CN110680457A - Thrombus removing system - Google Patents
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Abstract
本发明实施例提供了一种血栓清除系统,该系统通过在连通导管的头端设置可收缩和可膨胀的血管封堵机构,可以在血管封堵机构处于释放状态时,与血管壁紧密贴合并将血管进行短暂封堵,能够阻止血管内的血液流动对血栓造成冲击,通过在牵引导丝上设置可收缩和可膨胀的血栓抓捕机构,可以在血栓抓捕机构处于释放状态时,对血管壁进行充分地支撑扩张,有利于对血栓进行抓捕,通过在牵引导丝的远端设置可收缩和可膨胀的碎片拦截机构,可以在碎片拦截机构处于释放状态时,对血液中的血栓碎片进行过滤清除,防止其流动至血管远端位置,符合临床使用的需要。The embodiment of the present invention provides a thrombus removal system. By disposing a retractable and inflatable blood vessel blocking mechanism at the head end of the communication catheter, the system can closely adhere to the blood vessel wall when the blood vessel blocking mechanism is in a released state. Temporary occlusion of the blood vessel can prevent the blood flow in the blood vessel from impacting the thrombus. By setting a retractable and expandable thrombus capture mechanism on the traction guide wire, the blood vessel can be blocked when the thrombus capture mechanism is in a released state. The wall is fully supported and expanded, which is conducive to the capture of thrombus. By setting a retractable and inflatable debris interception mechanism at the distal end of the traction guide wire, when the debris interception mechanism is in a released state, the thrombus debris in the blood can be removed. It is filtered and removed to prevent it from flowing to the distal position of the blood vessel, which is in line with the needs of clinical use.
Description
技术领域technical field
本发明属于血管疾病治疗装置技术领域,具体涉及一种血栓清除系统。The invention belongs to the technical field of vascular disease treatment devices, and in particular relates to a thrombus removal system.
背景技术Background technique
血栓是在继发内源性或外源性凝血系统的病理情况下,由血液中的红细胞、血小板、纤维蛋白和白细胞等有形成分按照不同比例,在血管内发生异常聚集而形成的血凝块。血栓不仅能够在身体任何部位的血管内形成,而且还可以遍布于人体的各种组织器官中。血栓形成后会造成血管闭塞和血流受阻,引起相关的组织器官缺血甚至坏死,从而产生相应的组织器官功能障碍的症状。由于血栓形成而导致的心肌大面积梗死,动静脉管腔闭塞和缺血性脑卒中等相关心血管类疾病已经成为了临床上的常见病和多发病,并且给大量患者造成了极高的致死率和致残率。Thrombosis is a blood coagulation formed by abnormal aggregation of red blood cells, platelets, fibrin and white blood cells in the blood according to different proportions in the pathological conditions of the secondary endogenous or extrinsic coagulation system. piece. Thrombosis can not only form in blood vessels in any part of the body, but also spread throughout various tissues and organs of the human body. Thrombosis will cause vascular occlusion and blood flow obstruction, causing ischemia or even necrosis of related tissues and organs, resulting in symptoms of corresponding tissue and organ dysfunction. Cardiovascular diseases such as large-area myocardial infarction, arteriovenous lumen occlusion and ischemic stroke caused by thrombosis have become common clinical diseases and frequently-occurring diseases, and have caused extremely high fatalities to a large number of patients. rate and disability rate.
针对以上临床问题,早期大多采用药物溶栓方法进行治疗,但是该方法只适用于体积较小的血栓,对大体积血栓闭塞的治疗效果很不理想,在临床上主要表现为溶栓速度迟缓、血管再通率低、管腔再通时间长和预后效果较差等情况,而且通常大约只有3~5%的患者适合做药物溶栓治疗。近年来机械取栓方法已经成为血栓治疗领域的重点研究方向,该方法是将取栓装置输送至血栓附近,然后通过取栓装置将血栓抓捕并清除出体外。采用机械取栓方法的手术操作时间短、相关并发症少、血栓清除彻底和预后效果良好,然而目前临床上使用的取栓装置大多数为单层支架型结构,不但对于血栓的抓捕效率较低,而且在取栓操作时需要通过反复推拉来固定血栓,导致块状血栓极易形成碎片脱落并流动至血管远端位置,这就极大的增加了患者血管再闭塞的风险。In view of the above clinical problems, drug thrombolysis was mostly used for treatment in the early stage, but this method is only suitable for small thrombus, and the treatment effect on large-volume thrombus occlusion is very unsatisfactory. Low recanalization rate, long lumen recanalization time and poor prognosis, and usually only about 3-5% of patients are suitable for drug thrombolysis. In recent years, mechanical thrombectomy has become a key research direction in the field of thrombus treatment. This method is to deliver a thrombectomy device to the vicinity of the thrombus, and then capture and remove the thrombus through the thrombectomy device. The mechanical thrombectomy method has the advantages of short operation time, less related complications, complete thrombus removal and good prognosis. However, most of the thrombectomy devices currently used in clinical practice are single-layer stent structures, which not only have better thrombus capture efficiency In addition, during the thrombectomy operation, the thrombus needs to be fixed by repeated pushing and pulling, which makes the block thrombus easily form fragments and fall off and flow to the distal position of the blood vessel, which greatly increases the risk of vascular reocclusion in patients.
发明内容SUMMARY OF THE INVENTION
为了解决现有技术中存在的问题,本发明实施例提供了一种血栓清除系统,该系统工作时,通过血管封堵机构、血栓抓捕机构和碎片拦截机构三者的共同配合作用,并且在显影环节的辅助定位下,能够彻底清除血栓以及血栓碎片。本发明实施例还提供了一种血栓清除系统的使用方法。In order to solve the problems existing in the prior art, the embodiments of the present invention provide a thrombus removal system. When the system works, the blood vessel blocking mechanism, the thrombus catching mechanism and the debris blocking mechanism cooperate with each other, and when the system works, Under the auxiliary positioning of the imaging link, the thrombus and thrombus fragments can be completely removed. Embodiments of the present invention also provide a method for using the thrombus removal system.
为实现上述目的,本发明实施例采用以下技术方案:To achieve the above object, the embodiment of the present invention adopts the following technical solutions:
一种血栓清除系统,包括:A thrombus removal system comprising:
回收导管;recovery catheter;
传输导管,所述传输导管活动套设于所述回收导管中;a transmission conduit, which is movably sleeved in the recovery conduit;
连通导管,所述连通导管活动套设于所述传输导管中;a communication conduit, which is movably sleeved in the transmission conduit;
牵引导丝,所述牵引导丝设置于所述连通导管内的中心轴线上,相对于所述连通导管沿中心轴线方向移动,所述牵引导丝具有牵引端和推进端两个端头;a pulling guide wire, the pulling guide wire is arranged on the central axis in the communication conduit, moves in the direction of the central axis relative to the communication conduit, and the pulling guide wire has two ends, a pulling end and a pushing end;
血管封堵机构,所述血管封堵机构固定设置于所述连通导管的头端,所述血管封堵机构为可收缩和可膨胀的囊体结构;a blood vessel blocking mechanism, the blood vessel blocking mechanism is fixedly arranged at the head end of the communication conduit, and the blood vessel blocking mechanism is a contractible and inflatable balloon structure;
血栓抓捕机构,所述血栓抓捕机构固定设置于所述牵引导丝上、所述推进端与所述血管封堵机构之间,所述血栓抓捕机构为可收缩和可膨胀的网体结构;A thrombus capturing mechanism, the thrombus capturing mechanism is fixedly arranged on the traction guide wire, between the advancing end and the blood vessel blocking mechanism, and the thrombus capturing mechanism is a retractable and expandable mesh body structure;
碎片拦截机构,所述碎片拦截机构固定设置于所述牵引导丝的远端,所述碎片拦截机构为可收缩和可膨胀的篮体结构;以及a debris intercepting mechanism, the debris intercepting mechanism fixedly disposed at the distal end of the pulling guide wire, the debris intercepting mechanism being a collapsible and expandable basket structure; and
显影环节,所述显影环节固定绕制于所述连通导管和所述牵引导丝上。The developing link is fixedly wound on the communicating conduit and the pulling wire.
上述一种血栓清除系统中,回收导管、传输导管、连通导管、牵引导丝、血管封堵机构、血栓抓捕机构、碎片拦截机构和显影环节可以为同轴设置。非工作状态时,上述机构均收缩在回收导管中。工作状态时,通过控制装置将包含传输导管、连通导管和牵引导丝的回收导管沿血管送入至血栓附近,通过控制装置锁定回收导管,将包含连通导管和牵引导丝的传输导管推送并穿过血栓,通过控制装置锁定牵引导丝,并且在显影环节的辅助定位下,将连通导管回撤至适当距离,使设置在连通导管上的血管封堵机构和设置在牵引导丝上的血栓抓捕机构能够精确定位于血栓两端,随后通过控制装置锁定连通导管和牵引导丝,将传输导管回撤至回收导管的出口处,使设置在连通导管头端的血管封堵机构,设置在牵引导丝上的血栓抓捕机构和设置在牵引导丝远端的碎片拦截机构被依次释放至血管内。In the above-mentioned thrombus removal system, the recovery catheter, the transmission catheter, the communication catheter, the traction guide wire, the blood vessel blocking mechanism, the thrombus capturing mechanism, the debris intercepting mechanism and the developing link may be arranged coaxially. In the non-working state, the above mechanisms are all retracted in the recovery catheter. In the working state, the recovery catheter including the transmission catheter, the communication catheter and the traction guide wire is sent along the blood vessel to the vicinity of the thrombus through the control device, the recovery catheter is locked by the control device, and the transmission catheter including the communication catheter and the traction guide wire is pushed and threaded. After passing through the thrombus, the traction guide wire is locked by the control device, and under the auxiliary positioning of the developing link, the communication catheter is withdrawn to an appropriate distance, so that the blood vessel blocking mechanism set on the communication catheter and the thrombus set on the traction guide wire can catch the thrombus. The trapping mechanism can be precisely positioned at both ends of the thrombus, and then the communication catheter and the traction guide wire are locked by the control device, and the transmission catheter is withdrawn to the outlet of the recovery catheter, so that the blood vessel blocking mechanism arranged at the head end of the communication catheter is set in the traction guide. The thrombus capturing mechanism on the wire and the fragment intercepting mechanism arranged at the distal end of the pulling wire are sequentially released into the blood vessel.
血管封堵机构为囊体结构,收缩时呈圆管形,膨胀时呈圆球形,当血管封堵机构被释放到血管中时,可以与血管壁紧密贴合并将血管进行短暂封堵,能够阻止血管内的血液流动对血栓造成冲击,从而便于血栓抓捕机构将血栓捕获。The vascular occlusion mechanism is a balloon structure, which is in the shape of a tube when it contracts and a spherical shape when it expands. When the vascular occlusion mechanism is released into the blood vessel, it can be closely attached to the blood vessel wall and temporarily block the blood vessel, which can prevent The blood flow in the blood vessel impacts the thrombus, so that the thrombus is easily captured by the thrombus capturing mechanism.
血栓抓捕机构为网体结构,收缩时呈网管形,膨胀时呈圆梭形,当血管抓捕机构被释放到血管中时,可以对血管壁进行充分地支撑扩张,有利于对血栓进行抓捕。The thrombus capturing mechanism is a mesh structure, which is in the shape of a network tube when it is contracted, and a round fusiform when it is expanded. When the blood vessel capturing mechanism is released into the blood vessel, it can fully support and expand the blood vessel wall, which is conducive to the capture of the thrombus. catch.
碎片拦截机构为篮体结构,收缩时呈网管形,膨胀时呈圆兜形,当碎片拦截机构被释放到血管中时,可以对血液中的血栓碎片进行过滤清除,防止其流动至血管远端位置。The debris intercepting mechanism is a basket structure, which is in the shape of a network tube when it is contracted and a circular pocket when it is expanded. When the debris intercepting mechanism is released into the blood vessel, it can filter and remove the thrombus debris in the blood to prevent it from flowing to the distal end of the blood vessel. Location.
通过控制装置锁定连通导管和牵引导丝,将生理盐水等液体注入连通导管头端的血管封堵机构内,使其释放后与血管壁紧密贴合并将血管进行短暂封堵,能够阻止血管内的血液流动对血栓造成冲击,从而便于血栓抓捕机构将血栓捕获。The connecting catheter is locked by the control device and the guide wire is pulled, and the liquid such as normal saline is injected into the blood vessel blocking mechanism at the head end of the connecting catheter. The flow impinges on the thrombus, thereby facilitating the capture of the thrombus by the thrombus capture mechanism.
通过控制装置锁定回收导管、传输导管和连通导管,将牵引导丝缓慢回撤,在回撤过程中,设置在牵引导丝上的血栓抓捕机构将血栓进行抓捕并往近端方向推送,同时设置在牵引导丝远端的碎片拦截机构对血栓碎片进行过滤清除,防止其流动至血管远端位置。The retraction catheter, the transmission catheter and the communication catheter are locked by the control device, and the pulling guide wire is slowly withdrawn. At the same time, the debris intercepting mechanism arranged at the distal end of the pulling guide wire filters and removes the thrombus debris to prevent it from flowing to the distal end of the blood vessel.
通过控制装置锁定回收导管和传输导管,将连通导管头端的血管封堵机构内的生理盐水等液体抽出使其收缩,同时继续回撤牵引导丝,使设置在牵引导丝上的血栓抓捕机构和设置在牵引导丝远端的碎片拦截机构继续往近端方向推送,此时血栓已被血栓抓捕机构完全嵌入捕获,而血栓碎片也被碎片拦截机构过滤清除。The recovery catheter and the transmission catheter are locked by the control device, and the liquid such as normal saline in the vascular occlusion mechanism connected to the head end of the catheter is drawn out to make it contract, and at the same time, the retraction guide wire is continued to be withdrawn, so that the thrombus capturing mechanism arranged on the retraction guide wire is pulled out. The thrombus is completely embedded and captured by the thrombus capturing mechanism, and the thrombus fragments are also filtered and removed by the debris intercepting mechanism.
通过控制装置锁定回收导管,将传输导管、连通导管、血管封堵机构、血栓抓捕机构以及被捕获的血栓、碎片拦截机构以及被过滤的血栓碎片依次撤回至回收导管内。The recovery catheter is locked by the control device, and the transmission catheter, the communication catheter, the vessel blocking mechanism, the thrombus capturing mechanism and the captured thrombus, the debris intercepting mechanism and the filtered thrombus fragments are withdrawn into the recovery catheter in sequence.
通过控制装置将血栓清除系统全部平稳地撤出至体外,彻底完成对血栓以及血栓碎片的清除工作,使得血管内的血流恢复到正常的运行状态。Through the control device, the thrombus removal system is smoothly withdrawn to the outside of the body, and the removal of thrombus and thrombus fragments is completely completed, so that the blood flow in the blood vessel returns to a normal operating state.
显影环节的作用主要有以下三点:(1)采用显影环节可以对血栓清除系统中的血管封堵机构、血栓抓捕机构和碎片拦截机构进行精确定位,通过显影环节的设置,使操作者在X射线下能够清楚的观察到血管封堵机构、血栓抓捕机构和碎片拦截机构在血管内的位置,并且使操作者能够准确和彻底的完成对于血栓以及血栓碎片的清除工作;(2)采用显影环节绕制在连通导管上,不但可以明显增加连通导管整体的推送和牵拉能力,而且还可以提高血管封堵机构与连通导管的连接强度,能够更加有效的加强血栓清除系统使用时的安全性;(3)采用显影环节绕制在牵引导丝上,不但可以明显增加牵引导丝整体的推送和牵拉能力,而且还可以提高血栓抓捕机构、碎片拦截机构与牵引导丝的连接强度,能够更加有效的加强血栓清除系统使用时的安全性。The functions of the developing link mainly include the following three points: (1) The developing link can precisely locate the vessel blocking mechanism, thrombus capturing mechanism and debris intercepting mechanism in the thrombus removal system. Under X-rays, the positions of the vascular occlusion mechanism, the thrombus capture mechanism and the debris interception mechanism in the blood vessel can be clearly observed, and the operator can accurately and thoroughly complete the removal of thrombus and thrombus fragments; (2) using The developing link is wound around the communicating catheter, which can not only significantly increase the overall pushing and pulling ability of the communicating catheter, but also improve the connection strength between the vascular occlusion mechanism and the communicating catheter, which can more effectively enhance the safety of the thrombus removal system in use. (3) The developing link is wound on the traction guide wire, which can not only significantly increase the overall pushing and pulling ability of the traction guide wire, but also improve the connection strength of the thrombus capturing mechanism, the debris intercepting mechanism and the traction guide wire. , can more effectively enhance the safety of the thrombus removal system when used.
优选地,所述囊体结构收缩时呈圆管形,膨胀时呈圆球形。作用是当血管封堵机构被释放到血管中时,可以与血管壁紧密贴合并将血管进行短暂封堵,能够阻止血管内的血液流动对血栓造成冲击,从而便于血栓抓捕机构将血栓捕获。Preferably, the balloon structure is in the shape of a tube when it is contracted, and in a spherical shape when it is expanded. The function is that when the vascular blocking mechanism is released into the blood vessel, it can be closely attached to the blood vessel wall and temporarily block the blood vessel, which can prevent the blood flow in the blood vessel from impacting the thrombus, thereby facilitating the thrombus capturing mechanism to capture the thrombus.
进一步优选地,所述囊体结构为聚合物层,所述聚合物层包括聚氯乙烯层、聚氨酯层、尼龙层、PET层和PEBAX层等。Further preferably, the capsule structure is a polymer layer, and the polymer layer includes a polyvinyl chloride layer, a polyurethane layer, a nylon layer, a PET layer, a PEBAX layer, and the like.
进一步优选地,所述囊体结构被释放到血管中时,是通过对其注入生理盐水等液体的方式使其膨胀并与血管壁紧密贴合。Further preferably, when the balloon structure is released into the blood vessel, it is inflated by injecting a liquid such as physiological saline into it and closely adheres to the blood vessel wall.
优选地,所述网体结构收缩时呈网管形,膨胀时呈圆梭形。作用是当血管抓捕机构被释放到血管中时,可以对血管壁进行充分地支撑扩张,有利于对血栓进行抓捕。Preferably, the mesh structure is in the shape of a network tube when it shrinks, and is in the shape of a round shuttle when it expands. The function is that when the vessel capturing mechanism is released into the blood vessel, the vessel wall can be fully supported and expanded, which is beneficial to capturing the thrombus.
进一步优选地,所述网体结构为金属丝网,所述金属丝网包括不锈钢网、镍钛合金网、钴铬合金网、钽合金网和钛合金网等。Further preferably, the mesh structure is a wire mesh, and the wire mesh includes a stainless steel mesh, a nickel-titanium alloy mesh, a cobalt-chromium alloy mesh, a tantalum alloy mesh, a titanium alloy mesh, and the like.
进一步优选地,所述网体结构被释放到血管中时,其近端部分的网孔面积较大,远端部分的网孔面积较小,以便于抓捕血栓时能具有更好的嵌入固定作用。Further preferably, when the mesh structure is released into the blood vessel, the mesh area of the proximal part is larger, and the mesh area of the distal part is smaller, so as to have better embedding and fixation when capturing the thrombus. effect.
优选地,所述篮体结构收缩时呈网管形,膨胀时呈圆兜形。作用是当碎片拦截机构被释放到血管中时,可以对血液中的血栓碎片进行过滤清除,防止其流动至血管远端位置。Preferably, the basket structure is in the shape of a network tube when it is contracted, and is in the shape of a round pocket when it is expanded. The function is that when the debris blocking mechanism is released into the blood vessel, the thrombus debris in the blood can be filtered and removed to prevent it from flowing to the distal position of the blood vessel.
进一步优选地,所述篮体结构为金属丝篮,所述金属丝篮包括不锈钢篮、镍钛合金篮、钴铬合金篮、钽合金篮和钛合金篮等。Further preferably, the basket body structure is a wire basket, and the wire basket includes a stainless steel basket, a nickel-titanium alloy basket, a cobalt-chromium alloy basket, a tantalum alloy basket, a titanium alloy basket, and the like.
进一步优选地,所述所述金属丝篮表面覆盖有聚合物膜,所述聚合物膜包括聚氨酯膜、聚碳酸酯膜、聚丙烯膜、聚四氟乙烯膜和尼龙膜等。Further preferably, the surface of the wire basket is covered with a polymer film, and the polymer film includes a polyurethane film, a polycarbonate film, a polypropylene film, a polytetrafluoroethylene film, a nylon film, and the like.
更进一步优选地,所述聚合物膜上均匀分布有直径为80~160μm的圆孔。More preferably, the polymer film is uniformly distributed with circular holes with a diameter of 80-160 μm.
在聚合物膜上均匀设置圆孔的作用是将血液中的血栓碎片经过圆孔筛选后进行过滤拦截,但是可以让血液穿过圆孔正常流通。The function of evenly setting round holes on the polymer membrane is to filter and intercept the thrombus fragments in the blood after being screened by the round holes, but it can allow the blood to circulate normally through the round holes.
优选地,所述显影环节包括第一显影环节、第二显影环节和第三显影环节。Preferably, the developing link includes a first developing link, a second developing link and a third developing link.
进一步优选地,所述显影环节的材质包括金或其合金、铂或其合金、钨或其合金和钽或其合金。Further preferably, the material of the developing link includes gold or its alloy, platinum or its alloy, tungsten or its alloy, and tantalum or its alloy.
进一步优选地,所述第一显影环节设置于所述连通导管上、血管封堵机构的近端。Further preferably, the first developing link is arranged on the communication conduit at the proximal end of the vessel blocking mechanism.
进一步优选地,所述第二显影环节设置于所述牵引导丝上、血栓抓捕机构的两端。Further preferably, the second developing link is arranged on the pulling wire and at both ends of the thrombus capturing mechanism.
进一步优选地,所述第三显影环节设置于所述牵引导丝上、碎片拦截机构的远端。Further preferably, the third developing link is arranged on the pulling wire and at the distal end of the debris intercepting mechanism.
本发明实施例血栓清除系统中的血管封堵机构、血栓抓捕机构和碎片拦截机构同时处于释放状态时,能够呈现出不同的外观结构,以便发挥各自特定的使用功能,不但可以彻底的清除血栓以及血栓碎片,并且操作简便、定位精确和开通快速,符合临床使用的需要。When the blood vessel blocking mechanism, the thrombus capturing mechanism and the debris intercepting mechanism in the thrombus removal system according to the embodiment of the present invention are in the released state at the same time, they can show different appearance structures so as to exert their specific functions, and not only can completely remove the thrombus and thrombus fragments, and the operation is simple, accurate in positioning and quick in opening, which meets the needs of clinical use.
本发明的有益效果The beneficial effects of the present invention
1、本发明实施例提供的一种血栓清除系统中,通过在连通导管的头端设置可收缩和可膨胀的血管封堵机构,可以在血管封堵机构处于释放状态时,与血管壁紧密贴合并将血管进行短暂封堵,能够阻止血管内的血液流动对血栓造成冲击;1. In a thrombus removal system provided by the embodiment of the present invention, by disposing a retractable and expandable blood vessel blocking mechanism at the head end of the communication catheter, the blood vessel blocking mechanism can be closely attached to the blood vessel wall when the blood vessel blocking mechanism is in a released state. Combined with short-term occlusion of the blood vessel, it can prevent the blood flow in the blood vessel from impacting the thrombus;
2、本发明实施例提供的一种血栓清除系统中,通过在牵引导丝上设置可收缩和可膨胀的血栓抓捕机构,可以在血栓抓捕机构处于释放状态时,对血管壁进行充分地支撑扩张,有利于对血栓进行抓捕;2. In the thrombus removal system provided by the embodiment of the present invention, by disposing a retractable and expandable thrombus capturing mechanism on the traction guide wire, when the thrombus capturing mechanism is in a released state, the blood vessel wall can be fully removed. Support expansion, which is conducive to the capture of thrombus;
3、本发明实施例提供的一种血栓清除系统中,通过在牵引导丝的远端设置可收缩和可膨胀的碎片拦截机构,可以在碎片拦截机构处于释放状态时,对血液中的血栓碎片进行过滤清除,防止其流动至血管远端位置;3. In the thrombus removal system provided by the embodiment of the present invention, by disposing a retractable and inflatable fragment interception mechanism at the distal end of the pulling guide wire, the thrombus fragments in the blood can be removed when the fragment interception mechanism is in a released state. Filter removal to prevent it from flowing to the distal location of the vessel;
4、本发明实施例提供的一种血栓清除系统中,通过血管封堵机构、血栓抓捕机构和碎片拦截机构三者的共同配合作用,并且在显影环节的辅助定位下,能够彻底清除血栓以及血栓碎片;4. In the thrombus removal system provided by the embodiment of the present invention, the thrombus can be completely removed and the thrombus can be completely removed by the joint action of the blood vessel blocking mechanism, the thrombus capturing mechanism and the fragment intercepting mechanism, and under the auxiliary positioning of the developing link. thrombus fragments;
5、本发明提供的一种血栓清除系统中,当血管封堵机构、血栓抓捕机构和碎片拦截机构同时处于释放状态时,能够呈现出不同的外观结构,以便发挥各自特定的使用功能,并且操作简便、定位精确和开通快速,符合临床使用的需要。5. In a thrombus removal system provided by the present invention, when the blood vessel blocking mechanism, the thrombus capturing mechanism and the debris intercepting mechanism are in the released state at the same time, they can present different appearance structures so as to exert their specific functions, and The operation is simple, the positioning is accurate and the opening is fast, which meets the needs of clinical use.
附图说明Description of drawings
图1为本发明实施例的一种血栓清除系统在收缩时的结构示意图。FIG. 1 is a schematic structural diagram of a thrombus removal system during contraction according to an embodiment of the present invention.
图2为本发明实施例的一种血栓清除系统在膨胀时的结构示意图。FIG. 2 is a schematic structural diagram of a thrombus removal system during expansion according to an embodiment of the present invention.
图3为本发明实施例的一种血栓清除系统的显影环节结构示意图。FIG. 3 is a schematic structural diagram of a developing link of a thrombus removal system according to an embodiment of the present invention.
图4为本发明实施例的一种血栓清除系统穿过血栓前的工作示意图。FIG. 4 is a schematic diagram of the operation of a thrombus removal system before passing through a thrombus according to an embodiment of the present invention.
图5为本发明实施例的一种血栓清除系统穿过血栓后的工作示意图。FIG. 5 is a schematic diagram of the operation of a thrombus removal system after passing through a thrombus according to an embodiment of the present invention.
图6为本发明实施例的一种血栓清除系统中全体机构定位时的工作示意图。FIG. 6 is a working schematic diagram of the entire mechanism in a thrombus removal system according to an embodiment of the present invention when the whole mechanism is positioned.
图7为本发明实施例的一种血栓清除系统中全体机构膨胀时的工作示意图。FIG. 7 is a working schematic diagram of the whole mechanism of a thrombus removal system according to an embodiment of the present invention when the whole mechanism is expanded.
图8为本发明实施例的一种血栓清除系统中血管封堵机构膨胀时的工作示意图。FIG. 8 is a working schematic diagram of a blood vessel blocking mechanism in a thrombus removal system according to an embodiment of the present invention when it is expanded.
图9为本发明实施例的一种血栓清除系统抓捕血栓以及过滤血栓碎片时的工作示意图。FIG. 9 is a working schematic diagram of a thrombus removal system according to an embodiment of the present invention when capturing thrombus and filtering thrombus fragments.
图10为本发明实施例的一种血栓清除系统中血管封堵机构收缩时的工作示意图。FIG. 10 is a working schematic diagram of a blood vessel occlusion mechanism in a thrombus removal system according to an embodiment of the present invention when it is contracted.
图11为本发明实施例的一种血栓清除系统将血栓以及血栓碎片清除至体外的工作示意图。FIG. 11 is a schematic diagram of the work of a thrombus removal system according to an embodiment of the present invention to remove thrombus and thrombus fragments to the outside of the body.
图12为本发明实施例的血栓以及血栓碎片被彻底清除后血流恢复正常运行的状态示意图。FIG. 12 is a schematic diagram of the state in which the blood flow returns to normal operation after the thrombus and the thrombus fragments are completely removed according to the embodiment of the present invention.
具体实施方式Detailed ways
本发明实施例提供了一种血栓清除系统,该系统包括回收导管、传输导管、连通导管、牵引导丝、血管封堵机构、血栓抓捕机构、碎片拦截机构和显影环节,该系统工作时,通过血管封堵机构、血栓抓捕机构和碎片拦截机构三者的共同配合作用,并且在显影环节的辅助定位下,能够彻底清除血栓以及血栓碎片。本发明实施例还提供了一种血栓清除系统的使用方法。The embodiment of the present invention provides a thrombus removal system, which includes a recovery catheter, a transmission catheter, a communication catheter, a traction guide wire, a blood vessel blocking mechanism, a thrombus capturing mechanism, a debris intercepting mechanism and a developing link. When the system works, Through the joint action of the blood vessel blocking mechanism, the thrombus capturing mechanism and the fragment intercepting mechanism, and with the assistance of the imaging link, the thrombus and thrombus fragments can be completely removed. Embodiments of the present invention also provide a method for using the thrombus removal system.
为了更好的理解上述技术方案,下面将结合具体的实施方式对上述技术方案进行详细地说明。可以理解的是,此处所描述的具体实施例仅用于解释本发明,而非对本发明的限定。另外还需要说明的是,为了便于描述,附图中仅示出了与本发明相关的部分而非全部。另外还需要说明的是,以下描述使用了术语“近端”和“远端”,其中“近端”指的是靠近操作者的一端,“远端”指的是远离操作者的一端。In order to better understand the above technical solutions, the above technical solutions will be described in detail below with reference to specific embodiments. It should be understood that the specific embodiments described herein are only used to explain the present invention, but not to limit the present invention. In addition, it should be noted that, for the convenience of description, the accompanying drawings only show some but not all of the parts related to the present invention. It should also be noted that the following description uses the terms "proximal end" and "distal end", where "proximal end" refers to the end close to the operator and "distal end" refers to the end away from the operator.
实施例1Example 1
本例提供了一种血栓清除系统,包括:This example provides a thrombus removal system that includes:
回收导管1;recovery catheter 1;
传输导管2,传输导管2活动套设于回收导管1中;The
连通导管3,连通导管3活动套设于传输导管2中;The
牵引导丝4,牵引导丝4设置于连通导管3内的中心轴线上,相对于连通导管3沿中心轴线方向移动,牵引导丝4具有牵引端和推进端两个端头;Pulling
血管封堵机构5,血管封堵机构5固定设置于连通导管3的头端,血管封堵机构5为可收缩和可膨胀的囊体结构;The blood
血栓抓捕机构6,血栓抓捕机构6固定设置于牵引导丝4上、推进端与血管封堵机构之间,血栓抓捕机构6为可收缩和可膨胀的网体结构;The
碎片拦截机构7,碎片拦截机构7固定设置于牵引导丝4的远端,碎片拦截机构7为可收缩和可膨胀的篮体结构;以及A
显影环节8,显影环节8固定绕制于连通导管3和牵引导丝4上。The developing
上述一种血栓清除系统中,回收导管1、传输导管2、连通导管3、牵引导丝4、血管封堵机构5、血栓抓捕机构6、碎片拦截机构7和显影环节8优选为同轴设置。非工作状态时,上述机构均收缩在回收导管1中,如图1所示。In the above-mentioned thrombus removal system, the recovery catheter 1, the
工作状态时,如图2所示,血管封堵机构5为囊体结构,膨胀时呈圆球形,当血管封堵机构5被释放到血管中时,可以与血管壁紧密贴合并将血管进行短暂封堵,能够阻止血管内的血液流动对血栓造成冲击,从而便于血栓抓捕机构6将血栓捕获。In the working state, as shown in FIG. 2 , the blood
血栓抓捕机构6为网体结构,膨胀时呈圆梭形,当血管抓捕机构6被释放到血管中时,可以对血管壁进行充分地支撑扩张,有利于对血栓进行抓捕。The
碎片拦截机构7为篮体结构,膨胀时呈圆兜形,当碎片拦截机构7被释放到血管中时,可以对血液中的血栓碎片进行过滤清除,防止其流动至血管远端位置。The
血管封堵机构5的囊体结构为聚合物层,聚合物层包括聚氯乙烯层、聚氨酯层、尼龙层、PET层和PEBAX层等。囊体结构收缩时呈圆管形,囊体结构膨胀时呈圆球形。The balloon structure of the
囊体结构被释放到血管中时,是通过对其注入生理盐水等液体的方式使其膨胀并与血管壁紧密贴合。When the balloon structure is released into the blood vessel, it is inflated by injecting a liquid such as physiological saline into it and tightly adheres to the blood vessel wall.
血栓抓捕机构6的网体结构为金属丝网,金属丝网包括不锈钢网、镍钛合金网、钴铬合金网、钽合金网和钛合金网等。网体结构收缩时呈网管形,网体结构膨胀时呈圆梭形。The mesh structure of the
网体结构被释放到血管中时,其近端部分的网孔面积较大,远端部分的网孔面积较小,以便于抓捕血栓时能具有更好的嵌入固定作用。When the mesh structure is released into the blood vessel, the mesh area of the proximal part is larger, and the mesh area of the distal part is smaller, so as to have a better embedding and fixation effect when capturing the thrombus.
碎片拦截机构7的篮体结构为金属丝篮,金属丝篮包括不锈钢篮、镍钛合金篮、钴铬合金篮、钽合金篮和钛合金篮等。篮体结构收缩状态时呈网管形,篮体结构膨胀状态时呈圆兜形。The basket structure of the
篮体结构表面覆盖有聚合物膜,聚合物膜包括聚氨酯膜、聚碳酸酯膜、聚丙烯膜、聚四氟乙烯膜和尼龙膜等。The surface of the basket structure is covered with a polymer film, and the polymer film includes a polyurethane film, a polycarbonate film, a polypropylene film, a polytetrafluoroethylene film, a nylon film, and the like.
聚合物膜上均匀分布有直径为80~160μm的圆孔。Circular holes with diameters of 80-160 μm are uniformly distributed on the polymer film.
如图3所示,部分显影环节8固定绕制于牵引导丝4上,显影环节8包括第一显影环节、第二显影环节和第三显影环节。显影环节8的材质包括金或其合金、铂或其合金、钨或其合金和钽或其合金。As shown in FIG. 3 , part of the developing
如图2所示,第一显影环节设置于连通导管3上、血管封堵机构5的近端。第二显影环节设置于牵引导丝4上、血栓抓捕机构6的两端。第三显影环节设置于牵引导丝4上、碎片拦截机构7的远端。As shown in FIG. 2 , the first imaging segment is arranged on the
显影环节8的作用主要有以下三点:(1)采用显影环节8可以对血栓清除系统中的血管封堵机构5、血栓抓捕机构6和碎片拦截机构7进行精确定位,通过显影环节8的设置,使操作者在X射线下能够清楚的观察到血管封堵机构5、血栓抓捕机构6和碎片拦截机构7在血管内的位置,并且使操作者能够准确和彻底的完成对于血栓以及血栓碎片的清除工作;(2)采用显影环节8绕制在连通导管3上,不但可以明显增加连通导管3整体的推送和牵拉能力,而且还可以提高血管封堵机构5与连通导管3的连接强度,能够更加有效的加强血栓清除系统使用时的安全性;(3)采用显影环节8绕制在牵引导丝4上,不但可以明显增加牵引导丝4整体的推送和牵拉能力,而且还可以提高血栓抓捕机构6、碎片拦截机构7与牵引导丝4的连接强度,能够更加有效的加强血栓清除系统使用时的安全性。The functions of the developing
实施例2Example 2
本例提供了一种血栓清除系统的使用方法,具体为:This example provides a method of using a thrombus removal system, specifically:
通过控制装置将包含传输导管2、连通导管3和牵引导丝4的回收导管1沿血管9送入至血栓10附近,如图4所示。The recovery catheter 1 including the
通过控制装置锁定回收导管1,将包含连通导管3和牵引导丝4的传输导管2推送并穿过血栓10,如图5所示。The retrieval catheter 1 is locked by the control device, and the
通过控制装置锁定牵引导丝4,并且在显影环节8的辅助定位下,将连通导管3回撤至适当距离,使设置在连通导管3上的血管封堵机构5和设置在牵引导丝上的血栓抓捕机构6能够精确定位于血栓10两端,如图6所示。The
通过控制装置锁定连通导管3和牵引导丝4,将传输导管2回撤至回收导管1的出口处,使设置在连通导管3头端的血管封堵机构5,设置在牵引导丝4上的血栓抓捕机构6和设置在牵引导丝4远端的碎片拦截机构7被依次释放至血管9内,如图7所示。The
通过控制装置锁定连通导管3和牵引导丝4,将生理盐水等液体注入连通导管3头端的血管封堵机构5内,使其膨胀后与血管壁紧密贴合并将血管9进行短暂封堵,能够阻止血管9内的血液流动对血栓10造成冲击,从而便于血栓抓捕机构6将血栓10捕获,如图8所示。The
通过控制装置锁定回收导管1、传输导管2和连通导管3,将牵引导丝4缓慢回撤,在回撤过程中,设置在牵引导丝4上的血栓抓捕机构6将血栓10进行抓捕并往近端方向推送,血栓抓捕机构6近端部分的网孔面积较大,远端部分的网孔面积较小,以便于抓捕血栓10时能具有更好的嵌入固定作用。同时设置在牵引导丝4远端的碎片拦截机构7对血栓碎片11进行过滤清除,防止其流动至血管9远端位置,如图9所示。The retraction catheter 1, the
通过控制装置锁定回收导管1和传输导管2,将连通导管3头端的血管封堵机构5内的生理盐水等液体抽出使其收缩,同时继续回撤牵引导丝4,使设置在牵引导丝4上的血栓抓捕机构6和设置在牵引导丝4远端的碎片拦截机构7继续往近端方向推送,此时血栓10已被血栓抓捕机构6完全嵌入捕获,而血栓碎片11也被碎片拦截机构7过滤清除,如图10所示。The recovery catheter 1 and the
通过控制装置锁定回收导管1,将传输导管2、连通导管3、血管封堵机构5、血栓抓捕机构6以及被捕获的血栓10、碎片拦截机构7以及被过滤的血栓碎片11依次撤回至回收导管1内,如图11所示。The recovery catheter 1 is locked by the control device, and the
通过控制装置将血栓清除系统全部平稳地撤出至体外,彻底完成对血栓10以及血栓碎片11的清除工作,使得血管9内的血流恢复到正常的运行状态,如图12所示。The thrombus removal system is stably withdrawn from the body through the control device, and the removal of
以上对本发明的具体实施例进行了描述。需要理解的是,本发明并不局限于上述特定实施方式,本领域技术人员可以在权利要求的范围内作出各种变形或修改,这并不影响本发明的实质内容。Specific embodiments of the present invention have been described above. It should be understood that the present invention is not limited to the above-mentioned specific embodiments, and those skilled in the art can make various variations or modifications within the scope of the claims, which do not affect the essential content of the present invention.
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