WO2022134714A1 - 球囊导管及消融系统 - Google Patents

球囊导管及消融系统 Download PDF

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Publication number
WO2022134714A1
WO2022134714A1 PCT/CN2021/121399 CN2021121399W WO2022134714A1 WO 2022134714 A1 WO2022134714 A1 WO 2022134714A1 CN 2021121399 W CN2021121399 W CN 2021121399W WO 2022134714 A1 WO2022134714 A1 WO 2022134714A1
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Prior art keywords
temperature measuring
balloon
wire
components
limiting
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PCT/CN2021/121399
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English (en)
French (fr)
Inventor
奚云珠
梁波
吴启明
姚孙武
黄利
孙毅勇
Original Assignee
上海微创电生理医疗科技股份有限公司
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Application filed by 上海微创电生理医疗科技股份有限公司 filed Critical 上海微创电生理医疗科技股份有限公司
Priority to US18/269,410 priority Critical patent/US20240050711A1/en
Priority to EP21908715.2A priority patent/EP4268880A1/en
Publication of WO2022134714A1 publication Critical patent/WO2022134714A1/zh

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/01Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/01Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue
    • A61B5/015By temperature mapping of body part
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/68Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A61B5/6852Catheters
    • A61B5/6853Catheters with a balloon
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • A61B2018/00023Cooling or heating of the probe or tissue immediately surrounding the probe with fluids closed, i.e. without wound contact by the fluid
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00214Expandable means emitting energy, e.g. by elements carried thereon
    • A61B2018/0022Balloons
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345Vascular system
    • A61B2018/00351Heart
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345Vascular system
    • A61B2018/00351Heart
    • A61B2018/00375Ostium, e.g. ostium of pulmonary vein or artery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345Vascular system
    • A61B2018/00404Blood vessels other than those in or around the heart
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00434Neural system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00505Urinary tract
    • A61B2018/00511Kidney
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577Ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00696Controlled or regulated parameters
    • A61B2018/00714Temperature
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00791Temperature
    • A61B2018/00797Temperature measured by multiple temperature sensors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00964Features of probes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A61B2018/0212Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques using an instrument inserted into a body lumen, e.g. catheter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A61B2018/0231Characteristics of handpieces or probes
    • A61B2018/0262Characteristics of handpieces or probes using a circulating cryogenic fluid

Definitions

  • the invention relates to the technical field of medical devices, in particular to a balloon catheter and an ablation system.
  • Atrial fibrillation patients with atrial fibrillation have a high risk of stroke.
  • atrial fibrillation occurs, the atrium beats irregularly and rapidly, losing its systolic function, and blood is easily stagnated in the atrium to form a thrombus. stroke.
  • the pulmonary vein is ablated by applying energy to the pulmonary vein through the interventional catheter, so as to isolate the pulmonary vein potential, and the therapeutic effect can be achieved.
  • Hypertension has the characteristics of high incidence, low awareness and great harm.
  • Experimental data have demonstrated that hypertension is associated with elevated renal sympathetic nerve excitability in patients. Blocking renal sympathetic nerves by ablation can not only reduce blood pressure, but also have an impact on chronic organ-specific diseases caused by excessive sympathetic nerve activation.
  • Ablation can be performed by means of cryoballoon ablation.
  • Cryoballoon ablation is based on anatomical considerations, using the contact between the balloon and the tissue for freezing, and has the characteristics of disposable and continuous.
  • a cryoablation balloon catheter is used, a balloon is arranged at the distal end of the catheter, and a freezing device is connected at the proximal end.
  • the surgeon places the cryoablation balloon catheter into the cardiac cavity through the percutaneous puncture approach, reaches the pulmonary vein port, inflates the balloon, adjusts the contact between the outer wall of the balloon and the myocardial tissue, and then injects fluid into the cryoablation balloon catheter.
  • the tube sprays the frozen liquid directly to the inner surface of the balloon, and the frozen liquid is rapidly vaporized and absorbed heat under the influence of the conduction heat of the myocardium, so that the myocardial tissue in contact with the balloon is cooled to produce cryoablation.
  • the myocardial tissue can only form an effective ablation focus when the hypothermia reaches enough time.
  • the inside of the cryoablation balloon catheter is equipped with a temperature sensor.
  • the temperature sensor is placed in the middle of the balloon to monitor the inside of the balloon.
  • the estimated balloon surface temperature may have a large deviation from the actual temperature, resulting in low accuracy of the balloon surface temperature, which directly affects the ablation effect.
  • a balloon catheter with a linear sensor has been disclosed, and the temperature measuring component can be displaced relative to the balloon, so that the temperature measuring component can better comply with the expansion or contraction of the balloon, but the applicant found that with With the increase of the number of temperature measuring components in the balloon part, the number of wires of the temperature measuring components between the outer tube and the core rod of the balloon catheter will also increase.
  • the wires interfere with each other during the activity, the active space of the wires will be bound, which will easily cause the wires to be broken by force, so that the monitoring of the surface temperature of the balloon cannot be realized.
  • use of balloon catheters In addition, the intertwining of the wires will also hinder the movement of the core rod, which affects the surgical operation and increases the difficulty of the surgical operation.
  • the purpose of the present invention is to provide a balloon catheter and an ablation system.
  • a limiting member outside the lead wire of the temperature measuring component, the interference between the lead wires can be effectively prevented, and the problem of the lead wire breaking under force can be avoided. It can also solve the problem that the guide wire hinders the movement of the catheter body, thereby improving the reliability of the instrument and reducing the difficulty of surgical operation.
  • a balloon catheter provided by the present invention includes a catheter body, a balloon, a temperature measuring component and a limiting component;
  • the balloon is arranged at the distal end of the catheter body;
  • the temperature measurement component includes a wire and a temperature measurement module, the temperature measurement module is arranged on the balloon or the catheter body, and the temperature measurement component is a portion of the guide wire is disposed within the cavity of the catheter body and extends axially of the cavity of the catheter body;
  • the limiting component is arranged in the cavity of the catheter body, and is used to limit the position of the wire of the temperature measuring component in the cavity of the catheter body.
  • the catheter body includes an outer tube and a core rod disposed in the outer tube, the distal end of the core rod extends out of the outer tube, and an annular space is formed between the outer tube and the core rod.
  • a cavity the distal end of the balloon is connected with the core rod, the proximal end of the balloon is connected with the outer tube, the cavity of the catheter body includes the annular cavity; the limiting member is provided with in the annular cavity.
  • the number of the temperature measuring components is multiple;
  • the number of the limiting components is the same as the number of the temperature measuring components, a plurality of the limiting components are separately arranged in the cavity of the catheter body, and the wires of the multiple temperature measuring components pass through different
  • the limit component, or, the number of the limit components is at least one and less than the number of the temperature measurement components, some of the wires of the temperature measurement components pass through the limit components, and each of the The limiting part is used for passing through a wire of the temperature measuring part.
  • the conducting wires of the temperature measuring components configured with the limiting components are arranged non-adjacently, or at least the adjacent limiting components are arranged staggered along the axial direction of the cavity of the catheter body.
  • the limiting member is fixedly connected to the inner wall of the outer tube or the outer wall of the core rod, or the balloon catheter further includes a control handle, which is arranged at the proximal end of the catheter body, and the The limiting component is fixedly connected with the control handle.
  • the number of the limiting members is multiple, the multiple limiting members are circumferentially spaced around the axis of the core rod, and the multiple limiting members are sequentially connected to form an annular structure.
  • the limiting member includes a sleeve, and the inside of the sleeve is used to pass the wire of the temperature measuring member to limit the position of the wire of the temperature measuring member, and a plurality of the sleeves are used. connected in sequence to form the annular structure, or, the limiting member includes an annular ring, and the inside of the annular ring is used to pass the wire of the temperature measuring member to limit the position of the wire of the temperature measuring member, A plurality of the annular rings are sequentially connected to form the annular structure, and a linear elastic body is connected between adjacent annular rings.
  • the limit component includes a first limit component and a second limit component, the first limit component is used to limit the position of the wire of the temperature measuring component, and the second limit component is used for to limit the position of the first limiting member;
  • the number of the first limiting components is multiple, and the plurality of the first limiting components are circumferentially spaced around the axis of the core rod;
  • the number of the second limit parts is multiple and less than the number of the first limit parts, some of the second limit parts are provided outside the first limit parts, and a plurality of the first limit parts are provided.
  • the two limiting components are connected in sequence to form a ring structure, or the number of the second limiting components is the same as the number of the first limiting components, and an external limiting component is provided outside each of the first limiting components.
  • the second limiting member is connected in sequence to form an annular structure.
  • the first limiting member is a sleeve
  • the second limiting member is an annular ring
  • the sleeve is arranged inside the annular ring
  • the inside of the sleeve is used for passing the sleeve.
  • a plurality of the annular rings are sequentially connected to form the annular structure, and a linear elastic body is connected between adjacent annular rings.
  • the number of the annular structures is one or more, and a plurality of the annular structures are arranged at intervals along the axial direction of the cavity of the catheter body.
  • the number of the temperature measuring components is multiple, and a part of the wires of the multiple temperature measuring components are all arranged in the cavity of the catheter body and extend along the axial direction of the cavity of the catheter body; Wherein, a wire of the temperature measuring component is passed through each of the limiting components constituting the annular structure, and the number of the limiting components constituting the annular structure is less than or equal to the temperature measuring component. the number of warm parts.
  • the limiting member includes a sleeve, and the inside of the sleeve is used to movably pass through the wire of the temperature measuring member, so as to limit the position of the wire of the temperature measuring member;
  • the sleeve includes a constricted portion and at least one enlarged portion, the cross-sectional area of the lumen of the constricted portion is smaller than the cross-sectional area of the lumen of the enlarged portion;
  • the lead wire of the temperature measuring component includes an extension part and at least one bending part, the bending part can be stretched and contracted; the extension part is arranged in the contraction part, and the bending part is arranged in the expansion part.
  • the balloon catheter includes a plurality of the temperature measuring components, and the wires of the plurality of temperature measuring components are all partially arranged in the cavity of the catheter body and along the axis of the cavity of the catheter body. to extend;
  • the number of the sleeves is the same as the number of the temperature measuring components, a plurality of the sleeves are separately arranged in the cavity of the catheter body, and the wires of the multiple temperature measuring components can pass through different at least the enlarged portion of the sleeve adjacent to the outside of the wire of the temperature measuring component is staggered along the axial direction of the cavity of the catheter body; or, the number of the sleeve is at least One and less than the number of the temperature-measuring components, some of the wires of the temperature-measuring components can movably pass through the sleeves, and each of the sleeves is provided with a wire of the temperature-measuring component to pass through, and is configured
  • the wires of the temperature-measuring component with the sleeve are disposed non-adjacently, or at least the enlarged portion of the sleeve adjacent to the outside of the wire of the temperature-measuring component is staggered along the axial direction of the cavity of the catheter body layout.
  • the balloon is a double-layered balloon, the number of the temperature-measuring components is multiple, and the temperature-measuring modules of a plurality of the temperature-measuring components are arranged in the interlayer of the double-layered balloon, and/ Or, a plurality of temperature measurement modules of the temperature measurement components are arranged on the pipe section of the catheter body located in the double-layer balloon.
  • the present invention also provides an ablation system, comprising any of the balloon catheters described above, an ablation energy output device and a control device, wherein the ablation energy output device is communicated with the balloon catheter. is used to provide the ablation medium to the balloon catheter; the control device is used to control the ablation energy output device to adjust the temperature of the ablation medium according to the temperature information detected by the temperature measuring component, so that the ball The temperature of the capsule surface is within a preset ablation temperature range.
  • the balloon catheter and ablation system provided by the present invention have the following advantages:
  • the use of limiting components to limit the protection of the wires of the temperature measuring components increases the mobility of the wires when the balloon is stretched and the catheter moves, so that the wires are not easily broken or entangled with each other, thus ensuring The reliability of balloon catheter temperature monitoring also avoids the obstruction of the guide wire to the movement of the catheter body, reducing the difficulty of surgical operation;
  • the bending part of the wire such as serpentine bending
  • multiple limit components can be used to limit the positions of the wires of different temperature measuring components, for example, non-adjacent wires are limited by the limit components, or all the wires pass the limit Therefore, the interference between multiple wires can be effectively avoided, and the problems of wire breakage and obstruction of catheter movement caused by a large number of wires can be better solved.
  • the first limiting member can be further limited. The position of the components avoids mutual interference of a plurality of first limiting components in the cavity of the catheter body, thereby reducing the obstruction of the cannula to the movement of the catheter body and further reducing the difficulty of surgical operations.
  • FIG. 1 is a schematic diagram of cardiac ablation performed by an ablation system in a preferred embodiment of the present invention
  • FIG. 2 is a schematic diagram of renal artery ablation performed by the ablation system in a preferred embodiment of the present invention
  • Fig. 3 is the working flow chart of the ablation system in the preferred embodiment of the present invention.
  • FIG. 4 is a flow chart of cryoablation performed by the ablation system in a preferred embodiment of the present invention.
  • FIG. 5 is a front view of an ablation catheter in a preferred embodiment of the present invention.
  • Figure 6 is a left side view of the ablation catheter shown in Figure 5;
  • FIG. 7 is a schematic diagram of the distal end of the ablation catheter in a preferred embodiment of the present invention.
  • FIG. 8 is a schematic end view of the catheter body of the ablation catheter in the preferred embodiment of the present invention.
  • Fig. 9 is the partial schematic diagram of the sleeve in the preferred embodiment of the present invention.
  • FIG. 10 is a schematic diagram of the first limiting member in the preferred embodiment of the present invention limiting the wires of all temperature measuring components in the cavity of the catheter body, wherein a second limiting member is provided outside the first limiting member, and A plurality of second limiting components are connected to form a ring structure;
  • FIG. 11 is a schematic diagram of the second limiting member or the limiting member being connected into a ring structure in a preferred embodiment of the present invention.
  • each embodiment of the following description has one or more technical features, but this does not mean that the person using the present invention must implement all the technical features in any embodiment at the same time, or can only implement different embodiments separately.
  • One or all of the technical features of the .
  • those skilled in the art can selectively implement some or all of the technical features in any embodiment according to the disclosure of the present invention and depending on design specifications or implementation requirements, or The combination of some or all of the technical features in the multiple embodiments is selectively implemented, thereby increasing the flexibility of the implementation of the present invention.
  • proximal and distal are the relative orientations, relative positions, directions of elements or actions relative to each other from the perspective of the physician using the product, although “proximal” and “distal” are not limiting but “proximal” generally refers to the end of the product that is closest to the physician during normal operation, while “distal” generally refers to the end that first enters the patient's body.
  • proximal generally refers to the end of the product that is closest to the physician during normal operation
  • distal generally refers to the end that first enters the patient's body.
  • the singular forms “a,” “an,” and “the” include plural referents unless the content clearly dictates otherwise.
  • the term “or” is generally employed in its sense including “and/or” unless the content clearly dictates otherwise.
  • the term “circumferential” generally refers to the direction about the axis of the balloon catheter; the term “axial” generally refers to the direction parallel to the axis of the balloon catheter.
  • a balloon catheter with a wire sensor is disclosed in the prior art, and the balloon catheter is recorded in the invention patent with the authorized publication number CN109646106 B, wherein the temperature measuring component in the interlayer of the double-layered balloon Displacement can be generated relative to the balloon, so that the temperature measuring component can better conform to the expansion or contraction of the balloon.
  • the inventor of the present application found that when the number of temperature measuring components in the interlayer increases, the number of wires in the cavity of the catheter body will also increase, and the space in the cavity is relatively limited, and the arrangement in the limited space When there are many wires, when the balloon is stretched and the catheter is rotated and twisted, the wires also need to make corresponding movements.
  • the movement of the wire is limited and cannot move with the expansion and contraction of the balloon and the movement of the catheter, and the wire is easily broken when subjected to force, so that the temperature of the surface of the balloon cannot be monitored, and the movement of the catheter is also hindered.
  • the present invention provides a balloon catheter, which aims to overcome the defects of the above-mentioned invention patent.
  • the measurement device located in the interlayer of the double-layer balloon in the embodiment of the present invention The temperature measuring components are similar to the temperature measuring components in the invention patent authorized by the applicant with the publication number CN109646106 B, but should not be limited to the method disclosed in the invention patent to realize the arrangement of the temperature measuring components in the interlayer, and those skilled in the art should also It should be understood that the balloon in the embodiment of the present invention is not limited to a double-layered balloon.
  • the temperature measuring component in the embodiment of the present invention is not limited to being arranged on the balloon, but can also be arranged on the tube section of the catheter body inside the balloon. That is to say, the balloon catheter of the present invention aims to solve the above-mentioned problems that exist when the number of wires in the cavity of the catheter body is large, and does not limit the specific arrangement position and arrangement of the temperature measuring components.
  • the structure of the balloon is only an embodiment of the present invention to solve the problem, and the present application does not limit the type, material and structural arrangement of the catheter body, etc. of the balloon.
  • the balloon catheter provided by the present invention includes: a catheter body; a balloon disposed at the distal end of the catheter body; a temperature measurement component, including a wire and a temperature measurement module, and the temperature measurement module is disposed on the balloon on or on the catheter body, and a part of the wire of the temperature measuring component is arranged in the cavity of the catheter body and extends along the axial direction of the cavity of the catheter body; and a limiting member, provided in the cavity of the catheter body and used to limit the position of the wire of the temperature measuring component in the cavity of the catheter body.
  • the wire of the temperature measuring component can move relative to the limiting member, so that the movement of the wire is not restricted when the balloon is deflated and the wire is prevented from breaking.
  • the wire of the temperature measuring component is fixed relative to the limiting member.
  • a plurality of the annular rings are sequentially connected to form an annular structure, adjacent to the A linear elastic body is connected between the annular rings. Due to the elasticity between the annular rings, it can bear a certain tensile force when the balloon is stretched. At this time, even if the wire is fixed with the annular ring, it will not cause the wire to break.
  • the balloon catheter of the present invention performs limit protection on the wires of the temperature measuring component through the limiting member, so as to avoid interference problems such as aggregation, stacking, and winding between the wires, thereby ensuring that the wires have the necessary space for movement in the cavity of the catheter body. It will not be restrained, thereby avoiding the risk of wire breakage due to force, and also avoiding the obstruction of the catheter body (mandrel and/or outer tube) movement due to interference problems such as aggregation, stacking, and winding of the wire, thereby reducing the surgical operation. difficulty.
  • the catheter body includes an outer tube and a core rod disposed in the outer tube, the distal end of the core rod protrudes from the outer tube, and the outer tube and the core rod are formed between the outer tube and the core rod.
  • an annular cavity the distal end of the balloon is connected to the core rod, the proximal end of the balloon is connected to the outer tube, the cavity of the catheter body includes the annular cavity, the limit Components are disposed within the annular cavity.
  • the balloon is preferably a double-layered balloon
  • the double-layered balloon includes an inner-layered balloon and an outer-layered balloon surrounding the inner-layered balloon.
  • the double-layered balloon The distal end of the double-layer balloon is connected with the core rod, and the proximal end of the double-layer balloon is connected with the outer tube.
  • the number of the temperature measuring components is multiple.
  • a plurality of temperature measurement modules of the temperature measurement components are arranged in the interlayer between the inner layer balloon and the outer layer balloon, such as arranged on the outer surface of the inner layer balloon or on the inner surface of the outer balloon.
  • a plurality of temperature measurement modules of the temperature measurement components are arranged on the catheter body (core rod) and located inside the inner layer balloon.
  • some temperature measurement modules are arranged in the interlayer, and some temperature measurement modules are arranged on the catheter body (core rod) and located inside the inner layer balloon.
  • the temperature measurement module when the temperature measurement module is arranged in the interlayer, such as the outer surface of the inner layer balloon or the inner surface of the outer layer balloon, at this time, the temperature measurement module can be relative to the inner layer balloon or the inner layer of the balloon connected to it.
  • the outer layer balloon is displaced, so that the temperature measurement module will not affect the expansion or contraction of the balloon, and the temperature measurement module will not be pulled and broken.
  • the balloon catheter proposed by the present invention will be further described below with reference to the accompanying drawings and preferred embodiments, and the balloon catheter of the present invention is not limited to an ablation catheter, but can also be a mapping catheter, or other catheters that need to monitor the surface temperature of the balloon .
  • the following description takes a double-layer balloon and an ablation catheter as an illustration, this illustration does not constitute a limitation of the present invention, and the solution of the present invention is also applicable to a single-layer balloon and a balloon catheter for other purposes.
  • FIG. 1 is a schematic diagram of cardiac ablation performed by an ablation system in a preferred embodiment of the present invention
  • FIG. 2 is a schematic diagram of renal artery ablation performed by an ablation system in a preferred embodiment of the present invention.
  • the present embodiment provides an ablation system including an ablation catheter 1 , an ablation energy output device 2 and a control device 3 , wherein the ablation energy output device 2 is in fluid communication with the ablation catheter 1 to send the ablation catheter to the ablation catheter.
  • the control device 3 is connected to the ablation energy output device 2 , which in turn is connected to the ablation catheter 1 .
  • the control device 3 may also be connected to the ablation energy output device 2 and the ablation catheter 1 respectively.
  • the control device 3 and the ablation energy output device 2 may be integrated into the same device. The present invention does not limit this.
  • the main function of the control device 3 is to control the ablation energy output device 2 to adjust the temperature of the ablation medium (such as the temperature of the freezing liquid) according to the temperature information detected by the temperature measuring component, so that the temperature of the surface of the double-layer balloon is within the preset temperature. ablation temperature range.
  • the ablation system includes, but is not limited to, cryoablation of the target tissue, and the target tissue may be a cardiac cavity or a renal artery, etc., which is not specifically limited.
  • the ablation system can be applied to the treatment of cardiac cavity, and the ablation catheter 1 is inserted into the interior of the cardiac cavity by interventional means to ablate the pulmonary vein 5 to realize the treatment of arrhythmia.
  • the ablation system can also be applied to the renal artery, and the ablation catheter 1 is inserted into the renal artery port 4 by interventional means to ablate the renal artery 7 to adjust the renal artery blood pressure.
  • cryoablation of the pulmonary vein as an example, the working principle of the ablation system will be further described with reference to FIG. 3 .
  • Step S1 before cryoablation, connect the control handle 6 of the ablation catheter 1 to the ablation energy output device 2 .
  • step S2 the ablation catheter 1 is inserted into the corresponding target tissue to be ablated, for example, into the tubular tissue inside the cardiac cavity, that is, into the pulmonary vein orifice.
  • step S3 the double-layer balloon 20 at the distal end of the ablation catheter 1 is inflated, and the freezing liquid is released to the double-layer balloon 20 .
  • Step S4 adjusting the position of the double-layer balloon 20 in the cylindrical tissue.
  • Step S5 analyze the temperature of the outer surface of the double-layer balloon 20 by using the temperature information detected by the temperature measuring component.
  • Step S6 determine the contact between the double-layer balloon 20 and the cylindrical tissue, if the double-layer balloon 20 is in good contact with the cylindrical tissue, proceed to the next step, and if the double-layered balloon 20 is in poor contact with the cylindrical tissue, then proceed to the next step. Return to step S4.
  • Step S7 start cryoablation.
  • step S8 the temperature of the outer surface of the double-layer balloon 20 is analyzed by using the temperature information detected by the temperature measuring component.
  • Step S9 verifying the ablation effect. Specifically, the effect of cryoablation was evaluated according to changes in pulmonary vein potential during cryoablation surgery. If the effect of cryoablation is not good, cryoablation can be repeated until the desired tissue ablation effect is obtained.
  • Step S10 ending the ablation operation.
  • the control device 3 analyzes and judges the contact situation between the double-layer balloon 20 and the target tissue according to the temperature information detected by the ablation catheter 1, and controls the ablation energy output device 2 to adjust the ablation temperature of the freezing liquid accordingly.
  • the control device 3 may comprise a refrigeration control unit.
  • the ablation energy output device 2 includes a refrigeration unit, a fluid source and a fluid output channel.
  • the fluid source is in communication with the fluid output channel, which is then used to output the fluid in the fluid source to the ablation catheter 1.
  • the fluid output channel is connected to the fluid input interface on the control handle 6, and the fluid output channel is connected to the ablation catheter 1 through the interface.
  • the ablation catheter 1 inputs an ablation medium.
  • the refrigeration unit is arranged on the fluid output channel, and is used for refrigerating the fluid conveyed in the fluid output channel.
  • the refrigeration unit may be a compressor or other refrigeration device, the structure of which is not specifically limited in the present invention.
  • the refrigerating unit is used to communicate with the refrigerating control unit, so as to control the working state of the refrigerating unit through the refrigerating control unit. More specifically, the refrigeration control unit is configured to control the operation of the refrigeration unit according to the received cryoablation instruction, so that the fluid output channel provides the cryogenic liquid to the ablation catheter 1 .
  • a cryoablation button may be provided on the control handle 6 or the computer interface. When the operator activates the cryoablation button, a cryoablation instruction is sent to the refrigeration control unit.
  • the computer interface may be set on the control device 3 or the ablation energy output device 2 . In a non-limiting operation, the refrigeration control unit sends a refrigeration signal to the refrigeration unit, and the refrigeration unit performs refrigeration according to the received refrigeration signal.
  • the refrigeration control unit may control the refrigeration unit to adjust its refrigeration temperature according to the temperature information fed back by multiple temperature measuring components, so as to control the temperature of the balloon surface to be within a preset cryoablation temperature range.
  • the working process of the ablation system implementing cryoablation specifically includes:
  • Step 401 the fluid source outputs fluid to the fluid output channel
  • Step 402 the refrigeration control unit controls the refrigeration unit to cool
  • Step 403 After cooling, make the fluid reach a preset cooling temperature
  • Step 404 spraying frozen liquid to the inner layer balloon; here, steps 401, 402, 403, and 404 can actually be performed at the same time, that is, spraying the frozen liquid to the inner surface of the balloon while cooling is started;
  • Step 405 During the cooling process, the cooling control unit controls the cooling temperature of the cooling unit according to the temperature information fed back by the temperature measuring component in real time;
  • Step 406 After the temperature of the balloon surface reaches the temperature required for cryoablation (for example, -40°C to -60°C) and maintains for a period of time (for example, 120 to 180 seconds), cryoablation can be ended.
  • the temperature required for cryoablation for example, -40°C to -60°C
  • a period of time for example, 120 to 180 seconds
  • the doctor determines whether to perform the next cryoablation according to the actual effect of cryoablation. However, it should be known that if the doctor determines that the next cryoablation needs to be performed, after the current cryoablation, step 407 (naturally rewarming the double-layer balloon 20 to body temperature in the body) needs to be performed, and then the cryoablation can be performed. next cryoablation.
  • the ablation catheter 1 includes a double-layer balloon 20 , a first temperature measuring component 17 , a catheter body 13 , and a fixing member 23 and inlet pipe 27.
  • the double-layer balloon 20 is disposed at the distal end of the catheter body 13 such that a part of the catheter body 13 is located in the double-layer balloon 20 .
  • the catheter body 13 includes an outer tube 131 and a core rod 132, the core rod 132 is arranged in the outer tube 131, and the distal end of the core rod 132 extends out of the outer tube 131 and is connected with the distal end of the double-layer balloon 20, The proximal end of the double-layer balloon 20 is connected to the outer tube 131 .
  • the distal end of the liquid inlet tube 27 is placed inside the double-layer balloon 20, and is spirally arranged on the core rod 132 for spraying ablation medium to the double-layer balloon 20, where the ablation medium includes but is not limited to frozen liquid .
  • An annular cavity is formed between the core rod 132 and the outer tube 131 .
  • the double-layer balloon 20 includes an outer-layer balloon 21 and an inner-layer balloon 22, the outer-layer balloon 21 surrounds the inner-layer balloon 22, and the outer-layer balloon 21 and the inner-layer balloon 22 are separated. Both the proximal end and the distal end are fixed on the catheter body 13 . Both the outer layer balloon 21 and the inner layer balloon 22 can be expanded, for example, the frozen liquid is sprayed into the inner cavity of the inner layer balloon 22 through the distal end of the liquid inlet tube 27, and the frozen liquid is instantly vaporized after absorbing the heat of the human tissue. expansion, thereby causing the inner layer balloon 22 to expand. When the inner layer balloon 22 is expanded, the outer layer balloon 21 is expanded under the action of the inner layer balloon 22 .
  • the first temperature measurement component 17 includes a wire 24 and a temperature measurement module.
  • the number of the wires 24 is generally two, for example, it is composed of parallel Cu wires and CuNi wires, and the Cu wires can be connected to a specific area of the balloon. Conduction with the CuNi wire to form the temperature measurement module (ie, the temperature measurement point 8, Figures 5 to 7).
  • the temperature measurement module is used to sense temperature and generate temperature information, and the temperature measurement module is also used to convert the temperature information into electrical information, and transmit the electrical information through a set of wires, so as to transmit the electrical information.
  • the first temperature measuring component 17 is at least one, and its temperature measuring module is disposed in the interlayer (not shown) formed by the inner layer balloon 22 and the outer layer balloon 21 .
  • the temperature measurement module of the first temperature measurement component 17 can detect the temperature information of the ablation region 16 adjacent to the first temperature measurement component 17, and the temperature measurement module of the first temperature measurement component 17 is arranged in the inner layer balloon 22 and the outer layer In the interlayer formed by the layer balloon 21, the distance between the area between the inner layer balloon 22 and the outer layer balloon 21 and the outer surface of the double layer balloon 20 is relatively close, so the temperature information detected by the first temperature measuring component 17 When estimating the temperature information of the outer surface of the double-layer balloon 20 , the accuracy of the estimated temperature information of the outer surface of the double-layer balloon 20 can be improved, thereby improving the ablation effect.
  • the first temperature measuring component 17 is attached to the inner layer balloon 22 or the outer layer balloon 21 through the fixing member 23 .
  • the first temperature measuring member 17 is attached to the inner layer balloon 22 or the outer layer balloon 21 through the fixing member 23 .
  • the temperature measurement module of the first temperature measurement component 17 can monitor the temperature at a designated position on the double-layer balloon 20 .
  • the fixing member 23 will be released when the double-layer balloon 20 is expanded or contracted through the adsorption capacity or other suitable capacity of the fixing member 23 .
  • the fixing member 23 is connected to the first temperature measuring component 17 and the corresponding balloon surface in a physical adsorption manner.
  • first temperature measuring components 17 there are preferably multiple first temperature measuring components 17 (herein, multiple refers to at least two), and the multiple temperature measuring modules of the first temperature measuring components 17 are in The different positions in the interlayer are distributed, preferably, evenly distributed in the circumferential direction around the central axis of the inner layer balloon 22, so that a plurality of temperature measurement points 8 can be formed, and the temperature measurement module of each first temperature measurement component 17 is A temperature measuring point 8 is formed.
  • temperature information at multiple positions can be detected by the first temperature measuring components 17 .
  • the number of temperature measuring points 8 is not limited to the six shown in FIG. 6 , and may be less than six or more than six.
  • the first temperature measurement component 17 is a linear sensor, such as a thermocouple temperature sensor or a thermistor temperature sensor, that is, the temperature measurement module can be a commonly used thermocouple or thermistor, for example, a thermocouple is T-type or K-type, etc.
  • a part of the wires 24 of all the first temperature measuring components 17 is arranged in the inner cavity of the balloon, and the other part is arranged in the annular cavity between the outer tube 131 and the core rod 132 and extends along the axial direction of the annular cavity, And the proximal end of the wire 24 of each first temperature measuring component 17 is connected to the electrical input and output interface 9 on the control handle 6, so as to output the measured temperature information to the outside.
  • the temperature measuring module may also be disposed in other positions.
  • the temperature measurement module set in the interlayer of the double-layer balloon 20 is defined as the temperature measurement module of the first temperature measurement component 17, and the temperature measurement modules at other positions are defined as the second temperature measurement component temperature measurement module.
  • the temperature measurement module of the second temperature measurement component 15 is further arranged on the pipe section of the core rod 132 located in the double-layered balloon 20 for acquiring the temperature information inside the balloon, and the second temperature measurement module
  • the temperature measurement module of the temperature measurement component 15 is also connected to the electrical input and output interface 9 on the control handle 6 through the wire 24 .
  • different temperature measuring components can be connected to the same electrical input and output interface 9, and different data channels can be set in the electrical input and output interface 9, so that each temperature measuring component transmits data through different data channels.
  • At least one temperature measurement module of the first temperature measurement component 17 is arranged in the interlayer of the double-layered balloon 20, and at least one second temperature measurement module is arranged on the pipe section of the core rod 132 in the balloon.
  • the temperature measurement modules of the temperature component 15 preferably, there are multiple first temperature measurement components 17.
  • six first temperature measuring components 17 and one second temperature measuring component 15 are used as illustrations to further illustrate how the wires 24 of the plurality of temperature measuring components are limited in the annular cavity.
  • each temperature measuring component eg, the first temperature measuring component 17 and the second temperature measuring component 15
  • each temperature measuring component includes a temperature measuring module and a set of wires 24 (one set is usually two).
  • six temperature measurement modules of the first temperature measurement component 17 can be arranged on the outer surface of the inner layer balloon 22
  • a temperature measurement module of the second temperature measurement component 15 can be arranged on the core rod 132 Module
  • the lead wires 24 of the six first temperature measuring components 17 and the lead wire 24 of one second temperature measuring component 15 are partially arranged in the annular cavity between the core rod 132 and the outer tube 131, and the other part is in the balloon. in the lumen.
  • the dimensions of the core rod 132 and the outer tube 131 are constant, as the number of the wires 24 increases, the movable space of the wires 24 in the annular cavity is also easily bound.
  • limiting components are provided outside the wires 24 of at least some temperature measuring components, so that the positions of the conducting wires 24 of at least some temperature measuring components are limited by the limiting components, so that the The wires 24 are isolated or spaced apart in the annular cavity to avoid interference (such as gathering, winding, etc.) of multiple wires 24 in the annular cavity, and the wires 24 limited by the limiting member can be relative to the limit.
  • the positioning member is movable, and can also be fixed relative to the limiting member, which is not limited in the present invention.
  • the mutual interference between the wires 24 can be avoided by the limiting member, so as to ensure that the movement of the wires 24 will not be restricted, so that the wires 24 are not easily broken when subjected to force, and at the same time, it can also prevent the wires 24 from interfering with the core rod 132 and/or the outer tube. 131's activity creates a hindrance.
  • the number of the limiting components is the same as the number of temperature measuring components, a plurality of the limiting components are separately provided in the annular cavity, and the wires 24 of the multiple temperature measuring components pass through respectively Different limit components are used, so that the wires 24 of all temperature measuring components are limited and protected by the limit components to achieve mutual isolation in the annular cavity, thereby effectively avoiding the problem of mutual interference between multiple wires 24.
  • the number of the limiting components is at least one and less than the number of temperature measuring components, and only part of the wires 24 of the temperature measuring components pass through the limiting components, and each limiting component is used for one measuring component.
  • the conducting wire 24 of the temperature component is passed through.
  • the conducting wires 24 restricted by the limiting components are not adjacently arranged.
  • the positions of the conducting wires 24 of all the temperature measuring components are not restricted, but only the positions of the non-adjacent conducting wires 24 are restricted. In this way, the effect of isolating or separating the plurality of wires 24 can also be achieved, the problem of mutual interference between the wires 24 can be avoided, and the limited space occupied by the limiting components can be reduced as much as possible.
  • limiting component when the position of the wire 24 of each temperature measuring component is limited by the limiting component, preferably at least adjacent limiting components are arranged staggered along the axial direction of the annular cavity (ie not in the same circumferential direction), so as to avoid multiple The problem of mutual interference of limit parts.
  • the limiting member can be fixedly arranged in the annular cavity, or can be movably arranged in the annular cavity.
  • the limiting member may be fixedly connected with the inner wall of the outer tube 131, or fixedly connected with the outer wall of the core rod 132, or, the limiting member may always be After extending to the proximal end of the catheter body 13 , it is fixedly connected with the control handle 6 . Therefore, the present invention does not limit the fixing manner of the limiting member.
  • the position-limiting component has a limit groove that penetrates through the axial direction.
  • the position-limiting component can be
  • the structure is simple, and the limiting components can be arranged in a limited space.
  • the limiting slot can cooperate with the inner wall of the outer tube 131 to completely surround the wire 24, that is, the limiting slot is designed as a non-closed cavity, or the limiting slot itself is designed to be closed the cavity, so that the limiting groove itself can completely surround the wire 24 .
  • the present invention does not limit the length of the limiting member around the wire 24, it can surround a part of the length of the wire 24 in the annular cavity, or can surround the entire length of the wire 24 in the annular cavity. That is, the axial length of the limiting member may be less than or equal to the axial length of the outer tube 131 . It should be further understood that, herein, each temperature measuring component includes two wires 24 and forms a group, and the position of the group of wires is limited by one or more limiting members.
  • the limiting member can be designed as a sleeve 25 (refer to FIG. 7 ), and the sleeve 25 can be a circular or oval tube.
  • the sleeve 25 only needs to be sleeved on the outside of the wire 24, and the wire 24 is preferably movable relative to the sleeve 25, which can better ensure that the wire 24 can expand and contract freely.
  • the sleeve 25 is movable or fixed in the annular cavity.
  • one or more sleeves 25 may be sleeved on the wire 24 of the same temperature measuring component, and the plurality of sleeves 25 on the same group of wires are arranged at intervals along the extending direction of the wire 24 .
  • the material of the sleeve 25 is a polymer material, more preferably a thermoplastic material, and the thermoplastic material includes PET (polyethylene terephthalate), Pebax (polyetheramide), PTFE (polytetrafluoroethylene) One or more combinations of polymer materials such as PI (polyimide) and PA (nylon) to obtain a sleeve 25 with a certain hardness and softness, which not only avoids damage to the wire 24, but can also Good isolated wire 24.
  • PET polyethylene terephthalate
  • Pebax polyetheramide
  • PTFE polytetrafluoroethylene
  • PI polyimide
  • PA nylon
  • the material of the sleeve 25 is PET material, so as to obtain the sleeve 25 with a certain hardness, to avoid the deformation of the sleeve 25 during the movement of the wire 24, increase the difficulty of using the catheter, and make the use effect of the catheter more effective. it is good.
  • the size of the sleeve 25 cannot be designed to be large, and in order to save space during manufacture, the inner wall of the sleeve 25 can be further
  • the inner dimension (eg inner diameter) of the sleeve 25 matches or is slightly larger than the outer diameter of the wire 24, and the wire 24 can be moved in the sleeve 25.
  • the sleeve 25 can be fixedly connected to the outer tube 131 or the core rod 132 through glue, or can be extended to the proximal end and fixedly connected to the control handle 6 .
  • the present invention does not limit the length of the cannula 25 , for example, it can be the same as the length of the outer tube 131 , or shorter than the length of the outer tube 131 , for example, only a small section of cannula is provided near the proximal end of the double-layer balloon 20 25.
  • the length of the sleeve 25 is short, it can be directly attached to the inner wall of the outer tube 131 .
  • the sleeve 25 can also be attached to the control handle 6 .
  • the wire 24 can also be partially processed into a curved shape, such as serpentine bending, so as to obtain the wire 24 with the curved portion 241 (refer to FIG. 9 ).
  • the wire 24 includes an extension portion 242 and at least one bent portion 241 , and the extension portion 242 is a wire without bending.
  • the curved portion 241 is in the contracted state, the overall radial dimension of the curved portion 241 is larger than the radial dimension of the extension portion 242 of the wire 24 .
  • the copper wire can be bent into a serpentine shape under heating, and then quenched and shaped.
  • the curved portion 241 has a performance similar to that of a spring, which can be stretched under tension, and automatically retracted when the external force disappears. Therefore, by arranging the curved portion 241, a certain expansion and contraction margin can be provided for the movement of the guide wire 24, so as to prevent it from breaking when the catheter is moved or the balloon is expanded and contracted.
  • the axial length of the bending portion 241 in the contracted state ie, the wire in the dotted frame 30 shown in FIG. 9
  • the overall extensible displacement of the lead 24 does not exceed 60% of the outer diameter of the inner layer balloon 22 after inflation.
  • such a dimension is set so that when the balloon changes from a contracted state to an expanded state, the lead 24 can expand and contract together with the balloon because the lead 24 has a certain expansion and contraction margin, and at the same time, the extensible wire 24 can expand and contract.
  • the displacement does not need to be too large.
  • the wires 24 are prevented from being entangled with each other.
  • the present invention does not limit the number and position of the curved portion 241, and the curved portion 241 can be located at any position on the guide wire 24, such as near the proximal end of the balloon or near the control handle 6, or at the proximal end of the balloon and the control handle anywhere between 6.
  • the sleeve 25 preferably includes a constricted portion 252 and at least one expanded portion 251 (the expanded portion 251 is circled by the dashed frame 30 in FIG. 9 ), and the cross-sectional area of the inner cavity of the constricted portion 252 is less than The cross-sectional area of the lumen of the enlarged portion 251 .
  • the curved portion 241 of the lead wire 24 is stored by the enlarged portion 251, and the curved portion 241 is limited and protected to prevent the curved portions 241 on different leads from being entangled with each other when the balloon is retracted or the catheter is moving, thereby further reducing the problem of lead wire interference, Reduce the risk of wire breakage.
  • constricted portion 252 stores the extension portion 242 of the wire 24 .
  • maximum outer dimension (outer diameter) of the enlarged portion 251 is smaller than the width of the annular cavity between the outer tube 131 and the core rod 132 . This configuration ensures the flexibility of the curved portion 241 when the balloon is inflated or deflated, and further ensures that the wire 24 will not be pulled off when being stressed.
  • the number of the sleeves 25 is the same as the number of the temperature measuring components, the multiple sleeves 25 are separately arranged in the annular cavity, and the wires 24 of the multiple temperature measuring components are movably passed through different The sleeve 25, at this time, preferably at least the enlarged portion 251 of the sleeve 25 outside the lead wire 24 of the adjacent temperature measuring component is arranged staggered along the axial direction of the annular cavity (that is, not at the same circumferential position of the core rod 132), so that The risk of interference between sleeves 25 is reduced.
  • the number of the sleeves 25 is at least one and less than the number of the temperature measuring components
  • the wires 24 of some of the temperature measuring components can pass through the sleeves 25 movably, and each sleeve 25 is used for the wires 24 of one temperature measuring component to pass through.
  • the wires 24 of the temperature measuring components configured with the sleeves 25 are not adjacent, or at least the enlarged portions 251 of the sleeves 25 outside the wires 24 of the adjacent temperature measuring components are arranged staggered along the axial direction of the annular cavity.
  • the sleeve 25 only needs to be put on the wire 24 of the temperature measuring component, and the sleeve 25 is moved to the bent part 241 of the wire 24 to ensure that the bent part 241 of the wire is in the enlarged part 251 of the sleeve 25 .
  • the axial length of the sleeve 25 is 10 mm to 20 mm, which is preferably arranged near the proximal end of the balloon. At the same time of cost, it can also ensure that the bent portion 241 of the wire is located in the enlarged portion 251 of the sleeve 25 to prevent the wires 24 from interfering with each other.
  • the present invention does not limit the shape of the sleeve 25, and is not limited to the above-mentioned oval and circular shapes, but may also be other shapes, such as regular shapes such as circles and rectangles, or other irregular shapes.
  • first temperature measuring components 17 and one second temperature measuring component 15 are arranged on the balloon catheter, for a total of seven temperature measuring components, preferably, outside the wires 24 of each temperature measuring component At least one sleeve 25 is provided.
  • the sleeves 25 on different wires 24 can be arranged uniformly or non-uniformly along the circumferential direction of the annular cavity, and can also be randomly arranged in the annular cavity.
  • other lumens or other wires are usually arranged in the annular cavity, such as a liquid inlet tube 27 and a wire pulling tube 28 , and there are two wire pulling tubes 28 .
  • a pulling wire is arranged in the pulling wire tube 28 to control the bending deformation of the distal end of the balloon catheter.
  • the ablation catheter 1 includes a plurality of limiting components.
  • a plurality of the sleeves 25 are circumferentially spaced around the axis of the core rod 132, and a plurality of the sleeves
  • the tubes 25 are preferably connected in sequence in a ring structure. That is, in some embodiments, the plurality of circumferentially arranged sleeves 25 are independent and not connected to each other, and in other embodiments, the plurality of circumferentially arranged sleeves 25 are connected to each other to form an annular structure. It should also be understood that in this solution, a plurality of sleeves 25 are movably disposed within the annular cavity and connected to each other.
  • the number of the annular structures is one or more, and a plurality of the annular structures are arranged at intervals along the axial direction of the core rod 132 , so that a plurality of annular structures can be arranged along the extending direction of the wire 24 for limiting. bit.
  • a wire 24 can be passed through each sleeve 25 constituting the annular structure, and the number of sleeves 25 in the annular structure is less than or equal to the number of temperature measuring components, so that part of the temperature can be measured.
  • the conductors 24 of the components are limited by the sleeves 25 , or the conductors 24 of each temperature measuring component are limited by the sleeves 25 .
  • the annular structure has elasticity and can be deformed correspondingly with the movement of the sleeve 25 or the guide wire 24, which not only does not hinder the movement of the catheter and the expansion and contraction of the balloon, but also avoids multiple Mutual interference between the sleeves 25 .
  • the wire 24 inside the cannula 25 is preferably movable relative to the cannula 25 .
  • the limiting member can be designed as an annular structure 31 with an annular ring, and adjacent annular rings 29 are connected by a linear elastic body 32 to form an annular structure 31 .
  • the inside of the annular ring 29 is for the wires 24 of the temperature measuring components to pass through.
  • the number of annular rings 29 is less than or equal to the number of the temperature measuring components, so that the wires of some temperature measuring components are limited by the annular ring 29, or each temperature measuring component is limited. All the wires are limited by the annular ring 29, and the annular ring 29 and the linear elastic body 32 are all made of elastic materials, such as silicone rubber, PA, Pebax, PI, etc. There is no specific material requirement.
  • the number of the annular structures 31 can be set to one or more, and the plurality of annular structures 31 are arranged at intervals along the axial direction of the core rod 132 , so that the plurality of annular structures 31 can be arranged along the extending direction of the wire 24 for limiting.
  • This design prevents the wires 24 from interfering with each other, and also prevents the movement of the wires 24 from affecting the operation of the internal components of the catheter body 13 .
  • the annular ring 29 can be either a toroidal coil structure or a PI tubular structure, which is not limited herein.
  • the limiting member includes a first limiting member and a second limiting member, the second limiting member is used to limit the position of the first limiting member, and the first limiting member The component is used to limit the position of the wire 24 of the temperature measuring component. Specifically, the conducting wire 24 is passed through the inside of the first limiting member, and the first limiting member is arranged inside the second limiting member.
  • the plurality of first limiting members are arranged at intervals around the axis of the core rod 132 in the circumferential direction.
  • the number of the second limiting members may be the same as that of the first limiting members. The numbers are the same, so that each first limiting member is limited by the second limiting member.
  • the number of second limiting members is multiple and less than the number of first limiting members, so that some of the first limiting members are limited by the second limiting members.
  • the second limiting member can be designed as an annular ring 29, a plurality of annular rings 29 are sequentially connected to form an annular structure 31 (FIG. 11), and adjacent annular rings 29 are connected by a linear elastic body 32, each of which is The inside of each annular ring 29 is provided with a first limiting member, and the first limiting member here may be a sleeve 25 or other suitable structures.
  • the ablation catheter 1 includes a first limiting member and a second limiting member disposed around the first limiting member.
  • the first limiting member is preferably a sleeve 25
  • the second limiting member is preferably an annular ring 29 .
  • Both the annular ring 29 and the sleeve 25 surround the axis of the core rod 132 Arranged at intervals along the circumferential direction, the inside of the sleeve 25 is used to pass the wire 24 of the temperature measuring component, so as to limit the position of the wire 24 through the sleeve 25.
  • the wire 24 of the temperature measuring component can be movably arranged on the In the casing 25, a casing 25 is arranged inside the annular ring 29, wherein a plurality of the annular rings 29 are sequentially connected to form the annular structure 31, and a linear elastic is connected between the adjacent annular rings 29
  • the body 32 preferably the sleeve 25 is fixedly arranged in the annular ring 29 .
  • the annular ring 29 can be formed into an annular shape by winding one or more filaments, and can be almost omitted compared to the length of the sleeve 25 .
  • the annular structure 31 is similar to that of a spring coil, so that all the sleeves 25 are fixed by the annular structure 31 .
  • the annular structure 31 is put on the outside of the core rod 132, and then the sleeves 25 containing the wires are respectively passed through the annular rings 29 on the circumference of the elastic coil.
  • the size of the constricted portion 252 and/or the enlarged portion 251 on the upper portion is similar, so that the wire 24 and the sleeve 25 are dispersed and fixed around the core rod 132 in the outer tube 131 .
  • the annular structure 31 is made of elastic material, such as silicone rubber, PA, Pebax, PI and the like. It should be understood that the annular structure 31 can be deformed correspondingly with the movement of the sleeve 25 or the wire 24, and the material of the annular structure 31 is preferably silicone rubber. Since silicone materials are commonly used and have good biocompatibility, And the flexibility is large, so it is safer and more reliable to use. Preferably, the position of the annular structure 31 can be restricted by the frictional force between the annular structure 31 and the outer tube 131 and the core rod 132. Compared with fixing with glue, the annular structure 31 can effectively reduce the limit. Overall stiffness of the catheter at the component.
  • a plurality of annular structures 31 can be arranged in sequence from the proximal end of the balloon of the ablation catheter 1 to the control handle 6 at a distance, for example, at an interval of 100 mm.
  • the catheter body 13 is a non-rigid structure and can be bent arbitrarily.
  • the material of the catheter body 13 is preferably a polymer material, such as thermoplastic polyurethane elastomer rubber (Thermoplastic polyurethanes, TPU) with metal braided wire, block polyetheramide resin (Pebax) or nylon, or a metal braided tube.
  • TPU thermoplastic polyurethane elastomer rubber
  • metal braided wire such as block polyetheramide resin (Pebax) or nylon, or a metal braided tube.
  • the proximal end of the catheter body 13 is provided with a control handle 6 , and the control handle 6 can specifically be used to manipulate and manipulate the bending state of the catheter body 13 .
  • the control handle 6 is provided with an electrical input and output interface 9, and the proximal end of the first temperature measuring component 17 is connected to the electrical input and output interface 9 through the catheter body 13, so as to transmit the detected temperature information to the outside. device transfer.
  • the control handle 6 may further include: at least one fluid interface 11 ; and at least one lumen interface 10 .
  • the lumen interface 10 is used for inserting instruments such as guide wires, mapping catheters, and conveying contrast agents.
  • the fluid interface 11 is in fluid communication with the liquid inlet tube 27 , and is used to input the ablation medium provided externally into the ablation catheter 1 , and can also be used to discharge the ablation medium or other medium in the double-layer balloon 20 .
  • the distal end of the liquid inlet tube 27 is disposed in the inner layer balloon 22 for spraying the ablation medium to the inner surface of the inner layer balloon 22 .
  • the liquid inlet pipe 27 specifically includes a helical structure at the distal end and a longitudinally extending portion in fluid communication with the helical structure, and the longitudinally extending portion passes through the catheter body 13 and is connected to the fluid interface 11 .
  • the helical structure is provided with a plurality of fluid jetting ports, and the plurality of fluid jetting ports are used for jetting the ablation medium a in different directions.
  • the control handle 6 is arranged on the outer tube 131 , and the liquid inlet tube 27 and the core rod 132 are threaded in the outer tube 131 side by side.
  • the core rod 132 is a hollow structure and is movably disposed in the outer tube 131, and the core rod 132 can be moved in the outer tube 131 by adjusting the control handle 6, so as to complete the double-layer balloon 20 unsheathing release and sheath return withdraw.
  • the proximal end of the core rod 132 is communicated with the lumen interface 10 on the control handle 6, and is used to deliver related instruments such as a guide wire, a mapping catheter or a contrast fluid.
  • the fluid discharge pipe is arranged between the core rod 132 and the outer pipe 131 .
  • the distal end of the core rod 132 extending out of the double-layer balloon 20 is preferably provided with a soft tip 19, and the soft tip 19 is made of soft material to avoid damage to the tissue.
  • the distal end of the core rod 132 is provided with a developing mark 18, and the material of the developing mark 18 is a metal developing material.
  • the doctor can use the developing equipment to confirm the double-layer balloon 20 through the developing mark 18. position relative to the outer sheath.
  • the limiting member is not limited to surrounding the wire by a tubular structure.
  • the coil surrounds the wire. Therefore, the structure of the limiting member surrounding the wire is not particularly limited, as long as the effect of separating the plurality of wires from each other can be achieved.
  • the various embodiments provided in this application can also be used in combination, for example, the wire is provided with a curved portion, the sleeve is provided with an enlarged portion, and the curved portion is provided in the enlarged portion, and there are multiple sleeves along the core rod.
  • the axes are arranged circumferentially, a plurality of the sleeves are provided with annular rings, the annular rings are used to limit the sleeves, and an annular structure is formed between adjacent annular rings, etc., which is not made in this application. limit.
  • the innovation of the present invention comes from the technical field of electrophysiological balloon catheter and its ablation system, those skilled in the art can understand that the present invention can also be applied to catheter technology in other fields, such as multi-claw catheter, each of which Several electrodes are arranged on the claw, and the multi-claw catheter can be bent according to actual needs to achieve the purpose of diagnosis and treatment.
  • the above-mentioned techniques can be used to solve the problem of wire breakage or mutual entanglement of the several electrodes; another example is a balloon radiofrequency ablation catheter, which is attached to the balloon.
  • Several electrodes and sensors are arranged for diagnosing, treating or monitoring tissue conditions.
  • the electrodes and sensors on the balloon are also easily broken when the balloon is stretched or retracted, or they are easily entangled in the catheter lumen, etc.
  • the above-mentioned technology can also be used to solve the problem that the wires of the electrode and the sensor are broken or intertwined. It can even be applied to other fields that need to solve problems such as mutual interference of wires or winding and breakage of wires.

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Abstract

本发明涉及一种球囊导管及消融系统,其中球囊导管包括导管本体、球囊、测温部件和限位部件;球囊设置于导管本体的远端;测温部件包括测温模块和导线,测温模块设置在球囊或导管本体上,测温部件的导线的一部分布置于导管本体的空腔内并沿空腔的轴向延伸;限位部件设置在导管本体的空腔内,并用于限制测温部件的导线在空腔内的位置。本发明通过限位部件对测温部件的导线进行限位保护,避免了导线在球囊伸缩或导管运动时被拉扯断裂的风险,同时也防止了导线对导管本体的活动造成阻碍。

Description

球囊导管及消融系统 技术领域
本发明涉及医疗器械技术领域,具体涉及一种球囊导管及消融系统。
背景技术
房颤患者具有很高的脑卒中风险,当房颤时,心房不规律地快速跳动,失去了收缩功能,血液容易在心房内淤滞而形成血栓,血栓脱落,随动脉进入脑中,即发生脑卒中。通过介入导管对肺静脉施以能量进行消融,从而隔离肺静脉电位,可以达到治疗的效果。高血压具有发病率高、知晓率低、危害大的特点。实验数据已证明高血压与患者的肾交感神经兴奋性偏高有关。通过消融阻断肾交感神经,不但能够使血压下降,并且还能够对交感神经过度激活造成的慢性器官特异性疾病产生影响。
可以采用冷冻球囊消融的方式进行消融。冷冻球囊消融基于解剖学考虑,利用球囊与组织的接触进行冷冻,且具有一次性、连续性等特点。具体的,采用冷冻消融球囊导管,在导管的远端设置球囊,近端连接冷冻设备。手术过程中,术者将冷冻消融球囊导管经皮穿刺入路放置进入心腔,到达肺静脉口,并使球囊充盈,调整球囊外壁与心肌组织接触,进而冷冻消融球囊导管内进液管将冷冻液体直接向球囊内表面喷射,冷冻液受心肌温度传导热影响迅速气化吸热,使与球囊接触的心肌组织降温产生冷冻消融。一般的,心肌组织只有在低温达到足够的时间,才能形成有效的消融灶,为此,冷冻消融球囊导管的内部配置有温度传感器,温度传感器被置于球囊中间,用于监测球囊内部温度,进而通过该内部温度去估算球囊表面的温度,但是估算得到的球囊表面温度与实际温度可能存在较大偏差,导致球囊表面温度的准确性低,从而直接影响消融效果。
现有技术中曾公开了一种带线状传感器的球囊导管,测温部件能够相对于球囊产生位移,使得测温部件能较好的顺应球囊的扩张或收缩,但是申请人发现随着球囊部分测温部件的数量的增加,在球囊导管的外管和芯杆之间的测温部件的导线的数量也会增加,消融时,由于球囊的伸缩变化及导管的 旋转、扭曲等活动会迫使导线做出相应的运动,一旦活动过程中,导线之间相互干扰,则导线的活动空间被束缚,容易导致导线受力断裂,从而不能实现对球囊表面温度的监测,影响了球囊导管的使用。而且导线的相互缠绕也会对芯杆的活动造成阻碍,影响了手术操作,提高了手术操作难度。
发明内容
为了解决上述技术问题,本发明的目的在于提供一种球囊导管及消融系统,通过在测温部件的导线的外部设置限位部件,可有效防止导线间的干扰,避免导线受力断裂的问题,还可解决导线阻碍导管本体运动的问题,从而提高器械的可靠性,降低手术操作难度。
为实现上述目的或其他相关目的,本发明提供的一种球囊导管,包括导管本体、球囊、测温部件和限位部件;
所述球囊设置于所述导管本体的远端;所述测温部件包括导线和测温模块,所述测温模块设置在所述球囊或所述导管本体上,所述测温部件的导线的一部分在所述导管本体的空腔内布置并沿所述导管本体的空腔的轴向延伸;
所述限位部件设置在所述导管本体的空腔内,并用于限制所述测温部件的导线在所述导管本体的空腔内的位置。
可选的,所述导管本体包括外管和设置于所述外管内的芯杆,所述芯杆的远端伸出所述外管,所述外管和所述芯杆之间形成环形空腔,所述球囊的远端与所述芯杆连接,所述球囊的近端与所述外管连接,所述导管本体的空腔包括所述环形空腔;所述限位部件设置在所述环形空腔内。
可选的,所述测温部件的数量为多个;
所述限位部件的数量与所述测温部件的数量相同,多个所述限位部件分开设置在所述导管本体的空腔内,多个所述测温部件的导线分别穿过不同的所述限位部件,或者,所述限位部件的数量为至少一个且少于所述测温部件的数量,部分所述测温部件的导线穿过所述限位部件,且每个所述限位部件供一个所述测温部件的导线穿设。
可选的,配置有所述限位部件的所述测温部件的导线非相邻设置,或者 至少相邻所述限位部件沿所述导管本体的空腔的轴向错开布置。
可选的,所述限位部件与所述外管的内壁或所述芯杆的外壁固定连接,或者,所述球囊导管还包括控制手柄,设置在所述导管本体的近端,所述限位部件与所述控制手柄固定连接。
可选的,所述限位部件的数量为多个,多个所述限位部件围绕所述芯杆的轴线周向间隔布置,且多个所述限位部件依次连接成环状结构。
可选的,所述限位部件包括套管,所述套管的内部用于穿设所述测温部件的导线,以限制所述测温部件的导线的位置,且多个所述套管依次连接成所述环状结构,或者,所述限位部件包括环形圈,所述环形圈的内部用于穿设所述测温部件的导线,以限制所述测温部件的导线的位置,多个所述环形圈依次连接成所述环状结构,且相邻环形圈之间连接一根线状弹性体。
可选的,所述限位部件包括第一限位部件和第二限位部件,所述第一限位部件用于限制所述测温部件的导线的位置,所述第二限位部件用于限制所述第一限位部件的位置;
所述第一限位部件的数量为多个,多个所述第一限位部件围绕所述芯杆的轴线周向间隔布置;
所述第二限位部件的数量为多个且少于所述第一限位部件的数量,部分所述第一限位部件的外部设置所述第二限位部件,且多个所述第二限位部件依次连接成环状结构,或者,所述第二限位部件的数量与所述第一限位部件的数量相同,并在每个所述第一限位部件的外部设置一个所述第二限位部件,所述第二限位部件依次连接成环状结构。
可选的,所述第一限位部件为套管,所述第二限位部件为环形圈,所述环形圈的内部设置所述套管,所述套管的内部用于穿设所述测温部件的导线,多个所述环形圈依次连接成所述环状结构,且相邻环形圈之间连接一根线状弹性体。
可选的,所述环状结构的数量为一个或多个,多个所述环状结构沿所述导管本体的空腔的轴向间隔地设置。
可选的,所述测温部件的数量为多个,多个所述测温部件的导线均一部 分在所述导管本体的空腔内布置并沿所述导管本体的空腔的轴向延伸;其中组成所述环状结构的每个所述限位部件的内部穿设有一个所述测温部件的导线,且组成所述环状结构的所述限位部件的数量小于或等于所述测温部件的数量。
可选的,所述限位部件包括套管,所述套管的内部用于可活动地穿设所述测温部件的导线,以限制所述测温部件的导线的位置;
所述套管包括收缩部和至少一个扩大部,所述收缩部的内腔的横截面积小于所述扩大部的内腔的横截面积;
所述测温部件的导线包括延伸部和至少一个弯曲部,所述弯曲部能够伸缩;所述延伸部设置于所述收缩部中,所述弯曲部设置于所述扩大部中。
可选的,所述球囊导管包括多个所述测温部件,多个所述测温部件的导线均一部分在所述导管本体的空腔内布置并沿所述导管本体的空腔的轴向延伸;
所述套管的数量与所述测温部件的数量相同,多个所述套管分开设置在所述导管本体的空腔内,多个所述测温部件的导线分别可活动地穿过不同的所述套管,同时至少相邻所述测温部件的导线外部的所述套管的扩大部沿所述导管本体的空腔的轴向错开布置;或者,所述套管的数量为至少一个且少于所述测温部件的数量,部分所述测温部件的导线可活动地穿过所述套管,每个所述套管供一个所述测温部件的导线穿设,且配置有所述套管的所述测温部件的导线非相邻设置,或至少相邻所述测温部件的导线外部的所述套管的扩大部沿所述导管本体的空腔的轴向错开布置。
可选的,所述球囊为双层球囊,所述测温部件的数量为多个,多个所述测温部件的测温模块设置在所述双层球囊的夹层中,和/或,多个所述测温部件的测温模块设置于所述导管本体位于所述双层球囊内的管段上。
为实现上述目的或其他相关目的,本发明还提供一种消融系统,包括任一所述的球囊导管、消融能量输出装置和控制装置,所述消融能量输出装置与所述球囊导管相连通,用于向所述球囊导管提供消融介质;所述控制装置用于根据所述测温部件检测到的温度信息控制所述消融能量输出装置调整所 述消融介质的温度,以使所述球囊表面的温度在预设的消融温度范围内。
与现有技术相比,本发明提供的球囊导管及消融系统具有以下的优点:
第一、利用限位部件对测温部件的导线进行限位保护,增加了导线在球囊伸缩以及导管活动时受力的可活动性,使导线不容易受力断裂或者相互缠绕,从而确保了球囊导管温度监测的可靠性,同时还避免了导线对导管本体活动的阻碍,降低了手术操作难度;
第二、利用限位部件上的扩大部来存储导线的弯曲部(如蛇形弯曲),确保了弯曲部在球囊伸缩以及导管活动时受力的可活动性,从而进一步保证了导线在受力时不至于被拉断,进一步提高温度监测的可靠性;
第三、当测温部件为多个时,可利用多个限位部件来限制不同测温部件的导线的位置,例如非相邻的导线通过限位部件来限制,或者所有导线都通过限位部件来限制,从而可有效避免多根导线之间的干扰,较好的解决导线数量较多时所造成的导线断裂以及导管活动受阻碍的问题。尤其当多个限位部件依次连接成环状结构或在第一限位部件的外部设置第二限位部件,且第二限位部件连接成环状结构时,还可进一步限制第一限位部件的位置,避免多个第一限位部件在导管本体的空腔内的相互干扰,从而降低套管对导管本体的活动的阻碍,进一步降低手术操作难度。
附图说明
为了更清楚地说明本发明实施例或现有技术中的技术方案,下面将对实施例或现有技术描述中所需要使用的附图作简单地介绍,显而易见地,下面描述中的附图仅仅是本发明的一些实施例,对于本领域普通技术人员来讲,在不付出创造性劳动的前提下,还可以根据这些附图获得其他的附图。
图1是本发明优选实施例中的消融系统进行心脏消融的示意图;
图2是本发明优选实施例中的消融系统进行肾动脉消融的示意图;
图3是本发明优选实施例中的消融系统的工作流程图;
图4是本发明优选实施例中的消融系统进行冷冻消融的流程图;
图5是本发明优选实施例中的消融导管的主视图;
图6是图5所示的消融导管的左视图;
图7是本发明优选实施例中的消融导管之远端的示意图;
图8是本发明优选实施例中的消融导管之导管本体的端面示意图;
图9是本明优选实施例中的套管的局部示意图;
图10是本发明优选实施例中的第一限位部件对导管本体的空腔内所有测温部件的导线进行限位的示意图,其中第一限位部件的外部设置第二限位部件,且多个第二限位部件连接成环状结构;
图11是本发明优选实施例中的第二限位部件或限位部件连接成环状结构的示意图。
附图标记说明如下:
1-消融导管;2-消融能量输出装置;3-控制装置;4-肾动脉口部;5-肺静脉;6-控制手柄;7-肾动脉;8-测温点;9-电性输入输出接口;10-内腔接口;11-流体接口;13-导管本体;131-外管;132-芯杆;15-第二测温部件;16-消融区域;17-第一测温部件;18-显影标识;19-软头;20-双层球囊;21-外层球囊;22-内层球囊;23-固定件;24-导线;241-弯曲部;242-延伸部;25-套管;251-扩大部;252-收缩部;27-进液管;28-拉线管;29-环形圈;30-虚线框;31-环状结构;32-线状弹性体。
具体实施方式
为使本发明的内容更加清楚易懂,以下结合说明书附图对本发明做进一步说明。当然本发明并不局限于该具体实施例,本领域的技术人员所熟知的一般替换也涵盖在本发明的保护范围内。其次,本发明利用示意图进行了详细的表述,但这些示意图仅为了便于详述本发明实例,不应对此作为本发明的限定。
另外,以下说明内容的各个实施例分别具有一或多个技术特征,然此并不意味着使用本发明者必需同时实施任一实施例中的所有技术特征,或仅能分开实施不同实施例中的一部或全部技术特征。换句话说,在实施为可能的前提下,本领域技术人员可依据本发明的公开内容,并视设计规范或实作需 求,选择性地实施任一实施例中部分或全部的技术特征,或者选择性地实施多个实施例中部分或全部的技术特征的组合,借此增加本发明实施时的弹性。
本文中,“近端”和“远端”是从使用产品的医生角度来看相对于彼此的元件或动作的相对方位、相对位置、方向,尽管“近端”和“远端”并非是限制性的,但是“近端”通常指该产品在正常操作过程中靠近医生的一端,而“远端”通常是指首先进入患者体内的一端。如在本说明书中所使用的,单数形式“一”、“一个”以及“该”包括复数对象,除非内容另外明确指出外。如在本说明书中所使用的,术语“或”通常是以包括“和/或”的含义而进行使用的,除非内容另外明确指出外。此外,术语“周向”通常指的是围绕球囊导管的轴线的方向;术语“轴向”通常指的是平行于球囊导管的轴线的方向。
如背景技术,现有技术中公开了一种带线状传感器的球囊导管,该球囊导管记载在授权公告号为CN109646106 B的发明专利中,其中双层球囊之夹层中的测温部件能够相对于球囊产生位移,使得测温部件能较好的顺应球囊的扩张或收缩。但是本申请发明人发现,当夹层中的测温部件的数量增加时,在导管本体之空腔中的导线的数量也会增加,且空腔内的空间较为有限,在该有限的空间内布置较多导线时,当球囊发生伸缩、导管发生旋转和扭曲等活动时,由于导线也需要做出相应的运动,运动过程中,一旦导线发生干扰,如聚集、堆叠或缠绕等问题,就会导致导线的活动受到限制而不能随着球囊的伸缩以及导管的运动而运动,进而导线受力时就容易断裂,从而不能对球囊表面的温度进行监测,而且还会阻碍导管的活动。
鉴于此,本发明提供了一种球囊导管,旨在克服上述发明专利所存在的缺陷,但本领域技术人员应当可以理解,尽管本发明实施例中的位于双层球囊的夹层中的测温部件与申请人授权公告号为CN109646106 B的发明专利中的测温部件相似,但应当不限于该发明专利所公开的方式来实现测温部件在夹层中的布置,而且本领域技术人员还应当理解,本发明实施例中的球囊不限于双层球囊,此外,本发明实施例中的测温部件不限于在球囊上布置,还可以布置在导管本体位于球囊内部的管段上。也就是说,本发明的球囊导管 旨在解决导管本体之空腔中的导线数量较多时所存在的上述问题,而不限制测温部件的具体布置位置和布置方式,上述列举的球囊导管的结构仅为本发明解决问题的一个实施例,本申请对球囊的类型、材质以及导管本体的结构布置等等不做限制。
具体地,本发明提供的球囊导管包括:导管本体;球囊,设置于所述导管本体的远端;测温部件,包括导线和测温模块,所述测温模块设置在所述球囊上或设置在所述导管本体上,且所述测温部件的导线的一部分在所述导管本体的空腔内布置并沿所述导管本体的空腔的轴向延伸;以及限位部件,设置在所述导管本体的空腔中,并用于限制所述测温部件的导线在所述导管本体的空腔内的位置。在一些实施方式中,所述测温部件的导线能够相对于所述限位部件活动,使得球囊伸缩时导线的活动不受限制而避免导线断裂。在另外一些实施方式中,所述测温部件的导线相对于所述限位部件固定,如当导线外部套设环形圈时,多个所述环形圈依次连接成环状结构,相邻所述环形圈之间连接一根线状弹性体,由于环形圈之间有弹性,在球囊伸缩时可承受一定的拉力,此时,导线即使与环形圈固定设置也不会引起导线断裂。
本发明的球囊导管通过限位部件对测温部件的导线进行限位保护,避免导线之间发生聚集、堆叠、缠绕等干扰问题,从而保证导线在导管本体的空腔中具有必要的活动空间而不会受到束缚,由此避免导线受力断裂的风险,并且还可避免导线因聚集、堆叠、缠绕等干扰问题对导管本体(芯杆和/或外管)活动的阻碍,从而降低手术操作难度。
在一个实施例中,所述导管本体包括外管和设置于所述外管内的芯杆,所述芯杆的远端伸出所述外管,所述外管和所述芯杆之间形成环形空腔,所述球囊的远端与所述芯杆连接,所述球囊的近端与所述外管连接,所述导管本体的空腔包括所述环形空腔,所述限位部件设置在所述环形空腔内。
本发明较佳实施例中,所述球囊优选为双层球囊,所述双层球囊包括内层球囊和包围所述内层球囊的外层球囊,所述双层球囊的远端与所述芯杆连接,所述双层球囊的近端与所述外管连接。
本发明较佳实施例中,所述测温部件的数量为多个。在一些实施方式中, 多个所述测温部件的测温模块设置于所述内层球囊和所述外层球囊之间的夹层中,如设置于内层球囊的外表面上或外层球囊的内表面上。在另一些实施方式中,多个所述测温部件的测温模块设置于所述导管本体(芯杆)上并位于所述内层球囊的内部。在其他实施方式中,一些测温模块设置于所述夹层中,一些测温模块设置于所述导管本体(芯杆)上并位于所述内层球囊的内部。其中当测温模块设置于所述夹层中,如在内层球囊的外表面或外层球囊的内表面,此时,所述测温模块能够相对于与之连接的内层球囊或外层球囊产生位移,使测温模块不会影响球囊的扩张或收缩,且测温模块也不会被拉扯断裂。
以下结合附图和优选实施例,对本发明提出的球囊导管作进一步的说明,且本发明的球囊导管不限于消融导管,也可以是标测导管,或者其他需要监测球囊表面温度的导管。以下描述中虽以双层球囊和消融导管为示意,但此示意不以此构成对本发明的限定,本发明的方案同样适用于单层球囊,以及其他用途的球囊导管。
图1是本发明优选实施例中的消融系统进行心脏消融的示意图,图2是本发明优选实施例中的消融系统进行肾动脉消融的示意图。
如图1和图2所示,本实施例提供一种消融系统,包括消融导管1、消融能量输出装置2和控制装置3,其中消融能量输出装置2与消融导管1流体连通,以向消融导管1提供消融介质。在一些实施例中,控制装置3与消融能量输出装置2连接,而消融能量输出装置2又与消融导管1连接。在另一些实施例中,控制装置3也可以分别与消融能量输出装置2和消融导管1连接。在另一些实施例中,控制装置3与消融能量输出装置2可整合在同一设备中。本发明对此不做限制。所述控制装置3的主要作用是根据测温部件检测到的温度信息控制消融能量输出装置2调整消融介质的温度(如冷冻液体的温度),以使双层球囊表面的温度在预设的消融温度范围内。所述消融系统包括但不限于对目标组织进行冷冻消融,而目标组织可以是心腔或肾动脉等,具体不作限制。
例如图1所示,可将消融系统应用于心腔治疗,将消融导管1通过介入 方式置入心腔内部,以对肺静脉5进行消融,实现心律失常的治疗。或者如图2所示,也可将消融系统应用于肾动脉,将消融导管1通过介入方式置于入肾动脉口部4,对肾动脉7进行消融,以此调节肾动脉血压。
进一步的,以肺静脉的冷冻消融为例,结合图3对消融系统的工作原理做进一步的说明。
步骤S1,在冷冻消融前,将消融导管1的控制手柄6与消融能量输出装置2连接。
步骤S2,将消融导管1插入相应需要进行消融手术的目标组织中,如插入到心腔内部的筒状组织中,即插入肺静脉口。
步骤S3,消融导管1远端的双层球囊20充盈,并向双层球囊20释放冷冻液体。
步骤S4,调整双层球囊20在筒状组织中的位置。
步骤S5,通过测温部件检测的温度信息分析双层球囊20的外表面的温度。
步骤S6,判断双层球囊20与筒状组织的接触情况,若双层球囊20与筒状组织的接触良好则进行下一步骤,若双层球囊20与筒状组织的接触不良则返回步骤S4。
步骤S7,开始冷冻消融。
步骤S8,通过测温部件检测的温度信息分析双层球囊20的外表面的温度。
步骤S9,验证消融效果。具体地,根据冷冻消融手术过程中的肺静脉电位的变化来评价冷冻消融的效果。若冷冻消融的效果不佳,可重复进行冷冻消融,直至组织获得理想的组织消融效果。
步骤S10,结束消融手术。
其中,所述控制装置3根据消融导管1检测的温度信息,分析判断双层球囊20与目标组织的接触情况,并据此控制消融能量输出装置2调整冷冻液体的消融温度。
所述控制装置3可包括制冷控制单元。所述消融能量输出装置2包括制冷单元、流体源和流体输出通道。所述流体源与流体输出通道连通,流体输出通道进而用于向消融导管1输出所述流体源中的流体,例如所述流体输出 通道与控制手柄6上的流体输入接口连接,通过该接口向消融导管1输入消融介质。所述制冷单元设置于流体输出通道上,用于对流体输出通道中输送的流体进行制冷。所述制冷单元可以是压缩机或其它制冷装置,本发明对其结构不作具体限定。所述制冷单元用于与制冷控制单元通信连接,以通过制冷控制单元控制制冷单元的工作状态。更进一步来说,所述制冷控制单元用于根据接收到冷冻消融的指令,控制制冷单元工作,使流体输出通道向消融导管1提供冷冻液体。本发明实施例中,可在控制手柄6或电脑界面上设置冷冻消融按钮,当操作者启动冷冻消融按钮时,即向制冷控制单元发出冷冻消融的指令。其中电脑界面可以设置在控制装置3或消融能量输出装置2上。在一非限制性的操作中,所述制冷控制单元向制冷单元发出一制冷信号,制冷单元根据接收到的所述制冷信号进行制冷。
在冷冻消融时,所述制冷控制单元可根据多个测温部件反馈回的温度信息,控制制冷单元调节其制冷温度,以此控制球囊表面的温度在预设的冷冻消融温度范围内。
更详细来说,如图4所示,所述消融系统实施冷冻消融的工作过程具体包括:
步骤401:流体源向流体输出通道输出流体;
步骤402:制冷控制单元控制制冷单元制冷;
步骤403:经过制冷后,使流体到达预设的制冷温度;
步骤404:向内层球囊喷射冷冻液体;这里,步骤401、402、403、404实际上可同时进行,即开始制冷的同时向球囊内表面喷射冷冻液体;
步骤405:制冷过程中,制冷控制单元实时根据测温部件反馈回的温度信息,控制制冷单元的制冷温度;
步骤406:球囊表面的温度到达冷冻消融所需的温度(例如是-40℃~-60℃),并维持一段时间后(例如是120~180秒),即可结束冷冻消融。
完成一次冷冻消融后,根据实际冷冻消融的效果,医生确定是否进行下一次的冷冻消融。但是,应知晓的是,如果医生确定需要进行下一次的冷冻消融,则在本次冷冻消融后,需要进行步骤407(将双层球囊20在体内自然 复温到体温),之后才可实施下一次的冷冻消融。
所述消融导管1的优选结构如图5和图6所示,并结合图8和图10,所述消融导管1包括双层球囊20、第一测温部件17、导管本体13、固定件23和进液管27。所述双层球囊20设置于导管本体13的远端,并使得导管本体13的一部分位于双层球囊20内。所述导管本体13包括外管131和芯杆132,所述芯杆132设置在外管131内,且所述芯杆132的远端伸出外管131并与双层球囊20的远端连接,而双层球囊20的近端则与外管131连接。所述进液管27的远端置于双层球囊20的内部,并螺旋设置在芯杆132上,用于向双层球囊20喷射消融介质,这里的消融介质包括但不限于冷冻液体。所述芯杆132和外管131之间形成环形空腔。
所述双层球囊20包括外层球囊21和内层球囊22,所述外层球囊21包围在内层球囊22外,所述外层球囊21和内层球囊22的近端和远端皆固定于导管本体13上。所述外层球囊21和内层球囊22均可扩张,例如通过进液管27的远端向内层球囊22的内腔喷射冷冻液体,冷冻液体在吸收人体组织热量后瞬间气化扩张,从而使得内层球囊22发生扩张。所述内层球囊22扩张时,所述外层球囊21在所述内层球囊22的作用下扩张。
所述第一测温部件17包括导线24和测温模块,所述导线24的数量一般为两根,例如由并行的Cu导线和CuNi导线组成,并可在球囊的特定区域点将Cu导线和CuNi导线导通,形成所述测温模块(即测温点8,图5~图7)。所述测温模块用于感测温度并产生温度信息,所述测温模块还用于将温度信息转换为电信息,并通过一组导线传递所述电信息,从而将电信息传递出去。所述第一测温部件17至少为一个,且其测温模块设置在内层球囊22和外层球囊21所形成的夹层(未图示)中。由于第一测温部件17的测温模块可检测与第一测温部件17临近的消融区域16的温度信息,而第一测温部件17的测温模块又设置在内层球囊22和外层球囊21形成的夹层中,内层球囊22和外层球囊21之间的区域与双层球囊20的外表面的距离较近,因此通过第一测温部件17检测的温度信息估算双层球囊20的外表面的温度信息时,可使估算的双层球囊20的外表面的温度信息的准确度提高,进而可改善消融效果。 此外,所述第一测温部件17通过固定件23贴附于内层球囊22或者外层球囊21,例如在图7中,所述第一测温部件17通过固定件23贴附于内层球囊22的外表上或外层球囊21的内表面上,从而使得第一测温部件17的测温模块能够在双层球囊20上指定的位置进行温度的监测。而为了使第一测温部件17能够顺应双层球囊20的扩张和收缩,通过固定件23的吸附能力或其他合适的能力,当双层球囊20扩张或者收缩时,所述固定件23能够随着与之连接的球囊表面材料的变形相对于双层球囊20产生位移,而由于所述第一测温部件17通过固定件23贴附于内层球囊22或者外层球囊21上,进而也使得第一测温部件17也能够相对于双层球囊20或固定件23产生位移,且第一测温部件17与固定件23也可能产生相对位移。在本发明较佳实施例中,所述固定件23以物理吸附的方式与第一测温部件17以及相应的球囊表面连接,该方案的实现方式已经记载于申请人授权公告号为CN109646106 B的发明专利中,因此,不再详细叙述。
接下去参考图6和图7,所述第一测温部件17优选为多个(本文中,多个是指至少两个),且多个所述第一测温部件17的测温模块在所述夹层中的不同位置分布,优选地,围绕内层球囊22的中轴线沿周向均匀分布,这样可形成多个测温点8,每个第一测温部件17的测温模块即构成一个测温点8。本实施例中,由于设置有多个第一测温部件17,因此可通过第一测温部件17检测多个位置处的温度信息。测温点8的数量不限于图6中所示的六个,还可以少于六个或超过六个。进一步的,所述第一测温部件17为线状传感器,例如热电偶温度传感器或者热敏电阻温度传感器,也即所述测温模块可以是常用的热电偶或热敏电阻,热电偶例如是T型或K型等。其中所有第一测温部件17的导线24的一部分设置在球囊的内腔中,另一部分被布置在外管131和芯杆132之间的环形空腔中并沿环形空腔的轴向延伸,且每个第一测温部件17的导线24的近端与控制手柄6上的电性输入输出接口9连接,从而将测量的温度信息向外输出。
所应理解,除了在双层球囊20的夹层中设置测温模块以外,还可以在其他位置设置测温模块。为了便于区分,本文中,将在双层球囊20的夹层中设 置的测温模块定义为第一测温部件17的测温模块,而在其他位置的测温模块定义为第二测温部件的测温模块。例如图5所示,在芯杆132位于双层球囊20内的管段上还设置至少一个第二测温部件15的测温模块,用于获取球囊内部的温度信息,且所述第二测温部件15的测温模块亦通过导线24与控制手柄6上的电性输入输出接口9连接。当然不同的测温部件可连接同一个电性输入输出接口9,且在该电性输入输出接口9中可设置不同的数据通道,使各测温部件通过不同的数据通道传送数据。
本发明优选实施例中,所述双层球囊20的夹层中布置有至少一个第一测温部件17的测温模块,同时在芯杆132位于球囊内的管段上布置至少一个第二测温部件15的测温模块,优选的,第一测温部件17为多个。进一步地,在以下描述中,以六个第一测温部件17和一个第二测温部件15作为示意,对多个测温部件的导线24在环形空腔内的限位方式作进一步的说明。本实施例中,每个测温部件(如第一测温部件17、第二测温部件15)均包括一个测温模块和一组导线24(一组通常为两根)。
请继续参阅图5~图7,可在内层球囊22的外表上布置六个第一测温部件17的测温模块,并在芯杆132上布置一个第二测温部件15的测温模块,该六个第一测温部件17的导线24和一个第二测温部件15的导线24均一部分布置在芯杆132和外管131之间的环形空腔中,另一部分在球囊的内腔中。且当芯杆132和外管131的尺寸一定的情况下,随着导线24数量的增加,在环形空腔内的导线24的活动空间也容易受到束缚。为了解决该技术问题,在至少一些测温部件的导线24的外部设置限位部件,使得至少一些测温部件的导线24的位置被所述限位部件所限制,从而将多个测温部件的导线24在环形空腔中相隔离或隔开,避免多根导线24在环形空腔内干扰(如聚集、缠绕等),且被所述限位部件所限制的导线24既可相对于该限位部件活动,也可相对该限位部件固定,本发明对此不作限定。这样做,通过限位部件可避免导线24之间相互干扰,确保导线24的活动不会受到限制,从而在受力时不容易断裂,同时也可避免导线24对芯杆132和/或外管131的活动造成阻碍。
在一些实施例中,所述限位部件的数量与测温部件的数量相同,多个所 述限位部件分开设置在所述环形空腔内,且多个测温部件的导线24分别穿过不同的限位部件,从而使所有测温部件的导线24通过限位部件进行限位保护,实现在环形空腔内的相互隔离,以此有效地避免多根导线24间相互干扰的问题。
在另一些实施例中,所述限位部件的数量为至少一个且少于测温部件的数量,且仅部分测温部件的导线24穿过限位部件,且每个限位部件供一个测温部件的导线24穿设。进一步的,由所述限位部件限制的导线24非相邻设置,此时,并未对所有测温部件的导线24的位置进行限制,而仅对非相邻的导线24的位置进行限制,这样做,同样可达到隔离或隔开多根导线24的效果,避免导线24间相互干扰的问题,并且可以尽可能减少限位部件对有限空间的占用。
进一步的,当每个测温部件的导线24的位置均通过限位部件限制时,优选至少相邻限位部件沿环形空腔的轴向错开布置(即不在同一周向),从而避免多个限位部件相互干扰的问题。
进一步的,所述限位部件可以固定设置在环形空腔内,也可活动设置在环形空腔内。当所述限位部件固定设置在所述环形空腔内时,所述限位部件可与外管131的内壁固定连接,或与芯杆132的外壁固定连接,或者,所述限位部件一直延伸至导管本体13的近端后与控制手柄6固定连接。因此,本发明对限位部件的固定方式不作限定。
另外,还应理解,为了实现对导线24的限位,所述限位部件具有轴向贯通的限位槽,只要将测温部件的导线24穿入并穿出限位槽,即可达到对导线24进行限位的目的,结构简单,而且能够在有限的空间内布置限位部件。本实施例中,所述限位槽可以与外管131的内壁配合来全围绕导线24,也即,将限位槽设计为非闭合的腔体,或者所述限位槽本身被设计为闭合的腔体,使得限位槽自身可全围绕导线24。除此之外,本发明对限位部件围绕导线24的长度不作特别的限制,既可以围绕导线24在环形空腔内的一部分长度,也可以围绕导线24在环形空腔内的全部长度。也即,所述限位部件的轴向长度可以小于或等于外管131的轴向长度。进一步需要理解的是,本文中,每个 测温部件包括两根导线24并形成一组,该一组导线的位置通过一个或多个限位部件进行限制。
进一步的,所述限位部件可设计成套管25(参阅图7),套管25可以为圆形或椭圆形管子。在实际操作中,只要将套管25套设在导线24的外部即可,且导线24优选能够相对于套管25活动,可以更好的保证导线24能够自由伸缩。并且所述套管25在环形空腔中可活动或固定设置。进一步的,在同一个测温部件的导线24上可套设一个或多个套管25,同一组导线上的多个套管25沿导线24的延伸方向间隔布置。
所述套管25的材料为高分子材料,更优选为热塑性材料,所述热塑性材料包括PET(聚对苯二甲酸乙二醇酯)、Pebax(聚醚酰胺)、PTFE(聚四氟乙烯)、PI(聚酰亚胺)及PA(尼龙)等高分子材料中的一种或多种组合,以得到具有一定硬度和柔软度的套管25,不仅避免对导线24造成损伤,也可较好的隔离导线24。更优选的,所述套管25的材料为PET材料,以获得具有一定硬度的套管25,避免套管25在导线24活动过程中发生形变,增加导管使用的难度,使得导管的使用效果更好。
考虑到外管131和芯杆132之间的环形空腔的尺寸较小,因此,套管25的尺寸也不能设计的很大,并且在制作时为了节省空间,可进一步将套管25的内壁与其内部的导线24紧贴,即套管25的内尺寸(如内径)与导线24的外径相匹配或略大于导线24的外径,并保证导线24在套管25内可活动即可。所述套管25可通过胶水与外管131或芯杆132固定连接,或延伸至近端与控制手柄6固定连接。此外,本发明对套管25的长度不作限定,例如可以与外管131的长度一致,或短于外管131的长度,例如只在靠近双层球囊20的近端处设置一小段套管25。当套管25的长度较短时,可直接粘贴于外管131的内壁上,当套管25的长度延伸至近端的控制手柄6时,套管25还可粘贴于控制手柄6。
进一步的,所述导线24还可以局部被加工成弯曲形状,如蛇形弯曲,从而得到具有弯曲部241的导线24(参阅图9)。如图9所示,所述导线24包括延伸部242和至少一个弯曲部241,所述延伸部242即为没有弯曲的导线。 当弯曲部241在收缩状态下时,所述弯曲部241的整体径向尺寸大于导线24的延伸部242的径向尺寸。在实际制作时,可将铜线在加热状态下弯曲成蛇形,然后淬火处理定型。所述弯曲部241具有类似于弹簧的性能,能够在受拉力时伸长,且在外力作用消失后自动回缩。因此,通过设置弯曲部241,可为导线24的活动提供一定的伸缩余量,避免其在导管活动或球囊伸缩时断裂。较佳地,所述弯曲部241在收缩状态时(即图9上所示虚线框30中的导线)的轴向长度为2mm~5mm)。进一步的,导线24整体上可伸长的位移量不超过内层球囊22充气膨胀后外径的60%,在本实施例中,第一测温部件17的导线24的远端设置在双层球囊20的半球上,这样的尺寸设置,使得球囊从收缩状态变成膨胀状态时,由于导线24有一定的伸缩余量而能够随球囊一起伸缩,同时导线24的可伸长的位移量没必要太大,一方面因为所述导管本体的空腔的空间有限,没必要占用太多空间,另一方面也避免导线24的相互缠绕。本发明对弯曲部241的数量和位置不作限定,所述弯曲部241可位于导线24上的任意位置,如靠近球囊的近端或靠近控制手柄6,或者在球囊的近端和控制手柄6之间的任意位置。
继续参阅图9,所述套管25优选包括收缩部252和至少一个扩大部251(图9中利用虚线框30圈出了扩大部251),所述收缩部252的内腔的横截面积小于扩大部251的内腔的横截面积。从而通过扩大部251储存导线24的弯曲部241,对弯曲部241进行限位保护,防止不同导线上的弯曲部241在球囊伸缩或导管运动时相互缠绕,以此进一步降低导线干扰的问题,减小导线受力拉断的风险。此外,所述收缩部252储存导线24的延伸部242。且所述扩大部251的最大外尺寸(外径)小于外管131和芯杆132之间的环形空腔的宽度。如此构造,确保了弯曲部241在球囊膨胀或收缩时的可活动性,进一步保证了导线24在受力时不至于被拉断。在一些实施例中,所述套管25的数量与测温部件的数量相同,多个套管25分开设置在环形空腔内,多个测温部件的导线24分别可活动地穿过不同的套管25,此时,优选至少相邻测温部件的导线24外部的套管25的扩大部251沿环形空腔的轴向错开布置(即不在芯杆132的同一个周向位置),从而降低套管25之间的干扰风险。或者, 套管25的数量为至少一个且少于测温部件的数量,部分测温部件的导线24可活动地穿过套管25,每个套管25供一个测温部件的导线24穿设,且配置有套管25的所述测温部件的导线24非相邻设置,或至少相邻测温部件的导线24外部的套管25的扩大部251沿环形空腔的轴向错开布置。
进而在组装时,只要将套管25套在测温部件的导线24上,并将套管25移动至导线24的弯曲部241,保证导线的弯曲部241处于套管25的扩大部251中。进一步的,为了减少材料成本,优选设计较短的套管25,例如套管25的轴向长度为10mm~20mm,较佳的在靠近球囊的近端处设置,这样的尺寸设计,在减少成本的同时,也可以确保导线的弯曲部241处于套管25的扩大部251中,避免导线24相互干扰。
本发明对套管25的形状不作限定,不限于上述举例的椭圆形、圆形,还可以是其他形状,如圆形、矩形等规则形状,或其他不规则形状。
进一步参阅图8,例如在球囊导管上布置六个第一测温部件17以及一个第二测温部件15,总共七个测温部件,较佳的,在每个测温部件的导线24外部设置至少一个套管25。不同导线24上的套管25可沿环形空腔的周向均匀或不均匀布置,也可在环形空腔内随意布置。并且环形空腔内通常还会布置其他管腔或其他导线,如进液管27和拉线管28,拉线管28为2个。所述拉线管28内设置拉线,用于控制球囊导管远端的弯曲形变。
进一步的,所述消融导管1包括多个限位部件,以套管25作为限位部件为例,多个所述套管25围绕芯杆132的轴线周向间隔布置,且多个所述套管25优选依次连接成环状结构。也即,在一些实施方式中,多个周向布置的套管25彼此独立且不连接,在另一些实施方式中,多个周向布置的套管25彼此连接在一起,形成环状结构。还应理解,在此方案中,多个套管25可活动地设置在环形空腔内且相互连接在一起。进一步的,所述环状结构的数量为一个或多个,多个所述环状结构沿芯杆132的轴向间隔地设置,从而可沿导线24的延伸方向布置多个环状结构进行限位。在实际使用时,可在组成环状结构的每个套管25的内部穿设导线24,且该环状结构所具有的套管25的数量小于或等于测温部件的数量,使部分测温部件的导线24通过套管25来限 制,或者使每个测温部件的导线24均通过套管25来限制。在此,应理解,所述环状结构具有弹性,能够随着套管25或导线24的运动而产生相应的变形,不仅不会阻碍导管的运动和球囊的伸缩,而且还可以避免多个套管25之间的相互干扰。此时,套管25内部的导线24优选相对于套管25可活动。
在另外的实施方式中,如图11所示,所述限位部件可设计成带有环形圈的环状结构31,相邻的环形圈29通过线状弹性体32相连,形成环状结构31。环形圈29的内部供测温部件的导线24穿设,环形圈29的数量小于或等于测温部件的数量,使部分测温部件的导线通过环形圈29来限制,或者使每个测温部件的导线均通过环形圈29来限制,环形圈29和线状弹性体32均由弹性材料制成,如硅橡胶、PA、Pebax、PI等,具体材料没有要求。所述环状结构31的数量可设置为一个或者多个,多个环状结构31沿芯杆132的轴向间隔地设置,从而可沿导线24的延伸方向布置多个环状结构31进行限位,这样的设计可以防止导线24相互干扰,同时也可以防止导线24的运动影响导管本体13内部组件的操作。进一步的,所述环形圈29既可以为环形线圈结构,也可以为PI管状结构,在此不做限制。
在其他实施例中,所述限位部件包括第一限位部件和第二限位部件,所述第二限位部件用于限制所述第一限位部件的位置,所述第一限位部件用于限制所述测温部件的导线24的位置。具体的,在第一限位部件的内部穿设导线24,在第二限位部件的内部设置第一限位部件。
进一步的,当第一限位部件为多个时,多个第一限位部件围绕芯杆132的轴线沿周向间隔布置,此时,第二限位部件的数量可与第一限位部件的数量相同,以使每个第一限位部件通过第二限位部件进行限定。或者,当第一限位部件为多个时,第二限位部件的数量为多个且少于第一限位部件的数量,使得部分第一限位部件通过第二限位部件进行限制。本实施例中,第二限位部件可设计成环形圈29,多个环形圈29依次连接成环状结构31(图11),相邻的环形圈29通过线状弹性体32相连,其中每个环形圈29的内部设置第一限位部件,此处的第一限位部件可以是套管25或其他合适的结构。
本发明较佳实施例中,所述消融导管1包括第一限位部件和围绕所述第 一限位部件设置的第二限位部件。如图10所示,所述第一限位部件优选为套管25,所述第二限位部件优选为环形圈29,所述环形圈29和所述套管25均围绕芯杆132的轴线沿周向间隔布置,所述套管25的内部用于穿设测温部件的导线24,以通过套管25限制导线24的位置,优选地,测温部件的导线24可活动地设置于所述套管25中,所述环形圈29的内部设置套管25,其中多个所述环形圈29依次连接成所述环状结构31,且相邻环形圈29之间连接一根线状弹性体32,优选地,套管25固定设置于环形圈29中。环形圈29可由一根或多根细丝绕制成环状,相比于套管25的长度几乎可以省略不计。所述环状结构31类似于弹簧线圈的结构,从而利用环状结构31对所有的套管25进行固定。在实际使用时,首先将环状结构31套在芯杆132的外部,然后将内含导线的套管25分别穿过弹性线圈圆周上的环形圈29,环形圈29的大小可与套管25上的收缩部252和/或扩大部251的大小相接近,进而将导线24及套管25分散固定于外管131内的芯杆132的周围。
所述环状结构31由弹性材料制成,如硅橡胶、PA、Pebax、PI等。应理解,所述环状结构31能够随着套管25或导线24的运动而产生相应的变形,所述环状结构31的材料优选硅橡胶,由于硅胶材料比较常用且生物相容性好,而且弹性大,因此使用更为安全和可靠。较佳地,可以通过环状结构31与外管131和芯杆132之间的摩擦力对环状结构31进行位置限制,相较于使用胶水固定等方式,采用环状结构31可以有效降低限位部件处的导管整体硬度。
进一步的,多个环状结构31可以从消融导管1的球囊的近端向控制手柄6依次间隔一段距离设置,如间隔100mm设置。
继续参考图5,在本实施例中,所述导管本体13为非刚性结构,可任意弯曲。所述导管本体13的材料优选为高分子材料,如带有金属编织丝的热塑性聚氨酯弹性体橡胶(Thermoplastic polyurethanes,TPU)、嵌段聚醚酰胺树脂(Pebax)或尼龙,也可以是金属编织管。优选的,所述导管本体13的近端设置有控制手柄6,所述控制手柄6具体可用于操纵和操控导管本体13的弯曲状态。所述控制手柄6上设置有电性输入输出接口9,所述第一测温部件17的近端穿过导管本体13与电性输入输出接口9连接,以便于将检测到的温 度信息向外部设备传送。所述控制手柄6还可包括:至少一个流体接口11;以及至少一个内腔接口10。所述内腔接口10用来插入导丝、标测导管、输送造影剂等器械。所述流体接口11与进液管27流体连通,用于将外部提供的消融介质输入消融导管1,还可用于排出双层球囊20内的消融介质或其他介质。所述进液管27的远端设置于内层球囊22内,用于向内层球囊22的内表面喷射消融介质。进一步的,所述进液管27具体包括远端的螺旋结构和与螺旋结构流体连通的纵向延伸部分,所述纵向延伸部分穿过导管本体13与流体接口11连接。所述螺旋结构上设置有多个流体喷射口,多个流体喷射口用于朝不同的方向喷射消融介质a。
所述控制手柄6设置在外管131上,所述进液管27和芯杆132并排地穿设于外管131中。其中所述芯杆132为中空结构且可活动地设置在外管131内,且通过调节控制手柄6可使芯杆132在外管131内移动,以完成双层球囊20出鞘释放和入鞘回撤。所述芯杆132的近端与控制手柄6上的内腔接口10相连通,用来输送相关器械如导丝、标测导管或造影液等。实际应用时,流体排放管道设置于芯杆132和外管131之间。此外,所述芯杆132伸出双层球囊20的远端较佳地设置有软头19,所述软头19的材质较软,用于避免对组织造成损伤。优选的,所述芯杆132的远端设置有显影标识18,所述显影标识18的材料为金属显影材料,术中,医生可借助于显影设备,通过显影标识18可确认双层球囊20相对于外鞘管的位置。
最后,本发明较佳实施例如上所述,但不限于上述实施例所公开的范围,例如所述限位部件不限于管状结构包围导线,例如还可通过螺旋缠绕的方式包围导线,或者通过环形线圈包围导线,因此,对限位部件包围导线的结构不作特别的限制,只要能够达到令多根导线相互隔开的效果便可。本申请提供的各实施例之间还可以组合使用,比如:导线设置弯曲部,套管设置扩大部,所述弯曲部设置在所述扩大部中,所述套管有多个,沿芯杆的轴线周向布置,多个所述套管外设置有环形圈,所述环形圈用于限制所述套管,相邻所述环形圈之间形成环状结构等等,本申请对此不作限制。
本发明的创新虽然来源于电生理球囊导管及其消融系统技术领域,但本 领域的技术人员可以理解,本发明同时也可以应用于其他领域的导管技术,比如,多爪导管,其每个爪上布置有若干个电极,多爪导管可根据实际需求进行控弯实现诊断和治疗的目的,但在控弯过程中,其爪上的若干电极导线容易受到拉伸断裂,或者所述若干电极的导线在导管内腔中相关缠绕,影响导管的使用,此时,可使用上述技术解决所述若干电极的导线断裂或者相互缠绕的问题;再比如,球囊射频消融导管,其在球囊上布置有若干电极及传感器,用于诊断、治疗或监测组织情况,球囊上的电极及传感器的导线在球囊进行伸缩时同样容易断裂或者其在导管内腔中容易相互缠绕等等,此时,同样可以使用上述技术解决电极及传感器的导线断裂或者相互缠绕的问题。甚至可以应用于其他需要解决导线相互干扰或导线缠绕断裂等问题的领域,可以应用本发明的技术构思,仅需要进行结构上的适应性调整即可。
上述描述仅是对本发明较佳实施例的描述,并非对本发明范围的任何限定,本发明领域的普通技术人员根据上述揭示内容做的任何变更、修饰,均属于本发明的保护范围。

Claims (15)

  1. 一种球囊导管,其特征在于,包括导管本体、球囊、测温部件和限位部件;
    所述球囊设置于所述导管本体的远端;所述测温部件包括导线和测温模块,所述测温模块设置在所述球囊或所述导管本体上,所述测温部件的导线的一部分在所述导管本体的空腔内布置并沿所述导管本体的空腔的轴向延伸;
    所述限位部件设置在所述导管本体的空腔内,并用于限制所述测温部件的导线在所述导管本体的空腔内的位置。
  2. 根据权利要求1所述的球囊导管,其特征在于,所述导管本体包括外管和设置于所述外管内的芯杆,所述芯杆的远端伸出所述外管,所述外管和所述芯杆之间形成环形空腔,所述球囊的远端与所述芯杆连接,所述球囊的近端与所述外管连接,所述导管本体的空腔包括所述环形空腔;所述限位部件设置在所述环形空腔内。
  3. 根据权利要求1或2所述的球囊导管,其特征在于,所述测温部件的数量为多个;
    所述限位部件的数量与所述测温部件的数量相同,多个所述限位部件分开设置在所述导管本体的空腔内,多个所述测温部件的导线分别穿过不同的所述限位部件,或者,
    所述限位部件的数量为至少一个且少于所述测温部件的数量,部分所述测温部件的导线穿过所述限位部件,且每个所述限位部件供一个所述测温部件的导线穿设。
  4. 根据权利要求3所述的球囊导管,其特征在于,配置有所述限位部件的所述测温部件的导线非相邻设置,或者至少相邻所述限位部件沿所述导管本体的空腔的轴向错开布置。
  5. 根据权利要求2所述的球囊导管,其特征在于,所述限位部件与所述外管的内壁或所述芯杆的外壁固定连接;或者
    所述球囊导管还包括控制手柄,设置在所述导管本体的近端,所述限位 部件与所述控制手柄固定连接。
  6. 根据权利要求2所述的球囊导管,其特征在于,所述限位部件的数量为多个,多个所述限位部件围绕所述芯杆的轴线沿周向间隔布置,且多个所述限位部件依次连接成环状结构。
  7. 根据权利要求6所述的球囊导管,其特征在于,所述限位部件包括套管,所述套管的内部用于穿设所述测温部件的导线,以限制所述测温部件的导线的位置,且多个所述套管依次连接成所述环状结构;或者,
    所述限位部件包括环形圈,所述环形圈的内部用于穿设所述测温部件的导线,以限制所述测温部件的导线的位置,且多个所述环形圈依次连接成所述环状结构,且相邻所述环形圈之间连接一根线状弹性体。
  8. 根据权利要求6所述的球囊导管,其特征在于,所述限位部件包括第一限位部件和第二限位部件,所述第一限位部件用于限制所述测温部件的导线的位置,所述第二限位部件用于限制所述第一限位部件的位置;
    所述第一限位部件的数量为多个,多个所述第一限位部件围绕所述芯杆的轴线沿周向间隔布置;
    所述第二限位部件的数量为多个且少于所述第一限位部件的数量,部分所述第一限位部件的外部设置所述第二限位部件,且多个所述第二限位部件依次连接成环状结构,或者,
    所述第二限位部件的数量与所述第一限位部件的数量相同,并在每个所述第一限位部件的外部设置一个所述第二限位部件,所述第二限位部件依次连接成环状结构。
  9. 根据权利要求8所述的球囊导管,其特征在于,所述第一限位部件为套管,所述第二限位部件为环形圈,所述环形圈的内部设置所述套管,所述套管的内部用于穿设所述测温部件的导线,多个所述环形圈依次连接成所述环状结构,且相邻环形圈之间连接一根线状弹性体。
  10. 根据权利要求6-9中任一所述的球囊导管,其特征在于,所述环状结构的数量为一个或多个,多个所述环状结构沿所述导管本体的空腔的轴向间隔地设置。
  11. 根据权利要求10所述的球囊导管,其特征在于,所述测温部件的数量为多个,每个所述测温部件的导线一部分在所述导管本体的空腔内布置并沿所述导管本体的空腔的轴向延伸;其中组成所述环状结构的每个所述限位部件的内部穿设有一个所述测温部件的导线,且组成所述环状结构的所述限位部件的数量小于或等于所述测温部件的数量。
  12. 根据权利要求1或2所述的球囊导管,其特征在于,所述限位部件包括套管,所述套管的内部用于可活动地穿设所述测温部件的导线,以限制所述测温部件的导线的位置;
    所述套管包括收缩部和至少一个扩大部,所述收缩部的内腔的横截面积小于所述扩大部的内腔的横截面积;
    所述测温部件的导线包括延伸部和至少一个弯曲部,所述弯曲部能够伸缩;所述延伸部设置于所述收缩部中,所述弯曲部设置于所述扩大部中。
  13. 根据权利要求12所述的球囊导管,其特征在于,所述球囊导管包括多个所述测温部件,每个所述测温部件的导线一部分在所述导管本体的空腔内布置并沿所述导管本体的空腔的轴向延伸;
    所述套管的数量与所述测温部件的数量相同,多个所述套管分开设置在所述导管本体的空腔内,多个所述测温部件的导线分别可活动地穿过不同的所述套管,同时至少相邻所述测温部件的导线外部的所述套管的扩大部沿所述导管本体的空腔的轴向错开布置;或者,
    所述套管的数量为至少一个且少于所述测温部件的数量,部分所述测温部件的导线可活动地穿过所述套管,每个所述套管供一个所述测温部件的导线穿设,且配置有所述套管的所述测温部件的导线非相邻设置,或至少相邻所述测温部件的导线外部的所述套管的扩大部沿所述导管本体的空腔的轴向错开布置。
  14. 根据权利要求1或2所述的球囊导管,其特征在于,所述球囊为双层球囊,所述测温部件的数量为多个,多个所述测温部件的测温模块设置在所述双层球囊的夹层中和/或置于所述导管本体位于所述双层球囊内的管段上。
  15. 一种消融系统,其特征在于,包括如权利要求1-14中任一所述的球 囊导管、消融能量输出装置和控制装置,所述消融能量输出装置与所述球囊导管相连通,用于向所述球囊导管提供消融介质;所述控制装置用于根据所述测温部件检测到的温度信息控制所述消融能量输出装置调整所述消融介质的温度,以使所述球囊表面的温度在预设的消融温度范围内。
PCT/CN2021/121399 2020-12-25 2021-09-28 球囊导管及消融系统 WO2022134714A1 (zh)

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