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DE19842113A1 - Extraction catheter has tip wall divided into three identical sections made of self-expanding material acting as braces and interstices filled with elastic material - Google Patents

Extraction catheter has tip wall divided into three identical sections made of self-expanding material acting as braces and interstices filled with elastic material

Info

Publication number
DE19842113A1
DE19842113A1 DE19842113A DE19842113A DE19842113A1 DE 19842113 A1 DE19842113 A1 DE 19842113A1 DE 19842113 A DE19842113 A DE 19842113A DE 19842113 A DE19842113 A DE 19842113A DE 19842113 A1 DE19842113 A1 DE 19842113A1
Authority
DE
Germany
Prior art keywords
catheter
extraction
extraction catheter
funnel
braces
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
DE19842113A
Other languages
German (de)
Inventor
Matthias Fischer
Joerg Luedemann
Lech Wiemy
Karl-Ludwig Schulte
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
SCHULTE KARL LUDWIG
Original Assignee
SCHULTE KARL LUDWIG
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by SCHULTE KARL LUDWIG filed Critical SCHULTE KARL LUDWIG
Priority to DE29824584U priority Critical patent/DE29824584U1/en
Priority to DE19842113A priority patent/DE19842113A1/en
Publication of DE19842113A1 publication Critical patent/DE19842113A1/en
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/076—Surgical instruments, devices or methods for removing surgical staples or wound clamps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2215—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having an open distal end
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2002/9528—Instruments specially adapted for placement or removal of stents or stent-grafts for retrieval of stents
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/09—Guide wires
    • A61M2025/09125—Device for locking a guide wire in a fixed position with respect to the catheter or the human body

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Pulmonology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Vascular Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biophysics (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

The tip of the extraction catheter (1) has its wall divided into three sections forming a self-expanding funnel as braces (3) . The interstices between the funnel-braces are tensioned by elastic foldable material (4). The insertion appliance (2) folds in the funnel by inverting it from behind.

Description

Der Extraktionskatheter betrifft einen intravasalen Katheter, dessen Spitze sieh nach Verlassen eines Führungskatheters oder einer überlangen intravasalen Schleuse selbständig trichterförmig aufweitet und so eine Führung zur Extraktion intravasalen Materials bietet.The extraction catheter relates to an intravascular catheter, whose tip see Leaving a guide catheter or an extra-long intravascular lock independently expands in a funnel shape and thus provides guidance for the extraction of intravascular material.

Bei katheterinterventionellen Verfahren ist die Plazierung von Stents ein zunehmend angewandtes Verfahren. Indikationen betreffen vor allem nach Ballondilatation restenosierte Gefäße, aber auch Dissektionen arterieller Gefäßwände. Fehlplazierte, temporäre (Liermann DD et al. Does transient Stent implantation improve the results of permanent stents?. Cardiovasc Intervent Radiol. 1997; 20 Suppl 1: S72; Pt 99) oder wiederverschlossene Stents werden derzeit mittels Extraktionszangen aus dem betreffenden Gefäßgebiet geborgen (Liermann DD et al. Möglichkeiten zur Bergung fehlplazierter oder verschlossener metallischer Endoprothesen. in: Kollath J und Liermann D: Stents II. Schnetzor-Verlag. Konstanz. 1992: 139-150 Kuhn FP et al. Einsatz des Strecker-Stents zur Therapie der Nieren- und Transplantatnierenartereienstenose. in Kollath J und Liermann D: Stents II. Schnetzor-Verlag. Konstanz. 1992 : 209) und in größeren Gefäßen geparkt oder müssen gefäßchirurgisch entfernt werden (Erez E et al. Surgical removal of stents entrapped in proximal left coronary artery system. Ann Thorac Surg. 1996; 62 (3): 884-5).With catheter interventional procedures, stent placement is increasing method used. Indications primarily concern after balloon dilation restenosed vessels, but also dissections of arterial vessel walls. Misplaced, temporary (Liermann DD et al. Does transient stent implantation improve the results of permanent stents ?. Cardiovasc Intervent Radiol. 1997; 20 Suppl 1: S72; Pt 99) or reclosable stents are currently extracted from the affected one using extraction forceps Vascular area salvaged (Liermann DD et al. Possibilities to salvage misplaced or closed metallic endoprostheses. in: Kollath J and Liermann D: Stents II. Schnetzor publishing house. Constance. 1992: 139-150 Kuhn FP et al. Use of the Strecker stent for the therapy of renal and transplant renal artery stenosis. in Kollath J and Liermann D: Stents II. Schnetzor-Verlag. Constance. 1992: 209) and in larger vessels parked or have to be removed by vascular surgery (Erez E et al. Surgical removal of stents entrapped in proximal left coronary artery system. Ann Thorac Surg. 1996; 62 (3): 884-5).

Weiterhin werden innerhalb von Gefäßen durch verschiedenste pathophysiologische Mechanismen Thromben unterschiedlichster Zusammensetzung aus Blutzellen (z. B. Thrombozyten, Erythrozyten, Leukozyten) und Blutplasmabestandteilen (z. B. Fibrin) und arteriosklerotische Plaques (Schaumzellen mit Cholesterin, Kaleinsprossende Fibroblasten) gebildet. Diese Aggregate können sich unter bestimmten Bedingungen, auch während einer Katheterinterventionen ablösen und zu embolischen Verschlüssen von Gefäßen führen. Gleichfalls können Bakterienhaufen, Tumorzellen, Fremdkörper, Fettropfen, Knochenmarksbestandteile, Parasiten und Gase Emboli bilden. Oft wird die Entfernung dieser Gefäßpfröpfe notwendig. Dieses bedarf derzeit katheterinterventioneller oder chirurgischer Maßnahmen, den Fogarty-Katheter, den Aspirationskatheter, hydrodynamischer Katheter mittels Venturi-Effekt oder einer Lysetherapie (Gabrielle F et al. Leg embolism: treatment via percutaneous thrombo-aspiration. J Mal Vasc. 1996; 21 Suppl A: 76-82). Furthermore, various pathophysiological Mechanisms of different types of thrombi from blood cells (e.g. Platelets, erythrocytes, leukocytes) and blood plasma components (e.g. fibrin) and arteriosclerotic plaques (foam cells with cholesterol, potassium sprout end Fibroblasts). These aggregates can, under certain conditions, also detach during catheter interventions and lead to embolic occlusions lead from vessels. Bacteria clusters, tumor cells, foreign bodies, Drops of fat, bone marrow components, parasites and gases form emboli. Often it is Removal of these vascular plugs is necessary. This currently requires more catheter intervention or surgical measures, the Fogarty catheter, the aspiration catheter, hydrodynamic catheter using Venturi effect or lysis therapy (Gabrielle F et al. Leg embolism: treatment via percutaneous thrombo-aspiration. J Mal Vasc. 1996; 21 Suppl A: 76-82).  

Der im Vergleich zur Punktionsstelle zu große Durchmesser expandierter Stents und größerer Thromben oder Emboli läßt bislang nur bedingt eine katheterinterventionelle Beseitigung aus dem Körper des Patienten zu.The diameter of expanded stents and the diameter that is too large compared to the puncture site Larger thrombi or emboli have so far only partially allowed catheter intervention Elimination from the patient's body too.

Der Erfindung liegt die Idee zugrunde, eine Vorrichtung für die katheterinterventionelle Entfernung von Stents, Thromben und anderer größerer Partikel bzw. Instrumente aus dem Körper des Patienten über den per Punktion schon erfolgten Gefäßzugang zu schaffen. Diese Aufgabe wird mit einem Extraktionskatheter erfindungsgemäß gelöst, dessen Spitze sich nach Verlassen einer überlangen Schleuse oder eines Führungskatheters am Ort der Anwendung selbständig trichterförmig aufweitet. Diese Aufweitung paßt sich in ihrer Ausdehnung durch elastische Zwischenwände dem Gefäßdurchmesser an. Mit einer Extraktionszange gefaßte, flexible Stents werden durch Zug über diesen Trichter in den Extraktionskatheter mechanisch in ihrem Durchmesser verkleinert. Ebenso können andere Partikel, Instrumente oder Katheterfragmente in den Trichter gezogen werden. Durch Aspiration oder den Fogarty-Katheter in den Trichter positionierte Thromben erfahren während des Hineinziehens des Trichters in den Einführungskatheter durch Kompression von außen eine Verkleinerung. Anschließend können Stents, Thromben und andere Partikel, Instrumente und Katheterfragmente mit dem Extraktionskatheter aus dem Körper geborgen werden.The invention is based on the idea of a device for catheter interventional Removal of stents, thrombi and other larger particles or instruments from the To create the patient's body over the vascular access already done by puncture. This object is achieved according to the invention with an extraction catheter, the tip of which after leaving an excessively long sluice or a guiding catheter at the site of the Application automatically widens in a funnel shape. This expansion fits into her Expansion through elastic partitions to the vessel diameter. With a Extraction forceps with flexible stents are pulled into the Extraction catheter mechanically reduced in diameter. Others can as well Particles, instruments or catheter fragments are pulled into the funnel. By Experience aspiration or the Fogarty catheter thrombi positioned in the funnel while pulling the funnel into the delivery catheter by compression a reduction from the outside. You can then use stents, thrombi, and others Particles, instruments and catheter fragments with the extraction catheter from the body be recovered.

Entsprechende Anwendungsgebiete sind die katheterinterventionelle Entfernung fehl­ plazierter, temporärer, beschädigter und wiederverschlossener Stents, Thromben und anderer Partikel, Instrumente und Katheterfragmente aus allen Gefäß- und Einsatzgebieten.Appropriate fields of application are catheter interventional removal placed, temporary, damaged, and reclosed stents, thrombi, and other particles, instruments and catheter fragments from all vascular and application areas.

AusführungsbeispielEmbodiment

Nachfolgend soll die Erfindung anhand eines Ausführungsbeispiels erläutert werden. Die dazugehörigen Zeichnungen stellen dar:The invention will be explained below using an exemplary embodiment. The associated drawings show:

Fig. 1 entfalteter Extraktionskatheter mit Einführungsvorrichtung, Fig. 1 deployed extraction catheter insertion device,

Fig. 2 durch die Einführungsvorrichtung eingefalteter Extraktionskatheter a) Seitenansicht b) Draufsicht, Fig. 2 the folded through the introducer catheter extraction a) side view b) top view,

Fig. 3 Einführen des eingefalteten Extraktionskatheters in den Einführungskatheter und die intravasale Schleuse, Fig. 3 inserting the folded extraction catheter into the introducer catheter and intravascular sheath,

Fig. 4 durch Schleuse und Einführungskatheter am Ort der Anwendung positionierter, entfalteter Extraktionskatheter, Fig. 4 through lock and introducing catheter at the site of application positioned, unfolded extraction catheter,

Fig. 5 Zug eines Stents mit einer Faßzange in den Extraktionskatheter Fig. 5 train a stent with a grasping forceps in the extraction catheter

Fig. 6 Aspiration eines Thrombus in den Extraktionskatheter. Fig. 6 Aspiration of a thrombus in the extraction catheter.

Die Wand eines 6 French weitlumigen Katheters ist von der Spitze über 1,2 cm in 3 identische Abschnitte unterteilt. Die einzelnen Wandabschnitte sind selbstabspreizend und formen als Streben eine Trichterstruktur (Fig. 1). Die Zwischenräume dieser Trichter­ streben sind mit elastischem Material bespannt, welches innerhalb der Schleuse oder der Einführungsvorrichtung gefaltet vorliegt.The wall of a 6 French wide-lumen catheter is divided into 3 identical sections from the tip over 1.2 cm. The individual wall sections are self-expanding and form a funnel structure as struts ( FIG. 1). The spaces between these funnels are covered with elastic material that is folded inside the lock or the insertion device.

Die zu Extraktionskatheter zugehörige Einführungsvorrichtung wird von hinten über den Trichter gezogen (Fig. 1, 2). Anschließend ist die Einbringung der so eingefalteten Katheterspitze in die Schleuse und den Führungskatheter problemlos möglich (Fig. 3). Nach Verlassen des Führungskatheters entfaltet sich der Trichter (Fig. 4). Eine über diesen Extraktionskatheter geführte Extraktionszange greift den Stent oder andere Partikel, Instrumente oder Katheterfragmente (Fig. 5) und zieht diesen über den Trichter in den Extraktionskatheter hinein. Nach Positionierung und Entfaltung des Trichters direkt vor einem Thrombus (Fig. 6) kann dieser in den Extraktionskatheter aspiriert werden. Ebenso ist das Hinziehen eines Thrombus, Partikels, Instruments oder Katheterfragments in den Trichter durch den Fogarty-Katheter möglich. Anschließend wird der Stent oder Thrombus mit dem Extraktionskatheter über Führungskatheter und Schleuse entfernt. The insertion device associated with the extraction catheter is pulled over the funnel from behind ( FIGS. 1, 2). Subsequently, the catheter tip folded in this way can be inserted into the sheath and the guide catheter without any problems ( FIG. 3). After leaving the guide catheter, the funnel unfolds ( Fig. 4). An extraction forceps guided over this extraction catheter grasps the stent or other particles, instruments or catheter fragments ( FIG. 5) and pulls it into the extraction catheter via the funnel. After the funnel has been positioned and deployed directly in front of a thrombus ( FIG. 6), it can be aspirated into the extraction catheter. It is also possible to pull a thrombus, particle, instrument or catheter fragment into the funnel through the Fogarty catheter. The stent or thrombus is then removed with the extraction catheter via the guide catheter and sheath.

BezugszeichenlisteReference list

11

Extraktionskatheter
Extraction catheter

22nd

Einführungsvorrichtung
Insertion device

33rd

Trichterstreben
Funnel struts

44th

elastische Wandbespannung
elastic wall covering

55

Einführungskatheter
Insertion catheter

66

intravasale Schleuse
intravascular lock

77

Extraktionszange
Extraction forceps

88th

Stent
Stent

99

Thrombus
thrombus

Claims (4)

1. Extraktionskatheter ist dadurch gekennzeichnet, daß an seiner Spitze die in 3 Abschnitte unterteilte Wand als Streben einen selbstexpandierenden Trichter formt.1. Extraction catheter is characterized in that at its tip the wall divided into 3 sections forms a self-expanding funnel as struts. 2. Der Extraktionskatheter ist nach Anspruch 1, dadurch gekennzeichnet, daß die Zwischenräume der Trichterstreben mit elastischem und faltbarem Material bespannt sind.2. The extraction catheter is according to claim 1, characterized in that the Gaps between the funnel struts are covered with elastic and foldable material. 3. Der Extraktionskatheter ist nach Anspruch 1 und 2 durch eine zugehörige Einführungsvorrichtung gekennzeichnet, welche den Trichter durch Überstülpen von hinten zum Einfalten bringt.3. The extraction catheter is according to claim 1 and 2 by an associated Introducer characterized, which the funnel by slipping folds in at the back. 4. Der Extraktionskatheter ist nach Anspruch 1, 2 und 3 durch einen Einführungskatheter gekennzeichnet, welcher den Extraktionskatheter zum Ort der Anwendung führt.4. The extraction catheter is according to claim 1, 2 and 3 by an insertion catheter characterized which leads the extraction catheter to the site of application.
DE19842113A 1998-09-07 1998-09-07 Extraction catheter has tip wall divided into three identical sections made of self-expanding material acting as braces and interstices filled with elastic material Withdrawn DE19842113A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
DE29824584U DE29824584U1 (en) 1998-09-07 1998-09-07 Passage stent
DE19842113A DE19842113A1 (en) 1998-09-07 1998-09-07 Extraction catheter has tip wall divided into three identical sections made of self-expanding material acting as braces and interstices filled with elastic material

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
DE19842113A DE19842113A1 (en) 1998-09-07 1998-09-07 Extraction catheter has tip wall divided into three identical sections made of self-expanding material acting as braces and interstices filled with elastic material

Publications (1)

Publication Number Publication Date
DE19842113A1 true DE19842113A1 (en) 2000-03-09

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Family Applications (1)

Application Number Title Priority Date Filing Date
DE19842113A Withdrawn DE19842113A1 (en) 1998-09-07 1998-09-07 Extraction catheter has tip wall divided into three identical sections made of self-expanding material acting as braces and interstices filled with elastic material

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Country Link
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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20150342629A1 (en) * 2014-05-29 2015-12-03 The Spectranetics Corporation Material removal catheter having an expandable distal end
ITUA20163838A1 (en) * 2016-05-26 2017-11-26 Guido Casarotto MINI-INVASIVE DEVICE FOR ENDOUROLOGICAL TREATMENTS
CN114259293A (en) * 2020-09-16 2022-04-01 柯惠有限合伙公司 Multifunctional surgical operation instrument

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20150342629A1 (en) * 2014-05-29 2015-12-03 The Spectranetics Corporation Material removal catheter having an expandable distal end
US11877796B2 (en) * 2014-05-29 2024-01-23 The Spectranetics Corporation Material removal catheter having an expandable distal end
ITUA20163838A1 (en) * 2016-05-26 2017-11-26 Guido Casarotto MINI-INVASIVE DEVICE FOR ENDOUROLOGICAL TREATMENTS
WO2017203462A1 (en) * 2016-05-26 2017-11-30 Fmp Biotechnologies S.R.L. A mini-invasive device for the endourologic treatment
US10758115B2 (en) 2016-05-26 2020-09-01 Fmp Biotechnologies S.R.L. Mini-invasive device for the endourologic treatment
CN114259293A (en) * 2020-09-16 2022-04-01 柯惠有限合伙公司 Multifunctional surgical operation instrument

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