CN113208778A

CN113208778A - Anchoring device

Info

Publication number: CN113208778A
Application number: CN202110500984.XA
Authority: CN
Inventors: 屠攀; 徐军; 林林
Original assignee: Shanghai Huihe Healthcare Technology Co Ltd
Current assignee: Shanghai Huihe Healthcare Technology Co Ltd
Priority date: 2021-05-08
Filing date: 2021-05-08
Publication date: 2021-08-06

Abstract

The application provides an anchoring apparatus, mainly include the dabber, connect the anchoring structure of dabber, cup joint the cover axle on the dabber and the clamping structure who connects the cover axle, wherein, anchoring structure can be used to anchoring target tissue, the dabber can be for cover axle axial displacement in order to drive anchoring structure and move to clamping position by non-clamping position, and clamping structure can switch over to clamping state by the release state, target tissue in anchoring structure is anchored in the centre gripping, in view of the above, anchoring apparatus's anchoring force can be improved to this application, and anchoring state's stability can be promoted.

Description

Anchoring device

Technical Field

The embodiment of the application relates to the technical field of medical instruments, in particular to an anchoring instrument.

Background

The common diseases of the heart valves of the human body are valve insufficiency, valve leaflet prolapse and the like. In the case of the mitral valve, during systole, a portion of the left ventricle flows back through the orifice of the incompetent mitral valve to the left atrium. The left atrium receives blood from both left ventricular regurgitation and pulmonary venous inflow, and the volume of left atrial blood increases dramatically, raising pressure, and leading to hypertrophy of the left atrium. In diastole, more blood flows from the left atrium to the left ventricle, so that the left ventricle is enlarged due to the enhanced contraction, after the compensation phase is progressed to the decompensation phase, both the left atrium and the left ventricle are subjected to heart failure, and further pulmonary congestion, pulmonary arterial hypertension, right ventricular enlargement, right atrial enlargement, right heart failure and body circulation congestion sequentially occur.

Traditional treatment means include active surgical approaches or palliative efforts to combat inevitable heart failure with drugs. Among the surgical methods are valve replacement and annuloplasty. In surgical procedures, typical open chest surgery is very invasive, requires the establishment of extracorporeal circulation, and has a high incidence of complications and risk of infection. Patients are largely intolerant of significant surgical risks.

At present, the common technique for treating mitral valve and tricuspid valve regurgitation through a minimally invasive catheter is valve replacement and valve annulus repair. One of the difficulties with the annulus replacement technique is that the replacement device is securely fixed to the heart tissue of the human body, and the anchoring technique is one of the commonly used fixation methods. The annulus repair technique requires anchoring of a predetermined target soft tissue of the heart, thereby shaping the valve by pulling a predetermined anchor point, or fixing the repair device. While transcatheter treatment of leaflet prolapse typically involves creating artificial chordae tendineae in the leaflets and then anchoring them to the atrial tissue.

In summary, reliable anchoring devices play an important role in the transcatheter treatment of structural visceral diseases.

Disclosure of Invention

In view of the above problems, the present application provides an anchoring device that can not only improve anchoring force but also maintain a stable anchoring effect.

The present application provides an anchoring instrument, comprising: a mandrel; an anchoring structure connected to the mandrel; the sleeve shaft is movably sleeved on the mandrel; and a clamping structure connected with the sleeve shaft; the anchoring structure can be used for anchoring target tissue, the mandrel can move axially relative to the sleeve shaft to drive the anchoring structure to move from a non-clamping position to a clamping position, and the clamping structure can be switched from a releasing state to a clamping state to clamp the target tissue anchored on the anchoring structure.

Optionally, the anchoring structure may be circumferentially rotatable to anchor the target tissue.

Optionally, the anchoring structure comprises one of a single start helical anchor, a double start helical anchor, a multi start helical anchor.

Optionally, the anchoring structure may be simultaneously moved axially relative to the clamping structure to move from the clamping position to the non-clamping position as the anchoring structure is rotated circumferentially to anchor the target tissue.

Optionally, the sleeve shaft comprises an outer sleeve shaft and an inner sleeve shaft which are axially sleeved; the clamping structure comprises at least two clamping arms and at least two pivoting arms; each clamping arm is pivoted with the inner sleeve shaft, and each pivoting arm is pivoted with each clamping arm and the outer sleeve shaft respectively; the outer sleeve shaft can move axially relative to the inner sleeve shaft so as to drive the clamping arms to pivot through the pivoting arms, and the clamping structure is switched between the releasing state and the clamping state.

Optionally, the clamp structure comprises two of the clamp arms and two of the pivot arms; the two clamping arms are symmetrically arranged on two opposite sides of the inner sleeve shaft, and one end of each clamping arm is pivoted with the tail end of the inner sleeve shaft; the arrangement positions of the two pivoting arms correspond to the arrangement positions of the two clamping arms respectively, and the opposite two ends of each pivoting arm are pivoted with the middle position of each clamping arm and the tail end of the outer sleeve shaft respectively.

Optionally, the outer sleeve shaft may be reciprocally moved in its axial direction with respect to the inner sleeve shaft to increase or decrease a spacing distance between the distal end of the outer sleeve shaft and the distal end of the inner sleeve shaft; when the spacing distance between the tail end of the outer sleeve shaft and the tail end of the inner sleeve shaft is increased, the two pivoting arms can drive the two clamping arms to pivot, so that the clamping angle between the two clamping arms is increased; when the distance between the end of the outer sleeve shaft and the end of the inner sleeve shaft decreases, the two clamping arms can be driven to pivot by the two pivoting arms, so that the clamping angle between the two clamping arms decreases.

Optionally, the anchoring device further comprises an anti-slip portion provided on each of the clamping arms for preventing the target tissue from falling off the clamping structure when the clamping structure is in the clamping state.

Optionally, the anti-slip part comprises a spike arranged on the edge of the clamping arm.

Optionally, the mandrel is inserted into the inner sleeve shaft; after the anchoring structure anchors the target tissue, the mandrel can be axially moved relative to the inner sleeve to move the anchoring structure from the non-clamping position to the clamping position, and the outer sleeve is moved axially relative to the inner sleeve to switch the clamping structure from the releasing state to the clamping state to clamp the target tissue anchored on the anchoring structure.

According to the technical scheme, the anchoring device provided by the embodiment of the application utilizes the anchoring structure to be matched with the clamping and clamping, so that the anchoring force of the anchoring device can be improved, and a stable anchoring effect can be provided.

Drawings

In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the drawings needed to be used in the description of the embodiments or the prior art will be briefly described below, it is obvious that the drawings in the following description are only some embodiments described in the embodiments of the present application, and other drawings can be obtained by those skilled in the art according to the drawings.

Fig. 1 to 3 are schematic views of an embodiment of the anchoring instrument of the embodiment of the present application in different operating states.

Fig. 4 to 7 are schematic views illustrating different operating states of the anchoring instrument for anchoring cardiac target tissue according to the embodiment of the application.

Element number

10: an anchoring instrument;

20: a mandrel;

30: an anchoring structure;

40: a sleeve shaft;

42: an outer sleeve shaft;

44: an inner sleeve shaft;

50: a clamping structure;

52: a clamp arm;

54: a pivoting arm;

60: an anti-drop part;

62: pricking with a sharp point;

70: a target tissue.

Detailed Description

In order to make those skilled in the art better understand the technical solutions in the embodiments of the present application, the technical solutions in the embodiments of the present application will be described clearly and completely below with reference to the drawings in the embodiments of the present application, and it is obvious that the described embodiments are only a part of the embodiments of the present application, but not all embodiments. All other embodiments obtained by a person of ordinary skill in the art based on the embodiments in the present application shall fall within the scope of the protection of the embodiments in the present application.

The following further describes specific implementations of the embodiments of the present application with reference to the drawings of the embodiments of the present application.

Reference is made to fig. 1 to 3, which are schematic illustrations of an embodiment of the anchoring device 10 of the present application in different operating states, respectively.

As shown, the anchoring instrument 10 of the present application generally includes a mandrel 20, an anchoring structure 30, a sleeve shaft 40, and a gripping structure 50.

An anchoring structure 30 is attached to the mandrel 20 and is operable to anchor target tissue 70 (see fig. 4-7).

In this embodiment, the anchoring structure 30 can be rotated circumferentially to anchor the target tissue.

Alternatively, the anchoring structure 30 may be, for example, a single-start helical anchor, a double-start helical anchor, or a multi-start helical anchor.

The clamp structure 50 is connected to the sleeve shaft 40 and is switchable between a clamped state (refer to the state shown in fig. 3) and a released state (refer to the state shown in fig. 1 and 2).

In this embodiment, the sleeve shaft 40 may include an outer sleeve shaft 42 and an inner sleeve shaft 44 that are axially sleeved, and the clamping structure 50 may include at least two clamping arms 52 and at least two pivoting arms 54.

Wherein each clamping arm 52 is pivotally connected to the inner sleeve shaft 44, and each pivot arm 54 is pivotally connected to each clamping arm 52 and the outer sleeve shaft 42, respectively.

In this embodiment, the outer sleeve shaft 42 is axially movable relative to the inner sleeve shaft 44 to pivot the clamping arms 52 via the pivot arms 54 for switching the clamping structure 50 between the released state and the clamped state.

Alternatively, the clamping structure 50 may include two clamping arms 52 and two pivoting arms 54 (i.e., the embodiment shown in fig. 1 to 3), wherein the two clamping arms 52 may be symmetrically disposed on opposite sides of the inner sleeve shaft 44, one end of each clamping arm 52 is pivotally connected to the end of the inner sleeve shaft 44, the two pivoting arms 54 may be disposed at positions corresponding to the positions of the two clamping arms 52, and opposite ends of each pivoting arm 54 may be pivotally connected to the middle position of each clamping arm 52 and the end of the outer sleeve shaft 42.

In this embodiment, the outer sleeve shaft 42 is reciprocally movable along its axial direction with respect to the inner sleeve shaft 44 such that the distance between the distal end of the outer sleeve shaft 42 and the distal end of the inner sleeve shaft 44 increases or decreases.

Specifically, as the distance between the distal end of the outer sleeve 42 and the distal end of the inner sleeve 44 increases, the two clamping arms 52 can be pivoted via the two pivot arms 54, so that the clamping angle between the two clamping arms 52 increases; when the distance between the ends of the outer and

inner sleeves

42 and 44 is reduced, the two pivoting arms 54 pivot the two clamping arms 52 such that the clamping angle between the two clamping arms 52 is reduced.

Optionally, the anchoring device 10 further includes an anti-slip portion 60 provided on each of the clamping arms 52 for preventing the target tissue from falling out of the clamping structure 50 when the clamping structure 50 is in the clamped state.

In this embodiment, the retaining portion 60 may include a spike 62 disposed on an edge of the clamping arm 52.

The sleeve shaft 40 is movably sleeved on the core shaft 20, and the core shaft 20 is axially moved relative to the sleeve shaft 40 to drive the anchoring structure 30 connected to the core shaft 20 to move from the non-clamping position (refer to the state shown in fig. 1) to the clamping position (refer to the state shown in fig. 2), and then the clamping structure 50 is switched from the releasing state to the clamping state (refer to the state shown in fig. 3) to clamp the target tissue anchored on the anchoring structure 30.

Alternatively, the anchoring structure 30 can be simultaneously moved axially relative to the clamping structure 50 to move from the clamped position to the undamped position as the anchoring structure 30 is rotated circumferentially to anchor the target tissue.

Alternatively, the axial movement and circumferential rotation of the anchoring structure 30 relative to the clamping structure 50 may also be independently controlled, i.e., the anchoring structure 30 does not move axially relative to the clamping structure 50 when the anchoring structure 30 is rotated circumferentially to anchor the target tissue, which is not limited in this application.

Alternatively, the mandrel 20 may be disposed within the inner sleeve shaft 44, wherein after the anchoring structure 30 anchors the target tissue, the mandrel 20 may be axially moved relative to the inner sleeve shaft 44 to move the anchoring structure 30 from the non-clamping position to the clamping position, and by means of the outer sleeve shaft 42 being axially moved relative to the inner sleeve shaft 44 to switch the clamping structure 50 from the released state to the clamping state to clamp the target tissue anchored on the anchoring structure 30.

The operating steps of the anchoring instrument 10 of the present application will be described in detail below with reference to fig. 4 to 7:

step 1, the anchoring structure 30 is in the clamping position and the clamping structure 50 is in the clamping state, and the anchoring instrument 10 is delivered to the vicinity of the target tissue 70 to be anchored (e.g. the heart valve annulus) by means of a delivery system (not shown) (as shown in fig. 4).

Step 2, the clamping structure 50 is switched from the clamping state to the releasing state, so that the anchoring structure 30 can perform the anchoring operation on the target tissue 70 (refer to fig. 5).

And step 3: after the anchoring structure 30 anchors the target tissue 70, the target tissue can be pulled up between the two clamping arms 52 of the clamping structure 50 by the anchoring structure 30 by moving the mandrel 20 axially relative to the sleeve shaft 40 to move the anchoring structure 30 from the non-clamping position to the clamping position relative to the clamping structure 50 (refer to fig. 6).

Step 4, the clamping structure 50 is switched from the releasing state to the clamping state to clamp the target tissue anchored on the anchoring structure 30 (refer to fig. 7).

In summary, the anchoring device provided by the present application can further clamp the target tissue anchored on the anchoring structure by the clamping structure after the anchoring structure anchors the target tissue, which not only can help to increase the anchoring force of the anchoring structure, but also can provide a more stable anchoring effect.

Finally, it should be noted that: the above embodiments are only used for illustrating the technical solutions of the embodiments of the present application, and are not limited thereto; although the present application has been described in detail with reference to the foregoing embodiments, it should be understood by those of ordinary skill in the art that: the technical solutions described in the foregoing embodiments may still be modified, or some technical features may be equivalently replaced; and such modifications or substitutions do not depart from the spirit and scope of the corresponding technical solutions in the embodiments of the present application.

Claims

1. An anchoring device, characterized in that, comprising:

mandrel;

an anchoring structure connecting the mandrel;

a sleeve shaft movably sleeved on the mandrel; and

a clamping structure, which connects the sleeve shaft;

Wherein, the anchoring structure can be used to anchor the target tissue, the mandrel can move axially relative to the sleeve shaft to drive the anchoring structure to move from the non-clamping position to the clamping position, and the clamping The holding structure can be switched from a release state to a holding state to hold the target tissue anchored on the anchoring structure.

2. The anchoring instrument of claim 1, wherein the anchoring structure is circumferentially rotatable to anchor the target tissue.

3. The anchoring device of claim 1, wherein the anchoring structure comprises one of a single-ended helical anchor, a double-ended helical anchor, and a multi-ended helical anchor.

4. The anchoring instrument of claim 2, wherein the anchoring structure can simultaneously be relative to the gripping structure axis when the anchoring structure is rotated circumferentially to anchor the target tissue to move from the clamping position to the non-clamping position.

5. The anchoring device of claim 4, wherein

The sleeve shaft includes an outer sleeve shaft and an inner sleeve shaft that are axially sleeved;

the clamping structure includes at least two clamping arms and at least two pivoting arms;

Wherein, each of the clamping arms is pivotally connected to the inner sleeve shaft, and each of the pivot arms is respectively pivoted to each of the clamping arms and the outer sleeve shaft;

Wherein, the outer shaft can move axially relative to the inner shaft, so as to drive each of the clamping arms to pivot via each of the pivoting arms, so that the clamping structure is in the released state and in all switch between the clamping states.

6. The anchoring device of claim 5, wherein

the clamping structure includes two of the clamping arms and two of the pivoting arms;

The two clamping arms are symmetrically arranged on opposite sides of the inner sleeve shaft, and one end of each of the clamping arms is pivotally connected to the end of the inner sleeve shaft;

The setting positions of the two pivoting arms correspond to the setting positions of the two clamping arms respectively, and the opposite ends of each pivoting arm are pivotally connected to the middle position of each clamping arm and the the end of the outer shaft.

7. The anchoring device of claim 6, wherein

The outer shaft can reciprocate relative to the inner shaft along its axial direction, so as to increase or decrease the spacing distance between the end of the outer shaft and the end of the inner shaft;

Wherein, when the distance between the end of the outer shaft and the end of the inner shaft increases, the two clamping arms can be driven to pivot through the two pivot arms, so as to The clamping angle between the two clamping arms is increased; when the separation distance between the end of the outer shaft and the end of the inner shaft is reduced, the two pivots can be passed through the two pivots. The rotating arm drives the two clamping arms to pivot, so as to reduce the clamping angle between the two clamping arms.

8. The anchoring device according to claim 5, characterized in that, the anchoring device further comprises a disengagement prevention part provided on each of the clamping arms, for when the clamping structure is in the clamping In the holding state, the target tissue is prevented from falling off from the holding structure.

9. The anchoring instrument of claim 8, wherein the dislodgment prevention portion comprises spikes provided on an edge of the gripping arm.

10. The anchoring device according to claim 5, wherein the mandrel passes through the inner sleeve shaft;

After the anchoring structure anchors the target tissue, the mandrel is axially movable relative to the inner sleeve shaft to move the anchoring structure from the non-clamping position to the clamping position, and the outer shaft is moved axially relative to the inner sleeve shaft, so that the clamping structure is switched from the release state to the clamping state, so as to clamp the anchor on the anchor Structurally the target organization.