A kind of segmented takes pin deviceTechnical field
The utility model is related to technical field of medical instruments, more particularly to a kind of segmented takes pin device.
Background technology
It is common disease type in medical science that brain is sudden, and China is also cerebral apoplexy big country of the world, during cerebral apoplexy has turned into and causedThe primary cause of death of state resident；Occur according in every 4 apoplexy patients of external relevant epidemiologic studies have shown that, just there are 3 peopleDifferent degrees of deformity.
Acute ischemic stroke (acute ischemic stroke, AIS, be commonly called as cerebral infarction) is palsy most common type,The acute apoplexy accounted for caused by the 80% of all palsys, especially vessel occlusion, often the state of an illness is dangerous, the death rate, disability rateHeight, can cause maximum harm to patient；Once generation apoplexy, to patient in itself, family and society cause white elephant.
Time is life, and extreme early thromboembolism treatment has obtained the Evidence based medicine evidence of abundance, and in clinical expansionUsing more than 10 years, nevertheless, the 4.5h time windows of intravenous thrombolysis are too short, only about 5% or so patients with cerebral apoplexy can receiveThromboembolism treatment, and the thromboembolism treatment revascularization time is long, and symptomatic intracranial Bleeding rate is high after thrombolysis, and main artery near-end is hinderedThe patient outcome of plug is not good, in acute arteria cerebri media cerebral infarction, if thrombus length is more than 8mm, intravenous thrombolysis is hardlyThe blood vessel of obstruction can be led to again, can even be led to again, the probability blocked again is also very high.
In order to solve the above problems, for more than thrombolysis time window and the patient for having thromboembolism treatment contraindication, machine can be usedTool device removes thrombus, and the method can quickly make the revascularization of occlusion because of it, improve recanalization rate, reduce thrombolytic drugDosage, reduces the incidence of symptomatic intracerebral hemorrhage, and extended treatment time window shortens and leads to the time again, so as to be reversible cerebral ischemia-reperfusionTissue strives for more times, hence it is evident that improve the prognosis of patient.
There is the technology that thrombus is removed below by way of mechanical device in the prior art：
The B of China Patent No. CN 103417261, disclose a kind of intracranial vascular thrombus removal equipment, and it is network structure to take bolt deviceAnd can be changed between retrieving position and expanded position, take bolt device to be provided with a number of " fall on its lumen wallThorn ", it is tilted relative to tube wall, to help to fix thrombus and take out external.
The A of China Patent No. CN 104068912, disclose a kind of intracranial vessel and take bolt device and take pin device, take bolt device bagOuter stent and inner stent are included, ectonexine support is configured to netted, and outer stent is coated on outside inner stent, both itBetween form gap, improve capture stability.It is this inside and outside but the device does not consider that intracranial vessel is very tortuous and tinyLayer support can form adamantine run in conduit in advance, lead to not reach at embolism.
In order to improve the stability of capture thrombus, anti-tampon comes off in removal process, and increase hangnail etc. is complicatedThe bolt device that takes often volume is excessive, it is impossible to use, and considerably increased to blood vessel in the quite tortuous and tiny cerebrovascularWall causes the risk of damage.
Therefore, for above-mentioned deficiency, it is desirable to provide one kind is new to take pin device.
Utility model content
(1) technical problem to be solved
The technical problems to be solved in the utility model is to provide a kind of segmented and takes pin device, to solve existing to take bolt technologyThe thrombolysis of presence leads to time length again, thrombus is easy to fall off in acquisition procedure, take the problem of pin device compliance, transporting are poor.
(2) technical scheme
In order to solve the above technical problems, the utility model takes pin device there is provided a kind of segmented, it includes taking thrombusSupport and the induction system for being connected to described taking thrombus support one end, the taking thrombus support are that multiple unit grids are mutualThe self-expansion type network management framework being formed by connecting；The network management framework offers radial clearance, and the radial clearance is by the webmasterStructure is divided into multiple segmental structures being sequentially connected.
Wherein, the radial clearance is tapered gaps, and the unit grid is class rhombus；The width of the tapered gaps isThe integral multiple of the unit grid width.
Wherein, in addition to near-end development mark and distal end development mark, near-end development mark is arranged on the blood vesselOne end being connected with the induction system of bolt support is taken, the distal end development mark is arranged on the remote of the taking thrombus supportFrom one end of the induction system.
Wherein, in addition to intersegmental development mark, the intersegmental development mark is arranged on the positions of the tapered gaps.
Wherein, the intersegmental development mark is arranged at the tapered gaps on the water caltrop of unit grid；The distal end showsShadow mark is arranged on the water caltrop of far-end unit grid.
Wherein, it is described it is intersegmental development mark, near-end development mark and distal end development mark by welding, crimping, be glued orThe mode of coil winding is connected on the taking thrombus support.
Wherein, the intersegmental development mark, near-end development mark and distal end development mark material system visual under X-rayInto；The taking thrombus support is made up of shape-memory material, the surface of the taking thrombus support have anticoagulant coating,Antiplatelet medicine coating or hydrophilic coating.
Wherein, the filament of the taking thrombus carrier unit grid is leg portion, and the thickness of the leg portion is more thanWidth；The end being connected with the induction system of the taking thrombus support is pyramidal structure, institute under self-expanding stateThe taper of pyramidal structure is stated between 30 ° to 60 °.
Wherein, the induction system includes conveying silk, protection sheath, microtubular, guiding catheter and rotation haemostatic valve；It is described defeatedWire feed is connected with one end of the taking thrombus support；The taking thrombus support is in operation using anteposition in the protection sheathInterior, the protection sheath is connected by rotating haemostatic valve with the microtubular；During operation, the microtubular is pushed away by guiding catheterDeliver at blood vessel embolism.
Wherein, the taking thrombus support is connected with the conveying silk by way of welding, riveting or pressure are held；It is described to protectShield sheath is made up of polymeric material；The flexible wire that the conveying silk coats hydrophilic coating by surface is made.
(3) beneficial effect
Above-mentioned technical proposal of the present utility model has the following advantages that：
The segmented that the utility model is provided is taken in pin device, and network management framework offers radial clearance, and radial clearance is by netTubular construction is divided into multiple segmental structures being sequentially connected, and excessive mesh can be avoided to split thrombus, so as to keep the phase of thrombusTo integrality, reduce the risk that distal embolization occurs for thrombus breaks loose, realize it is fast and reliable take bolt, saved half dark space reversibleIschemic tissue of brain；Due to the design of segmental structure so that the compliance and transporting for taking bolt support more preferably, take bolt support can be with defeatedIt is sent to the thinner blood vessel in distal end；The network structure of segmented, metal occupation rate is low, takes during bolt to vascular wall and surroundingThe damage that endangium is caused is also less, reduces machinery and takes bolt related complication；Taking thrombus stent strut segment thickness is more thanWidth so that support has low extruding rigidity, and adherence quality is excellent, so as to take bolt more thorough, edge thrombus is not omitted；It is increased aobviousShadow mark facilitates doctor to operate, and improves procedure efficiency, is that patient strives for valuable time.
Brief description of the drawings
Fig. 1 is that the utility model segmented takes the medium vessels of pin device embodiment 1 to take bolt support with protecting the overall structure of sheathSchematic diagram；
Fig. 2 is the schematic diagram that the utility model segmented takes connecting portion between segmental structure in pin device embodiment 1；
Fig. 3 is the position that the utility model segmented takes development mark and distal end development mark between the stage casing of pin device embodiment 1Put and quantity；
Fig. 4 is the overall composition structural representation that the utility model segmented takes pin device embodiment 1；
Fig. 5 is that the utility model segmented takes pin device embodiment 1 to take bolt process, microtubular to be pushed at thromboembolismStructural representation；
Fig. 6 is that the utility model segmented takes pin device blood vessel embodiment 1 to take bolt support to be returned after being merged after deploying with thrombusThe schematic diagram of receipts；
Fig. 7 is that the utility model segmented takes pin device blood vessel embodiment 1 to take the signal for taking bolt compliance of bolt supportFigure；
Fig. 8 is the schematic diagram that the utility model segmented takes the taking thrombus support in pin device blood vessel embodiment 2；
Fig. 9 is the schematic diagram that the utility model segmented takes the taking thrombus support in pin device blood vessel embodiment 3；
Figure 10 is the schematic diagram that the utility model segmented takes the taking thrombus support in pin device blood vessel embodiment 4；
Figure 11 is the schematic diagram that the utility model segmented takes the taking thrombus support in pin device blood vessel embodiment 5.
In figure, 1：Radial clearance；2：Taking thrombus support；201：The taking thrombus support of compressive state；3：Near-end developsMark；4：Convey silk；5：Microtubular；6：Microtubular is identified；7：Intersegmental development mark；8：Distal end development mark；9：The big blood of encephalicPipe；10：Thrombus；11：Protect sheath；12：Guiding catheter.
Embodiment
With reference to the accompanying drawings and examples, embodiment of the present utility model is described in further detail.BelowEmbodiment is used to illustrate the utility model, but is not limited to scope of the present utility model.
In description of the present utility model, it is to be understood that " distal end " and " near in terms of the present utility modelEnd " is appreciated that from the direction of the doctor in charge.Distal end is the side away from the doctor in charge, and near-end is represented towards masterControl doctor.In the utility model, if phrase " axial direction " is with this document, it is to be understood as representing this practicalityThe direction that new device is pushed into, is defined as " radial direction " with axially vertical direction.
, it is necessary to which explanation, unless otherwise clearly defined and limited, term " are pacified in description of the present utility modelDress ", " connected ", " connection " should be interpreted broadly, for example, it may be fixedly connected or be detachably connected, or integratedlyConnection；Can be joined directly together, can also be indirectly connected to by intermediary, can be the connection of two element internals.ForFor one of ordinary skill in the art, concrete meaning of the above-mentioned term in the utility model can be understood with concrete condition.
Embodiment 1
As shown in Figure 1 to Figure 4, segmented of the present utility model takes pin device to remove in patients with cerebral apoplexy intracranial vessel 9Thrombus, so as to recover blood flow, it includes taking thrombus support 2 and is connected to the induction system of the one end of taking thrombus support 2, bloodPipe takes bolt support 2 to belong to self-expansion type support, and taking thrombus support 2 is the self-expansion type that multiple unit grids are connected with each otherNetwork management framework；Network management framework offers radial clearance 1, and the network management framework is divided into multiple points being sequentially connected by radial clearance 1Segment structure.Wherein, the architectural feature of the connecting portion of segmental structure radial clearance 1, the present embodiment is shown in the present embodiment Fig. 2In, its width is equal with unit grid width, and whole taking thrombus support 2 includes 2 radial taper gaps.
In the embodiment, as shown in figure 5, under the conveying effect of induction system, taking thrombus support 2 enters encephalic bloodAt bolt 10, the self-expanding of taking thrombus support 2 of network management framework expansion (d is the external diameter after expansion in Fig. 1), and incorporate thrombus 10,Bolt support and thrombus 10 will be taken to pull out slowly together, to reach the purpose of bolt, because network management framework offers radial clearance 1,Network management framework is divided into multiple segmental structures being sequentially connected by radial clearance 1, and excessive mesh can be avoided to split thrombus 10, fromAnd keep the relative fullness of thrombus 10, reduce thrombus breaks loose occur distal embolization risk, realize it is fast and reliable take bolt, drawThe reversible ischemic tissue of brain in half dark space is rescued, improves Function outcome；And as shown in fig. 7, due to the design of segmental structure, makeThe compliance and transporting that bolt support must be taken more preferably, take bolt support to be transported to the thinner blood vessel in distal end；As shown in fig. 6, pointThe network structure of segmentation, metal occupation rate is low, takes the damage caused during bolt to vascular wall and peripheral vessels inner membranceIt is less, reduce machinery and take bolt related complication.
Preferably, the radial clearance 1 is tapered gaps, and the unit grid is class rhombus, and the design of tapered gaps canIt is taper to make the thrombus do not split by mesh, may better maintain the relative fullness of thrombus, it is to avoid thrombus fragment enters distal endOr normal blood vessels, and the risk of reduction thrombus breaks loose；Unit grid is class rhombus, specially the rhombus of sine curve composition, canSupport is conducive to freely to be changed between expansion and contraction state；The width of tapered gaps is the integral multiple of unit grid width, is enteredAnd enough clearance spaces can be ensured, keep the relative fullness of thrombus and to take the compliance of bolt support more preferable.
Further, as shown in Figures 2 and 3, in addition to near-end development mark 3 and distal end development mark 8, near-end development markKnow 3 one end being connected with the induction system for being arranged on the taking thrombus support 2, the distal end development mark 8 is arranged onOne end of the remote induction system of the taking thrombus support 2；Also include intersegmental development mark 7, the intersegmental development markKnow 7 positions for being arranged on the tapered gaps.
Specifically, in the present embodiment, near-end mark quantity be 1, distal marker quantity be 4, every section have 2 it is intersegmentalIdentify, totally 4 intersegmental marks, increased development mark enables the surgeon to improve the accuracy for taking bolt by imaging device, isPatient strives for valuable time.
Specifically, the intersegmental development mark 7 is arranged at tapered gaps on the water caltrop of unit grid；The distal end developmentMark 8 is arranged on the water caltrop of far-end unit grid.
Preferably, the intersegmental development mark 7, near-end development mark 3 and distal end development mark 8 pass through welding, crimping, glueConnect or the mode of coil winding is connected on the taking thrombus support 2.
Usually, the intersegmental development mark 7, near-end development mark 3 and distal end development mark 8 are visual under X-rayMaterial is made, it is preferable that 90% platinum, 10% iridium alloy or 92% platinum, the one or two that 8% tungsten alloy is made；Taking thrombusSupport 2 is made up of shape-memory material, preferably Nitinol, and it is in integrally near cylindrical in expanded position to take bolt support, moreThe shape of blood vessel is complied with well；The surface of taking thrombus support 2 has anticoagulant coating, antiplatelet medicine coating or hydrophilic paintingLayer, preferably Parylene coating (Dymax adhesives), maleic anhydride coating, Sodium Hyaluronate mixture coating.
In the present embodiment, taking thrombus support 2 is obtained by 3D laser cut metals tubing and then after heat treatment shaping, mesh diameter be 1.5~4.5mm, length be 15~50mm, maximum outside diameter be 1.5~6mm, tube wall thickness be 0.05~0.2mm。
Specifically, the filament of the unit grid of taking thrombus support 2 is leg portion, the pillar of taking thrombus support 2Partial thickness is more than width；Contribution of the width of the leg portion of support to rigidity is three cubed so that support has lowRigidity is extruded, adherence quality is excellent, so as to take bolt more thorough, edge thrombus is not omitted.
Preferably, the end being connected with induction system of taking thrombus support 2 is pyramidal structure under self-expanding state,The taper of pyramidal structure is between 30 ° to 60 °.Under self-expanding state, the proximal end of taking thrombus support 2 sets tapered knotStructure, is gradually expanded by its proximate, is so conducive to the recovery of support.
Further, it is the overall structure diagram of the device, induction system described in the present embodiment shown in Fig. 1 and Fig. 4Including conveying silk 4, conveying silk 4 is connected with one end of taking thrombus support 2；Induction system also include protection sheath 11, microtubular 5,Guiding catheter 12 and rotation haemostatic valve；Taking thrombus support 2 is protected in sheath 11 in operation using anteposition in described, is compressive stateTaking thrombus support 201, protection sheath 11 connected by rotating haemostatic valve with the microtubular 5；During operation, protection sheath is removed11, taking thrombus support is located in microtubular 5, and microtubular 5 is pushed to blood vessel embolism by guiding catheter 12, then blood vesselTake the self-expanding at thrombus 10 of bolt support；Wherein, there is the distal end of microtubular 5 microtubular to identify 6, can make doctor by microtubular markLife can be accurately positioned microtubular by imaging device, improve the degree of accuracy of operation technique；Conveying silk 4 coats hydrophilic painting by surfaceThe flexible nitinol alloy wire of layer is made, and protection sheath 11 material is high density polyethylene (HDPE).
Taking thrombus support 2 of the present utility model belongs to self-expansion type support, by protecting sheath 11 to maintain it in compressionState, after patient's encephalic correct position is put into, releases self-expansion type support, support voluntarily recovers its shape.This segmented takesPin device can be reclaimed completely, it is to avoid lifelong anticoagulant therapy, improve the quality of life of patient.
Specifically, the taking thrombus support 2 is connected with the conveying silk 4 by way of welding, riveting or pressure are held；InstituteProtection sheath 11 is stated to be made up of polymeric material；The flexible wire that the conveying silk 4 coats hydrophilic coating by surface is made, excellentElect Nitinol as.
Segmented of the present utility model takes pin device when in use, as shown in figure 5, when patients with acute ischemic cerebral stroke craniumInterior big blood vessel 9 is blocked by thrombus 10, and taking thrombus support 2 is connected with conveying silk 4, under applied external force, and pressure is held into conveyingIn the protection sheath 11 of system, protection sheath 11 is interconnected by rotating haemostatic valve (not shown) with microtubular 5；Then such as Fig. 5 institutesShow, taking thrombus support 2 is pushed in microtubular 5 by conveying silk 4, microtubular 5 is pushed to blood vessel bolt in guiding catheter 12At plug, withdraw microtubular 5, taking thrombus support 2 can self-expanding deploy and incorporate thrombus, thrombus can adhere to because of the extruding of supportOn cradle wall or in support, taking thrombus support 2 and microtubular 5 are slowly pulled out into (Fig. 6) as an entirety, so as to realizeTake the dredging of bolt and blood vessel.
Embodiment 2
Fig. 8 is the structural representation that the utility model segmented takes the taking thrombus support 2 of pin device embodiment 2.Such as Fig. 8 institutesShow, what embodiment 2 was provided takes bolt support with taking bolt supporting structure basically identical in embodiment 1, mainly there is following difference：RadiallyThe width in gap 1 is equal with unit grid width, and whole taking thrombus support 2 includes 3 radial taper gaps.
Certainly, the width of radial clearance 1 can be the integral multiple of unit grid width；Taking thrombus support 2 can have other numbersPurpose radial taper gap.
Pin device embodiment 3 is taken to take the structural representation of bolt support for example, Fig. 9 is the utility model segmented.Such as Fig. 9 institutesShow, what embodiment 3 was provided takes bolt support with taking bolt supporting structure basically identical in embodiment 1, mainly there is following difference：RadiallyIts width of tapered gaps is 2 times of unit grid width, and whole support includes 2 radial taper gaps；
Figure 10 is that the utility model segmented takes pin device embodiment 4 to take the structural representation of bolt support.As shown in Figure 10,What embodiment 4 was provided takes bolt support with taking bolt supporting structure basically identical in embodiment 1, mainly there is following difference：Radially boreIts width of shape gap is 2 times of unit grid width, and whole support includes 3 radial taper gaps.
Figure 11 is that the utility model segmented takes pin device embodiment 5 to take the structural representation of bolt support.As shown in figure 11,What embodiment 5 was provided takes bolt support with taking bolt supporting structure basically identical in embodiment 1, mainly there is following difference：Radially boreIts width of shape gap is equal with unit grid width, and whole support includes 4 radial taper gaps.
In summary, the segmented that the utility model is provided is taken in pin device, is diametrically bored by taking thrombus support 2The design in shape gap can avoid excessive mesh from splitting thrombus, so as to keep the relative fullness of thrombus, reduce thrombus and take offShave one's head the risk of raw distal embolization；Due to the design of segmented so that the compliance of taking thrombus support 2 is more preferable, taking thrombusSupport 2 can be transported to the thinner blood vessel in distal end；The network structure of segmented, metal occupation rate is low, and it is right during bolt to takeThe damage that vascular wall and peripheral vessels inner membrance are caused is few；The leg portion thickness of taking thrombus support 2 is more than width so that support hasThere is low extruding rigidity, adherence quality is excellent, so as to take bolt more thorough, edge thrombus is not omitted；Increased development mark facilitates doctorOperation, improves procedure efficiency, is that patient strives for valuable time.
Described above is only preferred embodiment of the present utility model, it is noted that for the common skill of the artFor art personnel, on the premise of the utility model technical principle is not departed from, some improvement and modification can also be made, these changeEnter and protection domain of the present utility model is also should be regarded as with modification.