WO2018103662A1 - Conveying system for implant - Google Patents
Conveying system for implant Download PDFInfo
- Publication number
- WO2018103662A1 WO2018103662A1 PCT/CN2017/114809 CN2017114809W WO2018103662A1 WO 2018103662 A1 WO2018103662 A1 WO 2018103662A1 CN 2017114809 W CN2017114809 W CN 2017114809W WO 2018103662 A1 WO2018103662 A1 WO 2018103662A1
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- WO
- WIPO (PCT)
- Prior art keywords
- tube
- inner sheath
- core tube
- sheath core
- hooking
- 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.)
- Ceased
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Classifications
-
- 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
- A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
- A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
-
- 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
- A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
- A61F2/97—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve the outer sleeve being splittable
-
- 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
- A61F2002/9505—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
- A61F2002/9511—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument the retaining means being filaments or wires
-
- 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
- A61F2002/9534—Instruments specially adapted for placement or removal of stents or stent-grafts for repositioning of stents
-
- 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
- A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
- A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
- A61F2002/9665—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod with additional retaining means
Definitions
- the present invention relates to implantable medical devices, and in particular to delivery systems for implants.
- luminal stent intervention For diseases such as vascular stenosis, aneurysm and vascular dissection, luminal stent intervention has the advantages of less trauma, quick recovery, less complications, and better therapeutic effect.
- the metal skeleton structure of the self-expanding stent lumen stent is usually made of Nitinol, and after the heat setting process, the lumen stent has the ability to restore its shape.
- the tube of the delivery system of such a stent generally comprises an outer sheath tube and an inner sheath core tube pre-installed in the outer sheath tube.
- the proximal end of the inner sheath core tube is thicker and the distal end is thinner.
- the lumen bracket is received in the cavity between the outer sheath tube and the distal end portion of the inner sheath core tube, and the distal end of the stent and the inner sheath core tube are thicker.
- the distal end face of the portion is in close contact with the inner sheath core tube for connecting the seeker (or tip) and receiving and passing the guide wire.
- the blood vessel shape is bent and the lumen stent is also easily displaced. Will affect the subsequent release, and when the outer sheath is removed, the stent will be easily displaced, resulting in unsatisfactory release position, which will affect the therapeutic effect.
- this delivery system still has the following defects: (1) during the delivery of the lumen stent, when the outer sheath tube and the sheath core tube together pass through the curved portion of the human lumen, the bending radius of the curved blood vessel is smaller.
- the gap between the sheath core tube and the outer sheath tube is reduced; on the side of the curved radius of the curved blood vessel, the gap between the sheath core tube and the outer sheath tube is increased, and at this time, the rigid protrusion and the outer portion
- the distance between the inner walls of the sheath is increased, the rigid protrusions are easily separated from the lumen stent, and the lumen stent may be separated from the protrusions, thereby causing the position of the lumen stent to be displaced in the outer sheath tube, affecting Subsequent release.
- the lumen stent When the sheath core tube and the outer sheath tube reach the lesion site, when the operator withdraws the outer sheath tube and releases the lumen stent, the lumen stent may be completely released from the outer sheath tube quickly, and if the release position is not ideal, it cannot be Adjust the release position. (3) When the lumen stent is partially released from the outer sheath tube, if the release position of the lumen stent is found to be unsatisfactory, the distal position of the outer sheath tube needs to be adjusted, and the lumen stent may be sheathed during the adjustment process. The tube was completely released in advance.
- the implant delivery system that secures the implant to the sheath core tube even within a curved vessel. Avoid offset between the implant and the inner sheath core. Moreover, the implant can be gradually released during the release process, avoiding the disadvantage of being unable to adjust the release position after the sudden release of the implant, and adjusting the release position of the release implant. During the procedure, avoid complete release of the implant in advance.
- the present invention provides an delivery system for an implant, comprising an inner sheath tube extending through the inner sheath tube and extending distally from the inner sheath core tube of the inner sheath tube, movably sleeved outside the inner sheath tube And an outer sheath tube having a cavity between the inner sheath core tube and at least one hooking unit fixed to an outer surface of the inner sheath core tube.
- the hooking unit includes at least two flexible hooks.
- the hooking member includes a fixing portion connected to an outer surface of the inner sheath core tube, and a deformation portion connected to the fixing portion.
- the free end of the deforming portion is bendable relative to the fixing portion and cooperates with the fixing portion to form a hook when being received in a cavity between the outer sheath tube and the inner sheath core tube.
- the hook member hooks the implant, and the freedom of the hook member
- the end has a tendency to expand radially outward along the inner sheath core tube, and the inner wall of the outer sheath tube inhibits the tendency of the free end to expand radially outward of the inner sheath core tube, thus
- the hooks can limit the relative movement between the implant and the inner sheath core tube.
- the hooking member When the outer sheath tube moves axially proximally relative to the inner sheath core tube, the hooking member is released from a cavity between the outer sheath tube and the inner sheath core tube, the outer sheath
- the inner wall of the tube eliminates the tendency of the free end of the hook to expand radially outwardly of the inner sheath core tube, the deformed portion expanding radially outward of the inner sheath core tube And separating from the implant, the implant is released from the outer sheath.
- the deformation portion has elasticity.
- the extending direction of the deformation portion is opposite to the inner sheath core tube
- the angle between the proximal to distal directions ranges from 0 to 180 degrees.
- connection of the free end of each of the deformation portions is composed of
- the diameter of the circumscribed circle of the polygon is less than 90% of the diameter of the circumcircle of the polygon formed by the line of the implant at the junction with each of the hooks before being compressed.
- the circumscribed circle of the polygon composed of the line connecting the free ends of each of the deformation portions has a diameter ranging from 3 to 50 mm.
- the deformation portion is along the axial direction of the inner sheath core tube
- the length ranges from 3 to 50 mm.
- the hooking unit includes 2 to 12 hooks, and the 2 to 12 hooks are symmetrically disposed about a central axis of the inner sheath core tube.
- the hooking unit further includes a hollow tubular hoop member sleeved and fixed to an outer surface of the inner sheath core tube, the hooking member passing through the hoop member and the inner sheath The outer surfaces of the core tubes are connected.
- the fixing portion is located between the fastening member and an outer surface of the inner sheath core tube, the fastening member restricting the fixing portion and an outer surface of the inner sheath core tube Relative movement between.
- the fastening member has a blind hole in the axial direction, and the fixing portion of the hooking member is inserted into the blind hole and fixedly connected to the fastening member.
- the fastening member has a through hole in the axial direction, and the fixing portion of the hooking member is axially penetrated through the through hole and fixedly connected to the fastening member.
- the hoop member has a diameter in the range of 1 to 30 mm, and the hoop member has a length in the axial direction of the inner sheath core tube ranging from 2 to 10 mm.
- the delivery system further includes a limiting member disposed between the hooking unit and the distal end of the inner sheath core tube, the limiting member being fixed to the inner sheath core tube The outer surface projects toward the axial direction away from the inner sheath core tube.
- the hook has a U-shaped configuration of twin strands.
- At least a portion of the free end of the deformation of the hook is heat set.
- an angle between a plane in which at least a portion of the free end of the deformation portion of the hook portion is located and a plane in which the fixing portion is located ranges from 60 degrees to 120 degrees.
- an angle between a plane in which at least a portion of the free end of the deformation portion of the hook portion is located and a plane in which the fixing portion is located is 90 degrees.
- At least one receiving space for receiving the free end of the deformation portion is disposed on the outer surface of the tube of the fastening member.
- the delivery system of the present invention provides a flexible hook on the inner sheath core tube instead of the rigid protrusion to constrain the lumen support, and has at least the following beneficial effects:
- the flexible hook When the body of the delivery system loaded with the implant is delivered within the lumen of the body, the flexible hook is bent proximally through the end of the implant and is constrained to the inner sheath core tube and Between the outer sheath tubes and having a long length along the axial direction of the inner sheath core tube, the hook member is not detached from the implant even when passing through the relatively curved body lumen portion, avoiding the prior art rigid convexity.
- the gap between the material and the inner wall of the outer sheath tube creates a risk of the implant falling off from the rigid protrusion.
- the implant can be gradually released under the constraint of the outer sheath tube within the length of the flexible hook until all the flexible hooks are exposed, thereby avoiding the disadvantage that the release position cannot be adjusted after the implant is suddenly released.
- the operator can withdraw the body and adjust the distal position of the tube.
- the implant is fixed on the inner sheath core tube. And the relative movement between the implant and the outer sheath tube does not occur, effectively preventing the implant from being released in advance from the outer sheath tube.
- the portion near the proximal end of the implant is still fixed to the inner sheath core tube by the hook unit.
- the distal end of the outer sheath tube can be re-recovered into the cavity between the outer sheath tube and the inner sheath core tube by driving the outer sheath tube to move axially distally relative to the inner sheath core tube, and then the tube The body is withdrawn from the patient and replaced with an appropriately sized implant.
- the delivery system includes a handle housing, a slider, a tube body, and a hooking unit, the tube body including an outer sheath tube, an inner sheath core tube, and an inner sheath tube;
- Figure 2a is a cross-sectional view of the hook unit and the tube body of Figure 1 in a section parallel to the axial direction;
- 2b is a schematic structural view of another embodiment of a tubular body
- FIG. 3a to 3c are schematic views showing the structure of the hooking unit of FIG. 1.
- the hooking unit includes three hooking members and a tightening member, wherein FIG. 3a is a front view of the hooking unit not received in the tubular body.
- Figure 3b is a front view of the hooking unit housed in the pipe body, and
- Figure 3c is a cross-sectional view of the hooking unit not received in the pipe body in a section parallel to the axial direction;
- FIG. 4a to 4c are schematic structural views of the hooking member of Fig. 3a, wherein Fig. 4a is a front view, Fig. 4b is a schematic view of the hooking member at another angle, and Fig. 4c is a side view;
- FIG. 5a and 5b are schematic structural views of another embodiment of a hooking unit, wherein FIG. 5a is a front view and FIG. 5b is a side view;
- Figure 5c is a cross-sectional view of another embodiment of the hooking unit in a section parallel to the axial direction;
- FIG. 5d and 5e are schematic views of another embodiment of the hooking unit and the tube body of Fig. 1, wherein Fig. 5d is a cross-sectional view in a section parallel to the axial direction, and Fig. 5e is a view in Fig. 5d Partial enlarged view;
- Figure 6 is a cross-sectional view of the hooking unit, the tube body and the lumen bracket in a section parallel to the axial direction when the hooking unit of Figure 1 is fixed to the inner sheath core tube;
- Figure 7 is a schematic view of the hooking unit of Figure 1 no longer fixing the lumen stent to the inner sheath core tube;
- FIG. 8a and 8b are schematic views of the process of the tube delivery lumen stent of Fig. 1, wherein Fig. 8a is a schematic view of the process of releasing the lumen stent portion from the outer sheath tube after reaching the lesion site, and Fig. 8b is an adjustment tube body. Schematic diagram of the process at the remote location;
- FIG. 9a and FIG. 9b are schematic diagrams showing the process of recovering the lumen stent to the outer sheath tube of FIG. 1.
- FIG. 9a is a schematic view showing the release of the lumen stent portion from the outer sheath tube
- FIG. 9b is a schematic diagram of the lumen stent recovery to a schematic diagram of the process in the outer sheath;
- 10a to 10c are schematic views of a hooking unit in a transport system according to a second embodiment, the transport system includes a tube body, a hooking unit, a handle housing and a slider, and the hooking unit includes three hooking members, wherein 10a is a front view of the hooking unit not received in the pipe body; FIG. 10b is a front view of a hooking member in FIG. 10a, and FIG. 10c is a front view of the hooking member in FIG. 10a received in the pipe body;
- FIG. 10d to 10g are schematic views of another embodiment of the hooking unit, wherein FIG. 10d is a front view of the hooking unit not received in the tube body, and FIG. 10e is a hooking unit of FIG. 10d received in the tube.
- Figure 10f is a schematic view of the hooking unit when the lumen stent is fixed on the inner sheath core tube;
- Figure 10g is a schematic view of the lumen stent released from the outer sheath tube;
- Figure 10h is a front elevational view of another embodiment of the hooking unit.
- Figure 11 is a cross-sectional view of another embodiment of the hook unit in a section parallel to the axial direction;
- FIG. 12a and 12b are schematic views of another embodiment of a hooking unit, wherein FIG. 12a is a front view and FIG. 12b is a side view;
- FIG. 13a and 13b are schematic views of a transport system provided by a third embodiment.
- the transport system includes a tube body, a hooking unit and a limiting member.
- FIG. 13a is a front view
- FIG. 13b is a tube body, a hooking unit and a limit. a cross-sectional view of a portion of the bit member in a section parallel to the axial direction;
- FIG. 14a and 14b are schematic structural views of a transport system according to a fourth embodiment.
- the transport system includes a handle housing, a slider, a tube body and a hooking unit.
- the hooking unit includes a hooking member, wherein FIG. 14a is a tube body and a hook.
- Hanging unit main view, FIG. 14b is a cross-sectional view of a portion of the tube body and the hooking unit of FIG. 14a in a section parallel to the axial direction;
- FIG. 15a to 15c are schematic structural views of a conveying system according to a fifth embodiment.
- the conveying system includes a handle housing, a slider, a tube body and three hooking units.
- FIG. 15a is a front view of the tube body and the hooking unit.
- Figure 15b is a cross-sectional view of the tube body and the hooking unit in a section parallel to the axial direction, and
- Figure 15c is a schematic view showing a partial release of the lumen bracket from the tube body in Figure 15b;
- Figure 16 is a schematic view showing the structure of a conveying system including a plurality of hooking units.
- an element when referred to as being “fixed” to another element, it can be directly on the other element or the element can be present. When an element is considered to be “connected” to another element, it can be directly connected to the other element or.
- the end near the operator is usually referred to as the proximal end, and the end far from the operator is referred to as the distal end.
- proximal and distal are defined herein as a common term in the field of interventional medicine. Specifically, in the field of interventional medicine, “distal” refers to the end away from the operator during the surgical procedure, and “proximal” refers to the end that is close to the operator during the surgical procedure. Unless otherwise defined, all technical and scientific terms used in the present invention have the same meaning meaning The terminology used in the description is for the purpose of describing the particular embodiments, and is not intended to limit the invention.
- a delivery system 100 is provided in the first embodiment for delivering an implant to a lesion in a lumen of a human body.
- the delivery system 100 includes a tubular body 10, a hooking unit 20, and a handle including a handle housing 30 and a slider 33.
- the handle housing 30 includes a first housing 31 and a second housing (not shown) that are axially symmetrically disposed.
- the number of the sliders 33 is two.
- the two sliders 33 are respectively disposed on the first housing 31 and the second housing of the handle housing 30 and are symmetrical to each other.
- the implant is a lumen stent 200.
- the tube body 10 includes a hollow inner sheath tube 11 extending axially through the handle housing 30, a hollow inner sheath core tube 13 extending through the inner sheath tube 11 and distally extending from the inner sheath tube 11, and movably sleeved on the inner sheath tube 11
- An outer sheath tube 12 having a cavity between the outer and inner sheath core tubes 13 and a hollow tip 14 disposed at the distal end of the inner sheath core tube 13 and impervious to X-rays.
- the compressed lumen stent 200 is loaded into the cavity between the distal end of the inner sheath core tube 13 and the distal end of the outer sheath tube 12 and is in frictional contact with the outer surface of the inner sheath core tube 13.
- the outer sheath tube 12 can be moved in the axial direction relative to the inner sheath core tube 13 by the slider 33 on the operating handle, and the outer sheath tube 12 can be withdrawn proximally, eventually causing the lumen holder 200 from the outer sheath tube 12 Released among them.
- the handle can be of other construction as long as the handle can drive the outer sheath tube 12 to move axially relative to the inner sheath core tube 13.
- the delivery system 100 further includes a fluid guide assembly 15 that is fixedly mounted to the handle housing 30.
- the liquid guiding assembly 15 includes a hollow hose 151 for conveying a rinsing liquid or a contrast agent, a connecting head 152 connecting the hose 151 and the inner sheath tube 11, and a three-way valve 153 connecting the hose 151 at one end.
- the lumen of the hose 151 of the fluid guiding assembly 15 communicates with the cavity between the outer sheath tube 12 and the inner sheath tube 11.
- the syringe Before the surgery, the syringe is connected to the three-way valve 153 to introduce the rinse liquid to flush the outside of the inner sheath tube 11 or to discharge the air between the outer sheath tube 12 and the inner sheath tube 11.
- the syringe can also be connected to the three-way valve 153 before or during surgery, and the contrast agent can be injected for contrast.
- the inner sheath tube 11 extends axially through the proximal end face and the distal end face of the handle housing 30.
- the inner sheath tube 11 is fixedly coupled to the inner sheath core tube 13 located inside the inner sheath tube 11.
- the manner of fixing the connection may be a technical means commonly used in the art such as welding, bonding, sewing, hot-melting or screwing, and will not be described in detail herein.
- the inner sheath tube 11 is made of a polymer material having toughness. It can be understood that in other embodiments, the inner sheath tube 11 can also be made of a metal material.
- the inner sheath tube 11 can also be a combination of a tube body made of a polymer material and a tube body made of a metal material.
- the tube portion of the inner sheath tube 11 near the distal end is housed in the outer sheath tube 12, and is made of a tough polymer material to facilitate the passage of the inner sheath tube 11 in the curved human lumen.
- the tube portion of the inner sheath tube 11 near the proximal end is located inside the handle housing 30 and is made of a metal material to improve the support of the proximal end of the inner sheath tube 11.
- the tubular body 10 may not include the inner sheath tube 11.
- the tube body 10 includes a hollow inner sheath core tube 13 axially penetrating the handle housing 30, an outer sheath tube 12 movably sleeved outside the inner sheath core tube 13, and a sheath disposed at the inner sheath The distal end of the core tube 13 and the X-ray opaque hollow Tip head 14.
- the inner sheath core tube 13 includes a first tube body 131 near the proximal end and a second tube body 132 axially connected to the distal end of the first tube body 131, and the diameter of the first tube body 131 is larger than that of the second tube body 132 diameter.
- the compressed lumen stent 200 can be received in the cavity between the outer sheath tube 12 and the second tubular body 132 and in frictional contact with the second tubular body 132.
- the hooking unit 20 is disposed on the second tubular body 132 and detachably coupled to the lumen support 200 (see FIG. 2a). It can be understood that the first tube body 131 and the second tube body 132 can be made of different materials.
- the first tube body 131 is made of a tough polymer material
- the second tube body 132 is made of a metal material to ensure distal flexibility and proximal support of the inner sheath core tube 13.
- the first tube body 131 and the second tube body 132 can also be made of the same material.
- the first tube body 131 and the second tube body 132 are each made of a polymer material having toughness.
- the inner sheath core tube 13 may also include a third tube (not shown). The third pipe body may be sleeved on the pipe body portion of the first pipe body 131 near the proximal end.
- the third tube body may also be axially connected to the proximal end of the first tube body 131.
- the hardness of the third pipe body is higher than the hardness of the first pipe body 131 to enhance the straightness and improve the proximal support of the inner sheath core pipe 13.
- the outer sheath tube 12 is sleeved on the outer part of the inner sheath tube 11 and the inner sheath core tube 13, and can be driven by the handle relative to the inner sheath tube 11 and the inner sheath core tube 13 at the axis.
- the side wall of the outer sheath tube 12 adjacent to the proximal end is fixedly connected with the slider 33, whereby when the drag slider 33 is advanced distally or retracted proximally, the outer sheath tube 12 can be driven to perform the same direction. Axial movement.
- the outer sheath tube 12 is made of a tough polymer material or a metal material. It can be understood that, in other embodiments, a stiffer reinforcing tube (not shown) may be placed on the outer side of the outer sheath tube 12 near the proximal end, or a stiffer tube and outer sheath tube having a higher hardness may be placed. The proximal ends of 12 are axially connected. The reinforcing tube is also provided with a chute, whereby the firmness of the joint of the outer sheath tube 12 with the slider 33 can be enhanced, and the passage of the outer sheath tube 12 in the handle housing 30 can be improved.
- the tube body of the inner sheath core tube 13 near the proximal end is housed in the inner sheath tube 11.
- the tube body of the inner sheath tube 13 housed in the inner sheath tube 11 and the inner sheath tube 11 are fixed together by a common connection method in the field such as welding, bonding, sewing, hot-melting or screwing to improve the inner sheath core.
- the compressed lumen stent 200 is loaded into a cavity formed between the inner sheath core tube 13 and the outer sheath tube 12 which is not surrounded by the inner sheath tube 11.
- the distal end of the inner sheath core tube 13 is connected to a radiopaque hollow Tip head 14 which may be connected by injection molding or bonding.
- the lumen of the inner sheath core tube 13 communicates with the lumen of the Tip head 14.
- the inner sheath core tube 13 and the inner cavity of the Tip head 14 are for receiving and passing through a guide wire (not shown).
- the hooking unit 20 is disposed on the outer surface of the tubular body in which the inner sheath core tube 13 is not wrapped by the inner sheath tube 11.
- the hooking unit 20 includes a hollow tubular fastening member 21 fixed to the inner sheath core tube 11 and three flexible hook members 22 connected to the fastening member 21.
- the three flexible hooks 22 are symmetrically disposed about the central axis of the inner sheath core tube 13. Since the outer sheath tube 12 is axially movable relative to the inner sheath core tube 13, the free end of the flexible hook member 22 is movably received in the cavity formed between the outer sheath tube 12 and the inner sheath core tube 13.
- the hooking member 22 has a tendency to expand outward in the radial direction of the inner sheath core tube 13, and the inner wall of the outer sheath tube 12 suppresses the tendency of the hooking member 22 to expand outward in the radial direction of the inner sheath core tube 13, so that the hook The pendant 22 remains hooked.
- the hooks 22 can limit the relative movement between the lumen support 200 and the inner sheath core tube 13.
- the hooking unit 20 When the outer sheath tube 12 is axially moved relative to the inner sheath core tube 13, the hooking unit 20 is released from the cavity between the outer sheath tube 12 and the inner sheath core tube 13, and the inner wall of the outer sheath tube 12 is hooked.
- the restraining effect of the tendency of the hanger 22 to expand outward in the radial direction of the inner sheath core tube 13 disappears, and the hook member 22 is deployed outward in the radial direction of the inner sheath core tube 13 to return to the naturally unfolded state shown in Fig. 3a, and The lumen stent 200 is separated. That is, the hooking unit 20 is released from the hooking of the lumen holder 200.
- the hooking member 22 includes a fixing portion 221 connected to the outer surface of the inner sheath core tube 13, and is connected to the fixing portion 221. Deformation section 222.
- the fixing portion 221 is provided between the tightening member 21 and the outer surface of the inner sheath core tube 13. That is, the fastening member 21 is sleeved on the outside of the fixing portion 221 and restricts the movement of the fixing portion 221.
- one end of the deforming portion 222 is connected to the fixing portion 221, and the other end is a free end.
- the free end of the deformed portion 222 extends in a direction away from the axial direction of the inner sheath core tube 13. That is, the deformed portion 222 has a free end that extends in a direction away from the axial direction of the inner sheath core tube 13.
- the free end of the deformed portion 222 can be bent relative to the fixed portion 221 .
- the deformation portion 222 is made of a flexible material, preferably made of a material having elasticity.
- the deformation portion 222 is made of a nickel-titanium alloy having a shape memory function.
- the fixing portion 221 is also made of a nickel-titanium alloy, that is, the entire hook member 22 is made of a nitinol material by integral molding.
- the length L1 of the deformation portion 222 along the axial direction of the inner sheath core tube 13 ranges from 3 to 50. Millimeter.
- the detachable connection between the deformed portion 222 and the lumen support 200 is more reliable, and the deformed portion 222 is neither scratched after being released from the cavity between the outer sheath tube 12 and the inner sheath core tube 13.
- the blood vessels also do not affect the separation of the deformation portion 222 from the lumen 200.
- the length L1 of the deformed portion 222 along the axial direction of the inner sheath core tube 13 is 6 mm.
- the length L2 of the fixing portion 221 in the axial direction of the inner sheath core tube 13 ranges from 2 to 10 mm. Therefore, the fixing portion 221 does not affect the flexibility of the tube body 10, facilitates the passage of the tube body 10 in the human body to distort the blood vessel, and does not reduce the connection strength between the fixing portion 221 and the fastening member 21, and thus does not Affects the connection reliability of the lumen stent 200 and the inner sheath core tube 13.
- the length L2 of the fixing portion 221 in the axial direction of the inner sheath core tube 13 is 6 mm.
- the angle between the extending direction of the deforming portion 222 and the direction from the proximal end to the distal end of the inner sheath core tube 13 The range is from 0 to 180 degrees, preferably less than or equal to 90 degrees. In the present embodiment, the angle ⁇ between the extending direction of the deformed portion 222 and the direction from the proximal end to the distal end of the fixed portion 221 ranges from 0 degrees to 180 degrees.
- the connection reliability of the detachable connection between the lumen holder 200 and the deformation portion 222 can be ensured, and after the lumen holder 200 is released from the cavity between the outer sheath tube 12 and the inner sheath core tube 13,
- the dissociation between the deformed portion 222 and the lumen support 200 is separated.
- the angle between the extending direction of the deforming portion 222 and the direction from the proximal end to the distal end of the inner sheath core tube 13 and the extending direction of the deforming portion 222 and the proximal end to the distal end of the fixing portion 221 The angle ⁇ between the directions is the same, both being 90 degrees.
- the diameter D of the polygonal circumscribed circle formed by the line connecting the free ends of each deformation portion 222 is smaller than
- the lumen support 200 is 90% of the diameter of the circumscribed circle of the polygon formed by the line connecting the hooks 22 before being compressed.
- the diameter of the circumscribed circle of the polygon formed by the line connecting the free ends of each deformation portion 222 is 3 Up to 50 mm.
- the connection between the deformed portion 222 and the lumen 200 is more reliable, and the deformed portion 222 is released from the cavity between the outer sheath tube 12 and the inner sheath core tube 13, and the blood vessel is not scratched. Nor does it affect the separation of the deformation portion 222 from the lumen support 200.
- the lumen support 200 has a diameter of 12 mm.
- the diameter of the polygonal circumcircle composed of the line connecting the free ends of each of the deformed portions 222 is smaller than the inner diameter of the outer sheath tube 12.
- the diameter of the circumscribed circle of the polygon formed by the line connecting the free ends of each deformation portion 222 is 3.5 mm. .
- the hollow tubular fastening member 21 is sleeved on the outer surface of the inner sheath core tube 13.
- the fastening member 21 may be made of a polymer material or a metal material and fixedly connected to the outer surface of the inner sheath core tube 13 by adhesion, interference fit, stitching, hot melt or welding (for example, laser spot welding).
- the fastening member 21 is fixed to the outer surface of the inner sheath core tube 13 by adhesion.
- the fixing portion 221 of the hooking member 22 is located between the tightening member 21 and the outer surface of the inner sheath core tube 13.
- the tightening member 21 limits the relative movement between the fixed portion 221 and the outer surface of the inner sheath core tube 13.
- the inner diameter of the tightening member 21 is greater than or equal to the outer diameter of the inner sheath core tube 13.
- the diameter of the hoop member 21 is smaller than the inner diameter of the outer sheath tube 12.
- the diameter of the hoop member ranges from 1 to 30 mm, and the length of the hoop member 21 in the axial direction of the inner sheath core tube 13 is larger than the length of the fixed portion 221 in the axial direction of the inner sheath core tube 13.
- the length of the hoop member 21 in the axial direction of the inner sheath core tube 13 ranges from 2 to 10 mm. In the present embodiment, the length of the hoop member 21 along the axial direction of the inner sheath core tube 13 is 5 mm.
- the fastening member 21 and the fixing portion 221 of the hooking member 22 can have other connection manners.
- the clamping member 21 is a sleeve 210 having a certain wall thickness, and the tube wall of the sleeve 210 has a blind hole 211 in the axial direction.
- the length of the tightening member 21 in the axial direction of the inner sheath core tube 13 is larger than the length of the fixing portion 221 in the axial direction of the inner sheath core tube 13.
- the fastening member 21 may also be a sleeve 210 having a certain wall thickness, and the tube wall of the sleeve 210 has a through hole 212 in the axial direction.
- the length of the tightening member 21 in the axial direction of the inner sheath core tube 13 is smaller than the length of the fixing portion 221 in the axial direction of the inner sheath core tube 13.
- the ball 2211 is formed by laser spot welding of the fixing portion 221 away from the end of the deforming portion 222, and the diameter of the ball 2211 is larger than the diameter of the through hole 212 to ensure the fixing portion. 221 does not fall off the self-tightening member 21.
- the hoop member 21 can also be made of a resilient material.
- the hoop member 21 can be a sleeve of resilient material.
- the fastening member 21 is sleeved on the outer surface of the inner sheath core tube 13.
- the fixing portion 221 of the hooking member 22 is provided between the fastening member 21 and the inner sheath core tube 13.
- the portion of the inner sheath tube 11 near the distal end and the inner sheath core tube 13 have a space for receiving the tightening member 21.
- the portion near the proximal end of the hoop member 21 is provided in the gap between the inner sheath tube 11 and the inner sheath core tube 13.
- the tightening member 21 holds the inner sheath core tube 13 to restrict the movement of the fixing portion 221 of the hooking member 22.
- the distal end surface of the tightening member 21 is flush with the distal end surface of the inner sheath tube 11, and the fixing portion 221 of the hooking member 22 can be better fixed.
- the hoop member 21 may also be a hollow sleeve made of a heat shrinkable material.
- the fixing portion 221 of the hooking member 22 is provided between the fastening member 21 and the outer surface of the inner sheath core tube 13.
- the lumen stent 200 needs to be loaded into the body 10 of the delivery system 100 prior to implantation in the patient, and then delivered by the delivery system 100 to the lesion in the patient.
- the loading process of the lumen stent 200 is as follows: the lumen stent 200 is placed over the outer surface of the inner sheath core tube 13, and the deformed portion 222 of the hook member 22 is hooked to the hollow of the proximal end of the lumen stent 200 ( That is, the skeleton at the crest is such that the lumen stent 200 is fixed over the outer surface of the inner sheath core tube 13.
- the outer sheath tube 12 is driven to move axially distally relative to the inner sheath core tube 13 by pushing the slider 33 distally.
- the lumen stent 200 is gradually compressed from the proximal end to the distal end and received in a cavity between the outer sheath tube 12 and the inner sheath core tube 13.
- the slider 33 is further pushed toward the distal end, and the deformed portion 222 of the hooking member 22 is bent relative to the fixing portion 221 and formed with the fixing portion 221.
- the hook is received in a cavity between the outer sheath tube 12 and the inner sheath core tube 13.
- the slider 33 is continued to be pushed distally until the entire lumen holder 200 is received in the cavity between the outer sheath tube 12 and the inner sheath core tube 13.
- the lumen stent 200 is fixed to the inner sheath core tube 13 by the hook unit 20, and the hook unit 20 limits the lumen bracket 200. Relative movement with the inner sheath core tube 13. And since the free end of the deformed portion 222 has a tendency to expand outward in the radial direction of the inner sheath core tube 13, the inner wall of the outer sheath tube 12 suppresses the tendency of the free end to expand outward in the radial direction of the inner sheath core tube 13, The hooks 22 remain hook-shaped.
- the outer sheath tube 12 is driven relative to the distal end by withdrawing the slider 33 (see FIG. 1).
- the inner sheath core tube 13 moves axially toward the proximal end.
- the inner wall of the outer sheath tube 12 has a tendency to suppress the tendency of the free end of the deformed portion 222 to expand outward in the radial direction of the inner sheath core tube 13.
- the deformation portion 222 made of an elastic material is released from the cavity between the outer sheath tube 12 and the inner sheath core tube 13.
- the deformed portion 222 is restored to the deployed state due to its own elasticity, and is automatically separated from the hooked lumen bracket 200.
- the lumen stent 200 is no longer connected to the inner sheath core tube 13, and when the outer sheath tube 12 continues to move axially proximally relative to the inner sheath core tube 13, the lumen stent 200 is released from the outer sheath tube 12, and Rely on its own superelastic expansion and attach to the vessel wall.
- the entire tubular body 10 can be directly retracted, and the position of the distal end of the tubular body 10 can be adjusted, and With the aid of digital imaging, it is observed through the development mark on the lumen stent 200 until the distal end of the tubular body 10 is adjusted to a more desirable release position.
- the lumen support 200 is always fixed by the hook unit 20 due to the suppression of the tendency of the inner wall of the outer sheath tube 12 to the free end of the deformation portion 222 along the radially outward direction of the inner sheath core tube 13.
- the tube body 10 On the sheath core tube 13, at this time, the tube body 10 is withdrawn, and the relative movement between the outer sheath tube 12 and the lumen holder 200 does not occur, thereby avoiding the relative movement between the outer sheath tube 12 and the lumen holder 200, resulting in the tube.
- the cavity holder 200 is released in advance.
- the use process of the delivery system 100 provided by this embodiment includes the following steps:
- the first step percutaneous puncture into the guide wire to the lesion
- the second step transporting the tube body 10 pre-installed with the lumen stent 200 along the guide wire to the lesion;
- the third step keeping the position of the handle housing 30 unchanged, the outer sheath tube 12 connected to the slider 33 is driven to move proximally by the retracting slider 33. Thereby, the outer sheath tube 12 moves axially relative to the inner sheath core tube 13 and the lumen holder 200, and the lumen holder 200 is gradually released from the outer sheath tube 12. With the aid of medical imaging, it is evaluated whether the initial release position of the lumen stent 200 meets the clinical requirements by the development marker on the lumen stent 200.
- the fourth step if the initial release position of the lumen stent 200 is ideal, the slider 33 can be continuously withdrawn to the proximal end, and the outer sheath tube 12 is driven to move axially relative to the inner sheath core tube 13 until the lumen stent 200 is completely released from the outer sheath tube 12.
- Step 5 If the initial release position of the lumen support 200 is not satisfactory, the outer sheath tube 12 can be stopped, the relative position of the slider 33 and the handle housing 30 can be kept unchanged, the entire tube 10 can be retracted, and the tube body can be adjusted. 10 remote location.
- the position of the distal end of the tubular body 10 since the lumen stent 200 is fixed to the inner sheath core tube 13 by the hooking unit 20, between the lumen stent 200 and the outer sheath tube 12 and the inner sheath core tube 13 No relative movement occurs, effectively preventing the lumen stent 200 from being released early from the outer sheath tube 12.
- the sixth step when the distal end of the tubular body 10 is adjusted to a more desirable release position, the slider 33 on the handle housing 30 is again withdrawn, and the outer sheath tube 12 is driven to move axially proximally relative to the inner sheath core tube 13.
- the hooking member 22 is released from the cavity between the outer sheath tube 12 and the inner sheath core tube 13
- the deformed portion 222 of the hooking member 22 is restored to its natural unfolded state due to its elasticity, and is automatically separated from the hooked lumen bracket 200.
- the lumen stent 200 is no longer connected to the inner sheath core tube 13.
- the lumen stent 200 is completely released from the outer sheath tube 12, since the lumen stent 200 has superelasticity, the stent can be naturally inflated and attached to the lesion. Vascular wall.
- Step 7 Keep the position of the slider 33 unchanged, and then withdraw the handle housing 30 to drive the inner sheath core tube 13 to move proximally relative to the outer sheath tube 12. After the hooking member 22 of the outer surface of the inner sheath core tube 13 is received in the outer sheath tube 12, the entire delivery system 100 is withdrawn and the tube body 10 is withdrawn from the patient.
- the delivery system provided by this embodiment has at least the following beneficial effects:
- the inner wall of the outer sheath tube has an inhibitory effect on the unfolding tendency of the free end of the hooking unit, even when passing through a relatively curved body lumen portion
- the hooking member is also not detached from the lumen bracket, which avoids the gap between the rigid protrusion of the prior art and the inner wall of the outer sheath tube, resulting in the risk of the lumen bracket falling off from the rigid protrusion.
- the lumen stent is fixed on the inner sheath core tube by the hooking unit, and the lumen stent can be gradually released from the outer sheath tube, thereby avoiding the disadvantage that the release position cannot be adjusted after the lumen stent is suddenly released.
- the operator can withdraw the tubular body and adjust the distal position of the tubular body.
- the lumen stent is fixed on the inner sheath core tube. And the relative movement between the lumen stent and the outer sheath tube does not occur, effectively preventing the lumen stent from being released in advance from the outer sheath tube.
- each of the hooks has a U-shaped structure composed of double strands.
- the hooking unit comprises a hollow tubular fastening member and three hooking members connected to the fastening member.
- the hook has a fixing portion connected to the fastening member and a deformation portion connected to the fixing portion.
- Each hook consists of two straight rods and a circular rod connected between the two straight rods.
- the radial distance H between the two straight rods ranges from 0.05 to 10 mm.
- the reliability of the detachable connection between the lumen bracket and the hooking member is not reduced, and the automatic disengagement separation between the lumen bracket and the hooking member when the lumen stent is released is not affected.
- the radial distance H between the two straight rods is 3 mm.
- the central angle R of the circular arc rod ranges from 90 degrees to 180 degrees.
- the central angle R is defined as the angle between the center of the arcuate rod and the two lines between the intersection of the two straight rods and the circular rod.
- the hooking member can be flexible, bendable, and can be, for example, a wire.
- the hooking member can also be made of a resilient material.
- the hooking member is woven from nickel-titanium wire.
- Each hook can be individually woven.
- a hook having a U-shaped structure is woven on the woven mold bar each time using a nickel-titanium wire.
- a total of three hooks are woven and heat-set separately. Three separate hooks are then placed on the outer surface of the inner sheath core tube and symmetrically disposed about the central axis of the inner sheath core tube.
- the tightening member is sleeved on the outer surface of the inner sheath core tube, and the straight rod of the hook member is restrained between the inner surface of the tight band member and the outer surface of the inner sheath core tube to limit the hooking member and the inner sheath core Relative movement between tubes.
- the three hooks may also be woven from the same nickel titanium wire (see Figure 10c).
- the weaving method is as follows: three hooks having a U-shaped structure are sequentially woven on the woven mold bar using the same nickel-titanium wire, and the distal end of one straight rod of the first hooking member and one of the third hooking member are respectively The distal end of the straight rod is connected by common means such as hinge, welding, bonding, etc., and then subjected to high-temperature heat setting treatment to obtain three hook pieces connected to each other.
- the nickel-titanium wire used in the weaving of the hooks has a wire diameter ranging from 0.05 mm to 2 mm.
- the wire diameter of the nickel-titanium wire is related to the diameter of the lumen stent.
- a nickel-titanium wire having a wire diameter of 0.15 mm is used to woven a hook.
- the heat setting process can also be performed such that at least a portion of the free end of the deformation portion of the hook has a certain angle with the plane where the fixed portion is located, and the angle range is 60 degrees to 120 degrees, preferably 90 degrees.
- the angle between the plane where the circular rod is located and the plane where the two straight rods are located is 90 degrees.
- Figure 10f shows the state in which the hooking unit of the embodiment is housed in the outer sheath tube: the free end of the hooking member is bent toward the proximal end, and the arcuate rod of the hooking member is attached to the proximal end face of the tightening member. .
- the circular arc rod of the hooking member is not only restricted by the inner wall of the outer sheath tube, but also the radial movement of the circular arc rod along the conveying system, and is also close to the axial end of the circular rod along the axial direction of the conveying system. The limit of the end-to-end movement.
- FIG 10g shows the state in which the delivery system reaches the lesion and the lumen stent is fully released.
- the outer sheath tube is retracted from the distal end to the proximal end relative to the inner sheath core tube, and the inner wall of the outer sheath tube disappears in the radial direction of the hooking member, and the deformation portion of the hooking member is along the stent diameter under the action of elasticity or external force.
- the direction is reversed away from the inner sheath core tube, thereby releasing the connection with the lumen stent, and the lumen stent is attached to the stent under the self-expansion force to complete the release.
- At least one receiving space for receiving the free end of the deformation portion may be disposed on the outer surface of the outer surface of the tubular member.
- a plurality of grooves are provided on the outer surface of the tubular body of the hollow tubular hoop member near the proximal end.
- the volume of each groove is equal to or slightly larger than the volume of one arc bar. Therefore, each groove can correspondingly accommodate a heat-set arcuate rod.
- the arcuate rod fits into the recess, but is not caught by the recess or affects the release of the lumen bracket.
- the hooks may also be cut from a nickel-titanium tube (see Figure 11).
- the wall thickness of the nickel-titanium tube ranges from 0.05 mm to 2 mm.
- Each of the hooks can be individually cut by a nickel-titanium tube, or a plurality of hooks can be cut at a time by the same nickel-titanium tube.
- the fixing portion and the deformation portion of each hooking piece may be integrally cut by a nickel-titanium tube and then heat-set.
- the fixing portion and the deforming portion of each of the hooking members may be separately cut and heat-set by a nickel-titanium tube, and then the fixing portion and the deforming portion may be fixedly connected by welding or bonding.
- the fixing portion and the deformation portion of the hooking member may be made of the same material or different materials, and the deformation portion may be detachably connected to the lumen bracket as long as the deformation portion is made of a material having elasticity.
- the hooking member may further have other shapes such as an L shape, an S shape or a V shape, or be a strip or a sheet as long as the deformation portion is made of a material having elasticity, that is, The purpose of detachable connection to the lumen stent can be achieved.
- each of the hooking units may include only two hooks. It will be appreciated that in other embodiments, each of the hooking units may also include a greater number of hooks to increase the secure reliability of the hooking unit to the lumen support. However, in order for the diameter of the storage body to pass smoothly through the curved body lumen, the number of hooks should be less than or equal to twelve.
- each hooking unit includes four hooking members, and four hooking members surround the inner sheath core tube. The center axis is symmetrically set.
- the delivery system includes a tubular body 40, a handle housing 46, a slider 47, and a hooking unit 50.
- the tube body 40 includes an inner sheath tube 41, an outer sheath tube 42, an inner sheath core tube 43, and a Tip head 44.
- the stopper 45 is provided on the outer surface of the inner sheath core tube 43.
- the stopper 45 is protruded from the outer surface of the inner sheath core tube 43 in the axial direction away from the inner sheath core tube 43.
- the stopper 45 is fixed to the outer surface of the inner sheath core tube 43 near the distal end, and is closer to the distal end of the inner sheath core tube 43 than the hook unit 50.
- the outer sheath core tube 43 is provided with a stopper 45 which is convex from the outer surface of the inner sheath core tube 43 in the axial direction away from the inner sheath core tube 43.
- the limiting member 45 abuts against the proximal end surface or the proximal end hollow of the lumen stent 200, preventing the lumen stent 200 from being inwardly directed to the inner sheath core tube 43 with respect to the inner sheath core tube 43.
- the near end moves.
- the number of the limiting members 45 may be multiple.
- the plurality of stoppers 45 are evenly or unevenly spaced along the axial direction of the inner sheath core tube 43.
- the limiting member 45 can be a shape protrusion, a tapered protrusion or a spherical protrusion or the like, or a tube that is sleeved on the surface of the inner sheath core tube 43.
- the proximal end face or hollow of the abutment lumen stent 200 can also be achieved to prevent the lumen stent 200 from moving proximally relative to the inner sheath core tube 43.
- the delivery system provided in this embodiment has at least the following beneficial effects:
- the lumen stent is fixed to the inner sheath core tube by the hooking unit, and the lumen stent can be gradually released from the outer sheath tube.
- the limiting member of the delivery system is disposed on the outer surface of the inner sheath core tube near the distal end, so that when the outer sheath tube moves axially relative to the inner sheath core tube, even if the lumen bracket is external Friction between the inner walls of the sheath does not cause the lumen stent to move proximally, thereby reducing the possibility of lumen stent accumulation and reducing the release resistance of the lumen stent.
- the structure of the lumen stent delivery system provided in this embodiment is substantially the same as that of the lumen stent delivery system 100 provided in the first embodiment. The difference is that, in this embodiment, the position of the hooking unit on the tube body of the inner sheath core tube is different from the position of the hook unit of the first embodiment on the tube body of the inner sheath core tube.
- the conveying system comprises a pipe body 60, a hooking unit 70, a handle casing (not shown) and a slider (not shown).
- the tubular body 60 includes an inner sheath tube 61, an outer sheath tube 62, an inner sheath core tube 63, and a Tip head 64.
- the hooking unit 70 is provided on the outer surface of the tube of the inner sheath core tube 63 near the distal end.
- the hooking unit 70 includes a tightening member 71 and a hooking member 72. Referring to Figure 14b, when the hook 72 is received in the cavity between the outer sheath 62 and the inner sheath core 63, the free end of the hook 72 is bent toward the distal end and directed toward the distal end. Thus, when the lumen stent 200 is loaded into the cavity between the outer sheath tube 62 and the inner sheath core tube 63, the hook 72 hooks the distal end of the lumen stent 200.
- the hook member 72 hooks the lumen bracket 200 near the distal hollow, preventing the lumen bracket 200 from approaching the proximal end of the inner sheath core tube 63. Move or stack.
- the delivery system provided in this embodiment has at least the following beneficial effects:
- the hooking unit of the delivery system is disposed on the outer surface of the inner sheath core tube near the distal end, so that when the outer sheath tube moves axially relative to the inner sheath core tube, even if the lumen bracket and the outer sheath tube Friction between the walls does not cause the lumen stent to move proximally, thereby reducing the possibility of lumen stent accumulation and reducing the release resistance of the lumen stent.
- the structure of the lumen stent delivery system provided in this embodiment is substantially the same as that of the lumen stent delivery system 100 provided in the first embodiment. The difference is that, in the present embodiment, the number of the hooking units is different from the number of the hooking units 20 of the conveying system 100 provided in the first embodiment.
- the transport system includes a tube body 80 and a plurality of hooking units.
- the tube body 80 includes an inner sheath tube 81, an outer sheath tube 82, an inner sheath core tube 83, and a Tip head 84.
- Three hooking units are provided on the outer surface of the inner sheath core tube 83. And three hooking units are evenly spaced along the axial direction of the inner sheath core tube 83.
- the first hooking unit 91 is disposed above the outer surface of the inner sheath core tube 83 near the proximal end.
- the first hooking unit 91 has three hooking members 911.
- Each of the hooks 911 has a deformation portion 9111.
- the deformed portion 9111 of the hooking member 911 extends toward the proximal end, and is inside.
- the angle between the proximal end to the distal end of the sheath core tube 83 ranges from 0 degrees to 180 degrees.
- the angle between the extending direction of the deformation portion 9111 and the direction from the proximal end to the distal end of the inner sheath core tube 83 ranges from 30 degrees to 90 degrees. Specifically, in the present embodiment, the angle between the extending direction of the deformed portion 9111 and the direction from the proximal end to the distal end of the inner sheath core tube 83 is 60 degrees.
- the first hooking unit 91 can ensure that the lumen bracket 200 is fixed on the inner sheath core tube 83 during the process of withdrawing the tube body 80 or adjusting the distal end of the tube body 80, and no relative relationship occurs with the outer sheath tube 82. Move to avoid early release of lumen stent 200.
- the third hooking unit 93 is disposed above the outer surface of the inner sheath core tube 83 near the distal end.
- the third hooking unit 93 has three hooking members 931.
- Each of the hooks 931 has a deformation portion 9311.
- the deformation portion 9311 of the hooking member 931 extends distally, and the inner sheath core tube 83
- the angle between the proximal to distal directions ranges from 0 to 180 degrees.
- the angle between the deformation portion 9311 and the direction from the proximal end to the distal end of the inner sheath core tube 83 ranges from 90 degrees to 150 degrees. Specifically, in the present embodiment, the angle between the extending direction of the deformation portion 9311 and the direction from the proximal end to the distal end of the inner sheath core tube 83 is 120 degrees.
- the lumen stent 200 is generated due to friction between the lumen stent 200 and the inner wall of the outer sheath tube 82. The trend of moving to the near end.
- the third hooking unit 93 can prevent the lumen bracket 200 from moving to the proximal end, thereby reducing the possibility of the lumen stent 200 being stacked and reducing the release resistance of the lumen stent 200.
- the second hooking unit 92 is disposed between the first hooking unit 91 and the third hooking unit 93, and the distance between the second hooking unit 92 and the first hooking unit 91 and the second hooking unit 92 to the third The distances of the hooking units 93 are equal.
- the second hooking unit 92 has three hooking members 921. Each of the hooks 921 has a deformation portion 9211.
- the deformed portion 9211 of the hooking member 921 extends distally, and the inner sheath core tube
- the angle between the proximal to distal directions of 83 ranges from 0 degrees to 180 degrees. Specifically, in the present embodiment, the angle between the deformed portion 9211 and the direction from the proximal end to the distal end of the inner sheath core tube 83 is 90 degrees.
- the second hooking unit 92 can cooperate with the first hooking unit 91 to ensure that during the withdrawal of the tubular body 80 or the distal end of the tubular body 80, the lumen stent 200 is It is fixed on the inner sheath core tube 83, and no relative movement occurs between the outer sheath tube 82 and the lumen bracket 200 is prevented from being released in advance.
- the second hooking unit 92 can cooperate with the third hooking unit 93 to further prevent the lumen bracket 200 from accumulating and reduce the release resistance of the lumen bracket 200.
- the outer sheath tube 82 can be driven relative to the inner sheath.
- the core tube 83 is axially moved distally, and the tube stent 200, the second hooking unit 92, and the third hooking unit 93, which have been partially released, are re-accommodated between the outer sheath tube 82 and the inner sheath core tube 83. In the cavity.
- a greater number of hooking units 90 may be provided on the outer surface of the inner sheath core tube 83 (see Figure 16).
- the plurality of hooking units 90 are evenly or unevenly spaced along the axial direction of the inner sheath core tube 83.
- the hooks of the plurality of hooking units 90 are not in contact with each other.
- the number of hooking units 90 has a positive correlation with the axial length of the lumen support 200.
- a delivery system having a plurality of hooking units 90 is particularly suitable for the delivery and release of bare stents of longer axial length.
- the plurality of hooks of the plurality of hooking units are respectively hooked to the waveforms of different portions of the bare bracket.
- the fixed relationship between the bare stent and the inner sheath core tube is more reliable, and the relative movement between the bare stent and the inner sheath core tube during the loading process can be effectively prevented.
- the slider moves to pull the proximal sheath axially relative to the proximal end of the inner sheath core tube, so that the bare stent and the hook and the outer sheath tube are oppositely motion.
- the inner wall of the outer sheath tube disappears from the tendency of the free end of the deformed portion of the hooking member to expand radially outward along the inner sheath core tube, and is made of an elastic material.
- the hooking member is released from the cavity between the outer sheath tube and the inner sheath core tube, and the deformed portion of the hooking member is restored to the unfolded state due to its elasticity, and is automatically separated from the skeleton at the peak of the hooked bare bracket.
- the plurality of hooking units are released one by one from the outer sheath tube and automatically separated from the skeleton of the hooked bare stent peak until the entire bare stent is completely released from the outer sheath tube.
- the number of the hooking units and the tube of the hooking unit in the inner sheath core tube can be adjusted.
- the locations on the outer surface of the body are such that the number and location of the hooking units accommodate the skeletal structure of the lumen stent.
- the delivery system provided by this embodiment has at least the following beneficial effects:
- the lumen stent With the withdrawal of the outer sheath tube, the lumen stent can be released piece by piece, and the released lumen stent relies on its own elastic expansion and attaches to the blood vessel wall, and does not affect the release and expansion of the remaining portion of the lumen stent.
- the distal position of the tube body can be adjusted, and the advance release of the lumen stent is not caused during the adjustment process.
- the lumen stent can be recovered into the outer sheath tube, withdrawn from the patient's body, and the appropriate size of the lumen stent can be replaced.
- the delivery system provided by the invention is suitable for transporting a blood vessel stent, for example, for simultaneously opening aortic arch stenosis and left subclavian artery stenosis, placing a chimney bracket or a top hat bracket in the left subclavian artery, or conveying a tracheal stent and an esophageal stent to realize a product release position. Adjustment and recycling.
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Abstract
Description
本发明涉及植入式医疗器械,具体涉及植入物的输送系统。The present invention relates to implantable medical devices, and in particular to delivery systems for implants.
对于血管狭窄、动脉瘤和血管夹层等疾病,管腔支架介入手术具有创伤小、恢复快、并发症少、治疗效果好等优势。For diseases such as vascular stenosis, aneurysm and vascular dissection, luminal stent intervention has the advantages of less trauma, quick recovery, less complications, and better therapeutic effect.
自膨式支架管腔支架的金属骨架结构通常由镍钛合金制成,经过热定型工艺后,使得管腔支架具有恢复自身形状的能力。目前这类支架的输送系统的管体一般包含一根外鞘管,和一根预装于外鞘管内的内鞘芯管。内鞘芯管的近端较粗,远端较细,管腔支架收容于外鞘管与内鞘芯管远端部分之间的空腔中,且支架的远端与内鞘芯管较粗部分的远端端面紧贴,内鞘芯管用于连接导引头(或称Tip头)和容纳并通过导丝。当输送系统到达病变部位,向近端回撤外鞘管,使得外鞘管与管腔支架相对运动,将管腔支架自外鞘管内释放,管腔支架依靠自身的回弹性展开并贴附血管内壁。这种输送系统中管腔支架与鞘芯管之间仅通过摩擦力相连,当内鞘芯管与外鞘管通过人体血管的弯曲部位会适应血管形态而弯曲,管腔支架也容易发生移位,会影响后续释放,且在后撤外鞘管时,支架也会容易移位,导致释放位置不理想,进而影响治疗效果。The metal skeleton structure of the self-expanding stent lumen stent is usually made of Nitinol, and after the heat setting process, the lumen stent has the ability to restore its shape. At present, the tube of the delivery system of such a stent generally comprises an outer sheath tube and an inner sheath core tube pre-installed in the outer sheath tube. The proximal end of the inner sheath core tube is thicker and the distal end is thinner. The lumen bracket is received in the cavity between the outer sheath tube and the distal end portion of the inner sheath core tube, and the distal end of the stent and the inner sheath core tube are thicker. The distal end face of the portion is in close contact with the inner sheath core tube for connecting the seeker (or tip) and receiving and passing the guide wire. When the delivery system reaches the lesion site, the outer sheath tube is withdrawn to the proximal end, so that the outer sheath tube and the lumen stent move relative to each other, and the lumen stent is released from the outer sheath tube, and the lumen stent is deployed and attached to the blood vessel by virtue of its own resilience. Inner wall. In this delivery system, the lumen stent and the sheath core tube are only connected by frictional force. When the inner sheath core tube and the outer sheath tube pass through the curved portion of the human blood vessel, the blood vessel shape is bent and the lumen stent is also easily displaced. Will affect the subsequent release, and when the outer sheath is removed, the stent will be easily displaced, resulting in unsatisfactory release position, which will affect the therapeutic effect.
通过在内鞘芯管上设置刚性凸起物穿过管腔支架的镂空,可在内鞘芯管与外鞘管之间的空腔内限制管腔支架相对内鞘芯管移动。然而这种输送系统仍然存在如下缺陷:(1)在管腔支架的输送过程中,当外鞘管与鞘芯管共同通过人体管腔的弯曲部位时,在弯曲血管的弯曲半径较小的一侧,鞘芯管与外鞘管之间的间隙减小;在弯曲血管的弯曲半径较大的一侧,鞘芯管与外鞘管之间的间隙增大,此时刚性凸起物与外鞘管的内壁之间的距离增大,刚性凸起物与管腔支架较易分离,管腔支架可能脱离凸起物的约束,进而导致管腔支架在外鞘管中的位置发生偏移,影响后续释放。(2)当鞘芯管与外鞘管到达病变部位后,操作者后撤外鞘管释放管腔支架时,管腔支架可能快速自外鞘管中完全释放,如遇释放位置不理想,无法调整释放位置。(3)当管腔支架自外鞘管之中部分释放后,如发现管腔支架的释放位置不理想,需要调整外鞘管的远端位置,而管腔支架在调整过程中可能自外鞘管之中提前完全释放。By providing a rigid projection on the inner sheath core tube through the hollow of the lumen stent, the movement of the lumen support relative to the inner sheath core tube can be restricted within the cavity between the inner sheath core tube and the outer sheath tube. However, this delivery system still has the following defects: (1) during the delivery of the lumen stent, when the outer sheath tube and the sheath core tube together pass through the curved portion of the human lumen, the bending radius of the curved blood vessel is smaller. On the side, the gap between the sheath core tube and the outer sheath tube is reduced; on the side of the curved radius of the curved blood vessel, the gap between the sheath core tube and the outer sheath tube is increased, and at this time, the rigid protrusion and the outer portion The distance between the inner walls of the sheath is increased, the rigid protrusions are easily separated from the lumen stent, and the lumen stent may be separated from the protrusions, thereby causing the position of the lumen stent to be displaced in the outer sheath tube, affecting Subsequent release. (2) When the sheath core tube and the outer sheath tube reach the lesion site, when the operator withdraws the outer sheath tube and releases the lumen stent, the lumen stent may be completely released from the outer sheath tube quickly, and if the release position is not ideal, it cannot be Adjust the release position. (3) When the lumen stent is partially released from the outer sheath tube, if the release position of the lumen stent is found to be unsatisfactory, the distal position of the outer sheath tube needs to be adjusted, and the lumen stent may be sheathed during the adjustment process. The tube was completely released in advance.
发明内容Summary of the invention
基于此,有必要提供一种植入物的输送系统,即使在弯曲的血管内,该输送系统仍可以将植入物可靠地固定在鞘芯管上。避免植入物与内鞘芯管之间发生偏移。并且,可在释放过程中逐渐释放植入物,避免了植入物突然释放后无法调整释放位置的缺点,以及在调整释放植入物的释放位置的 过程中,避免植入物提前完全释放。Based on this, it is necessary to provide an implant delivery system that secures the implant to the sheath core tube even within a curved vessel. Avoid offset between the implant and the inner sheath core. Moreover, the implant can be gradually released during the release process, avoiding the disadvantage of being unable to adjust the release position after the sudden release of the implant, and adjusting the release position of the release implant. During the procedure, avoid complete release of the implant in advance.
本发明提供一种植入物的输送系统,包括内鞘管,贯穿所述内鞘管且远端伸出所述内鞘管的内鞘芯管,可动地套设于所述内鞘管外部并与所述内鞘芯管之间具有空腔的外鞘管、及固定于所述内鞘芯管的外表面的至少一个钩挂单元。所述钩挂单元包括至少两个柔性钩挂件。所述钩挂件包括与所述内鞘芯管的外表面相连的固定部、以及与所述固定部相连的变形部。所述变形部的自由端可相对所述固定部弯折并在收容于所述外鞘管与所述内鞘芯管之间的空腔内时,与所述固定部配合形成钩状物。由此,当所述钩挂件收容于所述外鞘管与所述内鞘芯管之间的空腔时,所述钩挂件钩挂所述植入物,而所述钩挂件的所述自由端具有沿所述内鞘芯管的径向向外展开的趋势,而所述外鞘管的内壁抑制所述自由端沿所述内鞘芯管的径向向外展开的趋势,因此,所述钩挂件可以限制所述植入物与所述内鞘芯管之间的相对移动。当所述外鞘管相对于所述内鞘芯管向近端轴向运动,所述钩挂件自所述外鞘管与所述内鞘芯管之间的空腔中释放,所述外鞘管的内壁对所述钩挂件的所述自由端沿所述内鞘芯管的径向向外展开的趋势的抑制作用消失,所述变形部沿所述内鞘芯管的径向向外展开并与所述植入物分离,所述植入物自所述外鞘管中释放。The present invention provides an delivery system for an implant, comprising an inner sheath tube extending through the inner sheath tube and extending distally from the inner sheath core tube of the inner sheath tube, movably sleeved outside the inner sheath tube And an outer sheath tube having a cavity between the inner sheath core tube and at least one hooking unit fixed to an outer surface of the inner sheath core tube. The hooking unit includes at least two flexible hooks. The hooking member includes a fixing portion connected to an outer surface of the inner sheath core tube, and a deformation portion connected to the fixing portion. The free end of the deforming portion is bendable relative to the fixing portion and cooperates with the fixing portion to form a hook when being received in a cavity between the outer sheath tube and the inner sheath core tube. Thereby, when the hook is received in a cavity between the outer sheath tube and the inner sheath core tube, the hook member hooks the implant, and the freedom of the hook member The end has a tendency to expand radially outward along the inner sheath core tube, and the inner wall of the outer sheath tube inhibits the tendency of the free end to expand radially outward of the inner sheath core tube, thus The hooks can limit the relative movement between the implant and the inner sheath core tube. When the outer sheath tube moves axially proximally relative to the inner sheath core tube, the hooking member is released from a cavity between the outer sheath tube and the inner sheath core tube, the outer sheath The inner wall of the tube eliminates the tendency of the free end of the hook to expand radially outwardly of the inner sheath core tube, the deformed portion expanding radially outward of the inner sheath core tube And separating from the implant, the implant is released from the outer sheath.
在其中一个实施例中,所述变形部具有弹性。In one of the embodiments, the deformation portion has elasticity.
在其中一个实施例中,当所述钩挂件未收容于所述外鞘管与所述内鞘芯管之间的空腔中时,所述变形部的延伸方向与所述内鞘芯管的近端至远端的方向之间的夹角范围为0度至180度。In one embodiment, when the hooking member is not received in the cavity between the outer sheath tube and the inner sheath core tube, the extending direction of the deformation portion is opposite to the inner sheath core tube The angle between the proximal to distal directions ranges from 0 to 180 degrees.
在其中一个实施例中,当所述钩挂件未收容于所述外鞘管与所述内鞘芯管之间的空腔中时,每个所述变形部的所述自由端的连线组成的多边形的外接圆的直径小于所述植入物在被压缩之前与每个所述钩挂件的连接处的连线组成的多边形的外接圆的直径的90%。In one embodiment, when the hooking member is not received in the cavity between the outer sheath tube and the inner sheath core tube, the connection of the free end of each of the deformation portions is composed of The diameter of the circumscribed circle of the polygon is less than 90% of the diameter of the circumcircle of the polygon formed by the line of the implant at the junction with each of the hooks before being compressed.
在其中一个实施例中,每个所述变形部的所述自由端的连线组成的多边形的外接圆的直径范围为3至50毫米。In one of the embodiments, the circumscribed circle of the polygon composed of the line connecting the free ends of each of the deformation portions has a diameter ranging from 3 to 50 mm.
在其中一个实施例中,当所述钩挂件未收容于所述外鞘管与所述内鞘芯管之间的空腔中时,所述变形部沿所述内鞘芯管的轴向的长度范围为3至50毫米。In one embodiment, when the hooking member is not received in the cavity between the outer sheath tube and the inner sheath core tube, the deformation portion is along the axial direction of the inner sheath core tube The length ranges from 3 to 50 mm.
在其中一个实施例中,所述钩挂单元包括2至12个钩挂件,所述2至12个钩挂件围绕所述内鞘芯管的中心轴呈对称设置。In one of the embodiments, the hooking unit includes 2 to 12 hooks, and the 2 to 12 hooks are symmetrically disposed about a central axis of the inner sheath core tube.
在其中一个实施例中,所述钩挂单元还包括套设并固定于所述内鞘芯管的外表面的中空管状紧箍件,所述钩挂件通过所述紧箍件与所述内鞘芯管的外表面相连。In one embodiment, the hooking unit further includes a hollow tubular hoop member sleeved and fixed to an outer surface of the inner sheath core tube, the hooking member passing through the hoop member and the inner sheath The outer surfaces of the core tubes are connected.
在其中一个实施例中,所述固定部位于所述紧箍件与所述内鞘芯管的外表面之间,所述紧箍件限制所述固定部与所述内鞘芯管的外表面之间的相对移动。In one embodiment, the fixing portion is located between the fastening member and an outer surface of the inner sheath core tube, the fastening member restricting the fixing portion and an outer surface of the inner sheath core tube Relative movement between.
在其中一个实施例中,所述紧箍件沿轴向具有盲孔,所述钩挂件的所述固定部穿设于所述盲孔中并与所述紧箍件固定连接。 In one embodiment, the fastening member has a blind hole in the axial direction, and the fixing portion of the hooking member is inserted into the blind hole and fixedly connected to the fastening member.
在其中一个实施例中,所述紧箍件沿轴向具有通孔,所述钩挂件的所述固定部轴向贯穿所述通孔后与所述紧箍件固定连接。In one embodiment, the fastening member has a through hole in the axial direction, and the fixing portion of the hooking member is axially penetrated through the through hole and fixedly connected to the fastening member.
在其中一个实施例中,所述紧箍件的直径范围为1至30毫米,所述紧箍件沿所述内鞘芯管的轴向的长度范围为2至10毫米。In one embodiment, the hoop member has a diameter in the range of 1 to 30 mm, and the hoop member has a length in the axial direction of the inner sheath core tube ranging from 2 to 10 mm.
在其中一个实施例中,所述输送系统还包括设于所述钩挂单元及所述内鞘芯管的远端之间的限位件,所述限位件固定于所述内鞘芯管的外表面并向远离所述内鞘芯管的轴向的方向凸起。In one embodiment, the delivery system further includes a limiting member disposed between the hooking unit and the distal end of the inner sheath core tube, the limiting member being fixed to the inner sheath core tube The outer surface projects toward the axial direction away from the inner sheath core tube.
在其中一个实施例中,所述钩挂件具有双股线构成的U型结构。In one embodiment, the hook has a U-shaped configuration of twin strands.
在其中一个实施例中,钩挂件的所述变形部的至少部分所述自由端经过热定型处理。In one of the embodiments, at least a portion of the free end of the deformation of the hook is heat set.
在其中一个实施例中,所述钩挂件的所述变形部的至少部分所述自由端所在的平面与所述固定部所在的平面之间的夹角范围为60度至120度。In one embodiment, an angle between a plane in which at least a portion of the free end of the deformation portion of the hook portion is located and a plane in which the fixing portion is located ranges from 60 degrees to 120 degrees.
在其中一个实施例中,所述钩挂件的所述变形部的至少部分所述自由端所在的平面与所述固定部所在的平面之间的夹角为90度。In one embodiment, an angle between a plane in which at least a portion of the free end of the deformation portion of the hook portion is located and a plane in which the fixing portion is located is 90 degrees.
在其中一个实施例中,所述紧箍件的管体外表面上,设置至少一个用于收容所述变形部的所述自由端的容置空间。In one embodiment, at least one receiving space for receiving the free end of the deformation portion is disposed on the outer surface of the tube of the fastening member.
本发明的输送系统在内鞘芯管上设置柔性钩挂件替代刚性凸起物来约束管腔支架,至少具有以下有益效果:The delivery system of the present invention provides a flexible hook on the inner sheath core tube instead of the rigid protrusion to constrain the lumen support, and has at least the following beneficial effects:
(1)当装载有植入物的输送系统的管体在人体管腔内输送时,柔性钩挂件穿过植入物端部的镂空后朝近端弯折并被约束在内鞘芯管和外鞘管之间,且沿内鞘芯管的轴向具有较长长度,即使通过较弯曲的人体管腔部位时,钩挂件也不会与植入物脱离,避免了现有技术的刚性凸起物会与外鞘管内壁之间产生缝隙,导致植入物自刚性凸起物脱落的风险。(1) When the body of the delivery system loaded with the implant is delivered within the lumen of the body, the flexible hook is bent proximally through the end of the implant and is constrained to the inner sheath core tube and Between the outer sheath tubes and having a long length along the axial direction of the inner sheath core tube, the hook member is not detached from the implant even when passing through the relatively curved body lumen portion, avoiding the prior art rigid convexity. The gap between the material and the inner wall of the outer sheath tube creates a risk of the implant falling off from the rigid protrusion.
(2)在柔性钩挂件长度范围内可以在外鞘管的约束下逐渐释放植入物,直至露出全部柔性钩挂件,避免了植入物突然释放后无法调整释放位置的缺点。(2) The implant can be gradually released under the constraint of the outer sheath tube within the length of the flexible hook until all the flexible hooks are exposed, thereby avoiding the disadvantage that the release position cannot be adjusted after the implant is suddenly released.
(3)当手术过程中需要调整植入物的释放位置时,操作者可以后撤管体并调整管体远端位置,在调整过程中,植入物被固定于内鞘芯管之上,且植入物与外鞘管之间不会发生相对运动,有效防止植入物自外鞘管之中提前释放。(3) When it is necessary to adjust the release position of the implant during the operation, the operator can withdraw the body and adjust the distal position of the tube. During the adjustment process, the implant is fixed on the inner sheath core tube. And the relative movement between the implant and the outer sheath tube does not occur, effectively preventing the implant from being released in advance from the outer sheath tube.
(4)在手术过程中,当植入物被部分释放,如发现植入物的尺寸与病变部位不符合,由于植入物靠近近端的部分仍然通过钩挂单元固定于内鞘芯管之上,可以通过驱动外鞘管相对于内鞘芯管向远端轴向运动,将已经释放的植入物重新回收至外鞘管与内鞘芯管之间的空腔之中,再将管体撤出病人体外,更换尺寸适宜的植入物。(4) During the operation, when the implant is partially released, if the size of the implant is found to be inconsistent with the lesion, the portion near the proximal end of the implant is still fixed to the inner sheath core tube by the hook unit. Upper, the distal end of the outer sheath tube can be re-recovered into the cavity between the outer sheath tube and the inner sheath core tube by driving the outer sheath tube to move axially distally relative to the inner sheath core tube, and then the tube The body is withdrawn from the patient and replaced with an appropriately sized implant.
(5)当钩挂单元的钩挂件自外鞘管与内鞘芯管之间的空隙中释放,具有弹性的钩挂件变形部恢复自然状态,植入物与内鞘芯管之间不再通过钩挂件连接,植入物可自外鞘管中快速释放并膨胀。 (5) When the hooking member of the hooking unit is released from the gap between the outer sheath tube and the inner sheath core tube, the elastic hook portion deforms back to a natural state, and the implant and the inner sheath core tube no longer pass. The hooks are attached and the implant can be quickly released and expanded from the outer sheath.
附图及附图说明BRIEF DESCRIPTION OF THE DRAWINGS AND DRAWINGS
图1为实施例一提供的管腔支架输送系统的主视图,输送系统包括手柄外壳、滑块、管体及钩挂单元,管体包括外鞘管、内鞘芯管及内鞘管;1 is a front view of a lumen stent delivery system according to a first embodiment, the delivery system includes a handle housing, a slider, a tube body, and a hooking unit, the tube body including an outer sheath tube, an inner sheath core tube, and an inner sheath tube;
图2a为图1中的钩挂单元及管体在平行于轴向的截面上的剖视图;Figure 2a is a cross-sectional view of the hook unit and the tube body of Figure 1 in a section parallel to the axial direction;
图2b为管体的另一种实施方式的结构示意图;2b is a schematic structural view of another embodiment of a tubular body;
图3a至图3c为图1中的钩挂单元的结构示意图,钩挂单元包括三个钩挂件及一个紧箍件,其中,图3a为未收容于管体中的钩挂单元的主视图,图3b为收容于管体中的钩挂单元的主视图,图3c为未收容于管体中的钩挂单元在平行于轴向的截面上的剖视图;3a to 3c are schematic views showing the structure of the hooking unit of FIG. 1. The hooking unit includes three hooking members and a tightening member, wherein FIG. 3a is a front view of the hooking unit not received in the tubular body. Figure 3b is a front view of the hooking unit housed in the pipe body, and Figure 3c is a cross-sectional view of the hooking unit not received in the pipe body in a section parallel to the axial direction;
图4a至图4c为图3a中的钩挂件的结构示意图,其中,图4a为主视图,图4b为钩挂件在另一角度下的示意图,图4c为侧视图;4a to 4c are schematic structural views of the hooking member of Fig. 3a, wherein Fig. 4a is a front view, Fig. 4b is a schematic view of the hooking member at another angle, and Fig. 4c is a side view;
图5a及图5b为钩挂单元的另一种实施方式的结构示意图,其中,图5a为主视图,图5b为侧视图;5a and 5b are schematic structural views of another embodiment of a hooking unit, wherein FIG. 5a is a front view and FIG. 5b is a side view;
图5c为钩挂单元的另一种实施方式在平行于轴向的截面上的剖视图;Figure 5c is a cross-sectional view of another embodiment of the hooking unit in a section parallel to the axial direction;
图5d及图5e为钩挂单元的的另一种实施方式与图1中的管体的示意图,其中,图5d为在平行于轴向的截面上的剖视图,图5e为图5d中A处的局部放大图;5d and 5e are schematic views of another embodiment of the hooking unit and the tube body of Fig. 1, wherein Fig. 5d is a cross-sectional view in a section parallel to the axial direction, and Fig. 5e is a view in Fig. 5d Partial enlarged view;
图6为图1中的钩挂单元将管腔支架固定于内鞘芯管之上时,钩挂单元、管体及管腔支架在平行于轴向的截面上的剖视图;Figure 6 is a cross-sectional view of the hooking unit, the tube body and the lumen bracket in a section parallel to the axial direction when the hooking unit of Figure 1 is fixed to the inner sheath core tube;
图7为图1中的钩挂单元不再将管腔支架固定于内鞘芯管之上的示意图;Figure 7 is a schematic view of the hooking unit of Figure 1 no longer fixing the lumen stent to the inner sheath core tube;
图8a及图8b为图1中的管体输送管腔支架的过程示意图,其中图8a为到达病变部位后,管腔支架部分自外鞘管之中释放的过程示意图,图8b为调整管体远端位置的过程示意图;8a and 8b are schematic views of the process of the tube delivery lumen stent of Fig. 1, wherein Fig. 8a is a schematic view of the process of releasing the lumen stent portion from the outer sheath tube after reaching the lesion site, and Fig. 8b is an adjustment tube body. Schematic diagram of the process at the remote location;
图9a为及图9b为管腔支架回收至图1中的外鞘管的过程示意图,其中,图9a为管腔支架部分自外鞘管之中释放的示意图,图9b为管腔支架回收至外鞘管之中的过程示意图;9a and FIG. 9b are schematic diagrams showing the process of recovering the lumen stent to the outer sheath tube of FIG. 1. FIG. 9a is a schematic view showing the release of the lumen stent portion from the outer sheath tube, and FIG. 9b is a schematic diagram of the lumen stent recovery to a schematic diagram of the process in the outer sheath;
图10a至图10c为第二实施例提供的输送系统中,钩挂单元的示意图,输送系统包括管体、钩挂单元、手柄外壳及滑块,钩挂单元包括三个钩挂件,其中,图10a为未收容于管体之中的钩挂单元主视图;图10b为图10a中的一个钩挂件的主视图,图10c为图10a中的钩挂件收容于管体之中的主视图;10a to 10c are schematic views of a hooking unit in a transport system according to a second embodiment, the transport system includes a tube body, a hooking unit, a handle housing and a slider, and the hooking unit includes three hooking members, wherein 10a is a front view of the hooking unit not received in the pipe body; FIG. 10b is a front view of a hooking member in FIG. 10a, and FIG. 10c is a front view of the hooking member in FIG. 10a received in the pipe body;
图10d至图10g为钩挂单元的另一种实施方式的示意图,其中,图10d为未收容于管体之中的钩挂单元主视图,图10e为图10d中的钩挂单元收容于管体之中的主视图;图10f为钩挂单元将管腔支架固定于内鞘芯管之上时的示意图;图10g为管腔支架自外鞘管中释放后的示意图;10d to 10g are schematic views of another embodiment of the hooking unit, wherein FIG. 10d is a front view of the hooking unit not received in the tube body, and FIG. 10e is a hooking unit of FIG. 10d received in the tube. Figure 10f is a schematic view of the hooking unit when the lumen stent is fixed on the inner sheath core tube; Figure 10g is a schematic view of the lumen stent released from the outer sheath tube;
图10h为钩挂单元的另一种实施方式的主视图;Figure 10h is a front elevational view of another embodiment of the hooking unit;
图11为钩挂单元的另一种实施方式在平行于轴向的截面上的剖视图; Figure 11 is a cross-sectional view of another embodiment of the hook unit in a section parallel to the axial direction;
图12a及图12b为钩挂单元的另一种实施方式的示意图,其中,图12a为主视图,图12b为侧视图;12a and 12b are schematic views of another embodiment of a hooking unit, wherein FIG. 12a is a front view and FIG. 12b is a side view;
图13a及图13b为第三实施例提供的输送系统的示意图,输送系统包括管体、钩挂单元及限位件,其中,图13a为主视图,图13b为管体、钩挂单元及限位件的局部在平行于轴向的截面上的剖视图;13a and 13b are schematic views of a transport system provided by a third embodiment. The transport system includes a tube body, a hooking unit and a limiting member. FIG. 13a is a front view, and FIG. 13b is a tube body, a hooking unit and a limit. a cross-sectional view of a portion of the bit member in a section parallel to the axial direction;
图14a及图14b为第四实施例提供的输送系统的结构示意图,输送系统包括手柄外壳、滑块、管体及钩挂单元,钩挂单元包括钩挂件,其中,图14a为管体及钩挂单元主视图,图14b为图14a中管体及钩挂单元的局部在平行于轴向的截面上的剖视图;14a and 14b are schematic structural views of a transport system according to a fourth embodiment. The transport system includes a handle housing, a slider, a tube body and a hooking unit. The hooking unit includes a hooking member, wherein FIG. 14a is a tube body and a hook. Hanging unit main view, FIG. 14b is a cross-sectional view of a portion of the tube body and the hooking unit of FIG. 14a in a section parallel to the axial direction;
图15a至图15c为第五实施例提供的输送系统的结构示意图,输送系统包括手柄外壳、滑块、管体及三个钩挂单元,其中,图15a为管体及钩挂单元主视图,图15b为管体及钩挂单元在平行于轴向的截面上的剖视图,图15c为管腔支架自图15b中的管体之中部分释放的示意图;15a to 15c are schematic structural views of a conveying system according to a fifth embodiment. The conveying system includes a handle housing, a slider, a tube body and three hooking units. FIG. 15a is a front view of the tube body and the hooking unit. Figure 15b is a cross-sectional view of the tube body and the hooking unit in a section parallel to the axial direction, and Figure 15c is a schematic view showing a partial release of the lumen bracket from the tube body in Figure 15b;
图16为包括多个钩挂单元的输送系统的结构示意图。Figure 16 is a schematic view showing the structure of a conveying system including a plurality of hooking units.
为了使本发明的目的、技术方案及优点更加清楚明白,以下结合附图及实施例,对本发明进行进一步详细说明。应当理解,此处所描述的具体实施例仅仅用以解释本发明,并不用于限定本发明。The present invention will be further described in detail below with reference to the accompanying drawings and embodiments. It is understood that the specific embodiments described herein are merely illustrative of the invention and are not intended to limit the invention.
需要说明的是,当元件被称为“固定于”另一个元件,它可以直接在另一个元件上或者也可以存在居中的元件。当一个元件被认为是“连接”另一个元件,它可以是直接连接到另一个元件或者可能同时存在居中元件。在介入领域,通常将相对操作者近的一端称为近端,相对操作者远的一端称为远端。It should be noted that when an element is referred to as being "fixed" to another element, it can be directly on the other element or the element can be present. When an element is considered to be "connected" to another element, it can be directly connected to the other element or. In the field of intervention, the end near the operator is usually referred to as the proximal end, and the end far from the operator is referred to as the distal end.
为了更加清楚地描述输送系统及植入物的结构,此处限定术语“近端”及“远端”为介入医疗领域惯用术语。具体而言,在介入医疗领域,“远端”表示手术操作过程中远离操作人员的一端,“近端”表示手术操作过程中靠近操作人员的一端。除非另有定义,本发明所使用的所有的技术和科学术语与属于本发明的技术领域的技术人员通常理解的含义相同。本发明在说明书中所使用的术语只是为了描述具体的实施例的目的,不是旨在于限制本发明。To more clearly describe the structure of the delivery system and implant, the terms "proximal" and "distal" are defined herein as a common term in the field of interventional medicine. Specifically, in the field of interventional medicine, "distal" refers to the end away from the operator during the surgical procedure, and "proximal" refers to the end that is close to the operator during the surgical procedure. Unless otherwise defined, all technical and scientific terms used in the present invention have the same meaning meaning The terminology used in the description is for the purpose of describing the particular embodiments, and is not intended to limit the invention.
实施例一Embodiment 1
请参见图1,实施例一提供的输送系统100,用于将植入物输送至人体管腔内的病变部位。输送系统100包括管体10、钩挂单元20、以及包括手柄外壳30及滑块33的手柄。Referring to Fig. 1, a
手柄外壳30包括轴对称设置的第一壳体31和第二壳体(图未示出)。滑块33的个数为两个。两个滑块33分别设置于手柄外壳30的第一壳体31和第二壳体上且互相对称。The
请一并参阅图2a,本实施例中,植入物为管腔支架200。管体10包括轴向贯穿手柄外壳30的中空的内鞘管11、贯穿内鞘管11且远端伸出内鞘管11的中空的内鞘芯管13、可动地套设于内鞘管11
外部并与内鞘芯管13之间具有空腔的外鞘管12、及设置于内鞘芯管13的远端且不透X射线的中空的Tip头14。压缩后的管腔支架200装载于内鞘芯管13的远端与外鞘管12的远端之间的空腔中,并与内鞘芯管13的外表面摩擦接触。由此,可通过操作手柄上的滑块33驱动外鞘管12相对内鞘芯管13在轴向上运动,向近端后撤外鞘管12,最终使得管腔支架200自外鞘管12之中释放。在其他实施例中,手柄可为其他结构,只要手柄能驱动外鞘管12相对内鞘芯管13在轴向运动即可。Referring to FIG. 2a together, in the embodiment, the implant is a
请再次参见图1,输送系统100还包括固定安装于手柄外壳30上的导液组件15。导液组件15包括用于传输冲洗液或者造影剂的中空的软管151、连接软管151与内鞘管11的连接头152、以及一端连接软管151的三通阀153。导液组件15的软管151的内腔与外鞘管12和内鞘管11之间的空腔相通。在手术前,将注射器与三通阀153连接,以导入冲洗液而冲洗内鞘管11的外部、或者排出外鞘管12与内鞘管11之间的空气。也可在术前或者术中,将注射器与三通阀153连接,注射造影剂进行造影。Referring again to FIG. 1, the
内鞘管11轴向贯穿手柄外壳30的近端端面与远端端面。内鞘管11与位于内鞘管11内部的内鞘芯管13固定连接。固定连接的方式可以是焊接、粘合、缝合、热熔或者螺纹连接等本领域常用的技术手段,在此不再详述。本实施例中,内鞘管11由具有韧性的高分子材料制成。可以理解的是,在其他实施例中,内鞘管11也可以由金属材料制成。还可以理解的是,在其他实施例中,内鞘管11也可以为高分子材料制成的管体与金属材料制成的管体的组合。例如,内鞘管11靠近远端的管体部分收容于外鞘管12之中,由具有韧性的高分子材料制成,以利于提高内鞘管11在弯曲的人体管腔中的可通过性;内鞘管11靠近近端的管体部分位于手柄外壳30内部,由金属材料制成,以提高内鞘管11近端的支撑性。The
可以理解的是,在其他实施例中,管体10可以不包括内鞘管11。具体地,请参见图2b,管体10包括轴向贯穿手柄外壳30的中空的内鞘芯管13、可活动地套设于内鞘芯管13外部的外鞘管12、及设置于内鞘芯管13的远端且不透X射线的中空的Tip头14。内鞘芯管13包括靠近近端的第一管体131及与第一管体131的远端轴向相连的第二管体132,且第一管体131的直径大于第二管体132的直径。由此,压缩后的管腔支架200可收容于外鞘管12与第二管体132之间的空腔中,并与第二管体132摩擦接触。钩挂单元20设于第二管体132上,并与管腔支架200(见图2a)可拆卸连接。可以理解的是,第一管体131及第二管体132可以由不同的材料制成。例如,第一管体131由具有韧性的高分子材料制成,第二管体132由金属材料制成,以保证内鞘芯管13的远端柔顺性及近端支撑性。还可以理解的是,在其他实施例中,第一管体131及第二管体132也可以由相同的材料制成。例如,第一管体131及第二管体132均由具有韧性的高分子材料制成。还可以理解的是,在其他实施例中,内鞘芯管13还可以包括第三管体(图未示出)。第三管体可以套设于第一管体131靠近近端的管体部分上。第三管体也可以与第一管体131的近端轴向相连。第三管体的硬度高于第一管体131的硬度,以起到加强挺直的作用,提高内鞘芯管13的近端支撑性。
It will be appreciated that in other embodiments, the
请一并参阅图1及图2a,外鞘管12套设于内鞘管11及内鞘芯管13的外部,并可在手柄的驱动下相对内鞘管11及内鞘芯管13在轴向运动。外鞘管12靠近近端的管体侧壁与滑块33固定连接,由此,当拖动滑块33向远端前进或者向近端后撤,即可驱动外鞘管12进行同向的轴向运动。当滑块33驱动外鞘管12向远端前进,可以实现管腔支架200收容至外鞘管12之中;当滑块33驱动外鞘管12向近端后撤,可以实现管腔支架200自外鞘管12之中释放。外鞘管12由具有韧性的高分子材料或者金属材料制成。可以理解的是,在其他实施例中,可以在外鞘管12靠近近端的管体外面套设硬度较高的加强管(图未示出),或者将硬度较高的加强管与外鞘管12的近端轴向相连。加强管亦设有滑槽,由此,可以增强外鞘管12与滑块33连接处的牢固性,并提高外鞘管12在手柄外壳30中的可通过性。Referring to FIG. 1 and FIG. 2a together, the
内鞘芯管13靠近近端的管体收容于内鞘管11之中。内鞘芯管13收容于内鞘管11之中的管体与内鞘管11通过焊接、粘合、缝合、热熔或者螺纹连接等本领域通用的连接方式固定在一起,以提高内鞘芯管13的支撑性。另外,当外鞘管12相对于内鞘管11及内鞘芯管13进行轴向运动时,内鞘管11的外壁与外鞘管12的内壁之间发生摩擦,固定在一起的内鞘芯管13与内鞘管11之间不易发生相对偏离或者弯折。内鞘芯管13的远端穿出内鞘管11的远端,即内鞘芯管13靠近远端的管体未被内鞘管11包裹。压缩后的管腔支架200装载于内鞘芯管13未被内鞘管11包裹的管体与外鞘管12之间形成的空腔中。内鞘芯管13的远端连接不透射线的中空的Tip头14,连接方式可以是注塑成型或者粘合等方式。内鞘芯管13的内腔与Tip头14的内腔相通。内鞘芯管13和Tip头14的内腔用于容纳并通过导丝(图未示出)。The tube body of the inner
请一并参见图3a,钩挂单元20设于内鞘芯管13未被内鞘管11包裹的管体的外表面。钩挂单元20包括一个中空管状的固定在内鞘芯管11上的紧箍件21及三个与紧箍件21相连的柔性钩挂件22。三个柔性钩挂件22围绕内鞘芯管13的中心轴呈对称设置。由于外鞘管12可以相对于内鞘芯管13轴向运动,因此柔性钩挂件22的自由端可活动地收容于外鞘管12与内鞘芯管13之间形成的空腔之中。Referring to FIG. 3a together, the hooking
请同时参阅图2a及图3b,当钩挂单元20收容于外鞘管12与内鞘芯管13之间形成的空腔之中,钩挂单元20的三个钩挂件22的自由端向靠近近端的方向弯折并指向近端形成钩状物,分别钩挂管腔支架200的靠近近端的镂空处(即,波峰处骨架)。此时,钩挂件22具有沿内鞘芯管13的径向向外展开的趋势,而外鞘管12的内壁抑制钩挂件22沿内鞘芯管13的径向向外展开的趋势,使钩挂件22保持钩状。因此,钩挂件22可以限制管腔支架200与内鞘芯管13之间的相对移动。Referring to FIG. 2a and FIG. 3b simultaneously, when the hooking
当外鞘管12相对于内鞘芯管13向近端轴向运动,钩挂单元20自外鞘管12与内鞘芯管13之间的空腔中释放,外鞘管12的内壁对钩挂件22沿内鞘芯管13的径向向外展开的趋势的抑制作用消失,钩挂件22沿内鞘芯管13的径向向外展开,恢复至图3a所示的自然展开状态,并与管腔支架200分离。即,钩挂单元20解脱与管腔支架200的钩挂。When the
请一并参见图3c,钩挂件22包括与内鞘芯管13的外表面相连的固定部221、及与固定部221相连
的变形部222。固定部221设于紧箍件21及内鞘芯管13的管体外表面之间。即,紧箍件21套设于固定部221的外部,并限制固定部221的移动。Referring to FIG. 3c together, the hooking
请参见图4a,变形部222的一端与固定部221相连,另一端为自由端。变形部222的自由端向远离内鞘芯管13的轴向的方向延伸。即,变形部222具有向远离内鞘芯管13的轴向的方向延伸的自由端。变形部222的自由端可相对固定部221弯折。在钩挂件22收容于外鞘管12与内鞘芯管13之间的空腔内时,变形部222与固定部221配合形成钩状物。由此,当所述钩挂件收容于所述外。变形部222由柔性材料制成,优选由具有弹性的材料制成。本实施例中,变形部222由具有形状记忆功能的镍钛合金制成。固定部221也由镍钛合金制成,即,整个钩挂件22由镍钛合金材料通过一体成型制成。Referring to FIG. 4a, one end of the deforming
请参见图4b,当钩挂件22未收容于外鞘管12与内鞘芯管13之间的空腔中时,变形部222沿内鞘芯管13的轴向的长度L1范围为3至50毫米。由此,变形部222与管腔支架200之间的可拆卸连接更为可靠,并且变形部222自外鞘管12与内鞘芯管13之间的空腔中释放后,既不会划伤血管,也不会影响变形部222与管腔200的分离。本实施例中,当钩挂件22未收容于外鞘管12与内鞘芯管13之间的空腔中时,变形部222沿内鞘芯管13的轴向的长度L1为6毫米。固定部221沿内鞘芯管13的轴向的长度L2范围为2至10毫米。由此,固定部221不会影响管体10的柔顺性,有利于管体10在人体迂曲血管中的可通过性,并且不会降低固定部221与紧箍件21的连接强度,因此不会影响管腔支架200与内鞘芯管13的连接可靠性。本实施例中,固定部221沿内鞘芯管13的轴向的长度L2为6毫米。Referring to FIG. 4b, when the hooking
当钩挂件22未收容于外鞘管12与内鞘芯管13之间的空腔中时,变形部222的延伸方向与内鞘芯管13的近端至远端的方向之间的夹角范围为0度至180度,优选小于或等于90度。在本实施例中,即变形部222的延伸方向与固定部221的近端至远端的方向之间的夹角α范围为0度至180度。由此,可以保证管腔支架200与变形部222之间的可拆卸连接的连接可靠性,及管腔支架200自外鞘管12与内鞘芯管13之间的空腔之中释放之后,变形部222与管腔支架200之间的解脱分离。优选地,本实施例中,变形部222的延伸方向与内鞘芯管13的近端至远端的方向之间的夹角与变形部222的延伸方向与固定部221的近端至远端的方向之间的夹角α相同,均为90度。When the hooking
请参见图4c,当钩挂件22未收容于外鞘管12与内鞘芯管13之间的空腔中时,每个变形部222的自由端的连线组成的多边形的外接圆的直径D小于管腔支架200在被压缩之前与钩挂件22的连接处的连线组成的多边形的外接圆的直径的90%。具体地,当钩挂件22未收容于外鞘管12与内鞘芯管13之间的空腔中时,每个变形部222的自由端的连线组成的多边形的外接圆的直径D范围为3至50毫米。由此,变形部222与管腔之间200之间的连接更为可靠,并且变形部222自外鞘管12与内鞘芯管13之间的空腔中释放后,既不会划伤血管,也不会影响变形部222与管腔支架200的分离。本实施例中,管腔支架200的直径为12毫米,当钩挂件22未收容于外鞘管12与内鞘芯管13之间的空腔中时,每个变形部222的自由端的连线组成的多边形的外接圆的直径D为10毫米。
Referring to FIG. 4c, when the hooking
当钩挂件22收容于外鞘管12与内鞘芯管13之间的空腔中时,每个变形部222的自由端的连线组成的多边形的外接圆的直径小于外鞘管12的内径。本实施例中,当钩挂件22收容于外鞘管12与内鞘芯管13之间的空腔中时,每个变形部222的自由端的连线组成的多边形的外接圆的直径为3.5毫米。When the hooking
请再次参见图2a及图3a,中空管状的紧箍件21套设于内鞘芯管13的外表面。紧箍件21可以由高分子材料或者金属材料制成,并与内鞘芯管13的外表面通过粘合、过盈配合、缝合、热熔或者焊接(例如,激光点焊)等方式固定连接。本实施例中,紧箍件21通过粘合固定于内鞘芯管13的外表面之上。钩挂件22的固定部221位于紧箍件21与内鞘芯管13的外表面之间。紧箍件21限制固定部221与内鞘芯管13的外表面之间的相对移动。紧箍件21的内径大于或者等于内鞘芯管13的外径。紧箍件21的直径小于外鞘管12的内径。紧箍件的直径范围为1至30毫米,紧箍件21沿内鞘芯管13的轴向的长度大于固定部221沿内鞘芯管13的轴向的长度。具体地,紧箍件21沿内鞘芯管13的轴向的长度范围为2至10毫米。在本实施例中,紧箍件21沿内鞘芯管13的轴向的长度为5毫米。Referring again to FIGS. 2a and 3a, the hollow
可以理解的是,在其他实施例中,紧箍件21与钩挂件22的固定部221还可以具有其他连接方式。请同时参见图5a及图5b,紧箍件21为具有一定壁厚的套管210,且套管210的管壁上沿轴向具有盲孔211。紧箍件21沿内鞘芯管13的轴向的长度大于固定部221沿内鞘芯管13的轴向的长度。由此,钩挂件22的固定部221(见图4b)穿设于盲孔211之中,并与套管210通过热熔、焊接、粘合或者螺纹连接等方式固定在一起。请参见图5c,紧箍件21也可以为具有一定壁厚的套管210,且套管210的管壁上沿轴向具有通孔212。紧箍件21沿内鞘芯管13的轴向的长度小于固定部221沿内鞘芯管13的轴向的长度。由此,钩挂件22的固定部221轴向贯穿通孔212后,将固定部221远离变形部222的一端通过激光点焊形成球体2211,且球体2211直径大于通孔212直径,以保证固定部221不会自紧箍件21中脱落。It can be understood that in other embodiments, the
可以理解的是,在其他实施例中,紧箍件21也可以由具有弹性的材料制成。具体地,请参见图5d及5e,紧箍件21可以为弹性材料制成的套管。紧箍件21套设于内鞘芯管13的外表面。钩挂件22的固定部221设于紧箍件21与内鞘芯管13之间。内鞘管11靠近远端的部分与内鞘芯管13之间具有容纳紧箍件21的空隙。紧箍件21的靠近近端的部分设于内鞘管11与内鞘芯管13之间的空隙之中。由此,内鞘管11挤压紧箍件21发生弹性形变后,紧箍件21抱紧内鞘芯管13,即可限制钩挂件22的固定部221的移动。优选地,紧箍件21的远端端面与内鞘管11的远端端面平齐,可以更好地固定钩挂件22的固定部221。It will be appreciated that in other embodiments, the
还可以理解的是,在其他实施例中,紧箍件21还可以为由热收缩性材料制成的中空套管。钩挂件22的固定部221设于紧箍件21与内鞘芯管13的外表面之间。通过将紧箍件21加热至热收缩性材料的热收缩温度,使得紧箍件21受热收缩并牢牢包裹内鞘芯管13,从而限制钩挂件22的固定部221与内鞘芯管13的外表面之间发生相对移动。
It will also be appreciated that in other embodiments, the
管腔支架200在植入病人体内前,需要先装载至输送系统100的管体10中,再由输送系统100输送至病人体内的病变部位。管腔支架200的装载过程如下:先将管腔支架200置于内鞘芯管13的外表面之上,并使钩挂件22的变形部222钩挂管腔支架200的近端的镂空处(即,波峰处骨架),使得管腔支架200被固定于内鞘芯管13的外表面之上。再通过向远端推送滑块33,驱动外鞘管12相对于内鞘芯管13向远端轴向运动。管腔支架200自近端至远端逐渐被压缩并收容于外鞘管12和内鞘芯管13之间的空腔中。当外鞘管12的远端端面抵顶钩挂件22的变形部222后,继续向远端推送滑块33,钩挂件22的变形部222相对固定部221弯折,并与固定部221配合形成钩状物,并被收容于外鞘管12和内鞘芯管13之间的空腔中。继续向远端推送滑块33,直至整个管腔支架200收容于外鞘管12和内鞘芯管13之间的空腔中。The
请参见图6,当管腔支架200与输送系统100之间的装载完成后,管腔支架200通过钩挂单元20固定于内鞘芯管13之上,且钩挂单元20限制管腔支架200与内鞘芯管13之间的相对移动。并且由于变形部222的自由端具有沿内鞘芯管13的径向向外展开的趋势,而外鞘管12的内壁抑制自由端沿内鞘芯管13的径向向外展开的趋势,使钩挂件22保持钩状。Referring to FIG. 6, after the loading between the
请参见图7,当装载有管腔支架200的管体10到达病变位置,准备释放管腔支架200时,通过向近端后撤滑块33(见图1),驱动外鞘管12相对于内鞘芯管13向近端轴向运动。外鞘管12的内壁对变形部222的自由端沿内鞘芯管13的径向向外展开的趋势的抑制作用消失。由弹性材料制成的变形部222自外鞘管12与内鞘芯管13之间的空腔中释放。变形部222由于自身弹性恢复至展开状态,并与钩挂的管腔支架200自动分离。此时,管腔支架200不再与内鞘芯管13连接,当外鞘管12继续相对于内鞘芯管13向近端轴向运动,管腔支架200自外鞘管12中释放,并依靠自身超弹性膨胀并贴附血管壁。Referring to FIG. 7, when the
请同时参阅图8a及图8b,当管腔支架200未完全释放,且管腔支架200已释放的部分较短时,可直接回撤整个管体10,调整管体10远端的位置,并在数字影像辅助下,通过管腔支架200上的显影标记点观察,直至管体10的远端调整至较理想的释放位置。在调整过程中,由于外鞘管12的内壁对变形部222的自由端沿内鞘芯管13的径向向外展开的趋势的抑制作用,管腔支架200始终被钩挂单元20固定于内鞘芯管13上,此时回撤管体10,外鞘管12与管腔支架200之间不会发生相对运动,避免由于外鞘管12与管腔支架200之间的相对运动,导致管腔支架200提前释放。Referring to FIG. 8a and FIG. 8b simultaneously, when the
请参见图9a及图9b,当管腔支架200未完全释放时,外鞘管12内壁对变形部222的自由端向外展开趋势具有抑制作用,管腔支架200仍然通过钩挂单元20固定于内鞘芯管13之上。此时如果发现管腔支架200的选型与病变部位不匹配,需要更换管腔支架,可以向远端推送滑块33(见图1),驱动外鞘管12相对于内鞘芯管13向远端轴向运动,使得管腔支架200已经释放的部分重新被压缩并回收至外鞘管12与内鞘芯管13之间的空腔中,再将管体10撤出病人体内,更换适宜的管腔支架。Referring to FIGS. 9a and 9b, when the
本实施例提供的输送系统100的使用过程包括如下步骤:
The use process of the
第一步:经皮穿刺置入导丝至病变部位;The first step: percutaneous puncture into the guide wire to the lesion;
第二步:将预装有管腔支架200的管体10沿导丝输送至病变部位;The second step: transporting the
第三步:保持手柄外壳30位置不变,通过后撤滑块33,驱动与滑块33连接的外鞘管12向近端移动。由此,外鞘管12相对于内鞘芯管13及管腔支架200发生轴向运动,管腔支架200逐渐自外鞘管12中释放。在医学影像辅助下,通过管腔支架200上的显影标记点,评估管腔支架200的初始释放位置是否满足临床要求。The third step: keeping the position of the
第四步:若管腔支架200的初始释放位置较理想,可继续向近端回撤滑块33,驱动外鞘管12相对于内鞘芯管13向近端轴向运动,直至管腔支架200自外鞘管12之中完全释放。The fourth step: if the initial release position of the
第五步:若管腔支架200的初始释放位置不理想,可停止后撤外鞘管12,保持滑块33与手柄外壳30的相对位置不变,回撤整个管体10,并调整管体10远端的位置。在调整管体10远端的位置的过程中,由于管腔支架200被钩挂单元20固定于内鞘芯管13之上,管腔支架200与外鞘管12、内鞘芯管13之间均不发生相对移动,有效地避免管腔支架200自外鞘管12中提前释放。Step 5: If the initial release position of the
第六步:当管体10远端被调整至较理想的释放位置,再次后撤手柄外壳30上的滑块33,驱动外鞘管12相对于内鞘芯管13向近端轴向运动。当钩挂件22自外鞘管12与内鞘芯管13之间的空腔中释放,钩挂件22的变形部222由于自身弹性恢复至自然展开状态,并与钩挂的管腔支架200自动分离。此时,管腔支架200不再与内鞘芯管13连接,当管腔支架200全部自外鞘管12中释放后,由于管腔支架200具有超弹性,可自然膨胀并贴附病变部位的血管壁。The sixth step: when the distal end of the
第七步:保持滑块33位置不变,后撤手柄外壳30,带动内鞘芯管13相对于外鞘管12向近端运动。待内鞘芯管13外表面的钩挂件22收容于外鞘管12之中后,回撤整个输送系统100,将管体10自病人体内撤出。Step 7: Keep the position of the
本实施例提供的输送系统与现有技术相比,至少具有以下有益效果:Compared with the prior art, the delivery system provided by this embodiment has at least the following beneficial effects:
(1)当装载有管腔支架的管体在人体管腔内输送时,由于外鞘管内壁对钩挂单元的钩挂件自由端的展开趋势具有抑制作用,即使通过较弯曲的人体管腔部位时,钩挂件也不会与管腔支架脱离,避免了现有技术的刚性凸起物会与外鞘管内壁之间产生缝隙,导致管腔支架自刚性凸起物脱落的风险。(1) When the tube body loaded with the lumen stent is transported in the lumen of the human body, the inner wall of the outer sheath tube has an inhibitory effect on the unfolding tendency of the free end of the hooking unit, even when passing through a relatively curved body lumen portion The hooking member is also not detached from the lumen bracket, which avoids the gap between the rigid protrusion of the prior art and the inner wall of the outer sheath tube, resulting in the risk of the lumen bracket falling off from the rigid protrusion.
(2)管腔支架被钩挂单元固定于内鞘芯管之上,管腔支架可以自外鞘管之中逐渐释放,避免了管腔支架突然释放后无法调整释放位置的缺点。(2) The lumen stent is fixed on the inner sheath core tube by the hooking unit, and the lumen stent can be gradually released from the outer sheath tube, thereby avoiding the disadvantage that the release position cannot be adjusted after the lumen stent is suddenly released.
(3)当手术过程中需要调整管腔支架的释放位置时,操作者可以后撤管体并调整管体远端位置,在调整过程中,管腔支架被固定于内鞘芯管之上,且管腔支架与外鞘管之间不会发生相对运动,有效防止管腔支架自外鞘管之中提前释放。(3) When the release position of the lumen stent needs to be adjusted during the operation, the operator can withdraw the tubular body and adjust the distal position of the tubular body. During the adjustment process, the lumen stent is fixed on the inner sheath core tube. And the relative movement between the lumen stent and the outer sheath tube does not occur, effectively preventing the lumen stent from being released in advance from the outer sheath tube.
(4)在手术过程中,当管腔支架被部分释放,如发现管腔支架的尺寸与病变部位不符合,由 于管腔支架靠近近端的部分仍然通过钩挂单元固定于内鞘芯管之上,可以通过驱动外鞘管相对于内鞘芯管向远端轴向运动,将已经释放的管腔支架重新回收至外鞘管与内鞘芯管之间的空腔之中,再将管体撤出病人体外,更换尺寸适宜的管腔支架。(4) During the operation, when the lumen stent is partially released, if the size of the lumen stent is found to be inconsistent with the lesion, The portion near the proximal end of the lumen stent is still fixed to the inner sheath core tube by the hooking unit, and can be moved axially relative to the inner sheath core tube by driving the outer sheath tube to re-open the lumen stent that has been released. Recovered into the cavity between the outer sheath tube and the inner sheath core tube, and then the tube body is withdrawn from the patient's body, and the appropriate size of the lumen stent is replaced.
(5)当钩挂单元的钩挂件自外鞘管与内鞘芯管之间的空隙中释放,具有弹性的钩挂件变形部恢复自然状态,管腔支架与内鞘芯管之间不再通过钩挂件连接,管腔支架可自外鞘管中快速释放并膨胀。(5) When the hooking member of the hooking unit is released from the gap between the outer sheath tube and the inner sheath core tube, the elastic hook portion is restored to the natural state, and the lumen bracket and the inner sheath core tube are no longer passed. The hooks are connected and the lumen support can be quickly released and expanded from the outer sheath.
实施例二Embodiment 2
本实施例提供的管腔支架输送系统的结构与实施例一提供的管腔支架输送系统100的结构基本相同。区别之处在于,本实施例中,每个钩挂件均具有双股线构成的U型结构。The structure of the lumen stent delivery system provided in this embodiment is substantially the same as that of the lumen
具体地,请参见图10a,本实施例中,钩挂单元包括中空管状的紧箍件及三个与紧箍件相连的钩挂件。钩挂件具有与紧箍件相连的固定部及与固定部相连的变形部。每个钩挂件由两根直杆及连接于两根直杆之间的圆弧杆组成。Specifically, referring to FIG. 10a, in the embodiment, the hooking unit comprises a hollow tubular fastening member and three hooking members connected to the fastening member. The hook has a fixing portion connected to the fastening member and a deformation portion connected to the fixing portion. Each hook consists of two straight rods and a circular rod connected between the two straight rods.
请一并参见图10b,两根直杆之间的径向距离H范围为0.05至10毫米。由此,既不会降低管腔支架与钩挂件之间的可拆卸连接的可靠性,也不会影响管腔支架释放时管腔支架与钩挂件之间的自动解脱分离。优选地,本实施例中,两根直杆之间的径向距离H为3毫米。Referring to Figure 10b together, the radial distance H between the two straight rods ranges from 0.05 to 10 mm. Thereby, the reliability of the detachable connection between the lumen bracket and the hooking member is not reduced, and the automatic disengagement separation between the lumen bracket and the hooking member when the lumen stent is released is not affected. Preferably, in the present embodiment, the radial distance H between the two straight rods is 3 mm.
圆弧杆的圆心角R的范围为90度至180度。本发明中,圆心角R的定义是:圆弧杆的圆心分别至两根直杆与圆弧杆的交点之间的两条连线之间的夹角。圆心角R范围为0度至180度时,既不会刮擦外鞘管的内壁,也不影响管腔支架的装载过程,同时不会降低钩挂件与管腔支架的波峰处骨架之间钩挂连接的可靠性。本实施例中,圆弧杆的圆心角R为180度。The central angle R of the circular arc rod ranges from 90 degrees to 180 degrees. In the present invention, the central angle R is defined as the angle between the center of the arcuate rod and the two lines between the intersection of the two straight rods and the circular rod. When the central angle R ranges from 0 to 180 degrees, neither the inner wall of the outer sheath tube nor the loading process of the lumen stent is affected, and the hook between the hook and the skeleton of the lumen stent is not reduced. The reliability of the connection. In this embodiment, the central angle R of the circular arc rod is 180 degrees.
钩挂件可以具有柔性,可弯曲,例如可以是线。钩挂件也可以由具有弹性的材料制成。本实施例中,钩挂件由镍钛丝编织而成。每个钩挂件可以单独编织。具体地,每次使用一根镍钛丝在编织模棒上编织一个具有U型结构的钩挂件。共编织三个钩挂件并分别进行热定型处理。再将三个独立的钩挂件置于内鞘芯管的外表面,并围绕内鞘芯管的中心轴对称设置。之后将紧箍件套设于内鞘芯管的外表面,并使得钩挂件的直杆被约束在紧箍件内表面与内鞘芯管的外表面之间,以限制钩挂件与内鞘芯管之间的相对移动。The hooking member can be flexible, bendable, and can be, for example, a wire. The hooking member can also be made of a resilient material. In this embodiment, the hooking member is woven from nickel-titanium wire. Each hook can be individually woven. Specifically, a hook having a U-shaped structure is woven on the woven mold bar each time using a nickel-titanium wire. A total of three hooks are woven and heat-set separately. Three separate hooks are then placed on the outer surface of the inner sheath core tube and symmetrically disposed about the central axis of the inner sheath core tube. Thereafter, the tightening member is sleeved on the outer surface of the inner sheath core tube, and the straight rod of the hook member is restrained between the inner surface of the tight band member and the outer surface of the inner sheath core tube to limit the hooking member and the inner sheath core Relative movement between tubes.
可以理解的是,在其他实施例中,三个钩挂件也可以均由同一根镍钛丝编织(参见图10c)。编织方法如下:在编织模棒上使用同一根镍钛丝依次编织三个具有U型结构的钩挂件,将第一个钩挂件的一根直杆的远端与第三个钩挂件的一根直杆的远端通过铰结、焊接、粘合等常用手段相连,再经高温热定型处理后即可得到三个彼此相连的钩挂件。It will be appreciated that in other embodiments, the three hooks may also be woven from the same nickel titanium wire (see Figure 10c). The weaving method is as follows: three hooks having a U-shaped structure are sequentially woven on the woven mold bar using the same nickel-titanium wire, and the distal end of one straight rod of the first hooking member and one of the third hooking member are respectively The distal end of the straight rod is connected by common means such as hinge, welding, bonding, etc., and then subjected to high-temperature heat setting treatment to obtain three hook pieces connected to each other.
编织钩挂件时使用的镍钛丝的丝径范围为0.05毫米至2毫米。镍钛丝的丝径与管腔支架的直径相关。用于钩挂直径较大的管腔支架时,需要使用丝径较大的镍钛丝编织钩挂件。具体地,本实施 例中,使用丝径为0.15毫米的镍钛丝编织钩挂件。The nickel-titanium wire used in the weaving of the hooks has a wire diameter ranging from 0.05 mm to 2 mm. The wire diameter of the nickel-titanium wire is related to the diameter of the lumen stent. When hooking a large diameter lumen stent, it is necessary to use a nickel-titanium wire braided hook with a large wire diameter. Specifically, the implementation In the example, a nickel-titanium wire having a wire diameter of 0.15 mm is used to woven a hook.
可以理解的是,在其他实施例中,还可以通过热定型处理,使得钩挂件的变形部的至少部分自由端所在的平面与固定部所在的平面之间具有一定的夹角,夹角范围为60度至120度,优选90度。例如,请参见图10d所示,通过热定型处理,圆弧杆所在的平面与两根直杆所在的平面之间的夹角为90度。由此,在钩挂件钩挂住管腔支架并相对固定部向近端弯折后,圆弧杆可以至少部分贴覆至紧箍件的近端端面(如图10e所示)。图10f示出了这种实施方式中的钩挂单元收容在外鞘管中的状态:钩挂件的自由端向近端弯折,同时钩挂件的圆弧杆贴覆至紧箍件的近端端面。此时,钩挂件的圆弧杆不仅被外鞘管内壁限制圆弧杆沿着输送系统的径向移动,还受到紧箍件近端端面对圆弧杆沿着输送系统的轴向由近端向远端移动的限制。由此,在装载有管腔支架的输送系统进入体内后,柔性的钩挂件即使受到轴向拉力作用,也不会被拉直并解脱与管腔支架之间的连接。图10g示出了输送系统到达病变部位,管腔支架完全释放的状态。此时,外鞘管相对内鞘芯管由远端向近端后撤,外鞘管内壁对钩挂件沿着径向的束缚作用消失,钩挂件的变形部在弹性或外力作用下沿支架径向向远离内鞘芯管的方向翻转,进而解脱与管腔支架之间的连接,管腔支架在支架自膨力的作用下贴壁,完成释放。It can be understood that, in other embodiments, the heat setting process can also be performed such that at least a portion of the free end of the deformation portion of the hook has a certain angle with the plane where the fixed portion is located, and the angle range is 60 degrees to 120 degrees, preferably 90 degrees. For example, as shown in Fig. 10d, by the heat setting process, the angle between the plane where the circular rod is located and the plane where the two straight rods are located is 90 degrees. Thus, after the hook member hooks the lumen bracket and is bent proximally relative to the fixed portion, the arcuate rod can be at least partially attached to the proximal end surface of the tightening member (as shown in Figure 10e). Figure 10f shows the state in which the hooking unit of the embodiment is housed in the outer sheath tube: the free end of the hooking member is bent toward the proximal end, and the arcuate rod of the hooking member is attached to the proximal end face of the tightening member. . At this time, the circular arc rod of the hooking member is not only restricted by the inner wall of the outer sheath tube, but also the radial movement of the circular arc rod along the conveying system, and is also close to the axial end of the circular rod along the axial direction of the conveying system. The limit of the end-to-end movement. Thus, after the delivery system loaded with the lumen stent enters the body, the flexible hook member will not be straightened and disengaged from the lumen stent even if subjected to axial tension. Figure 10g shows the state in which the delivery system reaches the lesion and the lumen stent is fully released. At this time, the outer sheath tube is retracted from the distal end to the proximal end relative to the inner sheath core tube, and the inner wall of the outer sheath tube disappears in the radial direction of the hooking member, and the deformation portion of the hooking member is along the stent diameter under the action of elasticity or external force. The direction is reversed away from the inner sheath core tube, thereby releasing the connection with the lumen stent, and the lumen stent is attached to the stent under the self-expansion force to complete the release.
还可以理解的是,在其他实施例中,还可以在紧箍件的管体外表面上,设置至少一个用于收容变形部的自由端的容置空间。具体地,请参见图10h,中空管状的紧箍件的靠近近端的管体外表面上设置有多个凹槽。每个凹槽的体积等于或者稍大于一个圆弧杆的体积。因此每个凹槽均可对应地收容一个热定型后的圆弧杆。由此,在钩挂件钩挂住管腔支架并且向近端弯折后,圆弧杆恰好嵌入凹槽内,但是不会被凹槽卡住或者影响管腔支架的释放。It can also be understood that, in other embodiments, at least one receiving space for receiving the free end of the deformation portion may be disposed on the outer surface of the outer surface of the tubular member. Specifically, referring to Fig. 10h, a plurality of grooves are provided on the outer surface of the tubular body of the hollow tubular hoop member near the proximal end. The volume of each groove is equal to or slightly larger than the volume of one arc bar. Therefore, each groove can correspondingly accommodate a heat-set arcuate rod. Thus, after the hook member hooks the lumen bracket and is bent toward the proximal end, the arcuate rod fits into the recess, but is not caught by the recess or affects the release of the lumen bracket.
可以理解的是,在其他实施例中,钩挂件还可以由镍钛管切割而成(参见图11)。镍钛管的管体壁厚范围为0.05毫米至2毫米。每个钩挂件可以由一根镍钛管单独切割,也可以由同一根镍钛管一次切割多个钩挂件。每个钩挂件的固定部及变形部可以由镍钛管整体切割,再经热定型。每个钩挂件的固定部及变形部也可以由镍钛管分别切割并热定型,之后将固定部与变形部通过焊接或者粘合等方式固定连接即可。钩挂件的固定部及变形部可以由相同的材料制成,也可以由不同的材料制成,只要变形部由具有弹性的材料制成,即可达到与管腔支架可拆卸连接的目的。It will be appreciated that in other embodiments, the hooks may also be cut from a nickel-titanium tube (see Figure 11). The wall thickness of the nickel-titanium tube ranges from 0.05 mm to 2 mm. Each of the hooks can be individually cut by a nickel-titanium tube, or a plurality of hooks can be cut at a time by the same nickel-titanium tube. The fixing portion and the deformation portion of each hooking piece may be integrally cut by a nickel-titanium tube and then heat-set. The fixing portion and the deforming portion of each of the hooking members may be separately cut and heat-set by a nickel-titanium tube, and then the fixing portion and the deforming portion may be fixedly connected by welding or bonding. The fixing portion and the deformation portion of the hooking member may be made of the same material or different materials, and the deformation portion may be detachably connected to the lumen bracket as long as the deformation portion is made of a material having elasticity.
可以理解的是,在其他实施例中,钩挂件还可以具有L型、S型或者V型等其他形状,或者为条状物或者片状物,只要变形部由具有弹性的材料制成,即可达到与管腔支架可拆卸连接的目的。It can be understood that in other embodiments, the hooking member may further have other shapes such as an L shape, an S shape or a V shape, or be a strip or a sheet as long as the deformation portion is made of a material having elasticity, that is, The purpose of detachable connection to the lumen stent can be achieved.
可以理解的是,在其他实施例中,每个钩挂单元可以仅包括2个钩挂件。可以理解的是,在其他实施例中,每个钩挂单元也可以包括更多数量的钩挂件,以增加钩挂单元与管腔支架连接的牢固可靠性。但是,为了保管体的直径可以顺利通过弯曲的人体管腔,钩挂件的数量应当小于或者等于12个。例如,请参阅图12a及图12b,每个钩挂单元包括四个钩挂件,且四个钩挂件围绕内鞘芯管的 中心轴呈对称设置。It will be appreciated that in other embodiments, each of the hooking units may include only two hooks. It will be appreciated that in other embodiments, each of the hooking units may also include a greater number of hooks to increase the secure reliability of the hooking unit to the lumen support. However, in order for the diameter of the storage body to pass smoothly through the curved body lumen, the number of hooks should be less than or equal to twelve. For example, referring to Figures 12a and 12b, each hooking unit includes four hooking members, and four hooking members surround the inner sheath core tube. The center axis is symmetrically set.
实施例三Embodiment 3
本实施例提供的管腔支架输送系统的结构与实施例一提供的管腔支架输送系统100的结构基本相同。本实施例中,参见图13a,输送系统包括管体40、手柄外壳46、滑块47及钩挂单元50。管体40包括内鞘管41、外鞘管42、内鞘芯管43及Tip头44。区别之处在于,本实施例中,在内鞘芯管43的外表面设置限位件45。The structure of the lumen stent delivery system provided in this embodiment is substantially the same as that of the lumen
具体地,请同时参见图13a及图13b,限位件45由内鞘芯管43的外表面向远离内鞘芯管43的轴向的方向凸起。限位件45固定于内鞘芯管43靠近远端的外表面,且较钩挂单元50更靠近内鞘芯管43的远端。Specifically, referring to FIG. 13a and FIG. 13b at the same time, the
现有技术中,当外鞘管相对于内鞘芯管向近端轴向运动时,收容于外鞘管与内鞘芯管之间的空腔中的管腔支架与外鞘管内壁发生摩擦,管腔支架相对于内鞘芯管向近端移动,导致管腔支架在外鞘管中发生堆积,影响管腔支架的释放。因此,本实施例中,在内鞘芯管43的外表面设置一个由内鞘芯管43的外表面向远离内鞘芯管43的轴向的方向凸起的限位件45。由此,当后撤外鞘管42时,限位件45抵顶管腔支架200的近端端面或者近端镂空处,防止管腔支架200相对于内鞘芯管43向内鞘芯管43的近端移动。In the prior art, when the outer sheath tube moves axially relative to the inner sheath core tube, the lumen bracket contained in the cavity between the outer sheath tube and the inner sheath core tube rubs against the inner wall of the outer sheath tube. The lumen stent moves proximally relative to the inner sheath core tube, causing the lumen stent to accumulate in the outer sheath tube, affecting the release of the lumen stent. Therefore, in the present embodiment, the outer surface of the inner
可以理解的是,在其他实施例中,限位件45的数量可以为多个。多个限位件45沿内鞘芯管43的轴向均匀或者不均匀地间隔分布。可以理解的是,在其他实施例中,限位件45可以为块状凸起、锥形凸起或者球形凸起等其他形状凸起,或者套设在内鞘芯管43表面上的管状物,也可达到抵顶管腔支架200的近端端面或者镂空处,防止管腔支架200相对于内鞘芯管43向近端移动的目的。It can be understood that in other embodiments, the number of the limiting
本实施例提供的输送系统,与现有技术相比,至少具有如下有益效果:Compared with the prior art, the delivery system provided in this embodiment has at least the following beneficial effects:
(1)当装载有管腔支架的管体在人体管腔内输送时,钩挂件不会与管腔支架脱离。(1) When the tube body loaded with the lumen stent is transported in the lumen of the human body, the hook member is not detached from the lumen bracket.
(2)管腔支架被钩挂单元固定于内鞘芯管之上,管腔支架可以自外鞘管之中逐渐释放。(2) The lumen stent is fixed to the inner sheath core tube by the hooking unit, and the lumen stent can be gradually released from the outer sheath tube.
(3)当手术过程中需要调整管腔支架的释放位置或者回收管腔支架时,管腔支架与外鞘管之间不会发生相对运动,有效防止管腔支架自外鞘管之中提前释放。(3) When the release position of the lumen stent needs to be adjusted or the lumen stent is recovered during the operation, no relative movement occurs between the lumen stent and the sheath catheter, effectively preventing the lumen stent from being released from the outer sheath tube in advance. .
(4)输送系统的限位件设置于内鞘芯管靠近远端的管体外表面上,故,当外鞘管相对于内鞘芯管向近端轴向运动时,即使管腔支架与外鞘管内壁之间发生摩擦,也不会导致管腔支架向近端移动,进而降低管腔支架堆积的可能,减小管腔支架的释放阻力。(4) The limiting member of the delivery system is disposed on the outer surface of the inner sheath core tube near the distal end, so that when the outer sheath tube moves axially relative to the inner sheath core tube, even if the lumen bracket is external Friction between the inner walls of the sheath does not cause the lumen stent to move proximally, thereby reducing the possibility of lumen stent accumulation and reducing the release resistance of the lumen stent.
实施例四 Embodiment 4
本实施例提供的管腔支架输送系统的结构与实施例一提供的管腔支架输送系统100的结构基本相同。区别之处在于,本实施例中,钩挂单元在内鞘芯管的管体上的位置与实施例一的钩挂单元在内鞘芯管的管体上的位置不同。The structure of the lumen stent delivery system provided in this embodiment is substantially the same as that of the lumen
具体地,请同时参见图14a及图14b,本实施例中,输送系统包括管体60、钩挂单元70、手柄外壳(图未示出)及滑块(图未示出)。管体60包括内鞘管61、外鞘管62、内鞘芯管63及Tip头64。Specifically, please refer to FIG. 14a and FIG. 14b at the same time. In the embodiment, the conveying system comprises a
钩挂单元70设于内鞘芯管63的靠近远端的管体外表面上。钩挂单元70包括紧箍件71及钩挂件72。请参见图14b,当钩挂件72收容于外鞘管62与内鞘芯管63之间的空腔中时,钩挂件72的自由端朝向远端弯曲并指向远端。由此,当管腔支架200装载于外鞘管62与内鞘芯管63之间的空腔之中时,钩挂件72钩挂管腔支架200的远端镂空处。并且当外鞘管62相对于内鞘芯管63向近端轴向运动时,钩挂件72钩挂管腔支架200靠近远端的镂空处,防止管腔支架200向内鞘芯管63近端移动或者堆积。The hooking
本实施例提供的输送系统,与现有技术相比,至少具有如下有益效果:Compared with the prior art, the delivery system provided in this embodiment has at least the following beneficial effects:
该输送系统的钩挂单元设置于内鞘芯管靠近远端的管体外表面上,故,当外鞘管相对于内鞘芯管向近端轴向运动时,即使管腔支架与外鞘管内壁之间发生摩擦,也不会导致管腔支架向近端移动,进而降低管腔支架堆积的可能,减小管腔支架的释放阻力。The hooking unit of the delivery system is disposed on the outer surface of the inner sheath core tube near the distal end, so that when the outer sheath tube moves axially relative to the inner sheath core tube, even if the lumen bracket and the outer sheath tube Friction between the walls does not cause the lumen stent to move proximally, thereby reducing the possibility of lumen stent accumulation and reducing the release resistance of the lumen stent.
实施例五Embodiment 5
本实施例提供的管腔支架输送系统的结构与实施例一提供的管腔支架输送系统100的结构基本相同。区别之处在于,本实施例中,钩挂单元的数量与实施例一提供的输送系统100的钩挂单元20的数量不同。The structure of the lumen stent delivery system provided in this embodiment is substantially the same as that of the lumen
具体地,请同时参见图15a及图15b,本实施例中,输送系统包括管体80及多个钩挂单元。管体80包括内鞘管81、外鞘管82、内鞘芯管83及Tip头84。在内鞘芯管83的外表面上设有三个钩挂单元。且三个钩挂单元沿内鞘芯管83的轴向均匀间隔设置。Specifically, please refer to FIG. 15a and FIG. 15b simultaneously. In this embodiment, the transport system includes a
第一钩挂单元91设置于内鞘芯管83靠近近端的管体外表面之上。第一钩挂单元91具有三个钩挂件911。每个钩挂件911均具有变形部9111。当第一钩挂单元91的钩挂件911未收容于外鞘管82与内鞘芯管83之间的空腔中时,钩挂件911的变形部9111朝靠近近端的方向延伸,且与内鞘芯管83的近端至远端的方向之间的夹角范围为0度至180度。优选地,变形部9111的延伸方向与内鞘芯管83的近端至远端的方向之间的夹角范围为30度至90度。具体地,在本实施例中,变形部9111的延伸方向与内鞘芯管83的近端至远端的方向之间的夹角为60度。第一钩挂单元91可以保证在回撤管体80或者调整管体80远端的过程中,管腔支架200被固定于内鞘芯管83之上,与外鞘管82之间不发生相对移动,避免管腔支架200提前释放。
The first hooking
第三钩挂单元93设置于内鞘芯管83靠近远端的管体外表面之上。第三钩挂单元93具有三个钩挂件931。每个钩挂件931均具有变形部9311。当第三钩挂单元93的钩挂件未收容于外鞘管82与内鞘芯管83之间的空腔中时,钩挂件931的变形部9311朝远端延伸,且与内鞘芯管83的近端至远端的方向之间的夹角范围为0度至180度。优选地,变形部9311与内鞘芯管83的近端至远端的方向之间的夹角范围为90度至150度。具体地,在本实施例中,变形部9311的延伸方向与内鞘芯管83的近端至远端的方向之间的夹角为120度。在管腔支架200释放过程中,当外鞘管82相对于内鞘芯管83向近端轴向运动时,由于管腔支架200与外鞘管82内壁之间发生摩擦,管腔支架200产生向近端移动的趋势。而第三钩挂单元93可以防止管腔支架200向近端移动,进而降低管腔支架200堆积的可能,减小管腔支架200的释放阻力。The third hooking
第二钩挂单元92设于第一钩挂单元91及第三钩挂单元93之间,且第二钩挂单元92至第一钩挂单元91的距离与第二钩挂单元92至第三钩挂单元93的距离相等。第二钩挂单元92具有三个钩挂件921。每个钩挂件921均具有变形部9211。当第二钩挂单元92的钩挂件921未收容于外鞘管82与内鞘芯管83之间的空腔中时,钩挂件921的变形部9211朝远端延伸,且与内鞘芯管83的近端至远端的方向之间的夹角范围为0度至180度。具体地,在本实施例中,变形部9211与内鞘芯管83的近端至远端的方向之间的夹角为90度。在管腔支架200的释放过程中,第二钩挂单元92可以与第一钩挂单元91协同作用,确保在回撤管体80或者调整管体80远端的过程中,管腔支架200被固定于内鞘芯管83之上,与外鞘管82之间不发生相对移动,避免管腔支架200提前释放。同时,第二钩挂单元92可以与第三钩挂单元93协同作用,进一步防止管腔支架200堆积,降低管腔支架200的释放阻力。The second hooking
请参见图15c,当在释放过程中发现管腔支架200的释放位置不理想,或者管腔支架200的尺寸不合适需要更换新的管腔支架200时,可以驱动外鞘管82相对于内鞘芯管83向远端轴向运动,将已经部分释放的管腔支架200、第二钩挂单元92及第三钩挂单元93重新收容于外鞘管82与内鞘芯管83之间的空腔中。Referring to FIG. 15c, when the release position of the
可以理解的是,在其他实施例中,内鞘芯管83的外表面上可以设置更多数量的钩挂单元90(参见图16)。多个钩挂单元90沿内鞘芯管83的轴向均匀或者不均匀地间隔分布。多个钩挂单元90的钩挂件之间互不接触。钩挂单元90的数量与管腔支架200的轴向长度具有正相关关系。具有多个钩挂单元90的输送系统尤其适用于轴向长度较长的裸支架的输送及释放过程。It will be appreciated that in other embodiments, a greater number of hooking
当将裸支架装载至内鞘芯管与外鞘管之间的空腔中时,多个钩挂单元的多个钩挂件分别与裸支架的不同部位的波形钩挂连接。裸支架与内鞘芯管之间的固定关系更可靠,可有效防止裸支架在装载过程中与内鞘芯管之间发生相对移动。 When the bare stent is loaded into the cavity between the inner sheath core tube and the outer sheath tube, the plurality of hooks of the plurality of hooking units are respectively hooked to the waveforms of different portions of the bare bracket. The fixed relationship between the bare stent and the inner sheath core tube is more reliable, and the relative movement between the bare stent and the inner sheath core tube during the loading process can be effectively prevented.
当装载有裸支架的管体到达病变部位后,通过后撤滑块,驱动外鞘管相对于内鞘芯管的近端轴向运动,使得裸支架及钩挂件与外鞘管之间发生相对运动。When the tube loaded with the bare stent reaches the lesion, the slider moves to pull the proximal sheath axially relative to the proximal end of the inner sheath core tube, so that the bare stent and the hook and the outer sheath tube are oppositely motion.
当外鞘管后撤至某一钩挂件时,外鞘管的内壁对钩挂件的变形部的自由端沿内鞘芯管的径向向外展开的趋势的抑制作用消失,由弹性材料制成的钩挂件自外鞘管与内鞘芯管之间的空腔中释放,钩挂件的变形部由于自身弹性恢复至展开状态,并与钩挂的裸支架波峰处骨架自动分离。由此,多个钩挂单元逐个自外鞘管中释放并与钩挂的裸支架波峰处骨架自动分离,直至整个裸支架全部自外鞘管之中释放。When the outer sheath tube is withdrawn to a certain hooking member, the inner wall of the outer sheath tube disappears from the tendency of the free end of the deformed portion of the hooking member to expand radially outward along the inner sheath core tube, and is made of an elastic material. The hooking member is released from the cavity between the outer sheath tube and the inner sheath core tube, and the deformed portion of the hooking member is restored to the unfolded state due to its elasticity, and is automatically separated from the skeleton at the peak of the hooked bare bracket. Thereby, the plurality of hooking units are released one by one from the outer sheath tube and automatically separated from the skeleton of the hooked bare stent peak until the entire bare stent is completely released from the outer sheath tube.
可以理解的是,在其他实施例中,当管腔支架的骨架在轴向上为非均匀分布或具有其他特殊结构时,可以调整钩挂单元的数量及钩挂单元在内鞘芯管的管体外表面上的分布位置,以使得钩挂单元的数量及位置适应管腔支架的骨架结构。由此,当管腔支架释放至某一钩挂单元时,该钩挂单元与管腔支架自动分离,管腔支架依靠自身弹性膨胀并贴附血管壁。It can be understood that, in other embodiments, when the skeleton of the lumen stent is non-uniformly distributed in the axial direction or has other special structures, the number of the hooking units and the tube of the hooking unit in the inner sheath core tube can be adjusted. The locations on the outer surface of the body are such that the number and location of the hooking units accommodate the skeletal structure of the lumen stent. Thus, when the lumen stent is released to a certain hooking unit, the hooking unit is automatically separated from the lumen stent, and the lumen stent is inflated by itself and attached to the vessel wall.
本实施例提供的输送系统与现有技术相比,至少具有以下有益效果:Compared with the prior art, the delivery system provided by this embodiment has at least the following beneficial effects:
(1)防止外鞘管后撤时,管腔支架堆积及管腔支架释放后形态不良。(1) When the outer sheath tube is removed, the lumen stent is stacked and the lumen stent is released.
(2)随着外鞘管后撤,管腔支架可以逐段释放,已释放出的管腔支架依靠自身弹性膨胀并贴附血管壁,不影响管腔支架剩余部分的释放和膨胀。(2) With the withdrawal of the outer sheath tube, the lumen stent can be released piece by piece, and the released lumen stent relies on its own elastic expansion and attaches to the blood vessel wall, and does not affect the release and expansion of the remaining portion of the lumen stent.
(3)如在释放过程中发现释放位置不理想,可以调整管体的远端位置,在调整过程中不会导致管腔支架的提前释放。(3) If the release position is found to be unsatisfactory during the release process, the distal position of the tube body can be adjusted, and the advance release of the lumen stent is not caused during the adjustment process.
(4)如在释放过程中发现管腔支架的尺寸与病变部位不符合,可以将管腔支架回收至外鞘管之中,撤出病人体外,更换尺寸适宜的管腔支架。(4) If the size of the lumen stent is not consistent with the lesion during the release process, the lumen stent can be recovered into the outer sheath tube, withdrawn from the patient's body, and the appropriate size of the lumen stent can be replaced.
本发明提供的输送系统适用于输送血管支架,例如为同时开通主动脉弓部狭窄及左锁骨下动脉狭窄在左锁骨下动脉中放置烟囱支架或礼帽支架,或输送气管支架、食道支架,实现产品释放位置的调整和回收。The delivery system provided by the invention is suitable for transporting a blood vessel stent, for example, for simultaneously opening aortic arch stenosis and left subclavian artery stenosis, placing a chimney bracket or a top hat bracket in the left subclavian artery, or conveying a tracheal stent and an esophageal stent to realize a product release position. Adjustment and recycling.
以上所述实施例的各技术特征可以进行任意的组合,为使描述简洁,未对上述实施例中的各个技术特征所有可能的组合都进行描述,然而,只要这些技术特征的组合不存在矛盾,都应当认为是本说明书记载的范围。The technical features of the above-described embodiments may be arbitrarily combined. For the sake of brevity of description, all possible combinations of the technical features in the above embodiments are not described. However, as long as there is no contradiction between the combinations of these technical features, All should be considered as the scope of this manual.
以上所述实施例仅表达了本发明的几种实施方式,其描述较为具体和详细,但并不能因此而理解为对发明专利范围的限制。应当指出的是,对于本领域的普通技术人员来说,在不脱离本发明构思的前提下,还可以做出若干变形和改进,这些都属于本发明的保护范围。因此,本发明专利的保护范围应以所附权利要求为准。 The above-described embodiments are merely illustrative of several embodiments of the present invention, and the description thereof is more specific and detailed, but is not to be construed as limiting the scope of the invention. It should be noted that a number of variations and modifications may be made by those skilled in the art without departing from the spirit and scope of the invention. Therefore, the scope of the invention should be determined by the appended claims.
Claims (18)
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| Application Number | Priority Date | Filing Date | Title |
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| CN201611123762.6A CN108186176B (en) | 2016-12-08 | 2016-12-08 | Implant delivery system |
| CN201611123762.6 | 2016-12-08 |
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| WO2018103662A1 true WO2018103662A1 (en) | 2018-06-14 |
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| PCT/CN2017/114809 Ceased WO2018103662A1 (en) | 2016-12-08 | 2017-12-06 | Conveying system for implant |
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| WO (1) | WO2018103662A1 (en) |
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| CN108186176B (en) | 2020-06-30 |
| CN108186176A (en) | 2018-06-22 |
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