WO2021136167A1 - Système de verrouillage de fil-guide et appareil de verrouillage de fil-guide - Google Patents

Système de verrouillage de fil-guide et appareil de verrouillage de fil-guide Download PDF

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Publication number
WO2021136167A1
WO2021136167A1 PCT/CN2020/140144 CN2020140144W WO2021136167A1 WO 2021136167 A1 WO2021136167 A1 WO 2021136167A1 CN 2020140144 W CN2020140144 W CN 2020140144W WO 2021136167 A1 WO2021136167 A1 WO 2021136167A1
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WO
WIPO (PCT)
Prior art keywords
inner core
sleeve
locking
wire
distal end
Prior art date
Application number
PCT/CN2020/140144
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English (en)
Chinese (zh)
Inventor
高国庆
王永胜
Original Assignee
杭州诺茂医疗科技有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from CN201922454640.0U external-priority patent/CN211935185U/zh
Priority claimed from CN201911423890.6A external-priority patent/CN113117239A/zh
Application filed by 杭州诺茂医疗科技有限公司 filed Critical 杭州诺茂医疗科技有限公司
Publication of WO2021136167A1 publication Critical patent/WO2021136167A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372—Arrangements in connection with the implantation of stimulators
    • A61N1/375—Constructional arrangements, e.g. casings
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00—Electrotherapy; Circuits therefor
    • A61N1/18—Applying electric currents by contact electrodes
    • A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
    • A61N1/39—Heart defibrillators

Definitions

  • This application relates to the technical field of interventional medical devices, and in particular to a wire locking device for locking an electrode wire implanted in a patient's body for a long time, and a wire locking system in the wire locking device.
  • elongated structures in the bodies of human or livestock patients.
  • elongated structures can include catheters, sheaths, cardiac electrical leads (such as pacemaker leads or defibrillator leads), and a variety of other devices.
  • the pacemaker is usually implanted in the subcutaneous tissue pocket in the chest wall of the patient, and the multiple wires of the pacemaker extend from the pacemaker to the chamber of the patient's heart through the vein; the defibrillator wire can be fixed in the heart Internal or external.
  • the implanted elongated structure needs to be removed from the patient's body.
  • the fibrous tissue that is close to the heart itself or the vein wall or other surrounding tissues will adhere to the surface of the slender structure and grow, and even surround the slender structure, especially in This happens in areas where blood flow is slow.
  • the fibrous tissue is very tough, making it difficult to remove the elongated structure from the area without causing damage to the area.
  • the current slender structure extraction technology involves the use of a wire locking device to assist in completion.
  • the wire locking device generally includes a handle and a wire locking system.
  • the expandable coil in the wire locking system can be selectively in two states, such as In the first state and the second state, the radial dimension of the expandable coil in the second state is greater than the radial dimension in the first state.
  • the surgeon delivers the wire locking system in the lumen of the implanted elongated structure; when the distal end of the wire locking system reaches the desired position (such as the distal end of the wire), the surgeon controls the expandable coil to switch to
  • the expandable coil is expanded radially to be fixed on the inner wall of the elongated structure, which facilitates the surgeon to pull the handle of the wire locking device and move it toward the proximal end to drive and withdraw the wire.
  • the position of implanting the elongated structure in the vasculature of different patients is different.
  • the expandable coil expands in the radial direction, there are only two kinds of contraction and expansion states, that is, the first mentioned above.
  • the state and the second state therefore, the existing expandable coils have limited choices of radial dimensions, which leads to the failure of the inflatable coils in some operations due to the failure of the locking effect of the expandable coils.
  • the present application provides a wire locking system.
  • the wire locking system includes a delivery assembly and a locking member.
  • the locking member is arranged on the delivery assembly and is used for inserting into the lumen of a wire.
  • the component is used to adjust the radial size of the locking member, so that the locking member abuts against the inner wall of the wire in the radial direction, and can drive the wire to move synchronously.
  • the present application also provides a wire locking device for taking out a slender tube structure implanted in the body.
  • the wire locking device includes a handle and a wire locking system.
  • the proximal end of the delivery component of the wire locking system is connected to the The handle, the wire locking system includes a delivery assembly and a locking member, the locking member is arranged on the delivery assembly and is used to insert a wire into the inner cavity, and the delivery assembly is used to adjust the radial direction of the locking member.
  • the size is such that the locking member is close to the inner wall of the wire in the radial direction and can drive the wire to move synchronously.
  • the radial size of the locking member is gradually increased by operating the conveying assembly until the locking member is firmly attached to the inner wall of the elongated tube structure , So that the wire locking system and the slender tube structure are firmly connected, and the slender tube structure can be moved out of the body by moving the handle to the proximal end. Since the radial size of the locking member can be adjusted, the locking member can not only lock the slender tube structure of different inner diameter sizes, and make the wire locking system suitable for the slender tube structure of different inner diameters, and is beneficial in different application environments. The locking of the wire locking system and the slender tube body structure is stable, and the locking effect is improved.
  • Fig. 1 is a schematic structural diagram of a wire locking device provided by a first embodiment of the present application
  • FIG. 2 is a schematic structural diagram of the wire locking system of the wire locking device in FIG. 1;
  • FIG. 3 is a schematic structural diagram of the wire locking system in FIG. 2 from another perspective;
  • Fig. 4 is a schematic structural diagram of a locking member of the wire locking system in Fig. 2;
  • Fig. 5 is a schematic structural diagram of the handle of the wire locking device in Fig. 1;
  • Fig. 6 is a perspective structural diagram of one of the locking members of the wire locking system in Fig. 3 in a folded state;
  • FIG. 7 is a schematic structural diagram of the wire locking system in FIG. 6 from another perspective
  • FIG. 8 is a schematic diagram of the structure of the locking member of the wire locking system of the wire locking device provided by the second embodiment of the present application;
  • Fig. 9 is an enlarged view of part IX in Fig. 8.
  • FIG. 10 is a partial structural diagram of one state of the conveying assembly of the wire locking system of the wire locking device provided by the third embodiment of the present application;
  • Fig. 11 is a partial structural diagram of the conveying assembly in Fig. 10 in another state
  • FIG. 12 is a schematic structural diagram of one state of the wire locking system of the wire locking device provided by the fourth embodiment of the present application.
  • FIG. 13 is a schematic structural diagram of the wire locking system in FIG. 12 in another state
  • FIG. 14 is a schematic structural diagram of one state of the wire locking system of the wire locking device provided by the fifth embodiment of the present application.
  • FIG. 15 is a schematic structural diagram of another state of the wire locking system in FIG. 14;
  • 16 is a schematic structural diagram of one state of the wire locking system of the wire locking device provided by the sixth embodiment of the present application.
  • Fig. 17 is a schematic structural diagram of the wire locking system in Fig. 16 in another state.
  • Fig. 18 is a schematic structural diagram of a wire locking device provided by a seventh embodiment of the present application.
  • Fig. 19 is a schematic structural diagram of one state of the locking member of the wire locking device in Fig. 18.
  • Fig. 20 is a schematic structural diagram of the locking member in Fig. 19 in another state.
  • Fig. 21 is a structural schematic diagram of the handle of the wire locking device in Fig. 18.
  • 22 is a schematic structural diagram of one state of the locking member of the wire locking device provided by the eighth embodiment of the present application.
  • Fig. 23 is a schematic structural view of the locking member in Fig. 22 in another state.
  • proximal refers to the end far away from the operator during the surgical operation
  • proximal end refers to the end closer to the operator during the surgical operation
  • the proximal end in this application is relative to the distal end from the operator ( The distance between the surgeon) is relatively short.
  • Axial refers to the direction of the central axis of the device, and the radial direction is the direction perpendicular to the central axis. Unless otherwise defined, all technical and scientific terms used in this application have the same meaning as commonly understood by those skilled in the technical field of this application. Conventional terms used in the specification of this application are only for the purpose of describing specific embodiments, and should not be construed as limiting the application.
  • an element when an element is referred to as being “fixed to” or “installed on” another element, the element can be directly connected to the other element, or indirectly connected to the other element through one or more connecting elements. On one component. When an element is said to be “connected to” another element, it can be directly connected to the other element or connected to the other element through one or more connecting elements.
  • FIG. 1 is a schematic structural diagram of a wire locking device 100 provided by a first embodiment of the present application.
  • the present application provides a wire locking device 100, which is used to take out a slender tube structure implanted in a patient.
  • the slender tube structure includes, but is not limited to, catheters, sheaths, cardiac electrical leads, and various other devices that have been implanted in the patient; the cardiac electrical leads include pacemaker leads or defibrillators Wire etc.
  • the present application takes the lead 500 of a pacemaker as an example.
  • the distal end of the lead 500 of the pacemaker is also connected with electrodes fixed on the heart.
  • the lead locking device 100 is used to connect the electrodes of the pacemaker. At least the lead wire 500 of the pacemaker is taken out during the removal operation or other surgical operations.
  • the wire locking device 100 includes a wire locking system 20 and a handle 50 disposed at the proximal end of the wire locking system 20.
  • the distal end of the wire locking system 20 is used to insert the inner cavity 502 of the wire 500 and lock the inner wall of the wire 500;
  • the wire locking system 20 includes
  • the locking member 22 and the conveying assembly 26 connected to the locking member 22 are adjusted by operating the conveying assembly 26 to adjust the radial size of the locking member 22, so that the locking member 22 abuts against the inner wall of the wire 500 in the radial direction, and can drive the wire 500 to make Synchronized movement.
  • the locking member 22 is connected to the distal end of the delivery assembly 26, and the handle 50 is connected to the proximal end of the delivery assembly 26.
  • the locking member 22 and the distal end of the delivery assembly 26 are used to insert the guide wire 500 into the inner cavity.
  • the radial size of the locking member 22 is gradually increased by controlling the delivery assembly 26 until the locking member 22 abuts against the inner wall of the guide wire 500 in the radial direction, so that moving the handle 50 to the proximal end can drive the locking member 22 Take the lead 500 out to the body.
  • the locking member 22 abuts against the inner wall of the wire 500 in the radial direction means that the locking member 22 is in an interference fit or abutting against the inner wall of the wire 500 in the radial direction, so that the locking member 22 locks the wire 500.
  • the radial size of the locking member 22 is gradually increased by controlling the conveying assembly 26 until the locking member 22 is firmly pressed against.
  • the wire locking system 20 is firmly connected to the wire 500, and then the handle 50 can be moved proximally to move the wire 500 out of the body. Since the radial size of the locking member 22 can be adjusted, the locking member 22 can lock the wires 500 with different inner diameter sizes, so that the wire locking system 20 is suitable for slender tube structures with different inner diameters, and is beneficial to use in different application environments.
  • the locking of the wire locking system 20 and the elongated tube structure is stable, which improves the locking effect and prevents operation failure.
  • FIG. 2 is a schematic structural diagram of the wire locking system 20 of the wire locking device in FIG. 1;
  • FIG. 3 is a schematic structural diagram of the wire locking system 20 in FIG. 2 from another perspective;
  • FIG. 4 It is a structural diagram of the locking member 22 of the wire locking system 20 in FIG. 2.
  • the conveying assembly 26 includes an inner core 261 and a sleeve 265 sleeved together.
  • the locking member 22 is arranged between the inner core 261 and the sleeve 265.
  • the inner core 261 and the sleeve 265 can move relative to each other, so that the inner core 261 and the sleeve 265 can move relative to each other.
  • the sleeve 265 has a cylindrical shape and is sleeved on the periphery of the inner core 261.
  • the sleeve 265 and the inner core 261 can slide relative to each other in the axial direction.
  • the proximal end of the inner core 261 is connected to the handle 50, and the locking member 22 is arranged in the inner core 261.
  • the distal end of the core 261 is located at the distal end of the sleeve 265.
  • the sleeve 265 slides toward the distal end relative to the inner core 261.
  • the locking member 22 is compressed and deformed by the sleeve 265 and the inner core 261 to gradually enlarge the locking member.
  • the distal end of the sleeve 265 and the proximal end of the locking member 22 may be connected or disconnected.
  • the proximal end of the locking member 22 and the distal end of the sleeve 265 are not connected.
  • the locking member 22 is at least one elastic piece disposed on the inner core 261, and the inner core 261 and the sleeve 265 move relatively close to the elastic piece in the axial direction to deform the elastic piece by squeezing the elastic piece to change the radial dimension.
  • the elastic sheet is in a strip structure, and the elastic sheet is penetrated on the inner core 261 through a plurality of through holes; specifically, the distal end of the elastic sheet is fixedly connected to the distal end of the inner core 261, and the sleeve 265 and the inner core 261 are along the axis The relative movement causes the force of the sleeve 265 to squeeze the other end of the elastic sheet to change.
  • the distal end of the sleeve 265 gradually approaches the proximal end of the elastic piece, and when the sleeve 265 continues to move to the distal end and squeeze the proximal end of the elastic piece
  • the elastic piece is squeezed toward the distal end to shrink and fold and deform, that is, the size of the elastic piece in the axial direction gradually decreases, the radial size of the elastic piece gradually increases, and the end of the sleeve 265 squeezes the The force of the elastic piece gradually increases, and the elastic deformation of the elastic piece also gradually increases.
  • the proximal end of the elastic piece is fixedly connected to the distal end of the sleeve 265, the distal end of the inner core 261 is connected to the distal end of the elastic piece, and the inner core 261 moves toward the proximal end relative to the sleeve 265 to squeeze
  • the elastic sheet is pressed to shrink toward the proximal end to be folded and deformed, so that the size of the elastic sheet in the axial direction is gradually reduced, and the radial size of the elastic sheet gradually increases.
  • the distal end of the elastic piece is fixedly connected to a position other than the distal end on the inner core 261; and/or the proximal end of the elastic piece is connected to the distal end of the sleeve 265; and/or the sleeve 265 is relative to
  • the locking member 22 is disposed on the outer periphery of the distal end of the inner core, and the proximal end of the locking member 22 is connected to the inner core 261.
  • the locking member 22 has a plurality of through holes 220 spaced apart along its length, the inner core 261 is inserted through the through holes 220 in turn, the distal end of the sleeve 265 and the distal end of the inner core 261 Close to each other to squeeze the locking member 22 to produce elastic deformation, so that the part between the two adjacent through holes 220 of the locking member 22 bends away from the axis of the inner core 261, so as to gradually increase the locking member 22 Radial size.
  • the width of the elastic piece is less than or equal to the outer diameter of the sleeve 265, so that the largest diameter component in the locking system 200 is the sleeve 265, which facilitates the insertion of the inner core 261 and the elastic piece into the wire 500 (FIG. 1).
  • the width of the elastic piece is greater than the inner diameter of the sleeve 265, so that when the sleeve 265 squeezes one end of the elastic piece, the elastic piece is prevented from being inserted into the sleeve 265 to facilitate operation.
  • the width of the elastic piece is equal to the outer diameter of the sleeve 265; when the inner core 261 is inserted through the through holes 220 in turn, the locking member 22 is in a stretched state before being squeezed. At this time, the locking The radial dimension of the member 22 is less than or equal to the outer diameter of the sleeve 265 and greater than the inner diameter of the sleeve 265.
  • the sleeve 265 can press against the end of the locking member 22 when sliding toward the distal end relative to the inner core 261.
  • each through hole 220 is a bar-shaped hole, and the through hole 220 extends in the axial direction. In this embodiment, each through hole 220 is a waist-shaped hole.
  • the distal end of the locking member 22 is fixedly connected to the distal end of the inner core 261 by welding or bonding; when the locking member 22 is in the extended state, the locking member 22 The proximal end of 22 does not touch or just touches the distal end of the sleeve 265, and the locking member 22 is not subjected to pressure from the sleeve 265.
  • the wire locking system 20 can be inserted into any wire whose inner diameter is larger than the outer diameter of the sleeve 265. Cavity.
  • the sizes of the through holes 220 of the locking member 22 at different positions are different. Specifically, the closer the locking member 22 is to the distal end of the inner core 261, the greater the degree of bending of the elastic piece, and the smaller the length of the through hole 220 can be set.
  • the size of the plurality of through holes 220 on the locking member 22 may be set to be the same.
  • the sleeve 265 is a stainless steel tube, the inner diameter of the sleeve 265 is 0.2-0.4 mm, and the outer diameter of the sleeve 265 is 0.4-0.6 mm.
  • the wire locking system 20 in this embodiment can lock the inner diameter Wire 500 larger than 0.4-0.6 mm.
  • the inner diameter and outer diameter of the sleeve 265 can be set as required to lock wires 500 of different sizes.
  • the inner core 261 has a linear shape and is used to carry the sleeve 265 and the locking member 22.
  • the inner core 261 is a stainless steel wire of 0.1-0.3 mm.
  • FIG. 5 is a structural diagram of the handle 50 of the wire locking device 100 in FIG. 1.
  • the handle 50 includes a first joint 53 and a second joint 54 movably connected to the first joint 53.
  • the first joint 53 is used for connecting the inner core 261
  • the second joint 54 is used for connecting the sleeve 265.
  • the first joint 53 and the second joint 54 are clamped to each other.
  • the first joint 53 includes a main body 52 and a connector 56.
  • the main body 52 is cylindrical and is provided with a threading cavity 520 penetrating in the axial direction.
  • the second joint 54 Clamped to the distal opening of the threading cavity 520, the proximal end of the inner core 261 extends from the distal end of the threading cavity 520 to the proximal end of the threading cavity 520, the connector 56 is inserted into the proximal opening of the threading cavity 520, and The proximal end of the inner core 261 is fixed between the plug 56 and the main body 52.
  • the main body 52 is used for the operator to grasp and control the relative movement between the inner core 261 and the sleeve 265.
  • the second joint 54 and the plug 56 are both detachably connected to the main body 52. Further, the second joint 54 and the plug The connecting pieces 56 are all detachably snap-connected to the main body 52.
  • the second joint 54 includes a fixing portion 541, a cylindrical neck 543, and a hook portion 545 arranged in sequence, and the diameters of the three are, in order from large to small, the fixing portion 541, the hook 545, and the neck 543.
  • the diameter of the fixing portion 541 is close to or equal to the diameter of the main body 52.
  • the threading cavity 520 of the main body 52 includes a slot cavity 521, a communication hole 525, and an insertion cavity 523 from the distal end to the proximal end.
  • the neck 543 and the hook portion 545 are used to be accommodated in the slot cavity 521, and the hook portion 545 and the slot The cavities 521 are engaged with each other so that the second joint 54 is detachably connected to the distal end of the main body 52.
  • the second joint 54 is axially provided with an inner cavity 542 penetrating the opposite end faces of the second joint 54.
  • the inner cavity 542 includes a first cavity 5421 disposed at the distal end of the second joint 54 and a second cavity disposed at the proximal end of the second joint 54 5423, the first cavity 5421 and the second cavity 5423 pass through.
  • the first cavity 5421 is used for accommodating and fixing the proximal end of the sleeve 265; the second cavity 5423 is used for inserting the inner core 261.
  • the plug 56 is matched with the plug cavity 523 at the proximal end of the main body 52.
  • the communication hole 525 is located between the slot cavity 521 of the main body 52 and the insertion cavity 523, and communicates with the slot cavity 521 and the insertion cavity 523.
  • the proximal end of the inner core 261 sequentially passes through the first cavity 5421, the second cavity 5423, and the communicating hole 525 into the insertion cavity 523.
  • the inner core 261 in the cavity 523 is inserted.
  • the proximal end of the pin is clamped between the plug 56 and the inner wall of the main body 52 adjacent to the plug cavity 523, so that the inner core 261 is fixed to the inside of the handle 50.
  • the outer surface of the plug 56 and the inner wall of the main body 52 adjacent to the plug cavity 523 can be provided with grooves and bumps that can be engaged with each other, and the plug 56 can be locked by the engagement of the grooves and the bumps. It is detachably plugged into the main body 52. When the plug 56 is removed from the main body 52, the inner core 261 can be removed.
  • the second joint 54 is used to maintain the relative positional relationship between the sleeve 265 and the inner core 261.
  • the second joint 54 is used to fix the sleeve 265 on the handle 50, which can effectively reduce the probability of misoperation; when the sleeve 265 needs to be pushed forward, the operator
  • the second connector 54 is pushed distally on the housing 50, so that the hook 545 is withdrawn from the slot cavity 521, that is, the second connector 54 is detached from the main body 52, and the second connector 54 moves distally to drive the sleeve 265 relative to each other.
  • the inner core 261 moves to the distal end so that the distal end of the sleeve 265 presses against the locking member 22.
  • the second connector 54, the main body 52, and the plug-in member 56 may all be elastic members; or only the main body 52 is an elastic member, and the second connector 54 and the plug-in member 56 are both hard members; or the main body 52 is a hard member. Both the second joint 54 and the plug-in member 56 are elastic members.
  • FIG. 6 is a three-dimensional structural diagram of the wire locking system 20 in FIG. 3 in one of the folded states
  • FIG. 7 is a structural diagram of the wire locking system 20 in FIG. 6 from another perspective.
  • the guidewire locking system 20 is inserted into the inner cavity 502 of the guidewire 500 in the body, and the handle 50 is pushed distally along the inner cavity of the guidewire 500 until the locking member 22 reaches a predetermined position, which is generally the distal end of the guidewire 500 , Which is closer to the heart and the electrode at the end of the lead 500.
  • the operator uses the first joint 52 to keep the inner core 261 stationary, and moves the second joint 54 to the distal end to drive the sleeve 265 to move distally relative to the inner core 261, so that the distal end of the sleeve 265 presses the proximal end of the locking member 22 , The proximal end of the locking member 22 is moved to its distal end, and the axial size of the locking member 22 is reduced.
  • the plurality of through holes 220 on the locking member 22 penetrate the locking member 22 on the inner core 261, so that at least two adjacent through holes 220
  • the elastically deformed part of the elastic piece protrudes away from the axis of the inner core 261, and presents a folded shape as shown in FIGS. 6-7.
  • the radial size of the locking member 22 becomes larger, and the inner wall of the wire 500 can be firmly clamped. , In order to achieve the locking of the distal end of the wire 500.
  • the wire locking probe 20 provided in this embodiment can gradually increase the radial size of the locking member 22 according to the needs of practical applications to achieve a better locking effect. For example, after the locking member 22 reaches a predetermined position, the operator moves toward the distal end. Pushing the sleeve 265, the radial dimension of the locking member 22 will gradually increase; if the operator pulls the inner core 261 to the proximal end, the inner core 261 cannot drive the sleeve 265 to move synchronously, it is obtained that the locking member 22 locks the wire 500 The effect is not good.
  • the wire locking device 100 provided in the present application can adjust the radial size of the wire locking probe 20 according to actual needs, so as to adapt to slender tube structures with different inner diameters, and can lock the locking member 22 and the slender tube structure firmly.
  • FIG. 8 is a structural diagram of the locking member 22a of the wire locking system of the wire locking device provided by the second embodiment of the present application
  • FIG. 9 is an enlarged view of the IX part in FIG. 8.
  • the structure of the wire locking device provided by the second embodiment of the present application is similar to that of the first embodiment, except that: in the second embodiment, the locking member 22a has two adjacent through holes 220 between each other. Set barb 222.
  • the locking member 22a is laser-cut at least one barb 222 between two adjacent through holes 220; preferably, each barb 222 is located in the middle between the two corresponding through holes 220 on the locking member 22a.
  • each barb 222 faces the proximal end, that is, each barb 222 faces the sleeve 265.
  • the tip of the barb 222 is tilted toward the proximal direction, so that the operator can pull out the wire 500 through the inner core 261.
  • the wire locking probe can more easily lock the inner wall of the elongated tube structure.
  • the method of using the wire locking device in the second embodiment is the same as that in the first embodiment, and will not be repeated here.
  • the conveying assembly 26 also includes a configuration A positioning member 266 at or adjacent to the proximal end of the sleeve 265 is connected between the inner core 261 and the sleeve 265.
  • the positioning member 266 is used to fix the inner core 261 and the sleeve 265, that is, the inner core 261 and the sleeve 265.
  • the sleeves 265 are fixed to each other by a positioning member 266, which prevents relative movement between the inner core 261 and the sleeve 265 in the axial direction.
  • the positioning member 266 is provided at the distal end of the handle 50.
  • the positioning member 266 includes a first positioning member 267 fixedly connected to the inner core 261 and a second positioning member 268 fixedly connected to the sleeve 265.
  • the first positioning member 267 and the second positioning member 268 cooperate with each other to obtain multiple positioning positions , To keep the locking member in different radial sizes, it can meet the needs of the slender tube structure; after the first positioning member 267 and the second positioning member 268 are engaged and positioned, the operator does not need to hold the sleeve 265 all the time To maintain the relative positional relationship between the two with the inner core 261, it is convenient for the operator to perform subsequent pulling of the wire 500 or other operations.
  • the second positioning member 268 is tubular, the first positioning member 267 can be inserted into the inner cavity of the second positioning member 268, and the first positioning member 267 and the second positioning member 268 are connected by an elastic block and Card hole for positioning.
  • the first positioning member 267 and the second positioning member 268 are both tubular, the first positioning member 267 is fixedly sleeved on the periphery of the inner core 261, and the distal end of the second positioning member 268 is fixedly sleeved near the sleeve 265.
  • the inner diameter of the second positioning member 268 is larger than the outer diameter of the first positioning member 267, and one of the two is an elastic member; the clamping hole and the clamping block are respectively provided on the outer peripheral surface of the first positioning member 267 and the second positioning member 268
  • the relative position between the second positioning member 268 and the first positioning member 267 also changes accordingly on the inner peripheral surface of the sleeve, and is locked into the corresponding hole through the clamping block Positioning.
  • the outer peripheral surface of the first positioning member 267 is provided with a plurality of clamping holes 2670 spaced along the axial direction, and the plurality of clamping holes 2670 are arranged at intervals along the axial direction, that is, each clamping hole 2670 is relative to the first positioning member 267.
  • the distance of the far end is different.
  • a clamping block 2680 is provided on the inner peripheral surface of the second positioning member 268, and the clamping block 2680 can be selectively clamped into any clamping hole 2670, so that the first positioning member 267 and the second positioning member 268 are positioned at different positioning positions in cooperation with each other. .
  • the clamping block 2680 is clamped into different clamping holes 2670, the radial size of the locking member is different.
  • a chamfer is provided on the side wall at the opening of each locking hole 2670 to facilitate the sliding of the locking block 2680; and/or a chamfer is provided around the end of the locking block 2680 to facilitate the sliding of the locking block 2680.
  • the inner wall (inner peripheral surface) of the second positioning member 268 has a plurality of locking holes spaced along the axial direction, and the outer peripheral surface of the first positioning member 267 is provided with elastic locking blocks, and the locking blocks can be selectively locked in.
  • the first positioning member 267 and the second positioning member 268 are positioned at different positioning positions in cooperation with each other, so that the radial size of the locking member 22 is different.
  • the structure of the wire locking device provided by the fourth embodiment of the present application is similar to the structure of the first embodiment, except that: in the fourth embodiment, the locking member 22b is at least one An elastic piece, the elastic piece is enclosed in a ring or a partial ring, the peripheral wall of the elastic piece is provided with two opposite through holes, and the distal end of the inner core 261 penetrates the two through holes of the elastic piece.
  • the sleeve 265 slides distally with respect to the inner core 261, and the distal end of the sleeve 265 presses against the elastic piece in the locking member 22b to deform, that is, the size of the elastic piece in the axial direction of the inner core 261 is reduced, and the radial direction of the elastic piece is reduced. The size is gradually increased, so that the locking member 22b is firmly locked to the inner wall of the wire 500.
  • the elastic sheet can be in the shape of a circular ring, an elliptical ring, a square ring or other irregular closed ring structures. Two opposite through holes are provided on the peripheral wall of the elastic piece, and the specific position of the through holes on the peripheral wall of the elastic piece is not limited.
  • the number of elastic pieces is multiple, and the plurality of elastic pieces are sleeved on the distal end of the inner core 261 through the through holes, and the most distal elastic piece is fixedly connected to the inner core 261.
  • the distal end of the sleeve 265 slides distally with respect to the inner core 261, the distal end of the sleeve 265 is pressed against the elastic pieces to deform, that is, the size of each elastic piece in the axial direction of the inner core 261 decreases, and the radial size of the elastic piece gradually decreases.
  • the enlargement facilitates the locking member 22b to be firmly locked to the inner wall of the wire 500. Only one through hole may be provided on the peripheral wall of the most distal elastic piece. After the distal end of the inner core 261 passes through the only through hole of the most distal elastic piece, it is welded or adhesively fixed with the most distal elastic piece.
  • each elastic piece has a circular ring shape, and two through holes on the elastic piece are arranged opposite to each other.
  • the axial size of the inner core 261 occupied by each shrapnel is relatively large, and the radial size is relatively small; in the squeezed state of the shrapnel, the axis of each shrapnel along the inner core
  • the radial size becomes smaller, the radial size becomes larger, that is, it deforms into an elliptical ring or similar shape.
  • the structure of the wire locking device provided by the fifth embodiment of the present application is similar to the structure of the first embodiment, except that: in the fifth embodiment, the locking member 22c is disposed on The elastic locking piece 223 on the inner core 261, the distal end of the locking piece 223 is connected to the inner core 261, the sleeve 265 is adjacent to the proximal end of the inner core 261 relative to the locking member 22c, and the distal end of the sleeve 265 is provided with a guide portion 2650 There is a gap between the proximal end of the locking piece 223 and the outer surface of the inner core 261, and the sleeve 265 slides relative to the inner core 261, so that the position of the guide portion 2650 inserted into the gap is changed, thereby adjusting the radial size of the locking member 22c .
  • the locking member 22c includes an elastic locking piece 223 provided at the distal end of the inner core 261, and a fixing barrel 225 connected to the distal end of the locking piece 223.
  • the distal end of the locking piece 223 is connected to the inner core 261 through the fixing barrel 225.
  • the inner core 261 and the sleeve 265 move relative to each other in the axial direction so that the guide portion 2650 of the distal end of the sleeve 265 is slidably inserted into the gap, and pushes against the inner surface of the proximal end of the locking piece 223 to push the locking piece 223
  • the elastic deformation causes the proximal end of the locking piece 223 to move toward the axis away from the inner core 261 to change the radial dimension.
  • the guide portion 2650 When the sleeve 265 slides toward the distal end relative to the inner core 261, the guide portion 2650 is slidably inserted into the gap and pushes against the inner surface of the proximal end of the locking piece 223, so that the proximal end of the locking piece 223 faces away from the axis of the inner core 261
  • the guide portion 2650 slides out of contact with the inner surface of the proximal end of the locking piece 223, so that The proximal end of the locking piece 223 moves toward the axis of the inner core 261, that is, moves away from the inner wall of the wire 500 (FIG. 1), so as to return to the original state.
  • the diameter of the guide portion 2650 gradually decreases from the proximal end to the distal end, that is, the diameter of the distal end of the guide portion 2650 is smaller than the diameter of the sleeve 265, so as to facilitate the insertion of the distal end of the guide portion 2650 between the locking piece 223 and the inner core 261.
  • the inner surface of the proximal end of the locking piece 223 is slidably pressed.
  • the locking piece 223 is made of a metal with high elasticity, such as spring steel and nickel titanium steel.
  • the cross section of the locking piece 223 is arc-shaped, and before the locking piece 223 is elastically deformed, the diameter of the outer circumferential surface of the locking piece 223 is less than or equal to the diameter of the outer circumferential surface of the sleeve 265.
  • the distal end of the inner core 261 is provided with two opposite locking pieces 223, and the two locking pieces 223 are connected to the distal end of the inner core 261 through a fixing barrel 225.
  • the two locking pieces 223 are both strip-shaped and extend axially toward the proximal end, and the gap between the two locking pieces 223 also extends axially.
  • the two locking pieces 223 are enclosed in a hollow tube shape, and the inner cavity extending along the axial direction enclosed by the two locking pieces 223 is used to accommodate part of the inner core 261, and the distal end of the inner core 261 is welded or welded through the aforementioned inner cavity. It is fixed to the inside of the fixed cylinder 225 by bonding.
  • the guide portion 2650 of the sleeve 265 does not enter the inner cavity enclosed by the two locking pieces 223, the locking piece 223 is not deformed, and the proximal ends of the two locking pieces 223 are close
  • the diameter of the outer circumferential surface of the two locking pieces 223 is less than or equal to the diameter of the outer circumferential surface of the sleeve 265.
  • the operator uses the handle 50 to control the inner core 261 to drive the locking member 22c to move in the inner cavity of the wire 500.
  • the locking member 22c reaches a predetermined position, such as a position close to the heart and electrodes, the operator uses the handle 50 to keep the inner core 261 stationary.
  • a plurality of locking pieces 223 are provided on the outer periphery of the distal end of the inner core 261, and the plurality of locking pieces 223 are arranged along the circumference of the inner core 261 and enclose an inner cavity that facilitates the insertion of the distal end of the sleeve 265, namely A plurality of locking pieces 223 are connected to the distal end of the inner core 261 through the fixing cylinder 225, and the locking pieces 223 are arranged in a circle along the circumference of the inner core 261 at intervals, and enclose a cavity that facilitates the insertion of the distal end of the sleeve 265.
  • Each locking piece 223 is strip-shaped and extends axially toward the proximal end, and the gap between two adjacent locking pieces 223 also extends axially. These locking pieces 223 are enclosed in a hollow tube shape. When the guide portion 2650 of the sleeve 265 does not enter the inner cavity enclosed by the locking pieces 223, the locking pieces 223 will not be deformed. The proximal ends of the locking pieces 223 are close to each other.
  • the outer peripheral surface is coplanar with the outer peripheral surface of the sleeve 265; when the guide portion 2650 of the sleeve 265 is inserted into the inner cavity enclosed by the locking piece 223, the guide portion 2650 slidably pushes the locking piece 223 so that the distal end of the locking piece 223
  • the elastic deformation causes the spacing between the proximal ends of the locking pieces 223 to gradually increase, so that the radial size of the locking piece 22c gradually increases, so as to firmly clamp the inner wall of the elongated tube structure to achieve alignment of the elongated tube body. Locking of the distal end of the structure.
  • adjacent locking pieces 223 may be arranged at intervals.
  • the structure of the wire locking device provided by the sixth embodiment of the present application is similar to the structure of the fifth embodiment, except that: in the sixth embodiment, the locking member 22d is provided in the The elastic locking piece 223 around the distal end of the sleeve 265, the proximal end of the locking piece 223 is connected to the distal end of the sleeve 265, the distal end of the inner core 261 is provided with a guide portion 2610, the distal end of the locking piece 223 and the inner core 261 There is a gap between the outer surfaces of the inner core 261 and the sleeve 265 relative to move in the axial direction, so that the guide portion 2610 of the inner core 261 is inserted into the gap to push the locking piece 223 to elastically deform, so that the distal end of the locking piece 223 faces toward Move away from the axis of the inner core 261, thereby adjusting the radial size of the locking member 22d.
  • the inner core 261 slides toward the proximal end relative to the sleeve 265, and the outer surface of the guide portion 2610 slidably pushes against the inner surface of the locking piece 223, so that the distal end of the locking piece 223 moves toward an axis away from the inner core 261.
  • the diameter of the guide portion 2610 gradually decreases from the distal end to the proximal end, that is, the diameter of the distal end of the guide portion 2610 is larger than the diameter of the inner core 261, so that the proximal end of the guide portion 2610 can be inserted between the locking piece 223 and the inner core 261.
  • the cross section of the locking piece 223 is arc-shaped.
  • the diameter of the outer circumferential surface of the locking piece 223 is less than or equal to the diameter of the outer circumferential surface of the sleeve 265.
  • the distal end of the sleeve 265 is provided with two relatively spaced locking pieces 223, the two locking pieces 223 are directly connected to the distal end of the sleeve 265, the locking piece 223 and the sleeve 265 are integrally formed, or the locking piece 223 Welded around the distal end of the sleeve 265.
  • the two locking pieces 223 are both strip-shaped and extend axially toward the proximal end, and the gap between the two locking pieces 223 also extends axially.
  • the two locking pieces 223 are enclosed in a hollow tube, and the inner core 261 is inserted into the hollow tube enclosed by the two locking pieces 223.
  • the guide portion 2610 of the inner core 261 does not enter the inner cavity enclosed by the two locking pieces 223, the locking piece 223 is not deformed, and the distal ends of the two locking pieces 223 are close ,
  • the diameter of the outer circumferential surface of the two locking pieces 223 is less than or equal to the diameter of the outer circumferential surface of the sleeve 265; pushing the inner core 261 to drive the guide portion 2610 to move distally, and the control sleeve 265 follows the guide portion 2610 to move distally, when When the distal end of the sleeve 265 reaches a predetermined position, the control sleeve 265 does not move, and the inner core 261 is pulled toward the proximal end, so that the proximal end of the guide portion 2610 gradually enters the inner cavity surrounded by the two locking pieces 223 and slides against it.
  • Pushing the inner surface of the locking piece 223 causes the distal ends of the two locking pieces 223 to expand, that is, the distance between the distal ends of the two locking pieces 223 gradually increases, so that the radial dimension of the locking piece 22d gradually increases to stabilize
  • the inner wall of the slender tube body structure is ground clamped to realize the locking of the distal end of the slender tube body structure. The closer the guide portion 2610 is to the sleeve 265 in the inner cavity, the larger the size of the locking member 22d in the radial direction.
  • the radial dimension of the locking member 22d can be reduced by pulling the sleeve 265 proximally or pushing the inner core 261 distally to restore the partial deformation of the locking piece 223.
  • more than two locking pieces 223 are provided on the outer periphery of the distal end of the sleeve 265, and the multiple locking pieces 223 are arranged at intervals along the circumference of the sleeve 265, and are enclosed to facilitate the insertion of the inner core 261.
  • Each locking piece 223 is strip-shaped and extends axially toward the proximal end, and the gap between two adjacent locking pieces 223 also extends axially. These locking pieces 223 are enclosed in a hollow tube shape. When the guide portion 2610 of the inner core 261 does not enter the inner cavity enclosed by the locking pieces 223, the locking pieces 223 will not be deformed.
  • the distal ends of the locking pieces 223 are close to each other.
  • the diameter of the outer peripheral surface is less than or equal to the diameter of the outer peripheral surface of the sleeve 265.
  • the structure of the wire locking device provided by the seventh embodiment of the present application is similar to the structure of the first embodiment, except for the locking member 22e and the handle 50a in the seventh embodiment
  • the structure of is different from that of the first embodiment. specifically:
  • the wire locking device in the seventh embodiment includes an inner core 261, a sleeve 265, and a locking member 22e.
  • the sleeve 265 is a steel sleeve, and the sleeve 265 is sleeved on the periphery of the inner core 261, that is, the inner core 261 is accommodated in the lumen of the sleeve 265.
  • the length of the inner core 261 is greater than that of the sleeve 265.
  • the sleeve 265 can The sleeve slides along the axial direction on the inner core 261.
  • the locking member 22e is a tube body with adjustable radial size sleeved on the periphery of the inner core 261; the sleeve 265 and the inner core 261 move relative to each other to change the force of the sleeve 265 pressing the tube body in the axial direction, thereby changing the tube body ⁇ radial dimension.
  • the tube body is a braided mesh tube with elasticity, the braided mesh tube is sleeved on the periphery of the inner core 261, and the distal end of the braided mesh tube may be fixed on the inner core 261 or not;
  • the net tube is disposed adjacent to the distal end of the inner core 261 relative to the sleeve 265, that is, the braided net tube is sleeved on the outer periphery of the distal end of the inner core 261, and the sleeve 265 is sleeved on the outer periphery of the proximal end of the inner core 261.
  • the distal end of the inner core 261 is provided with a blocking portion 269 for preventing the braided net tube from sliding out of the distal end of the inner core 261.
  • the diameter of the blocking portion 269 is larger than the diameter of the distal end of the braided net tube.
  • the upper section of the steel sleeve is fixed by welding to obtain a blocking portion 269 with a slightly larger diameter.
  • the braided mesh tube has elasticity in both the axial and radial directions. It can be woven from wire-like metal such as stainless steel wire or nickel-titanium wire or made of polymer materials such as nylon. The two ends of the braided mesh tube made of metal are soldered. Take-up processing.
  • the sleeve 265 When the sleeve 265 moves distally relative to the inner core 261, it abuts against the proximal end of the braided mesh tube. Because the distal end of the braided mesh tube is blocked by the blocking portion 269 and cannot continue to move to the distal end, it has an elastic axial dimension of the braided mesh tube. As the squeezing of the sleeve 265 gradually becomes smaller, the radial dimension gradually increases, that is, the braided mesh tube expands in the radial direction, thereby abutting against the inner wall of the wire to lock the wire.
  • the sleeve 265 is adjacent to the distal end of the inner core 261 relative to the locking member 22e, and the blocking portion 269 is provided at the proximal end of the locking member 22e.
  • the sleeve 265 compresses the locking member 22e from the distal end to the proximal end.
  • the wire locking device is also provided with a handle 50a.
  • the handle 50a includes a first joint 57 and a second joint 58 that are movably connected.
  • the first joint 57 is used to connect the inner core 261 and the second joint. Used to connect the sleeve 265.
  • the first joint 57 is located at the proximal end of the second joint 58, the inner core 261 passes through the second joint 58 in the axial direction and then is connected to the first joint 57; the first joint 57 and the proximal end of the inner core 261 are welded, bonded,
  • the second joint 58 is connected with the proximal end of the sleeve 265 by welding, bonding, screwing or clamping, etc.
  • the first joint 57 and the second joint 58 are used for the operator's handheld control The relative movement of the inner core 261 and the sleeve 265.
  • the first joint 57 and the second joint 58 are movably connected by threads or snaps.
  • the first joint 57 and the second joint 58 are locked by threads or snaps. Synchronous movement, when the wire 500 needs to be locked, the first joint 57 and the second joint 58 are controlled to separate from each other, the sleeve 265 slides distally with respect to the inner core 261, and the force of the sleeve 265 squeezing the braided net tube increases, so that The braided mesh tube expands, that is, the axial size of the braided mesh tube decreases and the radial size increases until the braided mesh tube locks the inner wall of the wire 500 in the radial direction. After the wire 500 is locked by the braided network tube, the second joint 58 can be retracted to perform re-locking again.
  • the structure of the wire locking device provided by the eighth embodiment of the present application is similar to that of the seventh embodiment.
  • the locking member 22f in the eighth embodiment is a tube body, which is similar to that of the seventh embodiment.
  • the difference is that the tube structure of the locking member 22f in the eighth embodiment is different from that in the seventh embodiment.
  • the locking member 22f is a heat-shrinkable tube, and the heat-shrinkable tube may be made of PTFE, FEP, PET and other materials.

Abstract

L'invention concerne un système de verrouillage de fil-guide (20), ledit système de verrouillage de fil-guide (20) comprenant un ensemble de transport (26) et une pièce de verrouillage (22). La pièce de verrouillage (22) est disposée sur l'ensemble de transport (26) et est utilisée pour être insérée dans une cavité interne (502) d'un fil-guide (500). L'ensemble de transport (26) est utilisé pour régler les dimensions radiales de la pièce de verrouillage (22) de manière à amener la pièce de verrouillage (22) à être en contact étroit avec une paroi interne du fil-guide (500), et est apte à entraîner un mouvement synchrone du fil-guide (500). La présente invention concerne en outre un appareil de verrouillage de fil-guide (100) pour le système de verrouillage de fil-guide (20) décrit.
PCT/CN2020/140144 2019-12-30 2020-12-28 Système de verrouillage de fil-guide et appareil de verrouillage de fil-guide WO2021136167A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
CN201922454640.0U CN211935185U (zh) 2019-12-30 2019-12-30 导线锁定系统及导线锁定装置
CN201911423890.6 2019-12-30
CN201922454640.0 2019-12-30
CN201911423890.6A CN113117239A (zh) 2019-12-30 2019-12-30 导线锁定系统及导线锁定装置

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WO2021136167A1 true WO2021136167A1 (fr) 2021-07-08

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090234428A1 (en) * 2004-06-28 2009-09-17 Xtent, Inc. Devices and methods for controlling expandable prostheses during deployment
US20100324490A1 (en) * 2009-06-23 2010-12-23 N.G.C. Medical S.P.A. Variable diameter tubular structure for a biomedical use
CN104622599A (zh) * 2009-05-18 2015-05-20 纽姆克斯股份有限公司 细长的肺减容装置在部署过程中的横截面变化
CN204814123U (zh) * 2015-08-15 2015-12-02 彭卫东 内窥镜取异物网篮
CN107080608A (zh) * 2016-09-23 2017-08-22 杭州启明医疗器械有限公司 一种便于回收介入器械的输送系统
CN211935185U (zh) * 2019-12-30 2020-11-17 杭州诺茂医疗科技有限公司 导线锁定系统及导线锁定装置

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090234428A1 (en) * 2004-06-28 2009-09-17 Xtent, Inc. Devices and methods for controlling expandable prostheses during deployment
CN104622599A (zh) * 2009-05-18 2015-05-20 纽姆克斯股份有限公司 细长的肺减容装置在部署过程中的横截面变化
US20100324490A1 (en) * 2009-06-23 2010-12-23 N.G.C. Medical S.P.A. Variable diameter tubular structure for a biomedical use
CN204814123U (zh) * 2015-08-15 2015-12-02 彭卫东 内窥镜取异物网篮
CN107080608A (zh) * 2016-09-23 2017-08-22 杭州启明医疗器械有限公司 一种便于回收介入器械的输送系统
CN211935185U (zh) * 2019-12-30 2020-11-17 杭州诺茂医疗科技有限公司 导线锁定系统及导线锁定装置

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