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FR2660851A1 - Device for unblocking vascular channels, such as the arteries - Google Patents

Device for unblocking vascular channels, such as the arteries Download PDF

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Publication number
FR2660851A1
FR2660851A1 FR9004964A FR9004964A FR2660851A1 FR 2660851 A1 FR2660851 A1 FR 2660851A1 FR 9004964 A FR9004964 A FR 9004964A FR 9004964 A FR9004964 A FR 9004964A FR 2660851 A1 FR2660851 A1 FR 2660851A1
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France
Prior art keywords
tool
face
hand
channel
front face
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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Withdrawn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
FR9004964A
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French (fr)
Inventor
Koskas David
Camus Michel
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Cardial SAS
Original Assignee
Cardial SAS
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Filing date
Publication date
Application filed by Cardial SAS filed Critical Cardial SAS
Priority to FR9004964A priority Critical patent/FR2660851A1/en
Publication of FR2660851A1 publication Critical patent/FR2660851A1/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/320758—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Vascular Medicine (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention relates to a device (1) for unblocking vascular channels, such as the arteries, which device comprises: - at least one instrument (3) of the rotary type equipped with at least one cutting edge (4), - at least one drive means (5) generating, at least indirectly, a movement for activating the abovementioned instrument (3), - at least one flexible member (6), called the transmission member, this device being characterised in that, instead of consisting of a drive means moving the instrument in constant rotation in one defined direction, the drive means (5) comprises a means for moving the instrument in alternating rotation, on the one hand over at least two predetermined angular extents of opposite directions, and on the other hand at least two angular speeds which are likewise predetermined and of opposite kinds.

Description

L'invention se rapporte à un dispositif de désobstruction de conduits vasculaires tels des artères. The invention relates to a device for clearing vascular ducts such as arteries.

Tel que cela est connu, les parois de certains conduits vasculaires peuvent se charger de dépôts dits plaques d'athérome qui, notanrent, engendrent l'obstruction de ces conduits. As is known, the walls of certain vascular conduits can be loaded with deposits called atheroma plaques which, in particular, cause obstruction of these conduits.

Pour remédier à l'obstruction de vaisseaux, il est connu de prélever récaniquement ces dépôts athéromateux au moyen d'un outil introduit par le biais d'un cathéter au niveau du site à traiter. To remedy the obstruction of vessels, it is known to recanally remove these atheromatous deposits by means of a tool inserted through a catheter at the site to be treated.

Ces outils sont classiquement animés d'un mouvement rotatif continu dans un sens donne et ont leur partie active sensiblement conçue comme celle d'une fraise d'usinage. These tools are conventionally driven by a continuous rotary movement in a given direction and have their active part substantially designed like that of a milling cutter.

Généralement, les dépôts athéromateux précités sont calcifiés et donc tres durs ce qui implique l'utilisation de fraises diamentées entraînées en rotation à plusieurs milliers de tours par minute. Generally, the above-mentioned atheromatous deposits are calcified and therefore very hard, which implies the use of diamond cutters driven in rotation at several thousands of revolutions per minute.

On reproche aux dispositifs de désobstruction ainsi constitues d'être trop agressifs vis à vis des parois des vaisseaux traites qu'en outre, ils sollicitent trop énergiquement en torsion, ce qui est néfaste compte tenu de la relative fragilité ce type de sollicitations mécaniques de ces parois altérées. The disobstruction devices thus constituted are criticized for being too aggressive with respect to the walls of the treated vessels that, in addition, they stress too strongly in torsion, which is harmful given the relative fragility of this type of mechanical stresses weathered walls.

De plus, avec ce type de dispositif de désobstruction, on contrôle mal la trajectoire de l'outil dans le conduit vasculaire, lequel outil peut tendre à perforer la paroi vasculaire. In addition, with this type of unclogging device, it is difficult to control the path of the tool in the vascular duct, which tool can tend to perforate the vascular wall.

Un résultat que l'invention vise à obtenir est un dispositif de désobstruction de conduits vasculaires qui rerédi e aux inconvénients précités. One result which the invention aims to obtain is a device for unblocking vascular conduits which reduces the aforementioned drawbacks.

A cet effet, l'invention a pour objet un dispositif du type précité notamment caractérisé en ce qu'au lieu de consister en un moyen moteur d'entraînement en rotation continue de l'outil dans un sens déterminé, le woyen moteur comprend un moyen d'entraînement de l'outil en rotation alternative selon, d'une part, au moins deux amplitudes angulaires prédéterminées de sens opposes, et, d'autre part, au moins deux vitesses angulaires salement prédéterminées et de signes opposés.  To this end, the subject of the invention is a device of the aforementioned type, in particular characterized in that, instead of consisting of a motor means for driving the tool in continuous rotation in a determined direction, the motor woyen comprises a means driving the tool in alternating rotation along, on the one hand, at least two predetermined angular amplitudes in opposite directions, and, on the other hand, at least two badly predetermined angular speeds and opposite signs.

L invention sera bien comprise à l'aide de la description ci-aprés faite à titre d'exemple non limitatif en regard du dessin ci-annexe qui représente schématiquement
- figure 1 : le dispositif de l'invention vue en coupe longitudinale,
- figure 2 : à plus grande échelle, une vue selon F de la figure 1.The invention will be clearly understood with the aid of the description below given by way of nonlimiting example with regard to the attached drawing which schematically represents
- Figure 1: the device of the invention seen in longitudinal section,
- Figure 2: on a larger scale, a view along F of Figure 1.

En se reportant au dessin, on voit un dispositif 1 de désobstruction de conduits vasculaires 2 tels des artères. Referring to the drawing, we see a device 1 for unblocking vascular conduits 2 such as arteries.

Le dispositif comprend
- au moins un outil 3 de type rotatif doté d'au moins une arête de coupe 4,
- au moins un moyen moteur 5 générant au moins indirectement un mouvement d'actionnement de l'outil 3 précité,
- au moins un organe flexible 6, dit de transmission, et dont l'une 7 des extrémités 7, 8 est accouplée à l'outil 3 tandis que l'autre extrémité 8 est accouplée au moyen 5 moteur.The device includes
at least one rotary type tool 3 provided with at least one cutting edge 4,
at least one motor means 5 generating at least indirectly an actuating movement of the aforementioned tool 3,
- At least one flexible member 6, said transmission, and one of which 7 of the ends 7, 8 is coupled to the tool 3 while the other end 8 is coupled to the motor means 5.

Selon l'invention, au lieu de consister en un moyen moteur d'entraînement en rotation continue de l'outil dans un sens déterminé, le moyen 5 moteur comprend un moyen d'entraînement de l'outil en rotation alternative selon, d'une part, au moins deux amplitudes angulaires prédéterminées de sens opposes, et, d'autre part, au moi nus deux vitesses angulaires également prédéterminées et de signes opposés. According to the invention, instead of consisting of a motor means for driving the tool in continuous rotation in a determined direction, the motor means comprises a means for driving the tool in alternating rotation according to a on the one hand, at least two predetermined angular amplitudes of opposite directions, and, on the other hand, on the naked self two angular velocities also predetermined and of opposite signs.

De préférence, le moyen moteur comprend des organes de réglage des valeurs des amplitudes et des vitesses angulaires précitées.  Preferably, the drive means comprises members for adjusting the values of the aforementioned amplitudes and angular speeds.

Les deux amplitudes angulaires sont, par exemple, identiques et de l'ordre de cent vingts degrés. The two angular amplitudes are, for example, identical and of the order of one hundred and twenty degrees.

Par exemple, le moyen moteur 5 imprime à l'outil un mouvement de l'ordre de cinquante alternances par secondes. For example, the motor means 5 gives the tool a movement of the order of fifty vibrations per second.

Conforément à l'invention, l'outil rotatif 3 utilisé comprend au foins deux arêtes 4 de coupe, chacune active dans l'un des deux sens de rotation. In accordance with the invention, the rotary tool 3 used comprises at hay two cutting edges 4, each active in one of the two directions of rotation.

De manière connue, l'organe de transmission 6 est logé dans un tube souple 9 dit cathéter.  In known manner, the transmission member 6 is housed in a flexible tube 9 called catheter.

Selon l'invention, ve l'outil comprend au moins une face frontale 10 dans laquelle, notamment en partie centrale, débouche au moins un premier canal 11 qui s'étend par ailleurs tout au long de l'outil et se prolonge lla dans l'organe de transmission sensiblement jusqu'à son extrémité 8 accouplée au moyen moteur 5 et, d'autre part, au moins une face dorsale 12 entre laquelle et la face extrême 13, en vis à vis d'un cathéter qui loge l'organe d'entraînement, subsiste un passage 14 relié à un second canal 15 qui s'étend quant à lui longitudinalement au cathéter et ce sensibleirent jusqu'à son extrémité libre voisine du moyen 5 moteur.  According to the invention, the tool comprises at least one front face 10 into which, in particular in the central part, opens out at least a first channel 11 which also extends throughout the tool and extends there in transmission member substantially up to its end 8 coupled to the motor means 5 and, on the other hand, at least one dorsal face 12 between which and the end face 13, opposite a catheter which houses the member drive, there remains a passage 14 connected to a second channel 15 which extends in turn longitudinally to the catheter and this sensitive to its free end near the motor means 5.

L'un 11 de ces canaux 11, 15 est relie à un moyen 16 d'injection de fluide tandis que l'autre 15 est relié à un moyen 17 d'aspiration de fluide. One 11 of these channels 11, 15 is connected to a fluid injection means 16 while the other 15 is connected to a fluid suction means 17.

Confor-éri ent l'invention, c'est le canal 11 débouchant dans la face frontale 10 de l'outil qui est relié au moyen 16 d'injection de fluide tandis que le canal 15 débouchant par le passage 14 au droit de la face dorsale 12 de cet outil est relié au moyen 17 d'aspiration de fluide. In accordance with the invention, it is the channel 11 opening into the front face 10 of the tool which is connected to the means 16 for injecting fluid while the channel 15 opening through the passage 14 to the right of the face dorsal 12 of this tool is connected to the fluid suction means 17.

D'une part, l'outil comporte un corps 18 globalement cylindrique de révolution et ce corps 18 porte des parties actives minces 19 telles des lames présentant chacune, en saillie, par rapport au dit corps 18 au moins une arête de coupe 4 et, d'autre part, au moins certaines de ces arêtes s'étendent sensiblement parallélement à l'enveloppe du corps cylindrique depuis le bord périphérique de la face dorsale 12 de l'outil jusque dans le plan de la face frontale 10 de cet outil. On the one hand, the tool comprises a generally cylindrical body 18 of revolution and this body 18 carries thin active parts 19 such as blades each having, projecting from said body 18 at least one cutting edge 4 and, on the other hand, at least some of these edges extend substantially parallel to the envelope of the cylindrical body from the peripheral edge of the dorsal face 12 of the tool as far as the plane of the front face 10 of this tool.

De préférence, chaque lame 19 s'étend dans un plan sensiblement radial au corps cylindrique de l'outil et présente au droit de la paroi cylindrique de cet outil, deux arêtes 4 qui, situées de part et d'autre d'un plan médian à la lame, convergent vers ce plan médian et ce, depuis la face frontale 10 de l'outil vers la surface dorsale 12. Preferably, each blade 19 extends in a plane substantially radial to the cylindrical body of the tool and has, at the right of the cylindrical wall of this tool, two edges 4 which, situated on either side of a median plane to the blade, converge towards this median plane and this, from the front face 10 of the tool towards the dorsal surface 12.

Ces fores permettent d'optimiser le décolmatage des lames de l'outil.  These drills optimize the cleaning of the blades of the tool.

Conformément à l'invention, au moins certaines des parties actives 19 de l'outil comportent une face extrême 20 sensiblernent radiale et située au niveau de la face frontale 10 de l'outil avec dans cette face extrême au moins une rainure 21 qui s'étend sensiblement parallèlement aux flancs 22 de la lame qui constitue la partie active considérée. According to the invention, at least some of the active parts 19 of the tool have an end face 20 which is substantially radial and situated at the level of the front face 10 of the tool with in this end face at least one groove 21 which s extends substantially parallel to the sides 22 of the blade which constitutes the active part considered.

Le dispositif de l'invention permet de remédier aux inconvénients des dispositifs animés d'un mouvement rotatif continu dans un sens déterminé.  The device of the invention overcomes the drawbacks of devices driven by a continuous rotary movement in a determined direction.

Précisément, il obvie à un échauffement notable induit au droit des parois vasculaires par les dispositifs connus. Specifically, it obviates a significant heating induced to the right of the vascular walls by the known devices.

Egalement, il permet l'élimination des particules de la plaque d'athérome détachées par l'outil. Also, it allows the removal of particles from the atheroma plaque detached by the tool.

De plus, l'alternance de mouvements de l'outil est moins agressive pour les conduits vasculaires que le mouvement rotatif continu des dispositifs connus. In addition, the alternation of movements of the tool is less aggressive for the vascular conduits than the continuous rotary movement of known devices.

Eventuellement, l'outil porte sur sa face frontale 10 au moins une excroissance centrale 23 qui constitue un nez de centrage dans un éventuel canal 24 pouvant subsister au centre du conduit vasculaire à traiter. Optionally, the tool carries on its front face 10 at least one central protuberance 23 which constitutes a centering nose in a possible channel 24 which may remain at the center of the vascular duct to be treated.

Le cathéter porte l'outil au moins par le biais d'un moyen 25 de guidage en rotation qui comporte au moins un passage 26 en vue d'assurer la continuité du conduit 15 débouchant à l'extrémité du cathéter 9 voisine de l'outil.  The catheter carries the tool at least by means of a guide 25 in rotation which comprises at least one passage 26 in order to ensure the continuity of the conduit 15 opening at the end of the catheter 9 adjacent to the tool .

Claims (9)

REVENDICATIONS 1. Dispositif (1) de désobstruction de conduits vasculaires (2) tels des artères, lequel dispositif comprend 1. Device (1) for clearing vascular ducts (2) such as arteries, which device comprises - au moins un outil (3) de type rotatif doté d'au moins une arête de coupe (4), - at least one rotary type tool (3) provided with at least one cutting edge (4), - au moins un moyen moteur (5) générant au moins indirectement un mouvement d'actionnement de l'outil (3) précité,  - at least one motor means (5) generating at least indirectly an actuating movement of the above-mentioned tool (3), - au moins un organe flexible (6), dit de transmission, et dont l'une (7) des extrémités (7, 8) est accouplée à l'outil (3) tandis que l'autre extrémité (8) est accouplée au moyen moteur (5), - At least one flexible member (6), called transmission, and one of which (7) of the ends (7, 8) is coupled to the tool (3) while the other end (8) is coupled to the medium engine (5), ce dispositif étant CARACTERISE en ce qu'au lieu de consister en un moyen moteur d'entraînement en rotation continue de l'outil dans un sens déterminé, le moyen moteur (5) comprend un moyen d'entraînement de # l'outil en rot rotation alternative selon, d'une part, au moins deux amplitudes angulaires prédéterminées de sens opposés, et, d'autre part, au moins deux vitesses angulaires également prédéterminées et de signes opposés. this device being CHARACTERIZED in that instead of consisting of a motor means for driving the tool in continuous rotation in a determined direction, the motor means (5) comprises a means for driving the # tool in rot alternating rotation according to, on the one hand, at least two predetermined angular amplitudes of opposite directions, and, on the other hand, at least two angular speeds also predetermined and of opposite signs. 2. Dispositif selon la revendication 1 caractérisé en ce que l'outil rotatif (3) utilisé comprend au moins deux arêtes (4) de coupe, chacune active dans l'un des deux sens de rotation. 2. Device according to claim 1 characterized in that the rotary tool (3) used comprises at least two cutting edges (4), each active in one of the two directions of rotation. 3. Dispositif selon la revendication 1 ou 2 caractérisé en ce que l'outil comprend au moins une face frontale (10) dans laquelle, notamment en partie centrale, débouche au moins un premier canal (11) qui s'étend par ailleurs tout au long de l'outil et se prolonge (lla) dans l'organe de transmission sensiblement jusqu'à son extrémité (8) accouplée au moyen moteur (5) et, d'autre part, au moins une face dorsale (12) entre laquelle et la face extrême (13), en vis à vis d'un cathéter qui loge l'organe d'entraînement, subsiste un passage (14) relié à un second canal (15) qui s'étend quant à lui longitudinalement au cathéter et ce sensiblement jusqu'à son extrémité libre voisine du moyen moteur (5).  3. Device according to claim 1 or 2 characterized in that the tool comprises at least one front face (10) into which, in particular in the central part, opens out at least a first channel (11) which also extends throughout along the tool and extends (lla) in the transmission member substantially to its end (8) coupled to the motor means (5) and, on the other hand, at least one dorsal face (12) between which and the end face (13), facing a catheter which houses the drive member, remains a passage (14) connected to a second channel (15) which in turn extends longitudinally to the catheter and this substantially to its free end close to the drive means (5). 4. Dispositif selon la revendication 3 caractérisé en ce que l'un (11) des canaux (11, 15) est relié à un moyen (16) d'injection de fluide tandis que l'autre (15) est relié à un moyen (17) d'aspiration de fluide. 4. Device according to claim 3 characterized in that one (11) of the channels (11, 15) is connected to a means (16) for injecting fluid while the other (15) is connected to a means (17) fluid suction. 5. Dispositif selon la revendication 4 ou 5 caractérisé en ce que c'est le canal (11) débouchant dans la face frontale (10) de l'outil qui est relié au moyen (16) d'injection de fluide tandis que le canal (15) débouchant par le passage (14) au droit de la face dorsale (12) de cet outil est relié au moyen (17) d'aspiration de fluide. 5. Device according to claim 4 or 5 characterized in that it is the channel (11) opening into the front face (10) of the tool which is connected to the means (16) for injecting fluid while the channel (15) emerging through the passage (14) to the right of the dorsal face (12) of this tool is connected to the means (17) of fluid suction. 6. Dispositif selon l'une quelconque des revendications 7 à 5 caractérisé en ce que d'une part, l'outil comporte un corps (18) globalement cylindrique de révolution et ce corps (18) porte des parties actives minces (19) telles des lames présentant chacune, en saillie, par rapport au dit corps (18) au moins une arête de coupe (4) et, d'autre part, au moins certaines de ces arêtes s'étendent sensiblement parallèlement à l'enveloppe du corps cylindrique depuis le bord périphérique de la face dorsale (12) de l'outil jusque dans le plan de la face frontale (10) de cet outil. 6. Device according to any one of claims 7 to 5 characterized in that on the one hand, the tool comprises a body (18) generally cylindrical of revolution and this body (18) carries thin active parts (19) such blades each having, projecting from said body (18) at least one cutting edge (4) and, on the other hand, at least some of these edges extend substantially parallel to the envelope of the cylindrical body from the peripheral edge of the dorsal face (12) of the tool up to the plane of the front face (10) of this tool. 7. Dispositif selon la revendication 6 caractérisé en ce qu'au moins certaines des parties actives (19) de l'outil comportent une face extrême (20) sensiblement radiale et située au niveau de la a face frontale (10) de l'outil avec dans cette face extrême au moins une rainure (21) qui s'étend sensiblement parallèlement aux flancs (22) de la lame qui constitue la partie active considérée.  7. Device according to claim 6 characterized in that at least some of the active parts (19) of the tool have an end face (20) substantially radial and situated at the level of the front face (10) of the tool with in this end face at least one groove (21) which extends substantially parallel to the sides (22) of the blade which constitutes the active part considered. 8. Dispositif selon l'une quelconque des revendications 1 à 7 caractérisé en ce que le cathéter porte l'outil au moins par le biais d'un moyen (25) de guidage en rotation qui comporte au moins un passage (26) en vue d'assurer la continuité du conduit (15) débouchant à l'extrémité du cathéter (9) voisine de l'outil. 8. Device according to any one of claims 1 to 7 characterized in that the catheter carries the tool at least by means (25) of guiding in rotation which comprises at least one passage (26) in sight to ensure the continuity of the conduit (15) opening at the end of the catheter (9) adjacent to the tool. 9. Dispositif selon l'une quelconque des revendications 1 à 8 caractérisé en ce que l'outil porte sur sa face frontale (10) au moins une excroissance centrale (23) qui constitue un nez de centrage dans un éventuel canal (24) pouvant subsister au centre du conduit vasculaire à traiter.  9. Device according to any one of claims 1 to 8 characterized in that the tool carries on its front face (10) at least one central protuberance (23) which constitutes a centering nose in a possible channel (24) which can remain at the center of the vascular duct to be treated.
FR9004964A 1990-04-11 1990-04-11 Device for unblocking vascular channels, such as the arteries Withdrawn FR2660851A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
FR9004964A FR2660851A1 (en) 1990-04-11 1990-04-11 Device for unblocking vascular channels, such as the arteries

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Application Number Priority Date Filing Date Title
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