CN113081169A - Intravascular device and vascular thrombus removal device - Google Patents
Intravascular device and vascular thrombus removal device Download PDFInfo
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- CN113081169A CN113081169A CN202110485668.XA CN202110485668A CN113081169A CN 113081169 A CN113081169 A CN 113081169A CN 202110485668 A CN202110485668 A CN 202110485668A CN 113081169 A CN113081169 A CN 113081169A
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22094—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for crossing total occlusions, i.e. piercing
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Abstract
The invention provides an intravascular device and a vascular thrombus extraction device, wherein the intravascular device comprises an expandable member, the expandable member comprises a plurality of net bag assemblies and a plurality of columnar assemblies, the net bag assemblies and the columnar assemblies are alternately arranged, each net bag assembly comprises at least one net bag unit, each columnar assembly comprises at least one columnar unit, the tail part of each net bag unit is provided with a plurality of extending bodies, the extending bodies are gathered at the same point towards the far end direction of the expandable member to form a net bag, and the tail part of each columnar unit is provided with a plurality of free bodies extending towards the far end of the expandable member. The design of the net bag unit increases the contact area with thrombus, can effectively capture the fallen thrombus, and the columnar unit is helpful for hooking the thrombus at the position of passing a curve in the blood vessel. And, by having the string bag assemblies alternate with the columnar assemblies in the axial direction, the expandable member's ability to deploy when tortuous blood vessels and the ability to capture thrombus are improved.
Description
Technical Field
The invention relates to the technical field of medical instruments, in particular to an intravascular instrument and a vascular thrombus extraction device.
Background
Acute Ischemic Stroke (CIS), also known as Cerebral Infarction (CI), is an Infarction of brain tissue due to occlusion of Cerebral arteries, accompanied by damage to neurons, astrocytes, and oligodendrocytes, and is the most important central nervous system vascular event leading to death and disability in modern society. Once ischemic stroke occurs, the vessel must be recanalized in a minimum amount of time. At present, there are two main treatment methods for intracranial thrombosis: drug thrombolysis and mechanical thrombus removal.
Venous thrombolysis is a currently accepted effective early treatment method for cerebral infarction, but the vascular recanalization rate of venous thrombolysis is limited for patients with large vessel occlusion, and the time window for venous thrombolysis is only 4.5 hours. It is important to rapidly open the "vital pathways" blocked by thrombus. For patients with acute stroke, it is critical to open blood vessels and restore cerebral blood supply. If the patient can not be in the effective time window, the blocked blood vessel is recanalized, and the brain tissue threatened by ischemic necrosis is saved, permanent brain function damage is caused, and the patient is disabled and even dies.
There are two main ways of mechanical embolectomy: one is stent embolectomy and the other is suction catheter based devices, which can be combined. The stent thrombus is taken out by entering an embolism position through a micro catheter system, capturing the thrombus at the embolism position after releasing, and then recovering through the micro catheter. The most popular device at present is the blood flow reconstruction device Solitaire manufactured by Medtronic corporation, which is a stent-like expandable cage. The device expands to 4mm and 6mm in diameter when released, and is selected for clinical use.
However, the existing mechanical bolt-removing system has the following defects:
(1) the blood vessel of cerebral vessels is tortuous, the existing embolectomy system is difficult to unfold when passing through a tortuous section, and the phenomenon of deflation occurs, so that the thrombus is extruded, crushed and falls off;
(2) at present, most of thrombus taking systems have no protection devices and can not capture fallen thrombus;
(3) most of the current thrombus taking systems are of a support structure, the axial direction is cylindrical, the axial contact area with thrombus is insufficient, and the thrombus taking effect is influenced.
Disclosure of Invention
The purpose of the present invention is to provide an intravascular device and a vascular thrombus removal device that can not only improve the thrombus capture capability, but also improve the deployment capability of an expandable member during the bypass of a blood vessel, reduce the occurrence of a collapse, and effectively reduce the breakage and detachment of a thrombus.
In order to achieve the above object, the present invention provides an intravascular device, including an expandable member, where the expandable member includes a plurality of string bag assemblies and a plurality of column assemblies, the string bag assemblies and the column assemblies are alternately arranged along an axial direction of the expandable member, each string bag assembly includes at least one string bag unit, each column assembly includes at least one column unit, a tail of the string bag unit has a plurality of extending bodies, the extending bodies are gathered at a same point toward a distal direction of the expandable member to form a string bag, and a tail of the column unit has a plurality of free bodies extending toward a distal end of the expandable member.
Optionally, the distal end of the expandable member is the tuck net unit.
Optionally, the adjacent string bag units are connected with the columnar units through at least two connection points.
Optionally, the connection point between the upper pair of adjacent string bag units and the column unit and the connection point between the lower pair of adjacent string bag units and the column unit are distributed along the axial projection of the expandable member in a staggered manner.
Optionally, the string bag unit reaches the column unit all includes a plurality of first meshs, and is adjacent the string bag unit reaches form a plurality of second meshs between the column unit, the size of second meshs is greater than the size of first meshs.
Optionally, the free body extends in an axial direction parallel to the expandable member, and a free end of the free body is bent inwardly in a direction closer to the axis of the expandable member.
Optionally, many the department cover that gathers together of extension body is equipped with first development spring, the tip cover of free body is equipped with second development spring, and is same second development spring on the many free bodies of column unit afterbody is followed the circumference dislocation distribution of expandable component.
Optionally, the intravascular device further includes two visualization wires, the proximal end of the expandable member is provided with two first stent ribs, the distal end of the expandable member is provided with two second stent ribs, and the two visualization wires are respectively wound to the second stent ribs along the axial direction of the expandable member by the first stent ribs.
Optionally, the intravascular device further includes a developing ring and a third developing spring, one end of the developing wire and the two first support ribs are inserted into the developing ring and fixed together, and the other end of the developing wire and the two second support ribs are inserted into the third developing spring and fixed together.
Optionally, the portions of the two first stent ribs located in the developing ring are fixed by a pin, one of the first stent ribs is provided with a fixing hole, and one end of a delivery guide wire is bent in a direction away from the expandable member after passing through the fixing hole.
Optionally, the winding directions of the two developing wires are opposite, wherein one developing wire is wound clockwise, and the other developing wire is wound counterclockwise.
Optionally, a film covers the string bag, and a plurality of through holes are densely distributed in the film.
Optionally, the film is made of PTFE, PU or PET.
Based on the above, the invention also provides a vascular thrombus extraction device, which comprises a delivery guide wire, an introduction sheath and the intravascular device, wherein the proximal end of the intravascular device is connected with the delivery guide wire, and the intravascular device and the delivery guide wire are sleeved in the introduction sheath.
In the intravascular instrument and the vascular thrombus extraction device provided by the invention, the closed tuck net-shaped design at the tail part of the tuck net unit is different from the cylindrical design of the columnar unit, so that the contact area between metal and thrombus is increased, the dropped thrombus can be effectively captured by a tuck net structure formed at the tail part, and the columnar unit is not provided with the tuck net, so that the thrombus can be hooked at the overbending part in the blood vessel. In addition, the net bag assemblies and the columnar assemblies are alternately arranged along the axial direction of the expandable component, so that the capturing capacity of the thrombus can be improved, the expansion capacity of the expandable component during tortuous blood vessels can be improved, the occurrence of the phenomenon of suffocation is reduced, and the breakage and falling of the thrombus are effectively reduced.
Drawings
It will be appreciated by those skilled in the art that the drawings are provided for a better understanding of the invention and do not constitute any limitation to the scope of the invention. Wherein:
FIG. 1 is a schematic perspective view of an intravascular device provided according to an embodiment of the present invention;
FIG. 2 is a schematic diagram of a distribution of connection points provided in an embodiment of the present invention;
FIG. 3 is a schematic plan view of an intravascular device provided in accordance with an embodiment of the present invention;
FIG. 4 is a schematic view of a delivery guidewire coupled to an expandable member according to an embodiment of the present invention;
wherein the reference numerals are:
10-a string bag unit; 11-an extension; 20-columnar units; 21-free body; 31-a first connection point; 32-a second connection point; 41-a first developing spring; 42-a second developing spring; 50-developing silk; 61-first support ribs; 62-second bracket ribs; 70-a developing ring; 80-pins; 90-delivery of guidewire.
Detailed Description
To further clarify the objects, advantages and features of the present invention, a more particular description of the invention will be rendered by reference to specific embodiments thereof which are illustrated in the appended drawings. It is to be noted that the drawings are in greatly simplified form and are not to scale, but are merely intended to facilitate and clarify the explanation of the embodiments of the present invention. Further, the structures illustrated in the drawings are often part of actual structures. In particular, the drawings may have different emphasis points and may sometimes be scaled differently. It should be further understood that the terms "first," "second," "third," and the like in the description are used for distinguishing between various components, elements, steps, and the like, and are not intended to imply a logical or sequential relationship between various components, elements, steps, or the like, unless otherwise indicated or indicated.
Referring to fig. 1, the present embodiment provides an intravascular device, including an expandable member, where the expandable member includes a plurality of string bag assemblies and a plurality of column assemblies, the plurality of string bag assemblies and the plurality of column assemblies are alternately arranged along an axial direction of the expandable member, each string bag assembly includes at least one string bag unit 10, each column assembly includes at least one column unit 20, a tail of the string bag unit 10 has a plurality of extending bodies 11, and the plurality of extending bodies 11 are gathered at a same point toward a distal direction of the expandable member to form a string bag, a tail of the column unit 20 has a plurality of free bodies 21, and the free bodies 21 are parallel to the axial direction of the expandable member and extend toward a distal end of the expandable member.
In particular, the expandable member is configured to engage a thrombus upon release to facilitate capture of the thrombus. In this embodiment, the expandable member may be cut from nitinol tubing or braided from nitinol wires to form a plurality of tuck net assemblies and a plurality of columnar assemblies.
In this embodiment, each of the string bag assemblies includes one string bag unit 10, and each of the column assemblies includes one column unit 20. It should be understood that one string bag assembly may further include 2 or more string bag units 10, and one column assembly may also include 2 or more column units 20, which should not be construed as limiting the present application.
In this embodiment, the distal end of the expandable member is the string bag unit 10.
The closed string bag shape design of afterbody of string bag unit 10 is different from the cylinder design of column unit 20, has increased the area of contact of metal with the thrombus, and the string bag structure that the afterbody formed can effectively catch the thrombus that drops, and column unit 20 does not have the string bag, helps crossing the bend and hook the thrombus in the blood vessel. In addition, the net bag assemblies and the columnar assemblies are alternately arranged along the axial direction of the expandable component, so that the capturing capacity of the thrombus can be improved, the expansion capacity of the expandable component during tortuous blood vessels can be improved, the occurrence of the phenomenon of suffocation is reduced, and the breakage and falling of the thrombus are effectively reduced.
In this embodiment, the ratio of the wall thickness to the rib width of the expandable member is 7: 4-7: 6, and a larger wall thickness can increase the contact area with the thrombus, improve the thrombus supporting capability, and enhance the embedding capability of the thrombus by a relatively thin rib width.
In this embodiment, the tail of each string bag unit 10 has two extending bodies 11, and the two extending bodies 11 converge to the same point towards the distal direction of the expandable member to form a string bag, which is similar to a conical structure. Of course, the number of the extension bodies 11 is not limited in this application, and may be three or more.
The tail of the columnar unit 20 has a plurality of free bodies 21 extending toward the distal end of the expandable member, the free bodies 21 extend in a direction parallel to the axial direction of the expandable member, and the free ends of the free bodies 21 are bent inward in a direction close to the axis of the expandable member to avoid scratching the inner wall of the blood vessel during the advancement, while increasing the contact area of the free bodies 21 with the thrombus to increase the drag force.
In this embodiment, each of the columnar units 20 has two free bodies 21 at the end thereof. The two free bodies 21 are symmetrically distributed. Likewise, the present application does not impose any restrictions as to the number and distribution of the free bodies 21.
Furthermore, the adjacent net bag units are connected with the columnar units through at least two connecting points. Through setting up a plurality of tie points and replacing the mode that the tradition set up single tie point and connect, effectively avoided the too big problem of single tie point, reduce the propelling movement power.
Furthermore, the connection point between the upper pair of adjacent net bag units and the column unit and the connection point between the lower pair of adjacent net bag units and the column unit are distributed along the axial projection of the expandable member in a staggered manner.
In this embodiment, the adjacent string bag units 10 and the columnar units 20 are connected by two connection points, which are symmetrical about the axis of the expandable member.
With reference to fig. 1 and 2, a connection point between the upper pair of adjacent string bag units 10 and the column unit 20 and a connection point between the lower pair of adjacent string bag units 10 and the column unit 20 are distributed in a 90 ° offset manner along an axial projection of the expandable member. For example, referring to fig. 2, the first string bag unit 10, the first column unit 20 and the second string bag unit 10 may be sequentially disposed from the proximal end to the distal end of the expandable member, such that a connection point between the first string bag unit 10 and the first column unit 20 is a first connection point 31, the first column unit 20 and the second string bag unit 10 is a second connection point 32, and two first connection points 31 and two second connection points 32 are equally spaced along the circumferential direction of the expandable member, i.e., a difference between two first connection points 31 is 180 °, and a difference between adjacent first connection points 31 and second connection points 32 is 90 °. The connection points on the expandable component are prevented from being too large in a staggered distribution mode, and the pushing force is reduced.
In this embodiment, each of the string bag units 10 and the column units 20 includes a plurality of first meshes, a plurality of second meshes are formed between the adjacent string bag units 10 and the column units 20, and the size of each second mesh is larger than that of each first mesh. In addition, each string bag unit 10 or the column unit 20 is a closed loop structure, the closed loop structure and the design of the small meshes can improve the adherence of the expandable member, and the large meshes can ensure the integrity of the thrombus.
In the embodiment, the opening angle of the first mesh or the second mesh is designed to be 30-75 degrees so as to provide better catheter pushing force.
With reference to fig. 1, a first developing spring 41 is sleeved at a convergence position of the plurality of extending bodies 11. First development spring 41 is used for developing so that observe the support open mode, and accessible laser fusion or glued mode are fixed, and then form mellow end, avoid puncturing the blood vessel. In addition, the first developing spring 41 at the rear of the string bag unit 10 at the distal end of the expandable member also has a guiding function.
With reference to fig. 1, the end of the free body 21 is sleeved with a second developing spring 42, and the second developing springs 42 on the plurality of free bodies 21 at the tail of the same columnar unit 20 are distributed along the circumferential direction of the expandable member in a staggered manner, so as to reduce the pushing resistance.
Referring to fig. 3, the intravascular device further includes two visualization wires 50, two first stent ribs 61 are disposed at a proximal end of the expandable member, two second stent ribs 62 are disposed at a distal end of the expandable member, and the two visualization wires 50 are respectively wound from the first stent ribs 61 to the second stent ribs 62 along an axial direction of the expandable member. It will be appreciated that two of the visualization wires 50 extend from the proximal end of the expandable member to the distal end of the expandable member, respectively, to provide a through body visualization to facilitate the state of the expandable member in clinical use. The developing wires 50 have no break points, so that the possibility of breakage can be reduced, and the two developing wires 50 do not intersect, so that the friction force can be reduced. Of course, the present application does not set any limit to the number of the first bracket rib 61 and the second bracket rib 62. In addition, the number of the developing wires 50 is not limited in this application.
Referring to fig. 1 and 4, the intravascular device further includes a developing ring 70 and a third developing spring, wherein one end of the developing wire 50 and the two first support ribs 61 are jointly inserted into the developing ring 70 and fixed, and the other end of the developing wire 50 and the two second support ribs 62 are jointly inserted into the third developing spring and fixed.
Further, the portions of the two first stent ribs 61 in the developing ring 70 are fixed by a pin 80, one of the first stent ribs 61 is provided with a fixing hole, and one end of a delivery guide wire 90 is bent in a direction away from the expandable member after passing through the fixing hole. The risk of breakage can be effectively reduced by connecting the delivery guidewire 90 to the expandable member by means of a hook. In this embodiment, the length of one of the first support ribs 61 is greater than that of the other support rib, and the end of the longer first support rib 61 is provided with the fixing hole for connecting with the delivery guide wire 90.
In this embodiment, the winding directions of the two developing wires 50 are opposite, wherein one of the developing wires 50 is wound clockwise, and the other developing wire 50 is wound counterclockwise. By reversing the winding direction of the two development wires 50, development of different areas of the expandable member is facilitated, and the development effect is better.
In this embodiment, the developing wire 50 material includes, but is not limited to, platinum-tungsten alloy/platinum-iridium alloy/tantalum.
In the embodiment, the string bag is covered with a film, and a plurality of through holes are densely distributed on the film. The thrombus capture capability of the net bag can be further improved through the thin film with the dense through holes.
In the embodiment, the net bag can be covered with PTFE/PU/PET and other films, and the films form a microporous structure by laser.
Based on this, this application still provides a vascular thrombus remove device, including the conveying guide wire, leading-in sheath pipe and endovascular instrument, the proximal end of endovascular instrument with the conveying guide wire is connected, endovascular instrument with the conveying guide wire suit in leading-in sheath pipe. Through the vascular thrombus extraction device, not only can the capturing capacity of thrombus be improved, but also the expansion capacity of an intravascular device during tortuous blood vessels can be improved, the occurrence of the phenomenon of contraction is reduced, and the breakage and the falling of thrombus are effectively reduced.
In summary, the invention provides an intravascular device and a vascular thrombus extraction device, the closed tuck net-shaped design of the tail part of the tuck net unit is different from the cylindrical design of the columnar unit, the contact area between metal and thrombus is increased, the tuck net structure formed at the tail part can effectively capture fallen thrombus, and the columnar unit has no tuck net, so that the tuck net can help to hook thrombus at the position of a curve in a blood vessel. In addition, the net bag assemblies and the columnar assemblies are alternately arranged along the axial direction of the expandable component, so that the capturing capacity of the thrombus can be improved, the expansion capacity of the expandable component during tortuous blood vessels can be improved, the occurrence of the phenomenon of suffocation is reduced, and the breakage and falling of the thrombus are effectively reduced.
It should be understood, however, that the intention is not to limit the invention to the particular embodiments described. It will be apparent to those skilled in the art from this disclosure that many changes and modifications can be made, or equivalents modified, in the embodiments of the invention without departing from the scope of the invention. Therefore, any simple modification, equivalent change and modification made to the above embodiments according to the technical essence of the present invention are still within the protection scope of the technical solution of the present invention, unless the content of the technical solution of the present invention is departed from.
Claims (14)
1. The utility model provides an endovascular instrument, its characterized in that, includes expandable member, expandable member includes a plurality of string bag subassemblies and a plurality of column subassembly, and is a plurality of string bag subassembly and a plurality of column subassembly is followed expandable member's axial sets up in turn, every the string bag subassembly includes at least one string bag unit, every the column subassembly includes at least one column unit, the afterbody of string bag unit has many extensions, and many the extension court the distal end direction of expandable member is gathered together in same point in order to form a string bag, the afterbody of column unit has many court the free body that the distal end of expandable member extended.
2. The intravascular device of claim 1, wherein the distal end of the expandable member is a net pocket unit.
3. The intravascular device of claim 1, wherein adjacent ones of the string bag units are connected to the columnar unit by at least two connection points.
4. The intravascular device of claim 3, wherein a connection point between an upper pair of adjacent net pocket units and the columnar unit and a connection point between a lower pair of adjacent net pocket units and the columnar unit are offset from each other along a projection of the expandable member in the axial direction.
5. The intravascular device of claim 1, wherein each of the string unit and the column unit comprises a plurality of first mesh openings, and a plurality of second mesh openings are formed between adjacent string units and column units, and the size of the second mesh openings is larger than that of the first mesh openings.
6. The intravascular device of claim 1, wherein the free body extends in an axial direction parallel to the expandable member and a free end of the free body is curved inwardly in a direction proximate an axis of the expandable member.
7. The intravascular device according to claim 1, wherein a first visualization spring is sleeved at a convergence position of the plurality of extension bodies, a second visualization spring is sleeved at an end of the free body, and the second visualization springs on the plurality of free bodies at the tail of the same columnar unit are distributed along the circumferential direction of the expandable member in a staggered manner.
8. The intravascular device of claim 1, further comprising two visualization wires, wherein the proximal end of the expandable member is provided with two first stent ribs, the distal end of the expandable member is provided with two second stent ribs, and the two visualization wires are respectively wound from the first stent ribs to the second stent ribs along the axial direction of the expandable member.
9. The intravascular device according to claim 8, further comprising a visualization ring and a third visualization spring, wherein one end of the visualization wire and the two first stent ribs are inserted into the visualization ring and fixed together, and the other end of the visualization wire and the two second stent ribs are inserted into the third visualization spring and fixed together.
10. The intravascular device of claim 9, wherein portions of two of the first stent ribs located within the visualization ring are fixed by a pin, wherein one of the first stent ribs is provided with a fixing hole, and an end of a delivery guide wire is bent away from the expandable member after passing through the fixing hole.
11. The intravascular device of claim 8, wherein the two visualization wires are wound in opposite directions, wherein one of the visualization wires is wound clockwise and the other visualization wire is wound counterclockwise.
12. The intravascular device of claim 1, wherein the string bag is covered with a film, and a plurality of through holes are densely distributed on the film.
13. The intravascular device of claim 12, wherein the membrane is PTFE, PU, or PET.
14. A vascular thrombus removal device comprising a delivery guidewire, an introducer sheath, and the intravascular device of any one of claims 1-13, wherein the proximal end of the intravascular device is coupled to the delivery guidewire, and wherein the intravascular device and the delivery guidewire are nested within the introducer sheath.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
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