DE202013101276U1 - Device for the introduction of objects - Google Patents

Abstract

Device for introducing articles, in particular implants, into vessels or body cavities of the human or animal body by means of a carrier / bar wire, with a handle (1) for holding and moving the carrier / bar wire, comprising a handle part (2) and a relative to the handle part movable actuating part (3), wherein by means of the relative movement between the handle part and the actuating part (3) of the carrier / latching wire is movable in at least one direction, characterized in that the handle part (2) and the actuating part (3) Having means for controlling the relative movement, wherein the means for controlling are formed such that the relative movement between the handle part (2) and the actuating part (3) in a first movement section substantially a rotational movement and in a second movement section is a translational movement.

Description

The invention relates to a device for introducing objects, in particular implants, in vessels or body cavities of the human or animal body by means of a carrier / bar wire, with a handle for holding and moving the carrier / bar wire, comprising a handle portion and a relative to the handle part movable actuating part, wherein by means of the relative movement between the handle part and the actuating part of the carrier / locking wire is movable in at least one direction.

Endovascular procedures are known from the prior art with which objects, in particular implants, can be introduced into the human or animal body for occlusion of abnormal openings or vessels. As a rule, an implant is inserted into the human or animal body by means of an insertion aid through a catheter and placed there.

In principle, an insertion aid for an object to be inserted comprises a carrier / bar wire located in the catheter, to which the object to be inserted is fastened, and a handle, which is designed to actuate the insertion aid and thus to move the carrier / holding wire.

It can be essentially differentiated between two different types of fastening.

The attachment of the object to be introduced on the wire can be realized on the one hand via a clamping connection, wherein the object to be introduced is fastened by means of a large clamping force on the wire. It is then spoken of an attachment by means of a support wire. On the other hand, the attachment can be realized via a lock, which is then spoken of an attachment by means of a locking wire. For this purpose, another wire is used, a so-called retaining wire. The locking wire engages in loops or loops of the object to be inserted and an eyelet or loop formed by the holding wire or through. The force holding the object to be introduced is in this case lower than in the case of fastening by means of a clamp. When fastening by means of the lock, the locking wire can pass beyond the object to be introduced in addition to the loop or eyelet. The engagement ensures a sufficient hold of the object to be introduced on the locking wire on the friction, which is caused by the material overlap of the eyelets or loop with the locking wire sure.

In order to place the object to be introduced at the intended location, this must be solved by the so-called dropping from the carrier / bar wire. The carrier / locking wire is pulled out of the jamming or locking. The correct devaluation must be ensured, since otherwise it can come in the return of the catheter to an unwanted deplacement of the introduced object. In addition to the non-guaranteed function of the object to be introduced, this entails the risks of injury and / or rupture of the surrounding tissue.

For discharging the object to be introduced from the insertion aid, essentially two mechanical methods are used in the known state of the art with which the connections between the objects to be introduced and the wires can be separated.

In this case, the support wire to release the clamping connection in fastenings with large clamping force by design must be withdrawn by a shorter distance than is required for fastenings by means of a lock. In addition, it requires a significantly greater force to release the clamp connection, as is required to release locks. So far, therefore, different insertion aids are used for introducing objects by means of corresponding wires.

The invention is in view of this prior art, the object to provide a device which is suitable for introducing a wide variety of objects in cavities or vessels of the human or animal body as universal as possible insertion.

For technical solution according to the invention is a device for introducing objects, in particular of implants, in vessels or body cavities of the human or animal body by means of a carrier / bar wire, with a handle for holding and movement of the carrier / bar wire, comprising a handle part and a relative to the handle part movable actuating part, wherein by means of the relative movement between the handle part and the actuating part of the carrier / locking wire is movable in at least one direction, proposed, which is characterized in that the handle part and the actuating part comprises means for controlling the relative movement, wherein the means for controlling are designed such that the relative movement between the grip part and the actuating part in a first movement section is essentially a rotational movement and in a second movement section is a translatory movement.

The invention is based on the finding that, in particular, the devices used for the mechanical separation of objects, in particular implants, into abnormal openings or vessels of the human or animal body can be implemented in a universal device with regard to their different modes of action. In particular, the mechanical shedding by a detachment process, which consists of two movement sections - a rotational movement and a translational movement - be simplified. It will be ensured that the inadvertent removal of an object to be inserted and thus any connected and caused injuries and / or ruptures are avoided.

The first movement section comprises a rotational movement which causes an axial movement of the carrier / bar wire. Due to the lever used by the rotational movement, a large force can be applied over a short distance. This further improves the meterability of the applied force. In particular, therefore, this movement section is suitable for releasing objects to be inserted, which are applied with a large clamping force on a support wire. Furthermore, by means of the translational movement of the second movement section, the force acting on the wire can be reduced, it being possible to retract the wire by a longer distance. This is particularly suitable for the release of objects to be introduced by a locking wire, which are held by means of a lower clamping force on the locking wire.

It is thus a further realization of the invention that the mechanical energy required for detachment from an object to be introduced is more easily controllable and deliverable by the article according to the invention.

Advantageously, the device is characterized in that the handle has a driver, wherein the carrier / bar wire by means of the driver in the at least one direction is movable. The driver establishes a connection between the carrier / bar wire and the device so that the carrier / bar wire can be moved upon actuation of the device. As a rule, the direction of movement of the carrier / bar wire has a degree of freedom. The carrier / bar wire can thus be moved back and forth by a catheter which, as seen by the user, corresponds to displaceability in the distal and proximal directions.

A further embodiment of the invention is characterized in that the handle for holding and moving a retaining wire, which is used in addition to the carrier / locking wire for the introduction of objects, is formed. This makes it possible to use the handle for the introduction of objects, in particular of implants, which are held by means of a lock on a locking wire. By design, such fasteners require that an additional retaining wire be connected to the object to be inserted. This is realized via two eyelets or loops. The first loop or eyelet is realized on the object to be introduced and the second eyelet or loop is arranged on the end side of the retaining wire. The two loops or loops have an overlap, through which a locking wire engages or passes through.

According to the invention, the device is advantageously characterized in that the handle has a further driver, wherein the holding wire by means of the driver in the at least one direction is movable. The arrangement of two drivers on the device according to the invention, an independent mobility of the wires used in a locking, bar wire and retaining wire allows. In order to eject a locked object to be introduced, the locking wire is first pulled out of the loops or loops in a first step. Now it is possible, by retracting the retaining wire and thus the eyelet or loop formed by the retaining wire to retract it, so that an object to be inserted can be placed. The retraction of the locking wire is realized according to the invention in the first movement section by the rotation of the handle, the retraction of the retaining wire is in the second movement section, in which the handle is moved in a translational movement realized. By separating the movements of bar wire and retaining wire is avoided that snagging can occur when dropping the object to be introduced.

A further embodiment of the invention provides that at least one of the drivers is rotatably mounted about the longitudinal axis of the device. A rotatable mounting of the driver may be required to prevent caused by the actuation of the device rotation of the carrier / bar wire. The consequences of this would be that an object to be inserted is twisted and positioning within a cavity or vessel can be made more difficult. If the driver is rotatably mounted, the carrier / locking wire is not twisted during a rotary actuation of the device.

An advantageous embodiment of the invention is characterized in that the handle part of the handle as a means for controlling the first Movement section a thread, in particular an internal thread, and the actuating part of the handle has a corresponding thread as a means for controlling the first movement section, in particular an external thread. For example, the handle part of the handle have an internal thread and corresponding thereto the actuating part of the handle an external thread.

A preferred embodiment of the invention is characterized in that the relative movement of the first movement section comprises an axial relative movement between the actuating part and the handle part, wherein the axial relative movement is caused by the rotational movement.

Further, the pitches of the threads used dictate how the relationship between the relative movement between the operating member and the handle portion of the handle and the resultant transmitted force is by means of the driver on the carrier / bar wire. In conjunction with the rotatably mounted driver is avoided that in the execution of the relative movement between the actuating part and the handle portion of the handle, a rotation of the carrier / locking wire occurs.

A particularly preferred embodiment of the invention is characterized in that the handle part of the handle has a guide element as a means for controlling the second movement section, the translational relative movement of the second movement section taking place along the path predetermined by the guide element. About the guide element can be made a translational relative movement of the actuating part relative to the handle part. Furthermore, the guide element can have a stop, so that the actuating part can not be moved beyond the guide element. In the second movement section, the wire (s) can be moved by a longer distance relative to the first movement section by means of the driver (s). For example, this can be done quickly and easily the insertion or withdrawal of / the wire / wires.

An embodiment of the invention provides that the handle part of the handle is integrally formed. The handle part can thus be made in one piece, for example, and have a threaded sleeve, a guide element and a receptacle for the carrier / bar wire. This facilitates the manufacture of the device, since the number of parts to be produced is reduced and the device is cheaper.

A further embodiment of the invention is characterized in that the handle has a detent with which the actuating part can be locked to the handle part of the handle. The locking can be realized for example via a pin element with an arranged handle, so that the pin engages through a bore on the handle part and the actuating part and a fixation is effected.

Advantageously, an embodiment of the invention is characterized by two further fuse wires connected to the object to be introduced, wherein the securing wires can be detached from the object to be introduced independently of one another by means of the handle. When inserting and positioning objects in abnormal openings or vessels of the human or animal body, it may happen that the object has been misplaced or determined that the object has not been placed as intended after a successful ejection of the object to be inserted. During implantation of the article to be inserted, the article is supported by the carrier / bar wire. After ejection of the object eliminates the support effect of this / this wire / wires, so that under certain circumstances, such a misplacement or unwanted placement may occur. Since the connection to the introduced object of the insertion aid is already separated in this state, a repositioning or removal of the object to be introduced can not take place. In these cases, for example, by means of a catching loop, which is introduced endovascularly to the affected area, the object to be introduced must be removed. Preferably, therefore, an object to be introduced is connected by means of two additional security wires with the device according to the invention. In a successful ejection of the introduced object by the retraction of the carrier / bar wire or retaining wire is still a connection via the security wires to the object to be introduced. In the case of slippage or misplacement of the object to be introduced, a repositioning or removal of the object to be introduced can easily take place via the securing wires. The fuse wires are advantageously designed to be flexible in order to avoid a force caused by the connection of the safety wires to the object to be introduced force, which would complicate the positioning.

The device according to the invention is suitable for introducing medical implants into a human or animal body. The medical implants are, for example, occluders or stents.

When inserting and placing a stent in the human or animal body, particular care must be taken to ensure that the stent is in place of discarding is not misplaced. By means of the device according to the invention, a dislocation can be prevented in that, after the first movement section, the stent partially rests against the tissue surrounding the implantation site. During the first part of the movement, the stent unfolds slowly due to the rotational movement and can thus be placed very precisely. During the second movement section, in which the stent unfolds more quickly, the placement is ensured by the contact between stent and tissue produced during the first movement section.

Further details, features and advantages of the invention will be explained in more detail with reference to the embodiments illustrated in the figures of the drawings. Showing:

1 in a schematic diagram of a device according to the invention in a first, locked state;

2 in a schematic diagram of a device according to the invention in a state of relative movement of the first movement section between the handle part and the actuating part of the device;

3 in a schematic schematic diagram of a device according to the invention in a state of relative movement of the second movement section between the handle part and the actuating part of the device;

4a in a schematic schematic diagram of a device according to the invention in a side view and

4b a sectional view of the device according to the invention along the section line AA according to 4a ,

In 1 is a device according to the invention with a handle 1 shown for holding and moving a carrier / bar wire or holding wire. The handle 1 has a handle part 2 on. Furthermore, on the handle part 2 a guide element 7 and a recording 9 arranged. The recording 9 is adapted to receive a carrier / bar wire or a holding wire to which an object to be inserted, in particular an implant, can be attached. The handle 1 includes an actuating part 3 which is rotatable and displaceable along the longitudinal direction of the device. In a hole 11 of the grip part 2 is a locking element 8th introduced, which is the actuating part 3 on the handle part 2 fixed. For this purpose, the actuating element 8th a pin and a holding part, wherein the pin on the one hand through the bore 11 on the handle part 2 and on the other hand by a corresponding hole 11 on the actuating part 3 engages, so that a lock can be achieved. How about the arrow 10 indicated, the locking element 8th be removed and the operating part 3 be released.

Within the guide element 7 is a driver 6a to recognize which in a recess of the guide element 7 is arranged. The driver 6a works with one in the recording 9 introduced holding wire together and is about the operating part 3 controlled.

When the locking element 8th is removed, the actuating part 3 first execute in a first movement section a substantially shaped by a rotational movement relative movement, which between the handle part 2 and the operating part 3 takes place. This is one in the recording 9 introduced carrier / bar wire, which with the carrier / latch wire driver 6b represented in 4b , interacts, moves.

The rotational movement of the actuating part 3 is exemplified by the arrow 4 in the 2 clarified. The rotational movement is realized by a thread, wherein the actuating part 3 an external thread as means for controlling the relative movement of the first movement section. In this case, a pin engages in a threaded sleeve 12 on the handle part 2 is arranged, a.

Furthermore, there is an axial relative movement between the actuating part 3 and the handle part 2 instead of. This is in 2 schematically represented by a longitudinal displacement between the actuating part 3 and the handle part 2 is shown and the actuating part 3 no longer directly next to the handle 2 located at the completed relative movement of the first movement section.

In 3 is the final state of the second movement portion of the relative movement between the actuating part 3 and the handle part 2 shown. For this purpose, a translational movement of the actuating part was compared to the final state of the first movement section 3 executed. The translatory movement is through the arrow 5 indicated. The translatory movement takes place here 5 by means of the guide element 7 predetermined path, so that the displacement of the operating part 3 opposite the handle part 2 takes place in the longitudinal direction of the device. The guide element 7 has a stop, so that the actuating part 3 not over the guide element 7 is also displaceable.

At the beginning of the second movement section abuts the carrier / Riegeldrahtmitnehmer 6b against the retaining wire driver 6a , so that in the second movement section both drivers 6a . 6b be moved simultaneously in the longitudinal direction of the device.

4a shows a device according to the invention in a side view, as far as these already from the 1 to 3 is known.

4b shows the device according to the invention along the section line AA according to 4a , The device 1 has a fixed handle part 2 and an actuating part 3 on. The actuating part 3 is on the handle part 2 by means of a lock 8th lockable. The handle 1 has two drivers 6a and 6b on. The carrier / latch wire driver is in the front, patient facing portion of the handle 1 arranged. The second driver, the retaining wire driver 6a , is in the back, the patient facing away from the grab handle 1 arranged.

Furthermore, in 4b a threaded sleeve 12 recognizable, which provides a thread, so that the actuating part 3 in the first movement section by rotation about that through the threaded sleeve 12 trained thread an axial displacement along the guide element 7 experiences.

The carrier / latch wire driver 6b can move depending on the used object to be inserted carrier wire or bar wire. During the first movement section of the device according to the invention, this driver is first 6b moved along the device in the longitudinal direction. Due to the force caused by the rotation caused by the leverage of the operating part 3 is amplified, the movement of the carrier / bar wire is performed with great force. This makes it possible to drop objects to be introduced, which are mounted on a support wire by means of clamping force, adequately.

After completion of the first movement section and the associated movement of the carrier / Riegeldrahtmitnehmers 6b This bumps against the retaining wire driver 6a , Now, if the second movement section of the device according to the invention carried out, both drivers 6a and 6b simultaneously moved in the longitudinal direction of the device. The retaining wire driver 6a is, as the name implies, responsible for the movement of a retaining wire. This is used only for imported objects, which must be dropped by means of a lock. Due to the strict division of the movement sections and the associated sequential movement first of the carrier / locking wire and then the retaining wire ensures that when dropping a abzuwerfen with a locking object to be introduced a hooking of the object between the locking wire and the retaining wire can not occur.

The illustrated and described in the figures of the drawing embodiment of the invention is only illustrative of the invention and is not limiting for this.

LIST OF REFERENCE NUMBERS

1

handle

2

handle part

3

actuating member

4

rotary motion

5

translational movement

6a

Haltedrahtmitnehmer

6b

Carrier / Riegelträgermitnehmer

7

guide element

8th

lock

9

admission

10

Release catch

11

drilling

12

threaded sleeve

Claims (11)

Device for introducing objects, in particular implants, into vessels or body cavities of the human or animal body by means of a carrier / bar wire, with a handle ( 1 ) for holding and moving the carrier / bar wire, comprising a handle part ( 2 ) and a relative to the handle portion movable actuating part ( 3 ), wherein by means of the relative movement between the handle part and the actuating part ( 3 ) the carrier / bar wire is movable in at least one direction, characterized in that the handle part ( 2 ) and the actuating part ( 3 ) Means for controlling the relative movement, wherein the means for controlling are designed such that the relative movement between the handle part ( 2 ) and the actuating part ( 3 ) is a rotational movement in a first movement section and a translatory movement in a second movement section. Device according to claim 1, characterized in that the handle ( 1 ) a driver ( 6b ), wherein the carrier / latching wire by means of the driver ( 6b ) is movable in the at least one direction. Device according to claim 1 or claim 2, characterized in that the handle ( 1 ) for holding and moving a holding wire, which is usable in addition to the carrier / bar wire for the introduction of articles, is formed. Device according to claim 3, characterized in that the handle ( 1 ) another driver ( 6a ), wherein the holding wire by means of the driver ( 6a ) is movable in the at least one direction. Apparatus according to claim 4, characterized in that at least one of the drivers ( 6a , b) is rotatably mounted about the longitudinal axis of the device. Device according to one of claims 1 to 5, characterized in that the handle part ( 2 ) of the handle ( 1 ) as a means for controlling the first movement section a thread, in particular an internal thread, and the actuating part ( 3 ) of the handle ( 1 ) has a corresponding thread as means for controlling the first movement section, in particular an external thread. Device according to one of claims 1 to 6, characterized in that the relative movement of the first movement section, an axial relative movement between the actuating part ( 3 ) and the handle part ( 2 ), wherein the axial relative movement is caused by the rotational movement. Device according to one of claims 1 to 7, characterized in that the handle part ( 2 ) of the handle ( 1 ) as a means for controlling the second movement section, a guide element ( 7 ), wherein the translational relative movement of the second movement section along the through the guide element ( 7 ) predetermined path takes place. Device according to one of claims 1 to 8, characterized in that the handle part ( 2 ) of the handle ( 1 ) is formed in one piece. Device according to one of claims 1 to 9, characterized in that the handle ( 1 ) has a detent, with which the actuating part on the handle part ( 8th ) of the handle ( 1 ) is lockable. Device according to one of claims 1 to 10, characterized by two further securing wires connected to the object to be introduced, the securing wires being held by means of the handle ( 1 ) are independently detachable from the object to be introduced.

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