WO2019227357A1 - Dispositif d'actionnement d'un système d'implantation précise de stent pour vaisseau ramifié - Google Patents

Dispositif d'actionnement d'un système d'implantation précise de stent pour vaisseau ramifié Download PDF

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Publication number
WO2019227357A1
WO2019227357A1 PCT/CN2018/089094 CN2018089094W WO2019227357A1 WO 2019227357 A1 WO2019227357 A1 WO 2019227357A1 CN 2018089094 W CN2018089094 W CN 2018089094W WO 2019227357 A1 WO2019227357 A1 WO 2019227357A1
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WO
WIPO (PCT)
Prior art keywords
handle
stent
guide
guide sheath
core
Prior art date
Application number
PCT/CN2018/089094
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English (en)
Chinese (zh)
Inventor
李雷
Original Assignee
Li Lei
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Li Lei filed Critical Li Lei
Priority to PCT/CN2018/089094 priority Critical patent/WO2019227357A1/fr
Publication of WO2019227357A1 publication Critical patent/WO2019227357A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters 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
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts

Definitions

  • the present disclosure relates to the field of stent implantation of blood vessels, and in particular, to an operation device of a precision stent implantation system for branched blood vessels.
  • Vascular stenosis and occlusion is a disease with high disability and mortality.
  • stent implantation in blood vessels is one of the main treatment methods. This technology is used to deliver a stent to a diseased site for radial support of blocked blood vessels. Stent implantation methods are mostly guided by a guide wire to the implanted position and then expanded, but most of the stent has a stent. Accurately locate and adapt to a variety of vascular structures. For example, in the opening part of the branch vessel structure with branch blood vessels, not only the structure of the vascular stent itself needs special design, but also the corresponding improvement of the implantation method to meet the purpose of accurately implanting the stent in such a position.
  • the implantation system of such a vascular stent usually includes a guide sheath, a guide core and a top core for delivering the stent.
  • This structure requires the operation of the implantation stent in vitro, and the guide sheath and the guide core are implanted after the stent is implanted in place. Remove from the body.
  • the related parts are easy to move, and the positioning is not accurate.
  • An object of the present disclosure is to provide an operating device for a precise implantation system for a stent of a branched blood vessel.
  • the operation device can operate a precise implantation system for a stent of a branched blood vessel in vitro, so that the stent can be quasi-implanted into the branched blood vessel.
  • the present disclosure provides an operating device of a stent precision implantation system for branched blood vessels.
  • the stent comprises a main body portion and an opening portion located at a rear end of the main body portion.
  • the stent precision implantation system includes a coaxial arrangement on the stent.
  • a guide core for conveying the stent inside the stent a first guide sheath connected to the guide core for accommodating the main body part, a second guide sheath for accommodating the opening part, and provided in the first A second guide sheath abuts a top core at the rear end of the opening, the rear end of the first guide sheath is open with the front end of the second guide sheath, and the operation device includes a means for conveying and retracting the A guide core, the top core, the first guide sheath, and a handle push-pull mechanism of the second guide sheath, and a housing for accommodating the handle push-pull mechanism.
  • the housing is provided with a housing that can be connected to or disconnected from the housing. The locking member of the handle push-pull mechanism is described.
  • the handle push-pull mechanism includes a first driving portion for conveying and retracting the guide core and the first guide sheath, a second driving portion for conveying and retracting the top core, and a conveying mechanism. And a third driving part retracting the second guide sheath,
  • the first driving portion includes a first handle and a first connecting rod connected to the first handle and connected to a tail end of the guide core,
  • the second driving part includes a second handle and a second connecting rod connected to the second handle for connecting with the tail end of the top core,
  • the third driving part includes a third handle and a third connecting rod connected to the third handle for connecting with the tail end of the second guide sheath.
  • the third driving portion is slidably sleeved on the outside of the second connecting rod, and the second driving portion is slidably sleeved on the outside of the first connecting rod.
  • a first empty slot is formed on one side of the housing, and the first handle, the second handle, and the third handle protrude from the first empty slot.
  • the first handle, the second handle, and the third handle are each formed as an I-shaped handle, and an upper handle portion of the I-shaped handle protrudes from the first empty slot, and the upper handle portion
  • the lower end mounting portion of the I-shaped handle is slidably fitted on the outer surface of the housing, and the lower end mounting portion is slidably fitted on the inside of the housing.
  • the vertical portion of the I-shaped handle is slidably disposed at the slot of the first empty slot, so that the I-shaped handle is pushed and pulled along the slot.
  • a first shaft shoulder is provided at both ends of the first hollow groove to stop the upper handle portion.
  • a second empty slot is provided on a side of the housing that is different from the first empty slot, and the locking member is formed as three threaded members that pass through the second empty slot.
  • a handle, the second handle, and the third handle are respectively provided with a first threaded hole, a second threaded hole, and a third threaded hole that match the threaded member, and the outer contour of the head of the threaded member The outer contour is larger than the second hollow groove, so that the head part bears on the outer surface of the casing.
  • the threaded member includes a polished rod portion that moves along the second hollow groove and a threaded portion that cooperates with the threaded hole, and an outer contour of the threaded portion is larger than an inner contour of the second hollow groove. So that the threaded portion abuts against the inner surface of the casing.
  • a second shaft shoulder is provided at both ends of the second hollow groove to stop the threaded member.
  • the operation device further includes a handle provided at a rear end of the housing.
  • the handle push-pull mechanism of the operation device transports or retracts the guide core, the top core, the first guide sheath, and the second guide sheath used for conveying the stent by pushing and pulling.
  • the push-pull mechanism of the handle can be locked by the locking member to ensure the stability of the entire process.
  • This operating device can match the precise implantation system of the corresponding stent of the branch vessel, thereby completing the precise implantation of the stent of the branch vessel.
  • FIG. 1 is a schematic structural diagram of an operation device when a stent is implanted into a blood vessel in a stent precision implantation system for a branch blood vessel according to an exemplary embodiment of the present disclosure
  • FIG. 2 is a schematic structural diagram of an operation device when a third handle of a stent precision implantation system for a branched blood vessel provided by an exemplary embodiment of the present disclosure moves the second guide sheath backward to release the stent opening;
  • FIG. 3 is a schematic structural diagram when a first handle in a manipulation device for a precision implantation system for a stent of a branched blood vessel provided by an exemplary embodiment of the present disclosure moves a guide core forward and a first guide sheath releases a stent main body;
  • FIG. 4 is a schematic structural diagram of an operation device when a stent precision implantation system of a branched blood vessel provided by an exemplary embodiment of the present disclosure is completely withdrawn from the body.
  • FIG. 5 is a top view of an operation device of a stent precision implantation system for a branch vessel according to an exemplary embodiment of the present disclosure
  • FIG. 6 is a bottom view of an operation device of a stent precision implantation system for a branch vessel according to an exemplary embodiment of the present disclosure
  • FIG. 7 is a schematic diagram when a locking member locks a handle push-pull mechanism provided by an exemplary embodiment of the present disclosure
  • FIG. 8 is a sectional view taken along line A-A in FIG. 5;
  • Figure 9 is a sectional view taken along line B-B in Figure 5;
  • FIG. 10 is a cross-sectional view taken along line C-C in FIG. 5;
  • FIG. 11 is a schematic structural diagram of a locking member according to an exemplary embodiment of the present disclosure.
  • Second shaft shoulder 32 First empty slot 331 Upper handle part 332 Lower end mounting part
  • orientation words such as “up and down” are defined based on the drawing directions of Figs. 1 to 4 unless otherwise stated to the contrary.
  • “Front and back” are usually defined by brackets and related components. It is defined on the basis of the implantation direction of the blood vessel, that is, the related components enter the blood vessel forward and exit the blood vessel backward.
  • These orientation words are only used to illustrate the present disclosure and are not used to limit the present disclosure.
  • the “first”, “second”, and the like used in the present disclosure are for distinguishing one element from another element and do not have order and importance.
  • branch blood vessels with branches are often encountered, that is, the blood vessel includes a main blood vessel and a branch blood vessel communicating with the main blood vessel, that is, the branch blood vessel is connected to the side wall of the main blood vessel.
  • the connecting area of the branch vessel has an arc-shaped transition, so that the size of the opening of the branch vessel close to the main vessel presents an outwardly expanding trumpet structure.
  • a trumpet-shaped stent with an opening that is outwardly opened is required to fit the branch vessel.
  • the opening transition area as shown in FIG.
  • such a stent includes a main body portion 21 formed as a straight tube structure to fit the blood vessel wall of a corresponding branch vessel, and an opening formed as an outwardly curved structure to fit the opening shape of a branch blood vessel.
  • the part 22, a precision implantation system for implanting a stent includes a guide core 11 coaxially disposed inside the stent for conveying the stent, a first guide sheath 12 connected to the guide core 11 for receiving the main body part 21, and used for receiving The second guide sheath 13 of the opening part 22 and the top core 14 provided in the second guide sheath 13 abut against the rear end of the opening part 22, and the rear end of the first guide sheath 12 and the front end of the second guide sheath 13 are opened.
  • a guide wire is used to guide the guide core 11 into the branch blood vessel, and the circumferential and axial positioning of the stent is achieved by positioning the guide wire to achieve precise stent implantation.
  • the guide wire extends from the main blood vessel to the branch blood vessel, and the guide core 11 is movably sleeved on the guide wire, so that the guide core 11 enters the branch blood vessel along the guide wire, and the guide wire is positioned to pass through the opposite stent.
  • the limiting hole is fixed and extends along the main blood vessel.
  • the present disclosure provides an operation device for a precise implantation system for a stent of a branch vessel.
  • the operation device includes a guiding core 11 for transporting and retracting the guide core 11, The handle push-pull mechanism of the top core 14, the first guide sheath 12, and the second guide sheath 13 and a housing 31 for receiving the handle push-pull mechanism.
  • the housing 31 is provided with a locking member that can be connected to or disengaged from the handle push-pull mechanism. Specifically, when the stent is implanted, the handle push-pull mechanism is pushed to transport the stent in place.
  • the handle pull-pull mechanism is retracted to transport the guide core 11, the top core 14, the first guide sheath 11, and the second guide sheath of the stent. 13 Retraction.
  • the locking device is used to lock the device that does not need to be operated to prevent the device from being operated incorrectly.
  • the locking device is released to ensure the stability of the operation.
  • the 31 structure can prevent the handle push-pull mechanism from contacting with the outside world to interfere with the work and play a protective role.
  • the handle push-pull mechanism of the operation device transports or retracts the guide core 11, the top core 14, the first guide sheath 12, and the second guide core for transporting the stent by pushing or pulling.
  • the guide sheath 13 can lock the handle push-pull mechanism by the locking member to ensure the stability of the entire process.
  • This operation device can match the corresponding branch vessel with a precise stent implantation system to complete the branch vessel. Precision implantation of stents.
  • the handle push-pull mechanism includes a first driving part for conveying and retracting the guide core 11, a second driving part for conveying and retracting the top core 14, and a third driving part for conveying and retracting the second guide sheath 13.
  • the first driving portion includes a first handle 51 and a first connecting rod 41 connected to the first end of the guide core 11 and connected to the tail end of the guide core 11, and the second driving portion includes a first Two handles 52 and a second connecting rod 42 connected to the second handle 52 for connecting with the tail end of the top core 14, and the third driving part includes a third handle 53 and a third handle 53 connected to the second guide 53
  • the third connecting rod 43 is connected to the tail end of the sheath 13.
  • the guide core 11 can be controlled to move back and forth in the blood vessel by pushing and pulling the first handle 51, so that the first guide sheath 12 and the main body portion 21 stored therein are moved, and the second handle 52 is pushed to control the core 14 in the blood vessel. It moves back and forth in the middle, so as to bear against the stent at the rear end of the stent opening 22, and pushes and pulls the third handle 53 to control the second guide sheath 13 to move back and forth in the blood vessel.
  • each part of the stent implantation system is operated by a separate handle, making the implantation process clear and simple.
  • the third driving portion is slidably sleeved outside the second connecting rod 42, and the second driving portion is slidably sleeved outside the first connecting rod 41 to save the radial space of the device.
  • the third handle 53 may be provided with a second through hole 531 having a diameter larger than the outer diameter of the second connecting rod 42, and the third connecting rod 43 may have an inner diameter larger than the second A hollow tube with an outer diameter of the connecting rod 42 allows the second connecting rod 42 to pass through and move freely.
  • the second handle 52 may be provided with a first through hole 521 having a diameter larger than the outer diameter of the first connecting rod 41, and the second connecting rod 42 can be a hollow tube with an inner diameter larger than the outer diameter of the first connecting rod 41, so that the first connecting rod 41 can pass through and move freely. This can ensure that the three connecting rods are independent and non-interfering with each other in the work project, thereby ensuring the smooth progress of the stent implantation process.
  • a side of the casing 31 may be provided with a first empty slot 32.
  • the first handle 51 and the second handle 52 And the third handle 53 protrudes from the first empty slot 32.
  • the first handle 51, the second handle 52, and the third handle 53 may all be formed as I-shaped handles, and the upper handle portion 331 of the I-shaped handles protrudes from the first space.
  • the slot 32, the lower end mounting portion 332 of the I-shaped handle is disposed inside the first empty slot 32, and the vertical portion 333 of the I-shaped handle is slidably provided at the slot of the first empty slot 32.
  • the I-shaped The handle can be locked at the position of the notch of the first empty slot 32, that is, the outer contour of the upper handle portion 331 and the lower mounting portion 332 is larger than the outline of the first empty slot 32, so that the upper handle portion 331 will not fall into the housing 31.
  • the inner and lower end mounting portions 332 are always left inside the casing 31 and do not protrude from the first hollow groove 32.
  • the lower surface of the upper handle portion 331 slidably fits the outer surface of the casing 31, and the upper surface of the lower end mounting portion 332 Slidingly fits on the inner surface of the casing 31, so that the handle can smoothly slide back and forth along the first empty slot 32, and it will not affect the stability by moving up and down during the stent implantation process.
  • first shaft shoulders 311 may be provided at the front and rear ends of the first hollow groove 32 to stop the upper handle portion 331. In this way, the upper handle portion 331 does not protrude from the range of the first empty slot 32 during the forward and backward sliding.
  • the position of the first shoulder 311 depends on the positions of the two ends of the first empty slot 32.
  • the length and position of the first empty slot 32 are determined by The motion state of the stent during implantation is determined and can be adjusted according to the actual application.
  • the locking member may be three threaded pieces 35 for locking the first handle 51, the second handle 52, and the third handle 53, respectively, the first handle 51, the second handle 52, and the third
  • the handle 53 is provided with a first threaded hole 511, a second threaded hole 512, and a third threaded hole 513 respectively corresponding to the corresponding threaded member 35, and the side of the housing 31 different from the first hollow groove 32 is provided with the above-mentioned
  • the corresponding second empty slot 34 of the first empty slot 32 for example, the second empty slot 34 can be opened on the lower side of the casing 31 opposite to the first empty slot 32, and the screw member 35 can pass upward from the lower side of the casing 31
  • the outer contour of the head 353 of the screw member 35 is larger than the outer contour of the second hollow groove 34, so that the head 353 abuts on the outer surface of the casing 31.
  • the threaded member 35 When the handle needs to be locked, move the threaded member 35 to the corresponding handle position along the direction of the second empty slot 34, and tighten the threaded member 35 into the threaded hole of the handle until the head 353 of the threaded member 35 is pressed against the housing. On the outer surface of 31, the threaded member 35 and the handle will not move. When the handle needs to be moved, the threaded member 35 can be rotated out of the threaded hole. As shown in FIG. 11, the threaded member 35 may be composed of a polished rod portion 351 capable of moving along the second hollow groove 34 and a threaded portion 352 mated with the threaded hole. The outer contour of the threaded portion 352 is larger than the inner contour of the second hollow groove 34.
  • the threaded portion 352 abuts against the inner surface of the casing 31.
  • the combination of the head 353, the polished rod portion 351, and the threaded portion 352 of the screw 35 is similar to the principle of the I-shaped handle described above, so that the screw 35 does not have the head 353 when locked. Entering into the casing 31, the casing 31 will not fall out when the threaded member 35 is loosened, so that the threaded member 35 is always on the casing 31, preventing falling off during operation, simple operation, and saving time and effort.
  • the front and rear ends of the second hollow groove 34 may be provided with a second shoulder 312 similar to the above-mentioned first shoulder 311 to stop the threaded member 35 and prevent the threaded member. 35 exceeds the second empty slot 34.
  • the principle of the second shaft shoulder 312 stop thread 35 is the same as the principle of the first shaft shoulder 311 stop handle, which is not described here.
  • the operating device of the present disclosure may further include a handle 36 at the rear end of the housing 31, which is convenient for holding during operation, and a handle portion corresponding to a finger may be provided at the position of the handle 36 361, which is more convenient for operation.
  • the position of the hand-held part 361 can be a non-slip material, such as rubber, to avoid misoperation due to hand sliding during operation.
  • the stent In the process of delivering the stent to the blood vessel, the stent is contracted to be accommodated in the first guide sheath 12 and the second guide sheath 13, and the screw members 35 are all adjusted to the released state, and then the front end of the first connecting rod 41 and the guide
  • the rear end of the core 11 is connected
  • the front end of the second connecting rod 42 is connected to the rear end of the top core 14
  • the front end of the third connecting rod 43 is connected to the rear end of the second guide sheath 13, and then the first handle 51
  • the second handle 52 and the third handle 43 move forward simultaneously, so that the stent moves into the branch vessel under the action of the guide core 11, the first guide sheath 12, the second guide sheath 13, and the top core 14, as shown in FIG. 1, 1 is the state of each handle of the operating device when the stent is moved to the corresponding position of the branch vessel.
  • the first handle 51 and the second handle 52 are locked with the screw 35 to keep the guide core 11 and the top core 14 stationary, and the third handle 53 is pulled back to make the second
  • the guide sheath 13 is moved backwards, and the opening 22 of the stent is released by the abutment of the fixed core 14.
  • the opening 22 can also be expanded to fit the transition area of the branch vessel, and then release the first handle
  • the threaded part 35 on 51 is used to tighten the third handle 53 to keep the second guide sheath 13 fixed. Push the first handle 51 forward to move the guide core 11 forward along the guide wire, thereby driving the first guide.
  • the sheath 12 moves forward synchronously.
  • FIG. 2 is a state of the handle of the operation device after the opening portion 22 is released
  • FIG. 3 is a state of the handle of the operation device after the body portion 21 is released.
  • the first handle 51 can be pulled back to guide
  • the core 11 synchronously drives the first guide sheath 12 to withdraw back to the outside body, and then pulls back the second handle 52 and the third handle 53 in order to pull back the top core 14 and the second guide sheath 13 to the outside body, thereby completing the branch blood vessels.
  • the stent is precisely implanted.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

L'invention concerne un dispositif d'actionnement d'un système d'implantation précise de stent pour un vaisseau ramifié. Un stent comprend une partie corps (21) et une partie d'ouverture (22) située à une extrémité arrière de la partie corps (21). Le système d'implantation précise de stent comprend un noyau de guidage (11) disposé de manière coaxiale dans le stent et utilisé pour le transporter, une première gaine de guidage (12) reliée au noyau de guidage (11) et utilisée pour recevoir la partie corps (21), une seconde gaine de guidage (13) pour recevoir la partie d'ouverture (22), et un noyau supérieur (14) disposé dans la seconde gaine de guidage (13) et venant en butée contre l'extrémité arrière de la partie d'ouverture (22); l'extrémité arrière de la première gaine de guidage (12) et l'extrémité avant de la seconde gaine de guidage (13) sont ouvertes. Le dispositif d'actionnement comprend un mécanisme de poussée-traction de poignée pour transporter et contracter le noyau de guidage (11), le noyau supérieur (14), la première gaine de guidage (12) et la seconde gaine de guidage (13), et un boîtier (31) utilisé pour recevoir le mécanisme de poussée-traction de poignée et pourvu d'un élément de fixation pour relier ou séparer du mécanisme de poussée-traction de poignée. Le mécanisme de poussée-traction de poignée du dispositif d'actionnement transporte ou contracte le noyau de guidage (11) pour transporter le stent, le noyau supérieur (14), la première gaine de guidage (12), et la seconde gaine de guidage (13) au moyen d'une poussée et d'une traction de façon à mettre en œuvre une implantation précise de stent du vaisseau ramifié.
PCT/CN2018/089094 2018-05-30 2018-05-30 Dispositif d'actionnement d'un système d'implantation précise de stent pour vaisseau ramifié WO2019227357A1 (fr)

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Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN1441654A (zh) * 2000-03-22 2003-09-10 先进扩张技术公司 导线引入器套
WO2004089249A1 (fr) * 2003-04-03 2004-10-21 William A. Cook Australia Pty. Ltd. Systeme et procede de deploiement d'un greffon sous forme de stent ramifie
CN101594838A (zh) * 2006-09-25 2009-12-02 A·维勒 用于分叉病变的自膨胀支架***
CN101897629A (zh) * 2009-05-26 2010-12-01 微创医疗器械(上海)有限公司 分支型覆膜支架输送***及其输送方法
CN102525699A (zh) * 2012-01-12 2012-07-04 微创医疗器械(上海)有限公司 分支型术中支架输送***及用于其的导引导管
CN103083122A (zh) * 2013-01-21 2013-05-08 北京华脉泰科医疗器械有限公司 一种覆膜支架的固定装置
CN105266936A (zh) * 2014-06-25 2016-01-27 李雷 分支血管的支架精确植入***
CN105310798A (zh) * 2014-06-25 2016-02-10 北京奇伦天佑创业投资有限公司 覆膜植入***以及覆膜和支架分别植入的植入***

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN1441654A (zh) * 2000-03-22 2003-09-10 先进扩张技术公司 导线引入器套
WO2004089249A1 (fr) * 2003-04-03 2004-10-21 William A. Cook Australia Pty. Ltd. Systeme et procede de deploiement d'un greffon sous forme de stent ramifie
CN101594838A (zh) * 2006-09-25 2009-12-02 A·维勒 用于分叉病变的自膨胀支架***
CN101897629A (zh) * 2009-05-26 2010-12-01 微创医疗器械(上海)有限公司 分支型覆膜支架输送***及其输送方法
CN102525699A (zh) * 2012-01-12 2012-07-04 微创医疗器械(上海)有限公司 分支型术中支架输送***及用于其的导引导管
CN103083122A (zh) * 2013-01-21 2013-05-08 北京华脉泰科医疗器械有限公司 一种覆膜支架的固定装置
CN105266936A (zh) * 2014-06-25 2016-01-27 李雷 分支血管的支架精确植入***
CN105310798A (zh) * 2014-06-25 2016-02-10 北京奇伦天佑创业投资有限公司 覆膜植入***以及覆膜和支架分别植入的植入***

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