WO2021136203A1

WO2021136203A1 - Lead extraction apparatus

Info

Publication number: WO2021136203A1
Application number: PCT/CN2020/140328
Authority: WO
Inventors: 唐闽; 王永胜; 高国庆; 梁良军
Original assignee: 杭州诺茂医疗科技有限公司
Priority date: 2019-12-30
Filing date: 2020-12-28
Publication date: 2021-07-08

Abstract

An extraction apparatus (100), used for extracting an elongated structure implanted into the body, the extraction apparatus (100) comprising a manipulating handle (20), a sheath (50) connected to the distal end of the manipulating handle (20), and an expanding head (80) connected to the distal end of the sheath (50), the manipulating handle (20) comprising a drive member and a rotating member, one end of the rotating member being connected to the proximal end of the sheath (50) and the other end of the rotating member connected to the drive member, and the drive member being used for driving the bidirectional rotation of the rotation member to drive the bidirectional rotation of the sheath (50) and the expanding head (80), enabling the expanding head (80) to effectively cut fibrous tissue wrapped around the elongated structure, preventing other leads (500) in the blood vessel from becoming entangled with one another, and preventing the blood vessel wall from twisting and being scratched by the expanding head (80).

Description

Wire extraction device

Technical field

This application relates to the technical field of interventional medical devices, and in particular to a lead extraction device for extracting electrode leads implanted in a patient's body for a long time.

Background technique

Various medical treatments and surgical procedures require the implantation of elongated structures in the bodies of human or livestock patients. Such elongated structures can include catheters, sheaths, cardiac electrical leads (such as pacemaker leads or defibrillator leads), and a variety of other devices. Among them, 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 wires can be fixed inside the heart Or external.

In some cases, it is necessary to remove the wires implanted in the patient's body. For example, the wires implanted in the patient's body are disconnected and cannot transmit signals, and a large number of fibrous (or calcified) tissues are formed at the electrode tips, which makes the pacemaker unable to provide enough Energy to run, infection at the wire site, clot or scar tissue blocking the vein, or other malfunctions. Since the elongated structure is implanted in the patient’s body for a long time, there will be a lot of fiber (or calcified) tissue attached to the lead, so that multiple leads, between the lead and the wall of the blood vessel, or between the lead and the inner wall of the heart, are attached together. The lead cannot be taken out directly. Forcibly taking it out will lead to breakage of the lead, damage to the surrounding lead, and damage to the blood vessel wall or the inner wall of the heart. At present, the wire extraction technology will be completed with a wire extraction device, which generally uses a cutting tip to perform a unidirectional rotational movement along a wire to cut fibrous tissue.

However, in order to peel off the fibrous tissue growing around a wire, one or more cuttings of the cutting tip may be required. When the fibrous tissue is not completely separated from the wire, the cutting tip will continue to rotate in the original direction to cut the fiber easily. The tissue will be entangled around the cutting tip, severely entangled multiple times. In this case, the fibrous tissue pulling the blood vessel may cause the blood vessel to twist and be scratched by the dilation head; if there are multiple wires wrapped by the fibrous tissue in the same blood vessel, the other wires are likely to be incompatible with the above due to the traction of the fibrous tissue. One of the wires is twisted together, so the difficulty of taking out the electrode wires will be greatly increased.

Summary of the invention

In view of this, the present application provides an extraction device for extracting an elongated structure implanted in the body. The extraction device includes a control handle, a sheath connected to the distal end of the control handle, and The expansion head at the distal end of the sheath, wherein the control handle includes a driving part and a rotating part, one end of the rotating part is connected to the proximal end of the sheath, and the other end of the rotating part is connected to the driving part. The driving member is used for driving the rotating member to rotate in both directions, so as to drive the sheath tube and the expansion head to rotate in both directions.

The control handle of the extraction device of the present application can drive the expansion head and the sheath to move in the patient's blood vessel, and the control handle can control the driving part to drive the rotating part to rotate in both directions, and the two-way rotation of the rotating part can drive the sheath and the expansion head Two-way rotation; the proximal end of the slender structure passes through the expansion head, the sheath, and the extraction device from the control handle extends to the outside of the body. The expansion head and the sheath are pushed distally in the blood vessel to cut and wrap around The fibrous tissue surrounding the elongated structure separates the elongated structure from the inner wall of the blood vessel. Because the control handle can drive the sheath tube and the expansion head to rotate in both directions by driving the rotating member, that is, the expansion head rotates in the first direction and then rotates in the second direction, which not only enables the expansion head to effectively cut and wrap around the slender structure The fibrous tissue can also reduce the chance that the slender structure and other wires in the blood vessel will be entangled with each other, and the blood vessel wall will be scratched by the elongated head due to traction and distortion.

Description of the drawings

In order to explain the technical solutions of the embodiments of the present application more clearly, the following will briefly introduce the drawings that need to be used in the embodiments. Obviously, the drawings in the following description are some embodiments of the present application, which are common in the field. As far as technical personnel are concerned, they can also obtain other drawings based on these drawings without creative work.

Fig. 1 is a schematic structural diagram of a take-out device provided by an embodiment of the present application.

FIG. 2 is a schematic sectional view of the structure of the take-out device in FIG. 1. FIG.

Fig. 3 is an exploded schematic view of the three-dimensional structure of the worm and worm gear assembly in Fig. 2.

Fig. 4 is an enlarged schematic diagram of the worm in Fig. 3.

Fig. 5 is an enlarged schematic diagram of the worm gear assembly and sheath tube joint in Fig. 3.

Fig. 6 is a cross-sectional view of the worm gear assembly, worm and sheath tube joint in Fig. 3 after assembly.

Fig. 7 is a partial cross-sectional view of Fig. 2.

Fig. 8 is a schematic diagram of a state of the cash withdrawal device in Fig. 7.

Fig. 9 is a schematic cross-sectional structure diagram of another view of the take-out device in Fig. 1.

Detailed ways

The technical solutions in the embodiments of the present application will be clearly and completely described below in conjunction with the accompanying drawings in the embodiments of the present application. Obviously, the described embodiments are only a part of the embodiments of the present application, rather than all the embodiments. Based on the embodiments in this application, all other embodiments obtained by a person of ordinary skill in the art without creative work shall fall within the protection scope of this application.

In addition, the description of the following embodiments refers to the attached drawings to illustrate specific embodiments that can be implemented in the present application. The directional terms mentioned in this application, for example, "upper", "lower", "front", "rear", "left", "right", "inner", "outer", "side", etc., only Refers to the direction of the attached illustration. Therefore, the direction terms used are for a better and clearer description and understanding of this application, rather than indicating or implying that the device or element referred to must have a specific orientation or a specific orientation. The structure and operation cannot therefore be understood as a limitation of this application. "The connection between the component A and the component B" means that the component A is directly connected to the component B, or the component A is indirectly connected to the component B through other components.

In order to describe the structure of the retrieval device more clearly, the limited terms "proximal", "distal" and "axial" described in this application are commonly used terms in the field of interventional medicine. Specifically, "distal" refers to the end far away from the operator during the surgical operation; "proximal end" refers to the end close to the operator during the surgical operation; "axial" refers to the direction of the central axis of the device, and the radial is the same as the center. The direction in which the axis is perpendicular. 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.

Please refer to FIG. 1 and FIG. 2. FIG. 1 is a schematic structural diagram of a take-out device 100 provided by a first embodiment of the present application; FIG. 2 is a cross-sectional structural diagram of the take-out device 100 in FIG. 1. The present application provides a retrieval device 100, which is used to retrieve an elongated structure implanted in the body. The elongated structure can be, but is not limited to, a catheter, sheath, cardiac pacemaker or defibrillator that has been implanted in the patient's body. The electrode lead of the device, and a variety of other devices; the electrode lead 500 (shown in FIG. 9) is taken as an example for description in this application. It is understandable that the elongated structure may also be the other long-term implants described above Tubular graft into the patient's body.

The retrieval device 100 includes a manipulation handle 20, a sheath 50 connected to the distal end of the manipulation handle 20, and an expansion head 80 connected to the distal end of the sheath 50; wherein the handle 20, the sheath 50 and the expansion head 80 are along the removal device 100 The threading lumen 201 for the transmission wire 500 is arranged in the axial direction. In the extraction device 100 provided in the present application, the manipulation handle 20 can control the sheath 50 and the expansion head 80 to rotate in both directions. The distal end of the expansion head 80 has a knife edge for cutting the fibrous tissue wrapped around the guidewire 500, so as to cut through or otherwise break obstacles encountered during the removal of the guidewire 500. Bidirectional rotation means that the sheath 50 and the expansion head 80 are rotated in a first direction and then rotated in a second direction, and the first direction is opposite to the second direction. The first direction may be a clockwise rotation direction or a counterclockwise rotation direction when viewed from the proximal end of the retrieval device 100 to the distal end, and the second direction corresponds to a counterclockwise rotation direction or a clockwise rotation direction.

When using the extraction device 100, the doctor inserts the proximal end of the electrode lead 500 in the patient into the inner cavity of the expansion head 80. The doctor grasps the control handle 20 and pushes the control handle 20 distally, so that the sheath 50 and the expansion head 80 gradually enter the patient's blood vessel along the electrode lead. When the resistance of pushing the control handle 20 to the distal end is large, it means that the expansion head 80 is in contact with the tissue around the guide wire 500, and then the control handle 20 controls the two-way rotation of the sheath 50 and expansion head 80, so that the expansion head The sharp blade of 80 cuts the tissue around the electrode lead to separate the lead from the tissue to facilitate subsequent lead removal operations. The bidirectional rotation of the sheath 50 and the expansion head 80 can also reduce the chance that the guide wire 500 and other wires in the blood vessel are entangled with each other and the blood vessel wall is twisted to be scratched by the expansion head 80.

Specifically, the control handle 20 includes a housing 21. The housing 21 is provided with a receiving cavity 211 for accommodating other components. The control handle 20 also includes a driving member and a rotating member arranged in the receiving cavity 211, and the rotating member is connected to the driving member. The control handle 20 also includes an operating member 26 partially accommodated in the receiving cavity 211, and the sheath 50 is partially accommodated at the distal end of the receiving cavity 211, wherein the operating member 26 is connected to the proximal end of the driving member and is used for receiving With external pulling force, one end (proximal end) of the sheath tube 50 away from the expansion head 80 enters the receiving cavity 211 through the distal opening of the housing 21 and is connected to the rotating member. The operating member 26 drives the driving member to move proximally in the axial direction under the action of external pulling force, and the axial movement of the driving member drives the rotating member to rotate in both directions to drive the sheath 50 and the expansion head 80 to rotate in both directions.

Please also refer to FIGS. 2 to 5, the driving member includes a worm 23, and the worm 23 is slidably disposed in the receiving cavity 211 of the housing 21 along the axial direction. The proximal end of the worm 23 is fixedly connected to the operating member 26, and the operating member 26 moves in the axial direction to drive the worm 23 to move in the axial direction. In this embodiment, the worm 23 is fixedly connected to the operating member 26 by a pin. In other embodiments, the proximal end of the worm 23 and the operating member 26 may be fixed by screwing or clamping, so that the worm 23 and the operating member 26 are movably connected as a whole.

The outer peripheral surface of the worm 23 is provided with a bidirectional spiral groove 231, and both ends of the bidirectional spiral groove 231 respectively extend spirally in opposite directions. The worm 23 includes a rod body 230, and the outer surface of the rod body 230 is provided with a bidirectional spiral groove 231 and a connecting column 235. The bidirectional spiral groove 231 is used to drive the rotating member to rotate, the connecting post 235 is used to be fixedly connected to the operating member 26, and the bidirectional spiral groove 231 is disposed at the distal end of the rod body 230 relative to the connecting post 235.

As shown in FIG. 4, the bidirectional spiral groove 231 includes a spirally extending first guide groove 232 provided at the distal end of the outer peripheral surface of the worm 23 and a spirally extending second guide groove 233 connected to the proximal end of the first guide groove 232, The first guide groove 232 helically extends in a first direction, and the second guide groove 233 helically extends in a second direction, and the first direction is opposite to the direction of the helical extension in the second direction. In this embodiment, viewed from the proximal end to the distal end of the extraction device 100, the first direction is a clockwise direction, and the second direction is a counterclockwise direction. In the modified embodiment, the first direction is a counterclockwise direction, and the second direction is a clockwise direction.

Further, the bidirectional spiral groove 231 further includes a steering switch portion 234 connected between the first guide groove 232 and the second guide groove 233. After the rotating wheel 251 passes the steering switch portion 234, the worm 23 drives the worm gear assembly 25 Rotate in the opposite direction. The distal end of the first guide groove 232 extends to the distal surface of the rod body 230, that is, the first guide groove 232 is formed with an opening on the distal surface of the rod body 230, and the steering switching portion 234 is a first guide groove 232 and a second guide groove 233 Preferably, the switching part 234 is a smooth transition groove between the transition grooves.

As shown in FIG. 3, the rotating member includes a worm gear assembly 25, the worm gear assembly 25 is formed with a through hole for piercing the worm 23, and the surface of the worm gear assembly 25 is also provided with a guide pin 2510 for inserting in the bidirectional spiral groove 231; When the worm 23 moves in the axial direction, the sliding guide pin 2510 slides in the bidirectional spiral groove 231, and two ends of the bidirectional spiral groove 231 are respectively driven by the sliding guide pin 2510 to drive the worm gear assembly 25 to rotate in opposite directions. That is, during the sliding of the guide pin 2510 from the proximal end to the distal end of the bidirectional spiral groove 231, or the process of sliding from the distal end to the proximal end of the bidirectional spiral groove 231, the bidirectional spiral groove 231 is used to drive the worm gear assembly 25 along two Rotation in the opposite direction, that is, the bidirectional spiral groove 231 is used to drive the worm gear assembly to rotate in two opposite directions in 25 time divisions or in time sequence. The proximal end of the sheath tube 50 is inserted into the receiving cavity 211 from the distal end of the housing 21 (FIG. 1) and then connected to the worm gear assembly 25. The sheath tube 50 rotates in the opposite direction with the worm gear assembly 25.

The worm gear assembly 25 includes a rotating wheel 251 and a connecting tube 255. The rotating wheel 251 is connected to the proximal edge of the connecting tube 255. In this embodiment, the rotating wheel 251 is connected to the proximal end of the inner cavity of the connecting tube 255. The rotating wheel 251 is sleeved on the rod body 230 of the worm 23 and is slidably connected with the rod body 230, and the connecting cylinder 255 is sleeved on the rotating wheel 251. The proximal end of the sheath 80 is sleeved inside the distal end of the connecting barrel 255, and the distal end of the sheath 80 passes through the distal end of the connecting barrel and extends to the distal end of the extraction device 100.

Please refer to FIG. 5 in conjunction with FIG. 4, the rotating wheel 251 has a ring shape, that is, a through hole is formed in the middle of the rotating wheel 251 along the axial direction, and the rotating wheel 251 is sleeved on the worm 23 through the through hole. The rotating wheel 251 protrudes into the through hole with at least one sliding guide pin 2510 slidably inserted into the bidirectional spiral groove 231.

During the sliding of the guide pin 2510 from the proximal end to the distal end of the two-way spiral groove 231 and the process of sliding from the distal end to the proximal end of the two-way spiral groove 231, the two-way spiral groove 231 is used to drive the worm gear assembly 25 along two time divisions. Rotate in the opposite direction.

The distal end of the bidirectional spiral groove 231 penetrates the distal surface of the worm 23. In the process of the worm 23 sliding in the axial direction, the sliding guide pin 2510 of the rotating wheel 251 slides in the bidirectional spiral groove 231. Specifically, the sliding guide pin 2510 slides along the first guide groove 232 over the steering switching portion 234 and can Slide into the second guide groove 233; the rotating wheel 251 slides along the second guide groove 233 over the steering switch portion 234 and then can slide into the first guide groove 232 to drive the rotating wheel 251 and the connecting barrel 255 to rotate in both directions, so that the sheath 50 And the expansion head 80 rotates bidirectionally with the connecting cylinder 255.

In other embodiments, the guide sliding pin 2510 may also be arranged at other positions on the rotating wheel 251, for example, the rotating wheel 251 faces or faces away from the surface of the sheath tube 50.

As shown in FIG. 5, in this embodiment, in order to balance the force of the rotating wheel 251, the number of guide sliding pins 2510 is two, and the two guide sliding pins 2510 are oppositely arranged on the surface of the rotating wheel 251 and extend into the through hole. The two guide sliding pins 2510 may be located at the same axial position of the rotating wheel 251, or may be at different axial positions. Two guide sliding pins 2510 are slidably inserted in the bidirectional spiral groove 231 of the worm 23. Correspondingly, two bidirectional spiral grooves 231 are provided on the surface of the rod body 230, and each guide sliding pin 2510 is correspondingly accommodated in a bidirectional spiral groove 231; in the embodiment where the two guide sliding pins 2510 have different axial positions, the two guide sliding pins 2510 have different axial positions. The guide pin 2510 can be used to be inserted into the same bidirectional spiral groove 231. In the modified embodiment, a plurality of guide sliding pins 2510 and a plurality of bidirectional spiral grooves 231 may also be provided, and the numbers of the guide sliding pins 2510 and the bidirectional spiral grooves 231 may not be equal. In the modified embodiment, the guide sliding pin 2510 is in a hemispherical shape, or the guide sliding pin 2510 is a spirally extending strip protruding from the inner surface of the rotating wheel 251 in the direction of the through hole. The shape of the guide sliding pin 2510 is similar to that of a bidirectional spiral. The groove 231 is matched to be accommodated in the bidirectional spiral groove 231.

The edge of the rotating wheel 251 is fixedly connected or movably connected with the connecting cylinder 255, that is, the rotating wheel 251 and the connecting cylinder 255 are connected by means of clamping or bonding. In this embodiment, the outer wall of the rotating wheel 251 is provided with a clamping hole 2512, and the clamping hole 2512 is used for clamping the clamping block 2554 on the connecting cylinder 255. As shown in FIGS. 2 to 3 and 5, the distal end of the connecting cylinder 255 is provided with a through hole for penetrating the worm 23. Driven by the rotating wheel 251, the connecting cylinder 255 rotates around the worm 23. In other embodiments, when the connecting barrel 255 is long enough (the control handle is long enough), the inner cavity of the connecting barrel 255 is used to house the rod 230, and the rod 230 does not need to be sleeved on the connecting barrel 255.

The connecting cylinder 255 includes a cylinder body 2551 sleeved on the edge of the rotating wheel 251 and a first engaging part disposed at the distal end of the cylinder body 2551.

The proximal end of the cylinder body 2551 is provided with a plurality of clamping blocks 2554, and the plurality of clamping blocks 2554 are used to be clamped to the clamping holes 2512 of the rotating wheel 251, so that the rotating wheel 251 and the connecting cylinder 255 are connected together.

The first engaging portion includes a connecting ring 2553 protruding from the inner surface of the connecting barrel 255 and a first rack 2556 provided on the connecting ring 2553. The connecting ring 2553 has a ring shape or a partial ring shape, and the through hole enclosed by the connecting ring 2553 is used for piercing the worm wheel 23. The first rack 2556 includes a series of protrusions protruding toward the rotating wheel 251.

Please refer to FIGS. 2 and 5 together. The sheath tube 50 includes a sheath tube connector 52 connected to the connecting barrel 255 and an inner sheath tube 54 connected to the distal end of the sheath tube connector 52. The end of the sheath connector 52 away from the inner sheath 54 is connected to the connecting barrel 255.

As shown in Figure 2, in this embodiment, the sheath tube connector 52 and the inner sheath tube 54 are fixed by a screw connection. Specifically, the distal end of the sheath tube connector 52 is provided with an internal thread, and the proximal end of the inner sheath tube 54 is provided with an internal thread. There is an external thread, and the internal thread and the external thread are assembled in place and fixed with thread glue, so that the sheath tube connector 52 and the inner sheath tube 54 are fixed together. The sheath joint 52 and the inner sheath 54 can also be fixed in other ways, such as welding.

As shown in FIG. 3, the sheath tube connector 52 has a cylindrical structure, and includes a tube body 521 inserted in the connecting ring 2553 and a second engaging part protruding from the outer surface of the proximal end of the tube body 521.

The second engaging portion includes a clamping ring 523 and a second rack 5232 disposed on the clamping ring 523. The second rack 5232 is disposed at the proximal end of the sheath tube connector 52 and includes a series of protrusions protruding toward the first rack 2556.

The first meshing part is used for meshing with the second meshing part. When the first meshing part and the second meshing part mesh with each other, the second meshing part is meshed with the first rack 2556 of the first meshing part through the second rack 5232. , The sheath joint 52 can move synchronously with the rotating wheel 251 and the connecting cylinder 255. Specifically, the first rack 2556 and the second rack 5232 are used to detachably mesh together, that is, the shapes of the protrusions in the first rack 2556 and the second rack 5232 match each other, and the directions after assembly are directly opposite. .

Further, as shown in FIG. 5, the rotating wheel 251 further includes a rotating ring 2511 and a first elastic member 2515 provided at the distal end of the rotating ring 2511. The rotating ring 2511 is in the shape of a ring and surrounds a through hole for piercing the worm 23. The opposite ends of the first elastic member 2515 respectively elastically abut against the distal end of the rotating ring 2511 and the proximal end of the sheath joint 52 in the axial direction, and are used to carry the first elastic member 2515. The engaging portion pushes the second engaging portion on the sheath tube joint 52 in the direction, so that the second engaging portion engages with the first engaging portion, and the sheath 50 rotates following the connecting barrel 255.

In this embodiment, the first elastic member 2515 includes a spring and an abutting member for abutting the sheath tube connector 52, the rotating wheel 251 is provided with a connecting groove, and the spring is accommodated in the connecting groove. The end abuts against the bottom wall of the connecting groove, and the distal end of the spring abuts against the abutting member. Preferably, the first elastic member 2515 is a spring plunger.

In this embodiment, the proximal surface of the sheath tube 50 is balanced in force, the number of the first elastic members 2515 is three, and the three first elastic members 2515 are evenly arranged along the circumference of the rotating wheel 251, that is, every two adjacent ones The angle between the first elastic member 2515 and the axis of the rotating wheel 251 is 120 degrees.

2 and 7 together, the worm gear assembly 25 and the sheath tube connector 52 can be rotatably received in the receiving cavity 211 of the housing 21. The difference is that the worm gear assembly 25 can move back and forth in the axial direction, and the sheath tube connector 52 It is restricted in the axial direction and cannot move back and forth, so that the first engaging part and the second engaging part can be disengageably engaged with each other. When the first engaging part and the second engaging part are engaged with each other, the sheath tube joint 52 follows the worm gear assembly 25 Synchronous rotation. Specifically, the housing 21 is provided with a receiving groove 212 for accommodating the worm gear assembly 25, and is also provided with a second limiting portion 218 and a third limiting portion 219 for limiting the sheath tube joint 52.

The worm gear assembly 25 is used to be movably received in the receiving groove 212. The two side walls of the receiving groove 212 are respectively a first reinforcing rib 214 and a second reinforcing rib 215 arranged at intervals along the axial direction. The first reinforcing rib 214 is closer to the proximal end than the second reinforcing rib 215, and the bottom of the receiving groove 212 The wall is the shell 21 between the first reinforcing rib 214 and the second reinforcing rib 215.

Further, the first reinforcement ribs 214 and the second reinforcement ribs 215 both extend along the circumference of the receiving groove 212 and protrude toward the axis. In this embodiment, the first reinforcement rib 214 and the second reinforcement rib 215 are both ring-shaped. It is understood that the first reinforcing rib 214 and the second reinforcing rib 215 may also be polygonal or rectangular with a hole in the middle. The receiving groove 212 encloses a receiving space 216, and the worm gear assembly 25 is used for receiving in the receiving space 216 between the first reinforcing rib 214 and the second reinforcing rib 215.

The axial dimension between the adjacent surfaces of the first reinforcement rib 214 and the second reinforcement rib 215 is greater than the sum of the axial extension length of the worm gear assembly 25 and the meshing depth of the first rack 2556 and the second rack 5232, so that the worm gear The assembly 25 can move back and forth in the axial direction; the radial size of the receiving space 216 is slightly larger than the radial size of the worm gear assembly 25, and the cross section of the receiving groove 212 along the axial direction (radial) is circular, so that the worm gear assembly 25 can rotate around its axis in the receiving groove 212. In this embodiment, the inner wall of the housing 21 between the first reinforcing rib 214 and the second reinforcing rib 215 is used to limit the worm gear assembly 25 in the radial direction, so that the axis line of the worm gear assembly 25 coincides with the axis line of the worm 23 , And the worm 23, the worm gear assembly 25, the sheath 50, and the expansion head 80 are coaxial with the extraction device 100.

In the modified embodiment, the inner wall of the housing 21 is provided with a receiving groove along its circumference, and the outer peripheral surface of the worm gear assembly 25 is protruded with a convex ring movably received in the receiving groove, and the receiving groove is along the axis of the housing 21. The length extending in the direction is greater than the length of the convex ring extending in the axial direction of the housing 21, and the convex ring can slide and rotate in the axial direction in the receiving groove.

In a modified embodiment, the inner wall of the housing 21 is provided with a convex ring along its circumference toward the receiving cavity 211, and the outer peripheral surface of the worm gear assembly 25 is provided with a receiving groove along its circumference, and the convex ring can be movably accommodated in the receiving groove The length of the receiving groove extending in the axial direction of the housing 21 is greater than the length of the convex ring extending in the axial direction of the housing 21, so that the convex ring can slide and rotate in the axial direction in the receiving groove.

As shown in FIG. 2, the inner wall of the receiving cavity 211 of the housing 21 is provided with a first limiting portion 217 for limiting the movement of the worm 23 in the radial direction. The first limiting portion 217 is disposed at the proximal end of the receiving groove 212, and the first limiting portion 217 extends from the inner wall of the receiving cavity 211 to the receiving cavity 211. Specifically, the first limiting portion 217 is an annular plate provided on the inner wall of the housing 21. The first limiting portion 217 forms a through hole along the axial direction. The worm 23 is inserted into the through hole of the first limiting portion 217 in the axial direction and then can slide in the axial direction. The axis lines coincide, and the inner diameter of the through hole of the first limiting portion 217 is slightly larger than the outer diameter of the worm 23 to limit the worm 23 in the radial direction of the extraction device 100.

The second limiting portion 218 is provided on the inner wall of the receiving cavity 211 of the housing 21 and is used for limiting the sheath joint 52 in the radial direction of the extraction device 100. The second limiting portion 218 is disposed at the distal end of the receiving groove 212, and the second limiting portion 218 is an annular plate protruding from the inner wall of the housing 21 toward the receiving cavity 211. The second limiting portion 218 forms a through hole along the axial direction, the sheath tube connector 52 is inserted into the through hole of the second supporting plate 218, and the inner diameter of the through hole of the second limiting portion 218 is slightly larger than the corresponding sheath tube connector 52. The outer diameter of the sheath tube connector 52 is limited in the radial direction of the extraction device 100.

As shown in Figures 2 and 9, the distal end of the inner wall of the receiving cavity 211 of the housing 21 is provided with a third limiting portion 219 for limiting the sheath 50 in the radial and axial directions, and the third limiting portion 219 is disposed adjacent to the distal end of the housing 21 relative to the second limiting portion 218. The third limiting portion 219 protrudes from the inner wall of the housing 21 toward the receiving cavity 211, and in this embodiment, is in the shape of an annular plate. The distal end of the sheath connector 52 in the housing 21 defines a limiting groove 5212 (FIG. 9) corresponding to the third limiting portion 219, and the third limiting portion 219 is used to be rotatably received in the limiting groove 5212 to define The range of movement of the proximal end of the sheath tube 50 in the radial and axial directions makes the sheath tube 50 hardly move relative to the housing 21 in the axial and radial directions, and the sheath tube 50 can rotate relative to the housing 21.

In the modified embodiment, the first limiting portion, the second limiting portion, and the third limiting portion may adopt the implementation of the first reinforcing rib 214 and the second reinforcing rib 215 (FIG. 7) as described above, or the present Other limit methods commonly used in the field are used to limit components, so I won’t repeat them here.

Please refer to FIGS. 3 and 6 together. When assembling the worm 23, the worm gear assembly 25 and the sheath tube joint 52, the rotating wheel 251 is rotatably sleeved outside the rod body 230, specifically, the guide pin 2510 of the rotating wheel 251 The distal end of the rod 230 is slidably inserted into the first guide groove 232; the end of the tube body 521 of the sheath tube connector 52 away from the clamping ring 523 is inserted into the cylinder 2551 of the connecting cylinder 255 from the proximal end, and from the connecting cylinder 255 The through hole of the distal end penetrates until the second rack 5232 of the clamping ring 523 and the first rack 2556 of the connecting ring 2553 mesh with each other; the assembled worm 23 and the rotating wheel 251 are mounted on the connecting cylinder 255, specifically Ground, one end of the rod body 230 provided with a bidirectional spiral groove 231 is inserted into the inner cavity of the sheath tube connector 52 from the proximal end of the sheath tube connector 52, and the rotating wheel 251 is clamped to the connecting cylinder 255, specifically, the clamping block of the connecting cylinder 255 2554 is respectively clamped in the corresponding clamping holes 2512 of the rotating wheel 251, so that the connecting cylinder 255 and the rotating wheel 251 are fixedly connected. At this time, the first elastic member 2515 elastically pushes the clamping ring 523 to make the first rack 2556 and the second rack 5232 mesh with each other; the distal end of the rod 230 is inserted into the inner cavity of the sheath joint 52 to drive the worm gear assembly 25 to face each other The worm 23 rotates in both directions.

As shown in FIG. 2, the proximal end of the manipulation handle 20 is also provided with a second elastic member 265 that moves synchronously with the worm 23, and the second elastic member 265 is used to drive the operating member 26 to move toward the distal end. Specifically, the second elastic member 265 is received in the receiving cavity 211 of the housing 21, and opposite ends of the second elastic member 265 abut against the proximal end of the connecting portion 261 of the operating member 26 and the proximal boundary of the receiving cavity 211, respectively. . The operating member 26 is used to receive external pulling force to drive the worm 23 to slide proximally in the axial direction and compress the second elastic member 265. When the external pulling force disappears, the second elastic member 265 rebounds and generates a force for pushing the operating member 26 and the worm 23 Elastic restoring force for distal movement. In this embodiment, the second elastic member 265 is a spring.

The control handle is provided with a tubular sheath 267 at one end of the second elastic member 265 close to the operating member 26. The sheath 267 includes a tubular main body 2671 and a bent portion 2673 extending from the main body 2671 toward the axis. The main body 2671 is sleeved on the periphery of the distal end of the second elastic member 265, and the distal end of the second elastic member 265 can be compressed or stretched in the main body 2671 in the axial direction. The side of the bending portion 2673 facing the proximal end abuts against the distal end of the second elastic member 265, and the side of the bending portion 2673 facing the distal end abuts the proximal end of the operating member 26. The length of the main body 2671 in the axial direction is greater than the length of the guide groove 213 in the axial direction. When the sheath 267 and the second elastic member 265 slide synchronously with the operating member 26, the sheath 267 can prevent the second elastic member 265 from moving radially. It deforms toward the inside of the guide groove 213 or extends through the guide groove 213 to the outside of the housing 21.

As shown in FIG. 2, the proximal end of the housing 21 is provided with a guide groove 213 communicating with the receiving cavity 211 along the axial direction. The operating member 26 includes a first part and a second part extending from the first part to at least one side. The second part is accommodated in the inner cavity of the housing 20, and the second part extends through the guide groove 213 to the outside of the housing 20, and the operating member 26 can slide along the guide groove 213. In this embodiment, the first part is a connecting part 261, and the second part is a handle 263 provided on opposite sides of the connecting part 261. The connecting part 261 is slidably accommodated in the housing 20 along the axial direction. The two handles 263 respectively extend through the guide slot 213 to the outside of the housing 21. The proximal end of the worm 23 is connected to the connecting portion 261, and the connecting portion 261 slides in the axial direction to drive the worm 23 to slide in the axial direction. The guide groove 213 extends in the axial direction and has a long enough length so that the operating member 26 can slide back and forth in the axial direction along the guide groove 213, and limits the movement range of the operating member 26 in the circumferential direction so that it cannot rotate around the axial direction. Therefore, the operating member 26 can drive the worm 23 to slide in the axial direction along the guide groove 213, but cannot drive the worm 23 to rotate in the circumferential direction.

In this embodiment, two opposite guide grooves 213 are provided on the housing 21, and the operating member 26 is pulled proximally to drive the connecting portion 261 to slide along the guide groove 213, and the sliding of the connecting portion 261 drives the worm 23 to slide. It can be understood that, in the modified embodiment, the operating member 26 includes a connecting portion 261 slidably along the guide groove 213 and a handle extending outward from the connecting portion 261, and the one handle extends through the guide groove 213 to the housing 21. outer.

Please refer to Figure 2, Figure 4 and Figure 9 again, the worm 23 is provided with a threading channel 2301 along the axial direction, the threading channel 2301 is connected to the threading lumen of the sheath 50, and the proximal opening formed at the proximal end of the threading channel 2301 is located at the worm 23 The proximal end of the guide wire 500 passes through the expansion head 80, the threading lumen of the sheath tube 50, and the threading channel of the worm 23 in sequence, and then passes through the housing 21 so that the operator, such as a surgeon, can take it out from the control handle 20 The wire after peeling off the fibrous tissue.

As shown in FIG. 9, the side wall of the housing 21 is provided with an outlet hole 2101 corresponding to the opening of the threading channel 2301. After the proximal end of the wire 500 passes through the distal opening 2301 of the threading channel, the extraction device 100 is extended through the outlet hole 2101. . The outlet hole 2101 is close to the proximal end of the operating member 26. The distal opening 2301 of the threading channel extends in the axial direction, and the proximal end of the wire 500 extends to the outlet hole 2101 through the distal opening 2301.

The housing 21 is also provided with a guide portion 2105 extending from the edge of the wire outlet hole 2101 into the distal opening 2301 of the wire channel. The wire 500 at the distal opening 2301 of the wire channel slides out of the wire hole 2101 along the guide portion 2105. Preferably, the end of the guide portion 2105 abuts against the boundary of the threading channel away from the distal opening 2301. When the worm 23 slides toward the proximal end in the axial direction, the tip of the guide portion 2105 slides in the distal opening 2301, and the guide portion 2105 and the threading channel The boundary of the wire 500 is seamlessly connected, and does not block the proximal end of the wire 500, and it is more convenient for the proximal end of the wire 500 to pass through the outlet hole 2101 along the guide portion 2105.

As shown in FIG. 2, the housing 21 has a tubular structure with a closed proximal end, and the housing 21 includes a body 209 and an end block 210 connected to each other. The main body 209 extends in the axial direction. The above-mentioned receiving cavity 211, the receiving groove 212, the first limiting portion 217, the second limiting portion 218, and the third limiting portion 219 are all provided in the main body 209, and the end block 210 is connected to The proximal end of the main body 209 is different from the extending direction of the main body 209. In this embodiment, the end block 210 is perpendicular to the extension direction of the body 209, that is, the end block 210 extends in a radial direction perpendicular to the axial direction. It can be understood that, in the modified embodiment, the extending direction of the end block 210 and the main body 209 is other than parallel and perpendicular. In addition, the end block 210 may extend from the proximal end of the body 209 to one or both sides in the radial direction or in the circumferential direction. Specifically, in this embodiment, the end block 210 is symmetrical about the axial direction (axis). In other words, the end block 210 extends from the proximal end of the body 209 to two opposite sides in the radial direction. Further, the end block 210 has a fishtail shape, and the fishtail shaped end block 210 can increase the contact area with the surgeon's fingers, which is convenient for operation. In the modified embodiment, the end block 210 may also adopt other shapes, such as a bar shape, a cone shape, a three-dimensional shape including a free-form surface, or other regular or irregular shapes.

The distal end of the housing 21 is provided with a hollow soft glue nozzle 2107, and the sheath tube 50 passes through the soft glue nozzle 2107; the outer sheath 55 is sheathed on the periphery of the sheath tube 50, and the proximal end of the outer sheath 55 is inserted into the soft glue nozzle Within 2107.

As shown in FIG. 2, the assembled worm gear assembly 25, worm 23, and sheath tube joint 52 are installed in the housing 21. Specifically, the worm gear assembly 25 is housed in the housing space 216 of the housing 21, and the connecting post of the worm 23 235 is connected to the distal end of the connecting portion 261, the first limiting portion 217 supports the worm 23 so that the worm 23 can slide in the axial direction; the guide portion 2105 is slidably inserted into the sliding groove 2303; the second limiting portion 218 supports the sheath tube joint The tube body 521 and the third limiting portion 219 of 52 are rotatably inserted into the limiting groove 5212 of the tube body 521, so that the sheath tube joint 52 can rotate with the worm gear assembly 25, but cannot slide in the axial direction. The proximal end of the sheath tube 50 is fixedly connected to the distal end of the sheath tube connector 52 by a screw connection. At this time, the expansion head 80 and the threading lumen of the sheath tube 50, the threading channel of the worm 23 and the threading hole 2101 of the housing 21 (such as 9) are connected to each other to form a continuous threading cavity 201 for the transmission wire 500 to facilitate the insertion of the wire 500.

Please refer to FIGS. 2, 7 and 9 together. During the specific operation of taking out the device 100, the doctor inserts the lead 500 in the patient's body, such as the proximal end of the electrode lead, into the threading cavity of the expansion head 80; the doctor grasps and manipulates The handle 20 pushes the control handle 20 distally, so that the sheath 50 and the expansion head 80 gradually enter the patient's blood vessel along the electrode lead 500; when the resistance to push the control handle 20 distally is large, the expansion head 80 is indicated It conflicts with the tissues surrounding the wire 500.

Pulling the operating member 26 to the proximal end drives the worm 23 to slide in the axial direction toward the proximal end, and the worm 23 drives the worm gear assembly 25 to move proximally until the proximal end of the rotating wheel 251 abuts the first reinforcing rib 214 and connects to the distal end of the barrel 255 The gap between the surface and the second reinforcing rib 215 is increased; the first elastic member 2515 elastically pushes the clamping ring 523 so that the first rack 2556 and the second rack 5232 mesh. The worm 23 slides toward the proximal end, and the inner surface of the second guide groove 233 slidably pushes against the guide pin 2510 of the rotating wheel 251 to drive the rotating wheel 251 in the first direction (that is, as viewed from the proximal end to the distal end of the extraction device 100). Since the rotating wheel 251 is fixedly connected to the connecting cylinder 255, and the first rack 2556 is engaged with the second rack 5232, the rotating wheel 251 drives the sheath joint 52, the sheath 50 and the expansion head 80 Rotate in the first direction, so that the sharp blade of the expansion head 80 cuts the tissue bonded around the guide wire 500.

Continue to pull the operating member 26 toward the proximal end to drive the worm 23 to continue to slide in the axial direction toward the proximal end. The guide pin 2510 of the rotating wheel 251 slides along the second guide groove 233 until it passes the steering switching portion 234, and the guide of the rotating wheel 251 The sliding pin 2510 slides along the first guide groove 232 to drive the rotating wheel 251 to rotate in the second direction (that is, the counterclockwise direction viewed from the proximal end to the distal end of the retrieval device 100); the rotating wheel 251 drives the sheath tube connector 52 and the sheath The tube 50 and the expansion head 80 rotate in the second direction, so that the sharp blade of the expansion head 80 cuts the tissue around the electrode lead; until the operating member 26 slides proximally along the guide groove 213 until the connecting portion 261 abuts The proximal end of the top two-way spiral groove 231.

In the entire process of pulling the operating member 26 toward the proximal end, the worm 23 first drives the rotating member and the sheath 50 to rotate in the first direction. When the guide slide pin 2510 passes the steering switch portion 234, the worm 23 then drives the rotating member and the sheath 50 Rotating 50 in the second direction not only enables the expansion head 80 to effectively cut the fibrous tissue wrapped around the guide wire 500, but also prevents other wires in the blood vessel from being entangled with each other and preventing the blood vessel wall from twisting and being scratched by the expansion head 80.

It can be seen from the specific operation process of the extraction device 100 that the operating member 26 includes a first period and a second period in the process of compressing the second elastic member 265. In the first period, the guide sliding pin 2510 is in the second guide groove 233. Sliding, that is, the sliding guide pin 2510 slides from the proximal end of the second guide groove 233 to the steering switching portion 234, corresponding to the worm gear assembly 25 rotating clockwise relative to the worm 23; in the second time period, the sliding guide pin 2510 is in the first Sliding in the guide groove 232, the guide sliding pin 2510 slides from the steering switching portion 234 to the distal end of the first guide groove 233, corresponding to the worm gear assembly 25 rotating counterclockwise relative to the worm 23. That is, when the operating member 26 compresses the second elastic member 265, the linear motion of the worm 23 is converted to the rotation of the worm gear assembly 25, and the worm gear assembly 25 realizes bidirectional rotation relative to the worm 23, first turning clockwise and then turning counterclockwise. In this embodiment, the angle at which the sheath 50 rotates clockwise and counterclockwise is about 280 degrees.

Please refer to FIGS. 2, 8 and 9 together. During the proximal movement of the worm 23, the second elastic member 265 is compressed to produce elastic deformation, and the compressed second elastic member 265 rebounds to generate elastic restoring force Used to push the worm 23 to move distally. When the tension on the control handle 20 is released, that is, the operating member 26 of the control handle 20 is released, the elastic force generated by the second elastic member 265 pushes the operating member 26 distally to drive the worm 23 to slide toward the distal end in the axial direction, and the worm 23 drives the worm gear assembly 25 moves to the distal end until the distal end of the rotating member abuts against the second reinforcing rib 215, the gap between the proximal surface of the rotating wheel 251 and the first reinforcing rib 214 increases; because the sheath joint 52 is axially relative to the housing 21 Fixed, therefore, the gap between the connecting ring 2553 and the clamping ring 523 increases until the gap between the first rack 2556 and the second rack 2532 is greater than the maximum engagement depth between the two, so that the first tooth The bar 2556 and the second rack 5232 are separated from each other, that is, the sheath tube joint 52 and the worm gear assembly 25 are not clamped. After the first meshing portion and the second meshing portion are disengaged from each other, the worm gear assembly 25 continues to rotate under the drive of the axial movement of the worm 23, and the rotation of the worm gear assembly 25 will not drive the sheath joint 52, the sheath 50 and the expansion head 80 rotations.

After the first meshing portion and the second meshing portion are separated from each other, the inner surface of the first guide groove 232 on the worm 23 continues to slide against the guide pin 2510 of the rotating wheel 251 to drive the rotating wheel 251 to continue along the first Since the sheath tube connector 52 and the worm gear assembly 25 are separated from each other, the friction force generated by the first elastic member 2515 of the worm wheel assembly 25 on the sheath tube connector 52 cannot drive the sheath tube connector 52 to rotate, therefore, the first elastic member 2515 The end of the clip slides along the proximal surface of the snap ring 523.

Since the rotating wheel 251 is fixedly connected to the connecting cylinder 255, the second elastic member 265 continues to push the operating member 26 to slide proximally, and the operating member 26 continues to drive the worm 23 to slide toward the distal end in the axial direction. The sliding guide pin 2510 of the rotating wheel 251 After sliding along the first guide groove 232 to pass the steering switching portion 234, the guide pin 2510 of the rotating wheel 251 slides along the second guide groove 233 to drive the rotating wheel 251 to rotate in the second direction; but the rotating wheel 251 will not drive The sheath joint 52, the sheath 50, and the expansion head 80 rotate.

During the rebound of the second elastic member 265, that is, after the operating member 26 is released, the sheath tube 50 and the expansion head 80 will not follow the rotation of the worm gear assembly 25, thereby reducing the rotation load of the worm gear assembly 25, which is beneficial to the rotation of the wheel 251. The guide sliding pin 2510 smoothly slides from the distal end of the first guide groove 232 to the proximal end of the second guide groove 233, so as to prevent the guide sliding pin 2510 from getting stuck in the two-way spiral groove 231, especially near the steering switch portion 234. .

When the operating member 26 slides along the guide groove 213 to the vicinity of the proximal end of the abutting guide groove 213, specifically, when the worm 23 moves from the proximal end to the farthest end in its axial movement range, the first rack 2556 and the first rack 2556 The two racks 5232 mesh with each other.

As shown in FIGS. 2 to 3, the proximally-directed thrust exerted by the first elastic member 2515 on the rotating wheel 251 is the first thrust, and the second elastic member 265 exerts the distally-directed force on the rotating wheel 251 through the worm 23. The thrust is the second thrust. During the rebound of the second elastic member 265, the elastic force gradually decreases, that is, the second thrust force gradually decreases. When the first thrust is greater than the second thrust, the first elastic member 2515 pushes the rotating wheel 251 and the connecting cylinder 255 to move proximally relative to the sheath joint 52 until the first rack 2556 and the second rack 5232 Engagement means that the first meshing portion and the second meshing portion are meshed with each other, so that the second elastic member 265, the operating member 26, the worm 23, and the worm gear assembly 25 return to the initial position, which is convenient for the user to pull the manipulation handle 20 toward the proximal end again. .

In other embodiments, the first elastic member 2515, the first rack 2556, and the second rack 5232 are omitted from the worm gear assembly 25, and the connecting barrel 255 is directly and fixedly connected to the sheath joint 52, that is, the distal end of the connecting barrel 255 is fixedly connected At the proximal end of the sheath connector 52 (for example, the connecting barrel 255 and the sheath connector 52 are integrally formed), the proximal end of the sheath connector 52 cannot be separated from the worm gear assembly 25. That is, in this embodiment, the process of the worm 23 moving toward the proximal end is the same as the foregoing embodiment. During the process of the worm 23 moving to the distal end, the worm gear assembly 25 drives the sheath joint 52 to rotate synchronously, that is, after the operating member 26 is released, The sheath 50 and the expansion head 80 rotate in two directions along with the worm gear assembly 25.

The above is the implementation of the embodiments of the present application. It should be pointed out that for those of ordinary skill in the art, without departing from the principle of the embodiments of the present application, several improvements and modifications can be made, and these improvements and modifications are also Treated as the scope of protection of this application.

Claims

A take-out device for taking out a slender structure implanted in the body, characterized in that the take-out device includes a control handle, a sheath connected to the distal end of the control handle, and a distal end connected to the sheath The expansion head, wherein the control handle includes a driving part and a rotating part, one end of the rotating part is connected to the proximal end of the sheath, the other end of the rotating part is connected to the driving part, and the driving part is used for The rotating member is driven to rotate in two directions to drive the sheath and the expansion head to rotate in two directions.
The extraction device according to claim 1, wherein:

The driving member includes a worm, the outer peripheral surface of the worm is provided with a bidirectional spiral groove, two ends of the bidirectional spiral groove respectively extend spirally in opposite directions;

The rotating member includes a worm gear assembly, the worm gear assembly is formed with a through hole for passing through the worm, and the surface of the worm gear assembly is also provided with a guide sliding pin for inserting in the bidirectional spiral groove;

During the axial movement of the worm, the guide sliding pin slides in the bidirectional spiral groove, and both ends of the bidirectional spiral groove drive the worm gear assembly to rotate in opposite directions through the guide sliding pin.
The retrieval device according to claim 2, wherein the guide pin is slid from the proximal end to the distal end of the bidirectional spiral groove, or is slid from the distal end of the bidirectional spiral groove to the proximal end. Wherein, the two-way spiral groove is used to drive the worm gear assembly to rotate in two opposite directions.
The extraction device according to claim 3, wherein the bidirectional spiral groove comprises a first guide groove provided on the outer peripheral surface of the worm and a second guide groove connected to the proximal end of the first guide groove, so The first guide groove spirally extends in a first direction, the second guide groove spirally extends in a second direction, and the first direction is opposite to the direction of the spiral extension in the second direction.
The extraction device according to claim 4, wherein the two-way spiral groove comprises a steering switch portion, the steering switch portion is connected between the first guide groove and the second guide groove, and the guide After the sliding pin passes the steering switching part, the worm drives the worm gear assembly to rotate in the opposite direction.
The extraction device according to claim 2, wherein the worm gear assembly comprises:

A rotating wheel, the surface of the rotating wheel is provided with the guide sliding pin; and

A connecting cylinder is buckled on the edge of the rotating wheel, and both the connecting cylinder and the rotating wheel are provided with the through hole for piercing the worm in the axial direction;

Driven by the worm, the rotating wheel rotates in two opposite directions, and the connecting cylinder moves in synchronization with the rotating wheel.
The take-out device according to claim 6, wherein the connecting cylinder and the rotating wheel are clamped and fixed to each other.
The removal device according to claim 7, wherein the sheath tube comprises a sheath tube connector and an inner sheath tube, and both ends of the inner sheath tube are respectively connected to the expansion head and the sheath tube connector, and the sheath tube The proximal end of the joint is connected with the worm gear assembly.
8. The extraction device according to claim 8, wherein the sheath tube joint is fixedly connected to the connecting barrel of the worm gear assembly.
The extraction device according to claim 8, wherein the proximal end of the sheath tube joint and the distal end of the connecting barrel are sleeved with each other.
The extraction device according to claim 10, wherein:

The corresponding positions of the proximal end and the distal end of the connecting barrel are provided with the through holes;

The proximal end of the sheath tube connector is sleeved inside the distal end of the connecting barrel, and the distal end of the sheath tube connector extends through the through hole at the distal end of the connecting barrel to the outside of the connecting barrel.
The extraction device according to claim 11, wherein the distal end of the connecting cylinder is formed with a first engaging portion protruding toward the proximal end of the sheath tube connector, and the proximal end of the sheath tube connector is provided with a The second engaging portion protruding in the direction of the first engaging portion, when the first engaging portion and the second engaging portion engage with each other, the sheath tube joint follows the connecting barrel to make a synchronous movement.
The extraction device according to claim 12, wherein the first engaging portion includes a first rack provided on the connecting barrel, and the second engaging portion includes a first rack provided on the sheath tube joint. Two racks, the first rack can disengageably engage the second rack.
The extraction device according to claim 12, wherein:

The position of the sheath tube joint in the axial direction is fixed;

When the worm moves proximally in the axial direction, the rotating wheel drives the connecting cylinder to follow the worm to move proximally with respect to the sheath tube joint, so that the first engaging portion and the second engaging portion Mutually meshing

When the worm moves distally in the axial direction, the rotating wheel drives the connecting cylinder to follow the worm to move distally with respect to the sheath tube joint, so that the first meshing portion and the second meshing portion that mesh with each other gradually Break away.
The extraction device according to claim 14, wherein after the first meshing portion and the second meshing portion are disengaged from each other, the worm gear assembly is driven by the axial movement of the worm to continue to rotate.
The retrieval device according to claim 14, wherein when the worm moves from the proximal end to the farthest end in the axial movement range, the first engaging portion and the second engaging portion are mutually engaged.
The extraction device according to claim 16, wherein the rotating wheel comprises a rotating ring and a first elastic member disposed at the distal end of the rotating ring, and both ends of the first elastic member are elastically pressed against each other in the axial direction. Connect the distal end of the rotating ring to the proximal end of the sheath tube joint, so that when the worm moves to the proximal end and when the worm moves to the farthest end of its axial movement range, it is ensured that all The first engaging portion and the second engaging portion are engaged with each other.
The retrieval device according to claim 17, wherein the proximal end of the control handle is further provided with a second elastic member that moves synchronously with the worm;

When the worm moves proximally, the second elastic member is compressed and elastically deformed, and the elastic restoring force generated by the rebound of the compressed second elastic member is used to push the worm to move distally;

The proximally directed thrust exerted by the first elastic member on the rotating wheel is a first thrust, and the distally directed thrust exerted by the second elastic member on the rotating wheel through the worm is a second thrust, During the rebound of the second elastic member, when the first thrust is greater than the second thrust, the first elastic member pushes the rotating wheel to move proximally relative to the sheath joint, So that the first engaging portion and the second engaging portion are engaged with each other.
The retrieval device according to claim 18, wherein the control handle further comprises an operating member connected between the worm and the second elastic member, and the operating member is used to receive an external pulling force to drive the The worm slides toward the proximal end in the axial direction and compresses the second elastic member. After the external pulling force disappears, the second elastic member rebounds and generates elasticity for pushing the operating member and the worm to move distally Resilience.
The extraction device according to claim 15, wherein the control handle further comprises a housing, and the housing is provided with a limiting portion extending toward the axis of the extraction device on its inner wall surface, and the limiting portion is used for The range of motion of the sheath tube joint in the axial direction is limited.
The extraction device according to claim 20, wherein the sheath tube connector defines a limiting groove corresponding to the limiting portion, and the limiting portion is used to be accommodated in the limiting groove, and the limiting groove The position portion is used to define the radial and axial movement range of the sheath tube joint.
The extraction device according to claim 21, wherein the inner wall of the housing is provided with a receiving groove, the worm gear assembly is used to be received in the receiving groove, and two side walls of the receiving groove are respectively along the axis The first reinforcement rib and the second reinforcement rib are arranged at intervals, the length of the worm gear assembly in the axial direction is the length of the worm gear, and the meshing length of the first meshing portion and the second meshing portion in the axial direction is meshing Depth, the axial dimension between the mutually adjacent surfaces of the first reinforcing rib and the second reinforcing rib is greater than the sum of the length of the worm gear and the depth of engagement.
The extraction device according to claim 20, wherein the driving member and the rotating member are disposed in the inner cavity of the housing, and the proximal end of the sheath tube connector is inserted into the outer cavity from the distal end of the housing. The inner cavity of the housing is connected with the rotating part.
The extraction device according to claim 20, wherein:

The housing is provided with a guide groove penetrating to its inner cavity, and the guide groove extends in the axial direction;

The control handle further includes an operating member connected to the proximal end of the worm, the operating member includes a first part and a second part extending from the first part to at least one side, the first part being accommodated in the housing In the inner cavity, the second part extends through the guide groove to the outside of the housing, and the operating member can slide along the guide groove.
The retrieval device according to claim 20, wherein the expansion head and the sheath tube are both provided with a threading lumen for transmitting the elongated structure, the worm is provided with a threading channel along the axial direction, and The housing is provided with an outlet hole corresponding to the opening of the threading channel, and the proximal end of the elongated structure passes through the threading lumen of the expansion head, the threading lumen of the sheath, the threading channel and the threading hole in sequence Extend the extraction device.
The extraction device according to claim 25, wherein the distal opening of the threading channel is opened on the side wall of the worm, and the housing is further provided with a guide part which extends from the wire outlet hole. The edge of the threading channel extends into the distal opening of the threading channel, and the elongated structure at the distal opening of the threading channel slides out of the wire outlet hole along the guide part.