WO2022148135A1 - Occlusion apparatus - Google Patents

Occlusion apparatus Download PDF

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Publication number
WO2022148135A1
WO2022148135A1 PCT/CN2021/130903 CN2021130903W WO2022148135A1 WO 2022148135 A1 WO2022148135 A1 WO 2022148135A1 CN 2021130903 W CN2021130903 W CN 2021130903W WO 2022148135 A1 WO2022148135 A1 WO 2022148135A1
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WO
WIPO (PCT)
Prior art keywords
inversion
rod
fixing portion
rods
turning
Prior art date
Application number
PCT/CN2021/130903
Other languages
French (fr)
Chinese (zh)
Inventor
李安宁
刘建勇
贾佳
汤麟
Original Assignee
先健科技(深圳)有限公司
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Application filed by 先健科技(深圳)有限公司 filed Critical 先健科技(深圳)有限公司
Publication of WO2022148135A1 publication Critical patent/WO2022148135A1/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00606Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00623Introducing or retrieving devices therefor

Definitions

  • the invention relates to the technical field of interventional medical devices, in particular to a blocking device.
  • the fixing plate used for implantation into the left atrial appendage to support and fix the function is currently made of a braided mesh by braiding a braided wire with a small diameter, or using a braided wire with a small diameter.
  • a skeleton structure including a plurality of support rods is made by cutting the tubular member by means of laser cutting or the like, that is, the fixed disc is made by pure weaving or pure cutting.
  • the support strength of the fixed disk made by cutting is higher than that of the woven mesh, but there is often a problem of stress concentration, or the support rod is easy to puncture the weak groove between the adjacent pectinate muscles in the left atrial appendage.
  • the braiding wire of such a fixed disc is often thinner, With good flexibility, the fixed plate can be turned over.
  • such a fixed disk tends to have a weak turning ability.
  • the resistance to the fixed disk is relatively large when the fixed disk is released, or because the deep position inside the left atrial appendage provides a slightly smaller space for the fixed disk to turn over, thus making the flipping
  • the fixed disk with weaker ability is blocked when it is turned over, and it is more difficult to fully unfold, which leads to weak fixation and even causes the occluder to fall off.
  • a blocking device comprises a sealing part and a fixing part connected with the sealing part
  • the fixing part comprises a support net and at least one inversion rod connected with the support net
  • the support net is passed through by a first braided wire Weaving into a mesh shape
  • the inversion rod is made into a rod shape by cutting a tubular member or a plurality of second braided wires are wound into a rod shape, and one end of the inversion rod is in the process of unfolding the fixing part, Extending toward the distal end and then turning outward toward the direction of the sealing portion, at least a part of the support net constitutes at least a part of the side wall of the fixing portion after the fixing portion is unfolded.
  • the fixing portion further includes a main end portion, one end of each of the plurality of turning rods is connected to the main end portion, and the other ends are connected from the main end portion.
  • the end portion is turned outwards in the direction of the sealing portion after being expanded radially outwards.
  • one end of the support net is connected to the other end of each of the plurality of turning rods at the distal end or side wall of the fixing portion, and the other end of the support net faces the seal extension in the direction of the section.
  • one end of the support mesh is expanded radially outward from the main end and turned outward toward the direction of the sealing portion, and then continues to extend toward the direction of the sealing portion.
  • the turning rods are respectively fixedly connected to the supporting nets.
  • the inversion strength of the whole formed by the plurality of inversion bars and the main end portion is greater than the inversion strength of the support net.
  • the one end of at least one of the inversion rods continues to extend toward the direction of the sealing portion after inversion.
  • the fixing part further includes a main end and a lead-out section, the lead-out section is made of a third braided wire to form a mesh tube, and one end of the lead-out section is carried out by the main end.
  • the closing mouth is fixed, and the other end is respectively connected with a plurality of the turning rods.
  • one end of the supporting net is respectively connected with the plurality of turning bars, and the other end extends toward the direction of the sealing part; or, the supporting net is multiple In each case, at least one of the turning rods is respectively connected with one end of at least one of the supporting nets.
  • the fixing portion is further provided with a spreading portion connected with the turning rod, and the spreading portion pushes the turning rod toward the seal during the unfolding process of the fixing portion.
  • the direction of the part is turned outward.
  • the fixing part further comprises a main end part, and one end of the supporting mesh is expanded radially outward from the main end part and turned outward toward the direction of the sealing part to form a concave area and the distal end face connected with the concave area, and then continue to extend towards the direction of the sealing part, the inversion rod is at least fixed on a part of the concave area of the support net and a part of the distal end face superior.
  • the end of the support mesh is open and bent toward the interior of the fixing portion
  • the sealing portion includes a distal disk surface at the distal end thereof, and at least a portion of the distal disk surface of the sealing portion is at least A part of the first film body is provided.
  • the turning rods there are a plurality of the turning rods, and a second film body is arranged on the fixing portion, and the second film body connects the plurality of turning rods in series along the circumferential direction of the fixing portion .
  • the supporting net and/or the inversion rod are provided with anchor thorns, and the ends of the anchor thorns face the sealing portion.
  • the length from the end of the inversion rod to the position between the vertex of the most distal end of the inversion rod ranges from 2 to 15 mm.
  • the inversion rod is made into a rod shape by cutting a tubular member or a plurality of second braided wires are wound into a rod shape, and its inversion strength is greater than that of the braided wires with the same axial length and predetermined bending shape. Inversion strength; and, compared with the sheet-like woven mesh structure with the same deployment diameter and inversion path, the inversion bar also has greater inversion strength, so it is easier to turn outwards during the unfolding process of the fixed portion, thereby ensuring the fixation The part can be fully deployed after release.
  • the side wall of the fixing part is composed of a mesh-like support mesh woven with the first woven wire, and when the fixing part is released and abuts against the cavity wall of the left atrial appendage, it can maintain a large contact area with the cavity wall , so that the extrusion force of the cavity wall by the fixed part is more uniform and dispersed, and the phenomenon of stress concentration is avoided.
  • the first braided filaments in the support mesh cross each other and the mesh holes are often small in practice, they can form surface contact with the cavity wall, and there is no chance that a certain part of the fixed part abuts between the adjacent comb muscles. The situation in the weak gullies between them avoids the adverse consequences caused by abrasion or puncturing of the cavity wall of the left atrial appendage.
  • the plugging device of the present application adopts a rod-shaped structure with high turnover strength combined with a soft woven mesh support structure to form a fixed part, which overcomes the existing problems of the fixed disk made by pure cutting or pure weaving in the prior art. For some problems, take the strengths of the two and make up for the weaknesses of the two, and at the same time overcome the technical prejudice that only the pure cutting method and the pure weaving method are used to make the fixed disk in the prior art. progress.
  • Example 1 is a schematic diagram of the overall structure of the plugging device of Example 1;
  • Fig. 2 is a schematic diagram of measuring the overturning strength of the overturning rod by means of a tensile machine
  • Figure 3 is a schematic diagram of measuring the inversion strength of a single first braided wire by means of a tensile machine
  • FIG. 4 is a schematic structural diagram of the fixing portion of the occluding device in FIG. 1 when viewed from the proximal end toward the distal end;
  • Example 5 is a schematic cross-sectional structure diagram of the plugging device of Example 2.
  • FIG. 6 is a schematic cross-sectional structure diagram of the plugging device of Example 3.
  • FIG. 7 is a schematic cross-sectional structural diagram of the plugging device of Example 4.
  • FIG. 7 is a schematic cross-sectional structural diagram of the plugging device of Example 4.
  • proximal end the end of the medical device implanted in the human body or animal body that is closer to the operator
  • distal end the end of the medical device implanted in the human body or animal body that is closer to the operator
  • proximal end the end of the medical device implanted in the human body or animal body that is closer to the operator
  • distal end the end farther from the operator
  • proximal end the end of the medical device implanted in the human body or animal body that is closer to the operator
  • distal end the end farther from the operator
  • distal end the end farther from the operator
  • the occlusion device proposed in Example 1 can be used to occlude the left atrial appendage, and can also be used to occlude other in vivo tissues with openings, such as atrial septal defect.
  • the following will take the occlusion of the left atrial appendage as an example to introduce the occlusion device in detail.
  • the blocking device 100 includes a sealing portion 110 and a fixing portion 120 connected to the sealing portion 110 .
  • the sealing portion 110 and the fixing portion 120 are spaced apart along the axial direction of the plugging device 100 .
  • the sealing part 110 is located at the proximal end of the occlusion device 100
  • the fixing part 120 is located at the distal end of the occlusion device 100 .
  • the occlusion device 100 has a compressed state housed within a sheath to facilitate delivery within the body, and a deployed state (ie, a natural state) as shown in FIG. 1 after extending outward from the distal end of the sheath and self-expanding.
  • the shape of the occlusion device 100 after being released in the cavity of the left atrial appendage is exactly the same as or substantially the same as that shown in FIG. 1 .
  • the distal end of the sealing portion 110 abuts the proximal end of the fixing portion 120 .
  • the sealing portion 110 and the fixation portion 120 can approach or abut each other after release to fix the occlusion device 100 in the space between the left atrium and the right atrium to achieve blocking.
  • the fixing portion 120 includes a main end portion 121 at its proximal end, a plurality of inversion rods 122 connected with the main end portion 121 , and a support net 123 connected with each inversion rod 122 .
  • the main end portion 121 may be a hollow tubular shape, the distal end of which is connected with the proximal end of each inversion rod 122 , and the proximal end is directly or indirectly connected with the distal end of the sealing portion 110 .
  • the support mesh 123 is made of one or more first braided wires 1231 to be woven into a mesh shape, and the inversion rod 122 is cut into a rod shape using a tubular member.
  • the cut inversion rod 122 is generally stiffer than the braided wire used in the occlusion device 100 and has a larger cross section than the braided wire.
  • the inversion rod 122 is stiffer and has a larger cross section than the first braided wire 1231 hardness and large cross section.
  • the inversion rod 122 can be formed into a rod shape by superimposing and winding one or more second braided wires, so that the hardness of the inversion rod 122 is greater than that of a single second braided wire, and the cross section It is larger than the cross section of a single second braided wire.
  • the first braided wire 1231 can be a braided wire made of nickel-titanium alloy, other alloys, or polymers
  • the second braided wire can be a braided wire made of nickel-titanium alloy, other alloys, or polymers.
  • the wire diameter of the wire may be thicker or the same as the wire diameter of the first braided wire 1231 .
  • the tubular parts used for cutting can be nickel-titanium alloy tubes, other alloy tubes or polymer tubes, etc. All of these materials have superelasticity and good shape memory properties.
  • the cross section or outer diameter of the inversion rod 122 is much larger than the cross section or outer diameter of a single first braided wire 1231 , specifically, the cross section or outer diameter of the inversion rod 122
  • the cross section is 1.5 to 5 times the cross section of the single first braided wire 1231
  • the outer diameter of the turning rod 122 is 1.5 to 5 times the outer diameter of the single first braided wire 1231 .
  • the elasticity of the material used for the inversion rod 122 is greater than that of the material used for the first braided wire 1231 , or the elasticity of the material used for the inversion rod 122 is greater than the elasticity of the material used for the first braided wire 1231 , and the transverse direction of the inversion rod 122
  • the cross section or outer diameter is much larger than that of a single first braided wire 1231 or the like.
  • the inversion strength can be measured with the aid of an existing tensile machine.
  • an inversion rod 122 and a first braided wire 1231 as an example, and the axial length of the inversion rod 122 is the same as the axial length of the first braided wire 1231 , both of them have the same curved shape through heat setting, that is, the flipping trajectory is the same.
  • the flipping rod 122 When the flipping rod 122 is in a natural state, it is naturally bent into a predetermined shape as shown in (a) in FIG. 2 . At this time, the proximal end of the flipping rod 122 is first fixed on the immovable fixing device, and then the flipping rod is fixed. The distal end of 122 is connected to a tensile machine (not shown).
  • the turning rod 122 is straightened under the driving of the pulling machine, and the measured value F1 on the pulling machine at this time is recorded. According to the basic knowledge of mechanics, the measured value F1 is related to the turning rod 122 The inversion strength is equal. As shown in FIG. 3 , using the same method as the inversion rod 122 to measure, it can be obtained that the inversion strength of the single first braided wire 1231 is equal to the measured value F2 on the tension machine. After a lot of experimental measurements and comparing the values of F1 and F2, it can be concluded that the inversion strength of the inversion rod 122 is greater than the inversion strength of the single first braided wire 1231 .
  • the portion located at the proximal end is described as the proximal end of each component in the fixing portion 120
  • the portion located at the distal end is described as the distal end of each component in the fixing portion 120 .
  • all the flipping rods 122 are spaced apart around the main end 121 , and there is no intersection between any flipping rod 122 and other flipping rods 122 .
  • each inversion rod 122 is welded on the main end portion 121, or all inversion rods 122 and the main end portion 121 are an integral structure formed by cutting the same tubular piece, so that all inversion rods 122 can be It is fixedly connected to the main end 121 .
  • Each inverting rod 122 expands radially outward from the main end portion 121 while extending a distance toward the distal end, and then inverts outward in the direction of the sealing portion 110 .
  • the distal end of the inversion rod 122 is disposed on the distal end face 126 of the fixing portion 120.
  • the support mesh 123 is disposed at the distal end of the fixing portion 120 , and includes a plurality of closed ends 1232 that close the first braided wires 1231 . All the closed ends 1232 are connected with all the inversion rods 122 in a one-to-one correspondence, specifically, one closed end 1232 is fixedly connected with the distal end of one inversion rod 122, such as welding, socketing, bonding, etc.
  • the support nets 123 extend a certain distance from each of the closed ends 1232 toward the sealing portion 110 , so as to constitute the side walls 124 of the fixing portion 120 . After that, as shown in FIG. 4 , the distal end of the support mesh 123 is bent toward the inside of the fixing portion 120 , and the distal end of the support mesh 123 is opened.
  • the whole formed by each inversion rod 122 and the main end 121 has a larger inversion strength (the two can be used by a tensile machine to adopt the above-mentioned inversion strength.
  • the fixing portion 120 has sufficient turning ability during the unfolding process, and it is easier to turn outwards, so as to ensure that the fixing portion 120 can be fully unfolded after release.
  • the side wall 124 of the fixing portion 120 is composed of a hollow mesh tube woven with the first braided wire 1231.
  • first braided wires 1231 in the hollow mesh tube cross each other and the meshes are often small, they can form surface contact with the cavity wall, and there is no chance that a certain part of the fixing portion 120 abuts between adjacent pectinate muscles The situation in the weak gully avoids the adverse consequences of grinding or puncturing the cavity wall of the left atrial appendage.
  • the end of the support net 123 is open, but not bent toward the interior of the fixing portion 120 , that is, the end of the support net 123 maintains the original direction toward the sealing portion 110 .
  • two adjacent flipping rods 122 may be connected by one or more struts, so as to keep the adjacent flipping rods 122 from crossing or shifting, and can strengthen the flipping rods 122 rollover strength.
  • the sealing portion 110 is braided into a mesh tube by a plurality of third braided wires 111 , and both ends of the mesh tube are closed and fixed by a sleeve 112 respectively at the ends of the third braided wires 111 . Then, the mesh tube is heat-set into a plug shape as shown by the sealing part 110 in FIG. 1 , so as to obtain the sealing part 110 for sealing the opening of the left atrial appendage. In other implementations, the sealing portion 110 can also be heat-set into a shape such as a disk shape or a column shape.
  • the sealing portion 110 includes a distal disk surface 113 located at its distal end and facing the fixing portion 120 , and a proximal disk surface 114 opposite to the distal disk surface 113 .
  • the interior of the sealing portion 110 may be provided with at least one layer of a third film body (not shown), wherein the edge of one third film body is fixed on the braided wire at the edge of the sealing portion 110, and the other third film bodies may be fixed on the sealing portion 110.
  • the other positions in the portion 110 may be as long as the passage of blood flow can be blocked.
  • the third membrane body is used to prevent blood flow from one side of the sealing portion 110 to the other side, so as to prevent blood flow from circulating between the left atrial appendage and the left atrium.
  • At least a part of the distal disk surface 113 of the sealing portion 110 is provided with a first film body (not shown), and the first film body is preferably disposed at a position opposite to the end opening of the support net 123 to prevent When the end of the support mesh 123 is bent toward the interior of the fixing part 120 , it is hooked to the third braided wire 111 on the distal disk surface 113 of the sealing part 110 and cannot be unfolded, thereby causing the occlusion device 100 to be unstablely fixed.
  • the first thin film body may further have a flow blocking effect.
  • the fixing portion 120 is provided with a second film body, and the second film body connects each of the turning rods 122 in series along the circumferential direction of the fixing portion 120 .
  • the second film body can be in a shape similar to a hemisphere, and is attached to the outer surface or inner surface of the fixing portion 120, and is fixedly connected with each inversion rod 122 by sutures or adhesives, etc., so that the multiple The plurality of turning rods 122 are connected in series along the circumferential direction of the fixing portion 120 to prevent the problem of hinge between the turning rods 122 during the unfolding process of the fixing portion 120 .
  • the second thin film body may further have a flow blocking effect.
  • a plurality of anchor barbs 125 are arranged on the support mesh 123 at intervals along the circumferential direction of the fixing portion 120 , and one end of the anchor barbs 125 is fixed on one of the first braided wires 1231 or wound around one or more first braided wires On the wire 1231, the end of the anchor barb 125 faces the sealing part 110, so that after the fixing part 120 is deployed, the anchor barb 125 penetrates into the body tissue, thereby assisting in fixing the occlusion device 100 and making it more stable.
  • the anchor barbs 125 are only provided on the inversion rod 122 , for example, at least one inversion bar 122 is provided with the anchor barbs 125 , and one end of the anchor barbs 125 is fixed on the inversion rod 122 or integrally formed with the inversion rod 122 , the end of the anchor barb 125 faces the sealing part 110 .
  • not only a plurality of anchor barbs 125 are provided on the support net 123, but also a plurality of anchor barbs 125 are respectively provided on the plurality of turning rods 122, and the ends of the anchor barbs 125 are all facing the sealing portion 110.
  • the anchor barbs 125 on the support net 123 and the anchor barbs 125 arranged on the overturning rod 122 form a staggered distribution along the axial direction of the fixing part 120 , which can fix the blocking device 100 in multiple directions and lift the fixed position of the blocking device 100 . stability. In other implementations, the anchor barb 125 may not be provided on the fixing portion 120 .
  • the value range of the length between the end of the flipping rod 122 and the vertex P of the most distal end of the flipping rod 122 is 2 to 15 mm, so that the entire fixing portion 120 is relatively smooth during the flipping process and can ensure sufficient flipping strength.
  • the vertex P at the farthest end of the turning rod 122 is often the point where the bending degree of the turning rod 122 is the greatest.
  • the occlusion device 100 can be delivered and controlled release in vivo with existing sheaths and delivery rods.
  • the proximal sleeve 112 of the sealing portion 110 is detachably connected to the distal end of the delivery rod.
  • the sealing part 110 is connected with the delivery rod and both are accommodated in the sheath, and are transported to the target position in the body along with the sheath.
  • the delivery rod is then pushed distally to release and deploy the fixation portion 120 from the distal end of the sheath.
  • the delivery rod is further pushed distally, so that the sealing portion 110 protrudes from the distal end of the sheath for release and deployment, so as to close the opening of the tissue in the body.
  • the connection between the delivery rod and the sealing part 110 is released, and the delivery rod and the sheath are recovered to the outside of the body, thereby completing the occlusion operation.
  • the occlusion device 200 of Embodiment 2 is substantially similar to the occlusion device 100 of Embodiment 1, and the same features will not be repeated here.
  • the main difference between the second embodiment and the first embodiment is that, as shown in FIG. Spread out and stretch for a distance toward the distal end, then turn outward toward the direction of the sealing portion 110, and then continue to extend for a distance toward the direction of the sealing portion 110, and finally, the distal end of the supporting mesh 223 is bent toward the interior of the fixing portion 120 to To prevent the end of the support mesh 223 from abutting on the cavity wall of the left atrial appendage after the fixing part 220 is deployed, causing abrasion.
  • the proximal end of the support mesh 223 can be crimped through the main end 121, or can be crimped through a sleeve.
  • the sleeve can be further accommodated in the cavity of the main end 121 , or sleeved outside the main end 121 to accommodate the proximal end of the first braided wire 1231 between the sleeve and the main end 121 . within the gap.
  • the proximal ends of the plurality of inversion rods 122 are respectively connected to the main end portion 121 , and the inversion rods 122 are respectively attached to and fixedly connected to the support mesh 223 at intervals along the circumferential direction of the fixing portion 220 .
  • the overall inversion strength formed by all the inversion rods 122 and the main end portion 121 is greater than the inversion strength of the support net 223 . Therefore, when the fixing portion 220 protrudes from the distal end of the sheath tube, each inversion rod 122 and the supporting mesh 223 are unfolded and flipped together, and because the inversion strength of the inversion rod 122 is relatively large, the flip rod 122 can be driven to fit and fix it together.
  • the corresponding part of the support net 223 is turned over, so that the support net 223 can still be fully expanded under the obstruction of the pectus muscle inside the left atrial appendage or when the release space in the cavity is small, which improves the overall stability of the fixing part 220.
  • the turning strength ensures that the blocking device 100 can be normally fixed in the cavity.
  • the turning rod 122 can be wound and fixed on the first braided wire 1231 of the support net 223 by sutures, or openings can be provided at one or more places on the turning rod 122, and then the sutures can be passed through the openings and the openings.
  • the corresponding portion of the support mesh 223 is fixed.
  • the turning rod 122 can also be fixed at a suitable position of the supporting net 223 by means of adhesive or sleeve.
  • the turning rod 122 can be fitted and fixed on the inner surface or the outer surface of the support net 223 , and can also be fixedly connected with the first braided wire 1231 of the support net 223 in an interpenetrating manner.
  • the distal end of the supporting mesh 223 may not be bent toward the inside of the fixing part 220 , but along the direction toward the sealing part 110 , and the end of the supporting mesh 223 is woven along the fixing part 220 by the first woven wire 1231 .
  • the circumferential direction is closed without several separate ends.
  • a plurality of flexible ends may be provided at the end of the support mesh 223 along the circumferential direction of the fixing portion 220 .
  • both ends of the inversion rod 122 are free ends, which can also enhance the overall inversion strength of the fixed part 220, so that the fixed part 220 can be more easily flipped and fully unfolded when limited.
  • the plugging device 300 of Embodiment 3 is generally similar to the plugging device 100 of Embodiment 1 and the plugging device 200 of Embodiment 2, and the same features are not repeated here.
  • the main difference between Embodiment 3 and Embodiment 1 and Embodiment 2 is that, as shown in FIG. Section 326 leads out.
  • the lead-out section 326 is made of a third braided wire 3261 to be woven into a net tube shape with a hollow interior and open ends at both ends. Welding, bonding, splicing through sleeves, etc.
  • the distal end of the lead-out section 326 is in the shape of an opening, and the edge of the distal end is fixedly connected with the supporting mesh 323 .
  • the support net 323 is woven into an inner hollow net tube through one or more first braided wires 1231, and has only one opening, and the opening can be closed and fixed by a sleeve 3231, and the sleeve 3231 is then fixed on the overturning rod 122. end.
  • connection method of the above-mentioned fixed connection may be welding, bonding, and socket connection through a sleeve.
  • a support net 323 may be respectively connected to the ends of several inversion bars 122 .
  • the distal end of the support mesh 323 can also be set to be open, or can be further closed and fixed through another sleeve.
  • the plurality of support nets 323 in FIG. 6 can be replaced by one support net 123 as shown in Embodiment 1, the proximal end of the support net 123 is the same as the distal end of the plurality of inversion rods 122 in FIG. 6 .
  • the distal ends are respectively connected, and the distal ends extend toward the direction of the sealing portion 110 ; alternatively, the distal ends of the supporting meshes 123 may be further bent toward the inside of the fixing portion 320 .
  • the occlusion device 400 of Embodiment 4 is substantially similar to the occlusion device 200 of Embodiment 2, and the same features are not repeated here.
  • the main difference is that, as shown in FIG. 7 , the fixing portion 420 is further provided with a spreading portion 427 connected with the turning rod 122 , and the spreading portion 427 pushes the turning rod 122 toward the seal during the unfolding of the fixing portion 420 .
  • the orientation of the portion 110 is flipped outward.
  • the spreading portion 427 includes at least a first strut 4271 and a second strut 4272 , the proximal end of the first strut 4271 is fixedly connected to one of the flipping rods 122 , and the proximal end of the second strut 4272 is fixedly connected to the On the other flipping rod 122, the two flipping rods 122 may be arranged symmetrically or not.
  • the distal end of the first strut 4271 and the distal end of the second strut 4272 are fixedly connected together. In other implementations, the distal end of the first strut 4271 and the distal end of the second strut 4272 may be spaced apart from each other or abut each other.
  • the first strut 4271 extends from its proximal end toward the distal end and toward the direction close to the central axis of the fixing portion 420
  • the second strut 4272 also extends from its proximal end toward the distal end and toward the center of the fixing portion 420 .
  • the direction of the axis extends.
  • the first strut 4271 and the second strut 4272 are symmetrically arranged.
  • the number of struts in the spreading portion 427 may be multiple, for example, three or more. In other implementations, one end of the first strut 4271 and the second strut 4272 close to the central axis of the fixing portion 420 may extend toward the proximal end.
  • the first strut 4271 and the second strut 4272 are constrained in a linear shape, and are surrounded by each of the turning rods 122 .
  • the first strut 4271 and the second strut 4272 return to a predetermined shape due to their own elasticity, so that the first strut 4271 and the second strut 4272 are mutually Under the push of the opposing force, or under the push of the force exerted by the first strut 4271 and the second strut 4272 to the support net 223 during the unfolding process, the turning rod 122 is pushed toward the direction of the sealing part 110 It is turned outward, thereby enhancing the turning strength of the turning rod 122 , thereby improving the overall turning strength of the fixing portion 420 .
  • At least one distal end of the inversion rod 122 continues to extend toward the direction of the sealing portion 110 after inversion. That is, the end of the inversion rod 122 continues to extend toward the proximal end at the position shown in FIG. 5 , for example, the support mesh 223 extends for a distance toward the proximal end, or further extends to a position close to the end of the support mesh 223 , At this time, the distal end of the turning rod 122 is also bent toward the inside of the fixing portion 420 , so that the turning of the entire supporting net 223 is easier under the driving of the turning rod 122 .
  • the plugging device 100 of Embodiment 1 the plugging device 200 of Embodiment 2, and the plugging device 300 of Embodiment 3, respectively, on the at least two inversion rods 122 of the fixing portion thereof, respectively.
  • the opening portion 427 as in the fourth embodiment is provided to enhance the overturning strength of the overturning rod 122 , which will not be repeated here.

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Abstract

An occlusion apparatus (100), comprising a sealing portion (110) and a fixing portion (120) connected to the sealing portion (110); the fixing portion (120) comprises a support mesh (123) and at least one turning rod (122) connected to the support mesh (123); the support mesh (123) is formed into a mesh shape by weaving first weaving wires (1231), the turning rod (122) is formed into a rod shape by cutting a tubular member or is formed into a rod shape by winding a plurality of second weaving wires; one end of the turning rod (122) extends towards the distal end and then turned outwards towards the direction of the sealing portion (110) during the spreading process of the fixing portion (120); and at least a part of the support mesh (123) forms at least a part of the side wall of the fixing portion (120) after the fixing portion (120) is spread. In the occlusion apparatus (100), the turning rod (122) enables the fixing portion (120) to have a greater turning strength and thus to be easier to completely turn, avoiding the situation where the left auricle is abraded or punctured due to the situation where a certain part of the fixing portion (120) abuts against the interior of a groove between pectinate muscles.

Description

封堵装置Blocking device 技术领域technical field
本发明涉及介入医疗器械技术领域,尤其涉及一种封堵装置。The invention relates to the technical field of interventional medical devices, in particular to a blocking device.
背景技术Background technique
在左心耳封堵器技术领域中,用于植入到左心耳内起到支撑和固定作用的固定盘,目前均是采用丝径小的编织丝通过编织的方式制成编织网,或是采用激光切割等方式切割管状件制成包含多个支撑杆的骨架结构,也即,固定盘采用纯编织方式或纯切割方式制成。采用切割方式制成的固定盘的支撑强度相对编织网大,但往往存在应力集中的问题,或支撑杆容易戳破左心耳内相邻梳状肌之间的薄弱沟壑的问题。而对于固定盘完全是由编织丝通过编织方式制成的网状结构来说,例如专利文献WO2017016411A1中公开的属于纯编织方式制成的锚定网,这样的固定盘的编织丝往往较细,以具有良好的柔韧性使固定盘能够翻转。然而,与专利文献CN211723305U中公开的属于纯切割方式制成的锚定部相比,这样的固定盘往往翻转能力较弱。由于一些左心耳的内部梳状肌较为发达,在固定盘释放时给予固定盘的阻力较大,或者由于左心耳内部较深的位置处提供给固定盘可翻转的空间稍小,因而,使得翻转能力较弱的该固定盘在翻转时受阻,更不容易完全展开,进而导致固定不牢,甚至会导致封堵器脱落。In the technical field of the left atrial appendage occluder, the fixing plate used for implantation into the left atrial appendage to support and fix the function is currently made of a braided mesh by braiding a braided wire with a small diameter, or using a braided wire with a small diameter. A skeleton structure including a plurality of support rods is made by cutting the tubular member by means of laser cutting or the like, that is, the fixed disc is made by pure weaving or pure cutting. The support strength of the fixed disk made by cutting is higher than that of the woven mesh, but there is often a problem of stress concentration, or the support rod is easy to puncture the weak groove between the adjacent pectinate muscles in the left atrial appendage. For the mesh structure in which the fixed disc is completely made of braided filaments, such as the anchor mesh disclosed in the patent document WO2017016411A1, which is made by pure weaving, the braiding wire of such a fixed disc is often thinner, With good flexibility, the fixed plate can be turned over. However, compared with the anchoring portion made by pure cutting method disclosed in the patent document CN211723305U, such a fixed disk tends to have a weak turning ability. Because the internal pectus muscles of some left atrial appendages are more developed, the resistance to the fixed disk is relatively large when the fixed disk is released, or because the deep position inside the left atrial appendage provides a slightly smaller space for the fixed disk to turn over, thus making the flipping The fixed disk with weaker ability is blocked when it is turned over, and it is more difficult to fully unfold, which leads to weak fixation and even causes the occluder to fall off.
发明内容SUMMARY OF THE INVENTION
基于此,有必要针对现有的上述编织网状结构的固定盘翻转能力较弱的问题,提供一种改进的封堵装置。Based on this, it is necessary to provide an improved blocking device for the problem that the existing fixed disk of the woven mesh structure has a weak turning ability.
一种封堵装置,包括密封部和与所述密封部连接的固定部,所述固定部包括支承网和与所述支承网连接的至少一个翻转杆,所述支承网由第一编织丝经过编织制成网状,所述翻转杆采用管状件经过切割制成杆状或者采用多根第二编织丝经过缠绕制成杆状,所述翻转杆的一端在所述固定部展开的过程中,朝向远端伸展后再朝向所述密封部的方向向外翻转,所述支承网的至少一部分在所述固定部展开后构成所述固定部的至少一部分侧壁。A blocking device comprises a sealing part and a fixing part connected with the sealing part, the fixing part comprises a support net and at least one inversion rod connected with the support net, the support net is passed through by a first braided wire Weaving into a mesh shape, the inversion rod is made into a rod shape by cutting a tubular member or a plurality of second braided wires are wound into a rod shape, and one end of the inversion rod is in the process of unfolding the fixing part, Extending toward the distal end and then turning outward toward the direction of the sealing portion, at least a part of the support net constitutes at least a part of the side wall of the fixing portion after the fixing portion is unfolded.
在其中一个实施例中,所述翻转杆有多个,所述固定部还包括主端部,多个所述翻转杆各自的一端均与所述主端部连接,另一端均从所述主端部径向向外展开后朝向所述密封部的方向向外翻转。In one embodiment, there are a plurality of the turning rods, the fixing portion further includes a main end portion, one end of each of the plurality of turning rods is connected to the main end portion, and the other ends are connected from the main end portion. The end portion is turned outwards in the direction of the sealing portion after being expanded radially outwards.
在其中一个实施例中,所述支承网的一端在所述固定部的远端或侧壁与多个所述翻转杆各自的所述另一端连接,所述支承网的另一端朝向所述密封部的方向延伸。In one embodiment, one end of the support net is connected to the other end of each of the plurality of turning rods at the distal end or side wall of the fixing portion, and the other end of the support net faces the seal extension in the direction of the section.
在其中一个实施例中,所述支承网的一端从所述主端部径向向外展开并朝向所述密封部的方向向外翻转,之后继续朝向所述密封部的方向延伸,多个所述翻转杆分别固定连接在所述支承网上。In one of the embodiments, one end of the support mesh is expanded radially outward from the main end and turned outward toward the direction of the sealing portion, and then continues to extend toward the direction of the sealing portion. The turning rods are respectively fixedly connected to the supporting nets.
在其中一个实施例中,多个所述翻转杆和所述主端部构成的整体的翻转强度,大于所述支承网的翻转强度。In one embodiment, the inversion strength of the whole formed by the plurality of inversion bars and the main end portion is greater than the inversion strength of the support net.
在其中一个实施例中,至少有一个所述翻转杆的所述一端,在翻转后继续朝向所述密封部的方向延伸。In one of the embodiments, the one end of at least one of the inversion rods continues to extend toward the direction of the sealing portion after inversion.
在其中一个实施例中,所述固定部还包括主端部和引出段,所述引出段由第三编织丝经过编织制成网管状,且所述引出段的一端由所述主端部进行收口固定,另一端与多个所述翻转杆分别连接。In one embodiment, the fixing part further includes a main end and a lead-out section, the lead-out section is made of a third braided wire to form a mesh tube, and one end of the lead-out section is carried out by the main end. The closing mouth is fixed, and the other end is respectively connected with a plurality of the turning rods.
在其中一个实施例中,所述支承网为一个时,所述支承网的一端与多个所述翻转杆分别连接,另一端朝向所述密封部的方向延伸;或者,所述支承网为多个时,至少一个所述翻转杆分别与至少一个所述支承网的一端连接。In one embodiment, when there is one supporting net, one end of the supporting net is respectively connected with the plurality of turning bars, and the other end extends toward the direction of the sealing part; or, the supporting net is multiple In each case, at least one of the turning rods is respectively connected with one end of at least one of the supporting nets.
在其中一个实施例中,所述固定部上还设有与所述翻转杆连接的撑开部,所述撑开部在所述固定部展开的过程中,推动所述翻转杆朝向所述密封部的方向向外翻转。In one embodiment, the fixing portion is further provided with a spreading portion connected with the turning rod, and the spreading portion pushes the turning rod toward the seal during the unfolding process of the fixing portion. The direction of the part is turned outward.
在其中一个实施例中,所述固定部还包括主端部,所述支承网的一端从所述主端部径向向外展开并朝向所述密封部的方向向外翻转,形成一个凹陷区和与所述凹陷区连接的远端端面,之后继续朝向所述密封部的方向延伸,所述翻转杆至少固定在所述支承网的所述凹陷区的一部分上和所述远端端面的一部分上。In one of the embodiments, the fixing part further comprises a main end part, and one end of the supporting mesh is expanded radially outward from the main end part and turned outward toward the direction of the sealing part to form a concave area and the distal end face connected with the concave area, and then continue to extend towards the direction of the sealing part, the inversion rod is at least fixed on a part of the concave area of the support net and a part of the distal end face superior.
在其中一个实施例中,所述支承网的末端呈开口状并朝向所述固定部的内部弯曲,所述密封部包括位于其远端的远端盘面,所述密封部的远端盘面的至少一部分上设有第一薄膜体。In one embodiment, the end of the support mesh is open and bent toward the interior of the fixing portion, the sealing portion includes a distal disk surface at the distal end thereof, and at least a portion of the distal disk surface of the sealing portion is at least A part of the first film body is provided.
在其中一个实施例中,所述翻转杆有多个,所述固定部上设有第二薄膜体,所述第二薄膜体将多个所述翻转杆沿所述固定部的周向方向串联。In one of the embodiments, there are a plurality of the turning rods, and a second film body is arranged on the fixing portion, and the second film body connects the plurality of turning rods in series along the circumferential direction of the fixing portion .
在其中一个实施例中,所述支承网和/或所述翻转杆上设有锚刺,所述锚刺的末端朝向所述密封部。In one of the embodiments, the supporting net and/or the inversion rod are provided with anchor thorns, and the ends of the anchor thorns face the sealing portion.
在其中一个实施例中,所述翻转杆的末端到所述翻转杆的最远端的顶点之间的位置处的长度的取值范围为2至15毫米。In one of the embodiments, the length from the end of the inversion rod to the position between the vertex of the most distal end of the inversion rod ranges from 2 to 15 mm.
上述封堵装置中,翻转杆采用管状件经过切割制成杆状或者采用多根第二编织丝经过缠绕制成杆状,其翻转强度大于与其具有相同轴向长度和预定弯曲形状的编织丝的翻转强 度;并且,与具有相同展开直径和翻转路径的片状编织网结构相比,翻转杆也具有更大的翻转强度,因而,在固定部展开的过程中更容易向外翻转,从而保证固定部在释放后能够完全展开。另一方面,固定部的侧壁由采用第一编织丝编织制成的网状的支承网构成,在固定部释放后抵接左心耳的腔壁时,能够与腔壁保持较大的接触面积,使腔壁受到固定部的挤压力较为均匀且分散,避免了应力集中的现象。此外,由于支承网中第一编织丝之间相互交叉且实际中网孔往往较小,因而能够与腔壁形成面接触,不会出现固定部的某一部分抵接在相邻的梳状肌之间的薄弱沟壑内的情况,避免了磨破或戳破左心耳的腔壁导致的不良后果。In the above-mentioned plugging device, the inversion rod is made into a rod shape by cutting a tubular member or a plurality of second braided wires are wound into a rod shape, and its inversion strength is greater than that of the braided wires with the same axial length and predetermined bending shape. Inversion strength; and, compared with the sheet-like woven mesh structure with the same deployment diameter and inversion path, the inversion bar also has greater inversion strength, so it is easier to turn outwards during the unfolding process of the fixed portion, thereby ensuring the fixation The part can be fully deployed after release. On the other hand, the side wall of the fixing part is composed of a mesh-like support mesh woven with the first woven wire, and when the fixing part is released and abuts against the cavity wall of the left atrial appendage, it can maintain a large contact area with the cavity wall , so that the extrusion force of the cavity wall by the fixed part is more uniform and dispersed, and the phenomenon of stress concentration is avoided. In addition, because the first braided filaments in the support mesh cross each other and the mesh holes are often small in practice, they can form surface contact with the cavity wall, and there is no chance that a certain part of the fixed part abuts between the adjacent comb muscles. The situation in the weak gullies between them avoids the adverse consequences caused by abrasion or puncturing of the cavity wall of the left atrial appendage.
本申请的封堵装置采用翻转强度较大的杆状结构与柔软的编织网支撑结构相结合制成固定部,克服了现有技术中纯切割方式或纯编织方式制成的固定盘所存在的一些问题,取两者之长处、补两者之短处,同时也克服了现有技术中只有纯切割方式和纯编织方式制作固定盘的技术偏见,结构上具有突出的特点,效果上具有显著的进步。The plugging device of the present application adopts a rod-shaped structure with high turnover strength combined with a soft woven mesh support structure to form a fixed part, which overcomes the existing problems of the fixed disk made by pure cutting or pure weaving in the prior art. For some problems, take the strengths of the two and make up for the weaknesses of the two, and at the same time overcome the technical prejudice that only the pure cutting method and the pure weaving method are used to make the fixed disk in the prior art. progress.
附图说明Description of drawings
图1为实施例1的封堵装置的整体结构示意图;1 is a schematic diagram of the overall structure of the plugging device of Example 1;
图2为借助拉力机测量翻转杆的翻转强度的示意图;Fig. 2 is a schematic diagram of measuring the overturning strength of the overturning rod by means of a tensile machine;
图3为借助拉力机测量单根第一编织丝的翻转强度的示意图;Figure 3 is a schematic diagram of measuring the inversion strength of a single first braided wire by means of a tensile machine;
图4为图1中封堵装置的固定部从近端朝向远端看去时的结构示意图;4 is a schematic structural diagram of the fixing portion of the occluding device in FIG. 1 when viewed from the proximal end toward the distal end;
图5为实施例2的封堵装置的剖面结构示意图;5 is a schematic cross-sectional structure diagram of the plugging device of Example 2;
图6为实施例3的封堵装置的剖面结构示意图;6 is a schematic cross-sectional structure diagram of the plugging device of Example 3;
图7为实施例4的封堵装置的剖面结构示意图。FIG. 7 is a schematic cross-sectional structural diagram of the plugging device of Example 4. FIG.
具体实施方式Detailed ways
为了使本发明的目的、技术方案及优点更加清楚明白,以下结合附图及实施例,对本发明进行进一步详细说明。应当理解,此处所描述的具体实施例仅仅用以解释本发明,并不用于限定本发明。In order to make the objectives, technical solutions and advantages of the present invention clearer, the present invention will be further described in detail below with reference to the accompanying drawings and embodiments. It should be understood that the specific embodiments described herein are only used to explain the present invention, but not to limit the present invention.
需要说明的是,在介入医疗器械领域,一般将植入人体或动物体内的医疗器械的距离操作者较近的一端称为“近端”,将距离操作者较远的一端称为“远端”,并依据此原理定义医疗器械的任一部件的“近端”和“远端”。“轴向”一般是指医疗器械在被输送时的长度方向,“径向”一般是指医疗器械的与其“轴向”垂直的方向,并依据此原理定义医疗器械的任一部件的“轴向”和“径向”。实施例中提到的“连接”,包括两个组件直接相连和借助其他组件间接相连的情况。在未特别说明时,以下描述针对的是装置在自然状态下或在体内释放展开后的情况。It should be noted that, in the field of interventional medical devices, the end of the medical device implanted in the human body or animal body that is closer to the operator is generally called the "proximal end", and the end farther from the operator is called the "distal end". ”, and define the “proximal end” and “distal end” of any part of the medical device according to this principle. "Axial" generally refers to the length direction of the medical device when it is delivered, and "radial" generally refers to the direction perpendicular to the "axial" of the medical device. According to this principle, the "axial" of any part of the medical device is defined Towards" and "Radial". The "connection" mentioned in the embodiment includes the case where two components are directly connected and indirectly connected by means of other components. Unless otherwise specified, the following description is directed to the device in its natural state or after deployment in vivo.
以下将结合具体实施例进一步详细说明本发明的技术方案。The technical solutions of the present invention will be further described in detail below with reference to specific embodiments.
实施例1Example 1
实施例1提出的封堵装置,可用于封堵左心耳,也可以用于封堵其他具有开口的体内组织,例如房间隔缺损等。以下将以封堵左心耳为例进行封堵装置的详细介绍。The occlusion device proposed in Example 1 can be used to occlude the left atrial appendage, and can also be used to occlude other in vivo tissues with openings, such as atrial septal defect. The following will take the occlusion of the left atrial appendage as an example to introduce the occlusion device in detail.
请参考图1,封堵装置100包括密封部110和与密封部110连接的固定部120。密封部110和固定部120沿封堵装置100的轴向方向间隔设置。密封部110位于封堵装置100的近端,固定部120位于封堵装置100的远端。封堵装置100具有收容在鞘管内的压缩状态,以便于在体内的输送,以及从鞘管的远端向外伸出并自膨胀展开后如图1所示的展开状态(即自然状态)。封堵装置100在左心耳的腔体内释放后的形态与图1完全相同或大体一致。在其他实现方式中,封堵装置100在释放后,密封部110的远端抵接固定部120的近端。在其他实现方式中,例如用于房间隔缺损封堵时,密封部110和固定部120可以在释放后相互靠近或抵接,以将封堵装置100固定在左心房和右心房之间的间隔上,从而实现封堵。Referring to FIG. 1 , the blocking device 100 includes a sealing portion 110 and a fixing portion 120 connected to the sealing portion 110 . The sealing portion 110 and the fixing portion 120 are spaced apart along the axial direction of the plugging device 100 . The sealing part 110 is located at the proximal end of the occlusion device 100 , and the fixing part 120 is located at the distal end of the occlusion device 100 . The occlusion device 100 has a compressed state housed within a sheath to facilitate delivery within the body, and a deployed state (ie, a natural state) as shown in FIG. 1 after extending outward from the distal end of the sheath and self-expanding. The shape of the occlusion device 100 after being released in the cavity of the left atrial appendage is exactly the same as or substantially the same as that shown in FIG. 1 . In other implementations, after the occlusion device 100 is released, the distal end of the sealing portion 110 abuts the proximal end of the fixing portion 120 . In other implementations, such as for atrial septal defect closure, the sealing portion 110 and the fixation portion 120 can approach or abut each other after release to fix the occlusion device 100 in the space between the left atrium and the right atrium to achieve blocking.
固定部120包括位于其近端的主端部121、与主端部121连接的多个翻转杆122,以及与各个翻转杆122连接的一个支承网123。主端部121可以为中空的管状,其远端与各个翻转杆122的近端连接,近端与密封部110的远端直接或间接连接。支承网123由一根或多根第一编织丝1231经过编织制成网状,翻转杆122采用管状件经过切割制成杆状。经切割制成的翻转杆122通常比用于封堵装置100的编织丝的硬度要大,横截面也会比编织丝要大,例如,翻转杆122的硬度和横截面都比第一编织丝1231的硬度和横截面大。在其他实现方式中,翻转杆122可采用一根或多根第二编织丝经过叠加缠绕制成杆状,由此,翻转杆122的硬度比单根第二编织丝的硬度大,且横截面比单根第二编织丝的横截面大。The fixing portion 120 includes a main end portion 121 at its proximal end, a plurality of inversion rods 122 connected with the main end portion 121 , and a support net 123 connected with each inversion rod 122 . The main end portion 121 may be a hollow tubular shape, the distal end of which is connected with the proximal end of each inversion rod 122 , and the proximal end is directly or indirectly connected with the distal end of the sealing portion 110 . The support mesh 123 is made of one or more first braided wires 1231 to be woven into a mesh shape, and the inversion rod 122 is cut into a rod shape using a tubular member. The cut inversion rod 122 is generally stiffer than the braided wire used in the occlusion device 100 and has a larger cross section than the braided wire. For example, the inversion rod 122 is stiffer and has a larger cross section than the first braided wire 1231 hardness and large cross section. In other implementations, the inversion rod 122 can be formed into a rod shape by superimposing and winding one or more second braided wires, so that the hardness of the inversion rod 122 is greater than that of a single second braided wire, and the cross section It is larger than the cross section of a single second braided wire.
第一编织丝1231可以为镍钛合金、其他合金或高分子等材料制成的编织丝,第二编织丝可以为镍钛合金、其他合金或高分子等材料制成的编织丝,第二编织丝的丝径可以比第一编织丝1231的丝径较粗或相同。切割用的管状件可以为镍钛合金管、其他合金管或高分子管等。以上这些材料均具有超弹性和良好的形状记忆特性。在第一编织丝1231和翻转杆122使用材料相同的情况下,翻转杆122的横截面或外径远大于单根第一编织丝1231的横截面或外径,具体地,翻转杆122的横截面为单根第一编织丝1231的横截面的1.5至5倍,或者,翻转杆122的外径为单根第一编织丝1231的外径的1.5至5倍。在其他实现方式中,翻转杆122所用材料的弹性大于第一编织丝1231所用材料的弹性,或者,翻转杆122所用材料的弹性大于第一编织丝1231所用材料的弹性,并且翻转杆122的横截面或外 径远大于单根第一编织丝1231的横截面或外径等。在轴向长度和预定弯曲形状相同的基础下,这些方式均能够使翻转杆122的翻转强度大于单根第一编织丝1231的翻转强度,也大于由第一编织丝1231形成的片状编织网的翻转强度。The first braided wire 1231 can be a braided wire made of nickel-titanium alloy, other alloys, or polymers, and the second braided wire can be a braided wire made of nickel-titanium alloy, other alloys, or polymers. The wire diameter of the wire may be thicker or the same as the wire diameter of the first braided wire 1231 . The tubular parts used for cutting can be nickel-titanium alloy tubes, other alloy tubes or polymer tubes, etc. All of these materials have superelasticity and good shape memory properties. Under the condition that the first braided wire 1231 and the inversion rod 122 use the same material, the cross section or outer diameter of the inversion rod 122 is much larger than the cross section or outer diameter of a single first braided wire 1231 , specifically, the cross section or outer diameter of the inversion rod 122 The cross section is 1.5 to 5 times the cross section of the single first braided wire 1231 , or the outer diameter of the turning rod 122 is 1.5 to 5 times the outer diameter of the single first braided wire 1231 . In other implementations, the elasticity of the material used for the inversion rod 122 is greater than that of the material used for the first braided wire 1231 , or the elasticity of the material used for the inversion rod 122 is greater than the elasticity of the material used for the first braided wire 1231 , and the transverse direction of the inversion rod 122 The cross section or outer diameter is much larger than that of a single first braided wire 1231 or the like. On the basis of the same axial length and predetermined bending shape, all of these methods can make the inversion strength of the inversion rod 122 greater than that of a single first woven wire 1231 and also greater than that of the sheet-like woven mesh formed by the first woven wire 1231 rollover strength.
翻转强度可借助现有的拉力机进行测量,具体地,以一个翻转杆122和一根第一编织丝1231为例,且翻转杆122的轴向长度与第一编织丝1231的轴向长度相同,两者通过热定型为弯曲形状相同,也即翻转轨迹相同。翻转杆122处于自然状态下时,自然弯曲成如图2中的(a)所示的预定形状,此时,先将翻转杆122的近端固定在不可移动的固定设备上,然后将翻转杆122的远端连接到拉力机(图未示)上。启动拉力机,并使拉力机的初始力值清零。如图2中的(b)所示,在拉力机的带动下将翻转杆122拉直,并记录此时拉力机上的测量值F1,根据力学的基础知识可知,该测量值F1与翻转杆122的翻转强度相等。如图3所示,采用与翻转杆122相同的方法测量可得到该单根第一编织丝1231的翻转强度与拉力机上的测量值F2相等。经过大量实验的测量并比较F1和F2的值可以得出,翻转杆122的翻转强度大于该单根第一编织丝1231的翻转强度。The inversion strength can be measured with the aid of an existing tensile machine. Specifically, take an inversion rod 122 and a first braided wire 1231 as an example, and the axial length of the inversion rod 122 is the same as the axial length of the first braided wire 1231 , both of them have the same curved shape through heat setting, that is, the flipping trajectory is the same. When the flipping rod 122 is in a natural state, it is naturally bent into a predetermined shape as shown in (a) in FIG. 2 . At this time, the proximal end of the flipping rod 122 is first fixed on the immovable fixing device, and then the flipping rod is fixed. The distal end of 122 is connected to a tensile machine (not shown). Start the pulling machine and reset the initial force value of the pulling machine to zero. As shown in (b) of FIG. 2 , the turning rod 122 is straightened under the driving of the pulling machine, and the measured value F1 on the pulling machine at this time is recorded. According to the basic knowledge of mechanics, the measured value F1 is related to the turning rod 122 The inversion strength is equal. As shown in FIG. 3 , using the same method as the inversion rod 122 to measure, it can be obtained that the inversion strength of the single first braided wire 1231 is equal to the measured value F2 on the tension machine. After a lot of experimental measurements and comparing the values of F1 and F2, it can be concluded that the inversion strength of the inversion rod 122 is greater than the inversion strength of the single first braided wire 1231 .
以下将以固定部120收容于鞘管内时,相对位于近端的部分描述为固定部120中各个组件的近端,相对位于远端的部分描述为固定部120中各个组件的远端。如图1所示,所有的翻转杆122围绕主端部121间隔开设置,任意一个翻转杆122与其他翻转杆122之间没有交叉。每个翻转杆122的近端均焊接在主端部121上,或者所有的翻转杆122与主端部121是通过切割同一个管状件形成的一体结构,由此,所有的翻转杆122均可固定连接在主端部121上。每个翻转杆122均从主端部121径向向外展开同时朝向远端伸展一段距离,之后再朝向密封部110的方向向外翻转。翻转杆122的远端末端设置于固定部120的远端端面126,在其他实现方式中,还可设置于固定部120的位于其近端端面和远端端面126之间的侧壁124,优选位于固定部120的靠近其远端端面126的侧壁124。支承网123的近端设置于固定部120的远端,且包括多个收口第一编织丝1231的收口端1232。所有的收口端1232与所有的翻转杆122一一对应连接,具体地,一个收口端1232与一个翻转杆122的远端固定连接,例如焊接或套接、粘接等。支承网123从各个收口端1232朝向密封部110的方向延伸一段距离,从而构成固定部120的侧壁124。之后,如图4所示,支承网123的远端朝向固定部120的内部弯曲,且支承网123的末端呈开口状。由各个翻转杆122和主端部121构成的整体,与具有相同展开直径和翻转轨迹的管状编织网结构相比,前者具有更大的翻转强度(可将两者借助拉力机,采用上述翻转强度测量方法进行测量比较),且在固定部120展开的过程中具有足够的翻转能力,更容易向外翻转,从而保证固定部120在释放后能够完 全展开。固定部120的侧壁124由采用第一编织丝1231编织构成的中空网管构成,在固定部120释放后抵接左心耳的腔壁时,能够与腔壁保持较大的接触面积,使腔壁受到固定部120的挤压力较为均匀且分散,避免了应力集中的现象。此外,由于中空网管中第一编织丝1231之间相互交叉且网孔往往较小,因而能够与腔壁形成面接触,不会出现固定部120的某一部分抵接在相邻梳状肌之间的薄弱沟壑内的情况,避免了磨破或戳破左心耳的腔壁导致的不良后果。In the following, when the fixing portion 120 is accommodated in the sheath, the portion located at the proximal end is described as the proximal end of each component in the fixing portion 120 , and the portion located at the distal end is described as the distal end of each component in the fixing portion 120 . As shown in FIG. 1 , all the flipping rods 122 are spaced apart around the main end 121 , and there is no intersection between any flipping rod 122 and other flipping rods 122 . The proximal end of each inversion rod 122 is welded on the main end portion 121, or all inversion rods 122 and the main end portion 121 are an integral structure formed by cutting the same tubular piece, so that all inversion rods 122 can be It is fixedly connected to the main end 121 . Each inverting rod 122 expands radially outward from the main end portion 121 while extending a distance toward the distal end, and then inverts outward in the direction of the sealing portion 110 . The distal end of the inversion rod 122 is disposed on the distal end face 126 of the fixing portion 120. In other implementations, it can also be disposed on the side wall 124 of the fixing portion 120 between the proximal end face and the distal end face 126 thereof, preferably The side wall 124 of the fixing portion 120 is located close to the distal end surface 126 thereof. The proximal end of the support mesh 123 is disposed at the distal end of the fixing portion 120 , and includes a plurality of closed ends 1232 that close the first braided wires 1231 . All the closed ends 1232 are connected with all the inversion rods 122 in a one-to-one correspondence, specifically, one closed end 1232 is fixedly connected with the distal end of one inversion rod 122, such as welding, socketing, bonding, etc. The support nets 123 extend a certain distance from each of the closed ends 1232 toward the sealing portion 110 , so as to constitute the side walls 124 of the fixing portion 120 . After that, as shown in FIG. 4 , the distal end of the support mesh 123 is bent toward the inside of the fixing portion 120 , and the distal end of the support mesh 123 is opened. Compared with the tubular braided mesh structure with the same deployment diameter and inversion trajectory, the whole formed by each inversion rod 122 and the main end 121 has a larger inversion strength (the two can be used by a tensile machine to adopt the above-mentioned inversion strength. measurement method), and the fixing portion 120 has sufficient turning ability during the unfolding process, and it is easier to turn outwards, so as to ensure that the fixing portion 120 can be fully unfolded after release. The side wall 124 of the fixing portion 120 is composed of a hollow mesh tube woven with the first braided wire 1231. When the fixing portion 120 is released and abuts against the cavity wall of the left atrial appendage, it can maintain a large contact area with the cavity wall, so that the cavity wall can be maintained. The pressing force received by the fixing portion 120 is relatively uniform and dispersed, avoiding the phenomenon of stress concentration. In addition, since the first braided wires 1231 in the hollow mesh tube cross each other and the meshes are often small, they can form surface contact with the cavity wall, and there is no chance that a certain part of the fixing portion 120 abuts between adjacent pectinate muscles The situation in the weak gully avoids the adverse consequences of grinding or puncturing the cavity wall of the left atrial appendage.
在其他实现方式中,支承网123的末端呈开口状,但不朝向固定部120的内部弯曲,也即,支承网123的末端保持原有的朝向密封部110的方向。在其他实现方式中,相邻的两个翻转杆122之间可通过一个或多个支杆连接起来,以保持相邻的翻转杆122之间不发生交叉或移位,且能够增强翻转杆122的翻转强度。In other implementations, the end of the support net 123 is open, but not bent toward the interior of the fixing portion 120 , that is, the end of the support net 123 maintains the original direction toward the sealing portion 110 . In other implementations, two adjacent flipping rods 122 may be connected by one or more struts, so as to keep the adjacent flipping rods 122 from crossing or shifting, and can strengthen the flipping rods 122 rollover strength.
密封部110由多根第三编织丝111编织成网管,网管的两端分别通过一个套管112将第三编织丝111的端部收口并固定。之后将网管热定型为如图1中密封部110所示的塞子状,从而得到用于封堵左心耳开口的密封部110。在其他实现方式中,还可以将密封部110热定型为盘状或柱状等形状。密封部110包括位于其远端且面向固定部120的远端盘面113,以及与远端盘面113相对的近端盘面114。密封部110的内部可设有至少一层第三薄膜体(图未示),其中一个第三薄膜体的边缘固定在密封部110边缘处的编织丝上,其他第三薄膜体可固定在密封部110内的其他位置,只要能够阻碍血流通过即可。第三薄膜体用于阻止血流从密封部110的一侧流向另一侧,以阻止血流在左心耳和左心房之间流通。在其他实现方式中,密封部110的远端盘面113的至少一部分上设有第一薄膜体(图未示),第一薄膜体优选设置在与支承网123的末端开口相对的位置,以防止支承网123的末端在朝向固定部120的内部弯曲时钩挂到密封部110的远端盘面113上的第三编织丝111而无法展开,进而导致封堵装置100固定不稳。第一薄膜体也可以进一步具有阻流效果。The sealing portion 110 is braided into a mesh tube by a plurality of third braided wires 111 , and both ends of the mesh tube are closed and fixed by a sleeve 112 respectively at the ends of the third braided wires 111 . Then, the mesh tube is heat-set into a plug shape as shown by the sealing part 110 in FIG. 1 , so as to obtain the sealing part 110 for sealing the opening of the left atrial appendage. In other implementations, the sealing portion 110 can also be heat-set into a shape such as a disk shape or a column shape. The sealing portion 110 includes a distal disk surface 113 located at its distal end and facing the fixing portion 120 , and a proximal disk surface 114 opposite to the distal disk surface 113 . The interior of the sealing portion 110 may be provided with at least one layer of a third film body (not shown), wherein the edge of one third film body is fixed on the braided wire at the edge of the sealing portion 110, and the other third film bodies may be fixed on the sealing portion 110. The other positions in the portion 110 may be as long as the passage of blood flow can be blocked. The third membrane body is used to prevent blood flow from one side of the sealing portion 110 to the other side, so as to prevent blood flow from circulating between the left atrial appendage and the left atrium. In other implementations, at least a part of the distal disk surface 113 of the sealing portion 110 is provided with a first film body (not shown), and the first film body is preferably disposed at a position opposite to the end opening of the support net 123 to prevent When the end of the support mesh 123 is bent toward the interior of the fixing part 120 , it is hooked to the third braided wire 111 on the distal disk surface 113 of the sealing part 110 and cannot be unfolded, thereby causing the occlusion device 100 to be unstablely fixed. The first thin film body may further have a flow blocking effect.
在其他实现方式中,进一步地,固定部120上设有第二薄膜体,第二薄膜体将各个翻转杆122沿固定部120的周向方向串联。具体地,第二薄膜体可以为类似半球形的形状,贴覆在固定部120的外表面或内表面,并与各个翻转杆122通过缝合线或粘结剂等方式进行固定连接,从而将多个翻转杆122沿固定部120的周向方向串联起来,防止固定部120在展开的过程中存在翻转杆122之间铰结的问题。第二薄膜体也可以进一步具有阻流效果。In other implementation manners, further, the fixing portion 120 is provided with a second film body, and the second film body connects each of the turning rods 122 in series along the circumferential direction of the fixing portion 120 . Specifically, the second film body can be in a shape similar to a hemisphere, and is attached to the outer surface or inner surface of the fixing portion 120, and is fixedly connected with each inversion rod 122 by sutures or adhesives, etc., so that the multiple The plurality of turning rods 122 are connected in series along the circumferential direction of the fixing portion 120 to prevent the problem of hinge between the turning rods 122 during the unfolding process of the fixing portion 120 . The second thin film body may further have a flow blocking effect.
在支承网123上沿固定部120的周向方向间隔地设置有多个锚刺125,锚刺125的一端固定在其中一根第一编织丝1231上或缠绕在一根或多根第一编织丝1231上,锚刺125的末端朝向密封部110,以在固定部120展开后,锚刺125刺入体内组织,从而辅助固定封堵 装置100,使之固定的更稳固。在其他实现方式中,锚刺125仅设置在翻转杆122上,例如,至少一个翻转杆122上设有锚刺125,锚刺125的一端固定在翻转杆122上或与翻转杆122为一体成型,锚刺125的末端朝向密封部110。在其他实现方式中,不仅在支承网123上设置多个锚刺125,还在多个翻转杆122上分别设置一个锚刺125,锚刺125的末端均朝向密封部110,由此,设置在支承网123上的锚刺125与设置在翻转杆122上的锚刺125沿固定部120的轴向方向形成上下错落的分布,能够多方位地固定封堵装置100,提升封堵装置100固定的稳固性。在其他实现方式中,固定部120上可不设置锚刺125。A plurality of anchor barbs 125 are arranged on the support mesh 123 at intervals along the circumferential direction of the fixing portion 120 , and one end of the anchor barbs 125 is fixed on one of the first braided wires 1231 or wound around one or more first braided wires On the wire 1231, the end of the anchor barb 125 faces the sealing part 110, so that after the fixing part 120 is deployed, the anchor barb 125 penetrates into the body tissue, thereby assisting in fixing the occlusion device 100 and making it more stable. In other implementations, the anchor barbs 125 are only provided on the inversion rod 122 , for example, at least one inversion bar 122 is provided with the anchor barbs 125 , and one end of the anchor barbs 125 is fixed on the inversion rod 122 or integrally formed with the inversion rod 122 , the end of the anchor barb 125 faces the sealing part 110 . In other implementation manners, not only a plurality of anchor barbs 125 are provided on the support net 123, but also a plurality of anchor barbs 125 are respectively provided on the plurality of turning rods 122, and the ends of the anchor barbs 125 are all facing the sealing portion 110. The anchor barbs 125 on the support net 123 and the anchor barbs 125 arranged on the overturning rod 122 form a staggered distribution along the axial direction of the fixing part 120 , which can fix the blocking device 100 in multiple directions and lift the fixed position of the blocking device 100 . stability. In other implementations, the anchor barb 125 may not be provided on the fixing portion 120 .
翻转杆122的末端到翻转杆122的最远端的顶点P之间的长度的取值范围为2至15毫米,以使固定部120整体在翻转的过程中较为平缓,且能保证足够的翻转强度。翻转杆122的位于最远端的顶点P,往往为翻转杆122的弯曲程度最大的点。The value range of the length between the end of the flipping rod 122 and the vertex P of the most distal end of the flipping rod 122 is 2 to 15 mm, so that the entire fixing portion 120 is relatively smooth during the flipping process and can ensure sufficient flipping strength. The vertex P at the farthest end of the turning rod 122 is often the point where the bending degree of the turning rod 122 is the greatest.
封堵装置100可借助现有的鞘管和输送杆进行体内输送和控制释放。密封部110的近端套管112与输送杆的远端可拆卸连接。在进行封堵手术时,密封部110与输送杆连接后均收容在鞘管内,并随着鞘管被输送至体内目标位置。之后朝向远端推送输送杆,以使固定部120从鞘管的远端伸出进行释放并展开。在固定部120释放并固定在体内目标位置后,继续朝远端推送输送杆,以使密封部110从鞘管的远端伸出进行释放并展开,以封堵体内组织的开口。最后,解除输送杆与密封部110的连接,并将输送杆和鞘管回收至体外,从而完成封堵手术。The occlusion device 100 can be delivered and controlled release in vivo with existing sheaths and delivery rods. The proximal sleeve 112 of the sealing portion 110 is detachably connected to the distal end of the delivery rod. During the occlusion operation, the sealing part 110 is connected with the delivery rod and both are accommodated in the sheath, and are transported to the target position in the body along with the sheath. The delivery rod is then pushed distally to release and deploy the fixation portion 120 from the distal end of the sheath. After the fixation portion 120 is released and fixed at the target position in the body, the delivery rod is further pushed distally, so that the sealing portion 110 protrudes from the distal end of the sheath for release and deployment, so as to close the opening of the tissue in the body. Finally, the connection between the delivery rod and the sealing part 110 is released, and the delivery rod and the sheath are recovered to the outside of the body, thereby completing the occlusion operation.
实施例2Example 2
实施例2的封堵装置200与实施例1的封堵装置100大体相似,其相同的特征在此不再赘述。实施例2与实施例1之间主要的不同之处在于,如图5所示,支承网223的近端收口,且支承网223近端的第一编织丝1231从主端部121径向向外展开并朝向远端伸展一段距离,再朝向密封部110的方向向外翻转,之后继续朝向密封部110的方向延伸一段距离,最后,支承网223的远端朝向固定部120的内部弯曲,以防止支承网223的末端在固定部220展开后抵接在左心耳的腔壁上造成磨损。支承网223的近端可通过主端部121进行收口固定,或者可通过一个套管进行收口固定。该套管还可进一步地收容在主端部121的腔体内,或套设在主端部121外从而将第一编织丝1231的近端末端收容在该套管和主端部121之间的空隙内。多个翻转杆122的近端分别连接在主端部121上,各个翻转杆122沿固定部220的周向方向间隔开地分别贴合在支承网223上并与之固定连接。所有的翻转杆122和主端部121构成的整体的翻转强度,大于支承网223的翻转强度。由此,当固定部220从鞘管的远端伸出后,各个翻转杆122和支承网223一起展开并翻转,且由于翻转杆122的翻转强度较 大,能够带动与其贴合固定在一起的支承网223的相应部分进行翻转,从而使支承网223能够在左心耳内部梳状肌的阻碍下或是在腔体内释放空间较小的情况下,依然能够完全展开,提高了固定部220整体的翻转强度,保证封堵装置100能够正常的被固定在腔体内。The occlusion device 200 of Embodiment 2 is substantially similar to the occlusion device 100 of Embodiment 1, and the same features will not be repeated here. The main difference between the second embodiment and the first embodiment is that, as shown in FIG. Spread out and stretch for a distance toward the distal end, then turn outward toward the direction of the sealing portion 110, and then continue to extend for a distance toward the direction of the sealing portion 110, and finally, the distal end of the supporting mesh 223 is bent toward the interior of the fixing portion 120 to To prevent the end of the support mesh 223 from abutting on the cavity wall of the left atrial appendage after the fixing part 220 is deployed, causing abrasion. The proximal end of the support mesh 223 can be crimped through the main end 121, or can be crimped through a sleeve. The sleeve can be further accommodated in the cavity of the main end 121 , or sleeved outside the main end 121 to accommodate the proximal end of the first braided wire 1231 between the sleeve and the main end 121 . within the gap. The proximal ends of the plurality of inversion rods 122 are respectively connected to the main end portion 121 , and the inversion rods 122 are respectively attached to and fixedly connected to the support mesh 223 at intervals along the circumferential direction of the fixing portion 220 . The overall inversion strength formed by all the inversion rods 122 and the main end portion 121 is greater than the inversion strength of the support net 223 . Therefore, when the fixing portion 220 protrudes from the distal end of the sheath tube, each inversion rod 122 and the supporting mesh 223 are unfolded and flipped together, and because the inversion strength of the inversion rod 122 is relatively large, the flip rod 122 can be driven to fit and fix it together. The corresponding part of the support net 223 is turned over, so that the support net 223 can still be fully expanded under the obstruction of the pectus muscle inside the left atrial appendage or when the release space in the cavity is small, which improves the overall stability of the fixing part 220. The turning strength ensures that the blocking device 100 can be normally fixed in the cavity.
翻转杆122可通过缝合线将其缠绕固定在支承网223的第一编织丝1231上,或者可以在翻转杆122上的一处或多处分别设置开孔,然后通过缝合线穿过开孔和对应的支承网223部分进行固定。此外,还可以通过粘结剂或套管等方式,将翻转杆122固定在支承网223的合适位置处。翻转杆122可贴合固定在支承网223的内表面或外表面,还可以与支承网223的第一编织丝1231采用穿插的方式固定连接。The turning rod 122 can be wound and fixed on the first braided wire 1231 of the support net 223 by sutures, or openings can be provided at one or more places on the turning rod 122, and then the sutures can be passed through the openings and the openings. The corresponding portion of the support mesh 223 is fixed. In addition, the turning rod 122 can also be fixed at a suitable position of the supporting net 223 by means of adhesive or sleeve. The turning rod 122 can be fitted and fixed on the inner surface or the outer surface of the support net 223 , and can also be fixedly connected with the first braided wire 1231 of the support net 223 in an interpenetrating manner.
在其他实现方式中,支承网223的远端可不朝向固定部220的内部弯曲,而是沿着朝向密封部110的方向,支承网223的末端通过第一编织丝1231编织为沿固定部220的周向方向为闭合的,而不具有几个独立的端部。进一步地,为了更好地避免支承网223的末端磨损体内组织,可在支承网223的末端沿固定部220的周向方向设置多个柔性端头。In other implementations, the distal end of the supporting mesh 223 may not be bent toward the inside of the fixing part 220 , but along the direction toward the sealing part 110 , and the end of the supporting mesh 223 is woven along the fixing part 220 by the first woven wire 1231 . The circumferential direction is closed without several separate ends. Further, in order to better prevent the end of the support mesh 223 from abrading the body tissue, a plurality of flexible ends may be provided at the end of the support mesh 223 along the circumferential direction of the fixing portion 220 .
在其他实现方式中,可在图5所示结构的基础上仅去掉主端部121而保留固定部220的其他特征,也即一个或多个翻转杆122沿固定部220的周向方向间隔开地分别贴合固定在支承网223上,且翻转杆122的两端均为自由端,也能够增强固定部220的整体翻转强度,使固定部220在受限时更容易翻转并展开完全。In other implementation manners, only the main end portion 121 may be removed on the basis of the structure shown in FIG. Both ends of the inversion rod 122 are free ends, which can also enhance the overall inversion strength of the fixed part 220, so that the fixed part 220 can be more easily flipped and fully unfolded when limited.
实施例3Example 3
实施例3的封堵装置300与实施例1的封堵装置100、实施例2的封堵装置200大体相似,其相同的特征在此不再赘述。实施例3与实施例1、实施例2之间主要的不同之处在于,如图6所示,固定部320包括位于其近端的主端部121和与主端部121的远端连接的引出段326。引出段326由第三编织丝3261经过编织制成内部中空且两端开口的网管状,近端由主端部121进行收口固定,远端与多个翻转杆122分别固定连接,连接方式可以为焊接、粘接、通过套管套接等。The plugging device 300 of Embodiment 3 is generally similar to the plugging device 100 of Embodiment 1 and the plugging device 200 of Embodiment 2, and the same features are not repeated here. The main difference between Embodiment 3 and Embodiment 1 and Embodiment 2 is that, as shown in FIG. Section 326 leads out. The lead-out section 326 is made of a third braided wire 3261 to be woven into a net tube shape with a hollow interior and open ends at both ends. Welding, bonding, splicing through sleeves, etc.
引出段326的远端呈开口状,且远端边缘与支承网323固定连接。本实施例中,支承网323有多个且相互独立,每个翻转杆122的末端分别与一个支承网323的近端固定连接。支承网323通过一根或多根第一编织丝1231编织成内部中空的网管,且仅有一个开口,该开口可通过一个套管3231进行收口固定,该套管3231再固定在翻转杆122的末端。上述固定连接的具体连接方式可以为焊接、粘接、通过套管套接等。在其他实现方式中,可以在若干几个翻转杆122的末端分别连接一个支承网323。在其他实现方式中,支承网323的远端也可以设置为开口的,或者还可以进一步通过另一个套管进行收口固定。The distal end of the lead-out section 326 is in the shape of an opening, and the edge of the distal end is fixedly connected with the supporting mesh 323 . In this embodiment, there are multiple supporting nets 323 and are independent of each other, and the end of each inversion rod 122 is fixedly connected to the proximal end of one supporting net 323 respectively. The support net 323 is woven into an inner hollow net tube through one or more first braided wires 1231, and has only one opening, and the opening can be closed and fixed by a sleeve 3231, and the sleeve 3231 is then fixed on the overturning rod 122. end. The specific connection method of the above-mentioned fixed connection may be welding, bonding, and socket connection through a sleeve. In other implementations, a support net 323 may be respectively connected to the ends of several inversion bars 122 . In other implementations, the distal end of the support mesh 323 can also be set to be open, or can be further closed and fixed through another sleeve.
在其他实现方式中,可将图6中的多个支承网323替换为一个如实施例1所示的支承网123,支承网123的近端与图6中的多个翻转杆122的远端分别连接,远端朝向密封部110的方向延伸;或者,支承网123的远端进一步可朝向固定部320的内部弯曲。In other implementations, the plurality of support nets 323 in FIG. 6 can be replaced by one support net 123 as shown in Embodiment 1, the proximal end of the support net 123 is the same as the distal end of the plurality of inversion rods 122 in FIG. 6 . The distal ends are respectively connected, and the distal ends extend toward the direction of the sealing portion 110 ; alternatively, the distal ends of the supporting meshes 123 may be further bent toward the inside of the fixing portion 320 .
实施例4Example 4
实施例4的封堵装置400与实施例2的封堵装置200大体相似,其相同的特征在此不再赘述。主要的不同之处在于,如图7所示,固定部420上还设有与翻转杆122连接的撑开部427,撑开部427在固定部420展开的过程中,推动翻转杆122朝向密封部110的方向向外翻转。具体地,撑开部427至少包括第一撑杆4271和第二撑杆4272,第一撑杆4271的近端固定连接在其中一个翻转杆122上,第二撑杆4272的近端固定连接在另一个翻转杆122上,这两个翻转杆122可以为对称设置的,也可以不是对称设置的。第一撑杆4271的远端和第二撑杆4272的远端固定连接在一起,在其他实现方式中,第一撑杆4271的远端和第二撑杆4272的远端可相互间隔开或相互抵接。第一撑杆4271从其近端末端朝向远端并朝着靠近固定部420的中心轴的方向延伸,第二撑杆4272也从其近端末端朝向远端并朝着靠近固定部420的中心轴的方向延伸。优选地,第一撑杆4271和第二撑杆4272对称设置。撑开部427中撑杆的个数可以为多个,例如3个或3个以上。在其他实现方式中,第一撑杆4271和第二撑杆4272的靠近固定部420的中心轴的一端,可以为朝向近端延伸。The occlusion device 400 of Embodiment 4 is substantially similar to the occlusion device 200 of Embodiment 2, and the same features are not repeated here. The main difference is that, as shown in FIG. 7 , the fixing portion 420 is further provided with a spreading portion 427 connected with the turning rod 122 , and the spreading portion 427 pushes the turning rod 122 toward the seal during the unfolding of the fixing portion 420 . The orientation of the portion 110 is flipped outward. Specifically, the spreading portion 427 includes at least a first strut 4271 and a second strut 4272 , the proximal end of the first strut 4271 is fixedly connected to one of the flipping rods 122 , and the proximal end of the second strut 4272 is fixedly connected to the On the other flipping rod 122, the two flipping rods 122 may be arranged symmetrically or not. The distal end of the first strut 4271 and the distal end of the second strut 4272 are fixedly connected together. In other implementations, the distal end of the first strut 4271 and the distal end of the second strut 4272 may be spaced apart from each other or abut each other. The first strut 4271 extends from its proximal end toward the distal end and toward the direction close to the central axis of the fixing portion 420 , and the second strut 4272 also extends from its proximal end toward the distal end and toward the center of the fixing portion 420 . The direction of the axis extends. Preferably, the first strut 4271 and the second strut 4272 are symmetrically arranged. The number of struts in the spreading portion 427 may be multiple, for example, three or more. In other implementations, one end of the first strut 4271 and the second strut 4272 close to the central axis of the fixing portion 420 may extend toward the proximal end.
当固定部420收容在鞘管内时,第一撑杆4271和第二撑杆4272被约束呈线状,并被各个翻转杆122包围。当固定部420从鞘管的远端伸出后,第一撑杆4271和第二撑杆4272由于自身的弹性而恢复到预定的形状,从而在第一撑杆4271和第二撑杆4272相互给予对方相反的作用力的推动下,或在第一撑杆4271和第二撑杆4272各自在展开的过程中给予支承网223的作用力的推动下,推动翻转杆122朝向密封部110的方向向外翻转,从而增强翻转杆122的翻转强度,进而提高固定部420的整体翻转强度。When the fixing portion 420 is accommodated in the sheath tube, the first strut 4271 and the second strut 4272 are constrained in a linear shape, and are surrounded by each of the turning rods 122 . After the fixing portion 420 is protruded from the distal end of the sheath, the first strut 4271 and the second strut 4272 return to a predetermined shape due to their own elasticity, so that the first strut 4271 and the second strut 4272 are mutually Under the push of the opposing force, or under the push of the force exerted by the first strut 4271 and the second strut 4272 to the support net 223 during the unfolding process, the turning rod 122 is pushed toward the direction of the sealing part 110 It is turned outward, thereby enhancing the turning strength of the turning rod 122 , thereby improving the overall turning strength of the fixing portion 420 .
在其他实现方式中,至少有一个翻转杆122的远端,在翻转后继续朝向密封部110的方向延伸。也即,翻转杆122的末端是在图5所示的位置处继续朝向近端延伸,例如贴合支承网223朝近端延伸一段距离,或者进一步一直延伸到靠近支承网223末端的位置处,此时,翻转杆122的远端也朝向固定部420的内部弯曲,从而在翻转杆122的带动下,使整个支承网223的翻转更容易。In other implementations, at least one distal end of the inversion rod 122 continues to extend toward the direction of the sealing portion 110 after inversion. That is, the end of the inversion rod 122 continues to extend toward the proximal end at the position shown in FIG. 5 , for example, the support mesh 223 extends for a distance toward the proximal end, or further extends to a position close to the end of the support mesh 223 , At this time, the distal end of the turning rod 122 is also bent toward the inside of the fixing portion 420 , so that the turning of the entire supporting net 223 is easier under the driving of the turning rod 122 .
在其他实施例中,可以在实施例1的封堵装置100、实施例2的封堵装置200和实施例3的封堵装置300中,分别在其固定部的至少两个翻转杆122上分别设置如实施例4的撑开部427,以增强翻转杆122的翻转强度,在此不再赘述。In other embodiments, in the plugging device 100 of Embodiment 1, the plugging device 200 of Embodiment 2, and the plugging device 300 of Embodiment 3, respectively, on the at least two inversion rods 122 of the fixing portion thereof, respectively. The opening portion 427 as in the fourth embodiment is provided to enhance the overturning strength of the overturning rod 122 , which will not be repeated here.
以上所述实施例的各技术特征可以进行任意的组合,为使描述简洁,未对上述实施例中的各个技术特征所有可能的组合都进行描述,然而,只要这些技术特征的组合不存在矛盾,都应当认为是本说明书记载的范围。The technical features of the above-described embodiments can be combined arbitrarily. For the sake of brevity, all possible combinations of the technical features in the above-described embodiments are not described. However, as long as there is no contradiction between the combinations of these technical features, All should be regarded as the scope described in this specification.
以上所述实施例仅表达了本发明的几种实施方式,其描述较为具体和详细,但并不能因此而理解为对发明专利范围的限制。应当指出的是,对于本领域的普通技术人员来说,在不脱离本发明构思的前提下,还可以做出若干变形和改进,这些都属于本发明的保护范围。因此,本发明专利的保护范围应以所附权利要求为准。The above-mentioned embodiments only represent several embodiments of the present invention, and the descriptions thereof are specific and detailed, but should not be construed as a limitation on the scope of the invention patent. It should be pointed out that for those of ordinary skill in the art, without departing from the concept of the present invention, several modifications and improvements can also be made, which all belong to the protection scope of the present invention. Therefore, the protection scope of the patent of the present invention should be subject to the appended claims.

Claims (14)

  1. 一种封堵装置,包括密封部和与所述密封部连接的固定部,其特征在于,所述固定部包括支承网和与所述支承网连接的至少一个翻转杆,所述支承网由第一编织丝经过编织制成网状,所述翻转杆采用管状件经过切割制成杆状或者采用多根第二编织丝经过缠绕制成杆状,所述翻转杆的一端在所述固定部展开的过程中,朝向远端伸展后再朝向所述密封部的方向向外翻转,所述支承网的至少一部分在所述固定部展开后构成所述固定部的至少一部分侧壁。A blocking device, comprising a sealing part and a fixing part connected with the sealing part, characterized in that the fixing part comprises a support net and at least one turning rod connected with the support net, the support net is formed by a first A braided wire is woven into a mesh shape, the inversion rod is made into a rod shape by cutting a tubular member or a plurality of second braided wires are wound into a rod shape, and one end of the inversion rod is unfolded at the fixing part During the process of extending toward the distal end and then turning outward toward the sealing portion, at least a part of the support net constitutes at least a part of the side wall of the fixing portion after the fixing portion is unfolded.
  2. 根据权利要求1所述的封堵装置,其特征在于,所述翻转杆有多个,所述固定部还包括主端部,多个所述翻转杆各自的一端均与所述主端部连接,另一端均从所述主端部径向向外展开后朝向所述密封部的方向向外翻转。The blocking device according to claim 1, wherein there are a plurality of the inversion rods, the fixing portion further comprises a main end portion, and one end of each of the plurality of inversion rods is connected to the main end portion , and the other ends are turned outward in the direction of the sealing portion after being expanded radially outward from the main end portion.
  3. 根据权利要求2所述的封堵装置,其特征在于,所述支承网的一端在所述固定部的远端或侧壁与多个所述翻转杆各自的所述另一端连接,所述支承网的另一端朝向所述密封部的方向延伸。The occlusion device according to claim 2, wherein one end of the support net is connected to the other end of each of the plurality of inversion rods at the distal end or side wall of the fixing portion, and the support The other end of the mesh extends in the direction of the sealing portion.
  4. 根据权利要求2所述的封堵装置,其特征在于,所述支承网的一端从所述主端部径向向外展开并朝向所述密封部的方向向外翻转,之后继续朝向所述密封部的方向延伸,多个所述翻转杆分别固定连接在所述支承网上。The occlusion device according to claim 2, wherein one end of the supporting mesh is expanded radially outward from the main end portion and turned outward toward the direction of the sealing portion, and then continues toward the sealing portion extending in the direction of the part, and a plurality of the turning rods are respectively fixedly connected to the supporting net.
  5. 根据权利要求4所述的封堵装置,其特征在于,多个所述翻转杆和所述主端部构成的整体的翻转强度,大于所述支承网的翻转强度。The blocking device according to claim 4, characterized in that, the inversion strength of the whole composed of the plurality of inversion rods and the main end portion is greater than the inversion strength of the support net.
  6. 根据权利要求1或4所述的封堵装置,其特征在于,至少有一个所述翻转杆的所述一端,在翻转后继续朝向所述密封部的方向延伸。The occlusion device according to claim 1 or 4, characterized in that, at least one end of the inversion rod continues to extend toward the direction of the sealing portion after inversion.
  7. 根据权利要求1所述的封堵装置,其特征在于,所述固定部还包括主端部和引出段,所述引出段由第三编织丝经过编织制成网管状,且所述引出段的一端由所述主端部进行收口固定,另一端与多个所述翻转杆分别连接。The occlusion device according to claim 1, wherein the fixing part further comprises a main end and a lead-out section, the lead-out section is made of a third braided wire to be woven into a mesh tube shape, and the lead-out section is One end is closed and fixed by the main end, and the other end is respectively connected with the plurality of turning rods.
  8. 根据权利要求7所述的封堵装置,其特征在于,所述支承网为一个时,所述支承网的一端与多个所述翻转杆分别连接,另一端朝向所述密封部的方向延伸;或者,所述支承网为多个时,至少一个所述翻转杆分别与至少一个所述支承网的一端连接。The plugging device according to claim 7, wherein when there is one supporting net, one end of the supporting net is respectively connected with the plurality of turning rods, and the other end extends toward the direction of the sealing portion; Alternatively, when there are multiple support nets, at least one of the inversion bars is respectively connected to one end of at least one of the support nets.
  9. 根据权利要求1所述的封堵装置,其特征在于,所述固定部上还设有与所述翻转杆连接的撑开部,所述撑开部在所述固定部展开的过程中,推动所述翻转杆朝向所述密封部的方向向外翻转。The blocking device according to claim 1, wherein the fixing portion is further provided with a spreading portion connected with the turning rod, and the spreading portion pushes the fixing portion during the unfolding process of the fixing portion. The turning lever is turned outward in the direction of the sealing portion.
  10. 根据权利要求1所述的封堵装置,其特征在于,所述固定部还包括主端部,所述支承网的一端从所述主端部径向向外展开并朝向所述密封部的方向向外翻转,形成一个凹陷区和与所述凹陷区连接的远端端面,之后继续朝向所述密封部的方向延伸,所述翻转杆至少固定在 所述支承网的所述凹陷区的一部分上和所述远端端面的一部分上。The occlusion device according to claim 1, wherein the fixing part further comprises a main end part, and one end of the supporting mesh is expanded radially outward from the main end part and faces the direction of the sealing part Inverted outward to form a concave area and a distal end face connected to the concave area, and then continue to extend toward the direction of the sealing portion, and the inversion rod is at least fixed on a part of the concave area of the support net and a portion of the distal end face.
  11. 根据权利要求1所述的封堵装置,其特征在于,所述支承网的末端呈开口状并朝向所述固定部的内部弯曲,所述密封部包括位于其远端的远端盘面,所述密封部的远端盘面的至少一部分上设有第一薄膜体。The occlusion device according to claim 1, wherein the end of the support mesh is open and bent toward the interior of the fixing portion, the sealing portion comprises a distal disk surface located at the distal end thereof, the A first film body is provided on at least a part of the distal disk surface of the sealing portion.
  12. 根据权利要求1所述的封堵装置,其特征在于,所述翻转杆有多个,所述固定部上设有第二薄膜体,所述第二薄膜体将多个所述翻转杆沿所述固定部的周向方向串联。The blocking device according to claim 1, wherein there are a plurality of the inversion rods, a second film body is provided on the fixing portion, and the second film body connects the plurality of the inversion rods along the The circumferential direction of the fixed portion is connected in series.
  13. 根据权利要求1所述的封堵装置,其特征在于,所述支承网和/或所述翻转杆上设有锚刺,所述锚刺的末端朝向所述密封部。The occlusion device according to claim 1, characterized in that, an anchor thorn is provided on the support net and/or the inversion rod, and the distal end of the anchor thorn faces the sealing portion.
  14. 根据权利要求1所述的封堵装置,其特征在于,所述翻转杆的末端到所述翻转杆的最远端的顶点之间的位置处的长度的取值范围为2至15毫米。The occlusion device according to claim 1, characterized in that, the length of the position between the end of the inversion rod and the vertex of the most distal end of the inversion rod ranges from 2 to 15 mm.
PCT/CN2021/130903 2021-01-05 2021-11-16 Occlusion apparatus WO2022148135A1 (en)

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