Prevent that thrombus extraction net from releasing in advance's thrombus extraction deviceTechnical Field
The invention relates to the technical field of medical instruments, in particular to a thrombus taking device for preventing a thrombus taking net from being released in advance.
Background
As shown in fig. 1, a thrombus removing device in the prior art generally includes a thrombus removing net 01, a pushing tube and a thrombus removing tube 02, wherein a proximal end of the thrombus removing net 01 is fixedly connected with a distal end of the pushing tube, a guide head 03 is fixedly connected with the distal end of the thrombus removing net 01, the thrombus removing tube 02 is provided with a tube cavity 04 for accommodating the thrombus removing net 01 and the pushing tube, the thrombus removing net 01 is in a radially contracted state when being accommodated in the tube cavity 04, the guide head 03 is connected with the distal end of the thrombus removing tube 02 in a matched mode, the thrombus removing tube 02 accommodating the thrombus removing net 01 can be conveyed to a thrombus in a blood vessel through pushing guide wires and the like and by utilizing the guiding effect of the guide head 03, and then the thrombus removing tube 02 moves relative to the thrombus removing net 01 along a direction of the distal end to the proximal end so as to be released and radially expanded to capture thrombus.
Since the distal end of the thrombolytic mesh 01 in the prior art is directly fixed to the guide head 03, when the thrombolytic mesh 01 is accommodated in the thrombolytic tube 02, the distal end of the thrombolytic mesh 01 is approximately aligned with the distal end of the thrombolytic tube 02, and if the thrombolytic tube 02 is withdrawn in advance due to misoperation, the early release of the thrombolytic mesh 01 occurs, which directly affects the success rate of thrombolysis.
Disclosure of Invention
The invention aims to solve the technical problems in the prior art, and provides a thrombus taking device for preventing a thrombus taking net from being released in advance, so as to overcome the technical defects that the thrombus taking net is easy to release in advance in the prior art.
According to the invention, there is provided a thrombus taking device for preventing a thrombus taking net from being released in advance, comprising a thrombus taking net, a pushing tube and a thrombus taking tube, wherein the thrombus taking tube is provided with a tube cavity for accommodating the thrombus taking net and the pushing tube, the thrombus taking net is in a contracted state of radial contraction when being accommodated in the thrombus taking tube, the thrombus taking tube is in a released state relative to the thrombus taking net after the thrombus taking net is retracted, the distal end of the pushing tube is fixedly connected with the proximal end of the thrombus taking net, the thrombus taking device further comprises an action tube, the distal end of the thrombus taking net is slidingly connected with the action tube, the action tube penetrates through the distal end of the thrombus taking net and is fixedly connected with a guide head, the maximum radial dimension of the guide head is larger than the maximum radial dimension of the tube cavity, the pushing tube is pulled along the distal end to the proximal direction, so that the thrombus taking net is positioned in the tube cavity, the guide head is clamped at the distal end of the thrombus taking tube, the thrombus taking net is in the contracted state, a safe distance is reserved between the thrombus taking tube and the distal end of the thrombus taking tube, the thrombus taking tube is in the released state relative to the thrombus taking net after the thrombus taking net is retracted, the thrombus taking net is in the released state, the thrombus taking net is gradually and the distal end of the thrombus taking net is gradually approaches the guide head to realize radial expansion.
Further, the safety distance is L, and L is more than or equal to 10mm and less than or equal to 40mm.
Further, the guide head includes a tapered end that facilitates penetration of the thrombus, the tapered end having a proximal diameter that is greater than a distal diameter thereof and greater than a lumen diameter.
Further, the guide head further comprises a cylindrical end which can be accommodated in the lumen, the distal end of the cylindrical end is fixedly connected with the proximal end of the conical end, a limiting step is formed between the distal end of the cylindrical end and the proximal end of the conical end, and after the thrombus taking net is positioned in place in the lumen, the limiting step is in contact with the distal end of the thrombus taking tube.
Further, when the acting tube moves along the distal end in the proximal direction and generates relative displacement with the pushing tube, the distal end of the thrombus taking net can be driven by the guide head to slide along the proximal direction so as to shorten the thrombus taking net to expand along the radial direction.
Further, the thrombus taking net comprises a first thrombus taking net and a second thrombus taking net which are sequentially connected, the shortening rate of the first thrombus taking net is smaller than that of the second thrombus taking net, the distal end of the pushing tube is fixedly connected with the first thrombus taking net, the acting tube penetrates through the distal end of the second thrombus taking net and is fixedly connected with the guide head, and the acting tube drives the distal end of the second thrombus taking net to slide towards the proximal direction through the guide head so that the second thrombus taking net expands in the radial direction.
Further, the first thrombus removing net is a cutting bracket for cutting thrombus in a blood vessel so as to separate the thrombus from the blood vessel, and the second thrombus removing net is a weaving bracket for collecting the separated thrombus.
Further, an action structure is arranged between the action tube and the first thrombus taking net, and the action structure is configured to drive the first thrombus taking net to be shortened to be expanded in the radial direction when the action tube drives the distal end of the second thrombus taking net to slide in the proximal direction through the guide head so that the second thrombus taking net expands in the radial direction.
Further, the action structure comprises a first action end fixed on the action tube and a second action end fixed on the inner wall of the first thrombus taking net, and the action tube is abutted to the second action end through the first action end to drive the first thrombus taking net to be shortened.
Further, the first acting end is an acting protrusion protruding out of the outer surface of the acting pipe, the second acting end is an acting ring sleeved on the acting pipe, and the maximum radial dimension of the acting ring is smaller than that of the acting protrusion.
Compared with the prior art, the distal end of the thrombus taking net is slidably connected to the action tube, the guide head is fixedly connected after the action tube penetrates through the distal end of the thrombus taking net, when the thrombus taking net is contained in the thrombus taking tube and the guide head is clamped at the distal end of the thrombus taking tube, a safe distance is reserved between the thrombus taking net and the distal end of the thrombus taking tube, so that when the thrombus taking tube is withdrawn in advance due to misoperation, the thrombus taking net cannot be released due to the existence of the safe distance, the possibility of the advanced release of the thrombus taking net caused by misoperation is reduced, the success rate of thrombus taking is further ensured, and the thrombus taking net is finally abutted with the guide head after being released and does not change so that the guide head stretches into a blood vessel too far to affect a non-pathological part of the blood vessel.
Drawings
The invention will be more fully understood and its attendant advantages and features will be more readily understood by reference to the following detailed description, taken in conjunction with the accompanying drawings.
Fig. 1 is a partial cross-sectional view of a prior art thrombolytic device with a thrombolytic mesh received within a thrombolytic tube.
Fig. 2 is a partial perspective view of the thrombolytic device according to the first embodiment when the thrombolytic mesh is accommodated in the thrombolytic tube.
Fig. 3 is a cross-sectional view of fig. 2.
Fig. 4 is a state diagram of fig. 3.
Fig. 5 is a schematic structural view of the thrombus removing device when the thrombus removing mesh of the first embodiment is in radial expansion.
Fig. 6 is a schematic structural view of the thrombus removing device when the thrombus removing mesh of the second embodiment is in radial expansion.
Fig. 7 is a schematic view of the structure of the action tube in fig. 6.
Fig. 8 is a schematic structural view of a thrombus removing device when the thrombus removing mesh of the second embodiment is in radial contraction.
Fig. 9 is a partial cross-sectional view of the thrombolytic device of the second embodiment when the thrombolytic mesh is received in the thrombolytic tube.
Fig. 10 is a state diagram of fig. 9.
In the accompanying drawings: 1 is a thrombus taking pipe, 2 is a pushing pipe, 3 is an action pipe, 4 is a thrombus taking net, 5 is a first thrombus taking net, 6 is a second thrombus taking net, 7 is a pipe cavity, 8 is a sliding block, 9 is a guide head, 10 is a conical end, 11 is a cylindrical end, 12 is a first action end, 13 is a second action end, and 14 is an action block.
It should be noted that the drawings are for illustrating the invention and are not to be construed as limiting the invention. Note that the drawings representing structures may not be drawn to scale. Also, in the drawings, the same or similar elements are denoted by the same or similar reference numerals.
Detailed Description
In order that the invention may be more readily understood, a detailed description of the invention is provided below along with specific embodiments and accompanying figures.
The terms "proximal" and "distal" in the sense of the present invention should be understood as meaning, viewed from the direction of the attending physician, the term "proximal" referring to the end proximal to the attending physician, i.e. corresponding to the "left end" referred to with reference to the accompanying drawings, and the term "distal" referring to the end distal to the attending physician, i.e. corresponding to the "right end" referred to with reference to the accompanying drawings.
Embodiment one: the structure of the thrombus removing device of this embodiment includes a thrombus removing tube 1, a pushing tube 2, an acting tube 3 and a thrombus removing net 4 as shown in fig. 2 to 5, the thrombus removing net 4 includes a first thrombus removing net 5 and a second thrombus removing net 6, the first thrombus removing net 5 and the second thrombus removing net 6 are self-expanding nets and have a plurality of meshes, so that the first thrombus removing net 5 and the second thrombus removing net 6 have a radially contracted state and a radially expanded state, the first thrombus removing net 5 is a cutting bracket, for example, the cutting bracket is harder than the woven bracket, the short shrinkage rate is small, thrombus is separated from the blood vessel by being suitable for cutting the thrombus in the blood vessel, the second thrombus removing net 6 is a woven bracket, for example, the woven bracket is softer by being woven by self-expanding wires, the short shrinkage rate is large, the allowable meshes are smaller, the proximal end and the distal end of the first thrombus removing net 5 are both open ends, the proximal end of the second thrombus removing net 6 is the proximal end of the open end, the distal end of the second thrombus removing net 6 is connected with the second thrombus removing net 6 at the proximal end 5, and the distal end of the second thrombus removing net 6 is connected with the first thrombus removing net 6, and the distal end of the first thrombus removing net 6 is connected with the second thrombus removing net 6 at the distal end of the open end 6, and the distal end is connected with the second thrombus removing net 6, and the open end is connected with the proximal end of the second thrombus removing net 5 is connected with the open end.
The thrombus taking tube 1 is provided with a tube cavity 7 for accommodating the pushing tube 2 and the thrombus taking net 4, the thrombus taking net 4 is in a contracted state of radial contraction when being accommodated in the thrombus taking tube 1, the thrombus taking tube 1 is in a released state relative to the thrombus taking net 4 after being retracted, the pushing tube 2 and the acting tube 3 are hollow tubes so as to facilitate penetration of pushing guide wires, the acting tube 3 is at least partially arranged in the pushing tube 2 in a sliding manner, the distal end of the thrombus taking net 4, namely the distal end of the second thrombus taking net 6, is in sliding fit on the acting tube 3, the distal end of the thrombus taking net 4, namely the distal end of the second thrombus taking net 6, is fixedly provided with a sliding block 8, the sliding block 8 is sleeved on the acting tube 3 and can slide relative to the acting tube 3, the acting tube 3 penetrates through the distal end of the thrombus taking net 4, namely the distal end of the second thrombus taking net 6, the radial dimension of the sliding block 8 is smaller than that of the guiding head 9, the maximum radial dimension of the guiding head 9 is larger than the maximum radial dimension of the tube cavity 7, and thus the guiding head 9 cannot completely extend into the tube cavity 7 at least. After the pushing tube 2 is pulled along the distal end to the proximal direction so that the thrombus taking net 4 is positioned in place in the lumen 7, the guide head 9 is clamped at the distal end of the thrombus taking tube 1, the thrombus taking net 4 is in a contracted state and has a safe distance L with the distal end of the thrombus taking tube 1, so when the thrombus taking tube 1 is withdrawn in advance due to misoperation, the distal end of the thrombus taking net 4, namely the distal end of the second thrombus taking net 6, cannot be exposed out of the thrombus taking tube 1 immediately, namely the thrombus taking net 4 cannot be released immediately, the possibility of the advanced release of the thrombus taking net 4 caused by misoperation is reduced, the success rate of thrombus taking is further ensured, and after the thrombus taking tube 1 is withdrawn relative to the thrombus taking net 4, the thrombus taking net 4 is in a released state, and the distal end of the thrombus taking net 4, namely the distal end of the second thrombus taking net 6, is gradually close to the guide head 9 so as to gradually realize radial expansion, namely the thrombus taking net 4 is finally abutted with the guide head 9 after being released, and the guide head 9 is not changed so as to cause the guide head 9 to excessively extend into a vascular lesion to be far away from a vascular lesion. The safety distance is L: in this embodiment, the safety distance L is 20mm, but the safety distance L may be 10mm, 15mm, 25mm, 30mm, 35mm, or 40mm, if the safety distance L is less than 10mm, the safety distance L is too small to prevent misoperation, if the safety distance L is greater than 40mm, the safety distance L is too large to cause too slow release of the thrombolytic net 4.
The guide head 9 comprises a conical end 10 which is convenient for penetrating thrombus and a cylindrical end 11 which can be accommodated in the lumen 7, the proximal end diameter of the conical end 10 is larger than the distal end diameter of the conical end and larger than the diameter of the lumen 7, namely, the conical end 10 cannot extend into the lumen 7, the radial size of the cylindrical end 11 is larger than the radial size of the sliding block 8, the proximal end of the cylindrical end 11 is fixedly connected with the distal end of the acting tube 3, the distal end of the cylindrical end 11 is fixedly connected with the proximal end of the conical end 10, a limit step is formed between the distal end of the cylindrical end 11 and the proximal end of the conical end 10, the thrombus taking net 4 is positioned in the lumen 7 in place, the cylindrical end 11 extends into the lumen 7, the conical end 10 is positioned outside the lumen 7 and is attached to the distal end of the thrombus taking tube 1, and the limit step is contacted with the distal end of the thrombus taking tube 1, and the guide head 9 is clamped at the distal end of the thrombus taking tube 1.
After the thrombolytic mesh 4 is released in the blood vessel, due to the self-expanding property, the distal end of the thrombolytic mesh 4, i.e. the distal end of the second thrombolytic mesh 6, is abutted against or close to the proximal end of the guide head 9, i.e. the proximal end of the cylindrical end 11, so as to realize expansion, and in order to ensure effective expansion, the action tube 3 of the present embodiment is configured to move along the distal end in the proximal direction and generate relative displacement with the push tube 2, and can drive the slider 8 through the proximal end of the guide head 9, i.e. the proximal end of the cylindrical end 11, so as to drive the distal end of the thrombolytic mesh 4, i.e. the distal end of the second thrombolytic mesh 6, to slide in the proximal direction, so that the thrombolytic mesh 4 is shortened to expand in the radial direction, and it is seen that the guide head 9 also plays a role of driving the thrombolytic mesh 4 to expand in the radial direction.
Since the slider 8 is fixed at the distal end of the second embolectomy 6, when the acting tube 3 moves along the distal end towards the proximal direction and generates relative displacement with the pushing tube 2, the acting tube 3 directly acts on the second embolectomy 6 through the guide head 9 and the slider 8 to shorten and radially expand, and the second embolectomy 6 drives the first embolectomy 5 connected with the second embolectomy to indirectly shorten and radially expand, then the acting tube 3 does not directly shorten and radially expand the first embolectomy 5, if the second embolectomy 6 is longer, the first embolectomy 5 cannot fully expand, and thus the effect of cutting thrombus by the first embolectomy 5 to separate thrombus is affected, an acting structure is arranged between the acting tube 3 and the first embolectomy 5, and the acting structure is configured to drive the first embolectomy 5 to shorten and radially expand when the acting tube 3 drives the distal end of the second embolectomy 6 to slide towards the proximal direction through the guide head 9 so as to radially expand the second embolectomy 6, and thus the second embolectomy 6 is directly driven to directly expand the second embolectomy 6, and the first embolectomy 5 is greatly improved.
The action structure of this embodiment includes a first action end 12 fixed on the action tube 3 and a second action end 13 fixed on the inner wall of the first thrombolytic mesh 5, the first action end 12 is an action protrusion protruding from the outer surface of the action tube 3, the second action end 13 is an action ring protruding toward the first thrombolytic mesh 5 and sleeved on the action tube 3, and the maximum radial dimension of the action ring is smaller than the maximum radial dimension of the action protrusion, so that the action tube 3 directly drives the first thrombolytic mesh 5 to shorten by abutting the first action end 12 against the second action end 13 for radial expansion.
Embodiment two: unlike the first embodiment, as shown in fig. 6 to 10, the action tube 3 of the present embodiment is further provided with an action block 14 spaced from the guide head 9, the action block 14 is located in the second thrombolytic wire 6 and is disposed near the distal end of the second thrombolytic wire 6, and the radial dimension of the action block 14 is larger than the radial dimension of the slide block 8, so that the slide block 8 is sleeved on the action tube 3 and configured to slide within the interval of the action tube 3 defined between the action block 14 and the guide head 9, and is also rotatable relative to the action tube 3, so that when the action tube 3 is configured to move in a predetermined direction and relatively displace with the push tube 2, the second thrombolytic wire 6 and thus the first thrombolytic wire 5 can be driven to radially contract by the action block 14 or the second thrombolytic wire 6 and thus the first thrombolytic wire 5 can be driven to radially expand by the guide head 9.
According to the embodiment, the action block 14 and the guide head 9 are arranged on the action tube 3 at intervals, the action block 14 and the guide head 9 drive the second thrombolytic net 6 and even the first thrombolytic net 5 to shrink and expand radially, so that the shrinkage and expansion of the second thrombolytic net 6 and even the first thrombolytic net 5 are controllable, the situation that the blood vessel cannot be withdrawn smoothly due to the fact that the second thrombolytic net 6 and even the first thrombolytic net 5 cannot shrink after the thrombolysis is finished can be prevented, the situation that the second thrombolytic net 6 and even the first thrombolytic net 5 cannot be expanded in the blood vessel and cannot fully thrombolytic is prevented, the distal end of the second thrombolytic net 6 can move towards the guide head 9 relative to the action tube 3 to shrink further after the second thrombolytic net 6 and even the first thrombolytic net 5 shrink, and the distal end of the second thrombolytic net 6 can also move towards the action block 14 to expand further relative to the action tube 3 after the second thrombolytic net 6 and even the first thrombolytic net 5 expands, the distal end position of the second thrombolytic net 6 is prevented from being completely limited, thrombus can be uniformly distributed in the thrombus position in the second thrombolytic net 6 along with the volume of the second thrombolytic net 6, and the thrombus can be regulated dynamically, and the thrombus can be uniformly regulated. The action block 14 can assist the second thrombus removing net 6 to collect thrombus, the axis of the action block 14 coincides with the axis of the second thrombus removing net 6, so that the action block 14 can collect part of thrombus in the second thrombus removing net 6, and the collected thrombus is arranged at the center and not too close to the inner wall of the second thrombus removing net 6 to escape, and thrombus in the second thrombus removing net 6 is effectively prevented from moving into the first thrombus removing net 5, and thrombus cutting efficiency of the first thrombus removing net 5 and thrombus collecting effect of the second thrombus removing net 6 are reduced, so that thrombus removing effect is improved.
In this embodiment, after the first and second thrombolytic nets 5 and 6 are completely retracted and before the first and second thrombolytic nets 5 and 6 are completely retracted into the sheath partially inserted into the blood vessel, the first and second thrombolytic nets 5 and 6 are configured to have at least a stage in which the whole body is in a contracted state, i.e. the whole body of the first and second thrombolytic nets 5 and 6 after the thrombus is in a radially contracted state, and then the first and second thrombolytic nets 5 and 6 are completely retracted into the sheath, so as to prevent thrombus from escaping and further improve the thrombus extraction effect.
Other structures of this embodiment are identical to those of the embodiment, and are not described herein.
It will be appreciated that although the invention has been described above in terms of preferred embodiments, the above embodiments are not intended to limit the invention. Many possible variations and modifications of the disclosed technology can be made by anyone skilled in the art without departing from the scope of the technology, or the technology can be modified to be equivalent. Therefore, any simple modification, equivalent variation and modification of the above embodiments according to the technical substance of the present invention still fall within the scope of the technical solution of the present invention.