Disclosure of Invention
The application aims to provide a pulmonary artery thrombus removing device and a thrombus removing system, which can solve the problem that the outer diameter of the conveying catheter of the existing pulmonary artery thrombus removing stent is overlarge, the outer diameter of the conveying conduit in the state that the thrombus taking support is pressed and lying in the conveying conduit is reduced, the thrombus taking support and the conveying conduit can be conveyed to the pulmonary artery or the farther part of the pulmonary artery branch vessel, and the thrombus taking support can be conveniently released after passing through thrombus, so that thrombus escape is avoided.
In order to achieve the aim, the first aspect of the invention provides a pulmonary artery thrombus removing device, which comprises a thrombus removing bracket made of nickel-titanium alloy material and a conveying catheter, wherein the thrombus removing bracket is connected with a bracket tip;
The distal end pipe orifice of the conveying catheter is exposed to the limit of the tip of the stent, the thrombus taking stent can stretch back and forth along the axial direction of the conveying catheter relative to the distal end pipe orifice, and the thrombus taking stent can be self-expanded and released to the outer side of the distal end pipe orifice and elastically compressed to the inner side of the distal end pipe orifice;
the guide wire channel comprises a tip inlet and a lateral outlet, the tip inlet is formed in the tip end face of the tip of the support, and the lateral outlet is formed in the side wall of the tip of the support so as to enable the guide wire to extend outside the conveying catheter in a guiding manner;
The stent tip comprises a conical tip which is coaxially arranged with the thrombus taking stent, and the guide wire channel comprises a bending passage arranged on the conical tip;
Or the stent tip comprises an eccentric bending tip, the guide wire channel comprises a linear passage arranged at the eccentric bending part, and the extending direction of the linear passage is parallel to the axial direction of the thrombus taking stent;
the stent tip is detachably connected to the distal end of the thrombolysis stent, and the proximal profile outer diameter of the stent tip is not smaller than the profile outer diameter of the distal nozzle.
In an alternative embodiment, the stent tip comprises a flexible tip with a solid structure, the flexible tip is provided with a mounting part, the mounting part comprises a connecting counter bore formed in the proximal end face of the flexible tip, the thrombus taking stent comprises a distal connecting section, the distal connecting section is elastically expanded outwards and radially pressed in the connecting counter bore, the guide wire channel comprises a through hole channel formed in the flexible tip, and at least a part of solid area is reserved between the through hole channel and the connecting counter bore.
In an alternative embodiment, the tip inlet includes a circular aperture disposed at the stent tip, and the lateral outlet includes an elliptical aperture disposed on a sidewall of the stent tip, the elliptical aperture including at least a length.
In an alternative embodiment, the bending passage on the conical tip comprises a straight passage and an inclined passage, the extending direction of the straight passage coincides with the axes of the thrombus taking support and the support tip, the inclined passage is communicated to the lateral outlet with the same pore diameter as the straight passage or with a pore diameter larger than the straight passage, and the inclined passage extends from far to near in the axial direction of the support tip.
In an optional embodiment, the proximal end of the thrombus taking support is connected with a pushing guide wire, the pushing guide wire is formed by weaving a plurality of strands of stainless steel wires, a fixing block, a screwing section, a spiral section and a connecting block are sequentially arranged from near to far along the length direction of the pushing guide wire, the spiral section comprises a hollow cavity positioned inside, the thrombus taking support comprises a proximal end connecting section, and the proximal end connecting section is fixedly connected with the connecting block through an adapter.
In an alternative embodiment, the adapter comprises a screw joint conical head, a connecting column is arranged at the distal end of the connecting block, and the connecting column is in threaded connection with a conical section of the screw joint conical head;
The distal end of the screw joint conical head is connected with a switching sleeve, and the proximal end connecting section penetrates through the switching sleeve and stretches into a straight section fixed on the screw joint conical head.
In an alternative embodiment, the delivery catheter comprises a single lumen catheter, wherein the wall of the single lumen catheter comprises multiple layers of materials, each comprising PEBAX material at the outer layer, stainless steel braided wire at the middle layer and PTFE material at the inner layer;
the outer diameter of the conveying catheter is not more than 7F, a radio-opaque marker ring is connected to the distal end of the conveying catheter, and a handle with a luer connector is connected to the proximal end of the conveying catheter.
In an alternative embodiment, the thrombus-removing stent comprises a plurality of sections of calabash shape in a released state, and thrombus in the pulmonary artery can be cut through a stent wire mesh after release.
In a second aspect, the present invention provides a pulmonary artery thrombi removal system comprising a suction catheter, a dilator, a Y-connector, and a pulmonary artery thrombi removal device of any of the foregoing embodiments, a distal end of the delivery catheter being inserted into and extending from a distal end of the suction catheter, a proximal end of the delivery catheter being exposed at a proximal end of the suction catheter;
the Y-shaped connector is connected with the proximal end of the delivery catheter, and the thrombus taking support enters the delivery catheter through the Y-shaped connector.
In an alternative embodiment, the proximal end of the suction catheter is connected to a suction tube, and an aspirator is connected to the suction tube;
the pulmonary artery thrombus removing system is characterized in that a suction catheter and a dilator are assembled in the using process and then conveyed to a thrombus position along a preset guide wire, and the dilator is taken out after reaching the thrombus position;
delivering a pulmonary artery thrombectomy device to a thrombus site along a guidewire within the aspiration catheter and passing a stent tip of a thrombectomy stent through the thrombus;
And withdrawing the conveying catheter, releasing the thrombus taking support in thrombus, and then withdrawing the thrombus taking support and the conveying support synchronously relative to the exposed release state relation of the thrombus taking support in the conveying catheter, taking the thrombus into the suction catheter, and carrying out negative pressure suction on the suction catheter through the aspirator to complete removal of pulmonary artery thrombus.
According to the pulmonary artery thrombus taking device, the tip of the stent is exposed out of the distal end pipe orifice of the conveying catheter in a limiting manner, and the guide wire channel on the tip of the stent is arranged between the tip of the stent and the side wall of the stent, so that the guide wire can be formed to go straight in and go out of the tip of the stent, the guide wire can be formed to go out laterally, the additional arrangement of catheter cavities on the thrombus taking stent and the conveying catheter is avoided, the diameter of the conveying catheter can be reduced to the greatest extent, and the thrombus taking stent attached to the conveying catheter and elastically compressed on the inner side of the distal end pipe orifice of the conveying catheter can smoothly pass through a vascular path to reach a specified position.
Simultaneously, for the pulmonary artery vessel of branch more tree-like structure, the smaller delivery catheter of diameter can be on the basis that the thrombus of taking the thrombus support through vascular route arrival assigned position smoothly, on the one hand can do benefit to delivery catheter and support pointed end and pass the thrombus, on the other hand can avoid thrombus aversion, effectively cuts the thrombus of assigned position through the thrombus of taking the thrombus support after reaching the self-expanding release of assigned position, does benefit to subsequent suction and clears away.
The shape structure of different types that the support pointed end includes can do benefit to the conveying resistance who reduces the time of not releasing the thrombus support, perhaps can make the support pointed end pass thrombus more easily, combines the guide wire passageway of the different forms that the support pointed end corresponds on the different structures, can make guide wire and guide wire passageway cooperate better, makes the support pointed end push under the guide effect of guide wire more smoothly.
The distal end of the thrombus taking support can be flexibly replaced according to different application conditions by detachably connecting the support tip to the distal end of the thrombus taking support, so that the thrombus taking support is convenient to adjust for different types of patients.
The outer diameter of the profile of the proximal end of the stent tip is not smaller than that of the distal end pipe orifice on the conveying pipe, so that the distal end pipe orifice of the conveying pipe can form a necessary limit relation, the stent tip can only be exposed outside the conveying pipe in a limited way and does not retract into the conveying pipe, the effective matching of the stent tip and the guide wire outside the conveying pipe is further ensured, and meanwhile, the stent tip exposed outside the distal end pipe orifice in a limited way can have a good open-circuit structure.
Additional features and advantages of the application will be set forth in the detailed description which follows.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present application more clear, the technical solutions of the embodiments of the present application will be clearly and completely described below with reference to the accompanying drawings in the embodiments of the present application. It will be apparent that the described embodiments are some, but not all, embodiments of the application. The components of the embodiments of the present application generally described and illustrated in the figures herein may be arranged and designed in a wide variety of different configurations.
In the description of the present application, it should be noted that, the azimuth or positional relationship indicated by the terms "inner", "outer", etc. are based on the azimuth or positional relationship shown in the drawings, or the azimuth or positional relationship that is commonly put in use of the product of this application, are merely for convenience of describing the present application and simplifying the description, and do not indicate or imply that the device or element to be referred to must have a specific azimuth, be configured and operated in a specific azimuth, and therefore should not be construed as limiting the present application. Furthermore, the terms "first," "second," and the like, are used merely to distinguish between descriptions and should not be construed as indicating or implying relative importance.
In the description of the present application, it should also be noted that, unless explicitly specified and limited otherwise, the terms "disposed" and "connected" are to be construed broadly, and may be, for example, fixedly connected, detachably connected, or integrally connected, or may be directly connected, or may be indirectly connected through an intermediate medium, or may be in communication with the inside of two elements. The specific meaning of the above terms in the present application will be understood in specific cases by those of ordinary skill in the art.
Referring to fig. 1, and referring to fig. 2-7, the pulmonary artery thrombus removing device of the present application is mainly applied to treatment and removal of thrombus in pulmonary artery blood vessels, specifically, by changing the penetration form of the existing guide wire 8 in the thrombus removing stent 1 and the conveying catheter 2, the diameter of the conveying catheter 2 is reduced, so that the thrombus removing stent 1 and the conveying catheter 2 are conveyed to thrombus positions in pulmonary artery blood vessels with more branches as much as possible, and the thrombus is cut by in-situ release of the thrombus removing stent 1, and the subsequent aspiration removal is performed.
By changing the guiding penetration form of the guide wire 8 to the thrombus taking support 1 and the conveying conduit 2, the penetrating property of the conveying conduit 2 in the pulmonary artery blood vessel is improved to the greatest extent, and the thrombus taking support 1 can be effectively and reliably conveyed to a thrombus position.
Referring to fig. 1, the main structure of the pulmonary artery thrombus removing device in the invention comprises a thrombus removing bracket 1 made of nickel-titanium alloy and a conveying catheter 2 for conveying the thrombus removing bracket 1, wherein in the specific conveying process, the tip end of the thrombus removing bracket 1 is exposed out of the conveying catheter 2, so as to enhance the trafficability of a bracket catheter matching body formed by the thrombus removing bracket 1 and the conveying catheter 2, and the bracket catheter matching body is especially a combination body in which the thrombus removing bracket 1 is elastically compressed in the conveying catheter 2.
The stent tip 3 is connected with the thrombus taking stent 1, and the stent tip 3 in the invention is in a state of being exposed out of the distal pipe orifice of the conveying pipe 2 in a limiting way no matter the thrombus taking stent 1 is elastically compressed inside the conveying pipe 2 or the thrombus taking stent 1 is released outside the conveying pipe 2 relatively. In particular, in the process of conveying the thrombus taking support 1 in the conveying catheter 2 with the compression state to the distal end of a blood vessel, a good pushing open state can be established through the support tip 3, and the effect of reducing pushing resistance is achieved.
The thrombus taking support 1 can stretch back and forth along the axial direction of the delivery catheter 2 relative to the distal end nozzle of the delivery catheter 2, so that the thrombus taking support 1 can be self-expanded and released outside the distal end nozzle and elastically compressed inside the distal end nozzle.
Specifically, during the delivery of the stent catheter complex, the thrombus-taking stent 1 is elastically compressed at the inner side of the distal orifice, and when the stent catheter complex is delivered to a thrombus site, particularly when the stent tip 3 just passes through and reaches the distal site of the thrombus, the distal orifice of the thrombus-taking stent 1 relative to the delivery catheter 2 is extended by the retracting movement of the delivery catheter 2, the thrombus-taking stent 1 is self-expanded and released at the thrombus site, and the thrombus is cut in situ while being released, so that the thrombus is cut.
During conventional delivery, the stent 1 and catheter 2 are guided by a guidewire 8 passing through the lumen of the guidewire, and specifically, when the device is passed from outside the body into a vessel, the distal end of the guidewire 8 exposed outside the body is passed into the lumen and out of the proximal end of the device, and under the guidance of the guidewire 8, the device is extended into the vessel and reaches the desired target site.
The present application breaks through the conventional knowledge that the guide wire 8 does not pass through the thrombus taking stent 1 and/or the delivery catheter 2, but rather, by the lateral guide wire channel 33 arranged on the stent tip 3 and combining the form that the stent tip 3 is exposed out of the delivery catheter 2 whenever the stent tip 3 is exposed, the guide wire 8 is led laterally, so that the guide wire 8 passes through the outer side of the delivery catheter 2, and the special guide wire cavity is avoided in the delivery catheter 2 or on the thrombus taking stent 1, so that the stent catheter matching body, particularly the outer diameter of the delivery catheter 2, is greatly reduced, and the stent catheter matching body is more suitable for pushing transmission in pulmonary arteries with smaller branches.
Meanwhile, from another angle, although the existing thrombus-taking stent 1 also has a part of no-wire cavity, more of the existing thrombus-taking stent 1 is used for taking a thrombus in a cranial artery, compared with a form with less branches of the cranial artery, the branch number of the pulmonary artery is extremely large, the thrombus-taking stent 1 can easily reach a designated part of the cranial artery without being guided by a guide wire 8, but the application scene cannot be contrasted with a structural form with more branches of the pulmonary artery in the application, the thrombus-taking stent 1 hardly reaches the designated part of the pulmonary artery without being guided by the guide wire 8, and in the conventional cognition, the application of the cranially artery no-wire cavity thrombus-taking stent 1 and the application of the guide wire 8 which does not reach the designated lesion part of the cranial artery through the guide of the guide wire 8 cannot be linked with the structural form of the guide wire 8 matched with the stent tip 3 side guide wire channel 33 in the application, so that the practical application angle is described.
The lateral guide wire channel 33 on the stent tip 3 in the present invention specifically includes a tip inlet 33a and a lateral outlet 33b, where the tip inlet 33a refers to a reverse insertion inlet of the tail end of the guide wire 8, and the tip inlet 33a is opened on the tip surface of the stent tip 3.
The lateral outlet 33b is a reverse-penetrating outlet of the tail end of the guide wire 8, and the lateral outlet 33b is formed on the side wall of the stent tip 3, and by means of this arrangement, the final purpose is to combine with the exposure of the stent tip 3 at the distal orifice of the delivery catheter 2, so as to enable the guide wire 8 to extend outside the delivery catheter 2.
It should be added that the existing conventional pulmonary artery thrombus removing stent 1 is mainly a delivery catheter 2 with a guide wire cavity, so that the diameter of the delivery catheter 2 is larger, the outer diameter of the delivery catheter 2 of the product on the market is 12F, the product is punctured by femoral vein, passes through lower limb vein, right atrium and right ventricle to reach pulmonary artery, the larger diameter directly influences the conveying performance, and the difficulty is increased for the thrombus removing stent 1 to reach pulmonary artery embolism, namely pulmonary artery thrombus.
By guiding the guide wire 8 outside the delivery catheter 2, the outer diameter of the delivery catheter 2 is greatly reduced and controlled to be within 7F. So that the thrombus taking support 1 can smoothly reach a designated position through a vascular path. The reduced outer diameter of the delivery catheter 2 may facilitate the passage of the entire stent catheter complex through the thrombus, particularly under the exposed open-circuit action of the stent tip 3, making the delivery catheter 2 more easily pass through the thrombus without causing displacement of the thrombus, so that relatively steady-state thrombus is effectively cut after release of the thrombus removal stent 1.
The stent tip 3 in the invention has the substantial effects of establishing an open circuit and penetrating thrombus, and can be selectively arranged according to specific actual requirements under different application scene requirements.
Specifically, the stent tip 3 comprises a generally conical tip 31, the conical tip 31 is coaxially arranged with the thrombus-taking stent 1, and the guide wire channel 33 comprises a bending passage 311 arranged on the conical tip 31, in such a way that the stent tip 3 can more easily pass through thrombus, and is suitable for treating pulmonary arterial thrombus of larger size.
Meanwhile, the stent tip 3 further comprises an eccentric bending tip 32, the guide wire channel 33 comprises a linear passage arranged at the eccentric bending part, the extending direction of the linear passage is parallel to the axial direction of the thrombus taking stent 1, obviously, the linear passage of the eccentric bending tip 32 can reduce the resistance when conveying along the guide wire 8, the friction interference between the guide wire 8 and the stent tip 3 is reduced as much as possible, and the guide wire is suitable for branching pulmonary arteries and is easier to penetrate in a curved blood vessel.
In any form, the guide wire 8 can be extended outside the delivery catheter 2, thereby achieving the technical purpose of reducing the outer diameter of the delivery catheter 2.
In order to better select different types of stent tips 3, the stent tips 3 are detachably connected to the distal end of the thrombus removal stent 1, and the outline outer diameter of the proximal end of the stent tip 3 is not smaller than that of the distal end orifice, so that the stent tips 3 can be exposed out of the distal end orifice of the delivery catheter 2 in a limited manner.
The form of the detachable connection of the stent tip 3 is also determined in the specific application scenario of the delivery catheter 2 according to the application with the thrombolytic stent 1. Specifically, after the stent catheter complex reaches the thrombus site, particularly after the stent tip 3 passes through the thrombus, the thrombus-taking stent 1 is not moved and is in an in-situ release state, and the delivery catheter 2 is retracted and moved relative to the thrombus-taking stent 1 to avoid relative release space.
When the thrombus is released by the thrombus removing stent 1 and the in-situ cutting of the thrombus is completed, the thrombus removing stent 1 and the conveying catheter 2 are retracted together and synchronously, so that the thrombus removing stent 1 and the conveying catheter 2 synchronously enter the suction catheter 5 of the thrombus removing system, therefore, the conveying catheter 2 does not push forward relative to the thrombus removing stent 1, only the tight fit degree between the stent tip 3 and the thrombus removing stent 1 is considered, and simultaneously, the thrombus is released and cut by the proximal stent body of the stent tip 3, so that the retraction obstruction of the thrombus on the stent tip 3 is reduced to the minimum, and the integral combination of the thrombus removing stent tip 3 and the thrombus removing stent 1 can be ensured by the tight fit of the distal end part of the thrombus removing stent 1 and the stent tip 3, so that the separation of the stent tip 3 and the thrombus removing stent 1 is fundamentally avoided.
In one particular embodiment, the stent tip 3 comprises a flexible tip of solid construction that enables the stent tip 3 to bend to conform to the curvature of the vessel, enhancing passability.
From the connection cooperation angle of support pointed end 3 and thrombus taking support 1, flexible pointed end is provided with the installation department, and the installation department is including seting up the connection counter bore 34 on flexible pointed end's proximal end face, and thrombus taking support 1 includes distal end linkage segment 11, because thrombus taking support 1 is nickel titanium alloy material, has certain elasticity by itself, can make distal end linkage segment 11 elasticity expand outward and radially compress tightly in connection counter bore 34, realizes the close-coupled cooperation of both.
The guide wire channel 33 comprises a through hole channel formed in the flexible tip end, so that the guide wire 8 can be effectively connected in a penetrating way, meanwhile, friction interference of the guide wire 8 in the guide wire channel 33 can be avoided through enough radial space of the through hole channel, and friction resistance between the guide wire 8 and the support tip end 3 is prevented.
On the basis of the vascular trafficability and thrombus trafficability of the stent tip 3, at least a part of solid area is reserved between the through hole and the connecting counter bore 34, so that a certain solid structure can be formed, the structural strength of the stent tip 3 is prevented from being influenced due to the arrangement of the through hole, and the stent tip 3 is prevented from being bent when the vascular passes and passes through the thrombus.
From the point of view of ensuring an efficient threading of the guide wire 8 in the guide wire channel 33 and of avoiding to a maximum extent friction of the guide wire 8 with the stent tip 3, the active space of the guide wire channel 33 with respect to the guide wire 8 needs to be taken into account. Specifically, tip inlet 33a comprises a circular aperture provided in stent tip 3, and lateral outlet 33b comprises an elliptical aperture provided in the side wall of stent tip 3, the elliptical aperture comprising at least a length, in such a way as to provide a sufficient amount of active space for guidewire 8 in guidewire channel 33, thereby avoiding the risk of frictional interference of guidewire 8 with stent tip 3.
The threading of the guide wire 8 in the present application must take into account the straight threading state of the guide wire 8, at which angle the straight path on the eccentrically folded tip 32 can be better achieved.
In the state of the bending passage 311 on the tapered tip 31, the necessary structure of the guide wire channel 33 is provided to avoid the influence of the bending passage 311 on the threading of the guide wire 8.
Specifically, when the stent tip 3 is the tapered tip 31, the bending passage 311 on the tapered tip 31 includes a straight passage 312 and an inclined passage 313, and on the basis that the stent tip 3 and the thrombolytic stent 1 are coaxially arranged, the extending direction of the straight passage 312 coincides with the axes of the thrombolytic stent 1 and the stent tip 3, so that the guide wire 8 can be caused to pass through at an angle parallel to the axes of the two, and the frictional contact interference of the guide wire 8 on the straight passage 312 is avoided.
And most importantly, the inclined passage 313 opens out to the lateral outlet 33b at the same tunnel diameter as the straight passage 312, or more preferably, the inclined passage 313 opens out to the lateral outlet 33b at a larger tunnel diameter than the straight passage 312 to provide a greater amount of clearance for the guidewire 8 in the inclined passage 313, thereby minimizing the risk of frictional contact interference of the guidewire 8 with the stent tip 3 at the bend-through location.
Further, the inclined passage 313 is inclined and extends radially from far to near relative to the axial direction of the stent tip 3, so that the obtuse angle between the axial center of the inclined passage 313 and the axial center of the straight passage 312 is not less than 120 degrees, thereby reducing the bending degree of the guide wire 8 in the bending passage 311 and reducing the risk of friction contact interference of the guide wire 8, particularly the bending part of the guide wire 8, and the stent tip 3.
In another specific embodiment, in order to conveniently push and withdraw the thrombus taking support 1, the proximal end of the thrombus taking support 1 is connected with a pushing guide wire 4, the pushing guide wire 4 is formed by weaving a plurality of strands of stainless steel wires 41, a fixing block 42, a screwing section 43, a spiral section 44 and a connecting block 45 are sequentially arranged along the length direction of the pushing guide wire 4 from the near to the far, and the fixing block 42 mainly fixes the plurality of strands of stainless steel wires 41 and is convenient for handheld operation.
The screwing section 43 can keep screwing connection of the plurality of stainless steel wires 41, is favorable for integrating different stainless steel wires 41, and the screw section 44 comprises a hollow cavity positioned inside, so that the whole flexibility of the pushing guide wire 4 can be enhanced, and the turning pushing adapted to bending is easier to carry out.
The thrombus taking support 1 comprises a proximal connecting section 12, the proximal connecting section 12 is fixedly connected with a connecting block 45 through an adapter 46, and the forward and backward actions of the thrombus taking support 1 can be controlled by pushing the guide wire 4 to push and pull forwards and backwards.
It should be noted that the thrombolysis stent 1 is fixedly connected with the pushing guide wire 4, so as to ensure the stable reliability of the connection of the thrombolysis stent 1 and the pushing guide wire 4.
On the basis of the above description, the adaptor 46 includes the screw-connection taper 46a, the screw-connection taper 46a includes a taper section on the proximal end side and a straight section on the distal end side, the distal end portion of the connection block 45 is fixedly provided with a connection post 45a, and the connection post 45a is in threaded connection with the taper section of the screw-connection taper 46a, so as to realize connection fixation of the pushing guide wire 8 and the adaptor 46.
From the angle of connection of the bolt taking support 1 and the adapter 46, the far end of the screw joint conical head 46a is connected with the adapter sleeve 46b, and the proximal end connecting section 12 of the bolt taking support 1 penetrates through the adapter sleeve 46b and stretches into the straight barrel section fixed on the screw joint conical head 46a, through the arrangement mode, the proximal end connecting section 12 can be fixedly installed on the adapter sleeve 46b and the screw joint conical head 46a, and then the stable reliability of connection is ensured.
By means of the arrangement, reliable connection of the thrombus taking support 1 and the pushing guide wire 8 can be achieved through the adapter 46, and detachment of the thrombus taking support 1 is fundamentally avoided.
Based on the penetration of the thrombolytic stent 1 in the delivery catheter 2 and the telescopic movement of the thrombolytic stent 1 relative to the delivery catheter 2, the delivery catheter 2 in the present invention comprises a single lumen catheter without providing an additional guidewire lumen.
The wall of the single-cavity catheter comprises multiple layers of materials, wherein the multiple layers of materials comprise PEBAX materials positioned on an outer layer, stainless steel braided wires positioned on a middle layer and PTFE materials positioned on an inner layer, the trafficability of the conveying catheter 2 in a blood vessel is guaranteed through the outer layer, the smoothness of the telescopic sliding of the thrombus taking support 1 relative to the inner wall of the outer tube is guaranteed through the inner layer, the pushing performance of the whole outer tube in the blood vessel is guaranteed through the middle layer, and meanwhile the strength and flexibility of the whole structure are comprehensively considered.
Because no separate guide wire cavity is arranged, the outer diameter of the conveying catheter 2 is not more than 7F, and the radiopaque marker ring 21 is connected to the far end of the conveying catheter 2, the position relation of the thrombus taking support 1 relative to the far end of the conveying catheter 2 can be examined, thereby ensuring the accurate release of the thrombus taking support 1. The proximal end of the delivery catheter 2 is connected to a handle 22 with a luer fitting 23 for easy withdrawal.
From the angle that thrombus of pulmonary artery thromboembolism can be accurately cut after being favorable for in-situ release of the thrombus taking support 1, the thrombus taking support 1 is made of nickel-titanium alloy with memory elasticity, the thrombus taking support 1 comprises a plurality of sections of calabash shapes in a release state, after the support tip 3 passes through the bulk thrombus, the thrombus can be divided into annular lumbar grooves between the sections of the calabash shapes after the thrombus taking support 1 is released, and then the thrombus is taken into a suction catheter 5 of a clearing system by combining with integral withdrawal of a pulmonary artery thrombus taking device and cleared from a blood vessel under the action of suction negative pressure.
It should be pointed out that, the thrombus taking support 1 has certain penetrability, and can also endow thrombus with certain fixing function through in-situ release, so that thrombus generation and escape are effectively avoided.
Referring to fig. 8, in combination with fig. 9-13, the present invention further provides a pulmonary artery thrombus removal system, comprising a suction catheter 5, a dilator 6, a Y-connector 9, and a pulmonary artery thrombus removal device as described above, wherein the distal end of a delivery catheter 2 is inserted into and extended from the suction catheter 5, and further wherein the delivery catheter 2 is movably inserted into the suction catheter 5, enabling the delivery catheter 2 to drive the thrombus removal stent 1 to the distal site of a thrombus, and enabling the thrombus removal stent 1 and the delivery catheter 2 to have a relatively wide flexible amount of telescoping space.
The proximal end of the conveying conduit 2 is exposed out of the proximal end of the suction conduit 5, so that the pushing and pulling operation of the conveying conduit 2 can be flexibly and conveniently performed, and different working condition states can be accurately controlled.
The Y-shaped connector 9 is connected with the proximal end of the delivery catheter 2, and the thrombus-taking stent 1 enters the lumen of the delivery catheter 2 through the Y-shaped connector 9.
The proximal end of the suction duct 5 is connected with a suction tube 51, the suction tube 51 is connected with a suction device 7, and through the arrangement of the suction device 7, suction operation can be performed, and stable and reliable suction negative pressure can be established for the suction duct 5.
The pulmonary artery thrombus removing system comprises the following steps in the using process:
the aspiration catheter 5 is assembled with the dilator 6 and then conveyed to the thrombus position along the preset guide wire 8, the dilator 6 can accurately reach the thrombus position under the guiding action of the guide wire 8, then the dilator 6 is taken out to obtain a good dilating passageway, when the passageway is established, the distal end of the dilator 6 does not penetrate through the thrombus, after the dilator stays at the proximal end side of the thrombus, the open circuit is completed, and then the dilator 6 is retracted.
The tail end of the guide wire 8 passes through the guide wire channel 33 of the stent tip 3, the stent catheter matching body of the pulmonary artery thrombus taking device is conveyed to the thrombus position along the guide wire 8 in the aspiration catheter 5, the stent tip 3 of the thrombus taking stent 1 passes through the thrombus, and the thrombus is passed through and fixed from another angle.
The conveying catheter 2 is retracted, the thrombus taking support 1 is released in situ in thrombus, the thrombus taking support 1 is used for cutting the thrombus in situ, then the thrombus taking support 1 and the conveying support are synchronously retracted relative to the exposed release state relation of the thrombus taking support 1 in the conveying catheter 2, the thrombus taking support 1 is elastically compressed at the distal end pipe orifice of the suction catheter 5, the pipe diameter of the suction catheter 5 is larger than that of the conveying catheter 2, the elastic compression is greatly smaller than that of the conveying catheter 2, the thrombus can be cut and intercepted in a smaller compression deformation state, the thrombus after cutting and interception is brought into the suction catheter 5, the suction catheter 5 is sucked in a negative pressure mode by combining the suction device 7, and the cut small-size thrombus is collected into the suction device 7 through the suction catheter 5, so that the removal of the pulmonary arterial thrombus is completed.
The pulmonary artery thrombus removing system can fundamentally ensure the thrombus removing effect in pulmonary artery blood vessels and provide technical support for timely and reliable treatment of pulmonary embolism.
It should be noted that the features of the embodiments of the present application may be combined with each other without conflict.
The above description is only of the preferred embodiments of the present application and is not intended to limit the present application, but various modifications and variations can be made to the present application by those skilled in the art. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present application should be included in the protection scope of the present application.