Summary of the invention
The object of this invention is to provide a kind of controllable bending guiding catheter and preparation method thereof, the technical problem that solve is to shorten operating time, improves operation safety.
The present invention is by the following technical solutions: a kind of controllable bending guiding catheter, be provided with conduit, the near-end of conduit is connected with handle, the far-end of described conduit is guiding-tube bend section, the far-end of guiding-tube bend section connection metal bracing wire, the near-end of metal bracing wire is connected on handle, and it is crooked that handle is controlled guiding-tube bend section through metal bracing wire.
The distal end of guiding-tube bend section of the present invention is equipped with development indicating, and the near-end of development indicating is equipped with becket anchor point, and the distance between becket anchor point and development indicating is 4mm～30mm, and described metal bracing wire far-end and becket anchor point are welded to connect.
Guiding-tube bend section of the present invention is linearity in free state, and the angle being bent is: 0 < angle≤270 °; Or described guiding-tube bend section is bending in free state, crooked angle is: 0 < angle≤90 °, the angle being bent is: 0 < angle≤270 °, the direction being bent and guiding-tube bend section are at the opposite direction of free state bending.
The part of guiding-tube bend section of the present invention between development indicating and becket anchor point is bending in free state; Or the junction of described guiding-tube bend section 7 and the non-bending section 6 of conduit, in free state, be bending.
Conduit of the present invention is connected and composed by guiding-tube bend section and the non-bending section of conduit of far-end.
Guiding-tube bend section of the present invention and the non-bending section of conduit are provided with conduit internal layer, conduit intermediate layer and catheter outer, and catheter outer is nested with outside conduit internal layer, and conduit intermediate layer is embedded in catheter outer; Described conduit internal layer adopts politef, conduit intermediate layer is woven wire cloth, catheter outer adopts macromolecule polymer material block polyamide, nylon or the polyurethane that hardness is 25D～72D, guiding-tube bend section adopts relatively soft macromolecule polymer material, and the non-bending section of conduit adopts the relatively high macromolecule polymer material of hardness; Described becket anchor point is embedded in catheter outer.
Near-end one side of becket anchor point of the present invention, along the axial direction of conduit, in catheter outer, being formed with cross section is poroid bracing wire chamber; At the non-bending section of conduit, bracing wire intracavity is provided with axial support molectron, metal bracing wire is arranged in the bracing wire chamber of guiding-tube bend section and the axial support molectron hole of the non-bending section of conduit: described axial support molectron is provided with internal layer, intermediate layer and skin, described internal layer adopts politef, intermediate layer is the net of metal wire knitted or the coil spring shape of coiling, and skin is high molecular polymer polyimides, polyether-ether-ketone, nylon, block polyamide or polyurethane.
Handle of the present invention is provided with push rod and the outdoor handle of tubular, and the near-end of push rod puts in a section of outdoor handle through hole far-end vertically, is formed with damping and is slidably connected; In one section of described outdoor handle through hole near-end, be provided with anchorage shoe, the near-end of described metal bracing wire is connected on anchorage shoe.
On the excircle of push rod of the present invention, have stopper slot, the length direction of stopper slot is parallel to the axis direction of push rod; On described outdoor handle, radially have pin-and-hole, insert limited location pin in pin-and-hole, spacer pin inwardly stretches out in one section of insertion stopper slot of pin-and-hole.
A preparation method for controllable bending guiding catheter, comprises the following steps:
One, make axial support molectron,
Internal layer adopts politef, and internal diameter is 0.25mm～2.5mm, thick 0.02mm～0.1mm, and length is 40cm～130cm;
Intermediate layer adopts stainless steel silk, tungsten filament, cochrome silk, titanium alloy wire or the nitinol alloy wire that string diameter is 0.01mm～0.1mm, silk number is 8～32, be woven into the net of 30～200PPI, or rotating speed is 5 ~ 20r/min, turning to external diameter is 0.3mm～3.0mm, the coil spring shape that pitch is 0.02mm～0.2mm;
Outer high molecular polymer polyimides, polyether-ether-ketone, nylon, block polyamide or the polyurethane of adopting, external diameter is 0.4mm～3.1mm;
It is 0.25mm～2.5mm that internal layer, intermediate layer, skin are nested with at external diameter by level, length is on the metal or plastics plug of 40cm～130cm, putting outside internal diameter is 1.0 ~ 3.0mm, shrinkage ratio is the fluorinated ethylene propylene copolymer heat-shrinkable tube of 1.3:1 ~ 2:1, rheological temperature 380 ~ 450 ℉, rheology speed 0.08 ~ 0.25cm/s, naturally cools to after room temperature, peel heat-shrinkable tube off, extract the making that plug completes axial support molectron;
Two, make conduit,
Conduit internal layer adopts polyfluortetraethylene pipe, and internal diameter is 0.6mm～6.0mm, thick 0.02mm～0.1mm, long 600mm～1450mm;
It is 0.02mm～0.1mm stainless steel silk or nitinol alloy wire that conduit intermediate layer adopts 8～32 rhizoid footpaths, is woven into the wire netting of 30PPI～100PPI;
Catheter outer adopts macromolecule polymer material block polyamide, nylon or the polyurethane tube that hardness is 25D～72D, and external diameter is 1mm～7mm, and guiding-tube bend section adopts relatively soft polymer pipe, long 10mm～100mm; The non-bending section of conduit adopts the relatively high polymer pipe of hardness, long 600mm～1400mm;
Developing mark adopts the macromolecular material of platinumiridio, platinum, gold, tantalum, tungsten, tungstenic or contains Bi2o3macromolecular material ring, be of a size of 0.6mm～6.0mm;
Becket anchor point adopts rustless steel, Nitinol or platinumiridio ring, is of a size of 0.6mm～6.0mm;
Metal bracing wire adopts stainless steel silk or the nitinol alloy wire that string diameter is 0.1mm～0.5mm, long 700mm～1600mm; One end of metal bracing wire is welded on to becket anchor point, and welding current is 75A～200A, and pulsewidth is 2ms～10ms, and the other end of metal bracing wire is through axial support molectron;
(1) conduit internal layer being nested with at external diameter is 0.6mm～6.0mm, and length is 600mm～1450mm, along on the reeded metal mandrel of axis band; (2), in order from far-end, by developing mark, be nested with the becket anchor point of metal bracing wire the position that is positioned at guiding-tube bend section at conduit internal layer, the distance between developing mark and becket anchor point is 4mm～30mm; (3) axial support molectron is arranged on vertically to the groove location of metal mandrel of the non-bending section of conduit of conduit internal layer; (4) conduit intermediate layer is nested with outside becket anchor point and axial support molectron; (5) outside conduit intermediate layer, be nested with catheter outer, the catheter outer of long 10mm～100mm is nested with at far-end; (6) at catheter outer, putting internal diameter is outward 1.3 ~ 9.5mm, the fluorinated ethylene propylene copolymer heat-shrinkable tube that shrinkage ratio is 1.3 ~ 2:1, rheological temperature 380 ~ 450 ℉, rheology speed 0.08 ~ 0.25cm/s, naturally cools to after room temperature, peels heat-shrinkable tube off, extract plug, obtain conduit;
Three, push rod, outdoor handle, spacer pin, anchorage shoe adopt medical stainless steel material, by existing machinery processing method, make;
Four, assembling, obtains controllable bending guiding catheter.
The present invention compared with prior art, regulate the relative position of outdoor handle and pulling-pushing rod, the metal bracing wire screw lock that is fixed, be equivalent to loosen or strain metal bracing wire, the far-end of guiding-tube bend section occurs bending and deformation, control the relative displacement of outdoor handle and push rod, can control the degree of crook of guiding-tube bend section far-end, realize distal end of catheter bending controlled, reach and use same conduit can enter a left side, right coronary artery, shorten operating time, alleviate patient suffering, improve the safety of percutaneous coronary intervention operation, also be applicable to the heart of different sizes and the coronary artery of different openings, compact conformation, cost is low.
The specific embodiment
Below in conjunction with drawings and Examples, the present invention is described in further detail.In Figure of description, each Reference numeral is: controllable bending guiding catheter 1, catheter adapter 2, outdoor handle 3, push rod 4, hold-down screw 5, the non-bending section 6 of conduit, guiding-tube bend section 7, metal bracing wire 8, development indicating 9, becket anchor point 10, conduit internal layer 11, conduit intermediate layer 12, catheter outer 13, axial support molectron 14, bracing wire chamber 15, catheter lumen 16, axial support molectron internal layer 17, axial support molectron intermediate layer 18, axial support molectron skin 19, push rod inner chamber 20, stopper slot 21, damped ring 22, spacer pin 23, through hole 24, anchorage shoe 25, catheter channel 26, bracing wire passage 27.
As shown in Figure 1, controllable bending guiding catheter 1 of the present invention, from near-end to far-end, is linked in sequence and is formed by catheter adapter 2, handle and conduit.Conduit is tubulose, length is 600mm～1450mm, and internal diameter is 0.6mm～6.0mm, and external diameter is 1mm～7mm, by the guiding-tube bend section 7 that is positioned at one section of far-end, connected and composed with non-bending section 6 two parts of the conduit being connected with guiding-tube bend section 7, guiding-tube bend section 7 length are 20mm～100mm.The distal end of guiding-tube bend section 7 is equipped with development indicating 9, near near-end one side of development indicating 9, is equipped with becket anchor point 10.In conduit, be provided with metal bracing wire 8, metal bracing wire 8 far-ends and becket anchor point 10 are welded to connect, and near-end is fixedly connected on handle.
As shown in Figure 2, guiding-tube bend section 7 is linearity in free state, and the far-end of guiding-tube bend section 7 can be operated to control by doctor and be bent, and the angle being bent is: 0 < angle≤270 °.
As shown in Figure 3, the part of guiding-tube bend section 7 between development indicating 9 and becket anchor point 10, in free state, it is bending, bending is 90 °, can be 0 < angle≤90 °, the angle being bent is: 0 < angle≤270 °, the direction being bent and guiding-tube bend section 7 are at the opposite direction of free state bending.
As shown in Figure 4, junction at guiding-tube bend section 7 and the non-bending section 6 of conduit, in free state, it is bending, bending is 90 °, can be 0 < angle≤90 °, the angle being bent is: 0 < angle≤270 °, the direction being bent and guiding-tube bend section 7 are at the opposite direction of free state bending.
As shown in Figure 5, the non-bending section 6 of guiding-tube bend section 7 and conduit consists of three-decker, is respectively conduit internal layer 11, conduit intermediate layer 12 and catheter outer 13, and catheter outer 13 is nested with outside conduit internal layer 11, and conduit intermediate layer 12 is embedded in catheter outer 13.Conduit internal layer 11 adopts politef, makes conduit have smooth inner chamber 16, and conduit internal layer 11 internal diameters are 0.6mm～6.0mm, thick 0.02mm～0.1mm.Conduit intermediate layer 12 is tinsel rustless steel or nitinol alloy wire mesh grid, and string diameter is 0.02mm～0.1mm, and density is 30PPI～100PPI(per inch order number), woven wire cloth makes conduit have good fracture resistance.Catheter outer 13 adopts macromolecule polymer material block polyamide, nylon or the polyurethane that hardness is 25D～72D, forms respectively the non-bending section 6 of guiding-tube bend section 7 and conduit.Guiding-tube bend section 7 adopts relatively soft macromolecule polymer material, and if hardness is 25D, the non-bending section 6 of conduit adopts the relatively high macromolecule polymer material of hardness, if hardness is 72D.The external diameter of catheter outer 13 is 1mm～7mm.Development indicating 9 adopts platinumiridio, platinum, gold, tantalum, the tungsten of ring-types, the macromolecular material of tungstenic or containing Bi2o3macromolecular material.Becket anchor point 10 is rustless steel, Nitinol or platinumiridio ring.Development indicating 9 is embedded in the catheter outer 13 of guiding-tube bend section 7 distal ends, and becket anchor point 10 is embedded near the catheter outer 13 development indicating 9 near-end one sides, and the distance between becket anchor point 10 and development indicating 9 is 4mm～30mm.Near-end one side at becket anchor point 10 starts, along the axial direction of conduit, between conduit internal layer 11 and conduit intermediate layer 12, be formed with the bracing wire chamber 15 that cross section is circular hole in catheter outer 13.At the non-bending section 6 of conduit, in bracing wire chamber 15, be provided with axial support molectron 14.The far-end of metal bracing wire 8 is welded to connect on becket anchor point 10, and metal bracing wire 8 is through the bracing wire chamber 15 of guiding-tube bend section 7, axial support molectron 14 endoporus of the non-bending section 6 of conduit, and near-end is connected with outdoor handle 3.When can absorbing metal bracing wire 8 stretching, axial support assembly 14 to non-bending section 6 axial compressive forces, avoid the non-bending section 6 of conduit to occur bending and deformation.The near-end of the non-bending section 6 of conduit has mouth, for metal bracing wire 8, from non-bending section 6 near-ends of conduit, stretches out.
As shown in Figure 6, the cylindrical cavity 16 that conduit internal layer 11 forms, along axis one sidewall to the center of circle in evagination, form the depression in the face of catheter outer 13, catheter outer 13 is to recess evagination, cross section be circular bracing wire chamber 15 evagination with cave between.As shown in Figure 7, axial support molectron 14 is embedded in the bracing wire chamber 15 of the non-bending section 6 of conduit.Bracing wire chamber 15 the structure between evagination and depression make guiding-tube bend section 7 is controlled be bent in, do not increase the wall thickness of conduit integral body.
As shown in Figure 8, axial support molectron 14 is nested with and is formed by three-decker, is respectively internal layer 17, intermediate layer 18 and outer 19.Internal layer 17 adopts politef, and internal diameter is 0.25mm～2.5mm, thick 0.02mm～0.1mm.Intermediate layer 18 is tinsel stainless steel silk, tungsten filament, cochrome silk, titanium alloy wire or the net of nitinol alloy wire braiding or the coil spring shape of coiling.String diameter wiry is 0.01mm～0.1mm, and the density of mesh grid is 30PPI～200PPI, and coil spring shape external diameter is 0.3mm～3.0mm, and pitch is 0.02mm～0.2mm.Outer 19 is high molecular polymer polyimides, polyether-ether-ketone, nylon, block polyamide or polyurethane, and external diameter is 0.4mm～3.1mm.The internal diameter of axial support molectron 14 is greater than the external diameter of metal bracing wire 8, can guarantee that the smooth and easy of metal bracing wire 8 passes through.
Metal bracing wire 8 adopts stainless steel silk or the nitinol alloy wire that string diameter is 0.1mm～0.5mm.
As shown in Figure 9, handle is provided with push rod 4 and outdoor handle 3, and push rod 4 and outdoor handle 3 forms being slidably connected vertically.The near-end of push rod 4 puts in a section of outdoor handle 3 through hole far-end vertically.Push rod 4 is shaped as cylindric, and the non-curved segment 6 of conduit is the inner chamber (endoporus) 20 along axis through push rod 4, is fixed on push rod 4.
On the excircle of the far-end of push rod 4, by machining, form the projection of outside a week, when projection operates for doctor, conveniently release or draw in push rod 4.On the middle part of push rod 4 and near-end excircle, have two cannelures, for embedding damped ring 22, increase the damping between push rod 4 and outdoor handle 3 endoporus, prevent that in process that guiding-tube bend section 7 is bent, push rod 4 moves to proximal direction.Between the outer surface of push rod 4, two cannelures, have the stopper slot 21 of a rectangular shape, the length direction of rectangle stopper slot 21 is parallel to the axis direction of push rod 4, one section of insertion of inwardly stretching out outdoor handle 3 pin-and-holes for the spacer pin 23 connecting on outdoor handle 3 wherein, make spacer pin 23 can be in stopper slot 21 movable along its length, the stroke that restriction push rod 4 moves relative to outdoor handle 3 axis.
Outdoor handle 3 is shaped as cylindric, in the distal portions of outdoor handle 3, the position that push rod 4 stretches into its through hole, radially has pin-and-hole on the wall of cylinder, and for inserting spacer pin 23, spacer pin 23 inwardly stretches out in one section of insertion stopper slot 21 of pin-and-hole.The proximal part of outdoor handle 3, is provided with an anchorage shoe 25 in through hole, anchorage shoe 25 forms dismountable connection with outdoor handle 3 in through hole, as be threaded, the built-in collar in two ends or boss coordinate with built-in collar.Anchorage shoe 25 is shaped as column, on anchorage shoe 25, along its axis, is provided with two passages (through hole), is respectively and the catheter channel 26 of outdoor handle 3 axis coaxles and the bracing wire passage 27 parallel with outdoor handle 3 axis.Lateral wall at the bracing wire passage 27 of outdoor handle 3 walls and anchorage shoe 25, along outdoor handle 3 radially, have screw, be used for screwing in hold-down screw 5, near the end of hold-down screw 5, have the through hole 24 vertical with hold-down screw 5 axis, when hold-down screw 5 screws in the screw of outdoor handle 3 and anchorage shoe 25, through hole 24 is communicated with bracing wire passage 27.The near-end of the non-bending section 6 of conduit stretches out outdoor handle 3 through inner chamber, the catheter channel 26 of push rod 4, is connected with catheter adapter 2.Metal bracing wire 8 is stretched out from the proximal openings of the non-bending section 6 of conduit, through bracing wire passage 27, also passes the through hole 24 of hold-down screw 5.Hold-down screw 5 is rotated a certain angle can be by metal bracing wire 8 fixing and lockings on outdoor handle 3.
Catheter adapter 2 adopts the female Luer of standard.
When doctor performs the operation, one holds outdoor handle 3, another hands forward (far-end) pushes away or (near-end) pulling-pushing rod 4 backward, because of screw 5 lockings that are fixed of the near-end of metal bracing wire 8, be equivalent to loosen or strain metal bracing wire 8, the non-bending section 6 of conduit does not produce waveform or arc-shaped bend, the far-end of guiding-tube bend section 7 occurs bending and deformation, control the relative displacement of outdoor handle 3 and push rod 4, can control the degree of crook of guiding-tube bend section 7 far-ends, realize distal end of catheter bending controlled, reach and use same conduit can enter a left side, right coronary artery, shorten operating time, alleviate patient suffering, improve the safety of percutaneous coronary intervention operation, also be applicable to the heart of different sizes and the coronary artery of different openings.The wall thickness of the not obvious increase conduit of controllable bending guiding catheter of the present invention, compact conformation, cost is low.
The preparation method of controllable bending guiding catheter of the present invention, comprises the following steps:
One, make axial support molectron,
Internal layer adopts politef, and internal diameter is 0.25mm～2.5mm, thick 0.02mm～0.1mm, and length is 40cm～130cm.
Intermediate layer material adopts stainless steel silk, tungsten filament, cochrome silk, titanium alloy wire or the nitinol alloy wire that string diameter is 0.01mm～0.1mm, silk number is 8～32, be woven into the net of 30～200PPI, the braider that adopts Grand Technology (Shenzhen) Co., Ltd. to manufacture, rotating speed 70 ~ 180r/min.Or the L80 coiling machine of employing U.S. RothGreaves & Associates Inc company, rotating speed is 5 ~ 20r/min, turning to external diameter is 0.3mm～3.0mm, the coil spring shape that pitch is 0.02mm～0.2mm.
Cladding material is high molecular polymer polyimides, polyether-ether-ketone, nylon, block polyamide or polyurethane, and external diameter is 0.4mm～3.1mm.
It is 0.25mm～2.5mm that internal layer, intermediate layer, skin are nested with at external diameter by level, length is on the metal or plastics plug of 40cm～130cm, putting outside internal diameter is 1.0 ~ 3.0mm, shrinkage ratio is the fluorinated ethylene propylene copolymer FEP heat-shrinkable tube of 1.3:1 ~ 2:1, with the Reflow-22 03-44 type rheology machine of U.S. USAAT INC company, three is fused together, rheological temperature 380 ~ 450 ℉, rheology speed 0.08 ~ 0.25cm/s, naturally cool to after room temperature, peel heat-shrinkable tube off, extract the making that plug completes axial support molectron 14.
Two, make conduit,
Conduit internal layer adopts polyfluortetraethylene pipe, and internal diameter is 0.6mm～6.0mm, thick 0.02mm～0.1mm, long 600mm～1450mm.
It is 0.02mm～0.1mm stainless steel silk or nitinol alloy wire that conduit intermediate layer adopts 8～32 rhizoid footpaths, is woven into the wire netting of 30PPI～100PPI, with the braider of Grand Technology (Shenzhen) Co., Ltd., rotating speed 70 ~ 180r/min.
Catheter outer adopts macromolecule polymer material block polyamide, nylon or the polyurethane tube that hardness is 25D～72D, and external diameter is 1mm～7mm.Guiding-tube bend section adopts relatively soft polymer pipe, if hardness is 25D, and long 10mm～100mm.The non-bending section of conduit adopts the relatively high polymer pipe of hardness, if hardness is 72D, and long 600mm～1400mm.
Developing mark adopts platinumiridio, platinum, gold, tantalum, the tungsten of the village, Hong Kong Xin Wanfeng noble metal company limited, the macromolecular material of tungstenic or containing Bi2o3macromolecular material ring, be of a size of 0.6mm～6.0mm.
Becket anchor point adopts rustless steel, Nitinol or the platinumiridio ring of Yangzhou Jin Yi precision tube company limited, is of a size of 0.6mm～6.0mm.
Metal bracing wire adopts stainless steel silk or the nitinol alloy wire that string diameter is 0.1mm～0.5mm, long 700mm～1600mm.One end of metal bracing wire is welded on to becket anchor point, adopts the laser-beam welding machine of Wuhan sky above Hubei and Hunan industrial lasers equipment company limited, welding current is 75A～200A, and pulsewidth is 2ms～10ms, and the other end of metal bracing wire is through axial support molectron.
(1) conduit internal layer being nested with at external diameter is 0.6mm～6.0mm, and length is 600mm～1450mm, along on the reeded metal mandrel of axis band.(2), in order from far-end, by developing mark, be nested with the becket anchor point of metal bracing wire the position that is positioned at guiding-tube bend section at conduit internal layer, the distance between developing mark and becket anchor point is 4mm～30mm.(3) axial support molectron is arranged on vertically to the groove location of metal mandrel of the non-bending section of conduit of conduit internal layer.(4) conduit intermediate layer is nested with outside becket anchor point and axial support molectron.(5) outside conduit intermediate layer, be nested with catheter outer, the catheter outer of long 10mm～100mm is nested with at far-end.(6) at catheter outer, putting internal diameter is outward 1.3 ~ 9.5mm, shrinkage ratio is the fluorinated ethylene propylene copolymer FEP heat-shrinkable tube of 1.3 ~ 2:1, with the Reflow-22 03-44 type rheology machine of U.S. USAAT INC company, each layer of conduit fused together, rheological temperature 380 ~ 450 ℉, rheology speed 0.08 ~ 0.25cm/s, naturally cools to after room temperature, peels heat-shrinkable tube off, extract plug, obtain conduit.
Three, push rod, outdoor handle, spacer pin, anchorage shoe and hold-down screw adopt medical stainless steel material, by existing machinery processing method, make.Catheter adapter is the standard Luer joint of outsourcing.
Four, assembling, catheter proximal end is packed into from the hole of push rod far-end and stretch out push rod, with AB glue, conduit and push rod are adhesively fixed, the through hole (inner chamber) that anchorage shoe is packed into outdoor handle near-end, to stretch out the conduit of push rod by the catheter channel of anchorage shoe, metal bracing wire is by the bracing wire passage of anchorage shoe simultaneously, and through the through hole on hold-down screw, outdoor handle near-end is started to be nested with on push rod from push rod far-end, spacer pin inserts and puts in stopper slot from the pin-and-hole of outdoor handle, and rotary fixing screw nail can fixing metal bracing wire.With AB glue, catheter proximal end and catheter adapter is bonding at the catheter proximal end that stretches out outdoor handle.AB glue is the happy safe epoxy AB glue of M-31CL.
Embodiment, the external diameter of controllable bending guiding catheter is 2.33mm, and effective length (conduit exposes the length of handle) is 1000mm, and guiding-tube bend section is 90 ° of bendings under free state, the non-bending section of conduit linear state under free state, the maximum bend angle of distal end of catheter is 270 °.
Animal experiment, select one of 20 kilograms of dog of body weight, this dog left and right coronary stenosis, adopt the controllable bending guiding catheter of the present embodiment and supporting convergent divergent channel, 2.0mm * 20mm PTCA(Percutenous transluminal coro-nary angioplasty Percutaneous transluminal coronary angioplasty) foley's tube and adapted seal wire (0.014 "; 195cm), ultrahard guide wire (0.035 ", 260cm), puncture sheath, Y-shaped connector accessory be a set of.Femoral artery puncture, sends ultrahard guide wire near position arteria coronaria entrance, convergent divergent channel is inserted from the joint of controllable bending guiding catheter, watch the development indicating of controllable bending guiding catheter, the combination of convergent divergent channel and controllable bending guiding catheter is sent near position arteria coronaria entrance along superhard seal wire, withdraw from ultrahard guide wire and convergent divergent channel, joint at controllable bending guiding catheter connects a Y-shaped connector, adjust the position of conduit in blood vessel, make 90 ° of bending sections of far-end arteria coronaria entrance dorsad, because the far-end of bracing wire is fixed on distal end of catheter by becket anchor point, near-end is fixed on outdoor handle with hold-down screw by anchorage shoe, when the palm of the hand is held outdoor handle, thumb pushes to (front) far away end, or to nearly (afterwards) end pulling-pushing rod, can change the degree of crook of the guiding-tube bend section of distal end of catheter, thumb pushes push rod forward to highest distance position, now the spacer pin on outdoor handle slides into the near-end of push rod stopper slot, curved distal tune is maximum 270 ° of bendings, the push rod of slowly pulling back, make the remote port of conduit enter to arteria coronaria entrance, from the side opening of Y-shaped connector, through controllable bending guiding catheter, inject contrast agent to arteria coronaria, confirm coronary stenosis position, by 0.014 ", 195cm seal wire enters from the positive hole of Y-shaped connector, along controllable bending guiding catheter, enters arteria coronaria and passes angiostenosis position, by PTCA foley's tube along 0.014 ", 195cm seal wire enters into coronary stenosis position, and makes the developing mark at sacculus two ends be positioned at the two ends of narrow location, Filled Balloon, expands angiostenosis position, after expansion, shrink sacculus, by PTCA foley's tube together with 0.014 ", 195cm seal wire is together withdrawn from, twisting push rod rotates a certain angle controllable bending guiding catheter, and make according to the method described above controllable bending guiding catheter make it enter to another arteria coronaria entry position, reenter according to the method described above 0.014 ", 195cm seal wire and PTCA foley's tube also carry out balloon expandable to angiostenosis position, after expansion, foley's tube shunk and retreat to controllable bending guiding catheter, and even controllable bending guiding catheter is together withdrawn from external.The blood circumstance of observing previous angiostenosis position by angiographic method, blood flow is unobstructed, completes the operation process of this coronary stenosis balloon expandable.
In the present embodiment, controllable bending guiding catheter of the present invention is used for coordinating balloon expandable operation, needs other apparatuses, as support, seal wire, sacculus are sent to arteria coronaria easily, all can to adopt controllable bending guiding catheter of the present invention in diagnosis or treatment.