In the medical care process, patient often needs medicine, blood or various fluid.Supplying with the most effective way of these materials is that they directly are deposited in patient's the blood flow, and blood circulation directly flows to required cell tissue or organ with material apace in blood flow.Material directly being supplied in patient's the blood flow method in common injects with conventional needles and syringe and realizes.Yet in processing procedure, patient can often need repeatedly or the successive medicine of using, and injects repeatedly with conventional needles and can damage vein or tremulous pulse, and patient is caused serious discomfort.
When patient needs repeatedly with medicine or other material, generally use in body the conduit outside the liquid lead body, this conduit is a kind of device, and its allows medicine directly to supply in patient's the blood flow repeatedly and continuously, or other position of health, and need not inject repeatedly.In a kind of common structure, this kind conduit has tubular sleeve pipe and jointer at close end of a hollow.The sleeve pipe of this conduit inserts in patient's the vein or tremulous pulse, and the jointer of this conduit is stayed outside the patient body.This jointer can be repeatedly and is entered patient's vascular system continuously, thereby has got rid of the demand of injection repeatedly.
Must enter patient's tremulous pulse in some cases.Generally be necessary in order to check blood pressure and extracting arterial blood sample.In any case it is ideal in some cases, entering tremulous pulse repeatedly and need not prick perforating arteries with the spininess head.What these situations were wished usually is to insert ductus arteriosus.
Have many well-known with the Apparatus and method in the conduit intravasation, a kind of employing of this device be " inboard syringe needle " structure.As its title signal, the conduit of this device is coaxial being configured among the hollow guiding syringe needle, penetrate patient's blood vessel with the guiding syringe needle, in a single day syringe needle is in the patient's blood vessel, and conduit then is advanced in the patient's blood vessel artificially, therefore is inserted into ideal catheter length, then removing syringe needle, to stay conduit in place, afterwards, jointer is connected with catheter proximal end portion, causes medicine or other material to be supplied with.
Another kind of conduit is directed into the device of patient's blood vessel, also be to adopt a kind of guiding syringe needle to penetrate blood vessel, but be " top syringe needle " structure.In this structure, conduit is coaxially to be configured in the syringe needle top.In case syringe needle is in patient's blood vessel, conduit advances till conduit is inserted into ideal length above the guiding syringe needle.Syringe needle is extracted simultaneously and is scrapped, and it is in place that conduit is stayed.Because conduit is configured in syringe needle top, jointer does not need conduit to place in blood vessel then not to be connected with conduit, but can with before placement, be connected with conduit.
For giving the comfortable of patient's maximum, conduit should adopt elasticity and flexible material is made.Yet material is more pliable and tougher, and it is just more difficult that conduit inserts blood vessel.This conduit has the trend that knotting inserts it into difficulty, and this is impossible under many circumstances, for the conduit particular importance of placing in tremulous pulse.Therefore, the vascular conduit adopts a kind of filament that is called guide wire typically, and it can enter in the tremulous pulse, for conduit provides path, and then locatees in blood vessel.
A kind of conduit like this is to adopt the guiding syringe needle that penetrates patient artery.In case in place, the guide wire manually-operated that is disposed in the guiding syringe needle is advanced into tremulous pulse.Conduit unloads from the guiding syringe needle, and enters endarterial guide wire propelling along guide catheter.Remove guiding syringe needle and guide wire then, it is in place to stay conduit.
Regrettably this Apparatus and method for has lost stability, and it requires palm of doctor to live pipe guide and another hands artificially promotion guide wire.When the guide wire artificially promoted, endarterial syringe needle moved and makes it to be difficult to stably to insert guide wire.
Some automatic and automanual Apparatus and method fors that promote guide wire are well-known prior aries.A kind of such requirement on devices doctor is thrust patient's skin carefully with the guiding syringe needle.In case thrust skin, before the guiding syringe needle penetrates blood vessel, produce vacuum by stretching out plunger or similar device artificially, then further promote the guiding syringe needle till penetrating blood vessel, when penetrating, vacuum is destroyed in the chamber, and guide wire a kind of of several different institutions by wherein is pushed.Replaceable scheme is, in case vacuum is destroyed, and sees blood in chamber, the operator can manually operatively begin to start the guide wire pushing mechanism.
As manual device, these automatic and semi-automatic requirement on devices doctors stretch out the vacuum while at plunger, stably arrest conduit with a hands.In addition, these requirement on devices doctor is very skilled.If penetrate blood vessel before the generation vacuum, then guide wire is can be not self-propelled.Moreover, can not suitably promoting if guide wire is malfunctioning, so automatic or automanual mechanism does not allow the guide wire pushing mechanism to restart.
Should be appreciated that improvements over the prior art are to provide a kind of device that enters vascular, it can automatically push blood vessel with guide wire.Another improvement to prior art is, guide wire can with stably with etc. speed ground promote, this device can restart if desired.Improvement again to prior art is need not require operator's a hands to leave this device with a hand propelled elastic yarn.
Here open and claimed is a kind of like this device that enters vascular.
The present invention be directed to a kind of for making conduit introduce the device that enters vascular of blood vessel.The present invention adopts a kind of guiding syringe needle that penetrates patient skin and blood vessel.In case in place, the operator can trigger the interior actuating device of this device of configuration in the artificially, then guide wire pushed away the tip and the intravasation of syringe needle.The conduit of concentric arrangement above the guiding syringe needle can promote along the guiding syringe needle then, and imports blood vessel by guide wire.In the time of in being fixed in blood vessel, guiding syringe needle and guide wire are removed, and it is in place that conduit is stayed.
In a most preferred embodiment, the device that enters vascular comprises a housing, a guiding syringe needle, a guide wire and an actuating mechanism, and the conduit of associated.This housing is generally cylindrical, and holds the actuating mechanism that is configured in its hollow centre.The close end of housing is lived with cap seal, and this lid can pass through various devices, comprises that screw thread or elastic device are connected with housing.The distal portion of housing has a protuberance, and this protuberance can be made a single piece with housing, or makes syndeton separately.The close end of guiding syringe needle is fixed in the protuberance, and the distal portion of guiding syringe needle has a Dou tip that is used to penetrate blood vessel.
Being connected the typical catheter of using with this device is made up of in the hollow sleeve of guiding syringe needle top a concentric arrangement.This proximal end portion is connected with jointer on being disposed at the housing protuberance, and joins by frictional fit.The concrete shape that should be understood that catheter mount and housing protuberance is not crucial for purposes of the invention.For example, this catheter mount can adapt with the TV kind feedway that provides fluid to supply with patient.
Guide wire is configured in the guiding syringe needle of hollow, and the protuberance that passes housing extends into housing cavity.As following detailed description, the close end of guide wire is to be connected with the actuating mechanism at housing rear portion.Guide wire is more longer than the guiding syringe needle.Yet when entering the vascular device and be in latched position (promote guide wire before), the distal portion tip of guide wire does not preferably extend through the oblique tip of guiding syringe needle.In the most preferred embodiment of this device, guide wire is flexible, but enough rigidity is arranged, and twines when preventing to insert blood vessel.One skilled in the art will appreciate that position that correct degree of flexibility and rigidity will depend on that conduit is inserted into and special purposes.
Actuating mechanism generally is to be configured in the housing rear portion, generally includes a flexible member, a dish and a starting element.The close end of portion of elasticity unit is connected with case lid, and the distal portion of flexible member is connected with dish, and the close end of guide wire also is connected with dish.When entering the vascular device and be in first latched position, flexible member and dish are pressed towards the rear portion of housing, and starting element engages with dish to prevent the flexible member extension and to prevent the guide wire propelling.
In use, the doctor penetrates skin and penetrates patient's blood vessel with the guiding syringe needle earlier.In case the guiding syringe needle is in the lumen of vessels, the artificially is to the starter pressurization of actuating mechanism, starter pressurization causing starter end is thrown off with dish, make flexible member and dish can axially uphold enclosure interior, the top ends that the extension of flexible member and dish promotes guide wire exceeds the oblique tip and the intravasation of guiding syringe needle, after this, catheter mount is removed the housing protuberance, and conduit slides along guiding syringe needle and guide wire, guide wire is introduced conduit till conduit is fixed in the blood vessel, in case conduit is in place, remove guiding syringe needle and guide wire, catheter cannula is stayed the patient's blood vessel intracavity, and catheter mount is stayed outside the patient body, to be convenient to introduce medicine, fluid, blood and other material.
These and other purpose and advantage of the present invention will more fully be understood by the description meeting in conjunction with the accompanying drawings most preferred embodiment.
To more specifically describe inventing above-mentioned explanation with reference to accompanying drawing.These accompanying drawings only are the data that understanding is provided for the exemplary embodiments that the present invention relates to, and therefore should not think the qualification to invention scope.The present invention is narrated by accompanying drawing employing bells and whistles and details and is explained, wherein:
An embodiment who enters the vascular device of the present invention represents with 10 in Fig. 1.This enters vascular device 10 and generally comprises a commoncylindrical housings 26, one guidings, 16, one actuating mechanisms 40 of 12, one conduits of syringe needle and a guide wire 22.The main member that is contained in this device in thehousing 26 comprises that by thespring 56 ofdish 50 stationary positioned, its operational circumstances can be discussed with additional detail in the back.The actuating mechanism 40 thatspring 56 is loosened selectively also is contained in thehousing 26.By dish 50 athousing 26 internal operations and to pass what enter syringe needle inside be guide wire 22.The main purpose of this device 10 is to help guidewire 22 to be placed in the blood vessel, and placement catheter 16 then.
As shown in Figure 1,housing 26 is generally cylindrical and a cylindrical chamber 36 is arranged.The lid 34 ofhousing 26 rearward end is sealed chamber 36, and lid 34 can comprise the mold pressing location by multiple mode, and the method that frictional fit or screwconnect connects.Housing 26 is preferably made with duroplasts.Yet, person of skill in the art will appreciate thathousing 26 also can be made of other stiff materials.Equally, the shape ofhousing 26 can change, to satisfy special demand.Make the operator firmly and cosily catch the Any shape that enters the vascular device all to fall within the scope of the invention.
More describe in detail below,housing 26 also has a groove 58, and this groove 58 holds the starter 42 of actuating mechanism 40.Groove 58 is to be covered by plastics or rubber protective cover 30, and protective cover 30 encases aroundhousing 26 outer peripheral edges.Protective cover 30 easily is not operated person's grasping yet and enters vascular device 10.
Housing 26 distal portion have a protuberance 28, and in most preferred embodiment, protuberance 28 andhousing 26 are made by the from one piece mold pressing.Yet protuberance 28 andhousing 26 can be made separate pieces, and available multiple mode comprises that the method for bonding or threaded engagement is connected.And protuberance 28 can be made with identical or different materials withhousing 26.
Guiding syringe needle 12 is connected with protuberance 28.As shown in Figure 1, guiding syringe needle 12 on its whole length be hollow or cover empty, and one oblique tip 18 is arranged in its distal portion, be used to penetrate skin and blood vessel.In Fig. 1, the close end of guiding syringe needle 12 passes the center of protuberance 28, and strides across its total length from chamber 36.Yet it is not crucial problem that guiding syringe needle 12 strides across protuberance 28 whole length.The close end of guiding syringe needle 12 can only be connected with the distal portion 29 of protuberance 28, a hole of passing protuberance 28 close ends 27 must be arranged in this case, so that a perforate from the chamber 36 ofhousing 26 to guiding syringe needle 12 to be provided,cause guide wire 22 can pass protuberance 28.
Fig. 1 also shows the conduit 16 that is connected with protuberance 28 by frictional fit between protuberance 28 and the catheter mount 38.Conduit 16 has 14, one cylindrical hollow sleeve pipes 62 of a tip and a jointer 38.Conduit 16 is fitted in guiding syringe needle 12 and protuberance 28 tops with one heart.The structure of jointer 38 makes it engage with protuberance 28 by frictional fit.Yet, can adopt other the fitting method that comprises screw thread and road E Shi locking mechanism to come conduit 16 is fastened to protuberance 28.The whole length of conduit 16 is such, and when conduit 16 was fastened to protuberance 28, the oblique tip 18 of guiding syringe needle 12 will extend through outside the tip 14 of conduit 16.
Continuation is with reference to Fig. 1, and entering vascular device 10 has an actuating mechanism 40.This actuating mechanism 40 is arranged in the chamber 36 towards the close end ofhousing 26, and actuating mechanism generally includes astarter 42,50 and springs 56 of a dish.In an illustrated embodiment,spring 56 is a kind of its diameter helical springs less than chamber 36 diameters.At the close end ofhousing 26,spring 56 is connected to and covers on 34, and in the opposite end of lid 34,spring 56 is connected with dish 50.Spring 56 can 50 be connected with lid 34 and dish, or lean cover 34 with coil 50.Dish 50 diameter is more preferably greater than the diameter ofspring 56, but is less than the diameter of chamber 36, make like thisdish 50 can by chamber 36 internal freedoms move.As shown in Figure 2, a dish joint 52 is offered in theU-shape hole 54 of dish 50.As illustrating later, when actuating mechanism was in latched position beforeguide wire 22 enters patient's blood vessel, dish joint 52 temporarily played a part the spring that is standing.
Guide wire 22 is connected with dish 50.As shown in Figure 1, the close end ofguide wire 22 penetratesdish 50, and fixing by frictional fit, bonding or the cooperation of other matching mechanism, and guidewire 22 extends through chamber 36, protuberance 28 and guiding syringe needle 12 forward from coiling 50.Before the actuating mechanism starting, the distal tip of guide wire is to place in the guiding syringe needle 12, but does not extend through oblique tip 18.
Starter 42bond pads 50 and spring 56.In an illustrated embodiment, starter 42 is a kind of sickleshaped elements, hasstarter axle 60 at its close end, has starter arm 44 in its distal portion.Near starter 42 centers, betweenstarter axle 60 and starter arm 42 a spherical boss 43, boss 43 has the vertically hole 45 of starter 42 rotations.Starter 42 can be made with any material known in the prior art, as plastics or metal, can be flexible or inflexible as shown in Figure 3.
As shown in Figure 1, starter 42 is to be rotationally connected by 26 one-tenth pivots of starter minor axis 46 and housing, and starter minor axis 46 passes the width of chamber 36, by the hole 45 of boss 43, and fixes with any one end of housing 26.Therefore, starter minor axis 46 is fixed tohousing 26 to starter 42.Yet the diameter in hole 45 is bigger than the diameter of minor axis 46.Like this, starter minor axis 42 can freely rotate around starter minor axis 46.
As Fig. 1 and Fig. 2 described,starter axle 60 extended from starter minor axis 46, and theotch 64 of the close end of thisstarter axle 60 has formed a seating plane 68.In latched position,spring 56 is towards chamber 36 rear portion pressurizeds, andotch 64 extends through theaperture 54 of dish 50.Because of coiling the seating plane 68 that joint 52 overlap joints and bias voltage lean against starter 42,spring 56 is not axially upheld and propelling along chamber 36.
Since the distal portion of starter spring 48 close starters 42, and kept the relative position that coilsjoint 52 and seating plane 68.Starter spring 48 is communicated with starter 42, and the resistance that overcomes starter arm 44 is provided.This resistance can provide by spring or the well-known spring of any other prior art or elastic device.The effect of starter spring 48 is to starter arm 44 application of forces, with the groove 58 that extends throughhousing 26, and against plastics maintenance cover 30.The power of starter arm 44 causes protective cover 30 extensions, makes starter arm 44 project into the groove 58 of housing 26.Simultaneously, the effect of starter spring 48 causes that starter 42 rotates around starter minor axis 46 and boss 43, promotes seating plane 68 bond pads joints 52.In addition, the resistance that faces toward thespring 56 ofdish 50 produces very big friction betweendish joint 52 and seating plane 68, guarantee that further the two remains on lap position.
Indish joint 52 and seating plane 68 overlap joints,spring 56 can not be along chamber 36 axial advance, andguide wire 22 is stayed in the guiding syringe needle 12.Exceed oblique tip 18 in order to promoteguide wire 22, the doctor depresses the starter arm 44 of the groove 58 that extends through housing 26.Starter 42 is rotated around starter minor axis 48, and force in thedish joint 52 thatstarter axle 60 leaves dish 50.Whenstarter axle 60 was removeddish joint 52, the seating plane 68 ofstarter axle 60 was from 52 landings of dish joint.
As shown in Figure 3 and Figure 4, when seating plane 68 no longer duringbond pads joint 52,spring 56 can be upheld andpromotion dish 50 passes chamber 36.Whenspring 56 was upheld,starter axle 60 passeddish 50 apertures 54.Spring 56 is upheld and is coiled 50 propulsive results and is,guide wire 22 is pushed over the oblique tip 18 of guiding syringe needle 12.Upheld orcoil 50 fully when being limited by boss 43 atspring 56,dish 50 andguide wire 22 are in halted state.One skilled in the art will understand that the power and the speed that promoteguide wire 22 are directly to be proportional to the power that is applied by spring 56.Therefore, becauseguide wire 22 expansion forces depend on the tram that conduit 16 is inserted into, so this power can give specific by the size ofselection spring 56 and the way of elastic force.
Have in the practical application, in latched position, guiding syringe needle 12 is used for pricking skin and through blood vessel.In case be in the blood vessel, utilize and to pass that plastic safety cover 30 is depressed starter arm 44 and starting actuating mechanism 40, cause that against the power of starter arm 44 starter 42 rotates around starter minor axis 46, makes seating plane 68 disengaging dish joints 52.This just makesspring 56 uphold, thereby towards guiding syringe needle 12 along chamber 36 axial advance dishes 50.Consequently pushed away the oblique tip 18 of guiding syringe needle 12 withdish 50 guide wire that are connected, andintravasation.Guide wire 22 has in fact also prevented the blood guiding syringe needle 12 that refluxed.Because any former thereby when making guide wire stop to advance fully, the doctor can break away fromhousing 26 by cover 34, and and then draws and cover 34 up to coiling 50 and the method that engages again of the seating plane 68 of starter 42, and actuating mechanism 40 is resetted.Covering 34 then can reconnect withhousing 26, and actuating mechanism 40 can be reset.
In the time of operator's clampinghousing 26, make conduit 16 break away from protuberances 28, and slide, until till the sleeve pipe 62 desired length of conduit 16 are in the blood vessel along guiding syringe needle 12 and guide wire 22.In case in place, operator's clamping conduit 16 is in place, returnhousing 26 simultaneously at leisure, guiding syringe needle 12 and guide wire 22.Thereby make conduit 16 can be used to supply with medicine or other fluid.
Fig. 5 shows another embodiment that the present invention adopts a kind of replaceable actuating device.Entervascular device 110 actuating mechanism that generally includesplunger 72,spring 78 and handle 84 is arranged.When actuatingmechanism 70 enters blood vessel when being in certain latched position in the past inguide wire 122,plunger 72 is towards the close end configuration of thechamber 136 of housing 126.Plunger 72 is cylindrical, and its diameter is littler thanhousing 126 diameters, and it is moved axially inchamber 136.
As shown in Figure 6, the proximal end face ofplunger 72 has a plurality of spokes 74 and a hub 76.Spoke 74 evenly separates at the plunger face center and concentrates on the hub 76.Plunger 72, spoke 74 andhub 76 can be made with the homogenous material mold pressing, or divide mold breakaway cylinder and assemble with bonding, screw thread or friction joiningmethod.Guide wire 122 is connected withhub 76 centers by the way of bonding, spiral or frictional engagement, and extends throughchamber 136 fromhub 76 tops and enter and guide syringe needle 112.Spoke 74 can have such shape; Promptly when plunger 72 when the top extends throughchamber 136, spoke 74 makesplunger 72 andguide wire 122 spirality.The spiralling of thisguide wire 122 helps its intravasation.
Thespring 78 of spirally-wound is withplunger 72 configurations.As will be described as further below, it is longer than plunger 72 when the complete stretched condition ofspring 78, causes it can be when actuating mechanism starts to promoteplunger 72 from the top.Plunger 76 proximal end faces are opened, and allowspring 78 to contact with thelid 134 of housing 126.When this entered the vascular device and is in latched position,spring 78 was limited by spoke 74 far-ends oflid 134 near-ends and plunger 72 towards the rear portion ofhousing 126 by compression.And the maximum pressured state that one skilled in the art will appreciate thatspring 78 is to be determined by the length of plunger 72.Therefore,guide wire 122 stretches into endovascular length and power owing to depend on the tram thatconduit 116 is inserted into, thus not only can be by size and the elastic force of selectingspring 78, and can give specific by the length of selecting plunger 72.For example, the combination of the spring of short column plug and high-tension will makeguide wire 122 produce the propelling of big distance and have the power of bigger intravasation.
Continuation is with reference to Fig. 5 and Fig. 6, andhousing 126 has a groove 80 and a passage 82.Groove 80 and passage 82 cause an aperture of going intochamber 136 throughhousing 126 together.As shown in Figure 5, passage 82 stretches into groove 80 total lengths.Person of skill in the art will appreciate that the length that the length of passage 82 only need be heldclaw 90 gets final product.When actuatingmechanism 70 was in latched position, groove 80 and passage 82 extended throughplunger 72 end faces from the distal portion ofhousing 126 near protuberance 128.Handle 84 is fixed in the above and stretches into the whole length of housing 126.Towards the close end ofhousing 126, tolid 134, handle 84 is connected withhousing 126 by the well-known adhesive joint in present technique field or other method from the close end of groove 80.In the distal portion ofhousing 126, handle 84 is placed in the groove 80, but is not connected with groove 80.
Handle 84 is made by for example plastics or metallic spring material, and it has anotch 85 and a joint 88.Otch 85 is adjacent with the position thathousing 126 is connected with handle.As following explanation,otch 85 is easy to make handle 84 bendings in enteringvascular device 110 start-up courses.Joint 88 is positioned at handle 84 distal portion, and its width is less than groove 80, but greater than passage 82, therefore prevents that handle 84 distal portion from entering thechamber 136 ofhousing 126 by passage 82.The height ofjoint 88 is to determine like this: in the time of promptly abovejoint 88 is placed in passage 82, handle 84 is flushed withhousing 126, and high together with handle 84 close ends.
Handle 84 distal portion have one throw offsilk handle knob 86, having one to throw offclaw 90 near groove 80 close ends.86 extensions above the groove 80 ofhousing 126 of handling knob of throwing off silk are for touching the doctor easily and catching.Thedisengagement claw 90 of handle 84 protrudes below groove 80 and passage 82, and enters thechamber 136 of housing 126.Whenactuating mechanism 70 is in latched position, throw off the end face ofclaw 90 overlap joint plungers 72.The elasticforce actuation plunger 72 ofspring 78 is against throwing offclaw 90, and claw 90 promotes to handleknob 86 pairs against supportingsurface 92, therefore preventsspring 78 extensions and prevents that plunger 72 from advancing from the top alongchamber 136.
In actual applications, be inserted into blood vessel at latched position guiding syringe needle 112.In case be in the blood vessel, the doctor catches the 86 startingactuating mechanisms 70 of handling knob of throwing off silk, and overcomes the elastic force ofspring 78 and away from supportingsurface 92 from the application of force nearby.86 no longer contact supportingsurface 92 when throwing off handling knob of silk, and when pressingspring 78 continuously, the doctor hold throw off silk handling knob upwards and away from housing 126.Power upwards causes that handle 84 distal portion are aroundotch 85 bendings.When handle 84 is bent upwards away fromhousing 126, throw off thatclaw 90 shifts outchamber 136 and away from plunger 72.When throwing offclaw 92 and plunger 72 when no longer overlapping, promotesplunger 72 alongchamber 136 from the top facing to the elastic force that cover 134spring 78,advance guide wire 122 to pass through to guide the oblique tips 118 of syringe needle 112, and enter patient's blood vessel.Whenplunger 72 promotes, spoke 74 makesplunger 72 andguide wire 122 form the spiral type of easy guide wire intravasation, perforate between the spoke 74 atplunger 72 distal face places allows blood to pass throughplunger 72 when it advances, and prevents that blood from importing patient's blood vessel again.When the distal face ofplunger 72contact housing 126 distal faces, plunger 72 quits work, incase guide wire 122 is in the position in the patient's blood vessel,conduit 116 is inserted, and removes like thatguide wire 122 and guiding syringe needle 112 are as explained above.
Fig. 7 shows a kind of guide wire propulsive mechanism that enters the put conversion of vascular device of the present invention.In Fig. 7, enteringvascular device 210 has anactuating mechanism 200 that generally includes plunger 202,spring 204,handle 208 and optional handle 206.Excepthandle 206 is that the shape of plunger 202,spring 204 andguide wire 222 is as Fig. 6 with the distal face of plunger 202 is connected.Handle 206 can be connected with the distal face of plunger 202 in several ways, comprising bonding, screw thread orfrictional engagement.Handle 206 extends through the center in thehole 207 ofspring 204 andlid 234 from plunger 202 distalfaces.Guide wire 222 is connected with plunger 202 distal faces, and extends through chamber 236 and guidingsyringe needle 212 from the top.
Onegroove 210 is arranged at the top of housing 226.Whenactuating mechanism 200 was in latched position beforeguide wire 222 advances,groove 210 extended to the distal face of plunger 202 near protuberance 228 from the close end of housing 226.By throwing off handlingknob 214, throwing off pawl card 216 of silk, thehandle 208 that returnspring 218 andfulcrum shaft 220 are formed is inserted in thegroove 210,handle 208 is connected withhousing 226 byfulcrum shaft 220, the correct way thathandle 208 is connected byfulcrum shaft 220 withhousing 226 is not a subject matter of the present invention, if this joint is forhandle 208 is rotated aroundfulcrum shaft 220, then screw thread, bonding or frictional engagement, or their any combination all can be adopted.
Continuation is with reference to Fig. 7,214 extends togroove 210 tops except throwing off handling knob of silk, andhandle 208 is concordant withhousing 226, and its reason will further describe below.Throw off claw 216 projection below groove and enter chamber 236, pass thedisengagement claw hole 212 in the housing 226.Whenactuating mechanism 200 is in latched position, throw off claw 216 overlap joint plungers 202, pass chamber 236 to prevent its propelling.Elastic force against thereturn spring 218 ofhousing 226 makeshandle 208 rotate aroundfulcrum shaft 220, to guarantee that throwing off claw 216 keeps engaging with plunger 202.
In actual applications, be not in latched position if enter the vascular device, the doctor at first from spurringhandle 206 nearby, throws offclaw hole 212 until the distal face of plunger 202 surpasses, and on the bond-off claw 216.In case be in latched position, will guidesyringe needle 212 and insert blood vessel.Thedoctor 214 begins to start actuatingmechanism 200 by handling knob of the disengagement silkdepressing housing 226grooves 210 tops and stretch out then.Relatively the disengagement silk ofreturn spring 218 downward force on 214 of handling knob makeshandle 208 rotate aroundfulcrum shaft 220, causes that throwing off claw 216 leaves chamber 236 and pass and throw offclaw hole 212, and away from the distal face of plunger 202.When throwing off claw 216 when leaving chamber 236 fully and no longer overlapping the distal face of plunger 202, plunger 202 is advanced along chamber 236 against the elastic force of thespring 204 of lid 234.When plunger 202 propellings,guide wire 222 is pushed over theoblique tip 218 of guidingsyringe needle 212, and enters patient's blood vessel.Incase guide wire 222 is in the position in the patient's blood vessel, conduit 216 is inserted into andguide wire 222 and guidingsyringe needle 212 are removed as described above.
Fig. 8 and Fig. 9 also show another embodiment of the present invention, and this embodiment has adoptedguide wire 322 to push a kind of convertible method of patient's blood vessel.In Fig. 8, the actuating mechanism 330 that enters vascular device 310 generally is made up ofplunger 332, spring 304, disengagement silk mechanism 336 and plunger guide rail 338.Guide rail 338 is by the well-known bonding joint of present technique or other juncture, the thin cylindrical tube that is connected with the inwall of housing 326.Yet, person of skill in the art will appreciate that guide rail 338 andhousing 326 can form with the homogenous material mold pressing.Guide rail 338 arrives or near the disengagement of throwing off silk mechanism 336 334 far-ends of handling knob from extending at most near lid 334housing 326 close ends.Person of skill in the art will appreciate that the exact length of guide rail 338 and housing 336 can insert the distance of patient's blood vessel and changes according toguide wire 322.
Plunger 332 is configured in the guide rail 338, and can move axially along guide rail 338.Except the distal face ofplunger 332 had aflange 340, joint 342 and blood by-pass prot 335,plunger 332 and spring 304 associated shape were with shown in Figure 6 the same.The spring 304 that is configured inplunger 332 is that the far-end by theflange 340 of lid 334 near-end andplunger 332 limits.As shown in Figure 9, blood by-pass prot 335forms joints 342, and prevents that flashback blood from importing the tremulous pulse by plunger when the top pushes chamber 336 again because of plunger 372.In addition, as following explanation, whenplunger 332 from distal portion along guide rail 338 when advancing, cross bars 344 are admitted in blood by-pass prot 335.Guide wire 322 is connected with joint 342 by the method for bonding, screw thread or frictional engagement, joint 342, and guidewire 322 extends through chamber 336, pod 348 and guiding syringe needle 312 from far-end.
When actuating mechanism 330 was in latched position, plunger 332 and spring 304 were temporarily fixing by the guide wire trip gear 336 that the chamber 336 with housing 326 disposes.Guide wire trip gear 336 comprises that handle knob 342, cross bars 344 and one of a disengagement throws off claw 346.Cross bar 344 with near being connected of housing 326 distal portion of protuberance 328, be by with screw thread, friction or the adhesive joint of pod 348, pod 348 is connected and centering above its near-end with the close end of protuberance 328.The following describes its reason, cross bar 344 has an aperture 345, and it is to be made by plastics, metal or other elastomeric material.Cross bar 344 extends to the distal face of plunger 332 from pod 348.Prestart is overlapped on the edge 340 on the distal face of plunger 332 at the disengagement claw 346 of cross bar 344 close ends, prevent that plunger 332 from advancing at guide rail 338 from far-end.In the distal portion of cross bar 344 with in disengagement claw 346 same orientation, connect to throw off and handle knob 342.Throw off 342 location like this of handling knob, promptly it stretches out from housing 326 and passes groove 350 and backup elastic webbing 352.The elastic force of cross bar 344 is guaranteed to throw off to handle knob and 342 is kept pressing elastic webbing 352.
In actual applications, guiding syringe needle 312 at first inserts blood vessel.In case be in the blood vessel, the doctor utilizes and to depress that throwing offhandles knob 342 start actuating mechanism 30 by elastic webbing 352, throws off the downward force of handling knob on 342 and makes cross bar 344 bendings, forces that to throw offclaw 346 downward and away from theflange 340 of plunger 332.When throwing offclaw 346 no longer during lap-joint flange 340, advance theguide wire 322 ofplunger 332 and guide rail 338 far-ends against the elastic force of the spring 304 of lid 334.Whenplunger 322 advances,cross bar 344 and throw offclaw 346 and pass the blood by-pass prot 335 onplunger 332 distal faces and the center of spring 304.Joint 342 promotescross bar 344 centers downwards and passes aperture 345.Because any former thereby when makingguide wire 322 stop to advance fully, the doctor can cover 334 and throws off withhousing 326 by making, and spurs and cover 334 near-end till 332upper flanges 340 ofclaw 346 engage pistons, with the actuating mechanism return.
The blood by-pass prot 335 ofplunger 332 distal faces, backflash blood passedplunger 332 when the far-end of plunger on guide rail 338 advanced.Therefore, backflash blood is no longer to lead to get back in the patient's blood vessel.When flange 340 arrived the supporting surface 354 of guide rail 338,plunger 332 stopped to move and guidewire 322 stops to advance.Incase guide wire 322 stops to advance and is in the interior position of patient's blood vessel, and conduit 316 is inserted,guide wire 322 and guiding syringe needle 312 are removed by top explanation.
Therefore, the present invention has overcome some important restrictions of prior art.The vascular device that enters provided by the invention can advance guide wire to go into blood vessel automatically, so that place ductus arteriosus.Stable and the constant speed propelling of guide wire, and can stop as requested.The present invention can insert guide wire with a hands, and this just makes the operator carefully and correctly place conduit in the blood vessel of receiving treatment.Therefore, the progress of the present invention's representative aspect the conduit placement technique.