WO2022268219A1 - 人工心脏瓣膜支架、装置、输送系统和介入系统 - Google Patents

人工心脏瓣膜支架、装置、输送系统和介入系统 Download PDF

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Publication number
WO2022268219A1
WO2022268219A1 PCT/CN2022/101336 CN2022101336W WO2022268219A1 WO 2022268219 A1 WO2022268219 A1 WO 2022268219A1 CN 2022101336 W CN2022101336 W CN 2022101336W WO 2022268219 A1 WO2022268219 A1 WO 2022268219A1
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Prior art keywords
heart valve
wire
lock
artificial heart
interventional instrument
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PCT/CN2022/101336
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English (en)
French (fr)
Inventor
张维
张志飞
张进明
龚全钢
宋威
Original Assignee
杭州启明医疗器械股份有限公司
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Application filed by 杭州启明医疗器械股份有限公司 filed Critical 杭州启明医疗器械股份有限公司
Priority to CN202280004892.5A priority Critical patent/CN115811962A/zh
Priority to CN202310103070.9A priority patent/CN116098740A/zh
Publication of WO2022268219A1 publication Critical patent/WO2022268219A1/zh

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2427Devices for manipulating or deploying heart valves during implantation
    • A61F2/2436Deployment by retracting a sheath
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0095Packages or dispensers for prostheses or other implants
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2412Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
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    • A61F2/2412Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/962Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
    • A61F2/966Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2/962Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
    • A61F2/966Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
    • A61F2002/9665Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod with additional retaining means
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    • A61F2250/0026Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in surface structures
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Definitions

  • the present application relates to the field of medical equipment, in particular to artificial heart valve stents, devices, delivery systems and interventional systems.
  • Heart valves As medical conditions have evolved, artificial heart valves have been used to treat heart valve disorders.
  • Native heart valves such as the aortic, pulmonary, and mitral valves, serve an important function in ensuring an adequate blood supply to the cardiovascular system.
  • natural heart valves may deteriorate due to congenital, inflammatory or infectious causes. Such damage to the natural heart valves can lead to serious injury or even death.
  • the common treatment for natural heart valve disease is to repair or replace the valve through surgery.
  • flexible catheters are used to intervene and implant artificial heart valves.
  • Transvascular techniques enable less invasive procedures than surgical procedures such as open heart surgery.
  • a prosthetic valve in a loaded state is mounted on the end portion of a flexible catheter and advanced through the patient's blood vessel until the prosthetic valve reaches the implantation site.
  • the prosthetic valve at the end of the catheter expands to its functional size at the site of the diseased native valve.
  • the inventors have discovered that, in the related art, during the implantation phase of a self-expanding prosthetic valve, when the operator begins to deliver the sheath from retraction in order to release the prosthetic valve, the prosthetic valve tends to "jump" from the end of the sheath extremely rapidly. In other words, the outward biasing force of the frame of the prosthetic valve tends to cause the prosthetic valve to eject extremely quickly from the distal end of the delivery sheath, making it difficult to deliver the prosthetic valve from the sheath in a precise and controlled manner and increasing the Risk of patient trauma.
  • valve products of the prior art usually when the valve is deployed to 2/3, the valve holder is pressed and held by the forward sheath to realize valve recovery; It is difficult to realize the recovery of the valve stent.
  • an artificial heart valve stent including:
  • annular portion is a radially deformable structure, the two ends of the annular portion in the axial direction are respectively a first end and a second end, wherein the edge of the first end is arranged in sequence along the circumferential direction of the annular portion multiple unit segments;
  • a plurality of guide parts are arranged at intervals in sequence along the circumferential direction of the annular part.
  • One side of each guide part is connected to a corresponding unit segment, and the shape of the other side of each guide part gradually converges to the end, and there is a threading loop at the end.
  • the prosthetic heart valve stent as a whole is based on radial deformation, and has a relative compressed state and a released state.
  • the axial direction of the annular part is taken as the length direction, and the length of the guide part is L1.
  • L1:L2 1:0.6 ⁇ 1.2.
  • one side of each guide portion is a connection side that abuts with a corresponding unit segment, and the connection sides of two adjacent guide portions engage with each other.
  • the convergence trend of the guide part from the connection side to the end is uniform convergence.
  • N there are N positions of the guiding parts, N is 2, 3, 4, 5 or 6, and the central angle corresponding to the connecting side of each guiding part is 360 degrees/N.
  • each guide portion is evenly arranged along the circumferential direction of the ring portion.
  • both the guide part and the ring part have a hollowed-out cell structure.
  • the junction between the guide part and the ring part is formed by The vertices of a row of cells in the circumferential direction are enclosed.
  • the guide part extends axially from the ring part along the ring part, and the extending path first expands outward in the radial direction of the ring part, and then gradually converges after reaching the maximum outer diameter.
  • the axial length of the annular portion is 1-2.5 units.
  • both the guide part and the annular part have a hollowed-out cell structure, and the cells in the guide part are divided into relatively sparse areas and dense areas, and at least a part of the sparse areas are close to adjacent The opening between the two guides.
  • the cell area of the dense area is 0.3-0.8 times the cell area of the sparse area (understood as the ratio of the area of a single cell, not referring to the area of the entire sparse area and the dense area).
  • the area of the cells in the dense area is 0.4-0.6 times that of the cells in the sparse area.
  • an edge frame bar adjacent to the opening is an edge frame bar, one end of the edge frame bar is connected to the threading ring, and the other end of the edge frame bar is connected to the ring part, so
  • the edge slats intersect with no more than two other slats in the tubular structure during extension.
  • the edge frame bar is connected with a branch frame bar near the first end, and the branch frame bar and the edge frame bar are respectively connected to different cell vertices on the first end.
  • the side of the threading ring close to the annular portion is a transition section shared with surrounding cells, the transition section is V-shaped, and the apex faces the annular portion.
  • the side of the threading ring away from the annular portion is a pulling section
  • the side of the threading ring close to the annular portion is a transition section shared with surrounding cells.
  • the pulling section and the transition section enclose one or more closed spaces.
  • the radius of the circumscribed circle of the threading ring is greater than or equal to twice the diameter of the rod of the threading ring.
  • the guide part includes four areas, which are:
  • the first area is provided with the threading ring
  • the second area is arranged along the circumferential direction of the annular part, the second area is aligned with the first area and serves as the central area of the guide part where it is located;
  • the third area and the fourth area are arranged on both sides of the central area along the circumferential direction of the annular portion.
  • only one cell is provided in the second, third and fourth regions, and one apex of each cell is in contact with the annular portion.
  • the guide part extends axially from the ring part along the ring part, and the extending path first expands outward in the radial direction of the ring part, and then gradually converges after reaching the maximum outer diameter.
  • a suture post is connected between the first area and the second area.
  • a second unit is provided in the second region, and the combination of the second unit and the valve is fixed.
  • the third and fourth areas are arranged symmetrically on both sides of the central area.
  • the cells in the third and fourth areas adjacent to the first and second areas are third cells, and among all the cells in the guide part, the area of the third cell is the largest.
  • the area of the first region is larger than the area of the second cell.
  • the prosthetic heart valve stent is a tubular structure as a whole, and the axial middle region of the tubular structure has a waist portion with a reduced diameter.
  • the junction of the guide part and the annular part is at the waist.
  • a junction between the guide portion and the annular portion is adjacent to the smallest outer diameter of the waist.
  • the opening there is an opening between two adjacent guide parts, and the opening expands radially outward along a direction away from the annular part to form a V-shaped structure.
  • leaflets when all the leaflets are closed, they converge on the axis of the annular portion, and the intersection point is adjacent to the waist in the axial direction of the annular portion.
  • the annular portion includes multiple rows of cells, and the size of the cells decreases along the direction of the guide portion.
  • each cell is quadrilateral, and the two sides near the second end are longer than the two sides near the first end.
  • an artificial heart valve device which includes an artificial heart valve support and leaflets
  • the artificial heart valve support is a tubular structure as a whole and has a blood flow channel inside
  • the leaflets are multiple pieces, each leaflet Cooperate with each other in the blood flow channel to relatively open or close the blood flow channel.
  • the edge of the leaflet includes a fixed edge fixed to the artificial heart valve bracket, and a free edge that cooperates with other leaflets to control the blood flow channel.
  • the The first end is the outflow side
  • the second end is the inflow side
  • the two ends of the fixed edge are respectively fixed on two adjacent guide parts, and the middle part of the fixed edge extends to the annular part.
  • the junction of the guide part and the ring part is adjacent to the free edge of the leaflet.
  • the adjacent valve leaflets are connected to each other through joint parts and fixed to the bracket, and each joint part is located in a corresponding guide part.
  • each guiding portion has its own structural axis of symmetry, and the fixing edges connecting the two leaflets converge on the corresponding axis of symmetry of the guiding portion.
  • the midpoint of the fixing edge is adjacent to the axial middle of the annular portion.
  • the inner side of the prosthetic heart valve stent has an inner covering, and the inner covering is on the inflow side of the valve leaflets and abuts with the fixed edge of each leaflet.
  • the inner covering membrane extends from the fixed edge of the leaflet to the second end of the annular part.
  • the prosthetic heart valve stent is also provided with an anti-peripheral leakage component on the inflow side of the valve leaflet.
  • the anti-peripheral leakage component is fixed on the outer side of the inner membrane, and the anti-peripheral leakage component is in the shape of blocks distributed at intervals and its position corresponds to the hollowed-out area of the tubular structure.
  • the anti-peripheral leakage component is integrated with the inner membrane, and in an expanded state, the anti-peripheral leakage component protrudes from the outer peripheral surface of the stent.
  • the inner covering film is made of PET, and the anti-circumferential leakage component is made of PU.
  • the tubular structure has a ring-covered multi-channel cell structure, and in the same piece of the leakage prevention component, the part with the highest protrusion is closer to the inflow side of the cell.
  • the distance between the point with the maximum convex height and the inflow side of the cell is S1
  • the distance between the point with the maximum convex height and the inflow side of the cell is S2, where S1: S2 is 0 to 0.8. (preferably 0.3 to 0.8).
  • the thickness gradually increases from the outflow side to the inflow side, and gradually becomes thinner after reaching the highest convex part.
  • the application also discloses a delivery assembly for an interventional device, including:
  • an inner sheath having opposing distal and proximal ends
  • the lock seat is connected to the distal part of the inner sheath
  • the inner core is slidably arranged in the inner sheath tube, one end of the inner core is an extension extending from the distal end of the inner sheath tube, and the radial gap between the inner core and the inner sheath tube is a threading channel;
  • a lock fixed to the extension of the inner core, and located at the distal side of the lock seat;
  • a pulling wire assembly the distal end of which is a working end, and the pulling wire assembly is movably arranged in the passageway;
  • the interventional device When the interventional device is loaded, the working end of the puller wire assembly extends out of the inner sheath distal end, and passes through the interventional device (the interventional device can have the artificial heart valve support above, and the puller wire and the threading ring therein After fitting), it is restrained to the lock piece, and the lock piece and the lock socket are plugged and fitted to restrict the pulling wire from being bound.
  • the lock base is provided with a locking part that cooperates with the lock piece, and in a locked state, the lock piece is inserted into the lock part and restricts the range of motion of the pulling wire.
  • the locking portion is a lock hole or a lock slot.
  • the lock moves with the inner core and has the following positions:
  • the lock piece In the locked position, the lock piece is inserted into the lock hole to constrain the working end of the pulling wire.
  • the extension section of the inner core is provided with a mounting seat, the locking element is fixed to the mounting seat, and extends from the mounting seat toward the proximal direction.
  • the installation base is provided with an installation hole for installing the lock piece, the far end of the lock piece is inserted and fixed in the installation hole, and the proximal end of the lock piece extends out of the installation hole.
  • a plurality of lock pieces are arranged at intervals in the circumferential direction of the inner core, and the lock holes are arranged correspondingly to the lock pieces.
  • the lock is rod-shaped.
  • the strokes of the at least two locks to switch from the release position to the lock position are different.
  • At least two lock pieces have different lengths.
  • any two lock pieces have different lengths.
  • the pulling wire assembly is one or more pulling wires extending from the handle of the delivery system.
  • the pull wire assembly includes a wire control tube and a pull wire
  • the wire control tube is movably sleeved outside the inner core
  • one end of the pull wire is a driving end and is connected to the wire
  • the connection of the control tube, the other end of the pulling wire is the working end, and when the interventional instrument is loaded, the working end is wound around the interventional instrument and then cooperates with the lock.
  • the proximal end of the wire control tube is movable relative to the control handle.
  • the wire control tube is movably sleeved between the inner core and the inner sheath.
  • a guide hole is further provided on the lock seat, and the pulling wire extends outward from the guide hole.
  • the lock seat includes a guide plate, a connecting sleeve and a fixed plate connected in sequence from the far end to the proximal end, wherein the lock hole is set on the fixed plate, and the guide plate is provided with a lock hole position.
  • the lock piece passes through the guide hole in the locked position and is inserted into the lock hole.
  • the lock piece is located in the middle of the guide plate and the fixed plate as a working section, and the working end of the pulling wire is constrained to the working section. .
  • the fixed disk is provided with a guide hole through which the pulling wire passes, and the pulling wire extends from the wire control tube to the distal side of the fixed disk through the guide hole, and connects with the lock parts fit.
  • the part of the puller wire extending to the distal side of the fixed plate is a controllable section that controls the release degree of the interventional instrument, and the length of the controllable section is 100% when the working end of the puller wire is restrained by the lock. Position adjustment via the remote tube.
  • the way in which the pulling wire is wound through the interventional device is as follows:
  • the working end of the puller wire cooperates with the lock after passing through the structure of the interventional instrument itself;
  • the interventional instrument is provided with a connecting piece, and the working end of the pulling wire passes through the connecting piece and cooperates with the locking piece.
  • gaps are provided in the structure of the interventional instrument itself or through holes are additionally provided.
  • the interventional instrument is provided with several connecting ears, and the passing holes are opened on the connecting ears.
  • the connecting member is a flexible wire loop, and the wire loop passes through the passing holes on each connecting ear in sequence.
  • a matching ring is provided at the working end of the pulling wire, and the lock piece passes through the matching ring to constrain the pulling wire.
  • the lock piece is in the shape of a rod extending axially on each pipe piece, and the lock piece in the locked position penetrates the inside where the puller wire is wound to achieve restraint on the puller wire.
  • the enclosed space is provided by the matching ring.
  • the matching ring is an independent component; or formed by winding the pulling wire itself.
  • the arrangement of the matching ring is at least one of the following:
  • the pulling wire is a single-wire structure from the driving end to the working end, and the single wire is wound around the working end itself to form the matching ring;
  • the pulling wire is a double wire structure, and the double wire is folded back at the working end, and the folded part forms the matching ring;
  • the pulling wire itself is formed by a multi-strand braided structure, and the gaps of the braided structure serve as the matching ring.
  • the interventional device delivery assembly further includes a wire control tube, the wire control tube is sheathed on the outside of the inner core, one end of the pulling wire is a driving end, and the driving end is connected to the wire.
  • the control tube extends toward the proximal end and is controlled by the control handle.
  • the other end of the pulling wire is the working end.
  • the proximal end of the wire control tube is fixed and movable relative to the control handle.
  • each puller wire is movably threaded in the corresponding lumens.
  • the interventional device delivery assembly further includes a bend adjustment member, the bend adjustment member is arranged inside or outside the inner sheath, and the distal ends of both the bend adjustment member and the inner sheath They are fixed to each other, and the proximal end is slidingly fitted to realize the bending adjustment of the inner sheath on the distal side.
  • the bending adjustment member is at least one of a pipe, a rod, and a pull wire; the bending adjustment member is located inside or outside the inner sheath.
  • the interventional instrument delivery assembly also includes an outer sheath tube, which is slidably sleeved outside the bending part, and the outer sheath tube moves relative to the interventional instrument to store or release the interventional instrument, and the pulling wire is constrained by the wire control tube Controlling the release of interventional devices.
  • the interventional device delivery assembly further includes a sheath tube, which is sheathed on the outside of the outer sheath tube for establishing an interventional channel.
  • the present application also discloses a delivery system for an interventional device, including the delivery assembly in the above technical solution and a control handle for driving the delivery assembly.
  • the inner sheath tube, the inner core, and the pulling wire of the delivery assembly extend To the control handle, relative movement is driven by the control handle.
  • control handle has opposite distal ends and proximal ends, which are used to drive the inner sheath, the inner core, and the puller wire to move relative to each other.
  • the control handle includes a support body and is installed on The multiple sets of connection components of the support body, relative to the support body, each connection component is divided into a fixed setting and a movable setting, wherein the connecting components of the movable setting include screw drive, rack and pinion drive, and direct drive according to the transmission mode, And the connecting components of each transmission mode are arranged in sequence from the far end to the near end.
  • the present application also discloses an interventional system, including an interventional instrument and a delivery assembly, the interventional instrument includes:
  • annular portion is a radially deformable structure, the two ends of the annular portion in the axial direction are respectively a first end and a second end, wherein the edge of the first end is arranged in sequence along the circumferential direction of the annular portion multiple unit segments;
  • a plurality of guide parts are arranged at intervals along the circumferential direction of the annular part, one side of each guide part is connected to a corresponding unit segment, and the shape of the other side of each guide part gradually converges to the end, and there is a threading ring at the end;
  • the transport assembly includes:
  • an inner sheath having opposing distal and proximal ends
  • the lock seat is connected to the distal part of the inner sheath
  • the inner core is slidably arranged in the inner sheath tube, one end of the inner core is an extension extending from the distal end of the inner sheath tube, and the radial gap between the inner core and the inner sheath tube is a threading channel;
  • a lock fixed to the extension of the inner core, and located at the distal side of the lock seat;
  • the puller wire assembly the distal end of which is the working end, the puller wire assembly is movably arranged in the passageway, and when the interventional instrument is loaded, the puller wire extends out of the distal end of the inner sheath and wraps around the Afterwards, the threading ring of the interventional instrument is bound to the lock piece, and the lock piece fits with the lock seat to prevent the pulling wire from being bound.
  • the technical solution disclosed in this application realizes full control of the artificial heart valve stent through the guide part, especially the threading ring.
  • the setting method and extension shape of the guide part can reduce the influence of the self-expanding characteristics of the artificial heart valve stent on its recovery. Improve the operating experience of medical staff and improve the treatment effect.
  • the pulling wire of the delivery component can realize the staged release of the interventional device, and the mutual movement of each tube can provide a structural basis for the full release and full recovery of the interventional device, thereby providing a more controllable interventional treatment process and improving the treatment effect. while improving the patient experience.
  • Fig. 1 is the schematic diagram of the resistance point in the recovery process of the support in the prior art
  • Fig. 2a is a schematic diagram of an artificial heart valve stent in an embodiment
  • Fig. 2b is a schematic view of the prosthetic heart valve stent in Fig. 2a from a top view;
  • Fig. 2c is a schematic diagram of the proportional relationship of the axial lengths of the parts of the artificial heart valve stent in Fig. 2a;
  • Figure 2d and Figure 2e are schematic views of different viewing angles of the artificial heart valve stent in Figure 2a;
  • Fig. 2f is an enlarged schematic view of the guide part of the artificial heart valve stent in Fig. 2a;
  • Figure 2g is an enlarged schematic view of the threading ring of the artificial heart valve stent in Figure 2a;
  • Fig. 2h is a perspective view of an artificial heart valve stent in another embodiment
  • Fig. 2i is the front view of the artificial heart valve stent of Fig. 2h;
  • Fig. 2j is a partially enlarged schematic diagram of the guide part in Fig. 2h;
  • Fig. 2k is a perspective view of an artificial heart valve stent in another embodiment
  • Fig. 2l is the front view of the artificial heart valve stent of Fig. 2k;
  • Fig. 2m is an enlarged schematic diagram of part of the guide part in Fig. 2k;
  • Fig. 3 a is a schematic diagram of an artificial heart valve stent in an embodiment
  • Fig. 3b, Fig. 3c and Fig. 3d are schematic views of different viewing angles of the artificial heart valve stent in Fig. 3a;
  • Figure 3e is an enlarged schematic diagram of the position of the circle in Figure 3a;
  • Fig. 3f is a three-dimensional schematic view of the prosthetic heart valve stent in Fig. 3a in a top view;
  • Figure 4a is a schematic diagram of an artificial heart valve device in an embodiment
  • Fig. 4b, Fig. 4c and Fig. 4d are schematic views of different viewing angles of the artificial heart valve device in Fig. 4a;
  • Fig. 4e is an enlarged schematic diagram of the artificial heart valve device in Fig. 4d;
  • Fig. 4f is a schematic diagram of the layout of the anti-circumferential leakage components in another embodiment
  • Fig. 4g is a schematic diagram of the layout of the anti-circumferential leakage components in another embodiment
  • Fig. 4h is a schematic diagram of the arrangement of the anti-circumferential leakage components in another embodiment
  • Figure 4i is a schematic structural view of the joint part of the artificial heart valve device in an embodiment
  • Figure 4j is a perspective view of Figure 4i;
  • Fig. 5a is a schematic diagram of the distal side of the delivery component in an embodiment of the present application.
  • Fig. 5b is an enlarged schematic diagram of the conveying assembly in Fig. 5a;
  • Fig. 5c is an enlarged schematic diagram of another viewing angle of the conveying assembly in Fig. 5a;
  • Fig. 5d is an enlarged schematic view of the lock seat and the pulling wire in the delivery assembly in Fig. 5a;
  • Fig. 5e is an enlarged schematic view of the lock seat in the delivery assembly in Fig. 5a;
  • Fig. 5f is a schematic diagram of different settings of locks in the conveying assembly in Fig. 5a;
  • Fig. 5g is a schematic diagram of cooperation between the puller wire and the interventional instrument through the connector in an embodiment
  • Fig. 6a is a schematic diagram of the control handle in one embodiment
  • Fig. 6b is a schematic diagram of the internal assembly of the control handle in Fig. 6a;
  • Fig. 6c is a schematic diagram of the internal structure of the control handle in Fig. 6a;
  • Fig. 6d is a schematic diagram of the internal structure of the control handle in Fig. 6a from another perspective;
  • Fig. 6e is a schematic structural diagram of an exhaust assembly in an embodiment
  • Fig. 7a is a schematic diagram of the control handle in another embodiment
  • Fig. 7b is a schematic diagram of the internal assembly of the control handle in Fig. 7a;
  • Fig. 7c is a schematic diagram of the internal structure of the control handle in Fig. 7a;
  • Fig. 7d is a schematic structural diagram of a gear connection assembly in an embodiment
  • Fig. 7e is a structural schematic diagram of another viewing angle of the gear connection assembly in Fig. 7d;
  • Fig. 7f is a schematic diagram of the internal structure of the gear connection assembly in Fig. 7d;
  • Figure 7g is a schematic diagram of the assembly of pipe fittings in one embodiment
  • Figure 7h is a perspective view of the control handle in another implementation.
  • Figure 7i is an exploded view of the control handle of Figure 7h;
  • Figure 7j is a cross-sectional view of the control handle of Figure 7h;
  • Fig. 7k is a partial structural schematic diagram of the control handle in Fig. 7i at the gear and the rack;
  • Figure 7l is an exploded view of Figure 7k
  • Fig. 7m is a schematic diagram of the structure between the gear, the rack and the clamping base in Fig. 7k;
  • Figure 7n is a front view of the control handle of Figure 7h;
  • Figure 7o is a sectional view of part A-A in Figure 7n;
  • Fig. 8a is a schematic diagram of bending of the distal side of the delivery component in an embodiment
  • Fig. 8b is a schematic diagram of delivering the interventional device to the target point by the delivery component in an embodiment
  • Fig. 8c is a schematic diagram of adjusting the position of the interventional instrument relative to the target point in an embodiment
  • Fig. 9a is a schematic diagram of the half-released interventional device of the delivery assembly in an embodiment
  • Fig. 9b is a schematic diagram of a state in which the delivery assembly fully releases the interventional device and prevents the pulling wire from loosening in one embodiment
  • Fig. 9c is a schematic diagram of a state in which the delivery assembly fully releases the interventional device and releases the puller wire in one embodiment.
  • control handle 61, support body; 611, fixed seat; 612, sliding seat; 62, thread matching area; 621, threaded connection assembly; 622, drive ring; 623, positioning ring; 624, positioning tooth; 625, clip Holder; 63, rack and pinion mating area; 631, gear connection assembly; 632, base; 6321, slide rail; 6322, elastic buckle; 6323, first limit boss; 6324, second limit boss ; 633, clamping base; 634, rack;
  • Interventional instruments 91. Connectors; 92. Connecting ears.
  • a component when a component is said to be “connected” to another component, it may be directly connected to the other component or intervening components may also exist. When a component is said to be “set on” another component, it may be set directly on the other component or there may be an intervening component at the same time.
  • an artificial heart valve device including an artificial heart valve stent and a plurality of leaflets and covering membranes located inside the stent, and the artificial heart valve stent is a tubular structure as a whole, with In the compressed state and the expanded state, the inside of the stent is a blood flow channel, and the valve leaflets cooperate with each other in the blood flow channel to relatively open or close the blood flow channel.
  • a kind of artificial heart valve support 70 comprise:
  • the annular part 71 is located at the inflow end of the stent, which can also be called the inflow end area;
  • the annular part 71 is a radially deformable structure, composed of a number of compressible cells, and the two ends of the annular part 71 in the axial direction They are the first end 711 and the second end 712 respectively, wherein the edge of the first end 711 includes a plurality of unit segments 713 arranged in sequence along the circumferential direction of the annular portion 71; the axial length of the annular portion 71 is 1.5 units long.
  • a plurality of guide parts 72 are located at the outflow end of the bracket, which can also be called the outflow end area; they are arranged at intervals along the circumferential direction of the annular part 71, and one side of each guide part 72 is connected to a corresponding unit segment 713, and each guide part The shape of the other side of 72 gradually converges to the end 721, and there is a threading ring 722 at the end 721.
  • the present application uses the guide part 72, especially the threading ring 722 to realize the full controllable release of the artificial heart valve stent 70, including recovering the valve stent that has completely detached from the sheath, and improving the accuracy of surgical implantation.
  • the arrangement and extension shape of the guide part 72 can reduce the influence of the self-expanding characteristic of the prosthetic heart valve stent 70 on its recovery.
  • the prosthetic heart valve stent 70 has a relative compression state and a release state based on radial deformation as a whole.
  • the axial direction of the annular portion 71 is the length direction
  • the length of the guide portion 72 is L1
  • the length of the annular portion 71 is L2
  • L1:L2 1:0.6-1.2.
  • connection side 723 that is docked with the corresponding unit segment 713, and two adjacent guide parts
  • the connecting sides 723 of the parts 72 abut each other.
  • the connecting sides 723 of two adjacent guiding parts 72 may also be arranged with a gap.
  • the length L3 of the connecting side 723 should be understood as the arc length on the peripheral surface of the annular portion 71 .
  • the artificial heart valve stent 70 in Fig. 3a to Fig. 3f and Fig. 4a to Fig. 4e is the same, and will not be repeated here.
  • N is 2, 3, 4, 5 or 6, and the central angle corresponding to the connecting side 723 of each guide part 72 is 360 degrees /N.
  • the convergence trend of the guide portion 72 from the connecting side 723 to the end 721 is uniform.
  • the convergence trend of the guide part 72 from the connection side 723 to the end 721 is first small, then large and finally small.
  • the uniform convergence mentioned in this embodiment should be understood as the overall trend, and it does not rule out that the edge of the guide part 72 is provided with protrusions at individual parts. raised or sunken.
  • the extension tendency of the guide part 72 can be set separately.
  • the guide part 72 extends axially from the annular part 71 along the annular part 71. , the extending path first expands outward in the radial direction of the annular portion 71 , and then gradually converges after reaching the maximum outer diameter point 7281 .
  • both the guide part 72 and the ring part 71 have a hollowed-out unit cell structure.
  • the cells in the ring part 71 have multiple turns, and the junction between the guide part 72 and the ring part 71 is formed by The vertices of a circle of cells are enclosed.
  • the guide part 72 and the annular part 71 of the cell structure can better adapt to the state switching of the artificial heart valve stent 70 , and can finely adjust the mechanical properties of the artificial heart valve stent 70 through the setting of the cell structure.
  • the axial length of the annular portion 71 is 1 to 2.5 cells. As shown in Figure 2i, the axial length of the annular part 71 spans 2 unit cells, as shown in Figure 2L, the axial length of the annular part 71 spans 2.5 unit cells, and the specific structure of the unit cells can be polygonal; for example, the accompanying drawings The rhombus grid shown in .
  • both the guide part 72 and the annular part 71 have a hollowed-out cell structure, and the cells in the guide part 72 are divided into opposite sparse areas 725 and dense areas 726, and at least a part of the sparse areas 725 are close to two adjacent guides.
  • the sparse area and the dense area in this application are relative terms.
  • the sparse area means that the cells have a larger area
  • the dense area means that the cells have a relatively small area, that is, the cell area of the sparse area is larger than the dense area.
  • the cell area of the region is relative terms.
  • the cell area corresponding to the sparse region 725 is larger than the cell area of the dense region 726; the cells of different degrees of sparseness can finely adjust the mechanical properties of each part of the guide part 72, thereby improving the compliance of the guide part 72, in releasing and Provide a smoother operating experience during the recycling process.
  • the guide part 72 includes four closed areas 727, which are:
  • the first area 7271 the first area is located at the proximal end of the stent and is used to connect the delivery system.
  • the first area is the threading ring 722, which includes a first unit;
  • the second area 7272 is a dense area 726, which is arranged along the circumference of the annular part 71.
  • the second area 7272 is aligned with the first area 7271 and serves as the central area 7275 of the guide part 72; the second area is used to fix the valve
  • the ear protector includes at least one second unit; in this embodiment, the second area only includes one unit, that is, the second unit, and in other embodiments, the second area may include multiple units.
  • the outflow end node A of the second unit cell is connected to the inflow end node B of the first unit cell through a suture post AB, and a suture hole is provided on the suture post AB, through which the flap is fixed. leaves, the first connecting bar is parallel to the longitudinal axis of the stent.
  • the third area 7273 is the sparse area 725, along the circumferential direction of the annular part 71, on one side of the central area 7275, in this embodiment, the third area only includes a third unit cell, in other embodiments, the third area Three regions can include multiple cells.
  • the fourth area 7274 is the sparse area 725, along the circumferential direction of the annular part 71, on the other side of the central area 7275.
  • the fourth area only includes one fourth unit cell.
  • the fourth area may include a plurality of cells.
  • the third cell and the fourth cell have the same size and have the largest area, the first cell has the smallest area, and the second cell has the largest area.
  • the cell area is between the third cell and the first cell.
  • the dense area 726 of the second area 7272 can be realized by increasing the number of cells in the same area, or by reducing the corresponding area under the premise of the same number of cells. In principle, it can be realized as Within a unit area, more ribs are pierced in the dense area 726 .
  • the cell area of the dense region 726 is 0.3 ⁇ 0.8 times of the cell area of the sparse region 725 . In a specific product, the cell area of the dense region 726 is 0.4 to 0.6 times the cell area of the sparse region 725 .
  • the cell shapes of the third area 7273 and the fourth area 7274 are the same or similar, and the cell shapes of the two are different from the cell shapes of the second area 7272 to form density changes.
  • the guide portion 72 extends axially from the annular portion 71 along the annular portion 71, and the extending path first expands outward in the radial direction of the annular portion 71, and then gradually Convergence, the maximum outer diameter 7281 is adjacent to the junction of the first area 7271 and the second area 7272 .
  • adjacent to the opening is an edge frame bar 7282, one end of the edge frame bar 7282 is connected to the threading ring, and the other end of the edge frame bar 7282 is connected to the ring portion 71, and the edge
  • the bars 7282 intersect no more than two other bars in the tubular structure during extension.
  • the edge frame bar 7282 is connected with a branch frame bar 7283 near the first end 711, and the branch frame bar 7283 and the edge frame bar 7282 are respectively connected to different units on the first end 711 grid vertices.
  • the whole process control of the artificial heart valve stent 70 requires the cooperation of the threading ring 722 .
  • the side of the threading ring 722 away from the annular portion 71 is a pulling section 7221 , and the pulling section 7221 is arc-shaped.
  • the side of the threading ring 722 close to the annular portion 71 is a transition section 7222 shared with the surrounding cells, the transition section 7222 is V-shaped, and its apex faces the annular portion 71 .
  • the pulling section 7221 and the transition section 7222 enclose one or more closed spaces.
  • the radius of the circumscribed circle of the threading ring 722 is greater than or equal to twice the diameter of the rod of the threading ring 722.
  • the key point of this setting is that the threading ring 722 has a certain size in space, not on the rod. opening.
  • the artificial heart valve stent 70 in Fig. 3a to Fig. 3f and Fig. 4a to Fig. 4e is the same, and will not be repeated here.
  • this embodiment has a structure similar to that of Embodiment 2a, including an annular portion 71a and a guide portion 72a, the difference being that the axial direction of the annular portion 71a spans two cells, And in the second region, the inflow node of the first cell is directly the same as the outflow node of the second cell, and the leaflet is directly sutured to the second cell;
  • the guide part 72b includes four areas, which are:
  • the first area a sparse area, the first area is located at the most proximal end of the stent, used to connect the delivery system, in the present invention, the first area is a threading ring 81, including a first unit;
  • the second area 82 is a dense area, arranged along the circumferential direction of the annular part 71b, the second area is aligned with the first area and serves as the central area of the guide part 72b; the second area is used to fix the ear protector of the valve, at least including One second cell 82a; in this embodiment, the second area includes a plurality of cells, which are respectively the second cell 82a and the cells 82b and 82c distributed on both sides of the second cell 82a. Along the direction of the outflow end of the bracket, the outflow end node of the second cell and the inflow end node of the first cell share an end node.
  • the third area 83 and the fourth area are sparse areas, along the circumferential direction of the annular part 71, the third area and the fourth area are symmetrically arranged on both sides of the second area, which include at least one unit cell, in this embodiment , which respectively include a third cell 84a, a cell 84b and a part of cells 84c.
  • the cells 84 span the guide portion and the ring portion longitudinally.
  • the third cell has the largest area
  • the second cell has the smallest area
  • the area of the first cell is between the third cell and the second cell. between grids.
  • the annular portion includes a plurality of rows of cells, the cells decreasing in size along the direction of the leading portion.
  • the artificial heart valve support 70 is a tubular structure as a whole, and the central region of the tubular structure axially has a There is a waist 701 of reduced diameter.
  • the junction of the guide portion 72 and the annular portion 71 is at the waist portion 701 .
  • the junction between the guide portion 72 and the ring portion 71 is adjacent to the smallest outer diameter of the waist 701 , and in the embodiment shown in the drawings, the junction between the guide portion 72 and the ring portion 71 is located at the waist 701 at the smallest outer diameter.
  • opening part 724 Between two adjacent guiding parts 72 is an opening part 724, and the opening part 724 is further flared from the waist part 701 to the back of the annular part 71 and opened. When they are closed, they converge on the axis of the ring portion 71 , and the intersection point is adjacent to the waist 701 at the axial position of the ring portion 71 .
  • each cell in a row of cells distributed along the circumference of the second end of the annular portion 71 , each cell is quadrilateral, and the two sides near the second end are longer than the two sides near the first end.
  • an artificial heart valve device including an artificial heart valve stent 70, a plurality of leaflets 73 and an inner covering, wherein the leaflets and the inner covering constitute a valve assembly
  • Each leaflet 73 cooperates with each other in the blood flow channel 75 to relatively open or close the blood flow channel 75 .
  • the edge of the leaflet 73 includes a fixed edge 731 fixed to the artificial heart valve support 70, and a free edge 732 that cooperates with the adjacent leaflet 73 to control the blood flow channel 75.
  • the first The end 711 is the outflow side 733
  • the second end 712 is the inflow side 734
  • the two ends of the fixing edge 731 are respectively located in the two adjacent guide portions 72
  • the middle part of the fixing edge 731 extends to the ring portion 71 .
  • the two ends of the free edge 732 extend toward the outflow side in the axial direction of the stent, and are fixed in a unit cell on the guide part 72 by a membrane.
  • the cell may be the cell constituting the central area mentioned above.
  • each guiding portion 72 has its own structural axis of symmetry 7284 , and the fixing edge 731 connecting the two petals 73 meets the corresponding axis of symmetry 7284 of the guiding portion 72 .
  • the midpoint of the fixing edge 731 is adjacent to the axial middle of the annular portion 71 .
  • the junction of the guide portion 72 and the annular portion 71 is adjacent to the position of the free edge 732 of the leaflet 73 .
  • Adjacent valve leaflets 73 are connected to each other through joint parts 735 and fixed to the artificial heart valve support 70 , and each joint part 735 is located in a corresponding guide part 72 .
  • the joint part 735 is fixed in the second unit cell in the second region.
  • the inner side of artificial heart valve support 70 has inner membrane 74, and inner membrane 74 is in the inflow side 734 of valve leaflet 73 and is fixed with each valve leaflet 73 Edge 731 docking.
  • the inner covering 74 extends from the leaflet 73 to the second end 712 of the annular portion 71 .
  • the prosthetic heart valve stent 70 is also provided with an anti-peripheral leakage component 741 on the inflow side 734 of the leaflet 73 .
  • the anti-peripheral leakage component 741 can be exposed on the outer peripheral surface of the prosthetic heart valve stent 70; the outer covering film can also be set to further wrap, that is, the inner covering film 74 and the outer covering film enclose the anti-peripheral leakage component 741 in the radial direction of the tubular structure.
  • the anti-circumferential leakage component 741 is fixed on the outside of the inner covering film 74 , and the anti-peripheral leakage component 741 is in the shape of blocks distributed at intervals and the positions correspond to the hollowed-out areas of the tubular structure.
  • the anti-circumferential leakage component 741 and the inner covering film 74 are integrally constructed. In the expanded state, the anti-circumferential leakage component 741 extends radially outward from the cell on the inflow end side of the annular portion, and protrudes outward on the outer peripheral surface of the artificial heart valve stent 70 or in contact with the prosthetic heart valve support 70. The outer surface of the stand is flush.
  • the inner covering film can be made of biocompatible biofilm or made of PET, and the anti-circumferential leakage component 741 is made of elastic material and/or absorbing body fluid expansion, or porous material, such as foamed by PU material.
  • the tubular structure has a ring-clothed multi-channel cell structure, and the arrangement of the anti-peripheral leakage components is as follows:
  • one or more rows of anti-circumferential leakage components 741 are arranged circumferentially along the inflow end of the annular portion, specifically arranged on the first ring of anti-peripheral leakage components 7411 on the inflow side 734, the first ring of anti-peripheral leakage components 7411 7411 is all over the cell.
  • the anti-circumferential leakage component 741 itself can be elongated and surround the periphery of the artificial heart valve stent 70, or, as shown in FIG. 3e, be a plurality of blocks distributed at intervals and be fixed in the corresponding hollow area of the tubular structure.
  • the dotted line in the figure is mainly used to indicate the surface extension tendency of the leakage preventing component 741 .
  • the anti-circumferential leakage component 741 in the expanded state is further convex in the radial direction relative to the tubular structure, and the outer peripheral surface and the outer peripheral surface of the tubular structure are smoothly transitioned.
  • the convex height is the largest The position is closer to the inflow side.
  • the distance between the maximum convex height of the anti-peripheral leakage part 741 and the inflow side of the cell unit is S1
  • the distance between the maximum convex height of the anti-circumferential leakage part 741 and the cell unit is The distance between the inflow and outflow sides
  • the ratio of S1:S2 ranges from 0.2 to 0.8, and the ratio range may preferably be from 0.3 to 0.8 in actual products.
  • the anti-circumferential leakage part 741 After the anti-circumferential leakage part 741 protrudes outwards, it can fill the space surrounded by the rods of the unit cell in terms of area. From the degree of convexity, the anti-circumferential leakage part 741 is close to the side edge of the rods of the cell in which it is located. That is, the lowest position of the anti-peripheral leakage component 741 is not lower than the outer peripheral surface of the unit cell bar, so as to avoid the gap generated between the anti-peripheral leakage component 741 and the side edge of the rod. The negative impact of this gap may absorb the anti-circumferential leakage component 741 The deformation of the rod reduces the plugging effect, and the side edge of the rod is understood as the side of the rod facing the inside of the cell.
  • the artificial heart valve device in this embodiment can adopt dry film preservation method or wet film preservation method, wherein the dry film preservation method is that the leaflets 73 are preserved in a non-liquid environment.
  • an interventional instrument 90 delivery assembly that can be operated by wire, including:
  • an inner sheath 30 having opposing distal and proximal ends
  • the lock seat 31 is connected to the distal part of the inner sheath tube 30;
  • the inner core 10 is slidably arranged in the inner sheath tube 30, one end of the inner core 10 is an extension section 11 protruding from the distal end of the inner sheath tube 30, and the radial gap between the inner core 10 and the inner sheath tube 30 is a passageway 12;
  • the lock piece 13 is fixed on the extension section 11 of the inner core 10 and is on the distal side of the lock seat 31;
  • the pulling wire 21 is movably arranged in the threading channel 12;
  • the pulling wire 21 extends out of the distal end of the inner sheath 30, and is bound to the lock 13 after passing through the threading ring 722 of the interventional instrument 90.
  • the backguy 21 is free from shackles.
  • the relative movement of the inner core 10 and the inner sheath 30 can realize the relative movement of the lock seat 31 and the lock member 13 , thereby changing the restraint state of the puller wire 21 .
  • the state of the pulling wire 21 can affect the movement process of the interventional device 90, especially during the release process of the interventional device 90, so that the phased release of the interventional device 90 can be realized through the pulling wire 21, and further, the mutual interaction of each tube
  • the movement can provide a structural basis for the full release and full retraction of the interventional device 90, thereby providing a more controllable interventional treatment process, improving the treatment effect and improving the patient experience.
  • the pulling wire 21 mainly cooperates with the threading ring 722 to realize the control of the interventional instrument, and at the same time, the structural optimization of the guide part 72 of the interventional instrument improves the compliance of its own structure during the state change, avoiding the existing Problems encountered in the full recovery process of interventional devices in technology.
  • the interventional device 90 can be an artificial heart valve or a vascular stent, etc.
  • the artificial heart valve can include a stent and leaflets connected to the stent to control blood flow interruption.
  • a skirt design is added to the inside and/or outside of the stent, and the stent itself can be formed by braiding or cutting from a tube.
  • Prosthetic heart valves are used to replace diseased valves in the heart, such as the aortic valve in particular.
  • the lock base 31 is provided with a locking part that cooperates with the lock piece 13, and in the locked state, the lock piece 13 is inserted into the lock part and constrains the range of motion of the pull wire 21 .
  • the locking portion is a lock hole or a lock slot, and this embodiment takes the lock hole as an example.
  • the lock hole 311 can constrain the lock piece 13 on the other side of the lock piece 13 relative to its own fixing structure, thereby improving the overall mechanical properties of the lock piece 13 .
  • the lock hole 311 can be represented as a specific through hole or blind hole for the lock member 13 to pass through; the lock hole 311 can also be represented as a structure that can improve the positioning effect of the lock member 13, For example, the structure of the locking member 13 should also be adjusted correspondingly for positioning recesses or positioning protrusions.
  • the lock 13 moves with the inner core 10 and has the following positions:
  • the lock member 13 In the locked position (refer to FIG. 9b ), the lock member 13 is inserted into the lock hole 311 to constrain the pulling wire 21 .
  • the different positions of the lock piece 13 specifically represent constraints on the movement state of the pulling wire in the passageway 12 .
  • the actual function of the lock 13 is to separate an independent restraint space in the passage 12.
  • the lock The member 13 realizes the constraining effect on the pulling wire 21 .
  • the release position ie the restricted space above, communicates with the threading channel 12 , so that the pulling wire 21 can move freely to release the interventional instrument 90 .
  • the pulling wire 21 is not in a completely immovable state during the process of being locked by the lock member 13 .
  • the pulling wire 21 can realize the following functions through its own material (such as deformable material) or size (such as a longer extension length): when the pulling wire 21 is constrained by the lock 13, it can release the preset degree of intervention through its own deformation. Apparatus 90 movement stroke.
  • the half-release of the interventional instrument 90 is realized when the lock 13 is not released, that is, the connecting ear 92 of the interventional instrument 90 is released from the corresponding structure , but the overall shape is still controlled by the pulling wire 21.
  • the above arrangement provides a structural basis for controlling the release process of the interventional instrument 90 through the control of the pulling wire 21 .
  • the above-mentioned deformation of the puller wire 21 refers to the deformation on the extension path of the puller wire 21 rather than the length change caused by the stretching of the material. To control the release, the elongation of the pulling wire should be as small as possible. Other descriptions in this paper about the deformation of the pulling wire 21 should also meet the above basic rules.
  • the extension section 11 of the inner core 10 is provided with a mounting base 131, the lock 13 is fixed on the mounting base 131 and extends from the mounting base 131 to the proximal direction, and the mounting base 131 is provided with a lock for installing the lock. 13 of the installation hole 132, the far end of the lock 13 is inserted and fixed in the installation hole 132, and the proximal end of the lock 13 extends out of the installation hole 132.
  • the mating direction of the lock piece 13 and the lock hole 311 in this embodiment is also a noteworthy arrangement detail. It can be understood that the distal side of the lock piece 13 is connected to the inner core 10 , and the proximal side of the lock piece 13 extends toward the lock seat 31 and cooperates with the lock hole 311 as it moves. The lock piece 13 extends from the distal side to the proximal side to achieve cooperation with the lock hole 311 , which can better achieve a compact structure. In the embodiment shown in the drawings, it is possible to set the lock 13 and the mounting seat 131 in the lock seat 31 inside the interventional instrument 90 in the loading state, which is located in the bare stent section of the valve stent.
  • the lock 13 in the set direction has better operational convenience.
  • the installation of the interventional device is more cumbersome, and it is very easy to fall off, resulting in rework and affecting production efficiency.
  • the function of the installation hole 132 is to achieve a stable fit between the lock piece 13 and the installation seat 131 .
  • the lock piece 13 and the mounting hole 132 can be fixedly connected. Considering the difficulty of production, it can be selected as bonding or welding.
  • the structure of the mounting hole 132 can better realize the assembly process and improve production efficiency.
  • the installation hole 132 is opened on the peripheral surface of the installation base 131 , and the opening part is at least available for the lock member 13 to be seated.
  • the open installation hole 132 can not only facilitate the operation, but also facilitate the inspection, ensure the stability of the connection, and improve the overall stability of the device. More importantly, the open installation hole 132 can structurally ensure that the lock piece 13 is installed to the bottom of the installation hole 132, avoiding the uncertainty caused by the blind hole structure, thereby ensuring that the end surface of the lock piece 13 is connected to the lock hole 311 Lock spacing between.
  • the locking pieces 13 and the locking holes 311 can also be adjusted accordingly.
  • a plurality of locking pieces 13 are arranged at intervals in the circumferential direction of the inner core 10 , and the locking holes 311 are arranged correspondingly to the locking pieces 13 .
  • the adjustment of the number of locks 13 and lock holes 311 can improve the restraint ability of the puller wire 21 , thereby realizing multi-dimensional control of the interventional instrument 90 , especially in terms of improving control accuracy.
  • the increase in the number will also increase the complexity of the structure, which will have a certain impact on assembly and stability. Therefore, in a specific product, at least three locking pieces 13 are evenly arranged in the circumferential direction of the inner core 10 , and the locking holes 311 are correspondingly arranged with the locking pieces 13 .
  • the locking elements 13 are rod-shaped.
  • the rod-shaped lock 13 has the advantage of a simple structure, and at the same time cooperates with the relevant details of the pulling wire 21 below to ensure the locking effect while having a simple structure.
  • At least two locks 13 have different strokes when switching from the release position to the locked position.
  • the “travel” refers to the locking distance between the end surface of the lock member 13 and the lock hole 311 , in other words, how much distance the end surface of the lock member 13 needs to travel to enter the lock hole 311 .
  • the advantage of this arrangement is that an asynchronous locking of different locking elements 13 can be achieved.
  • the main purpose of this technical effect is to improve the installation efficiency of the pulling wire 21 and the interventional instrument 90 .
  • the structure of the interventional machine 90 and the pulling wire 21 is small and complicated.
  • the lock 13 When the lock 13 is synchronously locked, the operator needs to complete the synchronous installation of the interventional instrument 90, which is very troublesome for a device with multiple installation points and seriously affects Assembly efficiency.
  • the phased installation of the interventional instrument 90 can be realized through the asynchronous locking of the lock, thereby greatly improving the production efficiency while ensuring the assembly quality.
  • the different strokes of the lock piece 13 from the release position to the lock position can be realized through the differential setting of the lock hole 311 , and it can also be realized through the differentiation of the lock piece 13 .
  • at least two locking elements 13 have different lengths.
  • the lock pieces with different lengths can realize that even if the lock pieces 13 move synchronously, each lock hole 311 cooperates with the corresponding lock piece 13 at different timings, so as to realize the above functions. Further, the lengths of any two lock pieces are different.
  • the delivery assembly of the interventional instrument 90 also includes a puller wire assembly, which includes a puller wire 21 and a wire control tube 20, the wire control tube 20 is movably sleeved outside the inner core 10, and one end of the puller wire 21 It is the driving end 211 and is connected to the wire control tube 20.
  • the other end of the pulling wire is the working end 212 (hereinafter referred to as the matching ring 22).
  • the matching ring 22 When the interventional instrument is loaded, the working end 212 is wound to the interventional instrument. Cooperate with lock piece 13 after 90.
  • the function of the wire control tube 20 is to control the working state of the puller wire 21 , especially to control the interventional instrument 90 by controlling the puller wire 21 .
  • the control-by-wire tube 20 is set to be active so as to realize its own driving function. That is, the proximal end of the wire control tube 21 is movable relative to the control handle. In this embodiment, it is shown that the proximal end of the wire-control tube 21 is moved relative to the inner sheath.
  • the wire control tube 20 is movably sleeved between the inner core 10 and the inner sheath tube 30 .
  • the wire control tube 20 is arranged between the inner core 10 and the inner sheath tube 30 to avoid interference with the wire control tube 20 and the lock seat 31 , thereby providing more space for the installation of the interventional instrument 90 .
  • a guide hole 312 is also provided on the lock seat 31 , and the pulling wire 21 extends outward from the guide hole 312 .
  • the wire-controlled tube 20 is a specific pipe fitting, but in principle, it can be realized by extending the proximal side of the puller wire 21 itself, that is, directly operating the puller wire 21 through the control handle 60 Near end to achieve the above functions. Therefore, in actual products, the specific shape of the remote control tube 20 may change. The following description is mainly carried out in conjunction with the product form of the wire control tube 20 in the accompanying drawings, and the same is true for other implementations, which will not be repeated here.
  • the half-release of the interventional instrument 90 is realized when the lock 13 is not released, that is, the connecting ear 92 of the interventional instrument 90 is released from the released in the corresponding structure, but the overall shape is still controlled by the pulling wire 21.
  • the above arrangement provides a structural basis for controlling the release process of the interventional instrument 90 through the control of the pulling wire 21 .
  • the part of the puller wire 21 extending to the distal side of the fixed disk of the lock seat 31 is a controllable section that controls the release degree of the interventional instrument.
  • the working state of the lock 13 and the working state of the wire control tube 20 can be linked or independent of each other.
  • the wire control tube 20 can control the restrained pulling wire 21 to adjust its own state through its own movement when the lock piece 13 is not unlocked.
  • the lock base 31 includes a guide plate 313, a connecting sleeve 314, and a fixed plate 315 connected in sequence from the distal end to the proximal end, wherein the lock hole 311 is opened on the fixed plate 315, and the guide hole 312 is set on the guide plate 313 and corresponds to the position of the lock hole 311;
  • the lock piece 13 passes through the guide hole 316 in the locked position, and is inserted into the corresponding lock hole 311 after passing through the periphery of the connecting sleeve 314.
  • the position of the lock piece 13 on the periphery of the connecting sleeve 314 is used as a working section, and the working end 212 of the pull wire 21 is drawn. Constrained to this work segment.
  • the guide disc 313 and the fixed disc 315 form a relatively closed small environment in the passageway 12 , thereby effectively improving the stability of the lock member 13 in cooperation with the pulling wire 21 .
  • the mechanical properties of the lock member 13 can be effectively improved, ensuring that the interventional instrument 90 with high elastic force can be controlled.
  • the lock seat 31 can also provide guidance to the pulling wire 21 .
  • the guide hole 312 through which the pulling wire 21 passes is provided on the fixing disc 315, and the pulling wire 21 extends from the wire control tube 20 to the distal end of the fixing disc 315 through the guide hole 312 side, and cooperate with the lock piece 13.
  • the pulling wire 21 needs to pass through the fixing plate 315 of the lock seat 31 . That is, it can be understood that the pulling wire 21 cooperates with the lock member 13 through the guide hole 312 .
  • the guide hole 312 can comb the pulling wire 21 , so as to realize the stable driving of the wire control tube 20 to the pulling wire 21 . Further, the position of the guide hole 312 can adjust the force application position of the pulling wire 21 to the interventional instrument 90 by setting its own position, so as to better control the interventional instrument 90 .
  • the lock seat 31 is provided with a lock hole 311 for matching with the lock member 13 , and there are multiple guide holes 312 and lock holes 311 , which are arranged alternately on the circumference of the fixed plate 315 .
  • the guide hole 312 and the lock hole 311 arranged adjacent to each other can realize the compact arrangement of the structures on the lock seat 31 and avoid the adjacent Unnecessary mutual interference between the pulling wires 21 (if there are multiple ones).
  • the constraint path of the pulling wire 21 is actually determined by three positions, which are respectively how the proximal end of the pulling wire 21 establishes a relationship with the control handle (in this embodiment, the proximal end of the pulling wire 21 is connected to the wire control tube) , how the working end 212 of the puller wire 21 interacts with the interventional instrument 90 , and how the working end 212 of the puller wire 21 interacts with the lock 13 .
  • the control handle in this embodiment, the proximal end of the pulling wire 21 is connected to the wire control tube
  • the working end 212 of the puller wire 21 interacts with the interventional instrument 90
  • the working end 212 of the puller wire 21 interacts with the lock 13 .
  • the puller wire 21 and the interventional device 90 are configured as follows:
  • the working end 212 of the pulling wire 21 cooperates with the lock 13 after going through the structure of the interventional instrument 90 itself; or
  • the interventional instrument 90 is provided with a connecting piece 91 , and the working end 212 of the pulling wire 21 passes through the connecting piece 91 and cooperates with the locking piece 13 .
  • This embodiment includes two implementation manners.
  • the working end 212 of the puller wire 21 cooperates with the lock 13 after going through the self-structure of the interventional instrument 90" (refer to Figure 5f )
  • the self-structure of the interventional instrument 90 may be a hollow part in the framework of the interventional instrument 90 itself, It may also be a hole opened on the skeleton of the interventional device 90 , or a part formed by extending the material of the interventional device 90 itself.
  • the interventional instrument itself is provided with gaps (such as the above-mentioned hollow part) or additional passing holes (such as the above-mentioned threading loop) in its own structure.
  • connecting ears 92 may also be provided on the interventional instrument 90 to improve the control capability of the delivery assembly for the interventional instrument 90 .
  • the connecting piece 91 can be configured as a through hole sequentially or respectively passed through the connecting ear 92 .
  • the working end 212 of the pulling wire 21 extends along the interventional instrument 90, passes through the hole at the end of the interventional instrument 90, extends along the direction of the lock seat 31, and is finally sheathed on the guide plate 313 and the fixed on the locking lever between the discs 315.
  • the advantage of this embodiment is that the puller wire 21 can directly control the interventional instrument 90, and the number of components is small, which facilitates production and assembly while reducing the possibility of component failure.
  • the connecting piece in "the interventional instrument 90 is provided with a connecting piece 91" (refer to FIG. 5g ) can refer to the self-closed wire loop shown in the drawing, or can be arranged in other forms, such as an independent connecting part.
  • the connector 91 is a flexible wire loop.
  • the connecting piece 91 is a wire loop.
  • the connector 91 can be pre-assembled on the interventional device. When in use, it is more convenient to intertwine with the puller wire 21 on site and optimize the stroke of the relative movement tube.
  • the proximal end of the interventional instrument has a plurality of connecting ears 92 with holes, and the wire loops pass through each connecting ear 92 in turn.
  • the number of connecting ears 92 is 2 to 6, and the sharp corners of the unit cells of the interventional device 90 can also be used.
  • the wire loop that is, the connecting piece 91 above
  • it can be threaded and connected with the pulling wire 21 in different ways.
  • the details of the setting of the pulling wire 21 are also different from other embodiments. Adjustments, but the basic principles remain the same, so no further elaboration.
  • One end of the pulling wire 21 is the driving end 211 , the driving end 211 is extended and controlled by the control handle, and the other end of the pulling wire 21 is the working end 212 (ie, the matching ring 22 hereinafter).
  • connection points can be set on the wire loop to facilitate the connection of the pulling wire.
  • the connection point can be an actual part, and there is a part with volume in space to realize the connection; the connection point can also be a virtual point, which has no actual part and only represents a position.
  • the end (i.e., the working end 212) of the puller wire 21 that cooperates with the lock member 13 is provided with a matching ring 22, and the lock member 13 penetrates through the fit.
  • the ring 22 is used to constrain the pulling wire 21 .
  • the matching ring 22 is that it can facilitate the setting of the lock piece 13 .
  • the lock piece 13 needs to be provided with a corresponding matching structure.
  • the matching ring 22 is formed by taking advantage of the structure of the pulling wire 21 to simplify the installation of the lock member 13 .
  • the lock piece 13 is a rod-shaped extension in the axial direction of each pipe piece, and the lock piece 13 in the locked position penetrates the inside of the closed part where the puller wire 21 is wound to realize the locking of the puller wire 21. constraint.
  • the closed position can be realized by passing through the pulling wire 21 , and can also be provided by the matching ring 22 .
  • the matching ring 22 is an independent component or is formed by winding the pulling wire 21 itself.
  • the setting of independent components facilitates the setting of different materials.
  • the matching ring 22 is made of a developed material, which is convenient for real-time control of the intervention process.
  • the winding form of the pulling wire 21 has the advantage of simple and stable structure, which is convenient for production and assembly.
  • the pulling wire 21 is a single-wire structure from the driving end 211 to the working end 212, and the single wire is wound around the working end 212 itself to form a matching ring.
  • a corresponding matching ring structure can also be provided at the proximal end of the pulling wire 21 to facilitate installation.
  • the pulling wire 21 has a double-wire structure, and the double wire is folded back at the working end 212 , and the folded part forms a matching loop.
  • the pulling wire 21 has better structural strength.
  • the pulling wire itself is formed of a multi-strand braided structure, and the gaps of the braided structure serve as matching rings. The gaps of the braided structure can be formed by the braiding process or by manipulation during the assembly process.
  • the assembly also includes a wire control tube 20, which is sleeved outside the inner core 10, and one end of the pulling wire 21 is a driving end 211, and the driving end 211 extends proximally in the wire control tube 20 and is controlled by the control handle.
  • the other end of the pulling wire 21 is the working end 212 (ie, the mating ring 22 hereinafter).
  • the working end 212 is wound around the interventional instrument 90 to cooperate with the lock 13 .
  • the wire control tube 20 in this embodiment provides an independent movement space for the driving of the pulling wire 21, so as to avoid mutual interference of the pulling wire 21 during the movement process, and in the specific driving
  • the proximal end of the pulling wire 21 can be set to be directly controlled by the control handle, or can be set to be connected to the control handle through an intermediate component.
  • the wire control tube 20 can be fixedly arranged in this embodiment. Referring to an embodiment, the proximal end of the wire control tube 20 is fixed and movable relative to the control handle. Further, the proximal end of the wire-controlled tube 20 is fixedly arranged relative to the inner sheath tube.
  • the tube wall of the wire control tube 20 has a plurality of lumens, and each puller wire is movably guided in the corresponding lumen.
  • the setting of the multi-lumen tube can realize the independent guidance of the puller wires 21 , thereby further avoiding mutual interference between the puller wires 21 .
  • the delivery assembly of the interventional instrument 90 further includes a bend adjustment member 40, the bend adjustment member 40 is arranged inside or outside the inner sheath 30, and the distal ends of the bend adjustment member 40 and the inner sheath 30 are fixed to each other , the proximal end is slidingly fitted to realize the bending adjustment of the inner sheath tube 30 on the distal end side.
  • both the bending member 40 and the inner sheath 30 are fixed to each other, and when the proximal end of one of them receives a force, the distal ends of the two tend to bend, thereby causing the distal end of the delivery assembly to bend.
  • the overall bending of the end referring to accompanying drawings 8a to 8c, can better realize the delivery process of the interventional device 90 .
  • the inner pipe fittings actively generate the driving force to drive the outer pipe fittings to adjust the bending together, which is the inner bending
  • the outer pipe fittings actively generate the driving force to drive the inner pipe fittings to adjust the bending together, which is the outer bending.
  • the two forms have their own advantages.
  • the pipe part that passively assists the bending part 40 to realize the bending is defined as the inner sheath tube 30, because the distal ends of the two are fixed to each other, so in the drawings The overall performance of the two is strong.
  • the bending adjustment form is preferably inner bending.
  • the bend adjusting member 40 is a tube sleeved inside or outside the inner sheath tube 30 .
  • the bending member 40 is a rod or a pull wire disposed inside or outside the inner sheath 30 .
  • the interventional instrument delivery assembly further includes a bend-adjusting pull wire, the distal end of which is fixed to the distal end of the inner sheath, and the bend-adjusting wire extends from the inner sheath to the handle.
  • the interventional instrument 90 may also be constrained by a tube.
  • the delivery assembly of the interventional instrument 90 further includes an outer sheath tube 50 , which is slidably sleeved outside the bend adjustment member 40 , and the outer sheath tube 50 moves relative to the interventional instrument 90 to accommodate or release the interventional instrument 90 ,
  • the pulling wire 21 controls the release of the interventional instrument 90 under the constraint of the wire control tube 20 .
  • the outer sheath 50 can realize the switching of wrapping or releasing the interventional instrument 90 through its own movement relative to the inner core 10 . With the cooperation of the puller wire 21 above, the outer sheath tube 50 can also recover the interventional device 90 , so that the release process of the interventional device 90 can be controlled throughout.
  • the delivery assembly of the interventional instrument 90 further includes a sheath tube, and the sheath tube is sheathed on the outside of the outer sheath tube 50 for establishing an interventional channel.
  • the stable channel established by the sheath tube can provide a stable environment for the treatment process.
  • the sheath tube is not the focus of improvement, so it will not be repeated in the drawings and text description.
  • the present application also discloses a delivery system for an interventional device, including the delivery assembly in the above technical solution and a control handle for driving the delivery assembly, the inner sheath, the inner core, and the puller wire of the delivery assembly respectively extend to the control handle, Relative movement driven by the control handle.
  • the control handle 60 has opposite distal ends and proximal ends, and is used to drive a plurality of controlled components to move relative to each other.
  • the handle includes a support body 61 and multiple sets of connecting components installed on the support body 61.
  • the supporting body 61, each connecting component is divided into fixed setting and movable setting, wherein the connecting components of movable setting include screw drive, rack and pinion drive, and direct drive according to the transmission mode, and the connecting components of each transmission mode are arranged from the far end to the proximal end. Set in sequence.
  • the controlled parts can be all tubes, and nested inside and outside, or not in the form of tubes, but only extend to the proximal end to the control handle.
  • the controlled parts can move relative to the control handle, or can be one of them.
  • One or more are fixedly arranged relative to the control handle.
  • Thread transmission, rack and pinion transmission, and direct transmission each have their own advantages.
  • the control handle 60 is arranged sequentially from the far end to the proximal end to meet the different motion requirements of each pipe fitting and the spatial structure of the control handle 60 to achieve structural optimization.
  • the volume of the handle 60 is constant, the driving effect of each controlled component can be improved, which will be explained in conjunction with the specific structure below.
  • control handle 60 is axially divided into a threaded mating area 62 on the distal side and a rack and pinion mating area 63 on the proximal side, using threaded transmission and rack and pinion transmission.
  • the connecting components are respectively arranged in the corresponding matching areas.
  • Threaded and rack-and-pinion fits are characterized by their ability to provide stable transmission ratios, especially where controlled components require precise control.
  • the advantage of the thread fit is that it can rotate in the circumferential direction of the control handle 60, thereby saving the circumferential space of the handle, but there are certain requirements for the axial space; correspondingly, the advantage of the rack and pinion fit is that it can save the axial space of the handle , but there are certain requirements for the circumferential space.
  • the layout of the control handle 60 is optimized by complementing the advantages and disadvantages of the two matching forms, so that the layout of the control handle 60 is optimized under the premise of ensuring the driving effect.
  • the ratio of the axial length of the threaded mating area 62 to the axial length of the control handle 60 is greater than or equal to 0.4. Further preferably, the ratio of the axial length of the threaded mating area 62 to the axial length of the control handle 60 is greater than or equal to 0.55.
  • the threaded fitting area 62 is provided with at least two sets of connecting components, which are sequentially arranged in the axial direction of the control handle. If considering the fixed connection components, the threaded mating area 62 can be considered to be distributed at intervals, but on the whole two sets of connection components are provided, that is, two sets of threaded connection components 621, and the threaded connection components 621 can improve the circumferential space of the handle. Taking advantage of the effect and combining the operator's ergonomics, arranging multiple sets of threaded connection components 621 on the distal side of the handle can provide a better operating experience. Each threaded connection assembly 621 is sequentially arranged in the axial direction of the control handle 60 to cooperate with the axially sleeved structure of each controlled component, which can more easily realize the driving of each controlled component.
  • connection assembly of the screw drive (also called the thread connection assembly 621) includes:
  • the clamping piece 625 is slidably installed on the supporting body 61 , and the clamping piece 625 is used for connecting with the controlled components.
  • the outer surface of the drive ring 622 is provided with a friction surface for the operator to hold.
  • the drive ring 622 as an active component, is rotatably mounted on the support body 61 to drive the clamping member 625.
  • the supporting body 61 can be provided with an axial sliding groove, and the clamping part 625 is slidably disposed in the axial sliding groove, and the clamping part 625 has an external thread structure at least partially, and is in transmission cooperation with the driving ring 622 .
  • the clamping part 625 is mainly used to fix the proximal end of the controlled component, and when the controlled component is a tube, it is preferably butted with the tube in a sealed manner.
  • each controlled component needs to be positioned after moving to a suitable position to avoid being affected by other operations.
  • the outer periphery of the supporting body 61 is slidingly sleeved with a positioning ring 623, and each driving ring 622 has a positioning state of engaging with the positioning ring 623 and a free state of mutual disengagement; in the positioning state, the positioning ring 623 restricts the The rotation of ring 622 is driven.
  • the positioning ring 623 can be configured as a structure that is slidably installed on the support body 61 , and the positioning or release of the driving ring 622 can be realized by changing its own position.
  • the positioning ring 623 should avoid rotation relative to the support body 61 while sliding on the support body 61 .
  • This structure can be realized by arranging guide sliding grooves/sliding rails on the support body 61 .
  • the cooperation between the positioning ring 623 and the chute/rail can be set as an interference fit, so as to ensure the friction between the two, and avoid the failure of the binding force of the positioning ring 623 to the driving ring 622 or cause accidental locking to affect the treatment process of the operator .
  • the driving ring 622 is provided with positioning teeth 624 on the side facing the positioning ring 623 , and the driving ring 622 is in the positioning state and meshes with the positioning teeth 624 .
  • the advantage of this setting is that it can realize the function of the positioning ring 623 while reducing the impact on the movement process of the driving ring 622 and optimize the layout of the components on the control handle 60 at the same time.
  • One or more positioning rings 623 can be provided.
  • the positioning rings 623 may be provided in common or separately for each driving ring 622 .
  • the specific setting method can be adjusted according to the working conditions or the positional relationship.
  • the positioning ring 623 in the axial direction of the control handle 60 , the positioning ring 623 is disposed between the threaded connection components 621 . More specifically, the positioning ring 623 is disposed between the driving rings 622 of the threaded connection components 621 .
  • the positioning ring 623 disposed on the multiple driving rings 622 can provide a structural basis for a single positioning ring 623 to lock multiple driving rings 622, and can also optimize the layout.
  • each driving ring 622 is locked by using an independent positioning ring 623 respectively. That is, there are at least two positioning rings 623 .
  • the advantage of providing positioning rings 623 for each driving ring 622 is that the interference between the two can be avoided, and a more flexible treatment process can be realized.
  • the controlled component is a pipe fitting as an example, and the inside of the pipe fitting should be exhausted as needed.
  • the control handle 60 is provided with an exhaust assembly 64 as a fixed connection assembly, and the corresponding controlled A component communicates and is secured proximally to the exhaust assembly.
  • the vent assembly 64 is fixedly connected to the inner sheath 30 .
  • Each tube is in controlled communication with an exhaust assembly 64 to exhaust air from the tube.
  • the exhaust assembly 64 is often implemented by injecting liquid (such as physiological saline) to achieve emptying.
  • liquid such as physiological saline
  • a single exhaust assembly can be used to empty each pipe through the opening of the pipe wall of each pipe and combined with relative movement. .
  • the form that each pipe piece shares an exhaust assembly 64 can effectively avoid repeated installation of the exhaust assembly 64 and improve the utilization of components in the control handle 60 .
  • the focus of this application with respect to the exhaust assembly 64 is the layout of the exhaust assembly 64 .
  • the positioning ring 623 only needs to use the circumferential space of the control handle 60 , so a corresponding structure can be provided inside the control handle 60 .
  • the exhaust assembly 64 is aligned with the positioning ring 623 .
  • the coaxial section arrangement of the positioning ring 623 and the exhaust assembly 64 can effectively utilize the space in each dimension of the control handle 60 to realize a three-dimensional layout.
  • the number of positioning rings 623 may increase. When the number of positioning rings 623 increases, the gap between each positioning ring 623 can provide convenience for setting the liquid injection port of the exhaust assembly 64 .
  • the exhaust assembly 64 includes a liquid injection port for exhaust, and the liquid injection port extends to the outside of the control handle 60 through a space between two adjacent positioning rings 623 .
  • the connecting component of the rack-and-pinion mating area 63 that is, the gear connecting component 631 is disposed at an end of the support body 61 near the proximal side.
  • the gear connection assembly 631 can improve the utilization effect of the shaft space of the handle. Combining with the operator's ergonomics, arranging the gear connection assembly 631 on the proximal side of the handle can provide a better operating experience.
  • the structure of the gear connection assembly 631 in the circumferential space can improve the operator's driving of the threaded connection assembly 621 above, and the two cooperate with each other to further improve the operating experience.
  • the gear connection assembly 631 includes:
  • the gear 635 is an active component, which can drive the rack 634 to drive the controlled component. Wherein at least a part of the gear 635 extends to the outside of the support body 61 or is provided with a corresponding structure extending to the outside of the support body 61 . In order to facilitate operation and assembly, the outer peripheral space of the supporting body can also be fully utilized to improve the space utilization rate.
  • the rack 634 may also be provided with a corresponding structure to improve cooperation with the controlled components.
  • the controlled part and the gear are connected in such a way that the support body is also provided with:
  • the base 632 is slidably installed inside the support body 61, and the rack 634 is fixedly arranged on the base 632;
  • the clamping base 633 is fixedly installed on the base 632 and used for sealing connection with corresponding controlled components.
  • the function of the base 632 is to provide a stable movement constraint, the clamping base 633 can realize the positioning of the controlled components and the application of the driving force, and the rack 634 is used to bear the driving force from the gear 635 .
  • connection locking mechanism 637 is provided between the gear 635 and the support body 61 to limit the relative positions of the two.
  • the connection locking mechanism 637 is used to locate the rotation state of the gear 635 , so that the positioning effect on the corresponding controlled component is realized through the transmission relationship between the gear 635 and the rack 634 .
  • the connection locking mechanism 637 includes:
  • the first locking tooth 6371 is arranged on the gear 635;
  • the second lock tooth 6372 is set on the support body 61,
  • the holding component 6373 keeps the first locking tooth 6371 and the second locking tooth 6372 in an engaged state
  • the gear 635 can slide relative to the supporting body 61 in its axial direction to realize the engagement or separation of the first locking tooth 6371 and the second locking tooth 6372 .
  • the gear 635 maintains the meshing relationship with the rack 634 all the time, so in a sense, the meshing width of the rack 634 is greater than the meshing width of the gear 635 .
  • the holding assembly 6373 includes:
  • the two clamping posts 6374 can approach or move away from the radial direction of the gear 635;
  • the clamping slot 6375 is set on the support body 61;
  • the holding assembly 6373 actually acts as a secondary lock to ensure the working stability of the connection locking mechanism 637 . Further, the holding assembly 6373 also includes a reset member 6376, which is arranged between the two clamping posts 6374 and is used to drive the two clamping posts 6374 to cooperate with the clamping groove 6375 to limit the sliding of the gear 635 relative to the supporting body 61 .
  • connection locking mechanism 637 is disposed on the gear 635 .
  • the gear 635 is linked with a driving portion 636 extending radially to the outside of the support body 61 . It is not difficult to understand that when the gear 635 is provided with a linked driving part 636, the connection locking mechanism 637 can also be equivalently arranged on the driving part 636, and the specific structure is the same, so it will not be repeated here.
  • the support body 61 includes an inner skeleton at the distal end and a support cylinder 638 at the proximal end, the rack 634 and the gear 635 are accommodated in the support cylinder, and the gear 635 is linked with a driving part extending to the outside of the support cylinder 636.
  • the driving part 636 is movably matched with the support body 61, and has a locked position where it engages with the support body 61, and a working position where it is released.
  • the retaining assembly between the parts 636 is used to limit the driving part 636 in the locked position.
  • a part of the support cylinder radially extends to form an outer convex part
  • the driving part 636 is arranged outside the outer convex part and is linked with the gear 635, and the connection locking mechanism acts between the driving part 636 and the outer convex part.
  • the driving part 636 is a hollow knob as a whole, and is covered by the convex part.
  • a part of the driving part 636 is placed around the outer periphery of the convex part, and locking teeth capable of engaging with each other are provided between the inner wall of this part of the driving part 636 and the outer wall of the convex part; for example, it includes:
  • the first locking tooth 6371 is arranged on the gear 635;
  • the second locking tooth 6372 is disposed on the convex portion.
  • the driving part 636 is slidably fitted with the supporting body 61 to switch between the locking position and the working position.
  • the gear 635 is fixedly connected to the driving part 636 , and the gear 635 always keeps meshing with the rack 634 during the position switching of the driving part 636 .
  • the rotation axis of the driving part 636 is in line with the rotation axis of the gear 635 and extends substantially along the radial direction of the control handle.
  • connection locking mechanism 637 can also be arranged on the rack 634 . That is, a connection locking mechanism 637 is provided between the rack 634 and the support body 61 to limit the relative positions of the two.
  • the connection locking mechanism 637 includes:
  • the lock pin 6377 is installed on the support body 61 and can slide in the radial direction of the support body 61;
  • the insertion hole 6378 is disposed on the rack 634 and realizes the locking of the rack 634 and the support body 61 when it is aligned with the locking pin 6377 .
  • the relative position of the rack 634 and the support body 61 is determined in the axial direction of the support body 61 , so as to realize the function of connecting the locking mechanism 637 .
  • a corresponding holding component 6373 can also be provided here.
  • the holding assembly 6373 can use a self-clamping clamp to clamp the locking pin 6377.
  • Figure 7f The specific structure can be seen in Figure 7f, which can be clearly understood by those skilled in the art and will not be repeated here.
  • At least one of the controlled components extends out of the proximal side of the control handle 60 for direct transmission.
  • the advantage of direct transmission is that the transmission is direct, and the movement of the controlled parts can be realized conveniently, especially when the movement precision is not high.
  • the direct drive on the proximal side of the control handle 60, the axial space on the proximal side of the control handle 60 and the structural characteristics of the axial arrangement of the controlled components are fully utilized.
  • the innermost one of the tubes can extend out of the proximal side of the control handle 60 to realize direct transmission.
  • a positioning mechanism 65 can be provided at the proximal end of the handle , and as a connecting component of direct transmission, the positioning mechanism can lock or release the controlled parts, and the controlled parts after release adopt direct transmission.
  • a control handle 60 which has opposite distal ends and proximal ends, and is used to drive five controlled components (five pipes set inside and outside as examples) to move relative to each other, and control
  • the handle includes a support body and multiple sets of connection components installed on the support body.
  • Each connection component includes five sets of connection components arranged in sequence from the distal end to the proximal end, and sequentially adopts thread transmission, fixed setting, thread transmission, and rack and pinion transmission. and direct drive;
  • the controlled components include an outer sheath tube, an inner sheath tube, a bending member, a puller wire and an inner core, and the proximal ends of the five are sequentially linked to five sets of connecting components in the control handle.
  • the outer sheath tube, the inner sheath tube, the bending part, the pulling wire (the near end is the wire control tube 20 ) and the inner core are arranged sequentially from the outside to the inside, and the screw drive, the fixed setting, the screw drive, the gear rack and direct drives,
  • the outer sheath 50 is slidably sleeved on the outside of the bend adjustment member 40, and the outer sheath 50 moves relative to the inner sheath 30 to release the interventional instrument 90;
  • the distal part of the inner sheath 30 is fixed with a lock seat 31;
  • the inner core 10 is slidingly arranged in the inner sheath tube 30, and one end of the inner core 10 is an extension section 11 protruding from the far end of the inner sheath tube 30, and the extension section 11 is provided with a lock 13 that cooperates with the lock seat 31, and the inner core 10
  • the radial gap between the inner sheath and the inner sheath 30 is the passageway 12 for the puller wire 21 to pass through, and the lock 13 is used to constrain the movement state of the puller wire 21;
  • the puller wire itself or through the wire control tube 20 fixed with the puller wire extends from the threading channel to the control handle to control the release process of the interventional instrument 90, that is, it is slidably arranged on the inner sheath tube 30 and the inner core between 10;
  • the bending part 40 is arranged inside the inner sheath tube 30, the distal parts of the bending part 40 and the inner sheath tube 30 are fixed to each other, and the proximal end is slidably fitted to realize the bending adjustment of the inner sheath tube 30 on the distal side ;
  • the outer sheath tube 50 is slidably sleeved on the outside of the bend adjustment member 40 , and the outer sheath tube 50 moves relative to the inner core 10 to release the interventional device 90 , and the pulling wire 21 controls the release process of the interventional device 90 under the constraint of the wire control tube 20 .
  • each pipe fitting is set as follows:
  • the inner core 10 is directly driven, and the proximal end extends to the axial end surface of the proximal end of the control handle 60;
  • the wire control tube 20 adopts rack and pinion cooperation, and the proximal side extends to the proximal side of the control handle 60;
  • the inner sheath tube 30 is fixedly connected with the control handle 60 as the benchmark for the movement of each pipe fitting;
  • the bending adjustment member 40 and the outer sheath tube 50 respectively adopt a thread driving method, and the proximal end extends to the distal end side of the control handle 60 .
  • connection mode of the inner sheath tube 30 and the bending member 40 can be interchanged, and adaptive adjustment can be made according to the different sheathing relationship between the two.
  • the number of pipes to be controlled can be further increased to improve the degree of integration.
  • connection relationship of each pipe fitting is illustrated as an example.
  • the inner core 10 runs through the control handle 60 from the distal end to the proximal end and extends from the end surface of the proximal end of the control handle 60 , and the proximal end of the control handle is in sealing fit with the outer peripheral surface of the inner core 10 .
  • the operator can directly drive the inner core through the part of the inner core 10 extending from the end surface of the proximal end of the control handle 60;
  • the wire control tube 20 is sleeved on the outer periphery of the inner core 10 and the proximal end extends to the proximal end of the control handle 60, and is connected with the proximal end of the control handle 60 through a rack and pinion fit, wherein the clamping in the gear connection assembly
  • the base is sealed and connected to the outer circumference of the remote control tube 20, and the movement of the rack is transmitted to the remote control tube 20 by clamping the base;
  • the bending part 40 is arranged on the outer periphery of the wire control tube 20 and the proximal end extends to a position close to the middle of the proximal end of the control handle 60, and is connected with the control handle 60 through a threaded form, wherein the clamping part of the threaded connection assembly and The bending adjustment part 40 is sealed and fitted, and the clamping part is used to transmit the thread driving force to the bending adjustment part 40;
  • the inner sheath tube 30 is sleeved on the outer periphery of the bend adjustment member 40 and the proximal end extends to the middle part of the control handle 60, and the control handle 60 is connected through a fixed connection, wherein the middle part of the control handle 60 is provided with a fixed clamping device, the clamping device is sealed and fixedly connected with the inner sheath tube 30 so as to determine the relative position of the inner sheath tube 30 and the control handle 60;
  • the outer sheath tube 50 is sleeved on the outer periphery of the inner sheath tube 30 and the proximal end extends to the position of the distal end of the control handle 60, and is connected with the control handle 60 in the form of threaded fit, wherein the clamping part of the threaded connection assembly is connected with the control handle 60.
  • the outer sheath 50 is sealingly fitted, and the clamp is used to transmit the screw driving force to the outer sheath 50 .
  • the distal ends of the bend-adjusting member 40 and the inner sheath 30 are fixed to each other, and when the proximal end of one of them receives a force, the distal ends of the two tend to bend, thereby An integral distal bend of the delivery assembly is produced.
  • the inner pipe fittings actively generate the driving force to drive the outer pipe fittings to adjust the bending together, which is the inner bending
  • the outer pipe fittings actively generate the driving force to drive the inner pipe fittings to adjust the bending together, which is the outer bending.
  • the two forms have their own advantages.
  • the pipe part that passively assists the bending part 40 to realize the bending is defined as the inner sheath tube 30, because the distal ends of the two are fixed to each other, so in the drawings The overall performance of the two is strong.
  • the bending adjustment form is preferably inner bending.
  • control handle 60 disclosed in accompanying drawing 7c is the same as the above, the difference is that there are two sets of gear connection components, and the set at the most end can be used to drive the inner core 10 or other parts that need to be moved, and the remaining parts are those skilled in the art.
  • the connection relationship between each pipe fitting and each component in the control handle 60 can be clearly understood according to the description of the present application, and details are not repeated here.
  • the present application also discloses a delivery system that can be controlled by wire, including an interventional instrument 90 delivery assembly and a control handle 60, the delivery system has opposite distal ends and proximal ends, and the control handle 60 is used to drive the interventional instrument 90 to deliver
  • the controlled components within the assembly move relative to each other, the controlled components include:
  • the inner sheath 30 is slidably arranged inside the outer sheath, and the outer sheath and the inner sheath move relatively to release the interventional instrument, and the distal part of the inner sheath 30 is fixed with a lock seat 31;
  • the inner core 10 is slidably arranged in the inner sheath tube 30.
  • One end of the inner core 10 is an extension section 11 protruding from the far end of the inner sheath tube 30.
  • the extension section 11 is provided with a lock 13 that cooperates with the lock seat 31.
  • the inner core The radial gap between 10 and the inner sheath tube 30 is the passageway 12 for the puller wire 21 to pass through, and the lock piece 13 is used to constrain the movement state of the puller wire 21;
  • Pulling wire the pulling wire itself or through the wire control tube fixed with the pulling wire extends from the threading channel to the control handle to control the release process of the interventional device;
  • the puller wire 21 extends out of the distal end of the inner sheath 30 and is bound to the lock 13 after passing through the interventional device 90 . bondage.
  • the control handle 60 in this embodiment can be the control handle in the corresponding embodiments above according to the specific arrangement of the pipe fittings.
  • the working process of the delivery system that can be controlled by wire will be explained in detail below in conjunction with the accompanying drawings.
  • the interventional device 90 is delivered into the human body, referring to the accompanying drawings 8a to 8c, the movement of the bending member 40 can realize the remote delivery of the delivery assembly. End in the human body to adjust the bend, so as to achieve the intervention process.
  • the initial release of the interventional instrument 90 can be achieved by withdrawing the outer sheath 50, wherein the accompanying drawing 9a is a half-release state, that is, the outer sheath 50 Halfway back, if an accident occurs at this time, the outer sheath tube 50 can be advanced to realize the recovery of the interventional instrument 90 .
  • the present application also discloses an interventional system, including an interventional instrument and a delivery assembly.
  • the interventional instrument includes: an annular part 71, which is a radially deformable structure, and the two ends of the annular part 71 in the axial direction are respectively first An end 711 and a second end 712, wherein the edge of the first end 711 includes a plurality of unit segments 713 arranged in sequence along the circumference of the annular portion 71;
  • a plurality of guide parts 72 are arranged at intervals along the circumferential direction of the annular part 71.
  • One side of each guide part 72 is connected to a corresponding unit segment 713, and the shape of the other side of each guide part 72 gradually converges to the end 721, and at the end 721 has threading ring 722;
  • Conveyor components include:
  • an inner sheath having opposing distal and proximal ends
  • the lock seat is connected to the distal part of the inner sheath
  • the inner core is slidably arranged in the inner sheath, one end of the inner core is an extension extending from the distal end of the inner sheath, and the radial gap between the inner core and the inner sheath is a passageway;
  • the lock is fixed on the extension of the inner core and is on the far side of the lock seat;
  • the puller wire is movable in the passageway.
  • the puller wire extends out of the distal end of the inner sheath, passes through the threading ring 722 of the interventional device, and is bound to the lock.
  • the lock and the lock seat The plug-in fit limits the pulling wire from breaking free.
  • the present application also provides another control handle, as shown in Fig. 7h to Fig. 7j, which has opposite distal and proximal ends, and is used to drive a plurality of controlled components to move relative to each other.
  • the handle includes a support Body 61 and multiple sets of connection assemblies installed on the support body 61. With respect to the support body 61, each connection assembly is divided into a fixed setting and a movable setting, wherein the movable connection components include screw drive, rack and pinion drive, and It is directly driven, and the connection components of each transmission mode are arranged in sequence from the far end to the near end.
  • the controlled parts can be all tubes, and nested inside and outside, or not in the form of tubes, but only extend to the proximal end to the control handle.
  • the controlled parts can move relative to the control handle, or can be one of them.
  • One or more are fixedly arranged relative to the control handle.
  • Thread transmission, rack and pinion transmission, and direct transmission each have their own advantages.
  • the control handle 60 is arranged sequentially from the far end to the proximal end to meet the different motion requirements of each pipe fitting and the spatial structure of the control handle 60 to achieve structural optimization.
  • the volume of the handle 60 is constant, the driving effect of each controlled component can be improved, which will be explained in conjunction with the specific structure below.
  • control handle 60 is axially divided into a thread mating area 62 on the distal side and a rack and pinion mating area 63 on the proximal side, and the connecting components that adopt thread transmission and rack and pinion transmission are respectively arranged in the corresponding mating areas .
  • Threaded and rack-and-pinion fits are characterized by their ability to provide stable transmission ratios, especially where controlled components require precise control.
  • the advantage of the thread fit is that it can rotate in the circumferential direction of the control handle 60, thereby saving the circumferential space of the handle, but there are certain requirements for the axial space; correspondingly, the advantage of the rack and pinion fit is that it can save the axial space of the handle , but there are certain requirements for the circumferential space.
  • the layout of the control handle 60 is optimized by complementing the advantages and disadvantages of the two matching forms, so that the layout of the control handle 60 is optimized under the premise of ensuring the driving effect.
  • the ratio of the axial length of the threaded mating area 62 to the axial length of the control handle 60 is greater than or equal to 0.4. Further preferably, the ratio of the axial length of the threaded mating area 62 to the axial length of the control handle 60 is greater than or equal to 0.55.
  • the threaded mating area 62 is provided with a set of threaded connection components 621, which includes:
  • the clamping piece 625 is slidably installed on the support body 61 , and the clamping piece 625 is used to connect with the controlled component, that is, the outer sheath 50 .
  • the clamping part 625 has a mounting hole, and the proximal end of the outer sheath tube 50 is inserted into the mounting hole, and is clamped and fixed by the wall of the mounting hole.
  • glue or fasteners can also be used to prevent loosening.
  • the outer surface of the drive ring 622 is provided with a friction surface for the operator to hold.
  • the driving ring 622 is used as an active component, and is rotatably mounted on the support body 61 to realize the driving of the clamping member 625 .
  • the supporting body 61 can be provided with an axial sliding groove, and the clamping part 625 is slidably disposed in the axial sliding groove, and the clamping part 625 has an external thread structure at least partially, and is in transmission cooperation with the driving ring 622 .
  • the clamping part 625 is mainly used to fix the proximal end of the controlled component, and when the controlled component is a tube, it is preferably butted with the tube in a sealed manner.
  • each controlled component needs to be positioned after moving to a suitable position to avoid being affected by other operations.
  • the outer periphery of the support body 61 is slidingly sleeved with a positioning ring 623, and the driving ring 622 has a positioning state in which it engages with the positioning ring 623 and a free state in which it is separated from each other; in the positioning state, the positioning ring 623 restricts the driving ring 622 rotation.
  • the positioning ring 623 can be configured as a structure that is slidably installed on the support body 61 , and the positioning or release of the driving ring 622 can be realized by changing its own position.
  • the positioning ring 623 should avoid its own rotation relative to the support body 61 while sliding on the support body 61 .
  • This structure can be realized by arranging guide sliding grooves/sliding rails on the support body 61 .
  • the cooperation between the positioning ring 623 and the chute/rail can be set as an interference fit, so as to ensure the friction between the two, and avoid the failure of the binding force of the positioning ring 623 to the driving ring 622 or cause accidental locking to affect the treatment process of the operator .
  • the side of the driving ring 622 facing the positioning ring 623 is provided with a positioning tooth 624 , and the driving ring 622 is in a positioning state and meshes with the positioning tooth 624 .
  • the advantage of this setting is that it can realize the function of the positioning ring 623 while reducing the impact on the movement process of the driving ring 622 and optimize the layout of the components on the control handle 60 at the same time.
  • the connecting component of the rack and pinion mating area 63 that is, the gear connecting component 631
  • the gear connection assembly 631 can improve the utilization effect of the shaft space of the handle. Combining with the operator's ergonomics, arranging the gear connection assembly 631 on the proximal side of the handle can provide a better operating experience.
  • the structure of the gear connection assembly 631 in the circumferential space can improve the operator's driving of the threaded connection assembly 621 above, and the two cooperate with each other to further improve the operating experience.
  • gear connection assembly 631 is a group, and is arranged at one end of the support body 61 close to the end side.
  • Gear connection assembly 631 includes:
  • a rack 634 moving in the axial direction of the support body 61 is provided with a clamping base 633 for sealingly connecting the corresponding controlled component, that is, the remote control tube 20;
  • the clamping base 633 has a mounting hole, and the proximal end of the wire control tube 20 is inserted into the mounting hole, and is clamped and fixed by the wall of the mounting hole.
  • glue or fasteners can also be used to prevent loosening.
  • the gear 635 is an active component, which can drive the rack 634 to drive the controlled component. Wherein at least a part of the gear 635 extends to the outside of the support body 61 or is provided with a corresponding structure extending to the outside of the support body 61 . In order to facilitate operation and assembly, the outer peripheral space of the supporting body can also be fully utilized to improve the space utilization rate.
  • the rack 634 may also be provided with a corresponding structure to improve cooperation with the controlled components.
  • the control handle 60 includes a support cylinder 638 sleeved on the proximal end of the support body, and the controlled components are connected to the gears in the support body 61:
  • the base 632 is slidably installed inside the support cylinder 638, and the rack 634 is fixedly arranged on the base 632;
  • the clamping base 633 is installed on the base 632 and used for connecting the proximal end of the wire control tube 20 .
  • the function of the base 632 is to provide a stable movement constraint
  • the clamping base 633 can realize the positioning of the wire control tube 20 and the application of the driving force
  • the rack 634 is used to bear the driving force from the gear 635 .
  • the clamping base 633 can be fixedly installed on the base 632, and there can also be a little axial movement margin relative to the base 632.
  • a guiding structure that cooperates with each other is provided between the clamping base 633 and the base 632 (in FIG. 7m) (in FIG. 7m)
  • the sliding rail 6321) guides the clamping base 633 to move axially, and can limit the radial separation from the base 632.
  • Position boss 6342, the distance between the first stop boss 6323 and the second stop boss 6324 is slightly larger than the clamping base 633, so that the clamping base 633 can slide slightly, wherein the second limit boss 6324 adopts elastic
  • the buckle 6322 is used to facilitate the installation of the clamping base 633 .
  • each controlled component needs to be positioned after being moved to a proper position, so as not to be affected by other operations.
  • the gear 635 is linked with a driving portion 636 extending radially to the outside of the support cylinder.
  • the drive part 636 is movably installed on the support cylinder 638, specifically including that the drive part 636 rotates relative to the support cylinder 638 to drive the gear 635 to rotate, and the drive part 636 slides relative to the support cylinder 638 with a connection that limits the rotation of the drive part 636.
  • Locking mechanism 637 is movably installed on the support cylinder 638, specifically including that the drive part 636 rotates relative to the support cylinder 638 to drive the gear 635 to rotate, and the drive part 636 slides relative to the support cylinder 638 with a connection that limits the rotation of the drive part 636. Locking mechanism 637.
  • connection locking mechanism 637 includes:
  • the first locking tooth 6371 is arranged on the driving part 636;
  • the second locking tooth 6372 cooperates with the first locking tooth 6371 and is arranged on the convex portion 6382;
  • the retaining component 6373 keeps the first locking tooth 6371 and the second locking tooth 6372 in an engaged state to limit the rotation of the driving part 636 .
  • the gear 635 is fixedly connected with the driving part 636 , and can slide relative to the support cylinder 638 in its axial direction to realize the engagement or separation of the first locking tooth 6371 and the second locking tooth 6372 .
  • the rotation axis of the driving part 636 is in line with the rotation axis of the gear 635 and extends substantially along the radial direction of the control handle.
  • the gear 635 maintains a meshing relationship with the rack 634 at all times during the sliding process. Therefore, in a sense, the gear 635 is always meshed with the rack 634 during its own sliding stroke.
  • the means for realizing this include, for example, the rack 634
  • the meshing width of is greater than the meshing width of the gear 635 .
  • the function of the holding component 6373 is to ensure the relative position of the driving part 636 and the protruding part 6382, so as to maintain the locking effect.
  • the holding assembly 6373 includes:
  • the two clamping columns 6374 are slidably installed on the driving part 636, and approach or move away from the radial direction of the gear 635;
  • the clamping block 6381 is arranged on the convex part 6382;
  • the reset member 6376 is disposed in the driving part 636 and acts on the two clamping posts 6374 so that the two are separated from each other.
  • the end surface of the clamping column 6374 is against one of the end surfaces of the clamping block 6381, keeping the connection locking mechanism 637 in a locked or unlocked state; when the two clamping columns 6374 are close to each other, The clamping post 6374 can overcome the constraint of the clamping block 6381 to realize the state switching of the connection locking mechanism 637 .
  • the holding assembly 6373 actually acts as a secondary lock to ensure the working stability of the connection locking mechanism 637 .
  • the gear 635 has a rotating shaft 6351 connected to the driving part 636, and the support cylinder 638 is fixedly provided with a limiting seat 6383 sleeved outside the rotating shaft 6351, and the limiting seat 6383 can be against the position of the gear 635.
  • the end face restricts the driving part 636 and the gear 635 from detaching from the support cylinder 638 .
  • the catheter assembly further includes a sheath tube 51 sleeved on the outer periphery of the outer sheath tube 50 , an inner sheath tube 30 sleeved inside the outer sheath tube 50 , and an inner core 10 sleeved inside the wire control tube 20 .
  • a first fixing seat 611 fixedly connected to the inner sheath 30 is fixedly installed on the support body 61 , and the first fixing seat 611 is located between the clamping member 625 and the clamping base 633 in the axial direction of the support body.
  • a sliding seat 612 fixedly connected with the inner core 10 is slidably installed on the proximal end of the support body 61 .
  • An exhaust assembly 64 is provided inside the control handle 60 as a fixed connection assembly, and the proximal end of the corresponding controlled component communicates with and is fixed to the exhaust assembly.
  • the proximal end of the sheath tube 51 is fixedly connected with the exhaust assembly 64 .
  • the air in the radial gap between the sheath tube 51 and the outer sheath tube 50 can be evacuated to the distal end by injecting liquid (such as physiological saline) through the liquid injection hole 641 on the exhaust assembly 64 .
  • liquid such as physiological saline
  • each pipe piece shares an exhaust assembly 64 can effectively avoid repeated installation of the exhaust assembly 64 and improve the utilization of components in the control handle 60 .

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Abstract

人工心脏瓣膜支架(70)、装置、输送系统和介入系统。其中人工心脏瓣膜支架(70)包括:环形部(71),环形部(71)为径向可形变结构,环形部(71)在自身轴向上的两端分别为第一端(711)和第二端(712),其中第一端(711)的边缘沿环形部(71)周向包括依次布置的多个单元段(713);多个引导部(72),沿环形部(71)周向依次间隔布置,各引导部(72)的一侧连接至对应的一单元段(713),各引导部(72)的另一侧形状逐渐收敛至末端(721),且在末端(721)带有穿线环(722)。通过引导部(72)尤其是穿线环(722)来实现对于人工心脏瓣膜支架(70)全程控制,同时引导部(72)的设置方式以及延伸形状能够减少因为人工心脏瓣膜支架(70)自膨特性对于其回收的影响。改善医护人员的操作体验、提高治疗效果。

Description

人工心脏瓣膜支架、装置、输送系统和介入系统 技术领域
本申请涉及医疗设备领域,特别是涉及人工心脏瓣膜支架、装置、输送系统和介入系统。
背景技术
随着医疗条件的发展,人工心脏瓣膜已经用于治疗心脏瓣膜障碍。天然心脏瓣膜(诸如主动脉瓣、肺动脉瓣和二尖瓣)在保证心血管系统的充分血液供应方面提供重要的功能。在一些治疗案例中,天然心脏瓣膜可能因为先天、炎性或传染性等原因造成天然心脏瓣膜工作效果恶化。天然心脏瓣膜的这种损伤可以导致严重的危害甚至死亡。
相关技术中,对天然心脏瓣膜病变的常见治疗是通过外科手术实现瓣膜的修复或替换。为了克服上述外科手术容易带来的许多并发症问题,相关技术中,尤其是经血管技术中,采用柔性导管介入并植入人工心脏瓣膜。经血管技术能够实现比心脏直视手术等外科手术更小的侵害。在经血管技术中,在装载状态中的人工瓣膜被安装在柔性导管的末端部分上并且被推进通过患者的血管直到人工瓣膜到达植入部位。导管末端的人工瓣膜在有病变的天然瓣膜部位处扩张到其实现功能的尺寸。
发明人发现,在相关技术中,植入自扩张的人工瓣膜相过程中,当操作人员开始从回撤递送鞘管以便释放人工瓣膜时,人工瓣膜趋向于极快地从鞘管的末端“跳”出;换言之,人工瓣膜的框架的向外偏置力趋向于引起人工瓣膜极快地从递送鞘管的远端弹出,从而很难以精确且受控的方式从鞘管递送人工瓣膜并且增加对患者创伤的风险。
其次,现有技术瓣膜产品中,通常在瓣膜展开到2/3时,通过前行鞘管压握瓣膜支架,实现瓣膜回收;当瓣膜完全展开时,由于瓣膜支架的端部已全部展开,很难实现对瓣膜支架的回收。
发明内容
为了解决上述技术问题,本申请公开了人工心脏瓣膜支架,包括:
环形部,所述环形部为径向可形变结构,所述环形部在自身轴向上的两端分别为第一端和第二端,其中第一端的边缘沿环形部周向包括依次布置的多个单元段;
多个引导部,沿环形部周向依次间隔布置,各引导部的一侧连接至对应的一单元段,各引导部的另一侧形状逐渐收敛至末端,且在末端带有穿线环。
可选的,所述人工心脏瓣膜支架整体上基于径向形变、具有相对的压缩状态和释放状态,释放状态下,以环形部轴向为长度方向,所述引导部的长度为L1,所述环形部的长度为L2,且满足L1:L2=1:0.5~1.5。
可选的,L1:L2=1:0.6~1.2。
可选的,沿环形部的轴向,各引导部的一侧为与相应单元段对接的连接侧,相邻两引导部的连接侧彼此衔接。
可选的,释放状态下,所述引导部由连接侧至末端的收敛趋势为均匀收敛。
可选的,沿环形部周向,所述连接侧的长度为L3且满足L1:L3=0.5~1.5。
可选的,所述引导部为N处,N为2、3、4、5或6,各引导部的连接侧所对应的圆心角为360度/N。
可选的,各引导部沿环形部的周向均匀布置。
可选的,相邻两引导部之间为开口部位,压缩状态下,相邻两引导部在彼此贴靠闭合开口部位。
可选的,所述引导部以及所述环形部均具有镂空的单元格结构,沿环形部轴向,环形部中的单元格为多排,所述引导部以及所述环形部的交界部位由其中周向的一排单元格的顶点围成。
可选的,所述引导部由环形部起沿环形部轴向延伸,延伸的路径先在环形部径向上外扩,至最大外径处后、再逐渐收敛。
可选的,所述环形部的轴向长度为1~2.5个单元格。
可选的,所述引导部以及所述环形部均具有镂空的单元格结构,所述引导部中的单元格单元格分为相对的稀疏区和稠密区,至少一部分所述稀疏区靠近相邻两引导部之间的开口部位。
可选的,稠密区的单元格面积为稀疏区的单元格面积的0.3~0.8倍(理解为单个单元格的面积之比,并非指整个稀疏区以及稠密区的面积)。
可选的,稠密区的单元格面积为稀疏区的单元格面积的0.4~0.6倍。
可选的,所述引导部中,邻近所述开口部位的为边缘框条,所述边缘框条的一端连接所述穿线环,所述边缘框条的另一端连接至所述环形部,所述边缘框条在延伸过程中与管状结构中的其他框条的交点不多于两个。
可选的,所述边缘框条在临近所述第一端处连接有分支框条,该分支框条与所述边缘框条分别连接至第一端上不同的单元格顶点。
可选的,所述穿线环在靠近所述环形部的一侧为与周边单元格共用的过渡段,所述过渡段为V形,且顶点朝向所述环形部。
可选的,所述穿线环在远离所述环形部的一侧为牵拉段,所述穿线环在靠近所述环形部的一侧为与周边单元格共用的过渡段。
可选的,所述牵拉段和所述过渡段合围成一个或多个封闭空间。
可选的,所述穿线环的外接圆的半径大于等于所述穿线环的杆件的直径的两倍。
可选的,所述引导部包括四个区域,分别为:
第一区域,设有所述穿线环;
第二区域,沿环形部周向设置,所述第二区域与所述第一区域两者对正且作为所在引导部的中心区;
第三区域和第四区域,沿环形部周向设置在所述中心区的两侧。
可选的,第二、第三和第四区域均仅设置一个单元格,各单元格的其中一顶点与所述环形部对接。
可选的,所述引导部由环形部起沿环形部轴向延伸,延伸的路径先在环形部径向上外扩,至最大外径处后、再逐渐收敛,所述最大外径处邻近所述第一区域和第二区域的交界部位。
可选的,沿着流出端方向,第一区域与第二区域之间连接有缝合柱。
可选的,所述第二区域中设置有第二单元格,所述第二单元格与瓣膜的联合固定。
可选的,第三、第四区域对称设置在所述中心区域的两侧。
可选的,所述第三、第四区域邻接第一、第二区域的单元格为第三单元格,在引导部中的所有单元格中,第三单元格的面积最大。
可选的,第一区域的面积大于第二单元格的面积。
可选的,人工心脏瓣膜支架整体上为管状结构,该管状结构轴向的中部区域带有缩径的腰部。
可选的,所述引导部和所述环形部两者的交界部位处在所述腰部。
可选的,所述引导部和所述环形部两者的交界部位邻近所述腰部的最小外径处。
可选的,相邻两引导部之间为开口部位,开口部沿着远离环形部的方向径向向外扩口,形成一V形结构。
可选的,所有瓣叶闭合时交汇在所述环形部的轴线,交汇点在环形部轴向的位置与所述腰部邻近。
可选的,所述环形部包括多排单元格,沿着引导部方向,所述单元格的大小减缩。
可选的,所述环形部的第二端的一圈单元格中,各单元格为四边形,靠近第二端的两边比靠近第一端的两边更长。
本申请还公开了一种人工心脏瓣膜装置,包括人工心脏瓣膜支架和瓣叶,所述人工心脏瓣膜支架整体上为管状结构且内部为血流通道,所述瓣叶为多片,各瓣叶处在血流通道内相互配合以相对的开放或封闭血流通道。
可选的,所述瓣叶的边缘包括固定至人工心脏瓣膜支架的固定缘,以及与其他瓣叶相互配合控制血流通道的自由缘,按照所述瓣叶对血流的控制方向,所述第一端为流出侧,所述第二端为流入侧,其中所述固定缘的两端分别固定在相邻的两个引导部上,固定缘的中部延伸至所述环形部。
可选的,沿环形部轴向,所述引导部以及所述环形部的交界部位邻近所述瓣叶的自由缘位置。
可选的,相邻瓣叶之间通过联合部彼此相连并固定于所述支架,各联合部的位置处在对应的一个引导部中。
可选的,沿环形部周向,各引导部均具有自身结构的对称轴,相连两瓣叶的固定缘交汇于相应引导部的对称轴。
可选的,所述固定缘的中点邻近所述环形部的轴向中部。
可选的,所述人工心脏瓣膜支架的内侧带有内覆膜,所述内覆膜处在瓣叶的流入侧并与各瓣叶的固定缘对接。
可选的,所述内覆膜由瓣叶的固定缘延伸至所述环形部的第二端。
可选的,所述人工心脏瓣膜支架还设有处在瓣叶流入侧的防周漏部件。
可选的,所述防周漏部件固定在所述内覆膜的外侧,所述防周漏部件为间隔分布的块状且位置与管状结构的镂空区域对应。
可选的,所述防周漏部件与所述内覆膜为一体结构,膨胀状态下,所述防周漏部件外凸于所述支架的外周面。
可选的,所述内覆膜采用PET材质,所述防周漏部件采用PU材质。
可选的,所述管状结构具有环布多道单元格结构,同一块防周漏部件中,外凸最高的部位更加靠近所在单元格的流入侧。
可选的,同一块防周漏部件中,外凸高度最大处到所在单元格的流入侧之间距离为S1,外凸高度最大处到所在单元格的流出入侧之间距离为S2,其中S1:S2为0~0.8。(优选0.3至0.8)。
可选的,同一块防周漏部件中,由流出侧至流入侧逐渐增厚、至外凸最高的部位后再逐渐变薄。
本申请还公开了一种介入器械的输送组件,包括:
内鞘管,具有相对的远端和近端;
锁座,连接于所述内鞘管的远端部位;
内芯,滑动设于内鞘管中,所述内芯的一端为伸出内鞘管远端的延伸段,所述内芯和所述内鞘管两者的径向间隙为穿引通道;
锁件,固定于所述内芯的延伸段,且处在所述锁座的远端侧;
牵拉线组件,其远端为工作端,所述牵拉线组件活动设置在所述穿引通道内;
介入器械在装载状态下,所述牵拉线组件的工作端延伸出内鞘管远端,绕经介入器械(介入器械可具有上文中的人工心脏瓣膜支架,且牵拉线与其中的穿线环配合)后被束缚至所述锁件,所述锁件与所述锁座插接配合限制所述牵拉线脱离束缚。
可选的,所述锁座上设有与所述锁件配合的锁合部,锁定状态下所述锁件插入所述锁合部并约束所述牵拉线的活动范围。
可选的,所述锁合部为锁孔或锁槽。
可选的,所述锁件随所述内芯运动且具有如下位置:
释放位置,所述锁件脱离所述锁孔以释放所述牵拉线工作端;
锁定位置,所述锁件插入所述锁孔以约束所述牵拉线工作端。
可选的,所述内芯的延伸段上设有安装座,所述锁件固定于所述安装座,且由所述安装座起向近端方向延伸。所述安装座上设有用于安装所述锁件的安装孔,所述锁件的远端插设固定在安装孔内,所述锁件的近端延伸出所述安装孔。
可选的,所述锁件在所述内芯的周向上间隔设置有多个,所述锁孔与所述锁件对应设置。
可选的,锁件在内芯的周向上均匀设置有至少三个。
可选的,所述锁件为杆状。
可选的,至少两个锁件由释放位置切换至锁定位置的行程不同。
可选的,至少两个锁件的长度不同。
可选的,任意两个锁件的长度不同。
可选的,所述牵拉线组件为从输送系统的手柄延伸的一条或多条牵拉线。
可选的,所述牵拉线组件包括线控管和牵拉线,所述线控管活动套设在所述内芯的外部,所述牵拉线的一端为驱动端且与所述线控管的连接,所述牵拉线的另一端为工作端,介入器械在装载状态下,所述工作端绕经至介入器械后与所述锁件配合。
可选的,所述线控管的近端相较于所述控制手柄活动设置。
可选的,所述线控管活动套设在所述内芯和所述内鞘管之间。
可选的,所述锁座上还设有引导孔,所述牵拉线由所述引导孔向外延伸。
可选的,所述锁座包括由远端至近端依次连接的导向盘、连接套和固定盘,其中所述锁孔开设于所述固定盘,所述导向盘上开设有与锁孔位置对应的导向孔;
锁件在锁定位置下贯穿所述导向孔,插入所述锁孔,所述锁件处在导向盘与固定盘中间的部位作为工作段,所述牵拉线的工作端被约束于该工作段。
可选的,所述固定盘上设有供牵拉线穿过的引导孔,所述牵拉线由线控管起经由所述引导孔延伸至固定盘的远端侧、并与所述锁件配合。
可选的,所述牵拉线延伸至固定盘远端侧的部分为控制介入器械释放程度的可控段,所述牵拉线的工作端被锁件约束状态下,该可控段的长度经由所述线控管的位置调整。
可选的,所述引导孔和所述锁孔分别有多个,且在固定盘的周向上交替设置。
可选的,所述牵拉线绕经介入器械的方式为:
所述牵拉线的工作端经由所述介入器械的自身结构后与所述锁件配合;或
所述介入器械上设有连接件,所述牵拉线的工作端穿引过该连接件后与所述锁件配合。
可选的,所述介入器械的自身结构内设有间隙或额外开设穿引孔。
可选的,所述介入器械上设有若干个连接耳,所述连接耳上开设有所述穿引孔。
可选的,所述连接件为柔性的线环,所述线环依次穿过各个连接耳上的穿引孔。
可选的,所述牵拉线的工作端设有配合环,所述锁件贯穿所述配合环以约束所述牵拉线。
可选的,所述锁件为在各管件轴向上延伸的杆状,锁定位置下的锁件贯穿牵拉线绕设的内部以实现对牵拉线的约束。
可选的,所述封闭空间由所述配合环提供。
可选的,所述配合环为独立部件;或由所述牵拉线自身绕设形成。
可选的,所述配合环的设置方式为以下至少一种:
所述牵拉线由所述驱动端至所述工作端之间为单线结构,且该单线在工作端自身绕设形成所述配合环;
或所述牵拉线为双线结构,且该双线在工作端折返,折返部位形成所述配合环;
或牵拉线自身为多股编织结构形成,编织结构的间隙部位作为所述配合环。
可选的,所述介入器械输送组件还包括线控管,所述线控管套设在所述内芯的外部,所述牵拉线的一端为驱动端,所述驱动端在所述线控管内向所述近端延伸并受控于控制手柄,所述牵拉线的另一端为工作端,介入器械在装载状态下,所述工作端绕经至介入器械后与所述锁件配合。
可选的,所述线控管近端相较于所述控制手柄固定动设置。
可选的,所述线控管的管壁内带有多个腔道,各牵拉线活动的穿引在对应的腔道内。
可选的,所述介入器械输送组件还包括调弯件,所述调弯件设置在所述内鞘管的内部或外部,所述调弯件与所述内鞘管两者的远端部位相互固定,近端处滑动配合以实现所述内鞘管在远端侧的调弯。
可选的,所述调弯件为管件、杆件、拉线中的至少一种;所述调弯件处在所述内鞘管的内部或外部。
可选的,介入器械输送组件还包括外鞘管,外鞘管滑动套设在调弯件外部,外鞘管与介入器械相对运动以收纳或释放介入器械,牵拉线在线控管的约束下控制介入器械的释放。
可选的,介入器械输送组件还包括护套管,护套管套设在外鞘管的外部,用于建立介入通道。
本申请还公开了一种介入器械的输送系统,包括上述技术方案中的输送组件和用于驱动所述输送组件的控制手柄,所述输送组件的内鞘管、内芯、牵拉线分别延伸至所述控制手柄,在所述控制手柄的驱动下相对运动。
可选的,所述控制手柄具有相对的远端和近端,用于驱动所述内鞘管、所述内芯、所述牵拉线彼此相对运动,所述控制手柄包括支撑体以及安装于所述支撑体的多套连接组件,相对于所述支撑体,各连接组件分为固定设置和活动设置,其中活动设置的连接组件按照传动方式包括螺纹传动、齿轮齿条传动、以及直接传动,且各传动方式的连接组件由远端至近端依次设置。
本申请还公开了一种介入系统,包括介入器械和输送组件,所述介入器械包括:
环形部,所述环形部为径向可形变结构,所述环形部在自身轴向上的两端分别为第一端和第二端,其中第一端的边缘沿环形部周向包括依次布置的多个单元段;
多个引导部,沿环形部周向依次间隔布置,各引导部的一侧连接至对应的一单元段,各引导部的另一侧形状逐渐收敛至末端,且在末端带有穿线环;
所述输送组件包括:
内鞘管,具有相对的远端和近端;
锁座,连接于所述内鞘管的远端部位;
内芯,滑动设于内鞘管中,所述内芯的一端为伸出内鞘管远端的延伸段,所述内芯和所述内鞘管两者的径向间隙为穿引通道;
锁件,固定于所述内芯的延伸段,且处在所述锁座的远端侧;
牵拉线组件,其远端为工作端,所述牵拉线组件活动设置在所述穿引通道内,介入器械在装载状态下,所述牵拉线延伸出内鞘管远端,绕经介入器械的穿线环后被束缚至所述锁件,所述锁件与所述锁座插接配合限制所述牵拉线脱离束缚。
本申请公开的技术方案通过引导部尤其是穿线环来实现对于人工心脏瓣膜支架全程控制,同时引导部的设置方式以及延伸形状能够减少因为人工心脏瓣膜支架自膨特性对于其回收的影响。改善医护人员的操作体验、提高治疗效果。
输送组件的牵拉线能够实现介入器械的阶段性释放,各管件的相互运动能够为介入器械的全释放和全回收回程提供结构基础,从而提供更为可控的介入治疗过程,提升治疗效果的同时改善患者体验。
具体的有益技术效果将在具体实施方式中结合具体结构或步骤进一步阐释。
附图说明
图1为现有技术中支架在回收过程中阻力点示意图;
图2a为一实施例中人工心脏瓣膜支架示意图;
图2b为图2a中的人工心脏瓣膜支架俯视视角示意图;
图2c为图2a中的人工心脏瓣膜支架各部分轴向长度比例关系示意图;
图2d和图2e为图2a中的人工心脏瓣膜支架不同视角示意图;
图2f为图2a中的人工心脏瓣膜支架的引导部放大示意图;
图2g为图2a中的人工心脏瓣膜支架的穿线环放大示意图;
图2h为另一实施例中人工心脏瓣膜支架立体视图;
图2i为图2h的人工心脏瓣膜支架的主视图;
图2j为图2h中引导部部分放大示意图;
图2k为另一实施例中人工心脏瓣膜支架立体视图;
图2l为图2k的人工心脏瓣膜支架的主视图;
图2m为图2k中引导部部分放大示意图;
图3a为一实施例中人工心脏瓣膜支架示意图;
图3b、图3c以及图3d为图3a中的人工心脏瓣膜支架不同视角示意图;
图3e为图3a中的圆圈位置放大示意图;
图3f为为图3a中的人工心脏瓣膜支架俯视状态立体示意图;
图4a为一实施例中人工心脏瓣膜装置示意图;
图4b、图4c以及图4d为图4a中的人工心脏瓣膜装置不同视角示意图;
图4e为图4d中人工心脏瓣膜装置放大示意图;
图4f为另一实施例的防周漏部件的布置示意图;
图4g为另一实施例的防周漏部件的布置示意图;
图4h为另一实施例的防周漏部件的布置示意图;
图4i为一实施例中人工心脏瓣膜装置的联合部处的结构示意图;
图4j为图4i的立体视图;
图5a为本申请一实施例中输送组件的远端侧示意图;
图5b为图5a中的输送组件放大示意图;
图5c为图5a中的输送组件另一视角放大示意图;
图5d为图5a中的输送组件中的锁座以及牵拉线放大示意图;
图5e为图5a中的输送组件中的锁座放大示意图;
图5f为图5a中的输送组件中各锁件差异设置示意图;
图5g为一实施例中牵拉线和介入器械通过连接件配合示意图;
图6a为一实施例中控制手柄示意图;
图6b为图6a中的控制手柄内部装配示意图;
图6c为图6a中的控制手柄内部结构示意图;
图6d为图6a中的控制手柄另一视角内部结构示意图;
图6e为一实施例中排气组件结构示意图;
图7a为另一实施例中控制手柄示意图;
图7b为图7a中的控制手柄内部装配示意图;
图7c为图7a中的控制手柄内部结构示意图;
图7d为一实施例中齿轮连接组件结构示意图;
图7e为图7d中的齿轮连接组件另一视角结构示意图;
图7f为图7d中的齿轮连接组件内部结构示意图;
图7g为一实施例中各管件装配示意图;
图7h为另一实施中控制手柄的立体视图;
图7i为图7h的控制手柄的爆炸视图;
图7j为图7h的控制手柄的剖视图;
图7k为图7i的控制手柄在齿轮、齿条处的部分结构示意图;
图7l为图7k的爆炸视图;
图7m为图7k中齿轮、齿条和夹持底座之间的结构示意图;
图7n为图7h的控制手柄的主视图;
图7o为图7n中A-A部的剖视图;
图8a为一实施例中输送组件远端侧调弯示意图;
图8b为一实施例中输送组件将介入器械输送至靶点示意图;
图8c为一实施例中输送组件调整介入器械相对靶点位置示意图;
图9a为一实施例中输送组件半释放介入器械示意图;
图9b为一实施例中输送组件全释放介入器械且防松牵拉线状态示意图;
图9c为一实施例中输送组件全释放介入器械且释放牵拉线状态示意图。
图中附图标记说明如下:
10、内芯;11、延伸段;12、穿引通道;13、锁件;131、安装座;132、安装孔;
20、线控管;21、牵拉线;211、驱动端;212、工作端;22、配合环;
30、内鞘管;31、锁座;311、锁孔;312、引导孔;313、导向盘;314、连接套;315、固定盘;316、导向孔;
40、调弯件;
50、外鞘管;51、护套管;
60、控制手柄;61、支撑体;611、固定座;612、滑动座;62、螺纹配合区;621、螺纹连接组件;622、驱动环;623、定位环;624、定位齿;625、夹持件;63、齿轮齿条配合区;631、齿轮连接组件;632、基座;6321、滑轨;6322、弹性卡扣;6323、第一限位凸台;6324、第二限位凸台;633、夹持底座;634、齿条;
635、齿轮;6351、旋转轴;636、驱动部;637、连接锁定机构;6371、第一锁齿;6372、第二锁齿;6373、保持组件;6374、卡接柱;6375、卡接槽;6376、复位件;6377、锁销;6378、插孔;64、排气组件;65、定位机构;
638、支撑筒;6381、卡接块;6382、外凸部;6383、限位座;
70、人工心脏瓣膜支架;701、腰部;702、阻力点;
71、环形部;711、第一端;712、第二端;713、单元段;
72、引导部;721、末端;722、穿线环;7221、牵拉段;7222、过渡段;723、连接侧;724、开口部位;725、稀疏区;726、稠密区;727、封闭区域;7271、第一区域;7272、第二区域;7273、第三区域;7274、第四区域;7275、中心区;7281、最大外径处;7282、边缘框条;7283、分支框条;7284、对称轴;
73、瓣叶;731、固定缘;732、自由缘;733、流出侧;734、流入侧;735、联合部;
74、内覆膜;741、防周漏部件;7411、第一圈防周漏部件;7412、第二圈防周漏部件;7413、第三圈防周漏部件;7414、 外凸部位;
75、血流通道;
90、介入器械;91、连接件;92、连接耳。
具体实施方式
下面将结合本申请实施例中的附图,对本申请实施例中的技术方案进行清楚、完整地描述,显然,所描述的实施例仅是本申请一部分实施例,而不是全部的实施例。基于本申请中的实施例,本领域普通技术人员在没有做出创造性劳动前提下所获得的所有其他实施例,都属于本申请保护的范围。
需要说明的是,当组件被称为与另一个组件“连接”时,它可以直接与另一个组件连接或者也可以存在居中的组件。当一个组件被认为是“设置于”另一个组件,它可以是直接设置在另一个组件上或者可能同时存在居中组件。
除非另有定义,本文所使用的所有的技术和科学术语与属于本申请的技术领域的技术人员通常理解的含义相同。本文中在本申请的说明书中所使用的术语只是为了描述具体的实施例的目的,不是在于限制本申请。本文所使用的术语“和/或”包括一个或多个相关的所列项目的任意的和所有的组合。
参考附图1所示,当手术时由于释放支架释放位置的不准确,需要对从鞘管中全部释放的现有支架进行回收时,由于支架的自膨特征,容易出现与输送组件干涉的阻力点702,干涉支架的回收过程)。
如图2a,3a,4a所示,本申请公开了一种人工心脏瓣膜装置,包括人工心脏瓣膜支架和位于支架内部的多片瓣叶和覆膜,人工心脏瓣膜支架整体上为管状结构,具有压缩状态和膨胀状态,所述支架的内部为血流通道,各瓣叶处在血流通道内相互配合以相对的开放或封闭血流通道。
参考附图2a至附图2g,公开了一种人工心脏瓣膜支架70,包括:
环形部71,环形部位于支架的流入端,也可以称之为流入端区域;环形部71为径向可形变结构,由若干可压缩单元格组成,环形部71在自身轴向上的两端分别为第一端711和第二端712,其中第一端711的边缘沿环形部71周向包括依次布置的多个单元段713;环形部71的轴向长度为1.5个单元格的长度。
多个引导部72,位于支架的流出端,也可以称之为流出端区域;沿环形部71周向依次间隔布置,各引导部72的一侧连接至对应的一单元段713,各引导部72的另一侧形状逐渐收敛至末端721,且在末端721带有穿线环722。
本申请通过引导部72尤其是穿线环722来实现对于人工心脏瓣膜支架70全程可控释放,包括对已经完全脱离鞘管的瓣膜支架进行回收,提高手术植入时的精准度。同时引导部72的设置方式以及延伸形状能够减少因为人工心脏瓣膜支架70自膨特性对于其回收的影响。
在引导部72整体的比例关系上,参考附图2b至图2c所示的实施例中,人工心脏瓣膜支架70整体上基于径向形变、具有相对的压缩状态和释放状态,释放状态下,以环形部71轴向为长度方向,引导部72的长度为L1,环形部71的长度为L2,且满足L1:L2=1:0.5~1.5。在特定产品中,L1:L2=1:0.6~1.2。
在引导部72连接形式上,参考附图2f所示的实施例中,沿环形部71的轴向,各引导部72的一侧为与相应单元段713对接的连接侧723,相邻两引导部72的连接侧723彼此衔接。在扩展的实施方式中,相邻两引导部72的连接侧723也可以间隙设置。不论相邻两引导部72之间如何设置,从各引导部72的整体布置来看,各引导部72沿环形部71的周向均匀布置,例如,如图2b所示,沿环形部71周向,连接侧723的长度为L3且满足L1:L3=0.5~1.5。其中连接侧723的长度L3应理解为在环形部71周面上的弧线长度。其中附图3a至附图3f以及附图4a至附图4e中的人工心脏瓣膜支架70同理,在此不再赘述。在引导部72数量的选择上,参考一实施例中,引导部72为N处,N为2、3、4、5或6,各引导部72的连接侧723所对应的圆心角为360度/N。
在引导部72延伸趋势上,参考附图2a和附图3b所示的实施例中,释放状态下,引导部72由连接侧723至末端721的收敛趋势为均匀收敛。参考附图4a所示的实施例中,释放状态下,引导部72由连接侧723至末端721的收敛趋势为先小后大最终变小。在考量收敛趋势时,应以引导部72在环形部71径向上的投影形状来判断,本实施例中提到的均匀收敛应理解为整体趋势,不排除引导部72的边缘在个别部位设置凸起或者凹陷。在其他方向观察时,引导部72的延伸趋势可以另行设置,参考附图2d、附图3c以及附图4b所示的实施例中,引导部72由环形部71起沿环形部71轴向延伸,延伸的路径先在环形部71径向上外扩,至最大外径处7281后、再逐渐收敛。
通过上文不难理解的,引导部72的末端721之间会存在一定的间隙,相邻两引导部72之间为开口部位724,压缩状态下,相邻两引导部72在彼此贴靠闭合开口部位724。人工心脏瓣膜支架70在状态切换的过程中,开口部位724的大小也会同步发生变化。
在具体实现形式上,引导部72以及环形部71均具有镂空的单元格结构,沿环形部71轴向,环形部71中的单元格为多圈,引导部72以及环形部71的交界部位由其中一圈单元格的顶点围成。
单元格结构的引导部72以及环形部71能够更好的适配人工心脏瓣膜支架70的状态切换,同时能够通过单元格结构的设置来精细化的调整人工心脏瓣膜支架70的力学特性。环形部71的轴向长度为1~2.5个单元格。如图2i所示,环形部71的轴向长度跨越2个单元格,如图2L所示,环形部71的轴向长度跨越2.5个单元格,单元格的具体结构可以为多边形;例如附图中所示的菱形格。
如图2a-2d,引导部72以及环形部71均具有镂空的单元格结构,引导部72中的单元格分为相对的稀疏区725和稠密区726,至少一部分稀疏区725靠近相邻两引导部72之间的开口部位。本申请中的稀疏区和稠密区是相对而言的,稀疏区是指单元格具有较大的面积,稠密区是指单元格具有相对较小的面积,即:稀疏区的单元格面积大于稠密区的单元格面积。例如稀疏区725对应的单元格面积大于稠密区726的单元格面积;不同稀疏程度的单元格能够精细化的调整引导部72各部位的力学特性,从而改善引导部72的顺应性,在释放和回收过程中提供更为顺畅的操作体验。
在具体的布局上,参考附图2f、附图3a以及附图4c所示的实施例中,引导部72中包括四个封闭区域727,分别为:
第一区域7271:第一区域位于支架的最近端,用于连接输送系统,在本发明中,第一区域为穿线环722,包括一个第一单元格;
第二区域7272:为稠密区726,沿环形部71周向设置,第二区域7272与第一区域7271两者对正且作为所在引导部72的中心区7275;第二区域用于固定瓣膜的护耳,至少包括一个第二单元格;在本实施例中,第二区域仅包括一个单元格,即第二单元格,在其他实施例中,第二区域可以包括多个单元格。沿着支架流出端方向,第二单元格的流出端节点A通过缝合柱AB与第一单元格的流入端节点B相连,所述缝合柱AB上设置有缝合孔,通过此缝合孔,固定瓣叶,所述第一连接条平行于支架的纵向轴线。
第三区域7273:为稀疏区725,沿环形部71周向,处在中心区7275的一侧,在本实施例中,第三区域仅包括一个第三单元格,在其他实施例中,第三区域可以包括多个单元格。
第四区域7274:为稀疏区725,沿环形部71周向,处在中心区7275的另一侧,在本实施例中,第四区域仅包括一个第四单元格,在其他实施例中,第四区域可以包括多个单元格。
在本实施例中,在第一、第二、第三、第四个单元格中,第三单元格和第四单元格大小相同,具有最大的面积,第一单元格面积最小,第二单元格面积介于第三单元格和第一单元格之间。
在实现方式上,第二区域7272的稠密区726可以通过相同面积内增加单元格数量来实现,也可以通过在相同数量单元格数量的前提下减少对应面积来实现,从原理上看,变现为在单位面积内,稠密区726内穿设有更多的筋条。参考一实施例中,稠密区726的单元格面积为稀疏区725的单元格面积的0.3~0.8倍。在特定产品中,稠密区726的单元格面积为稀疏区725的单元格面积的0.4~0.6倍。
参考附图2f所示的实施例中,第二区域7272、第三区域7273以及第四区域7274均仅设置一个单元格,各单元格的其中一顶点与环形部71对接。附图中,第三区域7273和第四区域7274的单元格形状相同或近似,且两者的单元格形状与第二区域7272的单元格形状不同以形成疏密变化。
参考附图2f所示的实施例中,引导部72由环形部71起沿环形部71轴向延伸,延伸的路径先在环形部71径向上外扩,至最大外径处7281后、再逐渐收敛,最大外径处7281邻近第一区域7271、第二区域7272的交界部位。参考附图2f所示的实施例中,引导部72中,邻近开口部位的为边缘框条7282,边缘框条7282的一端连接穿线环,边缘框条7282的另一端连接至环形部71,边缘框条7282在延伸过程中与管状结构中的其他框条的交点不多于两个。在附图中,交点为1个。参考附图2f所示的实施例中,边缘框条7282在临近第一端711处连接有一分支框条7283,该分支框条7283与边缘框条7282分别连接至第一端711上不同的单元格顶点。
人工心脏瓣膜支架70的全流程控制需要穿线环722的配合。参考附图2g所示的实施例中,穿线环722在远离环形部71的一侧为牵拉段7221,该牵拉段7221为弧形。穿线环722在靠近环形部71的一侧为与周边单元格共用的过渡段7222,过渡段7222为V形,且顶点朝向环形部71。
在牵拉段7221的设置上,参考一实施例中,牵拉段7221和过渡段7222合围成一个或多个封闭空间。在封闭空间的尺寸上,穿线环722的外接圆的半径大于等于穿线环722的杆件的直径的两倍,该设置的重点在于穿线环722在空间上具有一定的尺寸,而非杆件上的开孔。
其中附图3a至附图3f以及附图4a至附图4e中的人工心脏瓣膜支架70同理,在此不再赘述。
参见一实施例,如图2h~图2j所示,本实施具有类似实施例2a的结构,包括环形部71a和引导部72a,其不同点在于,环形部71a的轴向跨越2个单元格,且在第二区域中,第一单元格的流入端节点直接与第二单元格的流出端节点为同一个,瓣叶直接缝合至第二单元格;
且穿线环722的流出侧的端部进一步收敛。
参考图2k~图2m所示的实施例,包括环形部71b和引导部72b,
引导部72b中包括四个区域,分别为:
第一区域:为稀疏区,第一区域位于支架的最近端,用于连接输送系统,在本发明中,第一区域为穿线环81,包括一个第一单元格;
第二区域82:为稠密区,沿环形部71b周向设置,第二区域与第一区域两者对正且作为所在引导部72b的中心区;第二区域用于固定瓣膜的护耳,至少包括一个第二单元格82a;在本实施例中,第二区域包括多个单元格,分别是第二单元格82a和分布在第二单元格82a两侧的单元格82b和单元格82c。沿着支架流出端方向,第二单元格的流出端节点与第一单元格的流入端节点共同使用一个端节点。
第三区域83和第四区域:为稀疏区,沿环形部71周向,第三区域和第四区域对称设置第二区域的两侧,其包括至少 一个以上的单元格,在本实施例中,其分别包括一个第三单元格84a和单元格84b和部分单元格84c。单元格84纵向上跨越引导部与环形部。
在本实施例中,在第一、第二、第三单元格中,第三单元格具有最大的面积,第二单元格面积最小,第一单元格面积介于第三单元格和第二单元格之间。
所述环形部包括多排单元格,沿着引导部方向,所述单元格的大小减缩。
在人工心脏瓣膜支架70的整体形态上,参考附图2a、附图3a以及附图4a所示的实施例中,人工心脏瓣膜支架70整体上为管状结构,该管状结构轴向的中部区域带有缩径的腰部701。在附图中,引导部72和环形部71两者的交界部位处在腰部701。进一步的,引导部72和环形部71两者的交界部位邻近腰部701的最小外径处,在附图所示的实施例中,引导部72和环形部71两者的交界部位位于腰部701的最小外径处。相邻两引导部72之间为开口部位724,开口部位724由腰部701起在背向环形部71进一步扩口且开放参考附图4b以及附图4c所示的实施例中,所有瓣叶73闭合时交汇在环形部71的轴线,交汇点在环形部71轴向的位置与腰部701邻近。
在一实施例中,沿着环形部71的第二端的周向分布的一排单元格中,各单元格为四边形,靠近第二端的两边比靠近第一端的两边更长。
参考附图4a至附图4e所示,本申请还公开了一种人工心脏瓣膜装置,包括人工心脏瓣膜支架70、多片瓣叶73和内覆膜,其中瓣叶和内覆膜构成瓣膜组件,各瓣叶73处在血流通道75内相互配合以相对的开放或封闭血流通道75。瓣叶73的边缘包括固定至人工心脏瓣膜支架70的固定缘731,以及与相邻瓣叶73相互配合控制血流通道75的自由缘732,按照瓣叶73对血流的控制方向,第一端711为流出侧733,第二端712为流入侧734,其中固定缘731的两端分别处在相邻的两引导部72,固定缘731的中部延伸至环形部71。其中在自由缘732的固定上,自由缘732的两端在支架的轴向上朝向流出侧延伸,并在在引导部72上的一单元格内通过覆膜固定。该单元格可以是上文中提到的构成中心区域的单元格。
沿环形部71周向,各引导部72均具有自身结构的对称轴7284,相连两瓣叶73的固定缘731交汇于相应引导部72的对称轴7284。从另一角度来看,固定缘731的中点邻近环形部71的轴向中部。
其中沿环形部轴向,引导部72和环形部71的交界部位邻近瓣叶73的自由缘732的位置。
而相邻瓣叶73之间通过联合部735彼此相连并固定于人工心脏瓣膜支架70,各联合部735的位置处在对应的一个引导部72中。结合前述两实施例的人工心脏瓣膜支架70,联合部735固定在第二区域的第二单元格中。
参考附图3a至附图3f所示的实施例中,人工心脏瓣膜支架70的内侧带有内覆膜74,内覆膜74处在瓣叶73的流入侧734并与各瓣叶73的固定缘731对接。内覆膜74由瓣叶73其延伸至环形部71的第二端712。
人工心脏瓣膜支架70还设有处在瓣叶73流入侧734的防周漏部件741。防周漏部件741可以暴露于人工心脏瓣膜支架70的外周面;也可以设置外覆膜进一步包裹,即在管状结构径向上内覆膜74与外覆膜合围防周漏部件741。
在另一实施例中,防周漏部件741固定在内覆膜74的外侧,防周漏部件741为间隔分布的块状且位置与管状结构的镂空区域对应。防周漏部件741与内覆膜74为一体结构,膨胀状态下,防周漏部件741从环形部流入端侧的单元格径向往外延伸,外凸于人工心脏瓣膜支架70的外周面或与支架的外表面齐平。
其中内覆膜可以采用具有生物相容性的生物膜片或采用PET材质,防周漏部件741为弹性材料和/或吸收体液膨胀,或多孔材料,例如采用PU材质发泡而成。
在一实施例中,管状结构具有环布多道单元格结构,防周漏部件的布置方式:
如图4f所示防周漏部件741沿着环形部的流入端周向布置一排或多排,具体布置在靠流入侧734的第一圈防周漏部件7411,第一圈防周漏部件7411布满整个单元格。
或如图4g、图4h所示,增加邻近第一圈防周漏部件7411的流入侧734和/或流出侧733的第二圈防周漏部件7412和第三圈防周漏部件7413。其中位于第二圈和第三圈周漏部件的轴向长度等于半个单元格,且均具有一径向外凸部位7414,外凸部位7414更加靠近所在单元格的流入侧。防周漏部件741自身可以为长条形且环绕在人工心脏瓣膜支架70外周,或如附图3e中,为多个间隔分布的块状且固定在管状结构对应的镂空区域。图中虚线主要用于表示防周漏部件741的表面延伸趋势。
为保证封堵效果,膨胀状态下的防周漏部件741相对于管状结构在径向上进一步外凸,且外周面与管状结构的外周面平滑过渡,在管状结构的轴向上,外凸高度最大的部位更靠近流入侧,图中可见防周漏部件741外凸高度最大处到所在单元格单元的流入侧之间距离为S1,防周漏部件741外凸高度最大处到所在单元格单元的流出入侧之间距离为S2,其中S1:S2的比值范围为0.2至0.8,该比值范围在实际产品中可以优选为0.3至0.8。
防周漏部件741外凸后从面积上看可填满所在单元格杆件围成的空间,从外凸程度上看,防周漏部件741与所在单元格的杆件侧缘相互贴靠,即防周漏部件741的最低位置亦不低于单元格杆件的外周面,避免防周漏部件741与杆件侧缘之间产生的间隙,该间隙的负面影响可能吸收防周漏部件741的形变而降低封堵效果,其中杆件侧缘理解为杆件朝向所在单元格内部的一侧。
本实施例中的人工心脏瓣膜装置可以采用干膜保存方式或湿膜保存方式,其中干膜保存方式为瓣叶73在非液体环境中保存。
参考附图5a至附图5c,本申请公开了可线控操作的介入器械90输送组件,包括:
内鞘管30,具有相对的远端和近端;
锁座31,连接于内鞘管30的远端部位;
内芯10,滑动设于内鞘管30中,内芯10的一端为伸出内鞘管30远端的延伸段11,内芯10和内鞘管30两者的径向间隙为穿引通道12;
锁件13,固定于内芯10的延伸段11,且处在锁座31的远端侧;
牵拉线21,活动设置在穿引通道12内;
介入器械90在装载状态下,牵拉线21延伸出内鞘管30远端,绕经介入器械90的穿线环722后被束缚至锁件13,锁件13与锁座31插接配合限制牵拉线21脱离束缚。
内芯10和内鞘管30的相对运动能够实现锁座31和锁件13的相对运动,从而改变牵拉线21的约束状态。牵拉线21的状态能够影响介入器械90的运动过程,尤其是在介入器械90的释放过程中,从而实现通过牵拉线21来实现介入器械90的阶段性释放,进一步的,各管件的相互运动能够为介入器械90的全释放和全回收回程提供结构基础,从而提供更为可控的介入治疗过程,提升治疗效果的同时改善患者体验。
本申请中,牵拉线21主要通过与穿线环722配合以实现对于介入器械的控制,同时介入器械通过引导部72的结构优化以提升自身结构在状态变化过程中的顺应性,避免了现有技术中的介入器械在全回收过程中遇到的问题。
介入器械90可以是人工心脏瓣膜或血管支架等,人工心脏瓣膜可包括支架以及连接于支架上用以控制血流通断的瓣叶,瓣叶数量一般为两片或三片,根据需要还可以在支架的内侧和/或外侧增加裙边设计,支架本身可采用编织或管材切割方式形成。人工心脏瓣膜可用于替换心脏内的病变瓣膜,尤其是例如主动脉瓣膜。
锁件13的锁定效果体现为对牵拉线21的约束,不难理解,牵拉线21会对锁件13产生作用力,从而影响锁定效果。为了提高锁件13的力学性能,参考一实施例中,锁座31上设有与锁件13配合的锁合部,锁定状态下锁件13插入锁合部并约束牵拉线21的活动范围。锁合部为锁孔或锁槽,本实施例以锁孔为例。锁孔311能够在锁件13相对于自身固定结构的另一侧约束锁件13,从而提高锁件13整体的力学性能。在结构上,可以如附图所示,锁孔311表现为一个具体的通孔或盲孔,供锁件13穿设;锁孔311也可以表现为一个能够提高锁件13定位效果的结构,例如定位凹陷或者定位凸点,锁件13的结构也应相应的调整。
在锁件13和锁孔311的配合过程中实际上是内鞘管30和内芯10相对的运动过程。参考一实施例中,锁件13随内芯10运动且具有如下位置:
释放位置(参考附图9c),锁件13脱离锁孔311以释放牵拉线21;
锁定位置(参考附图9b),锁件13插入锁孔311以约束牵拉线21。
锁件13的不同位置具体表现为对牵引线在穿引通道12内的运动状态的约束。在附图公开的实施例中,锁件13的实际作用在于在穿引通道12内分隔出了独立的约束空间,当牵拉线21位于预设的位置(一般通过组装过程实现)时,锁件13实现对牵拉线21的约束作用。相应的,释放位置即上文中的约束空间与穿引通道12连通,牵拉线21从而能够自由运动以释放介入器械90。
值得注意的是,牵拉线21在被锁件13锁定的过程中,并非完全不能运动的状态。牵拉线21可以通过自身材质(例如形变材料)或者尺寸(例如较长的延伸长度)来实现以下功能:当牵拉线21被锁件13约束时,能够通过自身形变释放预设程度的介入器械90运动行程。结合附图9b所示的实施例,通过牵拉线21的自身形变,实现在锁件13未释锁的情况下的介入器械90半释放,即介入器械90的连接耳92从对应结构中释放,但是整体形态依旧由牵拉线21控制。上述设置为通过牵拉线21的控制来实现对介入器械90释放过程的控制提供了结构基础。
值得注意的是,上文中提到的牵拉线21形变指代的是牵拉线21延伸路径上的形变而非材料拉伸导致的长度变化,在本领域中,为了实现牵拉线对瓣膜释放的控制,牵拉线的延伸率应尽量小。本文中其他关于牵拉线21形变的描述也应满足上述基本规则。
如上文所述,锁件13的一端收到锁孔311的约束,另一端也需要相应的结构来实现稳定的连接。参考一实施例中,内芯10的延伸段11上设有安装座131,锁件13固定于安装座131且由安装座131起向近端方向延伸,安装座131上设有用于安装锁件13的安装孔132,锁件13的远端插设固定在安装孔132内,锁件13的近端延伸出安装孔132。
本实施例中的锁件13和锁孔311的配合方向也是值得注意的设置细节。可以理解为锁件13的远端侧与内芯10连接,锁件13的近端侧朝向锁座31延伸并随自身运动与锁孔311配合。锁件13由远端侧向近端侧延伸以实现与锁孔311的配合,能够更好的实现结构的紧凑程度。在附图所示的实施例中,能够实现将锁件13以及锁座31中的安装座131设置在装载状态的介入器械90内部,其位于瓣膜支架的裸支架段,在装载状态下,其起到填充瓣膜支架与内芯之间的较大空隙,防止瓣膜支架压握过程中因缺乏支撑而产生的塌陷或凹折现象;另一方面,将其设置在前端,可有效减少其与拉线管以及拉线之间的干涉,控制输送组件的整体体积,方便介入治疗过程中的一系列操作。
更重要的是,在介入器械90安装至输送组件的过程中,该设置方向的锁件13具有更佳的操作便利性。反之,若采用由近端向远端配合的锁定结构,在安装介入器械过程中,较为繁琐,非常容易出现脱落的情况,导致返工,影响生产效率。
安装孔132的作用在于实现锁件13与安装座131的稳定配合。在实际产品中,锁件13和安装孔132可以设置为固定连接,考虑到生产难度的因素,可以选择表现为粘接或焊接等形式。在组装过程中,安装孔132的结构能够更好的实现组装 过程,提高生产效率。在此基础上,参考一实施例中,安装孔132开放于安装座131的周面,且开放部分至少可供锁件13就位。
开放设置的安装孔132能够方便作业的同时还能够方便检查,确保连接的稳固,提高装置的整体的稳定性。更重要的是,开放设置的安装孔132能够从结构上确保锁件13安装至安装孔132的底部,避免了盲孔结构导致的不确定性,从而保证了锁件13的端面至锁孔311之间的锁定间距。
在数量上,锁件13和锁孔311也可以相应的调整,参考一实施例中,锁件13在内芯10的周向上间隔设置有多个,锁孔311与锁件13对应设置。锁件13和锁孔311在数量上的调整能够提高对牵拉线21的约束能力,从而实现对介入器械90的多维度的控制,尤其在提高控制精度方面具有较大意义。同时数量上的增加也会提高结构的复杂程度,对装配、稳定性产生一定的影响。因此在具体产品中,锁件13在内芯10的周向上均匀设置有至少三个,锁孔311与锁件13对应设置。
在多个锁件的相互设置共性上,参考一实施例中,锁件13为杆状。杆状的锁件13具有结构简单的优势,同时配合下文中的牵拉线21的相关细节,能够在结构简单的同时保证锁定的效果。
参考附图5f,在多个锁件的相互设置差异上,参考一实施例中,至少两个锁件13由释放位置切换至时锁定位置的行程不同。其中此“行程”指代的是锁件13的端面至锁孔311之间的锁定间距,换言之,即锁件13的端面需要经过多少距离能够进入锁孔311。该设置的优势在于能够实现不同锁件13的不同步的锁定。该技术效果的主要目的在于能够提高牵拉线21以及介入器械90的安装效率。介入机械90以及牵拉线21结构较小且复杂,当锁件13同步锁定时,需要操作人员完成介入器械90的同步安装,这对于具有对个安装点位的装置来说非常麻烦,严重影响装配效率。本申请通过锁件的不同步锁定,能够实现介入器械90的阶段性安装,从而在保证装配品质的同时大大提高生产效率。
锁件13由释放位置切换至时锁定位置的行程不同的实现方式具有多种方案,例如通过锁孔311的差异化设置来实现,也可以通过锁件13的差异化来实现。参考一实施例中,至少两个锁件13的长度不同。长度不同的锁件能够实现即使各锁件13同步运动,各锁孔311与对应锁件13配合的时机产生不同,从而实现上述功能。进一步的,任意两个锁件的长度不同。
实际与介入机械相互作用的为牵拉线21,因此牵拉线21的设置细节也具有协同作用。参考一实施例中,介入器械90输送组件还包括牵拉线组件,其包括牵拉线21和线控管20,线控管20活动套设在内芯10的外部,牵拉线21的一端为驱动端211且与线控管20的连接,所述牵拉线的另一端为工作端212(即下文中的配合环22),介入器械在装载状态下,工作端212绕经至介入器械90后与锁件13配合。
线控管20的作用在于控制牵拉线21的工作状态,尤其能够通过控制牵拉线21来实现对介入器械90的控制。线控管20在本实施例中为活动设置以实现自身驱动功能。即线控管21的近端相较于控制手柄活动设置。在本实施例中,表现为:线控管21的近端相较于内鞘管活动设置。在线控管20的具体结构上,参考一实施例中,线控管20活动套设在内芯10和内鞘管30之间。线控管20设置在内芯10和内鞘管30之间能够避免和线控管20和锁座31之间的干涉,从而实现为介入器械90的安装提供更多的空间。锁座31上还设有引导孔312,牵拉线21由引导孔312向外延伸。
线控管20在附图所示的实施例中为一具体的管件,而在原理上,可以通过牵拉线21的近端侧自身延伸实现,即通过控制手柄60直接操作牵拉线21的近端来实现上述功能。因此在实际产品中,线控管20的具体形态可以发生变化。下文中的描述主要结合附图中线控管20这个产品形态展开,其他实施方案同理,不再赘述。
参考上文中的表述,结合附图9b的实施例,通过牵拉线21的自身形变,实现在锁件13未释锁的情况下的介入器械90半释放,即介入器械90的连接耳92从对应结构中释放,但是整体形态依旧由牵拉线21控制。上述设置为通过牵拉线21的控制来实现对介入器械90释放过程的控制提供了结构基础。参考一实施例中,牵拉线21延伸至锁座31的固定盘远端侧的部分为控制介入器械释放程度的可控段,牵拉线21的工作端212被锁件约束状态下,该可控段的长度经由线控管20的位置调整。
其中锁件13的工作状态和线控管20的工作状态可以联动也可以相互独立。当两者相互独立时,锁件13未解锁时线控管20能够通过自身运动来控制被约束的牵拉线21调整自身状态。
在锁座的具体结构上,参考一实施例中锁座31包括由远端至近端依次连接的导向盘313、连接套314和固定盘315,其中锁孔311开设于固定盘315,引导孔312开设于导向盘313且与锁孔311位置对应;
锁件13在锁定位置下贯穿所述导向孔316,行经连接套314外围后插入对应锁孔311,锁件13处在连接套314外围的部位作为工作段,牵拉线21的工作端212被约束于该工作段。
导向盘313和固定盘315在穿引通道12内形成了一个相对封闭的小环境,从而能够有效提高锁件13对于牵拉线21配合的稳定性。同时在导向孔316的作用下,能够有效提高锁件13的力学性能,确保能够控制具有高弹力的介入器械90。
锁座31除了提供对锁件13的引导外,还能够提供对牵拉线21的引导。参考附图5c公开的实施例中,固定盘315上设有供牵拉线21穿过的引导孔312,牵拉线21由线控管20起经由引导孔312延伸至固定盘315的远端侧、并与锁件13配合。
牵拉线21为了与线控管20实现具体的连接,需要贯穿锁座31的固定盘315。即可以理解为牵拉线21经由引导孔312与锁件13配合。引导孔312能够对牵拉线21进行梳理,从而实现对线控管20对牵拉线21的稳定驱动。进一步的,引导孔312能够通过自身位置的设置来调整牵拉线21对介入器械90的施力位置,从而更好的实现对介入器械90的控制。参考一实施例中,锁座31上设有与锁件13配合的锁孔311,引导孔312和锁孔311分别有多个,且在固定盘315的周向上交替设置。相邻设置的引导孔312和锁孔311除了上文中关于调整牵拉线21对介入器械90的施力位置的作用外,还能够实现 锁座31上各结构的紧凑布置,同时避免相邻的牵拉线21(如果设有多个的话)之间的不必要的相互干涉。
牵拉线21的约束路径实际上由三个位置来确定,分别为牵拉线21的近端如何与控制手柄建立关系(在本实施例中牵拉线21的近端与线控管连接),牵拉线的21的工作端212如何与介入器械90相互作用,牵拉线的21的工作端212如何与锁件13相互作用。下面将示例性的分开阐释。
关于牵拉线的21的工作端212如何与介入器械90相互作用,参考一实施例中,牵拉线21和介入器械90如下配置:
牵拉线21的工作端212经由介入器械90的自身结构后与锁件13配合;或
介入器械90上设有连接件91,牵拉线21的工作端212穿引过该连接件91后与所述锁件13配合。
本实施例中包含了两种实现方式。
“牵拉线21的工作端212经由介入器械90的自身结构后与锁件13配合”(参考附图5f)中的介入器械90的自身结构可以是介入器械90的自身骨架中的镂空部分,也可以是开设在介入器械90骨架上的孔洞,也可以是介入器械90自身材料延伸形成的部分。参考一实施例中,所述介入器械的自身结构内设有间隙(例如上文中提到的镂空部分)或额外开设的穿引孔(例如上文中的穿线环)。
在介入治疗领域中,介入器械90上还可以设置连接耳92来提高输送组件对于介入器械90的控制能力。连接耳92数量上可以1个或多个。连接耳92上还可以开设穿引孔。连接件91可以设置为依次或分别穿设于连接耳92上的穿引孔。
在最佳实施方式中,牵拉线21的工作端212沿着介入器械90延伸,穿过介入器械90端部的孔洞,沿着锁座31方向延伸,最后套设在位于导向盘313与固定盘315之间的锁杆上。本实施方式的优点在于能够实现牵拉线21对于介入器械90的直接控制,并且部件数量少,便于生产装配的同时降低部件失效的可能性。
“介入器械90上设有连接件91”(参考附图5g)中的连接件可以参考附图中所示的自身闭环的线环,也可以其他设置形式,例如独立的连接部件。在附图所示的所示实施例中,连接件91为柔性的线环。具体的,连接件91为线环。介入器械释放后,连接件91可保留于介入器械,并不随牵拉线21撤除。也可以根据需要,在后期剪断撤出。
相对于上文中的牵拉线21自身直接牵拉介入器械90而言,连接件91可预先装配于介入器械,使用时现场与牵拉线21互绕更便于操作,优化相对运动管件的行程。
为了更好的实现牵拉线21与介入器械90的配合,参考一实施例中,介入器械的近端带有多个带孔的连接耳92,线环依次穿过各个连接耳92。连接耳92数量为2~6个,也可以利用介入器械90自身单元格单元的尖角部位。
在线环(即上文中的连接件91)的具体设置上,可采用不同方式穿引与牵拉线21相连,在下文的实施例中,牵拉线21的设置细节也较其他实施例有所调整,但是基本原理不变,因此不再展开阐述。
牵拉线21的一端为驱动端211,驱动端211延伸并受控于控制手柄,牵拉线21的另一端为工作端212(即下文中的配合环22)。
在牵拉线21与线环(即上文中的连接件91)的设置上,具有多种实现方式,下文中示例性的展示了若干种设置方式。其中线环上可以设置若干个连接点方便牵拉线的连接。连接点可以是实际的部件,在空间上存在一个具有体积的部件来实现连接;连接点也可以虚拟的点位,并无实际部件,只代表一个位置。
关于在牵拉线21和锁件13的具体配合过程中,参考一实施例中,牵拉线21与锁件13配合的一端(即工作端212)设有配合环22,锁件13贯穿配合环22以约束牵拉线21。
配合环22的优势在于能够方便锁件13的设置,为了实现稳定的力学连接,锁件13需要设置相应的配合结构。而本实施例中,通过牵拉线21的结构优势形成配合环22能够简化锁件13的设置。参考附图公开的实施例中,锁件13为在各管件轴向上延伸的杆状,锁定位置下的锁件13贯穿牵拉线21绕设的封闭部位内部以实现对牵拉线21的约束。封闭部位可以由牵拉线21的穿设来实现,也可以由配合环22提供。
在配合环22的形成方式上,参考一实施例中,配合环22为独立部件或由牵拉线21自身绕设形成。独立部件的设置方便进行不同材质的设置,例如在一些实施例中,配合环22部位采用显影材质,方便对介入过程的实时控制。牵拉线21自身绕设的形式具有结构简单稳定的优势,方便生产和组装。
在绕设的具体形式上,参考附图5g所示的实施例中,牵拉线21由驱动端211至工作端212之间为单线结构,且该单线在工作端212自身绕设形成配合环。相应的,在牵拉线21的近端也可设置相应的配合环结构,方便安装。或者参考附图5b所示的实施例中,牵拉线21为双线结构,且该双线在工作端212折返,折返部位形成配合环。本实施例中牵拉线21具有更好的结构强度。在其他实施例中,牵拉线自身为多股编织结构形成,编织结构的间隙部位作为配合环。编织结构的间隙可以由编织过程形成,也可以在装配过程中通过操作形成。
关于牵拉线21的近端如何与控制手柄建立关系的设置上,除了上文中牵拉线21的近端与线控管连接的设置方式外,还可以参考一实施例中,介入器械90输送组件还包括线控管20,线控管20套设在内芯10的外部,牵拉线21的一端为驱动端211,驱动端211在线控管20内向近端延伸并受控于控制手柄,牵拉线21的另一端为工作端212(即下文中的配合环22),介入器械在装载状态下,工作端212绕经至介入器械90后与锁件13配合。
相较于上文中的实施方式而言,本实施例中的线控管20为牵拉线21的驱动提供了独立的运动空间,避免的牵拉线21在运动过程中相互干涉,在具体驱动方式上,牵拉线21的近端可以设置为直接受控于控制手柄也可以设置为通过中间部件来实现与控制手柄的连接。
线控管20在本实施例中可以固定设置。参考一实施例中,线控管20近端相较于控制手柄固定动设置。进一步的,线控管20近端相较于内鞘管固定动设置。
在线控管20对牵拉线21的引导范围上,参考一实施例中,线控管20的管壁内带有多个腔道,各牵拉线活动的穿引在对应的腔道内。多腔管的设置可以实现牵拉线21的独立引导,从而进一步避免牵拉线21之间的相互干涉。
输送组件的本质是各管件的相互嵌套来实现不同的功能。因此除了上文中提到的各管件外,输送组件还可以设置其他管件提供其他功能。参考一实施例中,介入器械90输送组件还包括调弯件40,调弯件40设置在内鞘管30的内部或外部,调弯件40与内鞘管30两者的远端部位相互固定,近端处滑动配合以实现内鞘管30在远端侧的调弯。
调弯件40与内鞘管30两者的远端部位相互固定,当其中一者的近端侧收到作用力时,会导致两者的远端产生弯曲的趋势,从而产生输送组件的远端整体调弯,参考附图8a至附图8c,能够更好的实现介入器械90的输送过程。在产品设计中,在内的管件主动产生驱动力带动在外的管件一同调弯的形式为内调弯,在外的管件主动产生驱动力带动在内的管件一同调弯的形式为外调弯。在实际实现过程中,两种形式存在各自的优势。本申请中,通过将主动运动的管件定义为调弯件40,被动协助调弯件40实现调弯的管件定义为内鞘管30,因为两者的远端侧相互固定,因此在附图中两者表现的整体性较强。
在本实施例中,调弯形式优选为内调弯。
在调弯件40的实现形式上,参考附图所示,调弯件40为套设在在内鞘管30的内部或外部的管件。在其他实施例中,调弯件40为设置在内鞘管30的内部或外部的杆件或拉线。具体的,介入器械输送组件还包括调弯拉线,所述调弯拉线远端固定至内鞘管的远端,调弯线在内鞘管延伸至手柄。
介入器械90除了受牵拉线21的约束外,还可以通过管件约束。参考一实施例中,介入器械90输送组件还包括外鞘管50,外鞘管50滑动套设在调弯件40外部,外鞘管50与介入器械90相对运动以收纳或释放介入器械90,牵拉线21在线控管20的约束下控制介入器械90的释放。
外鞘管50能够通过自身相对内芯10的运动来实现对介入器械90的包裹或者释放的切换。在上文中牵拉线21的配合下,外鞘管50还能实现对介入器械90的回收,从而实现介入器械90的释放过程全程可控。
参考一实施例中,介入器械90输送组件还包括护套管,护套管套设在外鞘管50的外部,用于建立介入通道。护套管建立的稳定通道能够为治疗过程提供稳定的环境,在本申请中,护套管并不是改进的重点,因此在附图以及文字描述中不再赘述。
本申请还公开了一种介入器械的输送系统,包括上述技术方案中的输送组件和用于驱动输送组件的控制手柄,输送组件的内鞘管、内芯、牵拉线分别延伸至控制手柄,在控制手柄的驱动下相对运动。
参考一实施例中,控制手柄60,具有相对的远端和近端,用于驱动多个受控部件彼此相对运动,手柄包括支撑体61以及安装于支撑体61的多套连接组件,相对于支撑体61,各连接组件分为固定设置和活动设置,其中活动设置的连接组件按照传动方式包括螺纹传动、齿轮齿条传动、以及直接传动,且各传动方式的连接组件由远端至近端依次设置。
受控部件可以都是管件,且内外相互嵌套,也可以是并非管件形式,仅仅是向近端延伸至控制手柄而已,受控部件既可以相对于控制手柄都可以运动,还可以是其中一者或多者相对控制手柄固定设置。
螺纹传动、齿轮齿条传动、以及直接传动各有优势,在控制手柄60的由远端至近端依次设置能够配合各管件的不同运动需求以及控制手柄60的空间结构实现结构优化,从而在控制手柄60体积一定的前提下,提高各受控部件的驱动效果,下面将结合具体结构展开阐释。
在整体布局上,参考一实施例中,控制手柄60在轴向上分为位于远端侧的螺纹配合区62和位于近端侧的齿轮齿条配合区63,采用螺纹传动和齿轮齿条传动的连接组件分别设置在相应的配合区。
螺纹配合和齿轮齿条配合的特点在于能够提供稳定的传动比例,尤其在受控部件需要精准控制的情况中。螺纹配合的优势在于能够在控制手柄60的周向上实现旋转,从而节约手柄周向空间,但是对轴向空间有一定的要求;相应的,齿轮齿条配合的优势在于能够节约手柄的轴向空间,但是对周向空间有一定的要求。本实施例中通过两种配合形式的优缺点互补,优化了控制手柄60的布局形式,从而在保证驱动效果的前提下优化的控制手柄60的布局。在具体产品中,螺纹配合区62的轴向长度与控制手柄60轴向长度的比值大于等于0.4。进一步优选螺纹配合区62的轴向长度与控制手柄60轴向长度的比值大于等于0.55。
在螺纹配合区62具体设置上,参考一实施例中,螺纹配合区62设有至少两套连接组件,且在控制手柄的轴向上依次设置。如果考虑固定设置的连接组件,螺纹配合区62可视为间隔分布,但就整体而言设置了两套连接组件,即两套螺纹连接组件621,螺纹连接组件621能够提高手柄的周向空间的利用效果,结合操作人员的人体工学,在手柄的远端侧布置多组螺纹连接组件621能够提供更好的操作体验。各螺纹连接组件621在控制手柄60的轴向上依次设置配合各受控部件轴向套设的结构,能够更容易的实现各受控部件的驱动。
在具体部件的配合上,参考一实施例中,螺纹传动的连接组件(也称螺纹连接组件621)包括:
转动套设在支撑体61外周的驱动环622;
滑动安装于支撑体61的夹持件625,夹持件625用于与受控部件相连,夹持件625的外周与驱动环622的内周面之间螺纹配合。
相应的,驱动环622的外表面设有供操作人员握持的摩擦面。驱动环622作为主动部件,转动安装在支撑体61上,实 现对夹持件625的驱动。支撑体61可以设置轴向滑槽,夹持件625滑动设置在轴向滑槽内,夹持件625至少局部带有外螺纹结构,与驱动环622传动配合。夹持件625主要是用于固定受控部件的近端,在受控部件为管件时,优选与管件密封对接。
各受控部件在运动至合适位置后需要定位,以免受其他操作影响。参考一实施例中,支撑体61外周滑动套设有定位环623,各驱动环622具有与定位环623相互卡合的定位状态以及相互脱离的自由状态;定位状态下,定位环623限制所述驱动环622的旋转。
定位环623可以设置为滑动安装在支撑体61上的结构,能够通过自身位置变化来实现对驱动环622的定位或释放。
不难理解的,定位环623在支撑体61上滑动的同时应该避免自身相对支撑体61的旋转。该结构可以通过在支撑体61上设置导向滑槽/滑轨来实现。定位环623与滑槽/滑轨的配合可以设置为过盈配合,以保证两者之间的摩擦力,避免定位环623对驱动环622的约束力失效或者导致意外锁定影响操作人员进行治疗过程。
参考附图所示的实施例中,驱动环622朝向定位环623的一侧设有定位齿624,驱动环622位于定位状态时与定位齿624啮合。该设置的优势在于能够在实现定位环623功能的同时减小对于驱动环622运动过程的影响,同时优化控制手柄60上各部件的布局。
定位环623可以设置为一个或多个。相应的,各驱动环622可以共用或者分别设置定位环623。具体的设置方式可以根据使用工况或者位置关系来调整。例如,参见参考附图所示的实施例中,在控制手柄60的轴向上,定位环623设置在各螺纹连接组件621之间。更具体的来看,定位环623设置在各螺纹连接组件621的驱动环622之间。定位环623设置在多个驱动环622能够为单个定位环623锁止多个驱动环622提供结构基础,也能够优化布局布局。不过附图所示的方案中,在图示的实施例中,各驱动环622分别使用独立的定位环623实现锁定。即定位环623设有至少两个。各驱动环622分别设置定位环623的优势在于能够避免两者之间的干涉,能够实现更为灵活的治疗过程。
在介入治疗过程中,受控部件以管件为例,管件内要按需排气,参考一实施例中,控制手柄60内设有排气组件64且作为固定设置的连接组件,相应的受控部件近端连通并固定至所述排气组件。在图示的实施例中,排气组件64与内鞘管30固定连接。
各管件均与排气组件64受控连通以排出管件内的空气。排气组件64常采用注入液体(例如生理盐水)的方式来实现排空,在具体设置上,可以通过各管件管壁开孔、并结合相对运动来实现单个排气组件对各管件的排空。各管件共用一排气组件64的形式能够有效避免排气组件64的反复设置,提高控制手柄60内的部件利用。
本申请中的关于排气组件64的重点在于排气组件64的布局。定位环623只需要使用控制手柄60的周向空间,因此在控制手柄60的内部可以设置相应的结构。参考一实施例中,在控制手柄60的轴向上,排气组件64与定位环623对齐。定位环623和排气组件64的同轴切面设置,能有有效利用控制手柄60各维度上的空间,实现立体布局。如上文所述,定位环623的数量可能会增加,当定位环623数量增加时,各定位环623之间的间隙能够位设置排气组件64的注液口提供方便。参考一实施例中,定位环623设有至少两个,排气组件64包括用于排气的注液口,注液口经由相邻的两个定位环623之间延伸至控制手柄60外部。
齿轮齿条配合区63的连接组件即齿轮连接组件631,设置于支撑体61靠近近端侧的一端。齿轮连接组件631能够提高手柄的轴空间的利用效果,结合操作人员的人体工学,在手柄的近端侧布置齿轮连接组件631能够提供更好的操作体验。同时齿轮连接组件631在周向空间上的结构能够提高操作人员对于上文中的螺纹连接组件621的驱动,两者相互配合,进一步改善操作体验。
在齿轮连接组件631的具体部件上,参考一实施例中,齿轮连接组件631包括:
在支撑体61的轴向上运动的齿条634,齿条634用于与受控部件相连;
以及转动安装在支撑体61上且与齿条634啮合的齿轮635。
在本实施例中,齿轮635作为主动部件,能够驱动齿条634运动从而实现对于受控部件的驱动。其中齿轮635至少一部分延伸至支撑体61外部或设有延伸至支撑体61外部的相应结构。以便于操作和装配,也可充分利用支撑体的外周空间,提高空间利用率。
在实际结构中,齿条634也可以设有相应的结构以提高与受控部件的配合。参考一实施例中,受控部件与齿轮的连接方式为在支撑体内还设有:
基座632,滑动安装在所述支撑体61内部,且齿条634固定设置在基座632上;
夹持底座633,固定安装在所述基座632上且用于密封连接对应的受控部件。
基座632的作用在于提供稳定的运动关系约束,夹持底座633能够实现对于受控部件的定位以及驱动力的施加,齿条634用于承受来自齿轮635的驱动力。
与上文中螺纹连接组件621同理的,各受控部件在运动至合适位置后需要定位,以免因为其他操作影响。参考一实施例中,齿轮635和支撑体61之间设有限制两者相对位置的连接锁定机构637。连接锁定机构637用于定位齿轮635的转动状态,从而通过齿轮635-齿条634的传动关系实现对于对应受控部件的定位效果。在具体结构上,连接锁定机构637包括:
第一锁齿6371,设置在齿轮635上;
第二锁齿6372,设置在支撑体61上,
保持组件6373,将第一锁齿6371和第二锁齿6372保持的啮合状态;
齿轮635能够在自身轴向上相对支撑体61滑动以实现第一锁齿6371和第二锁齿6372啮合或者分离。
齿轮635在滑动的过程中因时刻保持与齿条634的啮合关系,因此从某种意义上来理解,齿条634的啮合宽度大于齿轮635的啮合宽度。
其中保持组件6373的作用在于确保齿轮635与支撑体61的相对位置,从而维持锁定的效果。在具体结构上,保持组件6373包括:
两个卡接柱6374,能够在齿轮635的径向上靠近或远离;
卡接槽6375,设置在支撑体61上;
当两卡接柱6374运动至预设状态时能够越过卡接槽6375的约束从而释放齿轮635相对支撑体61的滑动。
保持组件6373实际上起到一个二道锁的作用,确保连接锁定机构637工作的稳定性。进一步的,保持组件6373还包括复位件6376,复位件6376设置于两个卡接柱6374之间且用于驱动两卡接柱6374与卡接槽6375配合以限制齿轮635相对支撑体61的滑动。
上文中阐释的是连接锁定机构637设置在齿轮635上的设置方式,参考一实施例中,齿轮635联动有径向延伸至支撑体61外部的驱动部636。不难理解的,当齿轮635上设有联动的驱动部636时,连接锁定机构637也可以等效设置于驱动部636上,具体结构同理,在此不再赘述。
参考一实施例中,支撑体61包括位于远端的内骨架和位于近端的支撑筒638,齿条634和齿轮635收容在支撑筒内,齿轮635上联动有延伸至支撑筒外部的驱动部636。
参考一实施例中,驱动部636相对于支撑体61活动配合,且具有与支撑体61相互卡合的锁定位置,以及解除卡合的工作位置,连接锁定机构还包括作用在支撑体61和驱动部636之间的保持组件,保持组件用于将驱动部636限制在锁定位置。
支撑筒的局部径向延伸形成外凸部,驱动部636设置在外凸部的外部并与齿轮635联动,连接锁定机构作用在驱动部636和外凸部之间。驱动部636整体上为一空心的旋钮,且罩设于外凸部。
驱动部636的一部分绕置在外凸部的外周,驱动部636该部分的内壁与外凸部的外壁之间设有能够相互卡合的锁齿;例如包括:
第一锁齿6371,设置在齿轮635上;
第二锁齿6372,设置在外凸部上。
驱动部636相对于支撑体61滑动配合以切换锁定位置和工作位置,齿轮635与驱动部636固定连接,且在驱动部636切换位置过程中,齿轮635始终保持与齿条634的啮合。
驱动部636的旋转轴与齿轮635的旋转轴共线,且大致沿控制手柄的径向延伸,驱动部636切换位置时的滑动方向与驱动部636的旋转轴方向一致。
结合上文不难理解,齿轮齿条是相互的传动关系,因此连接锁定机构637还可以设置在齿条634上。即,齿条634和支撑体61之间设有限制两者相对位置的连接锁定机构637。在该方案中,连接锁定机构637包括:
锁销6377,安装在支撑体61上且能够在支撑体61的径向上滑动;
插孔6378,设置在齿条634上且当自身与锁销6377对正时实现齿条634和支撑体61的锁定。
当锁销6377与插孔6378配合时,在支撑体61的轴向上,齿条634和支撑体61的相对位置确定,从而实现连接锁定机构637的功能。与上文中的卡接柱6374同理的,此处也可以设置相应的保持组件6373。此处的保持组件6373可以采用自夹持的夹持件来实现对锁销6377的夹持,具体结构可以参见附图7f所示,本领域技术人员可以清楚的理解,在此不再赘述。
除了上文中提到了的螺接配合以及齿轮齿条配合外,参考一实施例中,受控部件中的至少一者延伸出控制手柄60的近端侧以实现直接传动。直接传动的优势在于传动直接,能够方便的实现受控部件的运动,尤其是对于运动精度不高的情况下。本实施例中通过将直接传动设置在控制手柄60的近端侧,充分利用了控制手柄60的近端侧的轴向空间以及受控部件轴向设置的结构特点。
受控部件为多根管件时,管件中处在最内层的一根可延伸出控制手柄60的近端侧以实现直接传动,当然为了保持预定位置,在手柄近端可设置定位机构65,并作为直接传动的连接组件,定位机构可锁紧或释放受控部件,释放后的受控部件采用直接传动。
在其他实施例中,还公开了一种控制手柄60,具有相对的远端和近端,用于驱动五个受控部件(下文以内外套设的五根管件为例)彼此相对运动,控制手柄包括支撑体以及安装于支撑体的多套连接组件,各连接组件包括为由远端至近端依次设置的五套连接组件、且依次采用螺纹传动、固定设置、螺纹传动、齿轮齿条传动和直接传动;
受控部件包括外鞘管、内鞘管、调弯件、牵拉线和内芯,五者近端依次联动至控制手柄中的五套连接组件。
受控部件中外鞘管、内鞘管、调弯件、牵拉线(近端为线控管20)和内芯由外而内依次布置,且依次采用螺纹传动、固定设置、螺纹传动、齿轮齿条传动和直接传动,
内鞘管和调弯件径向位置互换时,各自的驱动方式不变,但在控制手柄处的轴向位置互换。
其中:
外鞘管50,滑动套设在调弯件40外部,外鞘管50与内鞘管30相对运动以释放介入器械90;
内鞘管30的远端部位固定有锁座31;
内芯10滑动设于内鞘管30中,内芯10的一端为伸出内鞘管30远端的延伸段11,延伸段11上设有与锁座31配合的锁件13,内芯10和内鞘管30两者的径向间隙为供牵拉线21穿设的穿引通道12,锁件13用于约束牵拉线21的运动状态;
所述牵拉线自身或通过与牵拉线相固定的线控管20,从穿引通道向控制手柄延伸,用以控制介入器械90的释放过程,即滑动设于内鞘管30和内芯10之间;
调弯件40,设置在内鞘管30的内部,调弯件40与内鞘管30两者的远端部位相互固定,近端处滑动配合以实现内鞘管30在远端侧的调弯;
外鞘管50,滑动套设在调弯件40外部,外鞘管50与内芯10相对运动以释放介入器械90,牵拉线21在线控管20的约束下控制介入器械90的释放过程。
在本实施例中,各管件如下设置:
内芯10采用直接传动的方式,近端侧延伸至控制手柄60的近端侧的轴向端面;
线控管20采用齿轮齿条配合,近端侧延伸至控制手柄60的近端侧;
内鞘管30采用与控制手柄60固定连接,作为各管件运动的基准;
调弯件40和外鞘管50分别采用螺纹驱动方式,近端延伸至控制手柄60的远端侧。
其中内鞘管30和调弯件40的连接方式能够互换,根据两者套设关系不同适应性调整。
其中附图7a公开的实施例中,通过增加连接组件的数量还能够进一步增加管件的控制数量,提高集成程度。
结合附图6b公开的控制手柄60内的具体结构,示例性的阐述各管件的连接关系。
内芯10自远端至近端贯穿控制手柄60且自控制手柄的60的近端的端面延伸,控制手柄的近端与内芯10的外周面密封配合。操作人员能够通过内芯10延伸出控制手柄的60的近端的端面的部分实现对内芯的直接驱动;
线控管20套设在内芯10的外周且近端延伸至控制手柄的60的近端,通过齿轮齿条配合的形式与控制手柄的60的近端连接,其中齿轮连接组件中的夹持底座与线控管20的外周密封连接,夹持底座将齿条的运动传递至线控管20;
调弯件40设置在线控管20的外周且近端延伸至控制手柄的60的近端靠近中部的位置,通过螺纹配合的形式与控制手柄的60连接,其中该螺纹连接组件的夹持件与调弯件40密封配合,该夹持件用于将螺纹驱动力传递至调弯件40;
内鞘管30套设在调弯件40的外周且近端延伸至控制手柄的60的中部的位置,通过固定连接的形式控制手柄的60连接,其中控制手柄60的中部设有固定的夹持装置,该夹持装置与内鞘管30密封固定连接从而确定内鞘管30和控制手柄60的相对位置;
外鞘管50套设在内鞘管30的外周且近端延伸至控制手柄的60的远端的位置,通过螺纹配合的形式与控制手柄的60连接,其中该螺纹连接组件的夹持件与外鞘管50密封配合的,该夹持件用于将螺纹驱动力传递至外鞘管50。
上述连接方式中,调弯件40与内鞘管30两者的远端部位相互固定,当其中一者的近端侧收到作用力时,会导致两者的远端产生弯曲的趋势,从而产生输送组件的远端整体调弯。在产品设计中,在内的管件主动产生驱动力带动在外的管件一同调弯的形式为内调弯,在外的管件主动产生驱动力带动在内的管件一同调弯的形式为外调弯。在实际实现过程中,两种形式存在各自的优势。本申请中,通过将主动运动的管件定义为调弯件40,被动协助调弯件40实现调弯的管件定义为内鞘管30,因为两者的远端侧相互固定,因此在附图中两者表现的整体性较强。在本实施例中,调弯形式优选为内调弯。
附图7c公开的控制手柄60实施例与上述同理,区别在于齿轮连接组件设置两套,处在最近端的一套可以用来驱动内芯10或其他需要运动的部件,其余部分本领域技术人员能够根据本申请的描述清楚的了解各管件与控制手柄60内各部件的连接关系,在此不再赘述。
综上所述,本申请还公开了可线控操作的输送系统,包括介入器械90输送组件和控制手柄60,输送系统具有相对的远端和近端,控制手柄60用于驱动介入器械90输送组件内的受控部件彼此相对运动,受控部件包括:
外鞘管50;
内鞘管30,滑动设在外鞘管内部,外鞘管与内鞘管相对运动以释放介入器械,内鞘管30的远端部位固定有锁座31;
内芯10,滑动设于内鞘管30中,内芯10的一端为伸出内鞘管30远端的延伸段11,延伸段11上设有与锁座31配合的锁件13,内芯10和内鞘管30两者的径向间隙为供牵拉线21穿设的穿引通道12,锁件13用于约束牵拉线21的运动状态;
牵拉线,牵拉线自身或通过与牵拉线相固定的线控管,从穿引通道向控制手柄延伸,用以控制介入器械的释放过程;
介入器械90在装载状态下,牵拉线21延伸出内鞘管30远端,绕经介入器械90后被束缚至锁件13,锁件13与锁座31插接配合限制牵拉线21脱离束缚。
本实施例的控制手柄60,可根据管件的具体布置采用前文相应实施例中的控制手柄。下面结合附图具体阐释可线控操作的输送系统的工作过程,当介入器械90输送至人体内时,参考附图8a至附图8c,通过调弯件40的运动,能够实现输送组件的远端在人体内的调弯,从而实现介入过程。
当介入器械90输送至靶点附近时,参考附图9a至附图9b,通过后撤外鞘管50能够实现介入器械90的初步释放,其中附图9a为半释放状态,即外鞘管50后撤一半,此时如果出现意外情况,能够通过外鞘管50前行来实现介入器械90的回 收。
当外鞘管50后撤完成后,参考附图9b,介入器械90已经完全脱离外鞘管50的束缚但是近端依旧受到牵拉线21的约束,此时如果出现意外情况,操作人员依旧可以通过线控管20对于牵拉线21的驱动实现介入器械90的回收。
当介入器械90释放过程顺利时,参考附图9c,通过内鞘管30和和芯管的相对运动实现锁件13与锁孔311的脱离,牵拉线21被释放,此时介入器械90和输送组件分离,后撤输送组件,完成介入过程。
本申请还公开了一种介入系统,包括介入器械和输送组件,介入器械包括:环形部71,环形部71为径向可形变结构,环形部71在自身轴向上的两端分别为第一端711和第二端712,其中第一端711的边缘沿环形部71周向包括依次布置的多个单元段713;
多个引导部72,沿环形部71周向依次间隔布置,各引导部72的一侧连接至对应的一单元段713,各引导部72的另一侧形状逐渐收敛至末端721,且在末端721带有穿线环722;
输送组件包括:
内鞘管,具有相对的远端和近端;
锁座,连接于内鞘管的远端部位;
内芯,滑动设于内鞘管中,内芯的一端为伸出内鞘管远端的延伸段,内芯和内鞘管两者的径向间隙为穿引通道;
锁件,固定于内芯的延伸段,且处在锁座的远端侧;
牵拉线,活动设置在穿引通道内,介入器械在装载状态下,牵拉线延伸出内鞘管远端,绕经介入器械的穿线环722后被束缚至锁件,锁件与锁座插接配合限制牵拉线脱离束缚。
在另一实施例中,本申请还提供另一种控制手柄,如图7h~图7j所示,具有相对的远端和近端,用于驱动多个受控部件彼此相对运动,手柄包括支撑体61以及安装于支撑体61的多套连接组件,相对于支撑体61,各连接组件分为固定设置和活动设置,其中活动设置的连接组件按照传动方式包括螺纹传动、齿轮齿条传动、以及直接传动,且各传动方式的连接组件由远端至近端依次设置。
受控部件可以都是管件,且内外相互嵌套,也可以是并非管件形式,仅仅是向近端延伸至控制手柄而已,受控部件既可以相对于控制手柄都可以运动,还可以是其中一者或多者相对控制手柄固定设置。
螺纹传动、齿轮齿条传动、以及直接传动各有优势,在控制手柄60的由远端至近端依次设置能够配合各管件的不同运动需求以及控制手柄60的空间结构实现结构优化,从而在控制手柄60体积一定的前提下,提高各受控部件的驱动效果,下面将结合具体结构展开阐释。
其中控制手柄60在轴向上分为位于远端侧的螺纹配合区62和位于近端侧的齿轮齿条配合区63,采用螺纹传动和齿轮齿条传动的连接组件分别设置在相应的配合区。
螺纹配合和齿轮齿条配合的特点在于能够提供稳定的传动比例,尤其在受控部件需要精准控制的情况中。螺纹配合的优势在于能够在控制手柄60的周向上实现旋转,从而节约手柄周向空间,但是对轴向空间有一定的要求;相应的,齿轮齿条配合的优势在于能够节约手柄的轴向空间,但是对周向空间有一定的要求。本实施例中通过两种配合形式的优缺点互补,优化了控制手柄60的布局形式,从而在保证驱动效果的前提下优化的控制手柄60的布局。在具体产品中,螺纹配合区62的轴向长度与控制手柄60轴向长度的比值大于等于0.4。进一步优选螺纹配合区62的轴向长度与控制手柄60轴向长度的比值大于等于0.55。
本实施例中,螺纹配合区62设有一套螺纹连接组件621,其包括:
转动套设在支撑体61外周的驱动环622;
滑动安装于支撑体61的夹持件625,夹持件625用于与受控部件即外鞘管50相连,夹持件625的外周与驱动环622的内周面之间螺纹配合。
夹持件625带有安装孔,外鞘管50的近端插入至该安装孔,并受安装孔的孔壁夹持固定,当然也可以配合胶粘或紧固件等防止松动。
相应的,驱动环622的外表面设有供操作人员握持的摩擦面。驱动环622作为主动部件,转动安装在支撑体61上,实现对夹持件625的驱动。支撑体61可以设置轴向滑槽,夹持件625滑动设置在轴向滑槽内,夹持件625至少局部带有外螺纹结构,与驱动环622传动配合。夹持件625主要是用于固定受控部件的近端,在受控部件为管件时,优选与管件密封对接。
各受控部件在运动至合适位置后需要定位,以免受其他操作影响。参考一实施例中,支撑体61外周滑动套设有定位环623,驱动环622具有与定位环623相互卡合的定位状态以及相互脱离的自由状态;定位状态下,定位环623限制驱动环622的旋转。
定位环623可以设置为滑动安装在支撑体61上的结构,能够通过自身位置变化来实现对驱动环622的定位或释放。
不难理解,定位环623在支撑体61上滑动的同时应该避免自身相对支撑体61的旋转。该结构可以通过在支撑体61上设置导向滑槽/滑轨来实现。定位环623与滑槽/滑轨的配合可以设置为过盈配合,以保证两者之间的摩擦力,避免定位环623对驱动环622的约束力失效或者导致意外锁定影响操作人员进行治疗过程。
参考图7i所示驱动环622朝向定位环623的一侧设有定位齿624,驱动环622位于定位状态时与定位齿624啮合。该设置的优势在于能够在实现定位环623功能的同时减小对于驱动环622运动过程的影响,同时优化控制手柄60上各部件的 布局。
参考图7i~7m,齿轮齿条配合区63的连接组件即齿轮连接组件631,设置于支撑体61靠近近端侧的一端。齿轮连接组件631能够提高手柄的轴空间的利用效果,结合操作人员的人体工学,在手柄的近端侧布置齿轮连接组件631能够提供更好的操作体验。同时齿轮连接组件631在周向空间上的结构能够提高操作人员对于上文中的螺纹连接组件621的驱动,两者相互配合,进一步改善操作体验。
在齿轮连接组件631的具体部件上,参考一实施例中,齿轮连接组件631为一组,且设置于支撑体61靠近端侧的一端。齿轮连接组件631包括:
在支撑体61的轴向上运动的齿条634,齿条634上设有用于密封连接对应受控部件即线控管20的夹持底座633;
以及转动安装在支撑体61上且与齿条634啮合的齿轮635。
夹持底座633带有安装孔,线控管20的近端插入至该安装孔,并受安装孔的孔壁夹持固定,当然也可以配合胶粘或紧固件等防止松动。
在本实施例中,齿轮635作为主动部件,能够驱动齿条634运动从而实现对于受控部件的驱动。其中齿轮635至少一部分延伸至支撑体61外部或设有延伸至支撑体61外部的相应结构。以便于操作和装配,也可充分利用支撑体的外周空间,提高空间利用率。
在实际结构中,齿条634也可以设有相应的结构以提高与受控部件的配合。参考一实施例中,控制手柄60包括套设在支撑体近端的支撑筒638,受控部件与齿轮的连接方式为在支撑体61内还设有:
基座632,滑动安装在支撑筒638的内部,且齿条634固定设置在基座632上;
夹持底座633,安装在基座632上且用于连接线控管20的近端。
基座632的作用在于提供稳定的运动关系约束,夹持底座633能够实现对于线控管20的定位以及驱动力的施加,齿条634用于承受来自齿轮635的驱动力。
夹持底座633可固定安装在基座632上,还可以相对基座632略有轴向的活动余量,例如夹持底座633与基座632之间设有相互配合的导向结构(图7m中可见滑轨6321),引导夹持底座633轴向运动,且可限制径向脱离基座632,基座632上设有位于夹持底座633两侧的第一限位凸台6341和第二限位凸台6342,第一限位凸台6323和第二限位凸台6324之间的距离略大于夹持底座633,使得夹持底座633可小幅滑动,其中第二限位凸台6324采用弹性卡扣6322的方式,以便于夹持底座633的安装。
与上文中螺纹连接组件621同理的,各受控部件在运动至合适位置后需要定位,以免因为其他操作影响。参考一实施例中,齿轮635联动有径向延伸至支撑筒外部的驱动部636。驱动部636活动安装在支撑筒638上,具体包括驱动部636相对支撑筒638旋转以驱动齿轮635转动,以及驱动部636相对支撑筒638滑动且两者之间设置有限制驱动部636旋转的连接锁定机构637。
参考图7j~图7o,支撑筒638的局部径向延伸形成外凸部6382,驱动部636设置在外凸部6382的外部并与齿轮635联动。驱动部636整体上为一空心的旋钮,且罩设于外凸部6382。而连接锁定机构637包括:
第一锁齿6371,设置在驱动部636上;
第二锁齿6372,与第一锁齿6371配合并设置在外凸部6382上;
保持组件6373,将第一锁齿6371和第二锁齿6372保持的啮合状态以限制驱动部636的旋转。
齿轮635与驱动部636固定连接,并能够在自身轴向上相对支撑筒638滑动以实现第一锁齿6371和第二锁齿6372啮合或者分离。需要说明的是驱动部636的旋转轴与齿轮635的旋转轴共线,且大致沿控制手柄的径向延伸,驱动部636切换位置时的滑动方向与驱动部636的旋转轴方向一致。
齿轮635在滑动的过程中因时刻保持与齿条634的啮合关系,因此从某种意义上来理解,齿轮635在自身的滑动行程内始终与齿条634的啮合,实现的手段包括例如齿条634的啮合宽度大于齿轮635的啮合宽度。
在一实施例中,其中保持组件6373的作用在于确保驱动部636与外凸部6382的相对位置,从而维持锁定的效果。在具体结构上,保持组件6373包括:
两个卡接柱6374,滑动安装在驱动部636上,在齿轮635的径向上靠近或远离;
卡接块6381,设置在外凸部6382上;
复位件6376,设置在驱动部636内作用于两个卡接柱6374使得两者相互远离。
当两卡接柱6374相互远离时,卡接柱6374的端面相抵于卡接块6381的其中一端面,保持连接锁定机构637处于锁定或释锁的状态;当两卡接柱6374相互靠近时,卡接柱6374能够越过卡接块6381的约束从而实现连接锁定机构637的状态切换。
保持组件6373实际上起到一个二道锁的作用,确保连接锁定机构637工作的稳定性。
在一实施例中,齿轮635具有一与驱动部636连接的旋转轴6351,支撑筒638内固定设置有套设在旋转轴6351外的限位座6383,限位座6383能够相抵于齿轮635的端面,限制驱动部636和齿轮635脱离支撑筒638。
在一实施例中,导管组件还包括套设在外鞘管50外周的护套管51、套设在外鞘管50内的内鞘管30以及套设在线控管20内的内芯10。
支撑体61上固定安装有与内鞘管30固定连接的第一固定座611,第一固定座611在支撑体轴向上处在夹持件625和夹持底座633之间。支撑体61的近端滑动安装有与内芯10固定连接的滑动座612。
控制手柄60内设有排气组件64且作为固定设置的连接组件,相应的受控部件近端连通并固定至排气组件。护套管51的近端与排气组件64固定连接。
护套管51与外鞘管50两者径向间隙内的空气可通过排气组件64上的注液孔641,注入液体(例如生理盐水)的方式向远端排空。
还可以通过各管件管壁开孔、并结合相对运动来实现单个排气组件对各管件之间的排空。各管件共用一排气组件64的形式能够有效避免排气组件64的反复设置,提高控制手柄60内的部件利用。
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技术特征所有可能的组合都进行描述,然而,只要这些技术特征的组合不存在矛盾,都应当认为是本说明书记载的范围。不同实施例中的技术特征体现在同一附图中时,可视为该附图也同时披露了所涉及的各个实施例的组合例。
以上所述实施例仅表达了本申请的几种实施方式,其描述较为具体和详细,但并不能因此而理解为对申请专利范围的限制。应当指出的是,对于本领域的普通技术人员来说,在不脱离本申请构思的前提下,还可以做出若干变形和改进,这些都属于本申请的保护范围。

Claims (83)

  1. 人工心脏瓣膜支架,其特征在于,包括:
    环形部,所述环形部为径向可形变结构,所述环形部在自身轴向上的两端分别为第一端和第二端,其中第一端的边缘沿环形部周向包括依次布置的多个单元段;
    多个引导部,沿环形部周向依次间隔布置,各引导部的一侧连接至对应的一单元段,各引导部的另一侧形状逐渐收敛至末端,且在末端带有穿线环。
  2. 如权利要求1所述的人工心脏瓣膜支架,其特征在于,所述人工心脏瓣膜支架整体上基于径向形变、具有相对的压缩状态和释放状态,释放状态下,以环形部轴向为长度方向,所述引导部的长度为L1,所述环形部的长度为L2,且满足L1:L2=1:0.5~1.5。
  3. 如权利要求2所述的人工心脏瓣膜支架,其特征在于,L1:L2=1:0.6~1.2。
  4. 如权利要求2所述的人工心脏瓣膜支架,其特征在于,沿环形部的轴向,各引导部的一侧为与相应单元段对接的连接侧,相邻两引导部的连接侧彼此衔接。
  5. 如权利要求4所述的人工心脏瓣膜支架,其特征在于,释放状态下,所述引导部由连接侧至末端的收敛趋势为均匀收敛。
  6. 如权利要求5所述的人工心脏瓣膜支架,其特征在于,沿环形部周向,所述连接侧的长度为L3且满足L1:L3=0.5~1.5。
  7. 如权利要求1所述的人工心脏瓣膜支架,其特征在于,所述引导部为N处,N为2、3、4、5或6,各引导部的连接侧所对应的圆心角为360度/N。
  8. 如权利要求7所述的人工心脏瓣膜支架,其特征在于,各引导部沿环形部的周向均匀布置。
  9. 如权利要求1所述的人工心脏瓣膜支架,其特征在于,相邻两引导部之间为开口部位,压缩状态下,相邻两引导部在彼此贴靠闭合开口部位。
  10. 如权利要求1所述的人工心脏瓣膜支架,其特征在于,所述引导部以及所述环形部均具有镂空的单元格结构,沿环形部轴向,环形部中的单元格为多排,所述引导部以及所述环形部的交界部位由其中周向的一排单元格的顶点围成。
  11. 如权利要求10所述的人工心脏瓣膜支架,其特征在于,所述环形部的轴向长度为1~2.5个单元格。
  12. 如权利要求11所述的人工心脏瓣膜支架,其特征在于,所述引导部由环形部起沿环形部轴向延伸,延伸的路径先在环形部径向上外扩,至最大外径处后、再逐渐收敛。
  13. 如权利要求1所述的人工心脏瓣膜支架,其特征在于,所述引导部以及所述环形部均具有镂空的单元格结构,所述引导部中的单元格分为相对的稀疏区和稠密区,至少一部分所述稀疏区靠近相邻两引导部之间的开口部位。
  14. 如权利要求13所述的人工心脏瓣膜支架,其特征在于,稠密区的单元格面积为稀疏区的单元格面积的0.3~0.8倍。
  15. 如权利要求14所述的人工心脏瓣膜支架,其特征在于,稠密区的单元格面积为稀疏区的单元格面积的0.4~0.6倍。
  16. 如权利要求1所述的人工心脏瓣膜支架,其特征在于,相邻两引导部之间为开口部位,所述引导部中,邻近所述开口部位的为边缘框条,所述边缘框条的一端连接所述穿线环,所述边缘框条的另一端连接至所述环形部,所述边缘框条在延伸过程中与管状结构中的其他框条的交点不多于两个。
  17. 如权利要求16所述的人工心脏瓣膜支架,其特征在于,所述边缘框条在临近所述第一端处连接有分支框条,该分支框条与所述边缘框条分别连接至第一端上不同的单元格顶点。
  18. 如权利要求1所述的人工心脏瓣膜支架,其特征在于,所述穿线环在靠近所述环形部的一侧为与周边单元格共用的过渡段,所述过渡段为V形,且顶点朝向所述环形部;
    所述穿线环在远离所述环形部的一侧为牵拉段。
  19. 如权利要求18所述的人工心脏瓣膜支架,其特征在于,所述牵拉段和所述过渡段合围成一个或多个封闭空间。
  20. 如权利要求18所述的人工心脏瓣膜支架,其特征在于,所述穿线环的外接圆的半径大于等于所述穿线环的杆件的直径的两倍。
  21. 如权利要求1所述的人工心脏瓣膜支架,其特征在于,所述引导部包括四个区域,分别为:
    第一区域,设有所述穿线环;
    第二区域,沿环形部周向设置,所述第二区域与所述第一区域两者对正且作为所在引导部的中心区;
    第三区域和第四区域,沿环形部周向设置在所述中心区的两侧。
  22. 如权利要求21所述的人工心脏瓣膜支架,其特征在于,第二、第三和第四区域均仅设置一个单元格,各单元格的其中一顶点与所述环形部对接。
  23. 如权利要求21所述的人工心脏瓣膜支架,其特征在于,所述引导部由环形部起沿环形部轴向延伸,延伸的路径先在环形部径向上外扩,至最大外径处后、再逐渐收敛,所述最大外径处邻近所述第一区域和第二区域的交界部位。
  24. 如权利要求21所述的人工心脏瓣膜支架,其特征在于,沿着流出端方向,第一区域与第二区域之间连接有缝合柱。
  25. 如权利要求21所述的人工心脏瓣膜支架,其特征在于,所述第二区域中设置有第二单元格,所述第二单元格与瓣膜的联合固定。
  26. 如权利要求24或25所述的人工心脏瓣膜支架,其特征在于,第三、第四区域对称设置在所述中心区域的两侧。
  27. 如权利要求26所述的人工心脏瓣膜支架,其特征在于,所述第三、第四区域邻接第一、第二区域的单元格为第三单 元格,在引导部中的所有单元格中,第三单元格的面积最大。
  28. 如权利要求25所述的人工心脏瓣膜支架,其特征在于,第一区域的面积大于第二单元格的面积。
  29. 如权利要求1所述的人工心脏瓣膜支架,其特征在于,人工心脏瓣膜支架整体上为管状结构,该管状结构轴向的中部区域带有缩径的腰部。
  30. 如权利要求29所述的人工心脏瓣膜支架,其特征在于,所述引导部和所述环形部两者的交界部位处在所述腰部。
  31. 如权利要求30所述的人工心脏瓣膜支架,其特征在于,所述引导部和所述环形部两者的交界部位邻近所述腰部的最小外径处。
  32. 如权利要求29所述的人工心脏瓣膜支架,其特征在于,相邻两引导部之间为开口部位,开口部沿着远离环形部的方向径向向外扩口,形成一V形结构。
  33. 如权利要求1所述的人工心脏瓣膜支架,其特征在于,所述环形部包括多排单元格,沿着引导部方向,所述单元格的大小减缩。
  34. 如权利要求1所述的人工心脏瓣膜支架,其特征在于,所述环形部的第二端的一圈单元格中,各单元格为四边形,靠近第二端的两边比靠近第一端的两边更长。
  35. 一种人工心脏瓣膜装置,其特征在于,包括权利要求1~34任一项所述的人工心脏瓣膜支架,以及位于支架内的瓣叶,所述人工心脏瓣膜支架整体上为管状结构且内部为血流通道,所述瓣叶为多片,各瓣叶处在血流通道内相互配合以相对的开放或封闭血流通道。
  36. 如权利要求35所述的人工心脏瓣膜装置,其特征在于,所述瓣叶的边缘包括固定至人工心脏瓣膜支架的固定缘,以及与其他瓣叶相互配合控制血流通道的自由缘,按照所述瓣叶对血流的控制方向,所述第一端为流出侧,所述第二端为流入侧,其中所述固定缘的两端分别固定在相邻的两个引导部上,固定缘的中部延伸至所述环形部。
  37. 如权利要求36所述的人工心脏瓣膜装置,其特征在于,沿环形部轴向,所述引导部以及所述环形部的交界部位邻近所述瓣叶的自由缘位置。
  38. 如权利要求36所述的人工心脏瓣膜装置,其特征在于,相邻瓣叶之间通过联合部彼此相连并固定于所述支架,各联合部的位置处在对应的一个引导部中。
  39. 如权利要求38所述的人工心脏瓣膜装置,其特征在于,沿环形部周向,各引导部均具有自身结构的对称轴,相连两瓣叶的固定缘交汇于相应引导部的对称轴。
  40. 如权利要求36所述的人工心脏瓣膜装置,其特征在于,所述固定缘的中点邻近所述环形部的轴向中部。
  41. 如权利要求36所述的人工心脏瓣膜装置,其特征在于,所述人工心脏瓣膜支架的内侧带有内覆膜,所述内覆膜处在瓣叶的流入侧并与各瓣叶的固定缘对接。
  42. 如权利要求41所述的人工心脏瓣膜装置,其特征在于,所述内覆膜由瓣叶的固定缘延伸至所述环形部的第二端。
  43. 如权利要求41所述的人工心脏瓣膜装置,其特征在于,所述人工心脏瓣膜支架还设有处在瓣叶流入侧的防周漏部件。
  44. 如权利要求43所述的人工心脏瓣膜装置,其特征在于,所述防周漏部件固定在所述内覆膜的外侧,所述防周漏部件为间隔分布的块状且位置与管状结构的镂空区域对应。
  45. 如权利要求44所述的人工心脏瓣膜装置,其特征在于,所述防周漏部件与所述内覆膜为一体结构,膨胀状态下,所述防周漏部件外凸于所述支架的外周面。
  46. 如权利要求43所述的人工心脏瓣膜装置,其特征在于,所述内覆膜采用PET材质,所述防周漏部件采用PU材质。
  47. 如权利要求44所述的人工心脏瓣膜装置,其特征在于,所述管状结构具有环布多道单元格结构,同一块防周漏部件中,外凸最高的部位更加靠近所在单元格的流入侧。
  48. 如权利要求47所述的人工心脏瓣膜装置,其特征在于,同一块防周漏部件中,外凸高度最大处到所在单元格的流入侧之间距离为S1,外凸高度最大处到所在单元格的流出入侧之间距离为S2,其中S1:S2为0~0.8。
  49. 如权利要求44所述的人工心脏瓣膜装置,其特征在于,同一块防周漏部件中,由流出侧至流入侧逐渐增厚、至外凸最高的部位后再逐渐变薄。
  50. 一种介入器械的输送组件,其特征在于,包括:
    内鞘管,具有相对的远端和近端;
    锁座,连接于所述内鞘管的远端部位;
    内芯,滑动设于内鞘管中,所述内芯的一端为伸出内鞘管远端的延伸段,所述内芯和所述内鞘管两者的径向间隙为穿引通道;
    锁件,固定于所述内芯的延伸段,且处在所述锁座的远端侧;
    牵拉线组件,其远端为工作端,所述牵拉线组件活动设置在所述穿引通道内;
    介入器械在装载状态下,所述牵拉线组件的工作端延伸出内鞘管远端,绕经介入器械后被束缚至所述锁件,所述锁件与所述锁座插接配合限制所述牵拉线脱离束缚。
  51. 如权利要求50所述的介入器械的输送组件,其特征在于,所述锁座上设有与所述锁件配合的锁合部,锁定状态下所述锁件插入所述锁合部并约束所述牵拉线的活动范围。
  52. 如权利要求51所述的介入器械的输送组件,其特征在于,所述锁合部为锁孔或锁槽。
  53. 如权利要求52所述的介入器械的输送组件,其特征在于,所述锁件随所述内芯运动且具有如下位置:
    释放位置,所述锁件脱离所述锁孔以释放所述牵拉线工作端;
    锁定位置,所述锁件插入所述锁孔以约束所述牵拉线工作端。
  54. 如权利要求50所述的介入器械的输送组件,其特征在于,所述内芯的延伸段上设有安装座,所述锁件固定于所述安装座,且由所述安装座起向近端方向延伸;
    所述安装座上设有用于安装所述锁件的安装孔,所述锁件的远端插设固定在安装孔内,所述锁件的近端延伸出所述安装孔。
  55. 如权利要求52所述的介入器械的输送组件,其特征在于,所述锁件在所述内芯的周向上间隔设置有多个,所述锁孔与所述锁件对应设置。
  56. 如权利要求50所述的介入器械的输送组件,其特征在于,锁件在内芯的周向上均匀设置有至少三个。
  57. 如权利要求50所述的介入器械的输送组件,其特征在于,所述锁件为杆状。
  58. 如权利要求55所述的介入器械的输送组件,其特征在于,至少两个锁件由释放位置切换至锁定位置的行程不同。
  59. 如权利要求55所述的介入器械的输送组件,其特征在于,至少两个锁件的长度不同。
  60. 如权利要求50所述的介入器械的输送组件,其特征在于,所述牵拉线组件为从输送系统的手柄延伸的一条或多条牵拉线。
  61. 如权利要求50所述的介入器械的输送组件,其特征在于,所述牵拉线组件包括线控管和牵拉线,所述线控管活动套设在所述内芯的外部,所述牵拉线的一端为驱动端与所述线控管连接,所述牵拉线的另一端为工作端,介入器械在装载状态下,所述工作端绕经至介入器械后与所述锁件配合。
  62. 如权利要求61所述的介入器械的输送组件,其特征在于,所述线控管的近端相较于控制手柄活动设置。
  63. 如权利要求61所述的介入器械的输送组件,其特征在于,所述线控管活动套设在所述内芯和所述内鞘管之间。
  64. 如权利要求61所述的介入器械的输送组件,其特征在于,所述锁座上还设有引导孔,所述牵拉线由所述引导孔向外延伸。
  65. 如权利要求64所述的介入器械的输送组件,其特征在于,所述锁座包括由远端至近端依次连接的导向盘、连接套和固定盘,固定盘上设有锁孔,其中所述锁孔开设于所述固定盘,所述导向盘上开设有与锁孔位置对应的导向孔;
    所述锁件在锁定位置下贯穿所述导向孔,插入所述锁孔,所述锁件处在导向盘与固定盘中间的部位作为工作段,所述牵拉线的工作端被约束于该工作段。
  66. 如权利要求65所述的介入器械的输送组件,其特征在于,所述牵拉线延伸至固定盘远端侧的部分为控制介入器械释放程度的可控段,所述牵拉线的工作端被锁件约束状态下,该可控段的长度经由线控管的位置调整。
  67. 如权利要求66所述的介入器械的输送组件,其特征在于,所述引导孔和所述锁孔分别有多个,且在固定盘的周向上交替设置。
  68. 如权利要求50所述的介入器械的输送组件,其特征在于,所述牵拉线工作端绕经介入器械的方式为:
    所述牵拉线的工作端经由所述介入器械的自身结构后与所述锁件配合;或
    所述介入器械上设有连接件,所述牵拉线的工作端穿引过该连接件后与所述锁件配合。
  69. 如权利要求68所述的介入器械的输送组件,其特征在于,所述介入器械的自身结构内设有间隙或额外开设与所述牵拉线配合的穿引孔。
  70. 如权利要求69所述的介入器械的输送组件,其特征在于,所述介入器械上设有若干个连接耳,所述连接耳上开设有所述穿引孔。
  71. 如权利要求70所述的介入器械的输送组件,其特征在于,所述连接件为柔性的线环,所述线环依次穿过各个连接耳上的穿引孔。
  72. 如权利要求61所述的介入器械的输送组件,其特征在于,所述牵拉线的工作端设有配合环,所述锁件贯穿所述配合环以约束所述牵拉线;
    所述配合环为独立部件;或由所述牵拉线自身绕设形成。
  73. 如权利要求72所述的介入器械的输送组件,其特征在于,所述锁件为在各管件轴向上延伸的杆状,锁定位置下的锁件贯穿牵拉线绕设的内部以实现对牵拉线的约束。
  74. 如权利要求73所述的介入器械的输送组件,其特征在于,所述配合环的设置方式为以下至少一种:
    所述牵拉线由所述驱动端至所述工作端之间为单线结构,且该单线在工作端自身绕设形成所述配合环;
    或所述牵拉线为双线结构,且该双线在工作端折返,折返部位形成所述配合环;
    或牵拉线自身为多股编织结构形成,编织结构的间隙部位作为所述配合环。
  75. 如权利要求50所述的介入器械的输送组件,其特征在于,所述介入器械输送组件还包括线控管,所述线控管套设在所述内芯的外部,所述牵拉线的一端为驱动端,所述驱动端在所述线控管内向所述近端延伸并受控于控制手柄,所述牵拉线的另一端为工作端,介入器械在装载状态下,所述工作端绕经至介入器械后与所述锁件配合。
  76. 如权利要求75所述的介入器械的输送组件,其特征在于,所述线控管近端相较于所述控制手柄固定动设置。
  77. 如权利要求75所述的介入器械的输送组件,其特征在于,所述线控管的管壁内带有多个腔道,各牵拉线活动的穿引在对应的腔道内。
  78. 如权利要求50所述的介入器械的输送组件,其特征在于,所述介入器械输送组件还包括调弯件,所述调弯件设置在所述内鞘管的内部或外部,所述调弯件与所述内鞘管两者的远端部位相互固定,近端处滑动配合以实现所述内鞘管在远端侧的调弯。
  79. 如权利要求78所述的介入器械的输送组件,其特征在于,所述调弯件为管件、杆件、拉线中的至少一种;所述调弯件处在所述内鞘管的内部或外部。
  80. 如权利要求78所述的介入器械的输送组件,其特征在于,介入器械输送组件还包括外鞘管,外鞘管滑动套设在调弯件外部,外鞘管与介入器械相对运动以收纳或释放介入器械,牵拉线在线控管的约束下控制介入器械的释放。
  81. 如权利要求80所述的介入器械的输送组件,其特征在于,介入器械输送组件还包括护套管,护套管套设在外鞘管的外部,用于建立介入通道。
  82. 一种介入器械的输送系统,其特征在于,包括:
    权利要求50~81任一项所述的输送组件;
    和用于驱动所述输送组件的控制手柄,所述输送组件的内鞘管、内芯、牵拉线分别延伸至所述控制手柄,在所述控制手柄的驱动下相对运动。
  83. 一种介入系统,其特征在于,包括介入器械和输送组件,所述介入器械包括:
    环形部,所述环形部为径向可形变结构,所述环形部在自身轴向上的两端分别为第一端和第二端,其中第一端的边缘沿环形部周向包括依次布置的多个单元段;
    多个引导部,沿环形部周向依次间隔布置,各引导部的一侧连接至对应的一单元段,各引导部的另一侧形状逐渐收敛至末端,且在末端带有穿线环;
    所述输送组件包括:
    内鞘管,具有相对的远端和近端;
    锁座,连接于所述内鞘管的远端部位;
    内芯,滑动设于内鞘管中,所述内芯的一端为伸出内鞘管远端的延伸段,所述内芯和所述内鞘管两者的径向间隙为穿引通道;
    锁件,固定于所述内芯的延伸段,且处在所述锁座的远端侧;
    牵拉线组件,其远端为工作端,所述牵拉线组件活动设置在所述穿引通道内,介入器械在装载状态下,所述牵拉线延伸出内鞘管远端,绕经介入器械的穿线环后被束缚至所述锁件,所述锁件与所述锁座插接配合限制所述牵拉线脱离束缚。
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