CN115836927B - Bolt taking system - Google Patents

Bolt taking system Download PDF

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Publication number
CN115836927B
CN115836927B CN202310113982.4A CN202310113982A CN115836927B CN 115836927 B CN115836927 B CN 115836927B CN 202310113982 A CN202310113982 A CN 202310113982A CN 115836927 B CN115836927 B CN 115836927B
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thrombus
net
tube
trapping
embolectomy
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CN202310113982.4A
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CN115836927A (en
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黄嘉平
荆洪娟
柯长奋
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Hangzhou Yike Medical Technology Co ltd
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Hangzhou Yike Medical Technology Co ltd
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Publication of CN115836927A publication Critical patent/CN115836927A/en
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Publication of CN115836927B publication Critical patent/CN115836927B/en
Priority to PCT/CN2023/130977 priority Critical patent/WO2024120117A1/en
Priority to US18/529,981 priority patent/US20240180574A1/en
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Abstract

The invention discloses a thrombus taking system, which comprises a thrombus taking device and a thrombus collecting device, wherein the thrombus taking device comprises a thrombus taking net and a pushing pipe, the thrombus collecting device comprises a sheath pipe, a collecting pipe and a collecting net, the pushing pipe is used for pushing the thrombus taking net into a blood vessel to take the thrombus and retracting the thrombus taking net with the thrombus into the sheath pipe, the collecting net is used for at least partially wrapping the thrombus taking net in the process of retracting the thrombus taking net with the thrombus into the sheath pipe, after the thrombus taking net is ended and before the collecting net at least partially wraps the thrombus taking net, the thrombus taking net at least has a stage of being in a whole contracted state, and the inside of the collecting net is overturned to the outside to form an everting state and is provided with an everting guide surface; when the collecting pipe and the pushing pipe synchronously move along the distal end to the proximal end direction, the inside of the collecting net outside is quickly turned inwards along the inversion guide surface to at least partially wrap the thrombus taking net, and the thrombus taking net is retracted into the sheath pipe along with the thrombus taking net so as to prevent thrombus in the thrombus taking net from escaping.

Description

Bolt taking system
Technical Field
The invention relates to the technical field of medical instruments, in particular to a bolt taking system.
Background
In the prior art, a thrombus taking device for taking a thrombus by using a thrombus taking net is a relatively common mechanical thrombus taking medical instrument, the thrombus taking net is also called a thrombus taking bracket, is usually in an automatic expansion state and has a shrinkage state of radial shrinkage and an expansion state of radial expansion, after the thrombus taking net is placed into a blood vessel, the thrombus taking net can automatically and radially expand so as to capture thrombus in the blood vessel in the thrombus taking net, and finally the thrombus taking net with thrombus can be taken out by withdrawing the thrombus taking net into a sheath tube. Because of the existence of the mesh on the surface of the thrombus taking net, in the process of withdrawing the thrombus taking net with thrombus into the sheath tube to withdraw from the blood vessel, the condition that thrombus escapes from the thrombus taking net due to the extrusion of the surface of the thrombus taking net and the inner wall of the sheath tube often occurs, and the escaped thrombus can still be positioned in the blood vessel, so that the thrombus taking effect is not ideal.
In order to solve the above problem, CN115040197a adopts two adjacent thrombus removing members to form a nested double-layer structure, so as to form an inner and outer double-layer mesh structure, and can embed thrombus at two positions of the inner layer and the outer layer, so that two points of force can be generated for thrombus, the balance of moment applied to the thrombus is maintained, a larger thrombus grabbing force is generated, the thrombus can be better grabbed and fixed, and thrombus escape is prevented, but because a larger space is reserved between the outer layer thrombus removing mesh and the inner layer thrombus removing mesh of CN115040197a, i.e. the two are not completely adhered and wrapped, in the process of withdrawing to a sheath tube, the thrombus between the outer layer thrombus removing mesh and the inner layer thrombus removing mesh still can escape from the mesh of the outer layer thrombus removing mesh.
Disclosure of Invention
The invention aims to solve the technical problems in the prior art, and provides a thrombus taking system for overcoming the technical defects that thrombus is easy to escape from mesh openings of a thrombus taking net in the process of retracting to a sheath tube in the prior art.
According to the invention, there is provided a thrombus-taking system comprising a thrombus-taking device and a thrombus-trapping device, the thrombus-taking device comprising a thrombus-taking net and a pushing tube, the pushing tube being coupled to the thrombus-taking net, the thrombus-trapping device comprising a sheath tube and a trapping net which can be accommodated in the sheath tube, both the trapping net and the thrombus-taking net having a contracted state in which they are radially contracted and an expanded state in which they are radially expanded, the trapping net being coupled to the trapping tube, the pushing tube being for pushing the thrombus-taking net into a blood vessel to take a thrombus and for retracting the thrombus-taking net with thrombus into the sheath tube, the trapping net being for at least partially wrapping the thrombus-taking net during the retraction of the thrombus-taking net with thrombus into the sheath tube, the trapping net having at least a stage in which the entirety is in the contracted state after the thrombus-taking net has been completed and before the trapping net is at least partially wrapped around the thrombus-taking net, the trapping net being flipped inside to the outside to form an everted state and having a turned-in guide surface; when the collecting pipe and the pushing pipe synchronously move along the far end and the near end, the collecting net is positioned inside the outer part, quickly turns inwards along the inversion guide surface to at least partially wrap the thrombus taking net, and is retracted into the sheath pipe along with the thrombus taking net.
Further, the thrombus removing net comprises a first thrombus removing net and a second thrombus removing net which are connected in sequence, wherein the first thrombus removing net is used for cutting thrombus in a blood vessel to separate the thrombus from the blood vessel, the second thrombus removing net is used for collecting separated thrombus, and the first thrombus removing net is at least partially wrapped by the collecting net.
Further, the thrombolysis device also comprises an action tube which is configured to drive the first thrombolysis net and the second thrombolysis net to shrink or expand along the radial direction when moving along the preset direction and generating relative displacement with the pushing tube.
Further, the action tube, the pushing tube, the collecting tube and the sheath tube are coaxially arranged.
Further, a first action block and a second action block are fixed on the action tube at intervals, the distal end of the second thrombus taking net is sleeved on the action tube and can slide in a spacing range defined between the first action block and the second action block, and the proximal end of the first thrombus taking net is fixedly connected with the distal end of the pushing tube.
Further, the actuation tube is configured to actuate the first and second embolectomy radially through the first actuation block upon movement in a proximal-to-distal direction and movement relative to the pusher tube by a predetermined displacement.
Further, the actuation tube is configured to actuate the first and second embolectomy radially expansion by the second actuation block upon movement in a distal-to-proximal direction and movement of a preset displacement relative to the pusher tube.
Further, the trapping net has a first open end and a second open end axially opposite, the first open end being relatively fixedly connected to the distal end of the trapping tube after being turned inside out to form the distal end of the trapping net, and the second open end being a free end and forming the proximal end of the trapping net, before the trapping net at least partially wraps the first thrombolytic net.
Further, the trapping web forms an inversion guide surface proximate the first open end.
Further, when the collecting pipe and the pushing pipe synchronously move along the far end to the near end direction, the sheath pipe is abutted against the collecting net so that the collecting net turns inwards, after the collecting net turns inwards in place, the first opening end forms the near end of the collecting net, and the second opening end forms the far end of the collecting net.
Compared with the prior art, on one hand, after the thrombus taking net is ended and before the capturing net at least partially wraps the thrombus taking net, the thrombus taking net is configured to be at least in a stage of being in a whole shrinkage state, so that thrombus in the thrombus taking net is radially extruded to enable axial displacement to occur in the whole shrinkage process of the thrombus taking net, and finally, the thrombus in the thrombus taking net is relatively uniformly distributed, the phenomenon that the radial size of a part of the thrombus taking net is larger due to the fact that a large amount of thrombus is gathered at the part of the thrombus taking net is avoided, and further, the thrombus is not extruded to form thrombus escape due to the fact that scratch occurs between the thrombus taking net and the inner wall of a sheath tube is avoided; on the other hand through the capture net upset with the at least partial bolt taking net under the laminating parcel shrink state for the in-process that bolt taking net was withdrawn to the sheath is withdrawn while parcel, can effectively avoid the phenomenon that thrombus escape appears when withdrawing the bolt taking net that has thrombus to the sheath in, the capture net is in the state of turning up in order to wrap up the bolt taking net with at least part along the direction face of turning up fast inwards in addition, makes the capture net more easy to turn up with at least part parcel bolt taking net, parcel is more smooth and stable, the condition that parcel failed can not appear.
Drawings
The invention will be more fully understood and its attendant advantages and features will be more readily understood by reference to the following detailed description, taken in conjunction with the accompanying drawings.
Fig. 1 is a schematic diagram of the structure of a thrombolysis system.
Fig. 2 is a schematic view of the embolectomy device of fig. 1 (with the embolectomy mesh in an expanded state and positioned outside of the embolectomy tube).
Fig. 3 is a schematic view of the thrombolytic device with the thrombolytic mesh in a contracted state and outside the thrombolytic tube.
Fig. 4 is a schematic view of the thrombolytic device with the thrombolytic mesh in a contracted state and partially disposed within the thrombolytic tube.
Fig. 5 is a schematic view of the thrombolytic device with the thrombolytic mesh in a contracted state and fully positioned within the thrombolytic tube.
Fig. 6 is a schematic perspective view of the thrombolytic mesh and push tube of fig. 2.
Fig. 7 is a schematic view of the deployed configuration of the embolic net and push tube of fig. 2.
Fig. 8-12 are schematic diagrams of a thrombolysis procedure of the thrombolysis device.
Fig. 13 is a schematic view of a prior art thrombolysis showing "bulge".
Fig. 14 is a schematic view showing the structure of the thrombus-trapping device (the trapping net is located outside the trapping tube and fitted over the sheath) in fig. 1.
Fig. 15 is a partial cross-sectional view of the collection mesh and collection tube of fig. 14.
Fig. 16 is a schematic view of a thrombus-trapping device in which a trapping mesh is located in a trapping tube.
FIG. 17 is a schematic view showing a structure of a thrombus-trapping device in which a trapping net is provided outside a trapping tube but not over a sheath.
Fig. 18-19 are state diagrams of fig. 1.
In the accompanying drawings: 1 is a thrombus taking pipe, 2 is a pushing pipe, 3 is an acting pipe, 4 is a thrombus taking net, 5 is a first acting block, 6 is a second acting block, 7 is a sliding block, 8 is a first thrombus taking net, 9 is a second thrombus taking net, 10 is a first acting end, 11 is a second acting end, 12 is a first pipe seat, 13 is a second pipe seat, 14 is a third pipe seat, 15 is a first joint, 16 is a second joint, 17 is a first injection pipe, 18 is a second injection pipe, 19 is a sheath pipe, 20 is a collecting pipe, 21 is a collecting net, 22 is a first opening end, 23 is a second opening end, 24 is an inversion guide surface, 25 is an outer layer, 26 is an elastic net, 27 is an inner layer, and 28 is a collecting pipe seat; 100 is a thrombus-taking device, 200 is a thrombus-trapping device, 300 is a blood vessel, 400 is a thrombus.
It should be noted that the drawings are for illustrating the invention and are not to be construed as limiting the invention. Note that the drawings representing structures may not be drawn to scale. Also, in the drawings, the same or similar elements are denoted by the same or similar reference numerals.
Detailed Description
In order that the invention may be more readily understood, a detailed description of the invention is provided below along with specific embodiments and accompanying figures.
The terms "proximal" and "distal" in the sense of the present invention should be understood as meaning, viewed from the direction of the attending physician, the term "proximal" referring to the end proximal to the attending physician, i.e. corresponding to the "left end" referred to with reference to the accompanying drawings, and the term "distal" referring to the end distal to the attending physician, i.e. corresponding to the "right end" referred to with reference to the accompanying drawings.
As shown in fig. 1 to 19, the thrombus-removing system of the present embodiment includes a thrombus-removing device 100 and a thrombus-trapping device 200, wherein the thrombus-removing device 100 is used for removing a thrombus in a blood vessel, and the thrombus-trapping device 200 is used for wrapping the thrombus-removing device 100 after the thrombus-removing device 100 is removed from the blood vessel and before the thrombus-removing device 100 is removed from the blood vessel, so as to prevent thrombus in the thrombus-removing device 100 from escaping and avoid thrombus-removing failure or poor thrombus-removing effect.
The structure of the thrombus removing device 100 comprises a thrombus removing tube 1, a pushing tube 2, an acting tube 3 and a thrombus removing net 4, wherein the thrombus removing tube 1 is provided with a tube cavity for accommodating the pushing tube 2 and the thrombus removing net 4, the pushing tube 2 and the acting tube 3 are hollow tubes so as to facilitate pushing a guide wire to pass through, the acting tube 3 is at least partially arranged in the pushing tube 2 in a sliding manner, namely, the thrombus removing tube 1, the pushing tube 2 and the acting tube 3 are coaxially arranged from outside to inside in sequence, the thrombus removing net 4 is self-expanding net and is provided with a plurality of meshes, the thrombus removing net 4 is in a contracted state with radial contraction and an expanded state with radial expansion, the proximal end of the thrombus removing net 4 is an open end, the distal end of the thrombus removing net 4 is a closed end, thrombus in a blood vessel can be cut when the thrombus removing net 4 is positioned in the blood vessel and moves from the distal end to the proximal end, the separated thrombus is fixedly connected with the distal end of the pushing tube 2, and the thrombus removing net 4 can be pushed into the blood vessel by the pushing tube 2, the thrombus removing net 4 can be withdrawn by the thrombus removing net 4, and the thrombus removing net 4 can be withdrawn into the thrombus removing device 200.
The action tube 3 is provided with a first action block 5 and a second action block 6, the first action block 5 and the second action block 6 are fixed on the action tube 3 and are arranged at intervals, the distal end of the thrombus removing net 4 is sleeved on the action tube 3 and can slide in a spacing range defined between the first action block 5 and the second action block 6, when the action tube 3 is configured to move along a preset direction and generate relative displacement with the pushing tube 2, the thrombus removing net 4 is driven to shrink in the radial direction by the first action block 5 or the thrombus removing net 4 is driven to expand in the radial direction by the second action block 6, thus compared with the prior art, the embodiment can prevent the thrombus removing net 4 from shrinking after the thrombus removing is finished and leading to the failure to withdraw from blood vessels smoothly, the distal end of the thrombus removing net 4 can also be moved towards the second action block 6 to further contract relative to the action tube 3 after the thrombus removing net 4 contracts, and the distal end of the thrombus removing net 4 can be moved towards the first action block 5 to further expand relative to the action tube 3 after the thrombus removing net 4 expands, so that the distal end position of the thrombus removing net 4 is not completely limited, and the thrombus volume and other conditions in the thrombus removing net 4 can be dynamically regulated, so that the thrombus can be uniformly distributed in the thrombus removing net 4 at the automatic regulation position, and the thrombus removing effect of the embodiment is improved.
The distal end of the thrombus removing net 4 is fixedly connected with a sliding block 7 and is converged on the sliding block 7 to form a furled end, and the sliding block 7 is sleeved on the acting tube 3 and is configured to slide in the interval range of the acting tube 3 defined between the first acting block 5 and the second acting block 6 and also can rotate relative to the acting tube 3. The first action block 5 is positioned in the thrombus removing net 4, the second action block 6 is positioned outside the thrombus removing net 4, when the action tube 3 is pushed in the proximal direction and generates relative displacement with the pushing tube 2, the pushing tube 3 can drive the sliding block 7 to slide in the distal direction through the first action block 5 so that the thrombus removing net 4 is stretched to shrink in the radial direction, and when the action tube 3 is pulled in the distal direction and generates relative displacement with the pushing tube 2, the action tube 3 can drive the sliding block 7 to slide in the proximal direction through the second action block 6 so that the thrombus removing net 4 is shortened to expand in the radial direction.
The first action block 5 is an annular boss protruding out of the outer surface of the action tube 3, the annular boss is fixed with the action tube 3 in a split mode, the first action block 5 further plays a supporting role of supporting the thrombus taking net 4, a certain thrombus accommodating space can be reserved when the thrombus taking net 4 is in a radial shrinkage state, thrombus in the thrombus taking net 4 is prevented from being extruded due to the fact that the thrombus accommodating space is too small, thrombus is prevented from escaping, the thrombus is prevented from being taken out completely, and particularly, after the action tube 3 moves in the direction from the near end to the far end and moves for a preset displacement relative to the pushing tube 2, the first action block 5 moves to be in contact with the far end of the thrombus taking net 4, and at least partially props up the far end of the thrombus taking net 4. And because the first action block 5 is arranged to protrude out of the outer surface of the action tube 3, the first action block 5 can also gather part of thrombus in the thrombus taking net 4, and can effectively prevent thrombus at the far end of the thrombus taking net 4 from moving to the near end so as to reduce the thrombus cutting efficiency at the near end. The second action block 6 is also an annular boss protruding out of the outer surface of the action tube 3, the distal end of the second action block 6 is formed into a conical end, thrombus is convenient to penetrate, and after the thrombus taking net 4 is contained in the lumen of the thrombus taking tube 1 in place, the second action block 6 is clamped at the distal end of the thrombus taking tube 1.
The radial contraction and radial expansion of the thrombus removing net 4 in this embodiment can be achieved by manipulating the action tube 3, after the thrombus removing net 4 is completed and before the thrombus removing net 4 is completely retracted into the sheath, the thrombus removing net 4 is configured to have at least a stage in which the whole thrombus removing net 4 is in a contracted state, that is, the whole thrombus removing net 4 after the thrombus removing is in a radially contracted state and then is completely retracted into the sheath, so that the thrombus removing net 4 is in a radially expanded state to separate and store thrombus in a blood vessel, and the thrombus removing net 4 is in a contracted state to reduce the radial size after the thrombus removing is completed, so that the thrombus removing net 4 with thrombus can be smoothly retracted into the thrombus capturing device 200 to be withdrawn from the blood vessel, and in the process of the whole radial contraction of the thrombus removing net 4, the thrombus in the thrombus removing net 4 can be radially extruded to enable the thrombus in the thrombus removing net 4 to be axially displaced, and finally, the thrombus in the thrombus removing net 4 is relatively uniform in distribution, and the thrombus in the thrombus removing net 4 is prevented from being gathered at a certain place to have a large radial size at the place, and further, the thrombus in the place is prevented from being extruded between the thrombus capturing device 200 and from being escaped by thrombus formation.
The thrombus taking net 4 comprises a first thrombus taking net 8 and a second thrombus taking net 9, the first thrombus taking net 8 and the second thrombus taking net 9 are self-expanding nets and are provided with a plurality of meshes, so that the first thrombus taking net 8 and the second thrombus taking net 9 are in a contracted state with radial contraction and an expanded state with radial expansion, the first thrombus taking net 8 is a cutting bracket, for example, is formed by cutting by self-expanding tube laser, compared with a woven bracket, the cutting bracket is harder, the short shrinkage rate is small, the thrombus in a blood vessel is suitable for being cut to separate the thrombus from the blood vessel, the second thrombus taking net 9 is a woven bracket, for example, the woven bracket is soft, the short shrinkage rate is large, the allowable meshes are smaller, the proximal end and the distal end of the first thrombus taking net 8 are both open ends, the proximal end of the second thrombus taking net 9 is the open end, the distal end of the second thrombus taking net 9 is fixedly connected with the slider 7 to form the closed end, the proximal end of the first thrombus taking net 8 is fixedly connected with the distal end of the pushing tube 2, the thrombus taking net 9 is fixedly connected with the distal end of the second thrombus taking net 9 in the first thrombus taking net 9, and the second thrombus taking net is connected with the second thrombus taking net 9 at the position of the open end, and the second thrombus taking net is connected with the second thrombus taking net is in the open end after the second thrombus taking net is connected with the second thrombus taking net is in the first thrombus taking net is in the net.
The first action block 5 is located in the second thrombolytic net 9, the second action block 6 is located outside the second thrombolytic net 9, and because the slide block 7 is fixed at the distal end of the second thrombolytic net 9, when the action tube 3 moves along the distal end in the proximal direction and generates relative displacement with the push tube 2, the action tube 3 directly acts on the distal end of the second thrombolytic net 9 through the second action block 6 and the slide block 7 to move along the proximal direction, so that the second thrombolytic net 9 is directly shortened to expand in the radial direction, and the first thrombolytic net 8 connected with the second thrombolytic net 9 is driven by the second thrombolytic net 9 to indirectly shorten to expand in the radial direction, then the action tube 3 does not directly shorten the first thrombolytic net 8 to expand in the radial direction, if the second thrombolytic net 9 is longer, the first thrombolytic net 8 cannot be completely expanded, namely the expansion is not ideal, so that the effect of thrombus separation is influenced by the first thrombolytic net 8 is driven by the action tube 3, and the action structure is arranged between the action tube 3 and the first thrombolytic net 8, so that the action tube 3 drives the second thrombolytic net 9 to expand in the radial direction directly through the action tube 6 to drive the second thrombolytic net 9 to expand in the radial direction, so that the second thrombolytic net 8 is directly and the second thrombolytic net 8 is driven by the second action block 9 to expand in the radial direction. The action structure comprises a first action end 10 fixed on the action tube 3 and a second action end 11 fixed on the inner wall of the first thrombus taking net 8, wherein the first action end 10 is an action protrusion protruding out of the outer surface of the action tube 3, the second action end 11 is an action ring protruding towards the inside of the first thrombus taking net 8 and sleeved on the action tube 3, and the maximum radial dimension of the action ring is smaller than the maximum radial dimension of the action protrusion, so that the action tube 3 directly drives the first thrombus taking net 8 to be shortened through the first action end 10 abutting the second action end 11 so as to be expanded in the radial direction.
The proximal end of the thrombus taking tube 1 is fixedly sleeved with a first tube seat 12, the first tube seat 12 is communicated with the tube cavity of the thrombus taking tube 1, the proximal end of the pushing tube 2 passes through the first tube seat 12 and is fixedly sleeved with a second tube seat 13, the second tube seat 13 is communicated with the interior of the pushing tube 2, the proximal end of the action tube 3 passes through the second tube seat 13 and is fixedly sleeved with a third tube seat 14, and the third tube seat 14 is communicated with the interior of the action tube 3. The distal end of the second socket 13 is provided with a first connector 15 that can be fixedly connected with the first socket 12, for example, the first connector 15 is fixedly connected with the distal end of the second socket 13 and can be fixedly inserted into or clamped with the first socket 12, or the first connector 15 is rotatably connected with the distal end of the second socket 13 and can be rotatably fixed with the first socket 12. The proximal end of the second tube holder 13 is provided with a second joint 16 capable of connecting the third tube holder 14 and the action tube 3 relatively and fixedly, for example, the second joint 16 is rotationally connected with the proximal end of the second tube holder 13, and when the second joint 16 is rotated, a clamping sleeve with a clamping hole in the second tube holder 13 can be caused to deform so as to lock the action tube 3, so that the relative fixation between the action tube 3 and the third tube holder 14 is realized.
When the thrombus taking device 100 actually takes out a thrombus, referring to fig. 8, firstly, the thrombus taking tube 1 containing the first thrombus taking net 8 and the second thrombus taking net 9 is conveyed into the blood vessel 300, and the thrombus taking tube 1 penetrates through the distal end of thrombus 400 in the blood vessel 300 by pushing the guide wire and the conical end of the distal end of the second action block 6 in the process; then, the thrombus removing tube 1 is pulled along the direction from the far end to the near end, namely the thrombus removing tube 1 is withdrawn, so that the first thrombus removing net 8 and the second thrombus removing net 9 are in a release state, at this time, the first action block 5 is abutted against or close to the far end of the second thrombus removing net 9, so that the first thrombus removing net 8 and the second thrombus removing net 9 are still in a contracted state as shown in fig. 9, the near end of the first thrombus removing net 8 is positioned at the far end side of thrombus 400, and the first tube seat 12 is fixedly connected with the first joint 15, so that the thrombus removing tube 1 and the pushing tube 2 are relatively fixed; then, the action tube 3 is pulled along the direction from the distal end to the proximal end, and the action tube 3 moves for a preset displacement relative to the pushing tube 2, so that the action tube 3 directly acts on the distal end of the second thrombolytic net 9 through the second action block 6 and the sliding block 7 to move towards the proximal end, further the second thrombolytic net 9 is directly shortened to expand in the radial direction, the second thrombolytic net 9 drives the first thrombolytic net 8 connected with the action tube 3 to indirectly shorten to expand in the radial direction, meanwhile, the action tube 3 also directly drives the first thrombolytic net 8 to shorten to expand in the radial direction through the first action end 10 abutting against the second action end 11, and after the action tube 3 and the pushing tube 2 are fixed relatively through the second joint 16, the first thrombolytic net 8 and the second thrombolytic net 9 finally realize the expanded state shown in fig. 10; then, pulling any one of the thrombus removing tube 1, the pushing tube 2 and the action tube 3 along the direction from the far end to the near end can enable the first thrombus removing net 8 and the second thrombus removing net 9 to move relative to the blood vessel 300, and in the process, the thrombus 400 in the blood vessel 300 is cut by the first thrombus removing net 8 so as to separate the thrombus 400 from the blood vessel 300, the separated thrombus 400 is collected by the second thrombus removing net 9, namely, the thrombus 400 in the blood vessel 300 enters the second thrombus removing net 9 from the near end opening of the first thrombus removing net 8 and is collected, and finally, the thrombus 400 shown in fig. 11 is positioned in the first thrombus removing net 8 and the second thrombus removing net 9; finally, any one of the thrombus collecting tube 1, the pushing tube 2 and the action tube 3 is pulled continuously along the direction from the far end to the near end, so that the first thrombus collecting net 8 and the second thrombus collecting net 9 move to the inside of the thrombus collecting device 200 relative to the blood vessel 300 to withdraw the blood vessel 300, in order to facilitate the smooth withdrawal of the first thrombus collecting net 8 and the second thrombus collecting device 200 with thrombus 400, the near end of the first thrombus collecting net 8 is a bevel port, and after the near end of the first thrombus collecting net 8 enters the thrombus collecting device 200, the action tube 3 and the pushing tube 2 are unlocked through the second joint 16, and the action tube 3 is pushed along the direction from the near end to the far end, so that the action tube 3 moves to the preset displacement along the direction from the near end to the far end relative to the pushing tube 2, and further, in order to directly enable the second thrombus collecting net 9 to be stretched to be contracted along the radial direction through the first action block 5 and the sliding block 7, and further, the second thrombus collecting net 9 is contracted along the radial direction, and the whole thrombus collecting device 200 is prevented from being completely contracted along the first thrombus collecting net 9, and the whole thrombus collecting device 200 is completely contracted along the radial direction, and the first thrombus collecting net 9 is completely contracted, and the whole thrombus collecting device 200 is completely contracted along the radial direction, and the first thrombus collecting device is completely contracted, and the second thrombus collecting device is completely contracted by the first thrombus collecting device 9 is pushed by the first thrombus collecting device 8, and has the second thrombus collecting device 200, and has the whole thrombus collecting device is completely contracted by the inside the apparatus, and has the whole is completely contracted by the thrombus collecting device, and has the thrombus collecting device is completely and has a small.
Moreover, since the distal end of the second embolectomy 9, that is, the slider 7, is sleeved on the action tube 3 and can slide within the range of the spacing defined between the first action block 5 and the second action block 6, the distal end of the second embolectomy 9 is not completely limited, and thus, after the first embolectomy 8 and the second embolectomy 9 are contracted, the distal end of the second embolectomy 9 can also move towards the second action block 6 relative to the action tube 3 to further contract, so that the phenomenon that the second embolectomy 9 cannot be smoothly withdrawn into the sheath tube 19 of the thrombus-trapping device 200 due to "bulge" as shown in fig. 13 can be avoided. At the same time, after the first and second embolectomy 8, 9 have been expanded, the distal end of the second embolectomy 9 can also be moved relative to the working tube 3 toward the first working block 5 for further expansion. Therefore, the setting so for first thrombus taking net 8, second thrombus taking net 9 can carry out dynamic adjustment along with the conditions such as thrombus volume in it, so do benefit to thrombus 400 and realize evenly distributed in first thrombus taking net 8 and second thrombus taking net 9 in automatically regulated position, and then the thrombus taking is effectual.
The first tube seat 12 is provided with a first injection tube 17, the second tube seat 13 is provided with a second injection tube 18, the first injection tube 17 and the second injection tube 18 are used for injecting physiological saline, contrast agent and the like, the first injection tube 17 is communicated with the tube cavity of the thrombus taking tube 1 so as to be communicated with a space formed between the inner wall of the thrombus taking tube 1 and the outer wall of the pushing tube 2, and the second injection tube 18 is communicated with the interior of the pushing tube 2 so as to be communicated with a space formed between the inner wall of the pushing tube 2 and the outer wall of the acting tube 3.
As shown in fig. 14 to 17, the thrombus-trapping device 200 comprises a sheath tube 19, a trapping tube 20 and a trapping net 21 which can be accommodated in the sheath tube 19, a part of the sheath tube 19 is arranged in a blood vessel 300 in a penetrating manner, the other part of the sheath tube 19 is exposed out of the blood vessel 300, the thrombus-removing device 100 is inserted into the blood vessel 300 through the sheath tube 19 to remove a thrombus, the sheath tube 19, the trapping tube 20, the thrombus-removing tube 1, the push tube 2 and the action tube 3 are coaxially arranged, the trapping net 21 has a contracted state in which the trapping net 21 is contracted in a radial direction and an expanded state in a radial direction when the trapping net 21 is positioned in the sheath tube 19, as shown in fig. 17, the trapping net 21 has a first open end 22 and a second open end 23 which are axially opposite, the first open end 22 is coupled with a distal end of the trapping tube 20, the trapping net 21 is used for at least partially wrapping the thrombus-removing net 4 in the process of withdrawing the thrombus-removing net 4 with thrombus into the thrombus-trapping device 200, i.e. the sheath 19, specifically, the trapping net 21 at least partially wraps the first thrombus-removing net 8 of the thrombus-removing net 4, i.e. the proximal end of the first thrombus-removing net 8 can be completely wrapped, because the proximal end of the first thrombus-removing net 8 is open and the mesh of the first thrombus-removing net 8 is larger than the mesh of the second thrombus-removing net 9, when the first thrombus-removing net 8 is withdrawn into the sheath 19, the thrombus easily escapes from the first thrombus-removing net 8 due to the extrusion of the first thrombus-removing net 8 and the inner wall of the sheath 19, and the trapping net 21 at least partially wraps and is attached to the first thrombus-removing net 8, so that the problem can be well avoided.
In the initial state, the inside of the trapping net 21 is turned to the outside to form an everted state, the first opening end 22 is turned inwards and then is relatively fixedly connected to the far end of the trapping tube 20 to form the far end of the trapping net 21, the trapping net 21 forms an everting guide surface 24 near the first opening end 22, the everting guide surface 24 is a conical cambered surface, the proximal end of the first thrombus taking net 8 is convenient to retract into the sheath tube 19, the inside of the trapping net 21 outside can be turned inwards quickly and can be recovered, and the second opening end 23 is a free end and forms the proximal end of the trapping net 21. The collection tube 20 is configured to urge the inside of the collection mesh 21 on the outside to snap inwardly along the inversion guide surface 24 to at least partially encase the thrombolytic device 100 as the collection mesh 21 is moved distally in a proximal direction, with the first open end 22 forming the proximal end of the collection mesh 21 and the second open end 23 forming the distal end of the collection mesh 21 after the collection mesh 21 is flipped inwardly into place. Because the capturing net 21 is in an everting state in the initial state and forms the everting guide surface 24, the capturing net 21 is easier to evert inwards to recover, so that the capturing net 21 is easier to evert to wrap the thrombus taking device 100 at least partially, the wrapping is smoother and stable, the condition of wrap failure can not occur, thrombus can be effectively prevented from escaping from the thrombus taking device 100, and thrombus can be effectively captured.
The radial dimension of the trapping net 21 in the expanded state is larger than the radial dimension of the sheath tube 19, so that when the trapping net 21 is positioned outside the sheath tube 19 and the trapping net 21 can be gradually sleeved on the outer wall of the sheath tube 19 positioned in the blood vessel 300 along the distal end of the sheath tube 19 in the process of moving the trapping tube 20 in the distal end and proximal direction, the trapping net 21 can be enabled to be abutted against the trapping net 21, so that the trapping net 21 can be turned inwards, and the trapping net 21 can be further enabled to be turned inwards more easily, so that the thrombus taking device 100 can be wrapped more smoothly.
The fact that the sheath tube 19 abuts against the capturing net 21 so that the capturing net 21 turns inwards can be understood that, as shown in fig. 14 to 15, after the capturing net 21 is sleeved on the outer wall of the sheath tube 19, when the capturing tube 20 moves in the distal direction, the distal end of the sheath tube 19 abuts against the first open end 22 of the capturing net 21 so that the capturing net 21 turns inwards, or, as shown in fig. 17, the capturing net 21 does not sleeve on the outer wall of the sheath tube 19, the second open end 23 of the capturing net 21 can abut against the sheath tube 19, so that the distal end of the sheath tube 19 abuts against the second open end 23 of the capturing net 21 so that the capturing net 21 turns inwards, that is, in the process that the capturing tube 20 moves in the distal direction, the second open end 23 of the capturing net 21 abuts against the distal end of the sheath tube 19, so that the capturing net 21 does not immediately abut against the outer wall of the sheath tube 19, and at this time, the capturing net 21 abuts against the distal end of the second open end of the sheath tube 19, and the second open end of the capturing net 21 can abut against the outer wall of the sheath tube 19, so that the capturing net 21 gradually abuts against the distal end of the sheath tube 19, and the second open end of the capturing net 21 is achieved. In order to facilitate the trapping net 21 to be smoothly fitted over the distal end of the sheath tube 19, the distal end of the sheath tube 19 is tapered so that the trapping net 21 is fitted over the outer wall of the sheath tube 19 along the tapered end.
The collecting pipe 20 comprises an outer layer 25, an elastic net 26 and an inner layer 27, wherein the outer layer 25, the elastic net 26 and the inner layer 27 are coaxially arranged, the elastic net 26 is positioned between the outer layer 25 and the inner layer 27, namely, the collecting pipe 20 is of a three-layer pipe structure, the elastic net 26 is mainly used for improving the supporting performance, bending resistance and stretching performance of the collecting pipe 20, the first opening end 22 of the collecting net 21 is fixedly connected with the far end of the elastic net 26, so that the connection strength between the collecting net 21 and the collecting pipe 20 is improved, and of course, the far end of the elastic net 26 can be outwards turned after extending out of the far end of the collecting pipe 20 to form the collecting net 21, so that the collecting net 21 can be easily turned inwards to recover.
In use, after the thrombus is captured by the thrombus-harvesting device 100, the thrombus-harvesting device 100 is moved distally and proximally to the first open end 22 of the capturing net 21, and after the first and second thrombus- harvesting nets 8, 9 are in a radially contracted state, fig. 18, the capturing tube 20 and the thrombus-harvesting tube 1 are relatively fixed, for example, by rotating the capturing tube 28, by the capturing tube 28 at the proximal end of the capturing tube 20, and then pulling the capturing tube 20 distally and proximally relative to the sheath 19, so that the capturing tube 20, the thrombus-harvesting tube 1, the push tube 2 and the action tube 3 are synchronously moved distally and proximally, the capturing net 21 is rapidly turned inwardly along the inversion guide surface 24 to at least partially wrap the first thrombus-harvesting net 8 of the thrombus-harvesting net 4, and as the thrombus-harvesting net 4 is retracted into the sheath 19, for example, fig. 19, and finally, the capturing tube 20 is pulled distally and proximally relative to the sheath 19 to withdraw the thrombus-harvesting device 100 from the blood vessel 300, or the sheath 19 and the action tube 300 together. On the one hand, after the thrombus taking net 4 is completed and before the catching net 21 at least partially wraps the thrombus taking net 4, the thrombus taking net 4 is configured to be at least in a stage of being in a whole shrinkage state, so that thrombus in the thrombus taking net 4 is radially extruded to enable axial displacement to occur in the whole shrinkage process of the thrombus taking net 4, and finally, the thrombus in the thrombus taking net 4 is relatively uniformly distributed, the radial dimension of a certain part of the thrombus taking net 4, which is caused by a large amount of accumulated thrombus, is not generated, and further, the thrombus is not extruded to escape due to scraping between the thrombus taking net 4 and the inner wall of the sheath tube 19; on the other hand, the thrombus removing net 4 in the contracted state is wrapped at least partially through the overturning of the collecting net 21, so that the thrombus removing net 4 is retracted to the sheath tube 19 while being wrapped, the phenomenon that thrombus escapes when the thrombus removing net 4 with thrombus is retracted to the sheath tube 19 can be effectively avoided, the collecting net 21 is rapidly and inwards overturned along the inwards-turned guide surface 24 in the everted state to wrap the thrombus removing net 4 at least partially, the collecting net 21 is easier to overturned to wrap the thrombus removing net 4 at least partially, the wrapping is smoother and stable, and the wrapping failure can not occur.
It will be appreciated that although the invention has been described above in terms of preferred embodiments, the above embodiments are not intended to limit the invention. Many possible variations and modifications of the disclosed technology can be made by anyone skilled in the art without departing from the scope of the technology, or the technology can be modified to be equivalent. Therefore, any simple modification, equivalent variation and modification of the above embodiments according to the technical substance of the present invention still fall within the scope of the technical solution of the present invention.

Claims (10)

1. A thrombus-harvesting system comprising a thrombus-harvesting device (100) and a thrombus-trapping device (200), the thrombus-harvesting device (100) comprising a thrombus-harvesting network (4) and a push tube (2), the push tube (2) being coupled to the thrombus-harvesting network (4), the thrombus-trapping device (200) comprising a sheath tube (19) and a trapping tube (20) and a trapping network (21) receivable within the sheath tube (19), both the trapping network (21) and the thrombus-harvesting network (4) having a radially contracted state and a radially expanded state, the trapping network (21) being coupled to the trapping tube (20), the push tube (2) being adapted to push the thrombus-harvesting network (4) into a vessel for harvesting a thrombus and to retract the thrombus-harvesting network (4) into the sheath tube (19), the trapping network (21) being adapted to wrap at least part of the thrombus-harvesting network (4) during retraction of the thrombus-harvesting network (4) into the sheath tube (19), characterized in that after the end of the thrombus-harvesting network (4) and before at least part of the net (21) has been in a fully retracted state and the inside-harvesting network (21) has been wrapped, the entire-harvesting network (21) has been in a fully inverted state, and the inside-out of the capturing network (24 has been formed; when the collecting pipe (20) and the pushing pipe (2) synchronously move along the far end and the near end, the sheath pipe (19) is abutted against the collecting net (21) so that the collecting net (21) turns inwards, the collecting net (21) is positioned outside and inside and turns inwards rapidly along the inward turning guide surface (24) to at least partially wrap the thrombus taking net (4), and the thrombus taking net (4) is retracted into the sheath pipe (19).
2. A embolectomy system according to claim 1, characterized in that the embolectomy net (4) comprises a first embolectomy net (8) and a second embolectomy net (9) connected in sequence, the first embolectomy net (8) being used for cutting thrombus in a blood vessel to separate the thrombus from the blood vessel, the second embolectomy net (9) being used for collecting separated thrombus, and the trap net (21) at least partly surrounding the first embolectomy net (8).
3. A embolectomy system according to claim 2, characterized in that the embolectomy device (100) further comprises an actuation tube (3), the actuation tube (3) being configured to actuate the first and second embolectomy networks (8, 9) to radially contract or radially expand upon movement in a predetermined direction and relative displacement with the pusher tube (2).
4. A thrombolysis system according to claim 3, wherein said action tube (3), pushing tube (2), trapping tube (20), sheath tube (19) are coaxially arranged.
5. A thrombolysis system according to claim 3, characterized in that the action tube (3) is fixed with a first action block (5) and a second action block (6) at intervals, the distal end of the second thrombolysis net (9) is sleeved on the action tube (3) and can slide in a spacing range defined between the first action block (5) and the second action block (6), and the proximal end of the first thrombolysis net (8) is fixedly connected with the distal end of the pushing tube (2).
6. A embolectomy system according to claim 5, characterized in that the actuation tube (3) is configured to actuate, by means of the first actuation block (5), the first and second embolectomy nets (8, 9) to contract radially when moved in a proximal-distal direction and by a preset displacement with respect to the pusher tube (2).
7. A embolectomy system according to claim 5, characterized in that the actuation tube (3) is configured to actuate the first and second embolectomy networks (8, 9) to expand radially by means of the second actuation block (6) upon movement in a distal proximal direction and a preset displacement relative to the pusher tube (2).
8. A thrombolytic system according to claim 2, wherein the trapping net (21) has a first open end (22) and a second open end (23) axially opposite, the first open end (22) being relatively fixedly connected to the distal end of the trapping tube (20) and turned inwards to form the distal end of the trapping net (21) before the trapping net (21) at least partly encloses the first thrombolytic net (8), the second open end (23) being a free end and forming the proximal end of the trapping net (21).
9. A thrombolytic system according to claim 8, wherein said capturing mesh (21) forms an inversion guide surface (24) near the first open end (22).
10. A embolectomy system according to claim 8, characterized in that the first open end (22) forms the proximal end of the trap mesh (21) and the second open end (23) forms the distal end of the trap mesh (21) after the trap mesh (21) has been turned inwards into place when the trap tube (20) and the pusher tube (2) are moved in the distal to proximal direction simultaneously.
CN202310113982.4A 2022-12-06 2023-02-08 Bolt taking system Active CN115836927B (en)

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