CN104068918A - Catheter with atherosclerotic plaque cutting and sucking function - Google Patents
Catheter with atherosclerotic plaque cutting and sucking function Download PDFInfo
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- CN104068918A CN104068918A CN201410334459.5A CN201410334459A CN104068918A CN 104068918 A CN104068918 A CN 104068918A CN 201410334459 A CN201410334459 A CN 201410334459A CN 104068918 A CN104068918 A CN 104068918A
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- main body
- conduit
- catheter main
- cutting
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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
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
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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
- A61B2017/00831—Material properties
- A61B2017/00942—Material properties hydrophilic
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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
- A61B2017/22079—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 suction of debris
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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
- A61B17/32—Surgical cutting instruments
- A61B2017/320052—Guides for cutting instruments
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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
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B2017/320741—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions for stripping the intima or the internal plaque from a blood vessel, e.g. for endarterectomy
Abstract
The invention discloses a catheter with an atherosclerotic plaque cutting and sucking function. Guide wires or an inflatable balloon system or a support system can penetrate through stenosis and bending positions in occlusion conveniently. According to the catheter, the near end of a catheter body is connected with a connector, the far end of the catheter body is connected with a guide cutting device, and a guide block is arranged at the far end of the guide cutting device. The guide block is connected with the far end of the control guide wire and the far end of the cutting guide wire, the near end of the cutting guide wire is connected with the far end of the catheter body, and the near end of the control guide wire is connected with an adjusting knob used for adjusting and controlling the guide wires to make axial movement. The adjusting knob is connected to the near end of the connector. Compared with the prior art, the adjusting knob at the near end of the connector can be adjusted, thrombi at a diseased region can be cut off, a suction instrument at the Luer end can be operated, the cut thrombi can be sucked out, the guide wires or the inflatable balloon system or the support system can penetrate through the stenosis and bending positions in occlusion more conveniently.
Description
Technical field
The present invention relates to a kind of medical apparatus and instruments, particularly a kind of conduit for coronary artery disease Surgery.
Background technology
Coronary atherosclerotic heart disease refers to coronary artery generation atherosclerotic lesion and causes lumen of vessels stenosis or occlusion, causes myocardial ischemia, anoxia or heart disease downright bad and that cause, is referred to as " coronary heart disease ".For the operative treatment of this disease, be mainly taking percutaneous coronary intervention (pci) PCI as main.In the enforcement of percutaneous coronary intervention (pci) operation, conventional way is to use to guide seal wire from the subcutaneous vascular site producing on the heart that blocks pathological changes that pushes to via arteries, and then make to guide seal wire to pass whole obstruction pathological changes, again by guiding seal wire as transmission path, corresponding dilating sacculus system or mounting system etc. are sent to Occlusion position, finally carry out sacculus pressurising blood vessel dilating or strut support, in diseased region, place rebuilds out new tunnel, make cardiac muscle regain blood supply thereby reach, again the object of normal work.But in this operation process, can run into the comparatively serious case of diseased region place congestion situations, as obstruction place severe stenosis or complications, the CTO etc. that even entirely shuts, causes dilating sacculus system or mounting system, the situation of even guiding seal wire all cannot pass through.Under these circumstances; operation implementer can adopt other modes as grappling technology conventionally; reverse by technology etc.; help to guide seal wire, dilating sacculus system or mounting system to send to Occlusion position; complete operative treatment, or also may occur because of apparatus cannot be by the long situation that causes operation to be ended of, operating time.In these situations, all exist and use that operating theater instruments is more, may cause occurring the problems such as complication risk is higher, operating time is longer in more loaded down with trivial details, the art of operation.
Summary of the invention
The object of this invention is to provide a kind of conduit with cutting atherosclerotic plaque and pumping function, the technical problem that solve is to make to guide seal wire, dilating sacculus system or mounting system can pass more easily narrow, bending position in Occlusion.
The present invention is by the following technical solutions: a kind of conduit with cutting atherosclerotic plaque and pumping function, be provided with the catheter main body of tubulose, catheter main body near-end is connected with adapter, described catheter main body far-end is connected with guiding cutter sweep, the far-end of guiding cutter sweep is provided with guiding block, guiding block connects the far-end of controlling seal wire and 2～6 cutting seal wires, the near-end of cutting seal wire is connected with catheter main body far-end, the near-end of controlling seal wire is connected with regulating the axially movable adjusting knob of control seal wire, and adjusting knob is connected to the near-end of adapter.
The cross section external dimensions of guiding block of the present invention is 0.45～0.70mm, and cross sectional shape is circular, oval, trapezoidal or square.
The cross section external dimensions of cutting seal wire of the present invention is 0.10～0.20mm, and length is 8～20mm, and cross sectional shape is circular, oval, trapezoidal or square, adopts Nitinol or stainless steel silk, and in free state, cutting seal wire linearly.
Between catheter main body of the present invention and guiding cutter sweep, be connected with far-end pipe shaft, distal tube is as conical pipe, and the external diameter of near-end is consistent with the external diameter of catheter main body, and far-end is small end, small end end is angular cut, and the face that angular cut cut channel forms is plane, curved surface or cambered surface; Described far-end pipe shaft is by materials at two layers in conjunction with forming, and skin be outer tube, adopts and is applicable to the macromolecule polymer material that intervention apparatus is used, and internal layer is ripply Nitinol or stainless steel tube outside pipe, and pitch of waves edge is held greatly to small end and is changed to 0.5mm by 2mm.
Distal tube height degree of the present invention is 300mm, and far-end external diameter is 0.79～1.00mm, and outer tube thickness is 0.03～0.10mm.
Catheter main body external diameter of the present invention is 1.0～1.4mm, is separated into vertically small one and large one two inner chambers in catheter main body, and less inner chamber is guidewire lumen, and internal diameter is 0.26～0.36mm.
Described far-end pipe shaft or far-end pipe shaft and catheter main body surface-coated have hydrophilic coating, hydrophilic coating is end table double-decker, primer is polyesters macromolecular material, polyethers macromolecule or polyesters macromolecule and the high molecular block thing of polyethers, and skin-material adopts macromolecular material or natural polymer and derivant thereof; Described polyesters macromolecular material is polyurethane or Merlon, described polyethers macromolecular material is polyether polyol or EU, described macromolecular material is more than one of polyvinyl pyrrolidone, polyethylene glycol oxide, polypropylene oxide and poly N-vinyl lactams, and described natural polymer and derivant thereof are chitin, chitosan or agarose; Described skin depth is 0.005-0.035mm, and underlayer thickness is 0.005-0.035mm; Described hydrophilic coating region is that the distal end of far-end pipe shaft (4) starts to proximal extension, and length is 50-500mm.
Described adapter is y type Rule adapter, y type Rule adapter is provided with supervisor, supervisor middle part is connected with arm and forms y type structure, angle between arm and one section of near-end of supervisor is acute angle, arm is Rule end, and supervisor's far-end is coaxially connected with catheter main body, and supervisor's near-end is threaded ends, the outer peripheral edges of threaded ends are external screw thread, on internal chamber wall, have two symmetrical, vertically from the initial gathering sill to remote extension of near-end.
Described adjusting knob is made up of with the blocking cap that knob cap near-end is connected the slide block of the column arranging in knob cap, knob cap; Described knob cap distal portions is screw, form and be threaded with the external screw thread of threaded ends, knob cap proximal part is the through hole being communicated with screw, is provided with the snap ring that a circle protrudes in through hole, the proximal part outer peripheral edges of knob cap are external screw thread, form and are threaded with the female thread of blocking cap; Described slide block has eccentric through-hole vertically, in the outer rim of slide block, in axial direction be provided with two symmetrically arranged, outwardly guide rails, the interior formation of gathering sill that embeds threaded ends inner chamber is slidably connected, have annular annular groove near on the close end excircle of slide block, the snap ring of knob cap embeds wherein and forms and be slidably connected.
Described control seal wire near-end is connected with the far-end of slide block.
The present invention compared with prior art, distal end of catheter is connected with guiding cutter sweep, be adjusted in the adjusting knob of adapter near-end, the thrombosis of diseased region can be cut down, the suction apparatus of operation Rule end, just can be by the thrombosis sucking-off cutting down, not using more operating theater instruments, more under shirtsleeve operation, make to guide seal wire, dilating sacculus system or mounting system more easily through narrow, bending position in Occlusion, to complete smoothly percutaneous coronary intervention (pci) operation.
Brief description of the drawings
Fig. 1 is the structural representation of the embodiment of the present invention.
Fig. 2 is the structural representation of embodiment of the present invention y type Rule adapter.
Fig. 3 is the structural representation of embodiment of the present invention adjusting knob.
Fig. 4 is the A enlarged drawing of Fig. 3.
Fig. 5 is the cutaway view that embodiment of the present invention y type Rule adapter and adjusting knob coordinate.
Fig. 6 is the sectional view of embodiment of the present invention catheter main body.
Fig. 7 is the structural representation of embodiment of the present invention far-end pipe shaft.
Fig. 8 is the partial sectional view of embodiment of the present invention catheter main body and the docking of far-end pipe shaft.
Fig. 9 is the structural representation of embodiment of the present invention guiding cutter sweep.
Figure 10 is the photo of embodiment of the present invention guiding cutter sweep in free state.
Figure 11 is the photo that embodiment of the present invention guiding cutter sweep cutting seal wire opens.
Figure 12 is embodiment of the present invention guiding cutter sweep cutting photo.
Detailed description of the invention
Below in conjunction with drawings and Examples, the present invention is described in further detail.
As shown in Figure 1, the conduit (conduit) of band cutting atherosclerotic plaque of the present invention and pumping function, length is 1000～1500mm.Conduit is provided with y type Rule adapter 1, and y type Rule adapter 1 is provided with a supervisor, and supervisor middle part is connected with an arm and forms y type structure, and arm is acute angle with the angle of being responsible between one section of near-end.The far-end that y type Rule adapter 1 is responsible for is coaxially connected with catheter main body 3, and the far-end of catheter main body 3 is connected with far-end pipe shaft 4, and the far-end of far-end pipe shaft 4 is connected with guiding cutter sweep 5.Outside the far-end of being responsible at y type Rule adapter 1 and catheter main body 3 junctions, be equipped with conduit reinforcement 6, the near-end of being responsible at y type Rule adapter 1 is connected with adjusting knob 2.
As shown in Figure 2, the far-end that y type Rule adapter 1 is responsible for is conduit assembling end 7, and supervisor's near-end is threaded ends 8, and arm is Rule end 9, the inner chamber intercommunication of conduit assembling end 7, threaded ends 8 and Rule end 9.Y type Rule adapter 1 adopts rigid material.The endoporus that the near-end of catheter main body 3 puts in conduit assembling end 7 forms connection, and the external diameter of catheter main body 3 near-ends is consistent with conduit assembling end 7 internal diameters.The outer peripheral edges of conduit assembling end 7 are provided with annular protrusion, are nested with while being assemblied in catheter main body 3 with conduit assembling end 7 junction for conduit reinforcement 6, snap in the ring-shaped depression draw-in groove of conduit reinforcement 6 inwalls.In the outer peripheral edges of threaded ends 8, be processed with external screw thread, pitch is 0.5～2mm, and threaded portion length is 12～18mm, forms and is threaded with the female thread of adjusting knob 2.On the internal chamber wall of threaded ends 8, have two symmetrical, vertically from the initial straight gathering sill to remote extension of near-end, gathering sill length is 12～18mm.This gathering sill is for matching with the slide block 11 of adjusting knob 2.The 6% luer lock joint that Rule end 9 is standard, meets the female Luer of GBT 1962.2-2001 standard and ISO 594-2 1998 standards, can be used for connecting other apparatuses.
As shown in Figure 3, adjusting knob 2 is made up of with the blocking cap 19 that knob cap 10 near-ends are connected the slide block 11 of the column of knob cap 10, knob cap 10 interior settings, knob cap 10, and slide block 11 and blocking cap 19 coaxially arrange.Knob cap 10 distal portions are screw, and its female thread pitch is 0.5～2mm, and threaded portion length is 12～18mm, form and are threaded with the external screw thread of y type Rule adapter 1 threaded ends 8.Knob cap 10 its axially movable distance in the time that threaded ends 8 rotates is 4～6mm, can regulate the control seal wire 18 that is connected to slide block 11 far-ends to move axially 4～6mm in catheter main body 3 through slide block 11.Knob cap 10 proximal parts are the through hole being communicated with screw, are provided with the circle snap ring projecting inward to the center of circle in through hole, pack knob cap 10 into embed in the annular groove of slide block 11 outer peripheral edges when interior for slide block 11.The proximal part outer peripheral edges of knob cap 10 are external screw thread, and pitch is 0.5～2mm, and threaded portion length is 5mm, form and are threaded with the female thread of blocking cap 19.Knob cap 10 adopts and is applicable to the macromolecule polymer material that coronary artery disease intervention apparatus is used.Slide block 11 has the eccentric through-hole of internal diameter 1.5～2.0mm vertically, and eccentric through-hole is communicated with the suction chamber 13 of the double lumen tube of catheter main body 3, so that other seal wires pass through.In the outer rim of slide block 11, be in axial direction provided with two symmetrically arranged, outwardly guide rails, embed when being connected with y type Rule adapter 1 in the gathering sill of threaded ends 8 inner chambers and form and be slidably connected.As shown in Figure 4, near having annular annular groove on the close end excircle of slide block 11, pack knob cap 10 into when interior for slide block 11, the snap ring of knob cap 10 embeds wherein, and snap ring and annular groove formation are slidably connected, and mutually can freely rotate.The distal end of slide block 11 is connected with the near-end of controlling seal wire 18.Slide block 11 adopts and is applicable to the macromolecule polymer material that coronary artery disease intervention apparatus is used.Blocking cap 19 is cap shape, and near-end is closed, and distal portions is screw, and the pitch of screw female thread is consistent with the external screw thread of knob cap 10, is 0.5～2mm, and threaded portion length is 4mm, adopts and is applicable to the macromolecule polymer material that coronary artery disease intervention apparatus is used.The external diameter of controlling seal wire 18 is 0.20～0.30mm, adopts nitinol alloy wire.
As shown in Figure 5, after the female thread of the knob cap 10 of adjusting knob 2 is threaded with the external screw thread of y type Rule adapter 1 threaded ends 8, adjusting knob 2 is coaxial with the supervisor of y type Rule adapter 1, rotation adjusting knob 2 knob cap 10, can make knob cap 10 along its axis direction forward and backward movement of supervisor relative to y type Rule adapter 1.Because the guide rail of slide block 11 embeds in the gathering sill of external screw thread link 8 inner chambers, slide block 11 can not rotate with knob cap 10, the snap ring of knob cap 10 is embedded in the annular groove of slide block 11 simultaneously, therefore slide block 11 is only with knob cap 10 forward and backward movement vertically, slide block 11 is forward and backward movement vertically, drives the forward and backward movement of control seal wire 18 being connected with its far-end.
As shown in Figure 6, catheter main body 3 is double lumen, and the external diameter of catheter main body 3 is 1.0～1.4mm (3～4Fr).In catheter main body 3, be separated into vertically small one and large one two inner chambers, less inner chamber is guidewire lumen 12, and control seal wire 18 thus inner chamber passes, and the internal diameter of guidewire lumen 12 is 0.26～0.36mm; Larger inner chamber is suction chamber 13, for aspirating the thrombosis that comes off, through guiding seal wire.Catheter main body 3 adopts and is applicable to the macromolecule polymer material that coronary artery disease intervention apparatus is used, by prior art precision extrusion molding process, and an extrusion molding.Prior art precision extrusion molding process extrudes multi-lumen tube, and plastic grain enters the circular passage of tube core mouth intermode through extruder, is aided with compressed air corresponding channel interior is pressurizeed, and finally becomes multi-lumen tube by die extrusion.
As shown in Figure 7, far-end pipe shaft 4 profiles are conical pipe, and length is 300mm, and near-end is large end, and the external diameter of near-end is consistent with the external diameter of catheter main body 3, and is connected with catheter main body 3.Far-end is small end, and far-end external diameter is 0.79～1.00mm.Small end end is angular cut, face and far-end pipe shaft 4 axis out of plumb that angular cut forms, and the face that angular cut cut channel forms is plane, curved surface or cambered surface.When far-end pipe shaft 4 is admitted to far-end, angular cut play the guiding role.Far-end pipe shaft 4 is by materials at two layers in conjunction with forming, and skin is outer tube 14, and outer tube 14 adopts and is applicable to the macromolecule polymer material that coronary artery disease intervention apparatus is used, and thickness is 0.03～0.10mm.Internal layer is pipe ripply metal tube 15 in addition, adopt Nitinol or stainless steel tube, cut into outer ripple along metal tube outer peripheral edges with laser, the pitch of waves is changed to 0.5mm along holding greatly to small end by 2mm, can be even variation, can be also changed in stages, make metal tube 15 from near-end to far-end by firmly to soft gradual change, near-end has certain intensity, and far-end has good compliance.
As shown in Figure 8, catheter main body 3 is connected with the mode of overlap joint with docking with far-end pipe shaft 4.The metal tube 15 of far-end pipe shaft 4 near-ends docks with catheter main body 3 far-ends, and outer tube 14 stretches out 10mm from the large end of metal tube 15, entangles catheter main body 3, forms the syndeton of docking and overlap joint after bonding or welding.
Far-end pipe shaft 4 or far-end pipe shaft 4 have hydrophilic coating with catheter main body 3 surface-coated, and this hydrophilic coating is end table double-decker, and primer is polyesters macromolecular material, polyethers macromolecule or polyesters macromolecule and the high molecular block thing of polyethers.Polyesters macromolecular material is polyurethane or Merlon.Polyethers macromolecular material is polyether polyol or EU.Skin-material adopts macromolecular material or natural polymer and derivant thereof.Macromolecular material is more than one of polyvinyl pyrrolidone, polyethylene glycol oxide, polypropylene oxide and poly N-vinyl lactams, and natural polymer and derivant thereof are chitin, chitosan or agarose.Top layer lubricate, thickness is 0.005-0.035mm, and bottom plays fixing top layer, and thickness is 0.005-0.035mm.Hydrophilic coating region is that the distal end of far-end pipe shaft 4 starts to proximal extension, and length is 50-500mm.
As shown in Figure 9, guiding cutter sweep 5, by guiding block 17, controls 18 and 2～6 cutting seal wires 20 of seal wire and forms, and cutting seal wire 20 the bests are 2.Guiding block 17 is positioned at far-end, there is the effect that the whole conduit of guiding enters artery stenosis blood vessel, the cross section largest outer dimension that guiding block 17 is vertical with the axis of conduit is 0.45～0.70mm, cross sectional shape is circular, oval, trapezoidal or square, outer surface is round and smooth without corner angle, adopt nylon tube, Nitinol or rustless steel, available cut or grinding process processing and fabricating.Control seal wire 18 through far-end pipe shaft 4, the guidewire lumen 12 of catheter main body 3 and the supervisor of y type Rule adapter 1, near-end is connected with the far-end of 2 slide block 11 on adjusting knob, and far-end is connected to the center of guiding block 17 near-ends, and connected mode is for boning or welding.Cutting seal wire 20, the largest outer dimension in cross section is 0.10～0.20mm, and length is 8～20mm, and cross sectional shape is circular, oval, trapezoidal or square, adopts Nitinol or stainless steel silk.Cutting seal wire 20 is symmetricly set on controls seal wire 18 outsides, and far-end is connected with the near-end of guiding block 17, and near-end is connected to the inside pipe wall of the small end end of far-end pipe shaft 4, and connected mode is bonding or welding.
In free state, cutting seal wire 20 is linearly.When guiding block 17 moves to near-end, Distance Shortened between cutting seal wire 20 two ends is controlled in 7.5～7.8mm, cutting seal wire 20 is curved to outer process, arc outermost end is 0.8～1.3mm with controlling seal wire 18 towards the distance of the outer surface of cutting seal wire 20, makes to cut seal wire 20 and forms the radian of cutting preferably.In the time that cutting seal wire 20 is 2, because the external diameter of controlling seal wire 18 is 0.20～0.30mm, two symmetrically arranged cutting seal wires 20 are 1.8～2.9mm (0.8 × 2+0.2=1.8,1.3 × 2+0.3=2.9) to the external diameter after outer process, form symmetrical cutting edge.When guiding block 17 moves to far-end, make to cut seal wire 20 and be tightened up linearly.In the time pushing conduit to far-end, cutting seal wire 20 linearly; When cutting, cutting seal wire 20 is curved.
If one section of the far-end of catheter main body 3 is made into single chamber, middle part and near-end are double lumen, catheter main body 3 from near-end to far-end by firmly to soft gradual change, also can be without far-end pipe shaft 4, directly guiding cutter sweep 5 is connected to the far-end of catheter main body 3.
When operation, in conduit is pushed to coronary artery when inaccessible diseased region, continue to push guiding block 17 through diseased region, guiding block 17 is directed to the control seal wire 18 of guiding cutter sweep 5 and two cutting seal wires 20 behind target (diseased region) position, operative doctor is rotated counterclockwise the adjustment knob 2 on y type Rule adapter 1, its inner slide block 11 is moved to near-end, slide block 11 pulls control seal wire 18 to move to near-end, guiding block 17 on the guiding cutter sweep 5 of drive far-end moves to near-end, make to be arranged on to control two cuttings in seal wire 18 outsides seal wire 20 is curved and outwards open, form two cutting edges that open.At near-end rotary guide pipe, two cutting seal wires 20 are also followed rotation, the thrombosis on target location can be cut down.Then, with blocking cap 19, the through hole of adjusting on knob 2 is blocked, be connected to the suction apparatus of Rule end 9 of y type Rule adapter 1 by operation as the syringe of 30ml, make generation vacuum in conduit, just can be by the thrombosis cutting down via suction chamber 13 sucking-offs.Operate in by this that blood vessel internal object diseased region carries out once or repeatedly, can in blood vessel, re-establish a passage by this diseased region, be conducive to guide seal wire, expandable stent system is pushed to diseased region by pressurising dilating sacculus.
In the present embodiment, the catheter length of band cutting atherosclerotic plaque and pumping function is 1500mm, control seal wire 18 at the interior axial maximum moving distance 6mm of catheter main body 3, the cross section external dimensions that the guiding guiding block 17 of cutter sweep 5 and the axis of conduit are vertical is 0.70mm, cross sectional shape is circular, adopt nylon tube, controlling seal wire 18 external diameters is 0.30mm, adopts Nitinol.Two cutting seal wires 20, cross section external dimensions is 0.13mm, and length is 20mm, and cross sectional shape is circular, adopts 304 rustless steels (0Cr18Ni9).As shown in figure 10, in free state, cutting seal wire 20 is linearly.As shown in figure 11, adjust the cutting of 2, two of knobs seal wire 20 is curved and outwards open, form two cutting edges that open.As shown in figure 12, guiding cutter sweep 5 is carried out on HUOLONG sarcocarp to simulating cut experiment, on sarcocarp, obviously see cutting vestige, illustrate that guiding cutter sweep 5 can effectively cut, syringe, can be by the sarcocarp cutting down via suction chamber 13 sucking-offs by after in conduit, suction is vacuum state.Conduit by above-mentioned description of test band cutting atherosclerotic plaque of the present invention and pumping function can be for the cutting of human body atherosclerotic plaque and suction.
Conduit of the present invention uses in the treatment operation of comparatively serious obstruction place, severe stenosis, complications or the CTO symptom of entirely shutting, there is following advantage: 1, under prior art condition, when in the face of case as above, with needs adopt grappling technology or seal wire reverse by compared with technology, conduit of the present invention can reduce use apparatus, simplifies the instrumentation in operation process.2, owing to having reduced use apparatus, simplify instrumentation, can make operating time greatly shorten, also avoided complication odds, shortened the time that patient exposes under ray.3, may cannot pass through diseased region because of apparatus than prior art, and the situation that causes operation to be ended, conduit of the present invention is set up new tunnel in obstruction lesion, ensure that the apparatuses such as seal wire, dilating sacculus system or mounting system can, more easily through the advantage of diseased region, can significantly improve the success rate of operation.Conduit of the present invention, for the intervene operation of coronary artery severe stenosis or total occlusion provides an operation easier, uses equipment still less, and can effectively reduce the insertion type apparatus of operation risk.
Conduit of the present invention, the guiding cutter sweep of far-end can, effectively by the atherosclerotic plaque excision of diseased region, build and be beneficial to the passage that other apparatuses pass through in pathological changes stenosis.Distal tube body contour is taper, and far-end is angular cut, is more conducive to conduit and enters, arrives the blood vessel that some sizes that occur pathological changes symptom are less.Catheter main body is double cavity structure, and a chamber is the guidewire lumen of controlling guiding cutter sweep, and another chamber is the pathological changes speckle suction or transmit the suction chamber of other apparatuses of coming off, and when double cavity structure ensures that apparatus operates in art, is not mutually interfered.Distal tube body structure is double layer material, and outer is the macromolecule polymer material that soft applicable coronary artery disease intervention apparatus is used, and makes far-end pipe shaft have good compliance, ensures that blood vessel is not damaged by it; Internal layer is in addition ripply metal tube of pipe, ensures that far-end pipe shaft has good intensity, good control property and the propelling movement property turned round.The hydrophilic coating of far-end pipe shaft surface-coated, can effectively strengthen the far handling capacity of section of conduit, more easily makes conduit arrive diseased region, simultaneously the also effectively injury of reduction to blood vessel.
The present invention, for the intervene operation of coronary artery severe stenosis or total occlusion provides an operation easier, uses equipment still less, and can effectively reduce the intervention apparatus of operation risk.
Claims (10)
1. the conduit with cutting atherosclerotic plaque and pumping function, be provided with the catheter main body (3) of tubulose, catheter main body (3) near-end is connected with adapter, it is characterized in that: described catheter main body (3) far-end is connected with guiding cutter sweep (5), the far-end of guiding cutter sweep (5) is provided with guiding block (17), guiding block (17) connects the far-end of controlling seal wire (18) and 2～6 cutting seal wires (20), the near-end of cutting seal wire (20) is connected with catheter main body (3) far-end, the near-end of controlling seal wire (18) is connected with regulating the control axially movable adjusting knob of seal wire (18) (2), adjusting knob (2) is connected to the near-end of adapter.
2. the conduit of band cutting atherosclerotic plaque according to claim 1 and pumping function, is characterized in that: the cross section external dimensions of described guiding block (17) is 0.45～0.70mm, and cross sectional shape is circular, oval, trapezoidal or square.
3. the conduit of band cutting atherosclerotic plaque according to claim 1 and pumping function, it is characterized in that: the cross section external dimensions of described cutting seal wire (20) is 0.10～0.20mm, length is 8～20mm, cross sectional shape is circular, oval, trapezoidal or square, adopt Nitinol or stainless steel silk, in free state, cutting seal wire (20) linearly.
4. the conduit of band cutting atherosclerotic plaque according to claim 1 and pumping function, it is characterized in that: between described catheter main body (3) and guiding cutter sweep (5), be connected with far-end pipe shaft (4), far-end pipe shaft (4) is conical pipe, the external diameter of near-end is consistent with the external diameter of catheter main body (3), far-end is small end, small end end is angular cut, and the face that angular cut cut channel forms is plane, curved surface or cambered surface; Described far-end pipe shaft (4) is made up of materials at two layers combination, skin is outer tube (14), adopt and be applicable to the macromolecule polymer material that intervention apparatus is used, internal layer is the outer ripply Nitinol of pipe or stainless steel tube (15), and the pitch of waves is changed to 0.5mm along holding greatly to small end by 2mm.
5. the conduit of band cutting atherosclerotic plaque according to claim 4 and pumping function, it is characterized in that: described far-end pipe shaft (4) length is 300mm, far-end external diameter is 0.79～1.00mm, and outer tube (14) thickness is 0.03～0.10mm.
6. the conduit of band cutting atherosclerotic plaque according to claim 5 and pumping function, it is characterized in that: described catheter main body (3) external diameter is 1.0～1.4mm, in catheter main body (3), be separated into vertically small one and large one two inner chambers, less inner chamber is guidewire lumen (12), and internal diameter is 0.26～0.36mm.
7. the conduit of band cutting atherosclerotic plaque according to claim 6 and pumping function, it is characterized in that: described far-end pipe shaft (4) or far-end pipe shaft (4) have hydrophilic coating with catheter main body (3) surface-coated, hydrophilic coating is end table double-decker, primer is polyesters macromolecular material, polyethers macromolecule or polyesters macromolecule and the high molecular block thing of polyethers, and skin-material adopts macromolecular material or natural polymer and derivant thereof; Described polyesters macromolecular material is polyurethane or Merlon, described polyethers macromolecular material is polyether polyol or EU, described macromolecular material is more than one of polyvinyl pyrrolidone, polyethylene glycol oxide, polypropylene oxide and poly N-vinyl lactams, and described natural polymer and derivant thereof are chitin, chitosan or agarose; Described skin depth is 0.005-0.035mm, and underlayer thickness is 0.005-0.035mm; Described hydrophilic coating region is that the distal end of far-end pipe shaft (4) starts to proximal extension, and length is 50-500mm.
8. the conduit of band cutting atherosclerotic plaque according to claim 7 and pumping function, it is characterized in that: described adapter is y type Rule adapter (1), y type Rule adapter (1) is provided with supervisor, supervisor middle part is connected with arm and forms y type structure, angle between arm and one section of near-end of supervisor is acute angle, arm is Rule end (9), supervisor's far-end is coaxially connected with catheter main body (3), supervisor's near-end is threaded ends (8), the outer peripheral edges of threaded ends (8) are external screw thread, on internal chamber wall, have two symmetrical, vertically from the initial gathering sill to remote extension of near-end.
9. the conduit of band cutting atherosclerotic plaque according to claim 8 and pumping function, is characterized in that: described adjusting knob (2) is made up of with the blocking cap (19) that knob cap (10) near-end is connected the slide block (11) of the column arranging in knob cap (10), knob cap (10); Described knob cap (10) distal portions is screw, form and be threaded with the external screw thread of threaded ends (8), knob cap (10) proximal part is the through hole being communicated with screw, in through hole, be provided with the snap ring that a circle protrudes, the proximal part outer peripheral edges of knob cap (10) are external screw thread, form and are threaded with the female thread of blocking cap (19); Described slide block (11) has eccentric through-hole vertically, in the outer rim of slide block (11), in axial direction be provided with two symmetrically arranged, outwardly guide rails, the interior formation of gathering sill that embeds threaded ends (8) inner chamber is slidably connected, have annular annular groove near on the close end excircle of slide block (11), the snap ring of knob cap (10) embeds wherein and forms and be slidably connected.
10. the conduit of band cutting atherosclerotic plaque according to claim 9 and pumping function, is characterized in that: described control seal wire (18) near-end is connected with the far-end of slide block (11).
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| CN201410334459.5A CN104068918B (en) | 2014-07-14 | 2014-07-14 | Catheter with atherosclerotic plaque cutting and sucking function |
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| CN201410334459.5A CN104068918B (en) | 2014-07-14 | 2014-07-14 | Catheter with atherosclerotic plaque cutting and sucking function |
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| CN104068918B CN104068918B (en) | 2015-07-22 |
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| CN106955138A (en) * | 2017-03-09 | 2017-07-18 | 徐白生 | A kind of multi-functional zebra guide wire |
| CN108024820A (en) * | 2015-08-25 | 2018-05-11 | 阿坎迪斯有限两合公司 | Medical suction system and medical thrombectomby system |
| CN110198677A (en) * | 2016-12-30 | 2019-09-03 | 巴德股份有限公司 | With the embedded sacculus for translating embedded silk |
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| CN104068918B (en) | 2015-07-22 |
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