部件结构示意图;
图38为图37的增摩部件侧视图;图39为一实施例中介入器械的增摩部件结构示意图;
图40为一实施例中介入器械的增摩部件结构示意图;
图41为一实施例中介入器械的增摩部件结构示意图;
图42为一实施例中介入器械的增摩部件结构示意图;
图43为本申请以实施例中介入系统的结构示意图;
图44为图43中鞘芯组件的结构示意图;
图45为介入器械释放前即压缩状态的示意图;
图46为介入器械释放过程中远端局部扩张后的结构示意图。
图中附图标记说明如下:
1、支架;11、镂空区; 12、收纳空间边界;13、倒刺;14、防滑纹;15、波纹结构;16、镂空区内缘;
2、封闭膜;21、瓣叶;22、封闭膜边缘;23、驱动部;231、驱动部边缘;24、连接孔;
3、增摩部件;31、锚定部;32、支撑部;33、外凸部;311、U形的两臂;332、开捻区;333、热熔区;
4、邻近组织;
5、绑线;
6、控制手柄; 61、导管;;
7、介入器械;
8、鞘管;
9、鞘芯组件;91、芯管;92、锁件;93、引导头。
本发明的实施方式
下面将结合本发明实施例中的附图,对本发明实施例中的技术方案进行清楚、完整地描述,显然,所描述的实施例仅是本发明一部分实施例,而不是全部的实施例。基于本发明中的实施例,本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例,都属于本发明保护的范围。
需要说明的是,当组件被称为与另一个组件“连接”时,它可以直接与另一个组件连接或者也可以存在居中的组件。当一个组件被认为是“设置于”另一个组件,它可以是直接设置在另一个组件上或者可能同时存在居中组件。
除非另有定义,本文所使用的所有的技术和科学术语与属于本发明的技术领域的技术人员通常理解的含义相同。本文中在本发明的说明书中所使用的术语只是为了描述具体的实施例的目的,不是在于限制本发明。本文所使用的术语“和/或”包括一个或多个相关的所列项目的任意的和所有的组合。
参见图1~图4本申请其中一实施例中提供了一种便于定位的介入器械,包括:
支架1,支架1为带有镂空区11的框架结构且具有空间上的一轴线,支架1具有径向压缩的装载状态(图2所示),以及径向展开的释放状态(图1所示);
封闭膜2,与支架1相连且位置与至少部分镂空区11对应,装载状态下,支架1的外周面围拢形成收纳空间,封闭膜2处在该收纳空间内;
增摩部件3,与封闭膜2相连。
本申请中就支架1本身而言可采用常规技术,采用可径向压缩的结构,便于装载和输送,到达体内预定位置后,利用球扩或自身弹性得以释放,靠近操作者一侧为近端,进入体内靠近病灶的一侧为远端。
封闭膜2可采用生物相容性材料,至少可遮挡部分所对应的镂空区11,为了避免增加支架1的装载难度,装载状态下的封闭膜2处在收纳空间内,例如图3中外圈为收纳空间边界12,封闭膜2折叠后处在收纳空间边界12围拢的区域内,并没有延伸至其外部,并不会对支架1的外径造成影响,至于释放状态,封闭膜2与支架1的相对径向关系并没有严格限制,可以是处在支架内部,或者与支架侧壁的径向位置平齐,甚至局部凸于支架外侧。
增摩部件3与封闭膜2相连,装载状态下的增摩部件3可随封闭膜2延伸至收纳空间内,由于增摩部件3的局部甚至全部均处在收纳空间内,因此可减少对支架外周尺寸的影响,尽可能的避免装载难度的增加,这一点对于自膨式支架尤为重要。
本申请中,由于增摩部件3与封闭膜2相连,因此更重要的具备了在装载状态下进入收纳空间的可能,尽管在实际装载过程中,可能有部分增摩部件仍处在支架外部,但仅仅是操作不当,并不影响其进入收纳空间的可能或能力。
就增摩部件3本身而言可以采用生物相容性材料,为了便于在支架1改变状态时随封闭膜2运动,增摩部件3优选带有一定弹性,这样也可以在释放状态下更好的保持与邻近组织4相贴合张紧。在优选的实施例中,在释放状态下,增摩部件3伸向支架外侧用于与介入器械植入位的邻近组织4摩擦定位。
为了容许装载状态下的增摩部件3随封闭膜2延伸至收纳空间内,增摩部件3与支架1之间应减少直接相连部位,以避免对自由度的限制,释放状态下,增摩部件3伸向支架外侧,例如图4中,增摩部件3填充或张紧在支架1与邻近组织4之间,通过增加摩擦力的方式进一步提高定位效果。
支架1大致为网筒状,采用不锈钢或镍钛合金材质,支架1的内部为轴向通道,不同的实施例中,在释放状态下,轴向通道保持贯通,或在支架1内设置有可改变轴向通道贯通状态的瓣叶,例如图1中的瓣叶21。
若介入器械仅仅起到支撑作用,无需对血流进行控制和干涉,则释放状态下轴向通道可始终保持贯通,如需血流方向进行控制,例如防止逆流等,则可以在支架内设置瓣叶,常见的可以是单叶、两叶或三叶瓣,采用缝缀或粘结的方式固定在支架内,对轴向通道的开闭与否或开闭程度施以干涉。
瓣叶的形状特点以及功能,可以根据介入器械使用位置相应配置,在不同的实施例中瓣叶依据介入器械使用位置相应的为主动脉瓣、肺动脉瓣、二尖瓣、三尖瓣或静脉瓣,支架具有与使用位置相适应的形状。
介入器械使用位置不同,支架也具有相应的形状特点,以适应周边组织,例如介入器械使用位置为主动脉瓣时,以图1为例,则支架1以及瓣叶21则与之相适应,又例如在图5中支架1为血管支架,支架1内部覆有封闭膜2,在封闭膜2上设置增摩部件3。
本申请的改进重点并不在于支架和瓣叶,尽管在后续实施例中也提供了改进或优选的方式,但就支架以及瓣叶本身而言,也可参照常规技术实施。
根据支架在体内的释放方式,其中一实施例中支架为球扩型,而在优选的实施例中支架为自膨型。针对自膨型的支架,其装载空间有限,对装载状态下的外径变化更为敏感,常规技术中在支架外周设置覆着物而提高摩擦力的方式难免会增加装载状态下的外径,对于转载带来不便,也大大降低了支架装载部位的柔顺性,难以通过体内较复杂的路径,因此在自膨型的支架中,本申请中采用的增摩部件方式其优点更为突出。
在不同的实施例中,支架整体上采用管材切割方式制成或采用编织方式制成,或采用管材切割与编织相结合的方式制成。参见图6,在其中一实施例中显示支架1整体上采用管材切割方式制成,图中支架1处在装载状态,径向压缩后的支架1内壁与输送系统中的鞘芯之间仍有径向间隙,而本申请的封闭膜以及增摩部件(至少一部分)收纳在该径向间隙中。
为了进一步提高定位效果,在采用增摩部件的基础上,不同的实施例中还可以对支架进一步改进。
参见图7,其中一实施例中支架1设置有与邻近组织相作用的辅助定位结构,该辅助定位结构的方式为支架1上带有倒刺13,倒刺13可沿支架1的周向布置多个,释放状态下倒刺13可以锚定邻近组织,防止介入器械移位。
参见图8,其中一实施例中支架1设置有与邻近组织相作用的辅助定位结构,该辅助定位结构的方式为支架1上带有防滑纹14,防滑纹14可设置于支架1的周向局部或全部,轴向上至少其中一段设置防滑纹14,防滑纹14可在支架切割过程中同时加工,释放状态下防滑纹14可以作用于邻近组织提高摩擦力,防止介入器械移位。
参见图9,其中一实施例中支架1设置有与邻近组织相作用的辅助定位结构,该辅助定位结构的方式为支架1上带有波纹结构15,波纹结构15至少具有径向上的起伏,其可设置于支架1的周向局部或全部,轴向上至少其中一段设置波纹结构15,波纹结构15可以通过热定型的方式获得,释放状态下波纹结构15可以作用于邻近组织提高摩擦力,防止介入器械移位。
支架状态切换时,封闭膜与支架联动,同时也对提供增摩部件提供径向外扩力,使得增摩部件向外贴靠邻近组织,以获得足够的摩擦力。封闭膜的材质为生物膜或人造膜,覆盖支架内壁的局部或全部。
在人造膜中,优选采用织造膜,由于织造膜自身带有纤维间隙,增摩部件直接或间接的穿过纤维间隙时,可减少对织造膜自身的结构损伤,能够避免在增摩部件牵拉封闭膜时由于局部损伤或应力集中而撕裂封闭膜,具体就织造方式本身而言可利用现有技术。
参见图10,其中一实施例中,支架1在释放过程中周向扩展,封闭膜2与支架1的周向扩展联动,带动增摩部件3改变径向位置。
就同一镂空区而言,在支架周向上,支架1处在镂空区两侧的部位为联动边,封闭膜2至少连接至联动边,图10中封闭膜2在支架周向的两侧即封闭膜边缘22与支架1的联动边固定连接,支架1在释放过程中,镂空区两侧的联动边相互远离,即支架1周向扩展会绷紧封闭膜2,而连接于封闭膜2的增摩部件3则沿箭头A方向径向向外运动,直至与邻近组织贴靠。
封闭膜按照其相对于支架的径向位置,可采用不同的设置,结合图10,其中一实施例中,封闭膜2为贴靠在支架内壁的内封闭膜。装载状态下,封闭膜2至少局部折叠,增摩部件3的至少一部分被封闭膜2的折叠部分包裹。
由于封闭膜2整体上均处在收纳空间内,因此若增摩部件3均被封闭膜2的折叠部分包裹,这也可视为增摩部件3整体上也处在收纳空间内,可行的方式之一是增摩部件3的一部分被封闭膜2的折叠部分包裹,另一部分略延伸至支架外部,但处在支架外部的部分一般仅仅为增摩部件3的一小部分,并不会明显提高介入器械的装载难度。
若封闭膜面积较大,在支架内部即覆盖部分镂空区,也势必会覆盖支架的框条部位,封闭膜自身与支架相连时,一般是缝缀在支架的框条部位,因此为了减少径向尺寸的变化,在优选的实施例中,封闭膜的至少一部分区域为与镂空区相对应的驱动部,增摩部件连接在相应的驱动部上。装载状态下,驱动部折叠,增摩部件的至少一部分被折叠的驱动部包裹。
参见图11,其中一实施例中,支架1分布有多处镂空区11,封闭膜2为内封闭膜即覆着在支架1的内壁,封闭膜2通过绑线5(仅示意部分绑线)缝缀在支架1的框条部位,封闭膜2与图中其中一镂空区对应的部位为驱动部23,增摩部件(图中未示)设置在该驱动部23上,当然,图中仅仅示意了支架的局部,增摩部件的位置和数量和依照需求设置。由于封闭膜2是内封闭膜,因此本实施例中驱动部23的边缘贴靠在支架径向内侧。
参见图12,在另一实施例中,支架1分布有多处镂空区11,封闭膜2间隔分布,即每一镂空区11对应的驱动部23是独立的,分别绑线5(仅示意部分绑线)缝缀在支架1的框条部位,但驱动部23并非贴靠在支架内侧,而是驱动部23的边缘贴靠在所在镂空区内缘16处。
为了进一步表达封闭膜与支架的径向关系,还可以参见图13和图14,相应的文字关系分别对应图11和图12。
结合图11,释放状态下,根据封闭膜2的绷紧状态,在不同的实施例中,封闭膜2整体上均处在支架径向内侧,参见图15在另一实施例中,释放状态下,封闭膜2在连接有增摩部件的位置处(驱动部23)外凸越过支架外周面。
由于支架上的覆膜区域可能有多处,在优选的实施例中,支架上所带有的覆膜,均为上述形式的封闭膜。
封闭膜相对于支架的分布区域可处在支架轴向、周向的不同位置,在不同的实施例中,封闭膜在支架周向上间隔分布或连续分布。例如图11中,封闭膜2在支架1的周向上连续分布,又例如图16中,封闭膜在支架1的周向上间隔分布,图中驱动部23每隔一单元格设置一处。
在优选的实施方式中,封闭膜在支架周向上连续分布,且周向封闭。以方便可以保证连接以及自身强度,另外可以获得较好的封闭效果
在不同的实施例中,封闭膜将所对应的镂空区完全遮蔽或部分遮蔽。例如图11,图12中,封闭膜2将所对应的镂空区11完全遮蔽。
在其他实施例中,例如图17所示,支架1分布有多处镂空区11,封闭膜2为内封闭膜即覆着在支架1的内壁,封闭膜2通过绑线5(仅示意部分绑线)缝缀在支架1的框条部位,封闭膜2与图中其中一镂空区对应的部位为驱动部23,增摩部件(图中未示)设置在该驱动部23上,但驱动部23并没有完全遮蔽所在的镂空区11,驱动部边缘231亦处在镂空区11内,由于驱动部23周向的两侧固定于支架1,因此仍可以起到驱动增摩部件改变径向位置的作用。
为了便于加工以及保证材料的安全性,在优选的实施例中,增摩部件3为一根或多根线体。
就线体本身而言并非本申请改进重点,例如在不同的实施例中线体为单股线、包芯线或加捻的多股线。考虑到具体的应用环境和性能要求,线体表面应具有一定粗糙度,这一点既可以通过线体的表面处理获得,还可以选择合适的材质,在优选的实施例中,线体为涤纶材料。
线体作为增摩部件,其自身具有一定弹性,针对介入器械在生物体的使用场景尤为匹配,介入器械的周边组织(若没有明显的钙化)也具有一定弹性,能够与增摩部件之间实现相互的自适应形变,在常用的使用场景中,以主动脉瓣为例,其内周相对光滑且容易产生周漏,采用本申请带有增摩部件的介入器械,不仅进一步保证定位效果,也直接或间接的减少周漏的风险。
线体之间相互缠绕固定式简单易行的方式,可省去额外的连接件或锁定件,就此而言,线体的截面形状对缠绕固定的牢固度也具有一定影响,在优选的实施例中,线体为扁条状。
为了便于增摩部件与封闭膜的连接,以及充分发挥其增摩作用,参见图18,增摩部件3可包括连接于封闭膜2的锚定部31;在支架1径向上处在封闭膜2外侧的支撑部32;由支撑部32向支架1外侧延伸、用于与邻近组织摩擦定位的外凸部33。
参见图19,结合前述的线体结构,图中可见锚定部31、支撑部32、外凸部33这三部分的具体布置,三者均采用线体结构,由于线体便于相互缠绕、搭接、连接,因此就整体而言增摩部件3内包括的线体数量并没有严格限制。例如锚定部31、支撑部32、外凸部33三者各自独立的采用一根或多根线体,或其中两者之间共用至少一根线体。另外图中仅为原理示意,线体相对于封闭膜2的具体穿引方式没有严格限制。
参见图20,在其中一实施例中,就支撑部32和外凸部33两者与锚定部31之间的连接关系而言,根据线体的延伸路径,支撑部32和外凸部33两者均与锚定部31直接相连。图中支撑部32省略了具体的缠绕方式,当然也可以采用局部粘结或热熔的方式形成支撑部32。
参见图21,在其中一实施例中,就支撑部32和外凸部33两者与锚定部31之间的连接关系而言,根据线体的延伸路径,支撑部32与锚定部31直接相连,外凸部33通过支撑部32与锚定部31间接相连。图中支撑部32省略了具体的缠绕方式,当然也可以采用局部粘结或热熔的方式形成支撑部32。
参见图22,其中一实施例中,支架1上覆有内封闭膜,内封闭膜上分布的增摩部件3为多个,释放状态下,增摩部件3沿支架1周向分布,且各增摩部件3与相应的镂空区位置对应。在支架1的某一圈镂空区中,内封闭膜上与该圈每个镂空区均对应设置有增摩部件3,也视为增摩部件3周向连续分布。
参见图23,其中一实施例中,支架1上覆有内封闭膜,内封闭膜上分布的增摩部件3为多个,释放状态下,增摩部件3沿支架1周向分布,且各增摩部件3与相应的镂空区位置对应。在支架1的某一圈镂空区中,内封闭膜上与该圈中每隔一个镂空区对应设置有增摩部件3,也视为增摩部件3周向间隔分布。
参见图24,其中一实施例中,支架1上覆有内封闭膜,内封闭膜上分布的增摩部件3为多个,增摩部件3沿支架周向分为多组,图中方框中的两个增摩部件3可视为一组,且相邻组之间在支架轴向上错位布置,即相邻两方框的轴向位置是不同的,这样在装载时相邻组的增摩部件3轴向上错开布置,避免相互挤压干涉。
在介入器械置入血流通道时,邻近流入端的一侧首先承受血流冲击,因此在优选的实施例中,支架1的轴向一端为流入端,另一端为流出端,增摩部件3设置在邻近流入端的一侧(也可结合图22~图24或其他相关附图)。
同一镂空区内可以设置一个或多个增摩部件,设置多个增摩部件时,彼此之间可以沿支架轴向后周向排布,优选采用轴向排布,且彼此之间相互独立。
封闭膜的至少一部分区域为与镂空区相对应的驱动部,增摩部件具有锚定部,且通过该锚定部与驱动部相连。锚定部主要是为了提供连接点,与封闭膜固定连接,防止增摩部件3脱落,锚定部可以贴靠固定在封闭膜外侧,参见图25,其中一实施例中介入器械的,支架1上覆有封闭膜2,增摩部件的锚定部31贴靠固定在封闭膜2的外侧,其余部分沿径向相应向外延伸。
在另一实施例中,参见图26,锚定部31经由连接孔24贯穿封闭膜2,可起到更好连接作用,并提高连接强度,同一锚定部31对应的连接孔为1至3个。1至3个的不同实施例还可分别参见图26,图21和图20。
其中图21的锚定部31大致为U形,经由两个连接孔贯穿封闭膜2,图22的锚定部31大致为W形(或视为两个U形局部合并),经由三个连接孔贯穿封闭膜2。
锚定部31优选垂直贯穿封闭膜2,可尽量避免斜穿带来的撕裂隐患,尤其是当封闭膜2具有一定厚度时,效果更为明显。
锚定部31经由连接孔24贯穿封闭膜2,锚定部31处在封闭膜2内侧的部分通过封闭膜2的限制增摩部件脱出。图26中,锚定部31处在封闭膜2内侧的部分设有受阻于连接孔24的锚定头,锚定头为膨大部分可被连接孔24阻挡。锚定头与锚定部31的其余部分一体结构或为单独配置的限位件。
锚定头就其自身而言,可以是与线体为一体结构,例如其中一实施例中,参见图27,锚定头为线体打结形成,在其他实施例中,锚定头可以是与线体相连的限位件。
参见图28和图29,在一实施例中,锚定部31为U形,U形的两臂311经由相应的连接孔24贯穿封闭膜2,U形的两臂311在封闭膜2驱动部的内侧相交汇形成U形的底部,U形的两臂311在封闭膜2驱动部外侧采用缠绕方式形成支撑部32,U形的两臂311的至少一者由支撑部32进一步延伸形成外凸部33。
本实施例中就增摩部件整体而言可以采用一根或多根线体,优选采用一根线体,便于加工且可避免多余的连接操作,U形的锚定部31对应两个连接孔24,为了避免封闭膜2周向折叠时,对增摩部件产生轴向的牵拉,两个连接孔24沿支架轴向排列。
同一锚定部31对应两个或两个以上连接孔24时,至少两个或全部的连接孔24沿支架轴向排列,同一驱动部上的所有连接孔24优选沿支架轴向排列(视图可理解为展开状态)。
其中缠绕方式为U形的两臂311在驱动部23外侧相互打结或自身打结,打结的方式至少保证不易松脱,例如两者缠绕打结时至少互绕两次,打结后适当收紧,即在打结部位构成支撑部32,可减少释放状态下外凸部33的晃动,对邻近组织保持足够的张紧。
为了使得增摩部件与周边邻近组织有更好的接触,保持必要的相互作用,在一实施例中,封闭膜的至少一部分区域为与镂空区相对应的驱动部,增摩部件一端与驱动部相连,另一端在支架径向上处在封闭膜外侧并形成支撑部。支架释放后,支撑部可在自身弹性或预定型的作用下径向向外伸展。
为了进一步扩大与周边邻近组织的接触面积,在另一优选的实施例中增摩部件还包括由支撑部向支架外侧延伸、用于与邻近组织摩擦定位的外凸部。
为了更好的扶持外凸部,相对于外凸部,支撑部具有更高的刚度。例如在增摩部件采用线体结构时,支撑部且采用线体局部加强的方式以提高刚度。此处的提高刚度可视为相对于由锚定部直接延伸形成外凸部而言,提高刚度的方式可以依靠线体自身的变化或借助额外的部件。
参见图30,一实施例中,介入器械包括支架,支架上覆有封闭膜2,封闭膜2上分布的增摩部件,增摩部件为线体结构,包括连接于封闭膜2的锚定部31;处在封闭膜2外侧的支撑部32;由支撑部32向外侧延伸、用于与邻近组织摩擦定位的外凸部33,其中支撑部32处线体的材质变化,刚度更高,对外凸部33起到进一步的扶持作用。
参见图31,另一实施例中,介入器械包括支架,支架上覆有封闭膜2,封闭膜2上分布的增摩部件,增摩部件为线体结构,包括连接于封闭膜2的锚定部31;处在封闭膜2外侧的支撑部32;由支撑部32向外侧延伸、用于与邻近组织摩擦定位的外凸部33,其中支撑部32处线体加粗,相应的获得更高的刚度,对外凸部33起到进一步的扶持作用。
参见图33以及上述诸多相关的附图,另一实施例中,介入器械包括支架,支架上覆有封闭膜2,封闭膜2上分布的增摩部件,增摩部件为线体结构,包括连接于封闭膜2的锚定部31;处在封闭膜2外侧的支撑部32;由支撑部32向外侧延伸、用于与邻近组织摩擦定位的外凸部33,其中支撑部32处线体通过打结的方式相应的获得更高的刚度,对外凸部33起到进一步的扶持作用。本实施例中增摩部件一根线体,由U形的锚定部31延伸而出的两股之间相互打结形成支撑部32,外凸部采用拆股分叉的方式形成发散结构,各股线头指向相同或不同。
在其他实施例中,例如图34中增摩部件为两根线体,锚定部31以及支撑部32均由两根线体打结形成,外凸部采用拆股分叉的方式形成发散结构。
在其他实施例中,例如图35中增摩部件为一根线体,支撑部32由该线体自身打结形成,外凸部采用拆股分叉的方式形成发散结构。
参见图36,支撑部可以采用单独配置的部件,且与锚定部和外凸部均为分体结构。本实施例中介入器械包括支架,支架上覆有封闭膜2,封闭膜2上分布的增摩部件,增摩部件为线体结构,包括连接于封闭膜2的锚定部31;处在封闭膜2外侧的支撑部32;由支撑部32向外侧延伸、用于与邻近组织摩擦定位的外凸部33,其中支撑部32为垫片,相对于外凸部33、支撑部32具有更高的刚度,锚定部31依次贯穿封闭膜2的垫片,进一步延伸形成外凸部33。在其他实施中,支撑部32还可以采用套管,锚定部31依次贯穿封闭膜2的套管,进一步延伸形成外凸部33,支撑部32被夹持限定在封闭膜2和外凸部33之间。
为了避免支架状态变化时,不同镂空区的增摩部件相互牵扯,影响装载,在优选的实施例中,不同镂空区内的增摩部件中的支撑部各自独立配置。而同一镂空区内所有增摩部件中的支撑部为一体结构,或同一镂空区内不同增摩部件中的支撑部各自独立配置。
由于不镂空区支撑部各自独立配置,即可以避免支撑部包裹支架框条的外壁,由于支撑部具有较高的刚度,装载状态若处在支架外围,势必对装载造成不利影响,因此在进一步优选的实施例中,支架在装载状态下,驱动部折叠,支撑部被折叠的驱动部包裹,且位于收纳空间内(具体位置关系也可参见图3的示意)。在进一步优选的实施例中,装载状态下,外凸部被被折叠的驱动部包裹,且位于收纳空间内。
上述各实施例中,增摩部件采用线体时,外凸部中线头远离支撑部的一端为自由端部,该自由端与线头的其他部位相比进一步膨大;参见图37,外凸部33的膨大采用开捻方式,即形成开捻区332,外凸部33的膨大还可以采用局部热熔形变的方式,即形成热熔区333。
参见图37和图38,在另一实施例中介入器械的支架内侧缝缀有内封闭膜, 支架某一镂空区中,内封闭膜的驱动部23上以线体的方式形成增摩部件3,驱动部23上设置多个连接孔,线体经由各个连接孔在驱动部23的内外两侧形成迂回缝缀,形成锚定部31和外凸部33,同时外凸部33在靠近驱动部23外侧的部位通过线体打结的方式形成支撑部32。本实施例中针对同一驱动部23,增摩部件3包括多个单元,图中增摩部件为三根线体,分别绕置并各自成结。就每个单元而言可以各自独立采用图30~图36中相关的结构。
为了避免内封闭膜2周向折叠时,对增摩部件产生轴向的牵拉,各单元即各连接孔沿支架轴向依次排列。
同理,增摩部件3中的线体数量即单元数量还可以相应增减,参见图39,在另一实施例中增摩部件3包括两单元,图中增摩部件为两根线体,分别绕置并各自成结,就每个单元而言可以各自独立采用图30~图36中相关的结构。
为了保证支撑部的刚度,在支架释放后,增摩部件处在支架外侧的部分不至于整体溃塌,增摩部件可以在线体结构的基础上,采用多次连续打结的方式形成支撑部。
参见图40,在其中一实施例中,介入器械的支架内侧缝缀有封闭膜2,即采用内封闭膜的方式, 支架某一镂空区中,内封闭膜的驱动部上以线体的方式形成增摩部件,增摩部件为线体结构,包括连接于封闭膜2的锚定部31;处在封闭膜2外侧的支撑部32;由支撑部32向外侧延伸、用于与邻近组织摩擦定位的外凸部33。本实施例中增摩部件为一根线体,U形的锚定部31经由封闭膜2上的连接孔穿绕过封闭膜2,由延伸而出的两股之间相互打结形成支撑部32,打结后的线头进一步延伸形成外凸部33,外凸部33末端采用拆股分叉的方式形成发散结构。在支撑部32处采用连续多次打结的方式,图中可见打结次数为4次,在其他实施例中数量还可以相应增减,例如图41的另一实施例中打结次数为8次。
相对于图40的实施例,还可以不设置外凸部,例如在图42的另一实施例中,介入器械的支架内侧缝缀有封闭膜2,即采用内封闭膜的方式, 支架某一镂空区中,内封闭膜的驱动部上以线体的方式形成增摩部件,增摩部件为线体结构,包括连接于封闭膜2的锚定部31;处在封闭膜2外侧的支撑部32,图中U形的锚定部31经由封闭膜2上的连接孔穿绕过封闭膜2,由延伸而出的两股之间连续多次打结形成支撑部32,打结之后的线头并没有明显的向外延伸,即并没有形成由明显刚度变化的外凸部。
本申请一实施例中还提供一种介入器械的加工方法,介入器械可采用上述各实施例的任一或多个的组合,例如介入器械包括支架,支架为带有镂空区的框架结构且具有空间上的一轴线,支架具有径向压缩的装载状态,以及径向展开的释放状态;加工方法包括以任意次序实施的:
步骤S100,在支架上安装封闭膜,封闭膜与支架相连且位置与至少部分镂空区对应,装载状态下,支架的外周面围拢形成收纳空间,封闭膜处在该收纳空间内;在支架改变状态的过程中受支架牵引而形变;
步骤S200,在封闭膜上安装增摩部件,释放状态下,增摩部件伸向支架外侧用于与介入器械植入位的邻近组织摩擦定位。
在优选的实施例中,步骤S100中,封闭膜为贴靠在支架内壁的内封闭膜,安装时将内封闭膜贴覆在支架内侧并缝缀固定。
在优选的实施例中,步骤S200中,增摩部件为线体,安装时将线体的一端由支架外侧贯穿内封闭膜进入支架内侧,再将该端从同一镂空区的其他部位贯穿内封闭膜回到支架外侧、并与支架外侧的其他部分线体相互打结,在打结部位至少有一根线头伸向支架外侧用于与邻近组织摩擦定位。
参见图43~图46,本申请一实施例中还公开了一种介入系统,包括鞘管组件、控制手柄6和介入器械7,鞘管组件具有相对的远端和近端,介入器械7装载于鞘管组件的远端,控制手柄6连接于鞘管组件的近端,控制手柄可通过驱动鞘管组件释放介入器械7,其中介入器械7可采用上述各实施例的介入器械。
其中鞘管组件包括鞘管8和鞘芯组件9,其中鞘管8滑动配合于鞘芯组件9的外周。 其中鞘芯组件9包括芯管91,以及固定于芯管且用于连接介入器械7的锁件92。芯管91远端进一步延伸出锁件92并固定有引导头93。引导头93远端具有形状收敛的圆头结构以便于在体内穿引行进,在引导头93与锁件92之间的位置作为介入器械7的装载位,压缩状态的介入器械7处于该位置并与锁件92限位配合。
在其他实施例中,介入系统还可以包括与控制手柄6相对固定的导管61,导管61用于建立通道,防止鞘管8往复运动时伤及体内组织。
介入器械7装载于鞘芯组件9并在鞘管8的包裹下随导管61一同进入体内,而后鞘管8在控制手柄6的带动下可相对鞘芯组件9向近端滑动回撤,则介入器械7逐渐暴露释放。
以上实施例的各技术特征可以进行任意的组合,为使描述简洁,未对上述实施例中的各技术特征所有可能的组合都进行描述,然而,只要这些技术特征的组合不存在矛盾,都应当认为是本说明书记载的范围。不同实施例中的技术特征体现在同一附图中时,可视为该附图也同时披露了所涉及的各个实施例的组合例。
以上实施例仅表达了本发明的几种实施方式,其描述较为具体和详细,但并不能因此而理解为对发明专利范围的限制。应当指出的是,对于本领域的普通技术人员来说,在不脱离本发明构思的前提下,还可以做出若干变形和改进,这些都属于本发明的保护范围。因此,本发明专利的保护范围应以所附权利要求为准。

Claims (58)

  1. 便于定位的介入器械,其特征在于,包括:
    支架,所述支架为带有镂空区的框架结构且具有空间上的一轴线,所述支架具有径向压缩的装载状态,以及径向展开的释放状态;
    封闭膜,与所述支架相连且位置与至少部分镂空区对应,装载状态下,所述支架的外周面围拢形成收纳空间,所述封闭膜处在该收纳空间内;
    增摩部件,与所述封闭膜相连。
  2. 如权利要求1所述的便于定位的介入器械,其特征在于,释放状态下,所述增摩部件伸向支架外侧用于与介入器械植入位的邻近组织摩擦定位。
  3. 如权利要求1所述的便于定位的介入器械,其特征在于,所述支架的内部为轴向通道,在释放状态下,所述轴向通道保持贯通,或在所述支架内设置有可改变所述轴向通道贯通状态的瓣叶。
  4. 如权利要求3所述的便于定位的介入器械,其特征在于,所述瓣叶依据介入器械使用位置相应的为主动脉瓣、肺动脉瓣、二尖瓣、三尖瓣或静脉瓣,所述支架具有与使用位置相适应的形状。
  5. 如权利要求1所述的便于定位的介入器械,其特征在于,所述支架为球扩型或自膨型。
  6. 如权利要求1所述的便于定位的介入器械,其特征在于,所述支架整体上采用管材切割方式制成或采用编织方式制成,或采用管材切割与编织相结合的方式制成。
  7. 如权利要求1所述的便于定位的介入器械,其特征在于,所述支架设置有与邻近组织相作用的辅助定位结构,该辅助定位结构至少包括以下方式之一:
    所述支架带有径向起伏的波纹结构;
    所述支架上带有倒刺;
    所述支架的外表面带有防滑纹。
  8. 如权利要求1所述的便于定位的介入器械,其特征在于,所述支架在释放过程中周向扩展,所述封闭膜与所述支架的周向扩展联动,带动所述增摩部件改变径向位置。
  9. 如权利要求8所述的便于定位的介入器械,其特征在于,在支架周向上,所述支架处在镂空区两侧的部位为联动边,所述封闭膜至少连接至所述联动边,所述支架在释放过程中,镂空区两侧的联动边相互远离带动所述封闭膜展开,并径向外推所述增摩部件。
  10. 如权利要求1所述的便于定位的介入器械,其特征在于,所述封闭膜为贴靠在支架内壁的内封闭膜。
  11. 如权利要求1所述的便于定位的介入器械,其特征在于,所述封闭膜的至少一部分区域为与镂空区域相对应的驱动部,装载状态下,所述驱动部折叠,所述增摩部件的至少一部分被折叠的驱动部包裹。
  12. 如权利要求11所述的便于定位的介入器械,其特征在于,所述驱动部的边缘贴靠在支架径向内侧;或所述驱动部的边缘贴靠在镂空区的内缘处。
  13. 如权利要求1所述的便于定位的介入器械,其特征在于,释放状态下,所述封闭膜整体上均处在支架径向内侧。
  14. 如权利要求1所述的便于定位的介入器械,其特征在于,释放状态下,所述封闭膜在连接有所述增摩部件的位置处外凸越过支架外周面。
  15. 如权利要求1所述的便于定位的介入器械,其特征在于,所述封闭膜在支架周向上间隔分布或连续分布。
  16. 如权利要求15所述的便于定位的介入器械,其特征在于,所述封闭膜在支架周向上连续分布,且周向封闭。
  17. 如权利要求1所述的便于定位的介入器械,其特征在于,所述封闭膜采用缝缀或缠绕的方式与所述支架相连。
  18. 如权利要求1所述的便于定位的介入器械,其特征在于,所述封闭膜将所对应的镂空区完全遮蔽或部分遮蔽。
  19. 如权利要求1所述的便于定位的介入器械,其特征在于,所述封闭膜的材质为生物膜或人造膜,所述封闭膜覆盖支架内壁的局部或全部。
  20. 如权利要求1所述的便于定位的介入器械,其特征在于,所述增摩部件为一根或多根线体。
  21. 如权利要求20所述的便于定位的介入器械,其特征在于,所述线体为单股线、包芯线或加捻的多股线。
  22. 如权利要求21所述的便于定位的介入器械,其特征在于,所述线体为涤纶材料。
  23. 如权利要求20所述的便于定位的介入器械,其特征在于,所述线体为扁条状。
  24. 如权利要求20所述的便于定位的介入器械,其特征在于,所述增摩部件包括:
    连接于所述封闭膜的锚定部;
    在支架径向上处在封闭膜外侧的支撑部;
    由所述支撑部向支架外侧延伸、用于与邻近组织摩擦定位的外凸部;
    所述锚定部、支撑部和外凸部三者各自独立的采用一根或多根线体,或其中两者之间共用至少一根线体。
  25. 如权利要求24所述的便于定位的介入器械,其特征在于,根据线体的延伸路径,所述支撑部和所述外凸部两者均与所述锚定部直接相连或两者中的一者与所述锚定部直接相连,另一者与所述锚定部间接相连。
  26. 如权利要求20所述的便于定位的介入器械,其特征在于,所述增摩部件为多个,释放状态下,所述增摩部件沿支架周向分布,且各增摩部件与相应的镂空区位置对应。
  27. 如权利要求26所述的便于定位的介入器械,其特征在于,所述增摩部件沿支架周向分为多组,且相邻组之间在支架轴向上错位布置。
  28. 如权利要求26所述的便于定位的介入器械,其特征在于,所述支架的轴向一端为流入端,另一端为流出端,所述增摩部件设置在邻近所述流入端的一侧。
  29. 如权利要求26所述的便于定位的介入器械,其特征在于,同一镂空区内设置一个或多个增摩部件。
  30. 如权利要求1所述的便于定位的介入器械,其特征在于,所述封闭膜的至少一部分区域为与所述镂空区相对应的驱动部,所述增摩部件具有锚定部,且通过该锚定部与所述驱动部相连。
  31. 如权利要求30所述的便于定位的介入器械,其特征在于,所述锚定部经由连接孔贯穿所述封闭膜,所述锚定部处在封闭膜内侧的部分通过所述封闭膜的限制所述增摩部件脱出。
  32. 如权利要求31所述的便于定位的介入器械,其特征在于,所述锚定部通过连接孔贯穿所述封闭膜,所述锚定部处在封闭膜内侧的部分设有受阻于所述连接孔的锚定头。
  33. 如权利要求32所述的便于定位的介入器械,其特征在于,所述锚定头与所述锚定部的其余部分一体结构或为单独配置的限位件。
  34. 如权利要求31所述的便于定位的介入器械,其特征在于,所述锚定部为一个或多个U形,各U形的两臂经由相应的连接孔贯穿所述封闭膜,所述两臂在驱动部内侧相交汇形成U形的底部,所述两臂在驱动部外侧采用缠绕方式形成支撑部,所述两臂的至少一者由所述支撑部进一步延伸形成外凸部。
  35. 如权利要求34所述的便于定位的介入器械,其特征在于,所述缠绕方式为所述两臂在驱动部外侧相互打结或自身打结或与其他U形之间相互打结。
  36. 如权利要求31所述的便于定位的介入器械,其特征在于,所述锚定部垂直贯穿于所述封闭膜。
  37. 如权利要求31所述的便于定位的介入器械,其特征在于,同一锚定部对应两个或以上的连接孔,至少两个连接孔沿支架轴向排列。
  38. 如权利要求1~37任一项所述的便于定位的介入器械,其特征在于,所述封闭膜的至少一部分区域为与所述镂空区相对应的驱动部,所述增摩部件一端与所述驱动部相连,另一端在支架径向上处在封闭膜外侧并形成支撑部。
  39. 如权利要求38所述的便于定位的介入器械,其特征在于,所述增摩部件还包括由所述支撑部向支架外侧延伸、用于与邻近组织摩擦定位的外凸部。
  40. 如权利要求39所述的便于定位的介入器械,其特征在于,所述增摩部件为一根线体,所述支撑部由该线体自身缠绕形成;或所述增摩部件为多根线体,所述支撑部由多根线体之间相互缠绕形成;所述线体由所述支撑部进一步延伸形成所述外凸部。
  41. 如权利要求40所述的便于定位的介入器械,其特征在于,相对于外凸部、所述支撑部具有更高的刚度。
  42. 如权利要求41所述的便于定位的介入器械,其特征在于,所述支撑部采用线体局部加强的方式以提高刚度。
  43. 如权利要求42所述的便于定位的介入器械,其特征在于,所述局部加强的方式采用线体打结、线体增粗、线体材质变化中的至少一种。
  44. 如权利要求39所述的便于定位的介入器械,其特征在于,所述外凸部包括一根或多根线头,至少一根线头在贴近封闭膜的一端直径增大形成所述支撑部;或至少一根线头在贴近封闭膜的一端的材质相对于远离封闭膜的一端的材质具有更高的刚度。
  45. 如权利要求39所述的便于定位的介入器械,其特征在于,所述支撑部为单独配置的部件,且与所述增摩部件的其他部位为分体结构。
  46. 如权利要求45所述的便于定位的介入器械,其特征在于,所述支撑部为垫片或套管,所述外凸部贯穿所述支撑部或与所述支撑部相互贴靠。
  47. 如权利要求38所述的便于定位的介入器械,其特征在于,同一镂空区内所有增摩部件中的支撑部为一体结构,或同一镂空区内不同增摩部件中的支撑部各自独立配置。
  48. 如权利要求47所述的便于定位的介入器械,其特征在于,不同镂空区内的增摩部件中的支撑部各自独立配置。
  49. 如权利要求38所述的便于定位的介入器械,其特征在于,装载状态下,所述驱动部折叠,所述支撑部被折叠的驱动部包裹,且位于所述收纳空间内。
  50. 如权利要求40所述的便于定位的介入器械,其特征在于,所述外凸部为所述线体的线头和/或所述线体围成的线圈。
  51. 如权利要求50所述的便于定位的介入器械,其特征在于,所述线头为一根或发散的多根,所述线圈为一个或多个。
  52. 如权利要求51所述的便于定位的介入器械,其特征在于,各线头的轴向指向相同或至少两个线头的指向不同。
  53. 如权利要求52所述的便于定位的介入器械,其特征在于,所述线头远离支撑部的一端为自由端,该自由端与所述线头的其他部位相比进一步膨大;所述膨大采用开捻或局部热熔形变的方式。
  54. 如权利要求39所述的便于定位的介入器械,其特征在于,装载状态下,所述驱动部折叠,所述外凸部被被折叠的驱动部包裹,包裹,且位于所述收纳空间内。
  55. 介入器械的加工方法,所述介入器械包括支架,所述支架为带有镂空区的框架结构且具有空间上的一轴线,所述支架具有径向压缩的装载状态,以及径向展开的释放状态;其特征在于,所述加工方法包括以任意次序实施的:
    步骤S100,在所述支架上安装封闭膜,所述封闭膜与所述支架相连且位置与至少部分镂空区对应,装载状态下,所述支架的外周面围拢形成收纳空间,所述封闭膜处在该收纳空间内;在支架改变状态的过程中受支架牵引而形变;
    步骤S200,在所述封闭膜上安装增摩部件,释放状态下,所述增摩部件伸向支架外侧用于与介入器械植入位的邻近组织摩擦定位。
  56. 如权利要求55所述的介入器械的加工方法,其特征在于,步骤S100中,所述封闭膜为贴靠在支架内壁的内封闭膜,安装时将所述内封闭膜贴覆在支架内侧并缝缀固定。
  57. 如权利要求55所述的介入器械的加工方法,其特征在于,步骤S200中,所述增摩部件为线体,安装时将所述线体的一端由支架外侧贯穿所述封闭膜进入支架内侧,再将进入支架内侧的一端从同一镂空区的其他部位贯穿所述内封闭膜回到支架外侧、并与支架外侧的其他部分线体相互打结,在打结部位至少有一根线头伸向支架外侧用于与邻近组织摩擦定位。
  58. 介入系统,包括鞘管组件、控制手柄和介入器械,所述鞘管组件具有相对的远端和近端,所述介入器械装载于所述鞘管组件的远端,所述控制手柄连接于所述鞘管组件的近端,所述控制手柄可通过驱动所述鞘管组件释放所述介入器械,其特征在于,所述介入器械为权利要求1~54任一项所述的便于定位的介入器械。
     
PCT/CN2020/116324 2019-09-20 2020-09-18 便于定位的介入器械及加工方法和介入系统 WO2021052486A1 (zh)

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