CN116407226A - An adjustable rotary cutting structure and adjustable rotary cutting suction device - Google Patents

Abstract

The invention provides an adjustable rotary cutting structure and an adjustable rotary cutting suction device. The adjustable rotary cutting structure comprises a rotary cutting end part, a plurality of cutter heads and an operation piece, wherein the cutter heads are divided into n cutter head groups according to respective rotary cutting lengths, and each cutter head group at least comprises one cutter head; each cutter head is movably arranged at the rotary-cut end part, the rotary-cut end part is provided with a groove body at the position corresponding to the cutter head, and the cutter head is provided with a blade part; the control piece is used for controlling at least one cutter head in at least one cutter head group to switch between the first relative position and the second relative position; in the first relative position, at least the blade part of the cutter head is positioned in the groove body; in the second relative position, at least a portion of the blade portion of the cutter head is located outside the slot. The user can control the cutter heads with different rotary cutting lengths to finish the instant adjustment in the blood vessel, thereby avoiding the cutter head replacement in vitro, improving the adaptability of the device and simplifying the operation process.

Description

An adjustable rotary cutting structure and adjustable rotary cutting suction device

technical field

The invention relates to the technical field of medical devices, in particular to an adjustable rotary cutting structure and an adjustable rotary cutting suction device.

Background technique

Atherosclerosis is a common vascular disease, and there may be no clinical manifestations in the early stage. When the blood vessels are narrowed to a certain extent, ischemic symptoms will appear, which can be manifested as angina pectoris, intermittent claudication and other symptoms; if the plaque is unstable and ruptures, A thrombus will form on the basis of the rupture, and the shedding of the thrombus will lead to serious consequences such as cerebral infarction, myocardial infarction, and even death.

Currently commonly used plaque or thrombus removal devices can only be removed according to the degree of vascular stenosis caused by plaque or thrombus in a certain part. For further resection, the device needs to be withdrawn from the body and the cutter heads of different lengths need to be replaced, so that the device needs to be changed more frequently during use, the operation is cumbersome, and the operation time is prolonged.

Contents of the invention

The purpose of the present invention is to provide an adjustable rotary cutting structure and an adjustable rotary cutting suction device for removing plaque or thrombus in blood vessels, which can avoid changing the knife outside the body and simplify the operation.

In order to achieve the above object, the present invention provides an adjustable rotary cutting structure on the one hand, including a rotary cutting end, several cutter heads and a control member, and the several cutter heads are divided into n cutter heads according to their respective rotary cutting lengths. group, each of the cutter head groups includes at least one cutter head, and the n is a positive integer greater than 1; each cutter head is movably installed on the rotary cutting end, and the rotary cutting end A groove is provided at the head, and a blade is provided on the cutter head; there are a first relative position and a second relative position between the cutter head and the rotary cutting end, and the control member is used to control at least one At least one of the cutter heads in the cutter head group is switched between the first relative position and the second relative position; at the first relative position, at least the cutting edge of the cutter head is located at the In the groove; when in the second relative position, at least part of the blade of the cutter head is located outside the groove.

Another aspect of the present invention provides an adjustable rotary cutting suction device, which includes a suction catheter and the above-mentioned adjustable rotary cutting structure, and the adjustable rotary cutting structure is arranged at the distal end of the suction catheter.

Compared with the prior art, the adjustable rotary cutting structure and the adjustable rotary cutting suction device of the present invention are equipped with a plurality of cutter head groups with different rotary cutting lengths for rotary cutting plaque or thrombus in blood vessels, and each cutter head group At least one cutter head is included, the cutter head is movably installed on the end of the rotary cutting, and the control member can control the blade of the cutter head to be located in the groove on the rotary cutting end or extend out of the groove, the user can according to different parts in the blood vessel, In the case of different stenosis, the cutter heads of different lengths are controlled respectively to complete real-time adjustment in the blood vessel, so as to resect the plaque and thrombus correspondingly, avoiding the process of replacing the cutter head outside the body, improving the adaptability of the device, and simplifying the operation process , saving operation time.

Description of drawings

Fig. 1 is the overall schematic diagram of the adjustable rotary cutting structure of the embodiment of the present invention;

Fig. 2 is a partial three-dimensional exploded schematic diagram of the adjustable rotary cutting structure of the embodiment of the present invention;

Fig. 3 is a schematic diagram of the locking state of the manipulation member in the embodiment of the present invention;

Fig. 4 is a schematic diagram of the unlocking state of the control member in the embodiment of the present invention;

Fig. 5 is a three-dimensional structural schematic diagram of the cutter head in the adjustable rotary cutting structure of the embodiment of the present invention;

Fig. 6a is a schematic diagram of the first arrangement of multiple cutter heads in the adjustable rotary cutting structure of the embodiment of the present invention;

Fig. 6b is a schematic diagram of a plurality of cutter head groups arranged on a plane in Fig. 6a;

Fig. 6c is a schematic diagram of the cutter head on a plane in Fig. 6a being located in the groove;

Fig. 7 is a schematic diagram of a second arrangement of multiple cutter heads in the adjustable rotary cutting structure of the embodiment of the present invention;

Fig. 8 is a schematic view from another angle of view of the second arrangement of multiple cutter heads in the adjustable rotary cutting structure of the embodiment of the present invention;

Fig. 9 is a schematic diagram of a third arrangement of multiple cutter heads in the adjustable rotary cutting structure of the embodiment of the present invention;

Fig. 10 is an exploded schematic diagram of the structure of the adjustable rotary cutting suction device according to the embodiment of the present invention;

11 is a schematic cross-sectional view of the distal end of the adjustable rotary cutting suction device according to the embodiment of the present invention;

Fig. 12 is a schematic diagram of the working state of the adjustable rotary cutting suction device according to the embodiment of the present invention.

1. End of rotary cutting; 2. Cutter head; 21. Blade; 22. Cutting head; 23. Base; ; 44, push rod; 45, annular groove; 5, torsion spring; 51, spiral main body; 52, straight section; 6, connecting ring; 7, suction conduit; 71, injection port; Introducer sheath; 10, balloon.

Detailed ways

In order to enable those skilled in the art to better understand the present invention, the following will clearly and completely describe the technical solutions in the embodiments of the present invention. Obviously, the described embodiments are only a part of the present invention, rather than Full examples.

In the description of the present invention, it should be noted that, unless otherwise specified and limited, the terms "installation", "connection", "connection", and "set on..." should be understood in a broad sense, for example, it can be A fixed connection can also be a detachable connection or an integral connection; it can be a mechanical connection; it can be a direct connection or an indirect connection through an intermediary, and it can be an internal communication between two elements. In the field of interventional medical devices, the proximal end refers to the end closer to the operator, while the distal end refers to the end farther away from the operator; the axial direction refers to the direction parallel to the line between the center of the distal end and the center of the proximal end of the medical device. , the radial direction refers to the direction along the diameter or radius, the radial direction and the axial direction are perpendicular to each other, and the circumferential direction refers to the circumferential direction around the central axis. Those of ordinary skill in the art can understand the specific meanings of the above terms in the present invention in specific situations.

The embodiment of the present invention firstly discloses an adjustable rotary cutting structure. As shown in FIG. 1 and FIG. 2 , the adjustable rotary cutting structure includes a rotary cutting end 1 , several cutter heads 2 and a control member 4 . Referring to FIG. 6a to FIG. 9 , the several cutter heads 2 are divided into n cutter head groups according to their rotary cutting lengths L, where n is a positive integer greater than 1. At least one cutter head 2 is included in each cutter head group, and the rotary cutting length of each cutter head 2 in the same cutter head group is equal, and the cutter head 2 in one cutter head group is connected with the cutter head in another cutter head group. 2 The rotary cut lengths are not equal. Each cutter head 2 is movably installed on the rotary cutting end 1 , and several grooves 3 are arranged on the rotary cutting end 1 , and a blade 21 is arranged on the cutter head 2 . There is a first relative position and a second relative position between the cutter head 2 and the rotary cutting end 1, and the control member 4 is used to control at least one cutter head 2 in each cutter head group in the Switch between the first relative position and the second relative position; in the first relative position, the edge 21 of the controlled cutter head 2 is located in the groove 3 (as shown in FIG. 6c); At the second relative position, at least part of the cutting edge 21 of the cutter head 2 is located outside the groove body 3 (as shown in Fig. 6a, Fig. 7, Fig. 8 and Fig. 9).

Wherein, in the second relative position, the cutter head 2 is in an open state, and the blade portion is located outside the groove body 3. At this time, the whole adjustable rotary cutting structure can be rotated so that the blade portion 21 of the cutter head 2 can detect the plaque in the blood vessel. Or thrombus undergoes rotary excision. When in the first relative position, the cutter head 2 is outside the storage state, and the blade portion 21 is hidden in the groove body 3 and covered by the groove body 3. At this time, if the entire adjustable rotary cutting structure is moved in the axial direction, the knife Head 2 will not cause damage to the vessel wall.

As shown in FIG. 6 b , the rotary cutting length L refers to the distance between the cutting edge 21 and the central axis of the rotary cutting end 1 when the cutter head 2 is fully opened (or when the cutter head 2 extends radially). The rotary cutting length of cutter head 2 in different cutter head groups can be set as required, but the maximum rotary cutting length of each cutter head 2 should not exceed the blood vessel radius, so as not to damage the blood vessel wall; the minimum rotary cutting length of cutter head 2 should be Greater than 1mm, in order to pre-expand the narrowest part of the thrombus.

In the embodiment of the present invention, there may be 2 sets, 3 sets or more sets of cutter heads with different rotary cutting lengths. Optionally, the total number of cutter heads 2 in each cutter head group can be 1 to 9, and different numbers of cutter heads 2 can be set as required.

The adjustable rotary cutting structure provided by the embodiment of the present invention is provided with a plurality of cutter head groups with different rotary cutting lengths, each cutter head group includes at least one cutter head 2, and the cutter head 2 is movably installed on the rotary cutting end 1, and the control The part 4 can control the cutting edge 21 of the cutter head 2 to be located in the groove body 3 provided on the rotary cutting end 1 or protrude out of the groove body 3. The user can control the different parts and different degrees of stenosis in the blood vessel respectively. The cutter head 2 of the rotary cutting length is adjusted in real time in the blood vessel to perform corresponding excision of plaque and thrombus, avoiding the process of replacing the cutter head 2 outside the body, improving the adaptability of the device, simplifying the operation process, and saving operation time.

Optionally, the number of manipulators 4 is at least equal to the number of cutter head groups (that is, n), and one manipulator 4 corresponds to control a cutter head group; at most it is equal to the number of all cutter heads 2, and one manipulator 4 corresponds to control A single cutter head 2. A control member 4 can correspondingly control at least one cutter head 2 in a cutter head group to switch between a first relative position and a second relative position. Preferably, one control member 4 can be used to control all the cutter heads 2 in a cutter head group, avoiding the process of the user needing to control the control members 4 one by one to control the cutter heads 2 one by one, which is more convenient to operate.

As shown in FIG. 3 and FIG. 4 , several manipulation elements 4 may be arranged at intervals along the circumferential direction. According to different parts and different stenosis conditions in the blood vessel, the user can select and control the cutter head 2 with a suitable rotary cutting length to the second relative position through the corresponding control member 4, and perform rotary cutting on plaque and thrombus. In particular, each control member 4 can sequentially control at least one cutter head 2 in different cutter head groups to switch between the first relative position and the second relative position according to the order of rotary cutting length from small to large. Part 4 first controls the cutter head 2 with the smallest rotary cutting length to perform position conversion and implement rotary cutting; then another control member 4 controls the second smallest rotary cutting length cutter head 2 to perform position conversion and perform rotary cutting; advance in sequence, Until the control member 4 controls the cutter head 2 with the largest rotary cutting length to perform position conversion and perform rotary cutting. The advantage of this setting is that, for blood vessels with severe stenosis, the plaque or thrombus can be sliced progressively layer by layer.

Specifically, as shown in FIG. 5 , the cutter head 2 includes a cutting head 22 and a base 23 , the blade 21 is located on the cutting head 22 , the cutting head 22 is fixed on the base 23 , and the base 23 is movably installed in the tank body 3 . Among them, the cutting head 22 and its blade 21 are mainly used for excision and comminution of thrombus or plaque; In the working state, the control member 4 drives the cutter head 2, so that the cutting head 22 and the blade portion 21 protrude from the groove body 3 of the cutting end 1, and the thrombus or plaque on the inner wall of the blood vessel is removed and crushed; In the working state, the cutting head 22 and the blade portion 21 are housed in the groove body 3 and no longer touch the blood vessel wall, so as to avoid scratching the blood vessel arm. More specifically, the base 23 can be in the form of an annular body, and the cutting head 22 is fixed on the outer wall of the annular body; the base 23 is arranged in the groove body 3 of the rotary cutting end 1, and can rotate in the groove body 3, so that The cutting head 22 connected on the outer wall of the base 23 protrudes from the tank body 3 or turns into the tank body 3 . Further, as shown in FIG. 2 and FIG. 6 a to FIG. 9 , the axial direction of the base 23 is substantially perpendicular to the extending direction of the tank body 3 , so that the rotation of the base 23 in the tank body 3 is not hindered. The base 23 and the cutting head 22 can be made integrally, or can be made separately and then connected by means of laser welding or the like. Preferably, the base 23 and the cutting head 22 are integrally constructed.

As shown in Figures 2 and 5, the cutter head 2 also includes an elastic member 5, which is connected to the base 23 and the rotary cutting end 1 respectively, and the elastic member 5 is used to drive the cutter head 2 to switch from the first relative position to The second relative position is maintained at the second relative position. The elastic force of the elastic member 5 makes the cutter head 2 switch from the first relative position (storage state) to the second relative position (open state) and remains in the second relative position, so as to keep the cutter head 2 to implement the rotary cutting during the rotary cutting process. Stable in length.

In particular, the manipulating member 4 includes a pulling wire 41, the pulling wire 41 is connected with the elastic member or the base 23, and the pulling wire 41 is used to drive the cutter head 2 from the first relative position. transition to the second relative position.

Preferably, the elastic member 5 is a torsion spring 5 . The torsion spring 5 includes a helical body 51 fixed in the base 23 and a straight section 52 passing through the base 23 from the helical body 51 .

Referring back to FIG. 3 and FIG. 4 , the manipulator 4 includes a pull wire 41 and an operation switch 43 connected to the pull wire 41 , the operation switch 43 is used to allow the pull wire 41 to move or to lock the pull wire 41 in position.

The pulling wire 41 can be connected with the torsion spring 5 or the base 23 , and the pulling wire 41 can move axially in the tank body 3 . For example, the pull wire 41 is connected to the base 23, and the helical body 51 of the torsion spring 5 has a torsional force all the time. If the pull wire 41 is not locked and does not provide pulling to the base 23, the torsion spring 5 will make the cutter head under the action of its own elastic force. The cutting head 22 in 2 exposes the groove body 3, and the cutting head 2 is kept in the second relative position by the torsion spring 5. But when the torsion spring 5 is stressed by pulling the traction line 41 and the force applied by the traction line 41 to the base 23 can overcome the self elastic force of the torsion spring 5, since the straight section 52 of the torsion spring 5 is fixed on the rotary cutting end 1, The pulling wire 41 can drive the torsion spring 5 to rotate, so as to drive the base 23 and the cutting head 22 to rotate, so that the cutting head 22 turns into the tank body 3; after that, the position of the pulling wire 41 is locked, so that the cutting head 22 can be kept in the Inside the tank body 3. The end that the helical body 51 is connected with the straight section 52 is the first end, and the other end is the second end, preferably the straight section 52 of the torsion spring 5 is tangent to the first end of the helical main body 51; The angle between the second ends is preferably 90 degrees to ensure that the cutting head 22 can stretch out of the groove body 3 after turning 90 degrees, and after the rotation, the cutter head 2 is perpendicular to the axial direction of the rotary cutting end 1, thereby obtaining a larger and more stable Rotary cutting length is more ergonomic. Of course, in some other embodiments, the pulling wire 41 can also be connected to the other end of the torsion spring 5 , and can directly exert force on the torsion spring 5 to drive the torsion spring 5 to rotate.

The base 23, the cutting head 22 and the torsion spring 5 are all made of metal materials, preferably stainless steel or nickel-titanium alloy.

Specifically, the operation switch 43 has a cylindrical structure and is provided with several axial slots 42. The control member 4 also includes a push rod 44, which is connected to the pull wire 41, and the push rod 44 is installed in the axial slot 42, which can Axially move along the axial groove 42, each push rod 44 is connected to one or more traction wires 41 respectively, several push rods 44 are installed on the operation switch 43 at intervals along the circumferential direction, by controlling the movement of the push rod 44 to Make the cutter heads 2 in the first relative position or the second relative position to realize the control of one or more cutter heads 2 . The operating switch 43 is provided with an annular groove 45, the axial groove 42 communicates with the annular groove 45, and the proximal end of the push rod 44 is provided with a stopper 441 perpendicular to the push rod 44, when the push rod 44 is pulled toward the proximal end When the stopper 441 is close to the annular groove 45, the push rod 44 is rotated so that the stopper 441 is inserted into the annular groove 45, and the stopper 441 can be restricted by the groove wall of the annular groove 45, so that the push rod 44 and the pulling wire 41 is in a locked state, so that the cutter head 2 remains in the first relative position. When the control block 441 breaks away from the annular groove 45, the lock is unlocked, and the rotation of the torsion spring 5 can drive the pull wire 41 and the push rod 44 to move axially to the far end, and the cutter head 2 is converted to and remain in the second relative position.

The plurality of cutter heads 2 in each cutter head group can have various arrangements.

Exemplarily, as shown in FIG. 6 a , there are several grooves 3 spaced apart from each other along the circumference of the rotary cutting end 1 , and one or more cutter heads 2 are arranged in each groove 3 . Wherein, each groove body 3 extends a certain length on the rotary-cut end part 1 along the axial direction, and the groove body 3 penetrates the distal surface of the rotary-cut end part 1 . Multiple cutter heads 2 can be accommodated in one tank body 3 , but there is an axial distance between two adjacent cutter heads 2 so as not to interfere with any cutter head 2 turning into the tank body 3 .

6a to 6c, the adjustable rotary cutting structure has several planes perpendicular to the axial direction of the rotary cutting end 1 (P1, P2, P3 as shown in Figure 6a), and each plane is provided with multiple rotary cutting lengths. Different different cutter head groups (g1, g2, g3, g4, g5, g6 as shown in Figure 6b), each cutter head group includes at least one cutter head 2 of specific rotary cutting length; or in other words, in adjustable rotary cutting The structure is provided with a plurality of cutter head circles along its axial direction, each cutter head ring includes a plurality of cutter head groups with different rotary cutting lengths arranged around the circumference, and each cutter head group includes at least one cutter head 2 with a specific rotary cutting length. The above-mentioned plane can be understood as the plane where the sharpest point of each cutter head 2 is located on each cutter head circle. In this embodiment, among the plurality of cutter heads 2 of a plurality of different cutter head groups on the same plane, at least some of the cutter heads 2 are arranged in sequence along the circumferential direction of the rotary cutting end 1 according to the order of the rotary cutting length from small to large, as shown in As shown in Fig. 6b, there are six cutter head groups g1, g2, g3, g4, g5, g6 on one plane, and each cutter head group includes one cutter head. In the clockwise direction, the rotary cutting lengths of the cutter head groups g1 to g6 respectively corresponding to the cutter head 2 increase sequentially. Understandably, they may also be arranged sequentially in a counterclockwise direction. The length difference between two adjacent cutter heads 2 in the circumferential direction is preferably 0.05 mm, which is convenient for progressive rotary cutting of plaque or thrombus.

Referring to FIG. 1 , the adjustable rotary cutting structure further includes at least one connecting ring 6 , and one connecting ring 6 corresponds to the base 23 of a plurality of cutter heads 2 connected in series on a plane. The connecting ring 6 is used to provide a limit function and a rotation origin for the cutter head 2. The connecting ring 6 is arranged around the circumference, passes through a plurality of grooves 3 in turn, and passes through the base 23 and the base of each cutter head 2 on a plane in turn. The inside of the torsion spring 5 connects a plurality of cutter heads 2 in series, and makes the base 23 only rotate around the connecting ring 6 without moving axially relative to the rotary cutting end 1 or falling off from the rotary cutting end 1 . The retaining ring 6 can be made of metal materials such as nickel-titanium alloy.

In the arrangement form shown in Fig. 6a, it is not strictly limited that the rotary cutting lengths of two axially adjacent cutter heads 2 in the same groove body 3 are the same or different, that is, in the same groove body, the two adjacent cutter heads 2 on two adjacent planes The rotary cutting length of the cutter head 2 is not limited, and may be equal or unequal. Preferably, for two adjacent planes, the rotary cutting length of at least one cutter head 2 on the proximal side plane is greater than the rotary cutting length of at least one cutter head 2 on the distal side plane.

The arrangement shown in Fig. 7 and Fig. 8 is different from that in Fig. 6, different cutter head groups are divided according to the axial direction, and the same tank body 3 includes a plurality of different cutter head groups, and each cutter head group includes at least one cutter head 2, but All the cutter heads on each plane or on each cutter head circle belong to one cutter head group, that is, the rotary cutting lengths are the same. Preferably, the plurality of cutter heads in the same tank body 3 increase according to the direction from far to near or from near to far; more preferably, according to the direction from far to near, that is, for two adjacent planes, the The rotary cutting length of the cutter head 2 on the plane is greater than the rotary cutting length of the cutter head 2 on the plane on the distal end side. The cutter head 2 with the smallest rotary cutting length is close to the distal end of the rotary cutting end 1 , and the cutter head 2 with the largest rotary cutting length is close to the proximal end of the rotary cutting end 1 . The arrangement of cutter heads shown in Figure 7 is similar to forming a tapered structure, which can progressively cut plaque or thrombus.

As shown in Figure 9, another arrangement form of a plurality of cutter heads 2 is: only one cutter head 2 is set in a groove body 3, and according to the direction from the far end to the proximal end of the rotary cutting end, the cutter heads 2 on each plane The rotary cutting length increases sequentially, and at the same time increases sequentially in the circumferential direction, forming a spiral arrangement of progressive rotation.

It can be understood that the arrangement of the plurality of cutter heads 2 is not limited to the above-mentioned types, and may be a combination of any two arrangement forms, such as multiple cutter heads 2 comprising a plurality of different cutter head groups on each plane, and Among the multiple cutter heads 2 of multiple different cutter head groups on the same plane, at least some of the cutter heads 2 are arranged sequentially along the circumferential direction in order of the rotary cutting length from small to large; at the same time, in the axial direction, for two adjacent A plane, the rotary cutting length of at least one cutter head 2 located on the plane of the proximal side is greater than the rotary cutting length of at least one cutter head 2 located on the plane of the distal side.

Please refer to Fig. 10 and Fig. 11, another aspect of the present invention discloses an adjustable rotary cutting suction device, including a suction conduit 7 and the above-mentioned adjustable rotary cutting structure, the adjustable rotary cutting structure is arranged on the Suction the distal end of the catheter 7 . The suction catheter 7 is a hollow tube with a certain length, and the hollow lumen is used to connect to an external pressure device, so as to suck thrombus or plaque in the blood vessel out of the body through the suction catheter 7 . The hollow lumen of the suction catheter 7 runs through to the distal end as a suction port, through which plaque or thrombus flows into the suction catheter 7, and the surface of the suction port is smoothed to avoid tissue damage.

Specifically, as shown in FIG. 11 , the rotary cut end can be a part of the distal end structure of the suction catheter 7 , and can also be detachably mounted on the distal end of the suction catheter 7 . 3 and 4, the operation switch 43 of the control member 4 is located at the proximal end of the suction catheter 7 and is connected to the proximal end of the pull wire 41 through the push rod 44, and the pull wire 41 can be movably worn on the suction catheter 7. In the threading cavity (not marked) in the side wall, the distal end of the pulling wire 41 is connected to the torsion spring 5 or the knife seat 23 in the knife head 2, so that different rotary cuttings can be remotely controlled outside the patient’s body by operating the switch 43 and the push rod 44. The cutting head 22 of the length of the cutting head 2 protrudes and turns into the groove body 3 . The pulling wire 41 can be made of stainless steel, nickel-titanium alloy and other materials that are not easily deformed and have certain strength. The width of the tank body 3 is adapted to the width of the base 23 of the cutter head 2, and the unilateral gap is controlled between 0.05-0.1mm, which can not only ensure the smooth rotation of the base 23, but also prevent the base 23 from shaking greatly. The length of the tank body 3 is controlled between 3-10mm to avoid damage to the structure of the distal end of the suction catheter 7 caused by the excessive length of the tank body 3; the depth of the tank body 3 is more than 0.1mm higher than the height of the base 23, which can ensure the 2 Before it is used, it can all be accommodated in the tank body 3, which improves the safety of the device.

Optionally, referring to FIG. 1 , the suction conduit 7 is provided with several injection ports 71 near the adjustable rotary cutting structure. One end of the injection port 71 is open, and the other end is connected to the lumen of the suction catheter 7. Before the cutter head 2 works, the drug can be injected through the injection port 71 to soften the thrombus and facilitate the subsequent operation of the device; optionally, the injection port 71 It is a continuous or discontinuous linear structure with a width of less than 0.1mm and a length of 3-6mm, which is convenient for increasing the injection pressure and expanding the injection range of the drug.

Optionally, as shown in Figure 11 and Figure 12, the adjustable rotary cutting suction device also includes a support catheter 8 and an introducer sheath 9, the support catheter 8 is movably worn in the introducer sheath 9, and the suction The conduit 7 is movably threaded in the support conduit 8 . The catheter sheath 9 is a hollow tubular body with a certain length, which is located on the outermost layer of the entire adjustable rotary cutting suction device, and is used to establish a passage from the outside to the body, and the hollow lumen accommodates the support catheter 8 assembly and the suction catheter 7 Assembly, its near end can be connected with operating handle (not shown).

Wherein, the distal end of the support catheter 8 is also provided with an expandable balloon 10 , and passing liquid into the balloon 10 can make the balloon 10 inflated, so as to support the suction catheter 7 . Specifically, the support catheter 8 is usually a multi-lumen tube, one of which through the cavity is used for accommodating the suction catheter 7 and providing support for the suction catheter 7, and the other cavity is used for inflation and decompression of the balloon 10. fluid passage. In this embodiment, a coaxial double-chamber structure is adopted, the inner chamber is used to accommodate the suction catheter 7 , and the outer chamber is used as the filling chamber of the balloon 10 . And the inner diameter of the inner cavity of the support catheter 8 is adapted to the outer diameter of the rotary cutting suction catheter 7, and the radial gap is between 0.02-0.1 mm, which is beneficial to provide support for the suction catheter 7 and ensure that the suction catheter 7 It can rotate smoothly, and there is no large deflection between the suction catheter 7 and the support catheter 8, so as to ensure that the entire adjustable rotary cutting suction device can work more safely and effectively. After the plaque or thrombus is removed, the suction The space formed between the catheter 7 and the vessel wall is approximately coaxial with the vessel wall.

When the balloon 10 is inflated, as shown in FIG. 12 , the balloon 10 is attached to the inner wall of the introducer sheath 9, thereby providing support force for the support catheter 8, limiting the relative movement between the support catheter 8 and the introducer sheath 9, thereby supporting The conduit 8 can provide support for the suction conduit 7 . It can be understood that, when the balloon 10 is inflated or depressurized, the suction catheter 7 can realize the rotary cutting and suction functions of the plaque or thrombus, but after the balloon 10 is completely inflated, the suction catheter 7 can Provide better support, when the distal end of the suction catheter 7 encounters a larger, more viscous thrombus or plaque, you can increase the suction or select and control the appropriate cutter head 2 to perform rotary cutting without suction The catheter 7 vibrates or deviates greatly to achieve a better rotary cutting effect and improve the safety of use.

The adjustable rotary cutting suction device of the embodiment of the present invention also includes an electric pump group connected to the proximal end of the suction catheter 7 . The electric pump set is an external device, which may include a suction pump and a power pump, wherein the suction pump is an external negative pressure device used to provide power for continuous negative pressure suction; the power pump is used to provide rotational power for the suction conduit 7 , so that the cutter head 2 can rotate at a high speed, thereby rotary cutting and crushing thrombus or plaque.

Taking the removal of plaque in arteries as an example, the working process of the adjustable rotary cutting suction device in this embodiment is described in detail below:

S1. Puncture through the femoral artery or radial artery, under the guidance of the guide wire, use the catheter sheath 9 to establish an in vitro-in vivo passage, and then transport the support catheter 8 and the rotary cutting suction catheter 7 along the guide wire until the adjustable rotary cutting The suction device reaches the narrowed or occluded lesion of the blood vessel. During this process, the cutter head 2 and the support conduit 8 are all in a non-working state, the push rod 44 is locked on the operation switch 43, the pull wire 41 is in a stretched state, and the pull wire 41 pulls the torsion spring 5 in a compressed state, and all the cutter heads 2 is located in the tank body 3, that is, it is in the first relative position.

S2. Inflate the balloon 10 supporting the catheter 8 so that the balloon 10 sticks to the inner wall of the catheter sheath 9, thereby restricting the relative movement between the supporting catheter 8 and the catheter sheath 9, and then injecting medicine through the injection port 71 to treat thrombus or The plaque is softened.

S3. If there is only thrombus or small-sized plaque in the blood vessel, there is no need to switch the position of the cutter head 2 at this time, just turn on the suction pump to continue suction; if there is a large-sized or high-viscosity plaque in the blood vessel Thick, high-hardness thrombus and/or plaque, you need to select and control the cutter head 2 suitable for the length of the rotary cutting to perform thrombus/plaque excision and comminution: unlock the push rod 44, make the push rod 44 move to the distal end, and pull the wire 41. As the push rod 44 moves forward and relaxes, the torsion spring 5 is no longer constrained by the traction wire 41, and the torsion force of the torsion spring 5 drives the cutting head 22 of the corresponding cutter head 2 to rotate approximately 90° to switch to the second relative position. The axis of the received cutter head 2 and the suction conduit 7 is in a substantially vertical state.

S4. Manually or through an external power pump to drive the suction catheter 7 and the cutter head 2 to rotate, and at the same time use the suction pump to suction, so that the thrombus and pulverized plaque are sucked out from the suction port.

Optionally, the cutter heads 2 with different rotary cutting lengths can be operated separately according to the occlusion or stenosis of the blood vessel, firstly use the cutter head 2 with the smallest rotary cutting length to pre-expand the lesion, and then progressively select the rotary cutting length A plurality of cutting heads 2 are increased to remove plaque or thrombus layer by layer, which is beneficial to ensure the safety of the blood vessel wall and avoid directly using the cutting head 2 with too long rotary cutting length to cut the blood vessel wall.

S5. After the thrombus and plaque are suctioned, withdraw the push rod 44 to the proximal end, pull the pulling wire 41, so that the torsion spring 5 is reset, and the cutter head 2 returns to the groove body 3 to switch to the first position again. relative position, then perform pressure relief treatment on the balloon 10, and finally withdraw the whole device.

Finally, it should be noted that the above embodiments are only used to illustrate the technical solutions of the present invention and not to limit them. Although the present invention has been described in detail with reference to the above embodiments, those of ordinary skill in the art should understand that after reading this After the description of the application, the specific implementation mode of the present invention can still be modified or equivalently replaced, but none of these modifications or changes departs from the protection scope of the pending claims of the present application.

Claims (19)

1. The adjustable rotary cutting structure is characterized by comprising a rotary cutting end part, a plurality of cutter heads and an operation piece, wherein the cutter heads are divided into n cutter head groups according to respective rotary cutting lengths, each cutter head group at least comprises one cutter head, and n is a positive integer greater than 1; each cutter head is movably arranged at the rotary-cut end part, a groove body is arranged at the position corresponding to the cutter head at the rotary-cut end part, and a blade part is arranged on the cutter head; the control piece is used for controlling at least one cutter head in at least one cutter head group to switch between the first relative position and the second relative position; at least the blade portion of the cutter head is positioned in the groove body when the cutter head is positioned at the first relative position; in the second relative position, at least a part of the blade part of the tool bit is positioned outside the groove body.

2. The adjustable rotary cutting structure according to claim 1, comprising at least n control members, one of the control members being adapted to correspondingly control the switching of at least one of the cutting heads of one of the cutting head sets between the first and second relative positions.

3. The adjustable rotary cutting structure according to claim 2, wherein the n manipulating members sequentially control the switching of at least one of the cutter heads of different cutter head groups between the first relative position and the second relative position in order of the rotary cutting length from small to large.

4. The adjustable rotary cutting structure of claim 1, wherein the tool bit comprises a cutting head and a base, the blade is located on the cutting head, the cutting head is located on the base, and the base is movably mounted in the groove.

5. The adjustable rotational atherectomy device of claim 4, wherein the cutting head further comprises an elastic member coupled to the base and the rotational atherectomy end, respectively, the elastic member being configured to drive the cutting head from the first relative position to the second relative position and to remain in the second relative position.

6. The adjustable rotary cutting structure according to claim 5, wherein the elastic member is a torsion spring, and the base is rotatably connected with the groove body.

7. The adjustable rotary cutting structure according to claim 1, wherein a plurality of grooves are provided along the circumference of the rotary cutting end portion, and one or more cutter heads are provided in each groove.

8. The adjustable rotary cutting structure according to claim 7, wherein the adjustable rotary cutting structure has a plurality of planes perpendicular to the axial direction of the rotary cutting end, at least one of the planes being provided with a plurality of the cutter heads of a plurality of different cutter head groups; and in the plurality of tool bits of the plurality of different tool bit groups, at least part of the tool bits are sequentially arranged along the circumferential direction of the rotary cutting end part according to the sequence from small to large of the rotary cutting length.

9. The adjustable rotary cutting structure according to claim 4, wherein the adjustable rotary cutting structure has at least one plane perpendicular to the axial direction of the rotary cutting end, each of the planes having a plurality of the cutting heads disposed thereon; the adjustable rotary cutting structure further comprises at least one connecting ring, and one connecting ring is correspondingly connected with a plurality of bases on the plane in series.

10. The adjustable rotary cutting structure according to claim 7, wherein at least one of the groove bodies has a plurality of the cutting heads of a plurality of different sets of the cutting heads.

11. The adjustable rotary cutting structure according to claim 10, wherein each of the cutter bits is arranged in the groove body of the plurality of cutter bits provided with the plurality of different cutter bit groups in order of the rotary cutting length from small to large.

12. The adjustable rotary cutting structure according to claim 7, wherein the adjustable rotary cutting structure has a plurality of planes perpendicular to the axial direction of the rotary cutting end, and at least one cutter head is disposed on each of the planes; for adjacent two of the planes, the rotational cut length of at least one of the tips on the plane on the proximal side is greater than the rotational cut length of at least one of the tips on the plane on the distal side.

13. The adjustable rotational atherectomy structure of claim 12, wherein each of the planar surfaces comprises a plurality of the tips of a plurality of different sets of tips; and in the plurality of tool bits of the plurality of different tool bit groups on the same plane, at least part of the tool bits are sequentially arranged along the circumferential direction of the rotary cutting end part according to the sequence from small to large of the rotary cutting length.

14. The adjustable rotational atherectomy device of claim 5, wherein the control member comprises a traction wire coupled to the elastic member or the base, the traction wire being configured to drive the cutting tip from the second relative position to the first relative position.

15. The adjustable rotational atherectomy structure of claim 14, wherein the manipulation member further comprises an operating switch coupled to the pull wire, the operating switch being configured to allow the pull wire to move or lock the position of the pull wire.

16. An adjustable rotary cutting suction device comprising a suction catheter and an adjustable rotary cutting structure according to any one of claims 1-15 disposed at a distal end of the suction catheter.

17. The adjustable rotary cutting suction device of claim 16 wherein the suction catheter is provided with a plurality of jet ports adjacent the adjustable rotary cutting structure.

18. The adjustable rotary atherectomy aspiration device of claim 16, further comprising a support catheter and a catheter sheath, the support catheter being movably disposed within the catheter sheath, the aspiration catheter being movably disposed within the support catheter.

19. The adjustable rotary cutting suction device of claim 18 wherein the distal end of the support catheter is provided with a balloon.

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