CN113940724A

CN113940724A - False aneurysm sealer

Info

Publication number: CN113940724A
Application number: CN202111449686.9A
Authority: CN
Inventors: 洪心雅; 刘若枚
Original assignee: Zhongshan Hospital Xiamen University
Current assignee: Zhongshan Hospital Xiamen University
Priority date: 2021-12-01
Filing date: 2021-12-01
Publication date: 2022-01-18

Abstract

The invention discloses a pseudoaneurysm sealer, belonging to the technical field of interventional medical devices, comprising a cannula, the cannula comprising an outer tube (1) and an inner tube (2), the outer tube (1) and the inner tube (2) A balloon conduit (3) is arranged between, the front end of the balloon conduit (3) is connected with an elastic balloon (4), and the outer tube (1) is provided with several side through holes (9) , is also provided with a liquid medicine pipeline (10), the front end of the liquid medicine pipeline (10) is communicated with the side through hole (9); the present invention can prevent the coagulation medicine from flowing into the artery, and the elastic balloon compresses and seals the false artery The aneurysm leakage port can prevent the high-speed arterial blood flow from the pseudoaneurysm leakage port from continuing to enter the tumor body, making the thrombus in the tumor easier to form; at the same time, the coagulation drugs are injected into the tumor body through the side through hole to further promote the thrombosis in the tumor body. Thereby, the double guarantee of sealing the leakage of the pseudoaneurysm can be realized, and the occurrence of serious consequences can be avoided.

Description

False aneurysm sealer

Technical Field

The invention relates to the technical field of interventional medical instruments, in particular to a false aneurysm sealer.

Background

The gradual development of medical technology, interventional diagnosis and treatment technology are widely applied, and iatrogenic pseudo-aneurysms are more and more common and can not be completely avoided. Giant aneurysms can have symptoms of proximal nerve compression damage and distal tissue ischemia. If there is mural thrombosis in the tumor, it may be possible for thrombus migration to cause distal arterial embolism and cause corresponding symptoms, or it may be ruptured to bleed by trauma or increased internal pressure. Severe patients may even cause hemorrhagic shock, compartment syndrome, and the like. Timely and active treatment is therefore necessary.

The traditional treatment method is an operation, and comprises ligation of a parent artery, anastomosis of an aneurysm-excised end and an end, blood vessel transplantation, repair of a blood vessel in an aneurysm sac and the like, but the operation risk is obviously increased.

With the development of ultrasound technology, in 1991 Fellmeth et al first proposed ultrasound-guided compression therapy, which has since gradually become the first choice for the treatment of pseudoaneurysms. However, this method has the following disadvantages: (1) the treatment duration is long; (2) limb pain and discomfort, and possibly even ischemia, from prolonged compression; (3) the success rate is low, only about 75%, and the success rate of partial patients who are subjected to anticoagulation treatment is lower.

In recent years, many researchers have begun to treat pseudoaneurysms with ultrasound-guided injection of thrombin for embolization. The research shows that: the success rate of the embolization therapy is as high as 90%, and the embolization therapy of the pseudo-aneurysm under the guidance of the ultrasound has the following advantages: (1) the success rate is high; (2) the patient is easy to tolerate; (3) the operation time is short; (4) the recurrence rate is extremely low; (5) the safety is high; (6) this method may be selected for patients who have poor or failed to administer compression therapy. For patients who need systemic anticoagulation treatment after catheter operation, the success rate of embolotherapy is higher than that of compression therapy, and the recurrence rate is low.

However, the conventional ultrasound-guided pseudo-aneurysm embolization therapy still has some problems, and particularly, possible complications of the method include that hemostatic drugs such as thrombin accidentally flow into limb arteries in a reverse manner, so that iatrogenic arterial thrombosis is caused, and serious consequences are caused.

Disclosure of Invention

The present invention aims to provide a pseudo aneurysm occluder to solve the above problems.

In order to achieve the purpose, the technical scheme adopted by the invention is as follows: a pseudoaneurysm closer comprises a sleeve, wherein the sleeve comprises an outer tube and an inner tube sleeved in an inner cavity of the outer tube, a balloon pipeline is arranged between the outer tube and the inner tube, the front end of the balloon pipeline is connected with an elastic balloon, the elastic balloon extends out of the front end of the outer tube when being full, the rear end of the balloon pipeline is provided with a first inlet, a first sealing element is arranged at the position, close to the first inlet, of the balloon pipeline, and the first inlet and the first sealing element are both positioned on the outer side of the rear end of the outer tube; the liquid medicine pipeline is characterized in that a plurality of side through holes are formed in the outer pipe close to the front end, a liquid medicine pipeline is further arranged between the outer pipe and the inner pipe, the front end of the liquid medicine pipeline is communicated with the side through holes, and a second inlet is formed in the rear end of the liquid medicine pipeline.

According to the invention, the elastic balloon is arranged at the front end of the sleeve, so that the functions of local physical sealing and pressing are performed on the false aneurysm leakage opening, the position of part of the false aneurysm is deeper, and the broken leakage opening is difficult to press in vitro, so that under the ultrasonic guidance, a trocar is sleeved in the inner tube, a tumor body is penetrated through the trocar, the position reaches the vicinity of the leakage opening, the elastic balloon is filled through injecting physiological saline or gas and the like through the first inlet, and the leakage opening can be accurately pressed and sealed;

the front end of the sealer is provided with a plurality of side through holes, the leak port is sealed while the elastic saccule is pressed, at the moment, blood coagulation medicines such as thrombin, gelatin sponge and the like are injected into the liquid medicine channel, and at the moment, the liquid medicine flows out of the outer tube through the side through holes and enters the tumor cavity of the pseudo-aneurysm, so that thrombus is quickly formed in the tumor cavity; at this time, because the leakage port is sealed by the elastic saccule, the limb ischemia caused by iatrogenic arterial thrombosis caused by the inflow of blood coagulation medicines into the artery is avoided, and serious complications are avoided.

As a preferred technical scheme: the diameter of the inflated elastic saccule is 0.3cm-1.0 cm. The diameter of the conventional false aneurysm leakage opening is generally 0.1cm-0.5cm, and the elastic balloon is set to be 0.3cm-1.0cm, so that the optimal sealing effect can be achieved.

As a preferred technical scheme: the elastic saccule is annular and is positioned inside the front end of the outer tube when not being inflated.

As a preferred technical scheme: and an annular developing mark is arranged on the outer wall of the front end of the outer tube.

As a further preferable technical scheme: the development mark is a spiral metal sheet.

The developing mark plays a role in developing and marking under ultrasound, is convenient to clearly position under an image, avoids interference of gas or other factors, and is more accurate in positioning.

As a preferred technical scheme: the first seal is a clip. Choose clip simple structure for use, the flexible pipeline is chooseed for use to supporting sacculus pipeline certainly, and the convenience is intaking through sacculus pipeline or feed liquor so that with the elasticity sacculus of front full uplift after, seal sacculus pipeline to prevent that gas leakage or weeping cause elasticity sacculus pipe-out.

Of course, seals in the form of valves or the like may also be used.

Preferably, the rear end of the elastic balloon is fixed to the front end of the sleeve. Through the relative fixation of the elastic saccule and the sleeve, the sealing failure of the elastic saccule to a false aneurysm leakage opening caused by the displacement (backward movement) of the elastic saccule caused by the pulling of a saccule pipeline or excessive forward movement of inflation or injected liquid is prevented, and the stability and reliability of sealing are ensured.

As a preferred technical scheme: and a second sealing element is arranged at the position of the liquid medicine pipeline close to the second inlet.

As a further preferable technical scheme: the second seal is a clip.

As a preferred technical scheme: the trocar sleeve comprises an inner tube and is characterized by further comprising a sealing cap, wherein the sealing cap is in threaded connection with the inner wall of the tail end of the inner tube, and a socket used for being plugged into the trocar sleeve is arranged on the sealing cap. The sealing cap is arranged at the tail end of the inner tube, so that blood in the tumor cavity can be prevented from flowing out of the inner tube due to high pressure. The sealing cap can be connected with the inner pipe thread, and can also be inserted into the inner pipe in a form of arranging a sealing ring and the like, namely the sealing cap is inserted into the tail end of the inner pipe, and the sealing effect can be ensured due to the arrangement of the sealing ring.

Of course, it is also possible to use a sealing cap fixed to the trocar as a kit, and after the trocar is removed, another sealing cap without the trocar is sealingly connected to the inner tube.

Compared with the prior art, the invention has the advantages that: the invention prevents the blood coagulation medicine from flowing into the artery in a mode of plugging by the elastic saccule, the elastic saccule compresses and seals the false aneurysm leakage opening, and the high-speed arterial blood flow from the false aneurysm leakage opening can be prevented from continuously entering the aneurysm body, so that the thrombus in the aneurysm body is easier to form; and simultaneously, the blood coagulation medicine is injected into the tumor body through the side through hole, so that the thrombus formation in the tumor body is further promoted, the double guarantee of closing the false aneurysm leakage opening is realized, the iatrogenic arterial thrombus is prevented, and the occurrence of serious consequences is avoided.

Drawings

FIG. 1 is a view showing the state of the pseudo-aneurysm closure device according to example 1 of the present invention in an unused state;

FIG. 2 is a view showing the state of the prosthesis for closing an aneurysm according to example 1 of the present invention when a trocar is used to enter the leakage opening;

FIG. 3 is a view showing the configuration of the elastomeric balloon inflated during withdrawal of the trocar in the pseudo-aneurysm obturator of embodiment 1 of the present invention;

fig. 4 is a sectional view a-a of fig. 1.

In the figure: 1. an outer tube; 2. an inner tube, 3, a balloon conduit; 4. an elastic balloon; 5. a first inlet; 6. a first seal member; 7. a trocar; 8. a side through hole; 9. a liquid medicine pipeline; 10. a second inlet; 11. developing the mark; 12. a second seal member; 13. and (5) sealing the cap.

Detailed Description

The invention will be further explained with reference to the drawings.

Example 1:

referring to fig. 1 and 4, a pseudo-aneurysm occluder comprises a sleeve, the sleeve comprises an outer tube 1 and an inner tube 2 sleeved in an inner cavity of the outer tube 1, a balloon conduit 3 is arranged between the outer tube 1 and the inner tube 2, an elastic balloon 4 is connected to the front end of the balloon conduit 3, the elastic balloon 4 extends out of the front end of the outer tube 1 when being inflated, a first inlet 5 is arranged at the rear end of the balloon conduit 3, a first sealing member 6 is arranged at a position, close to the first inlet 5, of the balloon conduit 3, the first sealing member 6 in this embodiment is a clip, and the first inlet 5 and the first sealing member 6 are both located outside the rear end of the outer tube 1; a trocar 7 is sleeved in the inner tube 2; a plurality of side through holes 8 are formed in the outer tube 1 near the front end, a liquid medicine pipeline 9 is further arranged between the outer tube 1 and the inner tube 2, the front end of the liquid medicine pipeline 9 is communicated with the side through holes 8, a second inlet 10 is formed in the rear end of the liquid medicine pipeline 9, a second sealing element 12 is arranged in the liquid medicine pipeline 9 near the second inlet 10, and the second sealing element 12 is also a clamp;

in this embodiment, the diameter of the inflated elastic balloon 4 is 0.3cm to 1.0 cm;

an annular developing mark 11 is arranged on the outer wall of the front end of the outer tube 1; the development mark 11 of the present embodiment is a spiral metal sheet;

when in use, firstly, the false aneurysm leakage opening is measured by means of ultrasonic and the like, a sealer with a proper size (namely, the elastic saccule 4 with a proper size) is selected,

then, under the ultrasonic guidance, the trocar 7 is sleeved into the inner tube 2, the end of the sleeved hanging needle 7 is provided with a sealing cap 13, after the trocar 7 is sleeved into the inner tube 2, the outer wall of the sealing cap 13 at the tail part of the trocar is in threaded connection with the inner wall at the end of the inner tube 2 (the trocar 7 is convenient to fix and take out), namely, the trocar 7 is driven by the cannula to puncture into the pseudoaneurysm body at a position which is about 2mm away from a leakage opening, as shown in fig. 2; the trocar 7 is then withdrawn and the sealing cap 13 is closed, as shown in figure 3.

Then, injecting normal saline into the balloon pipeline 3 through the first inlet 5, so that the elastic balloon 4 at the front part is inflated to form a disc shape, pressing and closing the leakage opening, and closing the second sealing member 6 to keep the inflated state of the elastic balloon 4;

then, the blood coagulation medicine is injected into the outer tube through the second inlet 10, and then the second sealing element 12 is closed, so that the leakage opening is physically pressed, and the hemostatic medicine promotes the formation of thrombus in the tumor body;

and (3) ultrasonically observing a tumor body, if the thrombus is completely formed and no blood flow signal exists, pumping out the normal saline in the elastic saccule 4 through the first inlet 5, withdrawing the elastic saccule 4 into the outer tube 1, and removing the sleeve to finish the operation.

Example 2:

the first seal member 6 and the second seal member 12 of this embodiment are sealed valves, and the elastic balloon is inflated by pushing and inflating with a syringe, and the rest is the same as that of embodiment 1.

Example 3:

compared with the embodiment 1, the embodiment adopts the sealing cap and the trocar as a kit, adopts two sealing caps, one sealing cap is fixedly provided with the trocar, penetrates into the leakage opening, and is replaced with the other sealing cap without the trocar to be hermetically connected with the inner tube after being taken out, and the rest is the same as the embodiment 1.

In addition, in the embodiment 1, the trocar and the sealing cap can be connected in a threaded mode instead of splicing.

The above description is only for the purpose of illustrating the preferred embodiments of the present invention and is not to be construed as limiting the invention, and any modifications, equivalents and improvements made within the spirit and principle of the present invention are intended to be included within the scope of the present invention.

Claims

1. A pseudo-aneurysm closure device, comprising: the balloon inflation catheter comprises a sleeve, wherein the sleeve comprises an outer tube (1) and an inner tube (2) sleeved in an inner cavity of the outer tube (1), a balloon pipeline (3) is arranged between the outer tube (1) and the inner tube (2), the front end of the balloon pipeline (3) is connected with an elastic balloon (4), the elastic balloon (4) extends out of the front end of the outer tube (1) when being inflated, the rear end of the balloon pipeline (3) is provided with a first inlet (5), a first sealing element (6) is arranged at a position, close to the first inlet (5), of the balloon pipeline (3), and the first inlet (5) and the first sealing element (6) are both located on the outer side of the rear end of the outer tube (1); the medical liquid injection device is characterized in that a plurality of side through holes (8) are formed in the outer pipe (1) close to the front end, a medical liquid pipeline (9) is further arranged between the outer pipe (1) and the inner pipe (2), the front end of the medical liquid pipeline (9) is communicated with the side through holes (8), and a second inlet (10) is formed in the rear end of the medical liquid pipeline (9).

2. The prosthetic aneurysm sealer of claim 1, wherein: the diameter of the inflated elastic saccule (4) is 0.3cm-1.0 cm.

3. The prosthetic aneurysm sealer of claim 1, wherein: an annular developing mark (11) is arranged on the outer wall of the front end of the outer tube (1).

4. The prosthetic aneurysm sealer of claim 3, wherein: the development mark (11) is a spiral metal sheet.

5. The prosthetic aneurysm sealer of claim 1, wherein: the first seal (6) is a clip.

6. The prosthetic aneurysm sealer of claim 1, wherein: a second seal (12) is provided in the medical fluid conduit (9) adjacent the second inlet (10).

7. The prosthetic aneurysm sealer of claim 6, wherein: the second seal (12) is a clip.

8. The prosthetic aneurysm sealer of claim 1, wherein: the trocar sleeve is characterized by further comprising a sealing cap (13), wherein the sealing cap (13) is in threaded connection with the inner wall of the tail end of the inner tube (2), and the sealing cap (13) is provided with a plug-in port for plugging the trocar (7).