CN210408510U - Smooth delivery of interventional medical device delivery system - Google Patents
Smooth delivery of interventional medical device delivery system Download PDFInfo
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- CN210408510U CN210408510U CN201920499678.7U CN201920499678U CN210408510U CN 210408510 U CN210408510 U CN 210408510U CN 201920499678 U CN201920499678 U CN 201920499678U CN 210408510 U CN210408510 U CN 210408510U
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Abstract
本实用新型提供了一种输送顺畅的介入医疗器械输送系统，包括输送器及装载器，所述输送器包括输送鞘管及连接于所述输送鞘管近端的鞘管座，所述装载器包括装载管，所述装载管的远端与所述鞘管座可拆卸连接，所述鞘管座内开设有沿其轴向延伸的连接通孔以连通所述装载管与所述输送鞘管，所述连接通孔包括变径孔段，所述变径孔段的孔径自近端至远端逐渐缩小，所述装载管的远端端面自所述连接通孔的近端伸入所述变径孔段内，且所述装载管的远端端面与所述变径孔段的对应部位之间存在径向间隙。该介入医疗器械输送系统，能够顺畅的输送介入医疗器械，并降低对系统内装载管与鞘管座的装配要求。
The utility model provides an interventional medical device delivery system with smooth delivery. It includes a loading tube, the distal end of the loading tube is detachably connected to the sheath tube seat, and a connecting through hole extending along its axial direction is opened in the sheath tube seat to communicate the loading tube and the delivery sheath tube , the connecting through hole includes a variable-diameter hole segment, the diameter of the variable-diameter hole segment gradually decreases from the proximal end to the distal end, and the distal end face of the loading tube extends from the proximal end of the connecting through hole into the A radial gap exists between the distal end face of the loading tube and the corresponding part of the variable diameter hole section in the variable diameter hole section. The interventional medical device delivery system can smoothly deliver the interventional medical device, and reduces the assembly requirements for the loading tube and the sheath tube seat in the system.
Description
Technical Field
The utility model relates to the technical field of medical equipment, especially, relate to a carry smooth and easy intervention medical equipment conveying system.
Background
Minimally invasive interventional procedures are becoming more and more popular in clinical applications, and the delivery system of intraluminal interventional medical devices (such as left atrial appendage occluders, vascular plugs, filters, etc.) usually comprises several parts, such as a delivery device, a dilator, a loader, a pusher (such as a steel cable), etc., wherein the delivery device comprises a delivery sheath and a sheath seat. The channel is built between the conveying sheath tube and the dilator, then the dilator is withdrawn, the interventional medical device is collected into the loader through the pusher, then the sheath tube seat and the loader are connected, and the interventional medical device is guided into the conveying sheath tube through the pusher until the interventional medical device is conveyed to the target position.
Referring to fig. 1, a conventional interventional medical device delivery system typically handles a connection between a sheath hub a of a delivery device and a loading tube B of a loader by: the proximal end of the sheath tube seat A is provided with a straight stepped hole A10, the distal end of the loading tube B is inserted into the stepped hole A10 in a matching manner, and then the sheath tube seat A and the loading tube B are connected through threads to achieve a connecting effect, the distal end face of the loading tube B is required to be in seamless butt joint with the stepped surface A11 of the stepped hole A10 in the sheath tube seat A, and a higher requirement is provided for the connection matching of the loading tube B and the sheath tube seat A. However, during the actual connection and matching process, on one hand, the operator often excessively screws the screw thread to make the distal end surface of the loading tube B excessively abut against the stepped surface a11 of the stepped hole a10 in the sheath tube seat a, so that the distal end orifice of the loading tube B is reduced, the interventional medical device in the loading tube B cannot smoothly pass through the distal end orifice, the delivery is blocked, and the device may be damaged due to excessive resistance when the interventional medical device passes through the distal end orifice of the loading tube B; on the other hand, if the distal end of the loading tube B is not in proper abutment with the stepped surface a11 of the stepped hole a10, that is, there is an axial gap between the stepped surface a11 and the distal end of the loading tube B, some interventional medical devices with barb structures may be jammed in the gap, which may hinder the pushing of the interventional medical devices and increase the risk of the barbs breaking.
SUMMERY OF THE UTILITY MODEL
The to-be-solved technical problem of the utility model lies in, to prior art's defect, provide a carry smooth and easy intervention medical instrument conveying system, medical instrument is intervened in the transport that can be smooth and easy, improves conveying efficiency to reduce the assembly requirement of loading pipe and sheath pipe seat in to the system.
In order to solve the technical problem, the utility model provides a carry smooth and easy intervention medical instrument conveying system, including conveyer and loader, the conveyer including carry the sheath pipe and connect in the sheath pipe seat of carrying sheath pipe near-end, the loader is including loading the pipe, load the pipe the distal end with the connection can be dismantled to sheath pipe seat, a serial communication port, set up in the sheath pipe seat along its axial extension's connect the through hole with the intercommunication load the pipe with carry the sheath pipe, connect the through hole and include the reducing hole section, the aperture of reducing hole section reduces from near-end to distal end gradually, the distal end terminal surface of loading the pipe certainly connect the through hole's near-end stretches into in the reducing hole section, just the distal end terminal surface of loading the pipe with there is radial clearance between the corresponding position of reducing hole section.
The utility model provides an intervene medical instrument conveying system's sheath pipe seat in seted up connect the through-hole, and connect the through-hole and include the reducing hole section, the aperture of reducing hole section reduces gradually from the near-end to the distal end, the distal end terminal surface of loading pipe stretches into in the reducing hole section, when assembly loading pipe and sheath pipe seat, even assemble excessively, the distal end terminal surface of loading pipe is in the reducing hole section moves to the distal end, and can not lean on, extrude the inner wall of reducing hole section, can not cause the distal end throat of loading pipe and block to intervene medical instrument and pass through, and, because the gradually-shrinking type inner wall of reducing hole section has the guide effect, can guide to intervene medical instrument and steadily get into and carry the sheath pipe, thereby make the transport of interveneing medical instrument go on smoothly, improve conveying efficiency; even the assembly is not enough, because the distal end terminal surface that loads the pipe stretches into in the reducing hole section, load the distal end terminal surface of pipe with the inner wall of reducing hole section does not have axial gap to can not cause the intervention medical instrument card that has the barb structure to go into in the clearance, and, because the gradually-shrinking type inner wall of reducing hole section has the guide effect, can guide to intervene medical instrument and steadily get into and carry the sheath pipe, make the transport of interveneeing medical instrument smoothly go on equally, improve transport efficiency. It can be seen that the utility model discloses an intervene medical instrument conveying system can be smooth and easy transport intervene medical instrument to showing and having reduced the assembly requirement to loading pipe and sheath pipe seat.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings needed to be used in the embodiments will be briefly described below, and it is obvious that the drawings in the following description are some embodiments of the present invention, and it is obvious for those skilled in the art to obtain other drawings without creative efforts.
Fig. 1 is a schematic structural diagram of the docking of a sheath seat and a loading tube in a conventional interventional medical device delivery system.
Fig. 2 is a schematic structural diagram of an interventional medical device delivery system smoothly delivered according to a first embodiment of the present invention, where the interventional medical device delivery system includes a conveyor, an expander, a loader, a hemostatic valve, and a pusher.
Fig. 3 is a cross-sectional view of the conveyor of fig. 2.
Fig. 4 is an exploded schematic view of fig. 3.
Fig. 5 is a perspective view of the fitting of fig. 4.
Fig. 6 is a partial structural schematic view of a conveying sheath of the conveyor of fig. 2.
Fig. 7 is a schematic structural view of the dilator of fig. 2.
FIG. 8 is a schematic view of the dilator of FIG. 2 in combination with a delivery apparatus to form a dilator assembly.
Fig. 9 is a cross-sectional view of the expansion assembly of fig. 8 in a sheath seat position.
Fig. 10 is a schematic view of the structure of the cartridge of fig. 2.
FIG. 11 is a schematic view of the transporter, loader, and hemostasis valve of FIG. 2 after attachment.
FIG. 12 is a cross-sectional view of the position of the sheath hub of FIG. 11.
Figure 13 is a schematic view of the connection of the pusher to the occluding device.
Figure 14 is a schematic view of the pusher of figure 13 loading the occluding device into the loader.
FIG. 15 is a schematic view of the connection of the transporter, loader, hemostasis valve and pusher of FIG. 2.
Fig. 16 is a cross-sectional view of a sheath hub of a smooth-delivery interventional medical device delivery system according to a second embodiment of the present invention.
Detailed Description
The technical solutions in the embodiments of the present invention will be described clearly and completely with reference to the accompanying drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only some embodiments of the present invention, not all embodiments. Based on the embodiments of the present invention, all other embodiments obtained by a person of ordinary skill in the art without any creative effort belong to the protection scope of the present invention.
Furthermore, the following description of the various embodiments refers to the accompanying drawings, which are included to illustrate specific embodiments in which the invention may be practiced. Directional phrases used in this disclosure, such as "upper," "lower," "front," "rear," "left," "right," "inner," "outer," "side," and the like, refer only to the direction of the appended figures and, therefore, are used in order to better and more clearly illustrate and understand the present invention without indicating or implying that the device or element so referred to must have a particular orientation, be constructed and operated in a particular orientation and, therefore, should not be construed as limiting the invention.
Orientation definition: for clarity of description, the end of the procedure that is closer to the operator will be referred to as the "proximal end" and the end that is further from the operator will be referred to as the "distal end".
Referring to fig. 2 to 4, the present invention provides a smoothly delivering interventional medical device delivery system 100, which includes a delivery device 20, a dilator 40, a loader 60, a hemostatic valve 70 and a pusher 80. The delivery device 20 includes a delivery sheath 22 and a sheath holder 25 connected to the proximal end of the delivery sheath 22. The shuttle 60 includes a shuttle tube 62, a first connector 64 disposed at a distal end of the shuttle tube 62, and a second connector 66 disposed at a proximal end of the shuttle tube 62. The sheath seat 25 is connected between the delivery sheath 22 and the loading tube 62, the distal end of the loading tube 62 is detachably connected with the sheath seat 25, specifically, the first connector 64 of the loader 60 is connected with the proximal end of the sheath seat 25 by a threaded connection, and the hemostatic valve 70 is connected with the second connector 66 of the loader 60. The pusher 80 includes a push cable 82 and a handle 84 connected to the proximal end of the push cable 82.
It is worth noting that: the distal end surface of the loading tube 62 extends into the reducing bore section 2511 through the rear gland 255, and the proximal end surface of the rear gland 255 has a limiting function on the first connector 64, so that the first connector 64 cannot be screwed without limit, that is, the distal end surface of the loading tube 64 cannot extend into the reducing bore section 2511 without limit. Generally, the axial displacement of the distal end surface of the loading tube 62 caused by the difference between the over-tightening (the distal end surface of the loading tube 62 is at the distal limit position) and the loosening (the distal end surface of the loading tube 62 is at the proximal limit position) of the screw thread between the first connecting head 64 and the rear gland 255 is about 0.5mm, and in this process, the radial clearance between the distal end surface of the loading tube 62 and the corresponding portion of the reducing hole section 2511 is ensured as long as the hole diameter of the portion of the reducing hole section 2511 corresponding to the proximal limit position of the distal end surface of the loading tube 62 is larger than the outer diameter of the loading tube 62 and the hole diameter of the portion of the reducing hole section 2511 corresponding to the distal limit position of the distal end surface of the loading tube 62 is larger than the outer diameter of the loading tube 62, that is to say, the hole diameter of the reducing hole section 2511 over a certain length is larger than the outer diameter of the loading tube 62, and the certain length is larger than or equal to the near, the, The distance between the distal extreme positions; it is more preferable to provide the distal end of the reducing bore section 2511 with a bore diameter greater than or equal to the outer diameter of the loading tube 62.
The utility model provides an intervene connecting hole 2510 along its axial extension in medical instrument conveying system 100's sheath tube seat 25, connecting hole 2510 includes reducing hole section 2511, and reducing hole section 2511's aperture reduces from near-end to distal end gradually, and the distal end terminal surface of loading pipe 62 stretches into reducing hole section 2511 from connecting hole 2510's near-end in, and there is radial gap between the distal end terminal surface of loading pipe 62 and reducing hole section 2511's the corresponding position. When the loading tube 62 and the sheath tube seat 25 are assembled, even if the screw thread between the first connector 64 and the rear gland 255 is excessively screwed (i.e., the assembly is excessive), the distal end face of the loading tube 62 moves distally in the reducing hole section 2511 without abutting and extruding the inner wall of the reducing hole section 2511, so that the distal end of the loading tube 62 is not reduced to block the passage of the interventional medical instrument, and the tapered inner wall (which may be called a gradually-reduced inner wall) of the reducing hole section 2511 has a guiding function, after the interventional medical instrument is pushed out of the loading tube 62 and enters the reducing hole section 2511, the tapered inner wall of the reducing hole section 2511 enables the interventional medical instrument to be gradually and slowly compressed, and simultaneously the tapered inner wall guides the interventional medical instrument to smoothly enter the delivery sheath tube 22, so that the delivery of the interventional medical instrument is smoothly performed, and the delivery efficiency is improved; even if the screw thread between the first connector 64 and the rear gland 255 is not completely screwed (i.e., the assembly is insufficient), since the distal end surface of the loading tube 62 extends into the reducing hole section 2511, no axial gap exists between the distal end surface of the loading tube 62 and the inner wall of the reducing hole section 2511, so that the interventional medical device with a barb structure cannot be blocked in the gap to hinder the delivery or damage the interventional medical device, and the tapered inner wall of the reducing hole section 2511 has a guiding function, after the interventional medical device is pushed out of the loading tube 62 and enters the reducing hole section 2511, the tapered inner wall of the reducing hole section 2511 enables the interventional medical device to be gradually and slowly compressed, and simultaneously the tapered inner wall guides the interventional medical device to smoothly enter the delivery sheath tube 22, so that the delivery of the interventional medical device is performed, and the delivery efficiency is improved. It can be seen that, the utility model discloses an intervene medical instrument conveying system can be smooth and easy transport intervene medical instrument to showing and having reduced the assembly requirement to loading pipe 62 and sheath tube seat 25, the normal transport of interveneeing medical instrument can not be influenced with the assembly is not enough excessively in the assembly.
As shown in fig. 4, the sheath holder 25 comprises a main body 250, a connecting through hole 2510 is disposed in the main body 250, the proximal end of the delivery sheath 22 is connected to the distal end of the main body 250, and the main body 250 comprises a holder 251 and a fitting 256 adapted to be fitted into the distal end of the holder 251. The distal end of the seat 251 has an axial receiving hole 2514 for receiving the fitting 256, and the fitting 256 has an axial introduction hole 2560 penetrating the fitting 256. When the fitting 256 is accommodated in the accommodating hole 2514, the proximal end of the guide hole 2560 is butted and communicated with the connecting through hole 2510, the axis of the guide hole 2560 is overlapped with the axis of the connecting through hole 2510, further, the proximal end of the guide hole 2560 is butted with the distal end of the reducing hole section 2511, so that the guide hole 2560 and the connecting through hole 2510 are connected into a continuous and smooth through hole, the aperture of the distal end of the guide hole 2560 is smaller than or equal to the inner diameter of the conveying sheath tube 22, and the intervention medical instrument is prevented from being blocked when entering the conveying sheath tube 22 from the guide hole 2560. The fitting 256 is detachably received in the receiving hole 2514 of the housing 251, and when the sheath tube holder 25 needs to be matched with sheath tubes of different models, only the fitting 256 can be replaced without replacing the whole sheath tube holder 25, thereby improving the applicability of the sheath tube holder 25.
The seat 251 includes a generally cylindrical frame 2515, a front end connection portion 2516 protruding from a distal end of the frame 2515, and a rear end connection portion 2517 protruding from a proximal end of the frame 2515, the front cover 253 is connected to the front end connection portion 2516, and the rear cover 255 is connected to the rear end connection portion 2517. The connection through-hole 2510 axially penetrates the front end connection portion 2516, the frame 2515, and the rear end connection portion 2517. Specifically, a proximal straight hole section 2512 of the connection through hole 2510 is opened in the rear end connection portion 2517, and a variable diameter hole section 2511 is opened in the frame 2515 and communicated with the proximal straight hole section 2512. The proximal end of the receiving hole 2514 extends to the reducing hole section 2511 of the connection through hole 2510, the aperture of the receiving hole 2514 is larger than that of the distal end of the reducing hole section 2511, and thus a step surface is formed between the reducing hole section 2511 and the receiving hole 2514. The front end connection portion 2516 is cylindrical, and an external thread is provided on the outer circumferential surface of the front end connection portion 2516; the rear end connection portion 2517 is cylindrical, and a snap ring 2518 is provided on the outer circumferential surface of the rear end connection portion 2517.
Referring to fig. 4 and 5, the fitting 256 is generally cylindrical, and an inlet 2560 extends axially through a middle portion of the fitting 256. The inlet 2560 includes a tapered bore region 2561 at the proximal end, a straight bore region 2563 at the distal end, and a smooth transition region 2565 between the straight bore region 2563 and the tapered bore region 2561. Preferably, the minimum aperture of the variable diameter bore region 2561 is greater than or equal to the outer diameter of the loading tube 62, and the aperture of the straight bore region 2563 is less than or equal to the inner diameter of the delivery sheath 22. When the fitting 256 is received in the receiving hole 2514, the reducing hole region 2561 is abutted against the reducing hole section 2511 of the connecting through hole 2510 and has the same taper, that is, the inner wall of the reducing hole region 2561 smoothly continues the inner wall of the reducing hole section 2511. In other embodiments, the diameter-variable hole region 2561 may be replaced by a diameter-variable hole region such as a circular truncated cone hole region, a pyramid hole region or a frustum hole region, as long as the inner wall of the diameter-variable hole region smoothly continues the inner wall of the diameter-variable hole section.
Preceding gland 253 is the toper form generally, and the through-hole has been seted up axially in the middle part of preceding gland 253, the through-hole is including the near-end straight bore 2531 that is located the near-end of preceding gland 253, the distal end straight bore 2533 that is located the distal end of preceding gland 253 to and connect the circular cone hole 2535 between near-end straight bore 2531 and distal end straight bore 2533, and the aperture of near-end straight bore 2531 is greater than the aperture of distal end straight bore 2533. The inner surface of the proximal straight bore 2531 is provided with internal threads corresponding to the external threads of the front end connection 2516.
The rear gland 255 includes a cylindrical distal connector barrel 2551 and a proximal connector barrel 2553 axially disposed at a proximal end of the distal connector barrel 2551, the distal connector barrel 2551 having an outer diameter greater than an outer diameter of the proximal connector barrel 2553. The distal end connecting cylinder 2551 is axially provided with a connecting hole 2554, the connecting hole 2554 is configured to receive the rear end connecting portion 2517, and an inner circumferential surface of the connecting hole 2554 is provided with a locking groove 2552 adapted to the locking ring 2518. The proximal connecting cylinder 2553 is axially provided with a through hole 2556 communicating with the connecting hole 2554 of the distal connecting cylinder 2551, the through hole 2556 has an inner diameter smaller than that of the connecting hole 2554, and the through hole 2556 is coaxial with the connecting hole 2554.
As shown in fig. 4, 9 and 12, the sheath tube holder 25 further includes a sealing member 257 disposed between the proximal end of the main body portion 250 and the rear gland 255, and the distal end surface of the loading tube 62 extends into the connection through hole 2510 after passing through the sealing member 257. The seal 257 is usually provided with a cross-shaped cut in the middle, and naturally, the cross-shaped cut is closed, and when the loading tube 62 or the dilator 40 passes through the seal 257, the cross-shaped cut is opened and clings to the outer peripheral surface of the loading tube 62 or the dilator 40, so as to realize reliable sealing.
The tube wall of the conveying sheath tube 22 is a multi-layer structure, and sequentially comprises a polytetrafluoroethylene material layer, a stainless steel mesh woven layer, a polyether block polyamide layer (Pebax) and the like from inside to outside. As shown in fig. 3, 4 and 12, the proximal end of the delivery sheath 22 is provided with a conical flaring 222, which facilitates the connection of the proximal end of the delivery sheath 22 to the distal end of the main body 250, i.e. the conical flaring 222 is sleeved on the distal end of the main body 250.
As shown in FIG. 6, the delivery sheath 22 generally comprises a straight main body section 221 and one or more pre-shaped sections at the distal end of the main body section 221, wherein the number and shape of the pre-shaped sections can be set according to the physiological anatomy of the body lumen to fit the physiological anatomy of the body lumen, so that the distal end of the sheath 22 can reach the site to be treated, for example, for performing left atrial appendage closure, the delivery sheath 22 is provided with a first pre-shaped section 225 and a second pre-shaped section 223 at the distal end of the main body section 221, the first pre-shaped section 225 is connected between the second pre-shaped section 223 and the main body section 221, further, the bending angle α of the first pre-shaped section 225 relative to the main body section 221 ranges from 0 degree to 90 degrees, the bending angle (not shown) of the second pre-shaped section 223 relative to the first pre-shaped section 225 ranges from 0 degree to 45 degrees, and the first pre-shaped section 225 and the second pre-shaped section 223 are not in the same plane.
As shown in fig. 3 and 4, when the conveyor 20 is assembled, the fitting 256 is accommodated in the accommodating hole 2514 of the base 251, such that the proximal end of the fitting 256 contacts a step surface formed between the reducing hole section 2511 and the accommodating hole 2514, the distal end of the fitting 256 is close to the distal end of the base 251, the introduction hole 2560 of the fitting 256 is communicated with the connection through hole 2510, i.e., the reducing hole section 2561 at the proximal end of the introduction hole 2560 is in butt joint with the reducing hole section 2511 of the connection through hole 2510, and the taper is consistent; covering the proximal flare 222 of the delivery sheath 22 over the fitting 256 and distal end of the front end connection 2516; glue is coated on the outer surface of the proximal flared end 222 of the conveying sheath 22, the front gland 253 is sleeved in the distal end of the conveying sheath 22 until the internal thread of the front gland 253 is meshed with the external thread of the front end connecting part 2516 of the seat 251, so that the front gland 253 is connected to the distal end of the main body 250, and the proximal end of the conveying sheath 22 is fixed between the front gland 253 and the main body 250. The packing 257 is accommodated in the distal end connecting cylinder 2551 of the rear gland 255, the distal end connecting cylinder 2551 of the rear gland 255 is sleeved on the rear end connecting portion 2517, the snap ring 2518 of the rear end connecting portion 2517 is snapped into the snap groove 2552 of the distal end connecting cylinder 2551, the rear gland 255 is connected to the main body portion 250, and the packing 257 is clamped between the rear gland 255 and the main body portion 250, so that the conveyor 20 is assembled.
In other embodiments, the accessory 256 may be connected to the body 251 of the body 250 by gluing, i.e., glue is disposed between the outer surface of the accessory 256 and the inner surface of the receiving hole 2514 of the body 251.
In other embodiments, the fitting 256 may be threadably coupled within the housing 251 of the body portion 250, i.e., the outer surface of the fitting 256 is threadably coupled with the inner surface of the receiving hole 2514 of the housing 251.
Referring to fig. 7-9, the dilator 40 includes an expanding rod 42 and a connecting portion 45 disposed at a proximal end of the expanding rod 42, the expanding rod 42 is movably inserted into the sheath tube 22 of the transporter 20, and the connecting portion 45 is used for connecting with the sheath tube seat 25. In the operation process, the dilator 40 needs to be assembled into the transporter 20 to form a dilator assembly, specifically, the dilator rod 42 of the dilator 40 sequentially passes through the rear gland 255, the sealing member 257, the seat 251, the fitting 256, the front gland 253, and the delivery sheath 22 from the proximal end of the transporter 20 until the connecting portion 45 of the dilator 40 is connected to the rear gland 255, in this embodiment, the connecting portion 45 is connected to the rear gland 255 by a threaded manner.
Referring also to fig. 10-12, the loader 60 includes a loading tube 62, a first connector 64, and a second connector 66, with the distal end of the loading tube 62 extending beyond the first connector 64. After withdrawing the dilator 40 from the delivery device 20, the loader 60 is mounted to the proximal end of the delivery device 20, and specifically, the distal end of the loading tube 62 is passed through the rear gland 255 and the seal 257 into the variable diameter bore section 2511 of the attachment through bore 2510 of the body portion 250. The first connector 64 of the loader 60 is screwed to the rear gland 255 to connect the loader 60 with the conveyor 20. A hemostasis valve 70 is attached to the proximal end of the cartridge 60, and a three-way valve is provided on the hemostasis valve 70.
Referring to fig. 13 and 14, the distal end of the push cable 82 of the pusher 80 is detachably connected to the interventional medical device 300. Specifically, the proximal end of the interventional medical device 300 is provided with a coupling (not shown), typically a threaded tap, a curved retrieval hook, or at least one through hole, for removable connection with the push cable 82 of the pusher 80. The interventional medical device 300 may be, but is not limited to, a left atrial appendage occluder, a vascular filter, a cardiac defect occluder, or a vascular plug, among others. The interventional medical device 300 is made of a material having a shape memory function and, in use, may be stretched into a thin strip and loaded into the loading tube 62. In this embodiment, the interventional medical device 300 is a left atrial appendage occluder, which mainly includes two occluding disks and two layers of occluding membranes respectively disposed inside the two occluding disks. The plugging disc is made of materials with shape memory function, and the plugging membrane is made of materials such as polytetrafluoroethylene with good biocompatibility. The near end of the left auricle occluder is provided with a bolt head with internal threads, the far end of the push cable 82 is provided with external threads, and the far end of the push cable 82 and the bolt head of the left auricle occluder are detachably connected through threads.
Referring to fig. 14 and 15, the loading and delivering process of the interventional medical device 300 includes: the distal end of the push cable 82 is connected to the interventional medical device 300 after passing through the hemostasis valve 70 and the loading tube 62, and then the pusher 80 is withdrawn proximally to allow the interventional medical device 300 to be received into the loading tube 62 of the loader 60; connecting loader 60 to the proximal end of delivery apparatus 20, pusher 80 pushing interventional medical device 300 out of the distal end of loading tube 62, so that interventional medical device 300 enters connection through hole 2510 of main body portion 250 of sheath tube holder 25; because the reducing hole region 2561 at the proximal end of the fitting 256 is butted with the reducing hole section 2511 in the seat 251 and has the same taper, the interventional medical device 300 is pushed into the conveying sheath 22 along the reducing hole section 2511 in the seat 251 and the reducing hole region 2561 of the fitting 256; finally, pusher 80 is operated to deliver interventional medical device 300 to the target treatment site of the patient and released. Because the reducing hole section 2511 and the fitting 256 are provided with the reducing hole region 2561 in the main body part 250, even if the first connecting head 64 and the rear gland 255 are excessively assembled, the distal end face of the loading tube 62 moves towards the distal end in the reducing hole section 2511 without abutting and extruding the inner wall of the reducing hole section 2511, so that the distal end of the loading tube 62 is not reduced to block the interventional medical instrument 300 from passing through, and the tapered inner walls of the reducing hole section 2511 and the reducing hole region 2561 have a guiding function, after the interventional medical instrument is pushed out of the loading tube 62, the tapered inner walls enable the interventional medical instrument to be gradually and slowly compressed, and simultaneously guide the interventional medical instrument to smoothly enter the conveying sheath tube 22; even if the first connector 64 and the rear gland 255 are not assembled sufficiently, since the distal end surface of the loading tube 62 extends into the reducing hole section 2511, there is no axial gap between the distal end surface of the loading tube 62 and the inner wall of the reducing hole section 2511, so that the interventional medical device 300 with the barb structure is not blocked from being transported or damaged by being clamped into the gap, and the tapered inner wall has a guiding function, after the interventional medical device 300 is pushed out of the loading tube 62, the tapered inner wall enables the interventional medical device 300 to be gradually and slowly compressed, and at the same time, the tapered inner wall guides the interventional medical device to smoothly enter the transporting sheath 22. It can be seen that, the utility model discloses an intervene medical instrument conveying system can be smooth and easy transport intervene medical instrument 300 to showing and having reduced the assembly requirement to loading pipe 62 and sheath tube seat 25, the normal transport of interveneeing medical instrument can not be influenced with the assembly is not enough excessively in the assembly.
The following description will be given by taking the operation procedure of clinically delivering the left atrial appendage occluder as an example, to illustrate the use of the interventional medical device delivery system 100 of the present invention:
the distal end of dilator 40 is inserted from the proximal end of delivery apparatus 20 and exits the distal end of delivery apparatus 20, dilator 40 is connected to delivery apparatus 20 to form the dilator assembly shown in fig. 7, the dilator assembly is advanced from the femoral vein through the interatrial septum along a track established by a guidewire (not shown) to the left atrial appendage, and dilator 40 is withdrawn, leaving the delivery sheath 22 of delivery apparatus 20 in vivo to establish a passageway from outside the body to inside the body. During this process, blood does not flow out of the proximal end of the sheath hub 25 due to the sealing ability of the seal 257 within the sheath hub 25;
connecting the hemostatic valve 70 to the proximal end of the loader 60, sequentially passing the distal end of the push cable 82 of the pusher 80 through the hemostatic valve 70 and the loader 60, connecting the distal end of the push cable 82 to the proximal end of the left atrial appendage occluder, and withdrawing the pusher 80 proximally to allow the left atrial appendage occluder to be received within the loading tube 62 of the loader 60, as shown in fig. 13 and 14;
extending the distal end of the loading tube 62 into the variable diameter bore section 2511 through the rear gland 255 and the seal 257, with the first connector 64 connected to the rear gland 255, to obtain the delivery system loaded with the left atrial appendage occluder shown in figure 15;
the handle 84 is held to push the push cable 82 towards the far end, so that the left atrial appendage occluder is conveyed to the left atrial appendage and unfolded; in the process, whether the left atrial appendage occluder reaches a preset position or not can be evaluated by means of radiography, and the position of the left atrial appendage occluder is correspondingly adjusted to reach the preset position; specifically, when the position of the left atrial appendage occluder needs to be adjusted, the push cable 82 is retracted to drive the left atrial appendage occluder to retract into the conveying sheath 22, then the position of the distal end of the conveying sheath 22 is adjusted, and then the left atrial appendage occluder is pushed out of the sheath 22;
the connection between the left atrial appendage occluder and the push cable 82 is released, releasing the left atrial appendage occluder.
Referring to fig. 16, a second embodiment of the present invention provides an interventional medical device delivery system having a structure similar to that of the first embodiment, except that: the structure of the sheath hub 25a of the interventional medical device delivery system of the second embodiment is slightly different from the structure of the sheath hub 25 of the first embodiment. The sheath tube seat 25a is a sheath tube joint 252 that combines the fitting and the seat body in the first embodiment into a whole, a connection through hole 2520 that penetrates through a proximal end surface and a distal end surface of the sheath tube joint 252 is axially formed in the middle of the sheath tube joint 252, the connection through hole 2520 includes a tapered hole section 2521 and a straight hole section, the straight hole section includes a proximal straight hole section 2522 and a distal straight hole section 2524, the proximal straight hole section 2522 communicates with a proximal end of the tapered hole section 2521, and the distal straight hole section 2524 communicates with a distal end of the tapered hole section 2521. The aperture of the near-end straight hole segment 2522 is greater than the aperture of the far-end straight hole segment 2524, the aperture of the reducing hole segment 2521 is gradually reduced from the near end to the far end, the far-end face of the loading tube 62 is extended into the reducing hole segment 2521 from the near end of the connecting through hole 2520, and a radial gap exists between the far-end face of the loading tube 62 and the corresponding part of the reducing hole segment 2521. Preferably, the aperture of the distal end of the reducing hole 2521 is greater than or equal to the outer diameter of the loading tube 62, so as to ensure that when the first connection head 64 and the rear gland 255 are excessively assembled, the distal end surface of the loading tube 62 cannot abut against and press the inner wall of the reducing hole 2521, and the distal end of the loading tube 62 cannot be constricted to block the interventional medical device 300 from passing through, and the tapered inner wall of the reducing hole 2521 has a guiding function, so that after the interventional medical device is pushed out of the loading tube 62, the tapered inner wall gradually and slowly compresses the interventional medical device, and simultaneously the tapered inner wall guides the interventional medical device to smoothly enter the delivery sheath 22. Preferably, the diameter of the distal straight bore segment 2524 is smaller than or equal to the inner diameter of the delivery sheath 22, so as to prevent the interventional medical device from being obstructed when entering the delivery sheath 22 from the distal straight bore segment 2524. The sheath joint 252 of the second embodiment combines the fitting and the housing of the first embodiment, so that the number of parts is reduced, the structure is simpler, and the assembly process is simplified.
In other embodiments, the connection through hole in the sheath joint may only include the reducing hole section and the proximal straight hole section, and the distal straight hole section is omitted, and the distal end of the reducing hole section extends to the distal end surface of the sheath joint.
The above is an implementation manner of the embodiments of the present invention, and it should be noted that, for those skilled in the art, a plurality of improvements and decorations can be made without departing from the principles of the embodiments of the present invention, and these improvements and decorations are also considered as the protection scope of the present invention.
Claims (13)
1. The utility model provides a carry smooth and easy intervention medical instrument conveying system, includes conveyer and loader, the conveyer including carry the sheath pipe and connect in carry the sheath pipe seat of sheath pipe near-end, the loader is including loading the pipe, the distal end of loading the pipe with the connection can be dismantled to the sheath pipe seat, a serial communication port, set up in the sheath pipe seat along its axial extension's connect through hole with the intercommunication load the pipe with carry the sheath pipe, connect through hole includes the reducing hole section, the aperture of reducing hole section reduces from near-end to distal end gradually, the distal end terminal surface of loading the pipe certainly connect through hole's near-end stretches into in the reducing hole section, just the distal end terminal surface of loading the pipe with there is radial clearance between the corresponding position of reducing hole section.
2. The system of claim 1, wherein the diameter of the distal end of the variable diameter bore section is greater than or equal to the outer diameter of the loading tube.
3. The system of claim 1 or 2, wherein the sheath seat comprises a main body, the connecting through hole is disposed in the main body, and the proximal end of the delivery sheath is connected to the distal end of the main body.
4. The system of claim 3, wherein the main body of the sheath holder comprises a holder body and a fitting adapted to be fitted into a distal end of the holder body, the fitting has an axial inlet hole extending therethrough, an axis of the inlet hole coincides with an axis of the connecting through hole, and a proximal end of the inlet hole is in butt joint with the tapered hole section.
5. The system of claim 4, wherein the introducer hole comprises a proximal reducing hole region, the reducing hole region is in butt joint with the reducing hole section, and the inner wall of the reducing hole region smoothly continues the inner wall of the reducing hole section.
6. The system of claim 5, wherein the minimum pore size of the reducer hole region is greater than or equal to the outer diameter of the loading tube.
7. The system of claim 6, wherein the introducer hole further comprises a distal straight hole region, the straight hole region is in smooth communication with the variable diameter hole region through a transition region, and the diameter of the straight hole region is smaller than or equal to the inner diameter of the delivery sheath.
8. The system for smoothly delivering an interventional medical device of claim 3, wherein the sheath hub further comprises a sealing element disposed at the proximal end of the main body, and the distal end surface of the loading tube extends into the variable diameter bore section after passing through the sealing element.
9. The system of claim 8, wherein the sheath hub further comprises a rear gland coupled between the proximal end of the body portion and the distal end of the loading tube, the seal being clamped between the body portion and the rear gland.
10. The system of claim 3, wherein the sheath hub further comprises a front gland coupled to the distal end of the body portion, the proximal end of the delivery sheath being secured between the front gland and the distal end of the body portion.
11. The system for delivering a smoothly delivered interventional medical device of claim 1, further comprising a pusher comprising a push cable and a handle connected to a proximal end of the push cable; the pushing cable is movably arranged in the loading tube and the conveying sheath tube in a penetrating mode.
12. The interventional medical device delivery system capable of delivering smoothly according to claim 1 or 11, further comprising a dilator, wherein the dilator comprises a dilating rod and a connecting part arranged at the proximal end of the dilating rod, the dilating rod is movably arranged in the delivery sheath tube in a penetrating manner, and the connecting part is detachably connected to the proximal end of the sheath tube seat.
13. The system of claim 1 or 11, further comprising a hemostatic valve coupled to the proximal end of the loader or the proximal end of the sheath hub.
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| CN201920499678.7U CN210408510U (en) | 2019-04-12 | 2019-04-12 | Smooth delivery of interventional medical device delivery system |
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| CN201920499678.7U CN210408510U (en) | 2019-04-12 | 2019-04-12 | Smooth delivery of interventional medical device delivery system |
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Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN111803169A (en) * | 2019-04-12 | 2020-10-23 | 杭州诺茂医疗科技有限公司 | Smooth delivery of interventional medical device delivery system |
| US12402885B2 (en) | 2017-09-23 | 2025-09-02 | Universität Zürich | Medical occlusion device |
| US12426887B2 (en) | 2019-09-26 | 2025-09-30 | Universität Zürich | Left atrial appendage occlusion devices |
-
2019
- 2019-04-12 CN CN201920499678.7U patent/CN210408510U/en active Active
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US12402885B2 (en) | 2017-09-23 | 2025-09-02 | Universität Zürich | Medical occlusion device |
| CN111803169A (en) * | 2019-04-12 | 2020-10-23 | 杭州诺茂医疗科技有限公司 | Smooth delivery of interventional medical device delivery system |
| US12426887B2 (en) | 2019-09-26 | 2025-09-30 | Universität Zürich | Left atrial appendage occlusion devices |
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Address after: 310052 room 316, 3rd floor, building 2, 88 Jiangling Road, Xixing street, Binjiang District, Hangzhou City, Zhejiang Province Patentee after: Hangzhou DeNO electrophysiological Medical Technology Co.,Ltd. Address before: 310052 room 316, 3rd floor, building 2, 88 Jiangling Road, Xixing street, Binjiang District, Hangzhou City, Zhejiang Province Patentee before: HANGZHOU NUOMAO MEDICAL TECHNOLOGY Co.,Ltd. |
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