CN118892383B - Deep vein thrombosis removal device - Google Patents
Deep vein thrombosis removal device Download PDFInfo
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- CN118892383B CN118892383B CN202411397819.6A CN202411397819A CN118892383B CN 118892383 B CN118892383 B CN 118892383B CN 202411397819 A CN202411397819 A CN 202411397819A CN 118892383 B CN118892383 B CN 118892383B
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- outer tube
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/01—Filters implantable into blood vessels
- A61F2/011—Instruments for their placement or removal
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B2017/00831—Material properties
- A61B2017/00867—Material properties shape memory effect
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B2017/00831—Material properties
- A61B2017/00902—Material properties transparent or translucent
- A61B2017/00915—Material properties transparent or translucent for radioactive radiation
- A61B2017/0092—Material properties transparent or translucent for radioactive radiation for X-rays
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
- A61B2017/22034—Gripping instruments, e.g. forceps, for removing or smashing calculi for gripping the obstruction or the tissue part from inside
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
- A61B2017/22035—Gripping instruments, e.g. forceps, for removing or smashing calculi for retrieving or repositioning foreign objects
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22038—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for with a guide wire
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22082—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for after introduction of a substance
- A61B2017/22084—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for after introduction of a substance stone- or thrombus-dissolving
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
- A61B2017/2212—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/01—Filters implantable into blood vessels
- A61F2002/016—Filters implantable into blood vessels made from wire-like elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0014—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/0096—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers
- A61F2250/0098—Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers radio-opaque, e.g. radio-opaque markers
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Heart & Thoracic Surgery (AREA)
- Public Health (AREA)
- Vascular Medicine (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Veterinary Medicine (AREA)
- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Surgical Instruments (AREA)
Abstract
本发明提供一种深静脉血栓去除装置，涉及医疗器械领域，包括外管、内管和滤网；外管近端固定连接有外管手柄；内管穿过外管手柄，内管近端固定连接有内管手柄；滤网套设于内管外部且滤网的远端固定连接于内管、近端活动连接于内管，部分内管和全部滤网穿设于外管的中心管腔且内管与外管能够相对滑动以使外管收容或释放滤网；输送状态下，外管手柄近端与内管手柄远端相互远离，滤网被完全释放的状态下，外管手柄近端与内管手柄远端固定在一起。本发明缓解了现有技术中深静脉滤器植入时、植入后、回收时和回收后都对血管损伤较大、难回收及植入过程中和植入后易倾斜的技术问题，并且，可简化与溶栓导管配合溶栓的手术复杂度，提高手术效率。
The present invention provides a deep vein thrombosis removal device, which relates to the field of medical devices, including an outer tube, an inner tube and a filter; the outer tube proximal end is fixedly connected to an outer tube handle; the inner tube passes through the outer tube handle, and the inner tube proximal end is fixedly connected to the inner tube handle; the filter is sleeved on the outside of the inner tube, and the distal end of the filter is fixedly connected to the inner tube, and the proximal end is movably connected to the inner tube, part of the inner tube and all the filters are passed through the central tube cavity of the outer tube, and the inner tube and the outer tube can slide relative to each other so that the outer tube can accommodate or release the filter; in the conveying state, the proximal end of the outer tube handle and the distal end of the inner tube handle are far away from each other, and in the state where the filter is completely released, the proximal end of the outer tube handle and the distal end of the inner tube handle are fixed together. The present invention alleviates the technical problems in the prior art that deep vein filters cause great damage to blood vessels during, after, during and after recovery, are difficult to recover, and are easy to tilt during and after implantation, and can simplify the complexity of thrombolysis surgery in conjunction with thrombolysis catheters, and improve surgical efficiency.
Description
Technical Field
The invention relates to the technical field of medical equipment, in particular to a deep vein thrombosis removing device.
Background
Blood in normal venous vessels is flowing, deep vein thrombosis (DVT, deep Vein Thrombosis) refers to the formation of blood clots in venous vessels, which partially or completely occlude the lumen of the vein, and the formed blood clots can fall off along the blood vessels to block the pulmonary vessels (the situation that blood clots fall off to block the pulmonary vessels is called "pulmonary embolism"), thereby causing respiratory and circulatory dysfunction and seriously causing death. The most common symptoms of deep vein thrombosis of lower limbs mainly comprise (1) symptoms of swelling pain (most of the symptoms are pain behind lower legs), skin temperature rise, redness and the like caused by blood clot blocking of deep vein blood vessels of lower limbs, (2) symptoms of chest distress, shortness of breath, dyspnea and suffocation caused by blood clot falling off of the blood clot blocking of lung blood vessels, chest pain, cough, even hemoptysis, heart beat acceleration and the like caused by inspiration or exertion.
For the treatment mode of deep vein thrombosis, a vena cava filter is implanted into a lower vena cava through skin at present so as to capture thrombus falling off in a venous system, and the deep vein thrombosis of lower limbs is treated by combining an operation, a medicine or an intervention method, so that the incidence rate of lethal pulmonary arterial embolism can be reduced, the deep vein is kept unblocked, and the method plays an indispensable role in treating DVT and preventing pulmonary embolism. The existing vena cava filter mainly comprises a filter arm consisting of a fixed arm and an anchoring arm and a recovery hook fixedly connected with the proximal end of the filter arm, wherein the distal end of the anchoring arm is provided with the anchoring hook, the recovery hook is used for capturing the recovery hook in a blood vessel through a recovery device after the filter is implanted into a human body for a period of time and then pulling out the blood vessel to realize the recovery of the filter, the anchoring hook is of a barb structure, and the barb of the filter is inserted into the wall of a vein blood vessel after the filter is released in the blood vessel to prevent the filter from shifting.
The use of vena cava filters has positive therapeutic effects on the treatment of most patients, but at the same time has problems, mainly including:
(1) The vascular injury is large during implantation, after implantation, during recovery and after recovery, particularly, the vein is very thin, the barb of the anchoring hook is easy to stab or puncture the vein, so that bleeding at the implantation position is caused, and the vascular injury is large;
(2) The barbs are difficult to recover, in particular, the barb anti-displacement structure penetrates the vessel wall, the vascular endothelial hyperplasia and endothelial tissue gradually covers the vena cava filter after a certain time, so that the filter and the vessel grow together, the filter is difficult to be withdrawn from the vessel, the larger the contact area between the filter and the vessel tissue is, the more difficult the filter is to recover from the vessel (but the recovery time is too short, the time that the filter plays a role in the vessel is short, so that the treatment effect is far short);
(3) The vena cava filter is easy to incline during implantation and after implantation, specifically, after the vena cava filter is released in a blood vessel, the filter is easy to incline, the recovery hook is contacted with the wall of the blood vessel, so that the recovery hook is not easy to be caught by the recovery device, recovery is difficult to realize, although some vena cava filters adopt a large-angle bending part which is arranged at the part of a fixed arm close to the recovery hook and is used for preventing the inclination by contact with the wall of the blood vessel, the vena cava filter can not be completely prevented from inclining when in actual use, but the incidence rate of inclination of the filter is reduced, because the anchoring of the filter only has a plurality of points to contact when the filter is released, and blood can impact the filter, under the complex condition, the filter is easy to incline when the filter is released, so that the filter is difficult to safely take out of the blood vessel after the life is completed;
(4) The operation process is complicated and time-consuming, and when the catheter and the guide wire of the conveying filter are matched with the thrombolytic device, the catheter and the guide wire of the conveying filter are withdrawn from the body, and then another deep vein thrombolysis catheter is used for thrombolysis treatment.
Disclosure of Invention
The present invention aims to provide a deep vein thrombosis removing device which alleviates all or part of the technical problems of the prior art.
Specifically, the embodiment of the invention adopts the following technical scheme:
The embodiment of the invention provides a deep venous thrombosis removing device which comprises an outer tube, an inner tube and a filter screen, wherein a through central tube cavity is formed in the outer tube along the axial direction, an outer tube handle is fixedly connected to the proximal end of the outer tube, the inner tube penetrates through the outer tube handle, an inner tube handle is fixedly connected to the proximal end of the inner tube, the filter screen is sleeved outside the inner tube, the distal end of the filter screen is fixedly connected to the inner tube, the proximal end of the filter screen is movably connected to the inner tube, in a release state, the filter screen expands along the radial direction of the inner tube to form an umbrella-shaped or spindle-shaped structure with hollowed-out areas at the proximal end and the distal end, part of the inner tube and all of the filter screen penetrate through the central tube cavity of the outer tube, and the inner tube and the outer tube can slide relatively so that the filter screen is accommodated or released by the outer tube.
In the conveying state, the proximal end of the outer tube handle is far away from the distal end of the inner tube handle, and in the state that the filter screen is completely released, the proximal end of the outer tube handle is fixed with the distal end of the inner tube handle.
The filter screen comprises a near-end constraint tube, a far-end constraint tube and a middle hollow main body, wherein the near-end constraint tube is sleeved outside the inner tube and can axially slide relative to the inner tube, the far-end constraint tube is sleeved and fixedly connected to the outer wall of the far end of the inner tube, the near-end convergence of the middle hollow main body is fixedly or integrally connected with the near-end constraint tube, and the far-end convergence of the middle hollow main body is fixedly or integrally connected with the far-end constraint tube.
Optionally, the outer tube handle proximal end is equipped with grafting buckle, the inner tube handle distal end is equipped with the slot, under the state that the filter screen was released completely, outer tube handle proximal end with the inner tube handle distal end is through grafting buckle with the slot is pegged graft together.
Optionally, a developing ring is fixed to the distal end of the outer tube.
The deep vein thrombosis removing device at least relieves the technical problems that a deep vein filter in the prior art is large in vascular injury, difficult to recover and easy to incline in and after implantation during implantation, after implantation, recovery and recovery, and the specific operation process and effect analysis are detailed in the detailed implementation part of the specification.
In addition, in order to solve the technical problems that the operation process of the existing vena cava filter is complicated and long, when the existing vena cava filter is matched with a thrombolytic device, a catheter and a guide wire of a conveying filter are required to be withdrawn from the body, and then another deep vein thrombolysis catheter is used for thrombolysis treatment, the application makes the following further improvements on the basis of any optional embodiment:
In a first optional implementation manner, the outer tube is further provided with a thrombolysis tube cavity which is mutually spaced from the central tube cavity and has a closed distal end along the axial direction, a liquid injection hole communicated with the thrombolysis tube cavity is formed at the proximal end of the outer tube or the proximal end of the outer tube handle, and a liquid through hole communicated with the thrombolysis tube cavity is formed on the outer wall of the distal end of the outer tube.
In this alternative embodiment, further optionally, the cross section of the thrombolytic lumen along the circumferential direction of the outer tube is annular, a plurality of circles of the liquid through holes are arranged at intervals along the axial direction of the outer tube, and the liquid through holes of each circle are uniformly arranged along the circumferential direction of the outer tube.
In a second alternative embodiment, the deep vein thrombosis removing device further comprises a thrombolysis hose, and an outer tube side wall opening capable of penetrating the thrombolysis hose is arranged on the distal end side wall of the outer tube.
In this alternative embodiment, further:
as a first optional structure, the central lumen of the outer tube is used as a thrombolytic hose cavity, and the proximal end of the outer tube handle is provided with a tube orifice communicated with the central lumen of the outer tube as a thrombolytic hose insertion port;
As a second optional structure, a thrombolytic hose cavity is further arranged in the outer tube, the distal end of the thrombolytic hose cavity is communicated with the opening of the side wall of the outer tube, and a thrombolytic hose insertion opening communicated with the thrombolytic hose cavity is arranged at the proximal end of the outer tube handle. Further alternatively, the distal end inner wall surface of the thrombolytic hose chamber has a curved surface curved toward the side of the outer tube sidewall opening.
As a third alternative structure, the distal end side wall of the inner tube is provided with an inner tube side wall opening, and in a state in which the filter screen is completely released, the inner tube side wall opening coincides with the outer tube side wall opening, and the thrombolytic hose can penetrate into the lumen of the inner tube from the proximal end of the inner tube handle and out of the outer tube through the inner tube side wall opening and the outer tube side wall opening.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings that are needed in the description of the embodiments or the prior art will be briefly described, and it is obvious that the drawings in the description below are some embodiments of the present invention, and other drawings can be obtained according to the drawings without inventive effort for a person skilled in the art.
Fig. 1 is a schematic view of the overall structure of a deep vein thrombosis removing device according to a first alternative embodiment of the present invention, in which a filter screen is accommodated in an outer tube;
FIG. 2 is an enlarged view of a partial structure of the area A in FIG. 1;
Fig. 3 is a schematic view showing the overall structure of a deep vein thrombosis removing apparatus according to a first alternative embodiment of the present invention in a state in which a filter screen is released outside an outer tube;
FIG. 4 is an enlarged view of a partial structure of the area B in FIG. 3;
Fig. 5 is a schematic view of the distal end structure of an outer tube in a first alternative embodiment of a deep vein thrombosis removing device according to an embodiment of the present invention;
fig. 6 is a schematic view illustrating an operation state of the deep vein thrombosis removing device according to the embodiment of the present invention after the deep vein thrombosis removing device is implanted in a deep vein;
fig. 7 is a schematic overall structure of a first alternative structure of a second alternative embodiment of a deep vein thrombosis removing apparatus according to an embodiment of the present invention;
Fig. 8 is a schematic view of an operating state of the deep vein thrombosis removing device according to the second alternative embodiment of the present invention after the first alternative structure is implanted in a deep vein;
Fig. 9 is a schematic overall structure of a second alternative embodiment of a deep vein thrombosis removing apparatus according to an embodiment of the present invention;
FIG. 10 is an enlarged view of a portion of the structure of the region C in FIG. 9;
Fig. 11 is a schematic overall structure of a third alternative structure of the second alternative embodiment of the deep vein thrombosis removing apparatus according to the embodiment of the present invention;
FIG. 12 is an enlarged view of the partial structure of the area D in FIG. 11;
Fig. 13 is a schematic view showing an operation state of the deep vein thrombosis removing device according to the second alternative embodiment of the present invention after the third alternative structure is implanted in the deep vein.
The icons comprise a 1-outer tube, a 11-outer tube handle, a 111-plug buckle, a 101-central tube cavity, a 102-thrombolysis tube cavity, a 103-liquid through hole, a 104-outer tube side wall opening, a 105-thrombolysis tube cavity, a 106-curved surface, a 2-inner tube, a 21-inner tube handle, a 211-support tube section, a 201-inner tube side wall opening, a 3-filter screen, a 31-proximal constraint tube, a 32-distal constraint tube, a 33-middle hollow main body and a 4-thrombolysis tube.
Detailed Description
For the purpose of making the objects, technical solutions and advantages of the embodiments of the present invention more apparent, the technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present invention, and it is apparent that the described embodiments are some embodiments of the present invention, but not all embodiments of the present invention. The components of the embodiments of the present invention generally described and illustrated in the figures herein may be arranged and designed in a wide variety of different configurations.
Thus, the following detailed description of the embodiments of the invention, as presented in the figures, is not intended to limit the scope of the invention, as claimed, but is merely representative of selected embodiments of the invention. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
It should be noted that like reference numerals and letters refer to like items in the drawings, and thus once an item is defined in one drawing, no further definition or explanation thereof is necessary in subsequent drawings.
In describing the present invention, it should be noted that:
Unless specifically stated or limited otherwise, the terms "disposed," "mounted," "connected," and "connected" are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected, or may be directly connected, or may be indirectly connected through intervening media, or may be in communication between two elements. The specific meaning of the above terms in the present invention will be understood in specific cases by those of ordinary skill in the art.
The terms "proximal," "distal," "front," "rear," "axial," "radial," "inner," "outer," and the like refer to an orientation or positional relationship based on that shown in the drawings, or that is conventionally put in place when the inventive product is used, merely to facilitate description of the invention and to simplify description, and do not indicate or imply that the devices or elements referred to must have a particular orientation, be constructed and operated in a particular orientation, and therefore should not be construed as limiting the invention.
The terms "first," "second," and the like, are used merely for distinguishing between descriptions, and not for indicating a total number, or a relative position in time and/or space, and are not to be construed as indicating or implying relative importance.
In the following, some embodiments of the present invention will be described in detail with reference to the accompanying drawings, wherein the end of the medical instrument close to the operator during operation is the proximal end of the medical instrument, and the end of the medical instrument entering the blood vessel of the patient is the distal end of the medical instrument. The following examples and features of the various alternative implementations of the examples may be combined with one another without conflict.
The embodiment provides a deep vein thrombosis removing device, referring to fig. 1 to 13, the deep vein thrombosis removing device comprises an outer tube 1, an inner tube 2 and a filter screen 3, wherein a central tube cavity 101 penetrating through the outer tube 1 along the axial direction is fixedly connected with an outer tube handle 11 at the proximal end of the outer tube 1, the inner tube 2 penetrates through the outer tube handle 11, the inner tube handle 21 is directly or fixedly connected with the proximal end of the inner tube 2 through a support tube section 211, the filter screen 3 is sleeved outside the inner tube 2, the distal end of the filter screen 3 is fixedly connected with the inner tube 2, the proximal end of the filter screen 3 is movably connected with the inner tube 2 (at least can axially slide relative to the inner tube 2 so as to be capable of axially sliding relative to the inner tube 2 and rotating relative to the inner tube 2 in the circumferential direction, and in a release state, the filter screen 3 expands in an umbrella-shaped or spindle-shaped structure with hollow areas at the proximal end and the distal end along the radial direction of the inner tube 2, part of the inner tube 2 and all the filter screens 3 penetrate through the central tube cavity 101 of the outer tube 1, the inner tube 2 has a certain supportability and pushability, and the inner tube 2 can slide relative to the outer tube 1 so as to enable the outer tube 1 to accommodate or release of the filter screen 3. In the delivery state, the proximal end of the outer tube handle 11 and the distal end of the inner tube handle 21 are far away from each other, and in the state where the filter screen 3 is completely released, the proximal end of the outer tube handle 11 and the distal end of the inner tube handle 21 are fixed together.
The filter screen 3 is formed by braiding nickel-titanium alloy or other metal wires, or the filter screen 3 is formed by cutting a metal tube, is prefabricated into an umbrella-shaped or spindle-shaped structure with the middle part bulged outwards in the radial direction, can be contracted in the outer tube 1, automatically rebounds into a prefabricated shape after being released out of the outer tube 1, and can be released into a blood vessel of a patient if the blood vessel is released, the bulged part of the blood vessel is supported on the wall of the blood vessel, and the proximal end and the distal end of the blood vessel form a large hollowed-out area for entering and blocking thrombus, and generally, the hollowed-out area of the proximal end is larger than the hollowed-out area of the distal end as the best, so that thrombus is intercepted by the distal end while thrombus entering is not hindered. Optionally, as shown in fig. 4, the filter screen 3 includes a proximal constraint tube 31, a distal constraint tube 32 and a middle hollow main body 33, where the proximal constraint tube 31 is sleeved outside the inner tube 2 and can axially slide relative to the inner tube 2 at least to the inner tube 2 so as to axially slide relative to the inner tube 2 and rotate circumferentially relative to the inner tube 2 to be optimal, the distal constraint tube 32 is sleeved and fixedly connected to the distal outer wall of the inner tube 2, the proximal end of the middle hollow main body 33 is fixedly or integrally connected to the proximal constraint tube 31, the distal end of the middle hollow main body 33 is fixedly or integrally connected to the distal constraint tube 32, and the middle hollow main body 33 can be in a spindle shape as shown in fig. 4 or in a conical umbrella shape after being freely expanded.
In use, referring to FIGS. 1 and 2, the outer tube handle 11 is pushed forward axially relative to the inner tube handle 21 or the inner tube handle 21 is withdrawn axially relative to the outer tube handle 11 to separate the outer tube handle 11 and the inner tube handle 21 from each other so that the filter screen 3 is accommodated in the outer tube 1, then a guide wire is pushed into the target vessel, the distal end (front end) of the entire tubular structure of the deep vein thrombosis removing device is pushed into a target position under the guide wire guide so that the proximal end of the filter screen 3 is positioned in a thrombus region or on the downstream side of the thrombus (preferably on the downstream side of the thrombus), and next, the inner tube handle 21 is pushed forward axially relative to the outer tube handle 11 or the outer tube handle 11 is withdrawn axially relative to the inner tube handle 21 so that the distal end of the inner tube handle 21 and the proximal end of the outer tube handle 11 are fixed together, at this time the filter screen 3 is released in the vessel, and after the position is determined, a part of the proximal end of the outer tube 1 is exposed out of the patient's body is fixed on the skin by using a medical fixing patch so that the filter screen 3 is prevented from tilting or shifting by the filter screen 3 as a positioning member of the filter screen 3 after implantation, and the position and angle of the filter screen 3 can be adjusted at any time according to practical needs.
After the human blood vessel is put into to the deep vein thrombosis removing device that this embodiment provided, inner tube handle 21 and outer tube handle 11 are fixed together each other, outer tube 1 is fixed in the external skin layer of patient, under the traction of inner tube 2, need not to consider filter screen 3 and can take place the slope or by the blood stream scour shift, just also need not set up the supplementary anchor of barb on filter screen 3, when putting into and taking out filter screen 3, can not cause extra damage to the blood vessel because of having the barb, and, because of no barb structure, it is difficult for endothelialization to lead to difficult taking out after putting into patient's blood vessel, and then can implant longer cycle and conveniently retrieve. Therefore, the embodiment solves the technical problems that the deep vein filter is large in vascular injury, difficult to recover and easy to incline in the implantation process and after the deep vein filter is recovered during implantation, after implantation, during recovery and after recovery in the prior art, and besides, the position and the angle of the filter screen 3 can be adjusted at any time according to different thrombus positions due to the fact that the inner tube 2 pulls the filter screen 3, so that the function of removing the thrombus in multiple areas through one implantation is realized.
In order to fix the outer tube handle 11 and the inner tube handle 21 together quickly, and ensure that the outer tube handle 11 and the inner tube handle 21 can be disassembled quickly after being fixed, optionally and preferably, an inserting buckle 111 is arranged at the proximal end of the outer tube handle 11, a slot is arranged at the distal end of the inner tube handle 21, the proximal end of the outer tube handle 11 and the distal end of the inner tube handle 21 are inserted together through the inserting buckle 111 and the slot in a completely released state of the filter screen 3, the inserting buckle 111 is preferably made of metal or memory alloy, and can also be connected to the outer tube handle 11 in a matched spring mode, so that the reliability of inserting fixation is improved.
In addition, optionally and preferably, a developing ring is fixed at the distal end of the outer tube 1, so as to quickly and accurately release the filter screen 3 at a target position (the proximal end of the filter screen 3 is located at the thrombus area or the downstream side of the thrombus, preferably the downstream side of the thrombus) with the aid of the developing device, thereby ensuring that the filter screen 3 can effectively intercept more thrombus.
In addition, in order to solve the technical problems that the operation process of the existing vena cava filter is complicated and long, when the existing vena cava filter is matched with a thrombolytic device, a catheter and a guide wire of a conveying filter are required to be withdrawn from the body, and then another deep vein thrombolysis catheter is used for thrombolysis treatment, the application makes the following further improvements on the basis of any optional embodiment:
In a first alternative embodiment, referring to fig. 1 to 6, the outer tube 1 is further provided with a thrombolytic lumen 102 which is spaced from the central lumen 101 thereof in the axial direction and is closed at the distal end, a liquid injection hole which is communicated with the thrombolytic lumen 102 is provided at the proximal end of the outer tube 1 or the proximal end of the outer tube handle 11, and a liquid through hole 103 which is communicated with the thrombolytic lumen 102 is provided on the outer wall of the distal end of the outer tube 1. When the thrombolytic device is used, after the filter screen 3 is completely released, thrombolytic liquid is introduced into the thrombolytic lumen 102 through the liquid injection hole, the thrombolytic liquid is injected into a blood vessel through the liquid through hole 103 to help dissolve thrombus, after thrombolysis and filtering are completed, the outer tube 1 is kept fixed, the inner tube handle 21 is withdrawn to recover the filter screen 3, and finally the whole device is withdrawn outside the patient.
In this alternative embodiment, further alternatively, the thrombolytic lumen 102 is annular in cross section along the circumferential direction of the outer tube 1, and a plurality of circles of liquid through holes 103 are arranged at intervals along the axial direction of the outer tube 1, and the number of each circle of liquid through holes 103 may be one, two or more, preferably two or more, and each circle of liquid through holes 103 is uniformly arranged along the circumferential direction of the outer tube 1 to sufficiently dissolve thrombus.
In a second alternative embodiment, referring to fig. 7 to 13, the deep vein thrombosis removing apparatus further comprises a thrombolysis tube 4, and an outer tube side wall opening 104 capable of penetrating the thrombolysis tube 4 is provided on the distal side wall of the outer tube 1.
In this alternative embodiment, further:
as a first alternative structure, referring to fig. 7 and 8, the central lumen 101 of the outer tube 1 is used as a thrombolytic hose cavity 105 (i.e. the outer tube 1 is not additionally provided with other lumens except the central lumen 101), the proximal end of the outer tube handle 11 is provided with a nozzle communicated with the central lumen 101 of the outer tube 1 as a thrombolytic hose insertion port, when the filter screen 3 is completely released, the thrombolytic hose 4 is inserted into the central lumen 101 of the outer tube 1 through the thrombolytic hose insertion port, so that the distal end (front end) of the thrombolytic hose 4 is penetrated out of the side wall opening 104 of the outer tube into a blood vessel, and then the thrombolytic hose 4 is introduced with thrombolytic liquid to be injected into the blood vessel to help dissolve thrombus. Under the action of thrombolytic drugs, part of thrombus can be dissolved, part of thrombus can fall off, the thrombus that falls off is captured by the filter screen 3 along the blood flow, after the thrombus at the pathological change position is completely eliminated, the outer tube 1 is kept fixed, the thrombolytic hose 4 is removed in a back-out way and the inner tube handle 21 is withdrawn back to recover the filter screen 3, and finally the whole device is withdrawn outside the patient.
As a second alternative structure, referring to fig. 9 and 10, the inside of the outer tube 1 is provided with an additional thrombolytic hose cavity 105 in addition to the central lumen 101, the distal end of the thrombolytic hose cavity 105 being in communication with the outer tube sidewall opening 104, and the proximal end of the outer tube handle 11 being provided with a thrombolytic hose insertion opening in communication with the cap thrombolytic hose cavity 105. In use, after the filter screen 3 is completely released, the thrombolytic hose 4 is inserted into the thrombolytic hose cavity 105 of the outer tube 1 through the thrombolytic hose insertion port, so that the distal end (front end) of the thrombolytic hose 4 is penetrated out of the outer tube side wall opening 104 into the blood vessel, and then the thrombolytic liquid is introduced into the thrombolytic hose 4 to be injected into the blood vessel to help dissolve thrombus. Under the action of thrombolytic drugs, part of thrombus can be dissolved, part of thrombus can fall off, the thrombus that falls off is captured by the filter screen 3 along the blood flow, after the thrombus at the pathological change position is completely eliminated, the outer tube 1 is kept fixed, the thrombolytic hose 4 is removed in a back-out way and the inner tube handle 21 is withdrawn back to recover the filter screen 3, and finally the whole device is withdrawn outside the patient.
In this alternative structure, it is further preferable that the distal end inner wall surface of the thrombolytic hose cavity 105 is formed with a curved surface 106 curved toward the side of the outer tube side wall opening 104, so as to better and faster guide the thrombolytic hose 4 to pass out, and the curved surface is more favorable for guiding the thrombolytic hose 4 to complete "mountain turning" when the target vessel is a branch of a bifurcated vessel (for example, for iliofemoral vein thrombosis), and rapidly and accurately enter the target branch vessel for thrombolysis, and the structure can utilize the thrombolytic hose 4 to cooperate with the outer tube side wall opening 104, dissolve and remove thrombus in the branch vessel which is not easy to convey and reach by the filter screen 3, and reduce the burden of a patient.
As a third alternative structure, referring to fig. 11 to 13, the distal end side wall of the inner tube 2 is provided with an inner tube side wall opening 201, and in a state in which the screen 3 is completely released, the inner tube handle 21 and the outer tube handle 11 are fixed together and the inner tube side wall opening 201 coincides with the outer tube side wall opening 104, and the thrombolytic hose 4 can be passed from the proximal end of the inner tube handle 21 into the lumen of the inner tube 2 and out of the outer tube 1 via the inner tube side wall opening 201 and the outer tube side wall opening 104. In use, after the filter screen 3 is completely released, the thrombolytic hose 4 is inserted into the inner tube 2 through the thrombolytic hose insertion port, so that the distal end (front end) of the thrombolytic hose 4 is passed out into the blood vessel through the inner tube side wall opening 201 and the outer tube side wall opening 104, and then the thrombolytic liquid is introduced into the thrombolytic hose 4 to be injected into the blood vessel to help dissolve thrombus. Under the action of thrombolytic drugs, part of thrombus can be dissolved, part of thrombus can fall off, the thrombus that falls off is captured by the filter screen 3 along the blood flow, after the thrombus at the pathological change position is completely eliminated, the outer tube 1 and the inner tube 2 are kept fixed, the thrombolytic hose 4 is removed by withdrawing and the filter screen 3 is recovered by withdrawing the inner tube handle 21, and finally the whole device is withdrawn outside the patient.
The above-mentioned several optional embodiments of this embodiment combine the filter screen filtering plug and the thrombolysis process, do not need to withdraw the catheter and the guide wire for delivering the filter from the body, and then use another deep vein thrombolysis catheter to perform thrombolysis treatment, the operation process is simpler and more efficient, and, above all, the thrombus in the branch vessel which is not easy to deliver and arrive by the filter screen 3 can be dissolved and removed by matching the thrombolysis hose 4 with the outer tube side wall opening 104 (and the inner tube side wall opening 201), so that the burden of the patient is reduced, and a more thorough thrombolysis effect is achieved.
It should be noted that the above embodiments and the optional embodiments thereof in the present specification are only for illustrating the technical solution of the present invention and not for limiting the same, and although the present invention has been described in detail with reference to the above embodiments, it should be understood by those skilled in the art that the technical solution described in the foregoing optional embodiments may be modified or some or all of the technical features may be equivalently replaced, and these modifications or substitutions do not make the essence of the corresponding technical solution deviate from the scope of the technical solution of the embodiments of the present invention, and in addition, it is emphasized again that the features of the embodiments and the optional embodiments in the present specification may be mutually combined without conflict.
Claims (9)
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| JP4493608B2 (en) * | 2006-03-06 | 2010-06-30 | テルモ株式会社 | Atherectomy catheter |
| US20100286722A1 (en) * | 2009-05-11 | 2010-11-11 | Intersect Partners, Llc | Temporary venous filter system |
| WO2017140772A1 (en) * | 2016-02-19 | 2017-08-24 | Joline Gmbh & Co. Kg | Stent delivery system |
| CN109044483A (en) * | 2018-07-26 | 2018-12-21 | 河南亚都实业有限公司 | A kind of conduit for removal of thromboses |
| CN110870813A (en) * | 2018-09-03 | 2020-03-10 | 南微医学科技股份有限公司 | Medical instrument imbedding device |
| CN110882096B (en) * | 2019-12-24 | 2024-11-15 | 上海蓝脉医疗科技有限公司 | Implant delivery system |
| US11583426B2 (en) * | 2020-03-03 | 2023-02-21 | Teleflex Life Sciences Limited | Vessel lining device and related methods |
| CN215129581U (en) * | 2021-04-01 | 2021-12-14 | 上海善迪医疗科技有限公司 | Two-stage release bolt taking device |
| CN113069258B (en) * | 2021-06-07 | 2022-02-08 | 上海微创心脉医疗科技(集团)股份有限公司 | Conveyor and medical device |
| CN115634010B (en) * | 2022-12-02 | 2023-04-04 | 北京华通集智医疗器械有限公司 | Ultrasonic thrombolysis device and ultrasonic thrombolysis system |
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| CN209004327U (en) * | 2017-10-19 | 2019-06-21 | 朱建成 | A kind of aorta brain protection conduit |
| CN112438777A (en) * | 2019-08-28 | 2021-03-05 | 尤东侠 | Minimally invasive thrombus extraction device for treating vascular embolism |
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