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CN213963548U - Basket type thrombus removing device - Google Patents

Basket type thrombus removing device
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Publication number
CN213963548U
CN213963548UCN202022312983.6UCN202022312983UCN213963548UCN 213963548 UCN213963548 UCN 213963548UCN 202022312983 UCN202022312983 UCN 202022312983UCN 213963548 UCN213963548 UCN 213963548U
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disc
wire
thrombus
basket
developing
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夏欢
黄定国
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Shanghai Tendfo Medical Technologies Co Ltd
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Shanghai Tendfo Medical Technologies Co Ltd
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Abstract

The utility model relates to the technical field of medical equipment, a basket type thrombus clearing device is disclosed. The device includes: a distal filter disc, a proximal recovery disc and at least one intermediate thrombectomy disc, which are elastically expandable in radial direction and have a net structure; the far-end filtering disc, the middle thrombus taking disc and the near-end recovery disc are sequentially and coaxially connected; in a naturally deployed state, the intermediate embolic disc is flat disc-shaped, and the diameter of the intermediate embolic disc is larger than the diameter of the distal filter disc. The embodiment of the utility model provides a can provide quick, safe, effectual thrombus clearance mode for the embolism treatment of big, the thrombus volume of size such as pulmonary artery embolism to be favorable to improving acute well high risk pulmonary embolism patient's treatment.

Description

Basket type thrombus removing device
Technical Field
The utility model relates to the technical field of medical equipment, in particular to basket type thrombus clearing device.
Background
Pulmonary Embolism (PE), the clinical pathophysiological syndrome (PE) of pulmonary circulation disorder caused by the shedding of various emboli in the systemic circulation blocking pulmonary artery and branches thereof, is one of three fatal cardiovascular diseases in parallel with myocardial infarction and stroke. The most common pulmonary embolus is a thrombus, and pulmonary embolism caused by thrombus is also called Pulmonary Thromboembolism (PTE). At present, the endovascular intervention treatment is gradually becoming a trend of the treatment of the endovascular disease, but the treatment of patients suffering from acute pulmonary embolism currently lacks an effective intervention treatment means clinically. The products for treating vascular embolism in the current market mainly aim at the clinical application of small diameter of blood vessels and small thrombus amount, such as intracranial arteries, coronary arteries, lower limb arteries and the like, the pulmonary artery treatment is faced with the problems of large diameter of blood vessels and large thrombus amount, and the current thrombus taking products in other blood vessels cannot be applied or have low effect.
SUMMERY OF THE UTILITY MODEL
In view of this, the utility model aims at providing a basket formula thrombus clearing device aims at providing quick, safe, effectual thrombus clearance mode for big, the embolism treatment of thrombus volume of size such as pulmonary artery embolism to be favorable to improving acute well high risk pulmonary embolism patient's treatment.
In order to solve the technical problem, an embodiment of the utility model provides a basket type thrombus clearing device, include: a distal filter disc, a proximal recovery disc and at least one intermediate thrombectomy disc, which are elastically expandable in radial direction and have a net structure;
the far-end filtering disc, the middle thrombus taking disc and the near-end recovery disc are sequentially and coaxially connected;
in a naturally deployed state, the intermediate embolic disc is flat disc-shaped, and the diameter of the intermediate embolic disc is larger than the diameter of the distal filter disc.
Compared with the prior art, the utility model has the advantages that the basket type thrombus clearing device comprises a far-end filtering disc, a middle thrombus taking disc and a near-end recycling disc which can expand radially and are coaxially connected in sequence, the middle thrombus taking disc is flat disc-shaped in a natural expansion state, the diameter of the middle thrombus taking disc is larger than that of the far-end filtering disc, therefore, when the basket type thrombus clearing device is conveyed to a thrombus position and is fully opened, the middle thrombus taking disc can cut up soft thrombus and collect the soft thrombus in the middle thrombus taking disc by strong supporting force of the middle thrombus taking disc, the thrombus with larger hardness is extruded between the middle thrombus and a blood vessel wall, the thrombus is pulled out of the body when the thrombus clearing device is recycled, the far-end filtering disc can prevent small thrombus from escaping to a far-end blood vessel, when the basket type thrombus clearing device is recycled, the proximal recovery disc can play a guiding role, so that the whole thrombus removing device can be conveniently recovered into the outer sheath tube. Therefore, the basket type thrombus removal device can quickly, effectively and safely remove thrombus with large blood vessel size and large thrombus amount, thereby providing a beneficial scheme for treating acute high-risk pulmonary embolism.
As an example, in a natural deployment state, the axial thickness of the distal filter disk is equal to or greater than the axial thickness of the intermediate embolic disk.
As an example, in the naturally deployed state, the diameter of the intermediate thrombectomy disc may be 10% to 100% larger than the diameter of the vessel to which it is applied.
In one embodiment, the proximal end of the proximal recovery disk is tapered and the distal end of the proximal recovery disk is cylindrical in the natural deployment state.
In one embodiment, the distal filter disc, the middle embolectomy disc, and the proximal recovery disc are integrally braided of superelastic wire, and at least one connecting segment between each disc has a braid density greater than the braid density of the disc body of each disc;
optionally, the number of the middle embolectomy discs is more than 1, and the diameters of the middle embolectomy discs decrease in a gradient manner from the proximal end to the distal end.
In one embodiment, the distal filter disc, the middle embolectomy disc, and the proximal retraction disc are integrally woven from superelastic wires, and at least one of the mesh wires woven into each disc is a visualization wire.
In one embodiment, the number of strands of the developing wires is greater than 1, and each of the developing wires is uniformly distributed on the disk in the circumferential direction.
As an example, the developing wire is an elastic metal wire having developing properties; or
The developing wire comprises an elastic weaving wire and at least one strand of winding wire with developing performance, wherein the winding wire is wound on the elastic weaving wire;
optionally, the number of strands of the winding wire is 2; or
The developing wire comprises: the non-developing silk section and the developing silk section of integrative connection, just developing silk section distributes in each at least the circumference position of disc.
As an embodiment, the developing wire includes: a developing core wire and an elastic shell; the elastic shell is coated on the developing core wire;
optionally, the diameter of the developer core wire is greater than one thousandth of an inch.
As an embodiment, the apparatus further comprises: a push tube and a conical head; the near end of the near end recovery disc is fixedly connected with the far end of the pushing pipe;
the far end of the far-end filter disc is fixedly connected with the near end of the conical head.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings required to be used in the description of the embodiments or the prior art will be briefly introduced below, it should be understood that the drawings in the following description are only embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to the provided drawings without creative efforts.
Fig. 1 is a schematic structural view of a basket-type thrombus removal device according to an embodiment of the present invention;
FIG. 2 is a schematic diagram of an embodiment of a developing wire distribution on a disk;
FIG. 3 is a schematic diagram illustrating a three-dimensional distribution of developing wires according to an embodiment;
FIG. 4 is a schematic view of a developing wire distribution on a disk according to yet another embodiment;
FIG. 5 is a schematic diagram of a winding structure of a developing wire according to an embodiment;
FIG. 6 is a schematic view of a developing wire winding structure according to still another embodiment;
FIG. 7 is a schematic structural view of a developing wire according to still another embodiment;
FIG. 8 is a schematic view of a connecting section of the basket-type thrombectomy device according to an embodiment before stretching;
FIG. 9 is a schematic view of a stretched connecting section of the basket-type thrombectomy device according to an embodiment;
FIG. 10 is a schematic view showing the relationship between the diameters of a plurality of middle thrombectomy discs of the basket-type thrombectomy device according to one embodiment;
FIGS. 11-13 are schematic views illustrating the release state of a plurality of middle thrombectomy discs of the basket-type thrombectomy device according to one embodiment;
fig. 14 to 16 are schematic views illustrating the release and retraction of the basket-type thrombus removal device according to the embodiment of the present invention.
In the figure: the device comprises a basket type thrombus removal device 1, a distalend filtering disc 10, a middlethrombus taking disc 11, a proximalend recovery disc 12, aconical head 13, apushing tube 14, a developingwire 15, anelastic weaving wire 150, awinding wire 151, anelastic shell 152, a developingcore wire 153, a connectingsection 16, anouter sheath tube 2, ablood vessel 3 and thrombus 4.
Detailed Description
In order to make the objects, technical solutions and advantages of the embodiments of the present invention clearer, the following will explain in detail each embodiment of the present invention with reference to the accompanying drawings. However, it will be appreciated by those of ordinary skill in the art that in various embodiments of the invention, numerous technical details are set forth in order to provide a better understanding of the invention. However, the technical solution claimed in the present invention can be realized without these technical details and various changes and modifications based on the following embodiments.
Unless otherwise stated, the proximal and distal ends referred to in the present disclosure have the same meaning in the orientation, i.e., in the use state, the distal end is the end away from the operator, and the proximal end is the end close to the operator, who controls the thrombectomy device at the proximal end.
The embodiment of the utility model provides a basket formula thrombus clearing device is particularly suitable for the breakage of the thrombus that forms in the pulmonary artery blood vessel and clear away, and then not limited to this, should understand, the thrombus clearing device of this embodiment also is applicable to the clearance of the thrombus that other blood vessels size is big, the thrombus volume is big. As shown in figures 1 to 13, the basket-type thrombectomy device 1 comprises adistal filtering disc 10, aproximal recovery disc 12 and at least oneintermediate thrombectomy disc 11, which are elastically expandable in radial direction and have a net structure; the far-end filtering disc 10, the middle thrombus taking disc 111 and the near-end recovery disc 12 are coaxially connected in sequence; in the naturally deployed state, the centralembolic disc 11 is in the shape of a flat disc, and the diameter of the centralembolic disc 11 is larger than the diameter of thedistal filter disc 10. In the specific embodiment of the present invention, the basket-type thrombus removing device 1 may further include a pushingtube 14 and aconical head 13, the proximal end of theproximal recovery disc 12 is fixedly connected to the distal end of the pushingtube 14, and the distal end of thedistal filtration disc 10 is fixedly connected to the proximal end of theconical head 13. The structure of each component, and the positional relationship, connection relationship, and function between them will be described one by one.
Alternatively, in this embodiment, thedistal filter disk 10, theintermediate thrombectomy disk 11, and theproximal recovery disk 12 are all integrally braided from superelastic wire. By way of example and not limitation, thedistal filtering disk 10, themiddle embolectomy disk 11 and theproximal recovery disk 12 may be woven of superelastic nitinol wires, the wire diameter of the nitinol wires may be 0.05-0.25 mm, the woven mesh may be a diamond, rhomboid or equilateral quadrilateral, the woven mesh shapes of the disks may be the same or different, and the mesh size of the distal filteringdisk 10 may be smaller than that of themiddle embolectomy disk 11, so as to filter and intercept small thrombi and prevent the thrombi broken by the middle embolectomy disk from escaping to the distal blood vessel. During the processing of the basket type thrombus removal device, thedistal filtering disc 10, the middlethrombus removal disc 11 and theproximal recovery disc 12 which are coaxially connected and integrally knitted can be obtained after the steps of mould knitting and heat treatment setting. The far end of the far-end filtering disc 10 is fixedly connected with the near end of theconical head 13, the near end of the near-end recovery disc 12 is fixedly connected with the far end of the pushingtube 14, and the conveying, releasing and recovering of the basket type thrombus removing device are controlled by operating the pushingtube 14 and a sheath tube used in cooperation during the use process. In this embodiment, the material and diameter of the mesh wire of the basket-type thrombus removal device and the processing method and process of each disc are not limited at all.
The middlethrombus taking disc 11 is mainly used for fragmenting and catching thrombus. Optionally, in this embodiment, in the natural deployment state, the diameter of themiddle thrombectomy disc 11 is 10% -100% larger than the diameter of the applied blood vessel, so that themiddle thrombectomy disc 11 has better supporting force and does not damage the blood vessel. Preferably, the diameter of themiddle thrombectomy disc 11 is 20% to 30% larger than the diameter of the vessel to which it is applied. Specifically, the diameter of themiddle thrombectomy disc 11 can be designed according to the diameter of the pulmonary artery blood vessel, so that the diameter of the fully expanded middle thrombectomy disc is 20% larger than the diameter of the pulmonary artery blood vessel but not more than 30% of the diameter of the pulmonary artery blood vessel, thereby the supporting force of the middle thrombectomy disc is enough to break and capture most types of thrombi, and the blood vessel can be better protected from being damaged. In this embodiment, thedisk 11 of taking a embolism in the middle of can be regular symmetrical structure for the quotation ofdisk 11 is taken a embolism in the middle of is perpendicular or approximately perpendicular with the round axle, even make thedisk 11 of taking a embolism in the middle of be the chamfer cylindricality, the whole shape is very flat, thereby has very strong radial holding power, on the one hand can be at the open in-process of elasticity with thrombus gomphosis or cut up the thrombus, on the other hand can be when retrieving basket thrombus clearing device, can extrude partial harder thrombus between it and the vascular wall and take out of the body, thereby obtain the thrombus removal effect of preferred.
Thedistal filter disk 10 serves to filter debris flowing toward the distal end during interception of the debris. Optionally, in this embodiment, in the natural deployment state, the diameter of thedistal filtering disk 10 may be smaller than the diameter of the adjacentmiddle embolectomy disk 11 by 1-3 mm, for example, the diameter of thedistal filtering disk 10 may be smaller than the diameter of the adjacentmiddle embolectomy disk 11 by 1mm, 2mm or 3mm, so that the basket-type thrombectomy device conforms to the characteristic that the diameter of the blood vessel decreases toward the distal end as the blood vessel anatomy moves. In addition, the axial thickness of thedistal filter disc 10 is greater than or equal to the axial thickness of themiddle embolectomy disc 11, for example, the axial thickness of thedistal filter disc 10 may be 1-3 times of the axial thickness of themiddle embolectomy disc 11, for example, the axial thickness of thedistal filter disc 10 is 2 times or 3 times of the axial thickness of themiddle embolectomy disc 11, compared with the flat structure of themiddle embolectomy disc 11, the overall shape of thedistal filter disc 10 is more ellipsoidal, and the long axis direction of thedistal filter disc 10 is perpendicular to the axial direction of the basket-type thrombus removal device 1, so the radial supporting force of thedistal filter disc 10 is smaller than that of themiddle embolectomy disc 11, the wall of the distal blood vessel is not easily damaged, and the larger axial thickness thereof can better intercept the escaped thrombus.
The arrangement of theproximal recovery disc 12 is beneficial to smoothly recovering the basket type thrombus removal device 1 into the sheath tube. Alternatively, in this embodiment, in the naturally deployed state, the proximal end of theproximal recovery disk 12 is approximately conical and the distal end of theproximal recovery disk 12 is approximately cylindrical. In other words, the radius of curvature of the arc on the proximal side of theproximal recovery disk 12 is larger than that on the distal side, and for example, as shown in fig. 1, the proximal surface of theproximal recovery disk 12 is formed in an umbrella shape, so that resistance during recovery can be reduced.
On the basis of the above embodiment, further, in this embodiment, the basket-type thrombus removal device 1 further includes a developing structure, so that a doctor can be helped to clearly observe the position and the three-dimensional shape of the basket-type thrombus removal device 1 through an X-ray device in the operation process, so as to achieve a better operation effect. Specifically, in the basket-type thrombus removal device 1, at least one mesh woven into each disk is a developing wire. Preferably, the plurality of strands of mesh woven into each disc is replaced with a developing wire. The plurality of developing wires can be uniformly distributed on each disk along the circumferential direction or randomly distributed on each disk. In one example, as shown in fig. 2 to 3, in the basket-type thrombus removal device 1, 4 mesh wires among the mesh wires woven into the distalend filter disk 10, the intermediatethrombus removal disk 11, and the proximalend recovery disk 12 are replaced with developing wires. Further, the 4 strands of developing wires are uniformly distributed on each disk in the circumferential direction. Any two adjacent visualization wires are arranged at an angle of about 90 degrees when viewed perpendicular to the surface of the disc, so that whether the disc is fully opened and whether the disc interacts with thrombus can be observed from any angle during operation. In another example, as shown in fig. 4, in the basket-type thrombus removal device 1, 8 strands of mesh wires among the mesh wires woven into thedistal filtering disk 10, the middlethrombus removal disk 11 and theproximal recovery disk 12 are replaced with developing wires, and optionally, the 8 strands of developing wires are also uniformly distributed on each disk in the circumferential direction, so that the development of the basket-type thrombus removal device 1 can be more three-dimensionally clear. It is understood that the present embodiment is not particularly limited to the specific number of developing wires and the distribution manner on the disk.
Alternatively, the developing wire in the foregoing embodiment may be an elastic wire having developing properties. By way of example and not limitation, the elastic wire may be made of a metal having a general elasticity but good developing property, such as Pt (platinum), W (tungsten), or Au (gold), or an alloy thereof, or may be made of a developing super-elastic alloy. As an alternative, the developing wire in the basket-type thrombus removal device 1 may include an elastic braided wire and at least one winding wire having developing properties wound around the elastic braided wire. The elastic braided wire may be a superelastic nitinol wire, and the winding wire having developing properties may be made of a metal such as Pt (platinum), W (tungsten), Au (gold), or an alloy thereof. As shown in fig. 5, the developingwire 15 includes anelastic knitting wire 150 and a windingwire 151 having developing performance wound around theelastic knitting wire 150. In other examples, as shown in fig. 6, the developingwire 15 may include: one strand of theelastic braided wire 150 and two strands of the windingwires 151 having developing ability wound around theelastic braided wire 150 can reduce the amount of the metal wire having developing ability and improve the developing ability by winding a plurality of strands of the winding wires having developing ability.
As another alternative, as shown in fig. 7, the developingwire 15 may include: the developing device comprises anelastic shell 152 and a developingcore wire 153, wherein theelastic shell 152 covers the developingcore wire 153. The developingcore wire 153 may be made of metals such as Pt (platinum), W (tungsten), Au (gold), or alloys thereof, and theelastic casing 152 may be made of super-elastic nitinol. Further, by way of example and not limitation, the diameter of thedeveloper core wire 153 may be greater than one thousandth of an inch, but less than or equal to the diameter of the other mesh wires. By coating theelastic shell 152 on the developingcore wire 153, the developingwire 15 not only has good developing performance, but also theelastic shell 152 can improve the elasticity of the developing wire and make the elasticity closer to other mesh wires compared with the case of directly adopting a metal wire with general elasticity but developing performance as the developing wire, so that the mesh basket type thrombus removal device 1 has good developing performance and good elasticity. As a further alternative, the developing wire comprises a super-elastic wire section and a developing wire section which are integrally connected, and the developing wire section is at least distributed at the circumferential position of each disk. The embodiment of the developing wire is not particularly limited in this example.
Alternatively, on the basis of the above-mentioned embodiment, as shown in fig. 8, the knitting density of at least one connecting section between the disks of the basket-type thrombectomy device 1 is greater than the knitting density of the disk bodies of the disks. For example, the braiding density of all the connectingsegments 16 between thedistal filter disc 10, themiddle embolectomy disc 11 and theproximal recovery disc 12 is denser, while the braiding density of the respective disc bodies of thedistal filter disc 10, themiddle embolectomy disc 11 and theproximal recovery disc 12 is relatively thinner, or the braiding density of only one or a part of the connectingsegments 16 may be denser, which is not particularly limited herein. As shown in fig. 9 and 10, the distance between the discs of the basket-type thrombectomy device 1 is schematically shown before and after the connectingsections 16 are stretched, so that the axial length of the basket-type thrombectomy device of the present embodiment can be adjusted by stretching the length of the connecting sections with a dense knitting density, i.e., the basket-type thrombectomy device has a variable length, thereby enabling the basket-type thrombectomy device to be suitable for embolotherapy with different thrombus lengths during the operation, which is beneficial to improving the therapeutic effect.
On the basis of the above embodiment, as shown in fig. 10, the number of themiddle thrombectomy disks 11 of the basket-type thrombectomy device 1 is more than 1. Further, the diameter of each of theintermediate disks 11 decreases in a gradient from the proximal end to the distal end. For example, there may be 3middle thrombectomy disks 11 of the basket-type thrombectomy device 1, and the diameter of eachmiddle thrombectomy disk 11 decreases from the proximal end to the distal end. The basket type thrombus removal device can conform to the taper shape change of the blood vessel from near to far, and is favorable for protecting the blood vessel. In addition, as shown in fig. 11 to 13, the doctor can select the required embolectomy basket length of the corresponding lesion segment blood vessel by controlling the number of the releasedmiddle embolectomy disks 11 in the operation process. The present embodiment is not particularly limited to the specific number of the intermediate disks and the relationship between the diameters of the intermediate disks.
With reference to fig. 14 to 16, the usage of the basket-type thrombus removal device according to the embodiment of the present invention comprises the following steps:
in the thrombus clearing interventional operation treatment, an instrument interventional channel is established in a femoral vein vessel through a puncture needle, a puncture sheath, a guide wire and a contrast catheter. Guiding the catheter to the position of the blocked blood vessel through an intravascular interventional channel technology, and then carrying out selective radiography to determine the position of the blood vessel where the thrombus is. The replacement angiographic catheter is a super hard guide wire (the guide wire is introduced and then withdrawn from the catheter). The catheter of the matchedsheath 2 is guided into the position of theblood vessel 3 where the thrombus 4 is positioned by the guide wire. Take out the basket type thrombus removing device 1 of the embodiment of the utility model, enter the body through theouter sheath tube 2 until the thrombus 4 is judged to be in the middle part of the basket type thrombus removing device 1 through developing. Withdrawing theouter sheath tube 2, releasing the basket type thrombus clearing device 1 at the thrombus 4, judging whether each disc at the position of the thrombus 4 is completely opened and acts with the thrombus through X-ray development, standing for a period of time, and ensuring that the thrombus is embedded with the opened disc for enough time. Then the thrombus is collected into theouter sheath tube 2 by withdrawing the basket type thrombus removing device 1, and finally the thrombus is taken out of the body. In the process of thrombus removal, the thrombus can be sucked into the catheter in an auxiliary way by sucking theouter sheath tube 2. Finally, the catheter is withdrawn from the body, and the wound is sutured, thereby completing the operation.
The basket type thrombus removing device provided by the embodiment is used for crushing and capturing thrombus through the supporting force of the middle thrombus taking disc, filtering and intercepting escaping small thrombus through the far-end filtering disc, so that the thrombus with large blood vessel size and large thrombus amount can be rapidly, safely and effectively removed, and the basket type thrombus removing device is particularly suitable for treating acute high-risk pulmonary embolism. In addition, the embodiment of the invention replaces the mesh wire with the developing wire to weave the mesh basket type thrombus removing device, thereby being very convenient for observing the position and the three-dimensional shape of the mesh basket type thrombus removing device in the blood vessel, and improving the convenience and the success rate of the operation. In addition, the basket type thrombus removal device of the embodiment can also adjust the length of the basket type thrombus removal device by stretching the connecting section between the disks with larger weaving density, or adjust the length of the thrombus removal device by controlling the number of the released middle thrombus removal disks, so that the thrombus removal device can flexibly adapt to different thrombus lengths, and the universality of the thrombus removal device is improved.
It will be understood by those skilled in the art that the foregoing embodiments are specific examples of the invention, and that various changes in form and details may be made therein without departing from the spirit and scope of the invention in its practical application.

Claims (10)

CN202022312983.6U2020-10-162020-10-16Basket type thrombus removing deviceActiveCN213963548U (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication numberPriority datePublication dateAssigneeTitle
CN112089477A (en)*2020-10-162020-12-18上海腾复医疗科技有限公司Basket type thrombus removing device

Cited By (2)

* Cited by examiner, † Cited by third party
Publication numberPriority datePublication dateAssigneeTitle
CN112089477A (en)*2020-10-162020-12-18上海腾复医疗科技有限公司Basket type thrombus removing device
CN112089477B (en)*2020-10-162025-01-14上海腾复医疗科技有限公司 Basket-type thrombectomy device

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