CN117224821A - Carotid shunt tube and carotid surgical instrument - Google Patents

Abstract

The invention relates to the technical field of medical equipment, in particular to a carotid shunt tube and a carotid artery surgical instrument, wherein the carotid shunt tube comprises: the outer walls of the tube bodies at the two ends of the diverting tube body are provided with saccules; one end of the sheath tube is communicated with the middle part of the diversion tube body, and is arranged at a preset angle with the diversion tube body, and the other end of the sheath tube is a free end; and one end of the balloon catheter matched with the balloon is communicated with the balloon, and the other end of the balloon catheter is provided with a stop valve. The carotid artery transfer tube provided by the technical scheme can not only meet the temporary blood transfer function of the existing product, but also integrate the function of a vascular sheath, and interventional instruments such as a guide wire, a catheter and the like can be conveyed to a tandem lesion part through the sheath, so that the surgical stripping operation and the interventional operation can be simultaneously implemented through only one vascular incision, the operation is simplified, the complications related to the operation access are reduced, and the risk of cerebral infarction in the operation can be effectively reduced.

Description

Carotid artery bypass tube and carotid artery surgical instruments

Technical field

The invention relates to the technical field of medical devices, and in particular to a carotid artery bypass tube and a carotid artery surgical instrument.

Background technique

Carotid stenosis is one of the causes of ischemic stroke. Carotid artery stenosis is mainly caused by atherosclerosis. Risk factors for carotid artery stenosis include hypertension, smoking, diabetes, hyperlipidemia, family genetic factors, etc. Although the common sites of carotid artery stenosis are the carotid sinus and the initial segment of the internal carotid artery, the detection rate of serial lesions of the extracranial and extracranial carotid arteries is increasing year by year. As shown in Figure 1, carotid artery bifurcation site combined with common carotidstenosis (CCA)/innominate artery (IA) stenosis accounts for 4.8% of all carotid artery stenosis. About 1/6 patients with acute ischemic stroke have serial lesions in the intracranial and extracranial segments of the internal carotid artery (ICA). Tandem carotid artery lesions are more severe than stenosis at a single site, and the incidence of ischemic stroke in patients with combined common carotid/innominate artery bifurcation stenosis is as high as 17% to 30%.

Carotid endarterectomy is a surgical intervention that can remove plaques in the C1 segment of the internal carotid artery and the distal common carotid artery and relieve stenosis. It is currently regarded as the preferred surgical intervention method. For stenosis of the common carotid/innominate origin and stenosis of the C2 segment of the internal carotid artery and above, vascular interventional treatment is the first choice due to the difficult anatomy and large surgical trauma.

The carotid artery shunt (shunt) plays a very important role during carotid endarterectomy surgery and can reduce the cerebral ischemia time caused by carotid artery occlusion. When using the existing carotid artery shunt, after the carotid sinus is surgically incised, the inner end of the neck of the shunt is retrogradely inserted into the internal carotid artery, the balloon of the shunt is inflated to achieve fixation, and then the common end of the neck of the shunt is inserted. The common carotid artery is fixed with a shunt tube balloon, and the open system allows arterial blood to flow from the common carotid artery through the shunt tube into the internal carotid artery, establishing temporary blood perfusion of the brain tissue on the side of the operation.

Existing technical means cannot simultaneously complete carotid endarterectomy and carotid artery tandem lesions (the locations include the proximal end of the common carotid artery, the distal end of the internal carotid artery, and the intracranial segment of the internal carotid artery) through one vascular incision. Interventional treatment of lesions (including stenotic lesions, tumor-like lesions such as aneurysms) may not effectively avoid the risk of cerebral infarction caused by intraoperative blood clots and debris shedding. If you want to treat the initial segment of the common carotid artery and the internal carotid artery at the same time, you often need to perform additional carotid artery puncture under direct vision or establish a vascular access through the femoral artery, which increases the risk of surgical trauma and vascular damage at the puncture site, and faces certain risks. Risk of cerebral infarction.

Contents of the invention

In order to solve the problems in related technologies, embodiments of the present invention provide a carotid artery bypass tube and a carotid artery surgical instrument.

In a first aspect, an embodiment of the present invention provides a carotid artery shunt, including:

The diversion tube body has balloons arranged on the outer walls of the tube at both ends;

At least one sheath, one end of which is connected to the middle part of the diverter tube body and is arranged at a preset angle with the diverter tube body, and the other end is a free end;

The balloon catheter adapted to the balloon has one end connected to the balloon and a stop valve provided at the other end.

According to an embodiment of the present invention, there is one sheath tube, and it forms a preset angle with the diversion tube body in an oblique downward direction; or,

There are two sheath tubes, one of which forms a preset angle with the diversion tube body in an obliquely downward direction, and the other sheath tube forms a preset angle with the diversion tube body in an obliquely upward direction.

According to an embodiment of the present invention, the sheath tube is flexibly connected to the diversion tube body.

According to an embodiment of the present invention, a transition tube is provided between the sheath tube and the diverter tube body.

According to an embodiment of the present invention, the transition pipe and the flow converter body are arranged at a preset angle.

According to an embodiment of the present invention, the preset angle is 30-45 degrees.

According to an embodiment of the present invention, the preset angle is 45 degrees.

According to an embodiment of the present invention, a hemostatic valve is connected to the free end.

According to an embodiment of the present invention, a scale mark is provided on the inner wall of the diverter tube body.

According to an embodiment of the present invention, the inner diameter of the diverter tube body and sheath tube is not less than 5-6F.

In a second aspect, an embodiment of the present invention provides a carotid artery surgical instrument, including the carotid artery shunt tube according to any one of the first aspects and an interventional instrument delivered into the carotid artery via the sheath.

According to an embodiment of the present invention, the interventional instrument includes one or more of the following: a guidewire, a catheter, a balloon, and a stent.

Embodiments of the present invention provide a carotid artery diversion tube, which includes: a diversion tube body, balloons are provided on the outer walls of the tube at both ends; and at least one sheath, one end of which is connected to the middle part of the diversion tube body and is connected to the middle part of the diversion tube body. The diversion tube body is arranged at a preset angle, and the other end is a free end; a balloon catheter adapted to the balloon has one end connected to the balloon and a stop valve provided at the other end. The carotid artery shunt provided by the above technical solution can not only meet the temporary blood diversion function of existing products, but also integrates the function of a vascular sheath. Interventional instruments such as guidewires and catheters can be transported to serial lesions through the sheath. Therefore, surgical stripping surgery and interventional surgery can be performed simultaneously through only one vascular incision, which not only simplifies the surgical operation, reduces complications related to the surgical approach, but also effectively reduces the risk of intraoperative cerebral infarction.

It should be understood that the above general description and the following detailed description are exemplary and explanatory only, and do not limit the present invention.

Description of drawings

Other features, objects and advantages of the present invention will become more apparent from the following detailed description of the non-limiting embodiments in conjunction with the accompanying drawings. In the attached picture:

Figure 1 is a schematic diagram of the internal carotid artery in the prior art.

Figure 2 is a schematic structural diagram of a carotid artery shunt provided by an embodiment of the present invention.

Figure 3 is a schematic structural diagram of a carotid artery shunt provided by another embodiment of the present invention.

Figure 4 is a schematic structural diagram of a carotid artery shunt provided by yet another embodiment of the present invention.

Implementation

Hereinafter, exemplary embodiments of the present invention will be described in detail with reference to the accompanying drawings so that those skilled in the art can easily implement them. Furthermore, for clarity, parts irrelevant to describing the exemplary embodiments are omitted in the drawings.

In the present invention, it should be understood that terms such as "comprising" or "having" are intended to indicate the presence of features, numbers, steps, acts, parts, portions or combinations thereof disclosed in this specification, and are not intended to exclude a or the possibility that multiple other features, numbers, steps, acts, parts, portions, or combinations thereof may exist or be added.

In addition, it should be noted that, without conflict, the embodiments and features in the embodiments of the present invention can be combined with each other. The present invention will be described in detail below with reference to the accompanying drawings and embodiments.

Existing technical means cannot simultaneously complete carotid endarterectomy and carotid artery tandem lesions (the locations include the proximal end of the common carotid artery, the distal end of the internal carotid artery, and the intracranial segment of the internal carotid artery) through one vascular incision. Interventional treatment of lesions (including stenotic lesions, tumor-like lesions such as aneurysms) may not effectively avoid the risk of cerebral infarction caused by intraoperative blood clots and debris shedding. If you want to treat the initial segment of the common carotid artery and the internal carotid artery at the same time, you often need to perform additional carotid artery puncture under direct vision or establish a vascular access through the femoral artery, which increases the risk of surgical trauma and vascular damage at the puncture site, and faces certain risks. Risk of cerebral infarction.

Embodiments of the present invention provide a carotid artery shunt, which not only meets the temporary blood diversion function of existing products, but also integrates the function of a vascular sheath. Interventional instruments such as guidewires and catheters can be transported to the serial port through the sheath. Therefore, surgical stripping surgery and interventional surgery can be performed at the same time through only one vascular incision, which not only simplifies the surgical operation, reduces complications related to the surgical approach, but also effectively reduces the risk of intraoperative cerebral infarction.

Figure 2 is a schematic structural diagram of a carotid artery shunt provided by an embodiment of the present invention.

As shown in Figure 2, the carotid artery shunt tube includes a shunt tube body 10 and a sheath 20. Balloons 11 and 12 are provided on the outer walls of the tube at both ends of the diversion tube 10; one end of the sheath 20 is connected to the middle of the diversion tube 10 and forms a preset angle with the diversion tube 10 It is set that the other end of the sheath 20 is the free end; the carotid artery bypass tube also includes a balloon catheter 13 adapted to the balloon 11 and the balloon 12. One end of a balloon catheter 13 is connected to the balloon 11, and the other is A balloon catheter 13 is connected with the balloon 12, and the other end of each balloon catheter 13 is provided with a stop valve 14 for preventing balloon air leakage.

The carotid artery shunt provided by the present invention realizes the function of a conventional carotid artery shunt in carotid endarterectomy through a blood vessel incision, and then sends guide wires, catheters and various interventional instruments through the sheath, that is, Treat tandem lesions in the proximal common carotid artery or distal internal carotid artery at the same time.

According to an embodiment of the present invention, the sheath 20 is flexibly connected to the diversion tube body 10 . For example, the connection part can be made of flexible material. Specifically, appropriate materials can be selected with reference to the existing technology, which will not be described in detail here.

According to an embodiment of the present invention, a transition tube (not shown in the figure) is provided between the sheath tube 20 and the diversion tube body 10 .

According to an embodiment of the present invention, the transition pipe and the flow converter body 10 are arranged at a preset angle. When the sheath 20 is flexibly connected to the diversion tube body 10, the preset angle is preferably such that the interventional instrument can be delivered to the serial lesion site, and is preferably at an inclined angle. For example, the preset angle is 30-45 degrees, and more preferably 45 degrees. Spend. In some cases, considering the elasticity of the flexible material, as shown in Figure 2, the preset angle can also be 90 degrees, and it only needs to be bent upward or downward during use to adaptively deliver the access device into the common carotid artery. or within the internal carotid artery.

According to an embodiment of the present invention, a hemostatic valve is connected to the free end. Specifically, the free end of the sheath 20 allows interventional instruments to pass through. In addition, the free end is connected to a hemostatic valve 22 through the hose 21 to prevent blood from flowing out from the free end during the operation.

According to an embodiment of the present invention, a scale line is provided on the inner wall of the diversion tube body 10 to facilitate determination of the position extending into the blood vessel.

According to the embodiment of the present invention, the inner diameter of the diverter tube 10 and the sheath 20 is not less than 5-6F, and further, the inner diameter of the transition tube is not less than 5-6F, which facilitates the passage of guide wires of 0.014 inches to 0.038 inches. 5~6F catheter, 5~6F balloon, 5~6F stent and other interventional devices.

Figure 3 is a schematic structural diagram of a carotid artery shunt provided by another embodiment of the present invention. The number of the sheath tube 20 shown in FIG. 3 is one, and it forms a preset angle with the diversion tube body 10 in the oblique downward direction. Specifically, the preset angle is 45 degrees. For other technical details, reference can be made to the embodiment shown in FIG. 2 and will not be described again here. It should be noted that, in the embodiment shown in FIG. 3 , for example, if the lower end of the shunt tube body 10 is inserted into the common carotid artery, since the preset angle of the sheath 20 is set in the oblique downward direction, it is suitable for inserting the interventional instrument into the common carotid artery. When dealing with tandem lesions through and into the internal carotid artery, it is often no longer possible to deliver interventional devices into the common carotid artery.

Figure 4 is a schematic structural diagram of a carotid artery shunt provided by yet another embodiment of the present invention.

As shown in FIG. 4 , there are two sheath tubes 20 , one of which forms a preset angle with the diversion tube body 10 in the oblique downward direction, and the other sheath tube 20 forms a preset angle with the diversion tube body 10 along the diagonal direction. The diagonally upward direction is at a preset angle. For other technical details, reference can be made to the embodiment shown in FIG. 2 and will not be described again here. What is different from the embodiment of Figure 3 is that by providing two sheaths 20, the interventional instrument can be sent into the internal carotid artery through the obliquely downward direction of the sheath 20 to treat serial lesions, or the interventional instrument can be passed through the obliquely upward direction. The sheath 20 is introduced into the common carotid artery while treating serial lesions, further simplifying the surgical operation and reducing complications related to the surgical approach.

According to an embodiment of the present invention, the two sheath tubes 20 may each be connected to the diverter tube body 10 through a transition tube, so that the two sheath tubes 20 may not be connected to each other and may be separated by a certain distance. Of course, with appropriate technology, the two sheath tubes 20 can also be connected to the diverter tube body 10 through a transition tube, and the present invention is not limited to this.

It can be understood that the carotid artery shunt in the embodiment of FIG. 4 is schematically illustrated using only two sheaths 20 as an example. Of course, more sheaths 20 can also be provided as needed, which is not included in the present invention. Repeat.

Taking the carotid artery shunt in the embodiment of Figure 4 as an example, when the carotid artery shunt is used, after the carotid sinus is surgically incised, one end of the carotid artery shunt is inserted into the internal carotid artery, and the ball is balled through the balloon catheter The balloon is fixed, and then the other end of the carotid artery shunt tube is inserted into the common carotid artery, and the balloon is raised through the balloon catheter to achieve fixation. The arterial blood flows from the common carotid artery through the carotid artery shunt tube into the internal carotid artery, establishing a surgical procedure. Temporary perfusion of lateral brain tissue.

Please refer to Figure 1. Specifically, when dealing with serial lesions of the common carotid artery (CCA) (not shown in the figure), the interventional instrument is introduced through the sheath, and the temporary hemostatic forceps clamp the carotid artery shunt tube close to the internal carotid artery (ICA). ) to prevent microemboli and air from entering the internal carotid artery with the blood flow during the operation and reduce the risk of postoperative cerebral infarction. When dealing with serial lesions of the internal carotid artery, the interventional instrument is inserted through the sheath, and the temporary hemostatic clamp clamps the end of the carotid artery shunt tube close to the common carotid artery to reverse the blood flow of the internal carotid artery in a short period of time. Microemboli generated during the treatment of lesions can follow the reverse blood flow, pass through the bypass tube, and flow out of the body, reducing the risk of postoperative cerebral infarction.

Based on the same or similar inventive concept, the present invention also provides a carotid artery surgical instrument, including the carotid artery shunt tube as described in the above embodiment and an interventional instrument delivered into the carotid artery via the sheath.

According to an embodiment of the present invention, the interventional instrument includes one or more of the following: a guidewire, a catheter, a balloon, and a stent.

For other relevant technical details of the embodiments of the present invention, please refer to the above embodiments section and will not be described again here.

Compared with the existing technology, embodiments of the present invention provide a carotid artery shunt, which not only satisfies the temporary blood diversion function of existing products, but also integrates the functions of vascular sheaths, guidewires, catheters and other interventional devices It can be delivered to the serial lesion site through the sheath, so surgical stripping surgery and interventional surgery can be performed at the same time through only one vascular incision, which not only simplifies the surgical operation, reduces the complications related to the surgical approach, but also effectively reduces the intraoperative brain damage. The risk of stalking.

The above description is only an illustration of the preferred embodiments of the present invention and the technical principles used. Those skilled in the art should understand that the scope of the invention involved in the present invention is not limited to technical solutions formed by a specific combination of the above technical features, but should also cover any combination of the above technical features without departing from the concept of the invention. or other technical solutions formed by any combination of equivalent features. For example, a technical solution is formed by replacing the above features with technical features with similar functions disclosed in the present invention (but not limited to).

Claims (10)

1. A carotid shunt, comprising:

the outer walls of the tube bodies at the two ends of the diverting tube body are provided with saccules;

one end of the sheath tube is communicated with the middle part of the diversion tube body, and is arranged at a preset angle with the diversion tube body, and the other end of the sheath tube is a free end;

and one end of the balloon catheter matched with the balloon is communicated with the balloon, and the other end of the balloon catheter is provided with a stop valve.

2. The carotid shunt according to claim 1, wherein the sheath is one and forms a predetermined angle with the shunt body in a diagonally downward direction; or,

the number of the sheath pipes is two, one sheath pipe forms a preset angle with the diversion pipe body along the obliquely lower direction, and the other sheath pipe forms a preset angle with the diversion pipe body along the obliquely upper direction.

3. Carotid shunt according to claim 1 or 2, wherein the sheath is flexibly connected to the shunt body.

4. A carotid shunt according to claim 3, wherein a transition tube is provided between the sheath and the shunt tube.

5. The carotid shunt tube of claim 4, wherein the transition tube is disposed at a predetermined angle to the shunt tube.

6. The carotid shunt of claim 5 wherein the predetermined angle is 30-45 degrees.

7. The carotid shunt of claim 6 wherein the predetermined angle is 45 degrees.

8. The carotid shunt according to claim 1, wherein a hemostatic valve is connected at the free end.

9. A carotid surgical device comprising a carotid shunt according to any one of claims 1-8 and an interventional device delivered into the carotid artery via the sheath.

10. The carotid surgical instrument of claim 9, wherein the interventional instrument comprises one or more of the following: guide wires, catheters, balloons and stents.