Disclosure of Invention
The invention aims to solve the technical problems in the prior art and provides a thrombus taking device and a thrombus taking system.
According to the invention, a thrombus taking device is provided, which comprises a thrombus taking tube, a pushing tube and a thrombus taking support, wherein the pushing tube and the thrombus taking support are positioned in the thrombus taking tube, the thrombus taking tube comprises a first thrombus taking tube and a second thrombus taking tube, the distal end of the pushing tube penetrates through the first thrombus taking tube and then stretches into the second thrombus taking tube and is connected with the second thrombus taking tube, an interlayer is formed between the pushing tube and the second thrombus taking tube, the thrombus taking support is positioned in the interlayer, the proximal end of the thrombus taking support is connected with the distal end of the first thrombus taking tube, an abutting block abutting against the thrombus taking support is arranged in the interlayer, and after the pushing tube moves along the proximal end to the distal end direction and generates relative displacement with the first thrombus taking tube, the pushing tube is configured to move along the proximal end direction and generate relative displacement with the first thrombus taking tube, and only drives the thrombus taking support exposed out of the interlayer to expand radially through the abutting block.
Further, the abutting block is fixed on the outer surface of the pushing tube and abuts against the inner surface of the thrombus taking support in the interlayer.
Further, the abutting block is an annular boss protruding out of the outer surface of the pushing tube, and an annular surface of the annular boss forms an abutting surface abutting against the inner surface of the thrombus taking support.
Further, the abutting block is formed by protruding the outer surface of the pushing tube in the second thrombus taking tube partially outwards.
Further, the abutting block is fixed on the inner surface of the second thrombolysis tube and abuts against the outer surface of the thrombolysis bracket in the interlayer.
Further, the abutting block is formed by partially and inwards sinking the inner surface of the second thrombus removing tube.
Further, the proximal end of the first thrombus taking tube is fixed with a tube seat, the tube seat is provided with a sliding groove, the proximal end of the pushing tube is fixed with a pushing handle, and the pushing handle is in sliding fit connection with the sliding groove.
Further, when the pushing handle is positioned at the proximal end of the sliding groove, the proximal end of the second thrombolysis tube is in butt joint with the distal end of the first thrombolysis tube.
Further, when the pushing handle is positioned at the distal end of the sliding groove, the distal end of the thrombus taking support is still positioned in the interlayer and just abuts against the abutting block.
According to the invention, there is further provided a thrombus taking system, including a sheath tube and the above thrombus taking device, wherein the first thrombus taking tube is configured to move in a distal direction and generate relative displacement with the sheath tube in a process of retracting into the sheath tube after thrombus is captured, and the pushing tube can move freely relative to the first thrombus taking tube, so that the thrombus taking support can automatically shrink radially in a process of retracting into the sheath tube.
Compared with the prior art, the invention can determine the proper length of the thrombus taking support exposed in the blood vessel according to the diameter of the blood vessel, and only drives the part of the thrombus taking support to shorten through the abutting block so as to realize radial full expansion, thus ensuring that the part of the thrombus taking support can be attached to the inner wall of the blood vessel, and ensuring that the mesh on the surface of the part of the thrombus taking support is fully opened without influencing thrombus entering due to the full radial expansion of the part of the thrombus taking support.
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 schematic structural view of a thrombus removing device according to a first embodiment of the present invention.
Fig. 2 is a partial cross-sectional view of fig. 1.
Fig. 3 is a schematic view of the first embolectomy tube and the embolectomy stent of fig. 1.
Fig. 4 is a schematic view of the pushing tube and the second embolectomy tube of fig. 1.
Fig. 5 is a partial cross-sectional view of fig. 4.
Fig. 6-7 are usage charts of fig. 1.
Fig. 8 is a cross-sectional view of fig. 7.
Fig. 9 is a schematic structural view of a thrombus removal system according to a first embodiment of the present invention.
In the accompanying drawings: 1 is a first thrombus taking pipe, 2 is a second thrombus taking pipe, 3 is a pushing pipe, 4 is a thrombus taking bracket, 5 is an interlayer, 6 is an abutting block, 7 is a pushing handle, 8 is a pipe seat, 9 is a sliding groove, and 10 is a sheath pipe.
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, as shown in fig. 1 to 8, a first thrombus removing tube 1, a second thrombus removing tube 2, a pushing tube 3 and a thrombus removing support 4, where the first thrombus removing tube 1 and the second thrombus removing tube 2 are sequentially arranged from near to far, the proximal end of the second thrombus removing tube 2 can be aligned with the distal end of the first thrombus removing tube 1 to form an integral thrombus removing tube, the thrombus removing tube is used for accommodating the pushing tube 3 and the thrombus removing support 4, and delivering the pushing tube 3 and the thrombus removing support 4 to a thrombus formation site in a blood vessel, the pushing tube 3 is used for releasing the thrombus removing support 4 in the thrombus removing tube, and the thrombus removing support 4 is a self-expanding net and has a plurality of meshes, a radially contracted state and a radially expanded state, and can be embedded into thrombus in the blood vessel.
The pushing tube 3, the first thrombus removing tube 1 and the second thrombus removing tube 2 are coaxially arranged, the pushing tube 3 is provided with a guide wire cavity for a guide wire to pass through, and the distal end of the pushing tube 3 penetrates through the first thrombus removing tube 1, then stretches into the second thrombus removing tube 2 and is connected with the second thrombus removing tube 2, for example, the distal end of the pushing tube 3 is detachably connected inside the distal end of the second thrombus removing tube 2. An interlayer 5 is formed between the pushing tube 3 and the second thrombus removing tube 2, the thrombus removing support 4 is located in the interlayer 5, the proximal end of the thrombus removing support 4 is connected with the distal end of the first thrombus removing tube 1, for example, fixedly connected, the distal end of the thrombus removing support 4 is a free end, that is, the thrombus removing support 4 is sleeved on the pushing tube 3 and covered in the interlayer 5 by the second thrombus removing tube 2, that is, the second thrombus removing tube 2 covers the thrombus removing support 4 in the interlayer 5 formed between the pushing tube 3 and the second thrombus removing tube 2, and the thrombus removing support 4 is contracted in the interlayer 5. The middle layer 5 is internally provided with an abutting block 6 abutting against the thrombus taking support 4, the thrombus taking support 4 abuts against between the abutting block 6 and the second thrombus taking tube 2, as shown in fig. 6, after the pushing tube 3 is configured to move along the proximal end to the distal end direction and generate relative displacement with the first thrombus taking tube 1, and after the pushing tube 3 is configured to move along the distal end to the proximal end direction and generate relative displacement with the first thrombus taking tube 1, the pushing tube 3 only drives the thrombus taking support 4 exposed out of the middle layer 5 to radially expand through the abutting block 6, as shown in fig. 7 and 8, so that the thrombus taking support 4 can be attached to the inner wall of a blood vessel, and the thrombus taking effect is improved because the mesh on the surface of the thrombus taking support 4 is fully opened due to the sufficient radial expansion, and the thrombus taking support 4 can be formed into a disc shape with strong radial force after the radial expansion due to the proper length of the thrombus taking support 4 is favorable for scraping hard thrombus adhered to the inner wall of the blood vessel. Specifically, when the diameter of the blood vessel is smaller, the proper length of the thrombus taking support 4 exposed in the blood vessel is smaller, and when the diameter of the blood vessel is larger, the proper length of the thrombus taking support 4 exposed in the blood vessel is larger, so that the part of the thrombus taking support 4 exposed in the blood vessel can be fully and radially expanded under the action of the pushing tube 3 and the abutting block 6 to ensure that the meshes on the surface of the thrombus taking support 4 are fully opened, and finally smooth thrombus embedding is realized.
The abutting block 6 is fixed on the outer surface of the pushing tube 3 and abuts against the inner surface of the bolt taking support 4 in the interlayer 5, the abutting block 6 is an annular boss protruding out of the outer surface of the pushing tube 3, and can be formed by partially protruding outwards the outer surface of the pushing tube 3 in the second bolt taking tube 2, or can be fixed on the outer surface of the pushing tube 3 in a bonding, welding or other mode, the annular surface of the annular boss forms an abutting surface abutting against the inner surface of the bolt taking support 4, the annular surface is a smooth cylindrical surface, when the pushing tube 3 is configured to move in the distal direction along the proximal end and generate relative displacement with the first bolt taking support 1, the proximal end of the bolt taking support 4 is fixedly connected with the distal end of the first bolt taking support 1, the distal end of the bolt taking support 4 is a free end and is located in the second bolt taking support 2, the abutting block 6 can relatively move with the bolt taking support 4 at the moment under the pushing of the pushing tube 3, meanwhile, the second bolt taking support 2 is also pushed by the pushing tube 3 and separated from the first bolt taking support 4, the annular surface is a smooth cylindrical surface, and the abutting block 6 is still not exposed to the distal end of the first bolt taking support 4 under the condition is still in the radial direction due to the fact that the pushing tube is in the condition of being compressed and the abutting block 4 is exposed to the distal end of the first bolt taking support 4 is still in the opposite direction, and the distal end is still exposed to the distal end of the second bolt taking support 4 is configured to be in the opposite the distal end 4.
In order to facilitate the operation of the pushing tube 3, a pushing handle 7 is fixed at the proximal end of the pushing tube 3, a tube seat 8 is fixed at the proximal end of the first embolectomy tube 1, the tube seat 8 is provided with a sliding groove 9, and the pushing handle 7 is in sliding fit with the sliding groove 9, namely, the pushing handle 7 is operated to move relative to the tube seat 8, so that the pushing tube 3 can move relative to the first embolectomy tube 1. When the pushing handle 7 is positioned at the proximal end of the sliding groove 9, the proximal end of the second thrombus taking tube 2 is in butt joint with the distal end of the first thrombus taking tube 1, at the moment, the second thrombus taking tube 2 completely covers the thrombus taking support 4 in the interlayer 5, and when the pushing handle 7 is positioned at the distal end of the sliding groove 9, the distal end of the thrombus taking support 4 is still positioned in the interlayer 5 and just in butt joint with the butt block 6, namely, the distal end of the thrombus taking support 4 is always positioned in the interlayer 5, so that the pushing tube 3 can always drive the thrombus taking support 4 to be shortened through the butt block 6 to realize radial expansion.
In connection with fig. 9, this embodiment also provides a thrombus removing system using the above-mentioned thrombus removing device, the structure of the thrombus removing system includes a sheath 10 and the above-mentioned thrombus removing device, a portion of the sheath 10 is disposed in the blood vessel, another portion of the sheath 10 is disposed outside the blood vessel, the thrombus removing device is inserted into the blood vessel through the sheath 10 to capture thrombus and is retracted into the sheath 10 after capturing thrombus, and the first thrombus removing tube 1 is configured to move in a distal and proximal direction and to generate a relative displacement with the sheath 10 during retraction of the thrombus removing device into the sheath 10, and the pushing tube 3 is free to move relative to the first thrombus removing tube 1, so that the thrombus removing stent 4 is automatically retracted radially with respect to the sheath 10 during retraction into the sheath 10, that is, the pushing tube 3 is not retracted synchronously with the first thrombus removing tube 1, but is allowed to move relatively with the first thrombus removing tube 1, so that the thrombus removing stent 4 is automatically retracted radially with respect to the sheath 10 under the effect of being smoothly extruded and rapidly retracted into the sheath 10.
In the initial state, as shown in fig. 1, the proximal end of the second embolectomy tube 2 of the embolectomy device is aligned with the distal end of the first embolectomy tube 1 to form an integral embolectomy tube, the embolectomy support 4 is in a radially contracted state and is positioned completely in the interlayer 5, and the pushing handle 7 is positioned at the proximal end of the chute 9.
During the thrombus removing operation, the sheath tube 10 is firstly inserted into a blood vessel, the thrombus removing device is inserted into the blood vessel along the sheath tube 10 by means of a guide wire, the thrombus removing bracket 4 is ensured to be positioned at the far end of a thrombus forming part in the blood vessel by a radiography result in the process, then the position of the first thrombus removing tube 1 is kept unchanged, the pushing tube 3 is pushed in the far end direction along the near end, the second thrombus removing tube 2 and the abutting block 6 move along the far end direction along the pushing tube 3, and the abutting block 6 moves relatively to the thrombus removing bracket 4 and moves towards the far end direction under the pushing of the pushing tube 3 because the near end of the thrombus removing bracket 4 is connected with the first thrombus removing tube 1, and meanwhile the second thrombus removing tube 2 is separated from the first thrombus removing tube 1 under the pushing of the pushing tube 3 so as to gradually expose the thrombus removing bracket 4. As shown in fig. 6, after the exposed length of the thrombus removing stent 4 reaches the target size, the pushing tube 3 is pulled in the distal direction and the second thrombus removing tube 2 and the abutting block 6 move in the proximal direction along with the pushing tube 3, and because an abutting force exists between the abutting block 6 and the inner surface of the thrombus removing stent 4, the thrombus removing stent 4 located in the interlayer 5 moves in the proximal direction along with the abutting block 6, the second thrombus removing tube 2 and the pushing tube 3 synchronously, so that the thrombus removing stent 4 exposed out of the interlayer 5 is shortened and radially expanded, as shown in fig. 7 and 8, and finally the portion of the thrombus removing stent 4 is attached to the inner wall of a blood vessel, and at this time, the first thrombus removing tube 1 and the pushing tube 3 are pulled synchronously in the distal direction and the thrombus removing stent 4 is driven to move towards the thrombus so as to scrape and embed the thrombus, thereby realizing the thrombus removing step of the thrombus removing device. After the thrombus is removed, the thrombus removing device is retracted into the sheath tube 10, in the process, the first thrombus removing tube 1 is pulled along the distal end to the proximal direction, the pushing tube 3 is kept to move freely relative to the first thrombus removing tube 1, the thrombus removing support 4 is smoothly retracted into the sheath tube 10, and finally the sheath tube 10 is withdrawn from a blood vessel, so that the thrombus removing operation is completed.
Embodiment two: unlike the first embodiment, the present embodiment fixes the abutment block 6 on the inner surface of the second embolectomy tube 2 and makes it abut against the outer surface of the embolectomy support 4 in the interlayer 5, so that the abutment block 6 can move relatively to the embolectomy support 4 when moving in the distal direction, and the abutment block 6 can drive the embolectomy support 4 to move together when moving in the proximal direction. The abutment block 6 may be formed by partially recessing the inner surface of the second embolectomy tube 2, or may be fixed on the inner surface of the second embolectomy tube 2 by bonding, welding, or the like, and the abutment surface formed by the abutment block 6 must be a smooth annular surface to avoid damaging the embolectomy bracket 4.
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.