Recoverable visceral artery in-situ windowing positioning instrument

Abstract

The utility model provides a recoverable visceral artery in-situ windowing positioning instrument which comprises an operating handle, a positioner conveying sheath, a positioner conveying rod and a positioner marking part, the operating handle and the positioner conveying sheath are both tubular, and the operating handle is installed at the rear end of the positioner conveying sheath. A positioner marking part is mounted at the front end of the positioner conveying rod, the positioner marking part is a spiral alloy part with shape memory and elasticity, and the positioner conveying rod is axially arranged in the operating handle and the positioner conveying sheath in a sliding manner; a positioner adjusting roller and a positioner fixing button are arranged on the operating handle, and the positioner adjusting roller is in rolling friction fit with the positioner conveying rod so as to drive the positioner conveying rod to slide in the operating handle and the positioner conveying sheath. By means of the adjustable and recoverable visceral artery in-situ windowing positioning instrument, marking of visceral branch arteries can be simply, conveniently, accurately and controllably achieved.

Description

Technical Field

[0001] The utility model relates to a surgical instrument for in-situ fenestration of visceral arteries, in particular to a recyclable in-situ fenestration positioning instrument for visceral arteries. Background Art

[0002] Abdominal aortic dissection and abdominal aortic aneurysm are very likely to involve the visceral branch arteries, including the renal arteries, mesenteric arteries, and celiac arteries. Clinically, open surgery has always been the first choice for such patients, and endovascular surgery is an alternative treatment that is not suitable for open surgery. With the gradual maturity of endovascular technology, full endovascular treatment has become a trend. Full endovascular treatment of aortic disease involving visceral branch arteries has become a reality and is expected to gradually replace open surgery. At present, there are three technical solutions for full endovascular treatment of aortic disease involving visceral branch arteries:

[0003] 1) Parallel stent technology. Its advantages are obvious, such as simple operation, short operation time, and easy to popularize. However, its disadvantages are also prominent, such as easy internal leakage and stent deformation, which lead to high re-intervention rate.

[0004] 2) Fenestration / branch stent technology. This technology is used to modify the main stent before surgery, including fenestration marking, mechanical / laser fenestration, sewing of internal and external branches, etc. There are two types of fenestration / branch stents: commercial customization and physician-made modification. Currently, there is a lack of commercial customized stents suitable for Chinese people, and the customization price is high and the waiting time is long. Physician-made modified stents are highly dependent on personal treatment experience and technical level, and the modification time is long, with the risk of graft infection.

[0005] 3) In situ fenestration technology. This technology is to perform the main stent modification in the cavity by mechanical membrane rupture and laser ablation during the operation to achieve in situ fenestration of the branch vessels. This technology is the reconstruction method that best fits the patient's vascular anatomical structure.

[0006] The technical difficulty of in situ fenestration of visceral arteries lies in the accurate marking of visceral arteries, and the two existing technical methods have defects to varying degrees:

[0007] 1) The stent marking method is to pre-implant a vascular stent into the target artery, which can mark the opening and direction of the artery during surgery. However, this type of stent is not retrievable, which brings difficulties to the subsequent reconstruction of branch arteries and adds extra burden to patients.

[0008] 2) The image fusion method is to fuse the branch artery openings reconstructed by preoperative CT and the intraoperative angiography images. Although this method does not require additional implants, changes in the patient's arterial anatomical structure during the operation can lead to large errors. Utility Model Content

[0009] The utility model designs a recyclable positioning device that can accurately mark visceral arteries, which can solve the problem that branch arteries cannot be accurately positioned in the current in situ fenestration treatment. The specific solution is as follows:

[0010] A retrievable visceral artery in situ fenestration positioning device, the retrievable visceral artery in situ fenestration positioning device comprises an operating handle, a locator delivery sheath, a locator delivery rod, and a locator marking portion, the operating handle and the locator delivery sheath are both tubular and the operating handle is installed at the rear end of the locator delivery sheath, the locator delivery rod is installed at the front end of the locator delivery rod, the locator marking portion is a spiral alloy part with shape memory and elasticity, the locator delivery rod is axially slidably arranged in the operating handle and the locator delivery sheath, and the locator marking portion located in the locator delivery sheath is in a compressed state;

[0011] The operating handle is provided with a locator adjustment roller and a locator fixing button. The locator adjustment roller and the locator delivery rod are rollingly and frictionally matched to drive the locator delivery rod to slide in the operating handle and the locator delivery sheath. The locator fixing button is used to lock the locator delivery rod.

[0012] Furthermore, a first opening is provided on the upper side wall of the operating handle, and the locator adjustment roller is rotatably installed in the first opening. The lower edge of the locator adjustment roller is rollingly frictionally engaged with the locator conveying rod in the operating handle, and the upper edge of the locator adjustment roller is exposed outside the operating handle.

[0013] Furthermore, a second opening is formed on the upper side wall of the operating handle, and a push-type positioner fixing button is installed in the second opening. The positioner fixing button is pressed downward to compress the positioner conveying rod in the operating handle.

[0014] Furthermore, the outer diameter of the positioner adjustment roller is provided with a rubber ring or a rack distributed along the thickness direction.

[0015] Furthermore, the positioner fixing button is arranged between the positioner adjusting roller and the positioner conveying sheath.

[0016] Furthermore, the positioner delivery sheath and the positioner delivery rod are both made of flexible materials.

[0017] Furthermore, the outer wall of the operating handle is provided with anti-slip stripes or protrusions.

[0018] The advantages of the utility model are:

[0019] 1) A recyclable locator marker is used. By accurately releasing the locator marker to the specified position of the blood vessel, the annular marker near the aorta can be observed during intraoperative imaging, and laser in situ windowing can be performed in this area, reducing the difficulty and risk of the operation.

[0020] 2) Unique design and easy operation improve the surgical efficiency and success rate.

[0021] 3) A spiral alloy part with shape memory and elasticity is used as the locator marking part, which has good biocompatibility and stability. After release, it is adaptively fixed to the blood vessel wall to keep its position fixed, while facilitating observation by the surgical imaging system.

[0022] 4) The sliding of the locator conveying rod can be accurately controlled by the locator adjusting roller to ensure positioning accuracy, and the locator conveying rod can be locked by the locator fixing button.

[0023] 5) Both the positioner delivery sheath and the positioner delivery rod are made of flexible materials and have good adaptability and reliability.

[0024] 6) The outer wall of the operating handle is provided with anti-slip stripes or bumps, which improves the comfort and safety of operation.

[0025] The utility model can not only solve the problem that branch arteries cannot be accurately positioned in the current in situ fenestration treatment, but also reduce the risk of surgical complications and improve the success rate of surgery. The utility model provides a new technical solution for in situ fenestration treatment of visceral arteries, has important clinical application value, and brings more benefits to patients. BRIEF DESCRIPTION OF THE DRAWINGS

[0026] In order to more clearly illustrate the technical solutions in the embodiments of the present invention, the following briefly introduces the drawings required for use in the embodiments or the description of the prior art. Obviously, the drawings described below are only some embodiments of the present invention. For ordinary technicians in this field, other drawings can be obtained based on these drawings without creative work.

[0027] Figure 1 It is a schematic diagram of a retrievable visceral artery in situ window positioning device of the utility model;

[0028] Figure 2 It is a schematic diagram of the locator marker extending from the front end of the locator delivery sheath and being unfolded and released;

[0029] Figure 3 It is a schematic diagram of a gear-shaped positioner adjusting roller;

[0030] Figure 4 Schematic diagram of a positioner adjustment roller with a rubber ring installed on the outer diameter. DETAILED DESCRIPTION

[0031] In the following description, a large number of specific details are given to provide a more thorough understanding of the utility model. However, it is obvious to those skilled in the art that the utility model can be implemented without one or more of these details. In other examples, in order to avoid confusion with the utility model, some technical features known in the art are not described.

[0032] In order to thoroughly understand the present invention, detailed steps and detailed structures will be presented in the following description to illustrate the technical solution of the present invention. The preferred embodiments of the present invention are described in detail below, but in addition to these detailed descriptions, the present invention may also have other implementations.

[0033] Reference Figure 1 As shown, the utility model provides a retrievable visceral artery in situ fenestration positioning device, which includes an operating handle 1, a locator delivery sheath 4, a locator delivery rod 5, and a locator marking portion 6. The operating handle 1 and the locator delivery sheath 4 are both tubular, and the operating handle 1 is installed at the rear end of the locator delivery sheath 4. The locator delivery rod 5 is installed at the front end of the locator delivery rod 5. The locator marking portion 6 is a spiral alloy part with shape memory and elasticity. The locator delivery rod 5 is axially slidably arranged in the operating handle 1 and the locator delivery sheath 4. Among them, the locator marking portion 6 located in the locator delivery sheath 4 is in a compressed state. Once the locator marking portion 6 is pushed to extend from the front end of the locator delivery sheath 4 by the locator delivery rod 5, the locator marking portion 6 will automatically release and expand (such as Figure 2 ) and fits closely to the inner wall of the target artery.

[0034] The upper side wall of the operating handle 1 is provided with a first opening and a second opening in sequence in the front-to-back direction. A push-type positioner fixing button 3 is installed in the second opening, and the positioner fixing button 3 is pressed downward to compress the positioner delivery rod 5 in the operating handle 1. A positioner adjustment roller 2 is rotatably installed in the first opening, and the upper edge of the positioner adjustment roller 2 is exposed outside the operating handle 1 for easy manual rotation. The lower edge of the positioner adjustment roller 2 is in rolling frictional cooperation with the positioner delivery rod 5 in the operating handle 1. By turning the positioner adjustment roller 2, the positioner delivery rod 5 can be driven to slide in the operating handle 1 and the positioner delivery sheath 4.

[0035] In an optional embodiment, in order to increase the friction between the positioner adjustment roller 2 and the positioner conveying rod 5, a rubber ring 21 (such as Figure 4 ) or racks distributed along the thickness direction (such as Figure 3) can finely adjust the implantation position of the locator marker 6.

[0036] When in use, hold the operating handle 1 with your hand and use your thumb to move the locator adjustment roller 2 to drive the locator conveying rod 5 to move. By arranging the locator fixing button 3 at the front end of the locator adjustment roller 2, the locator fixing button 3 is away from the holding position, thereby improving the holding comfort.

[0037] In an optional embodiment, the operating handle 1 is 10 to 12 centimeters long and has an outer diameter of 2.5 to 3.5 centimeters. In addition, the outer wall of the operating handle 1 is provided with anti-skid stripes or convex points to play an anti-skid effect.

[0038] The locator delivery sheath 4 and the locator delivery rod 5 are both made of flexible materials that can be bent and can freely shuttle to the designated position in the blood vessel.

[0039] The program steps are as follows:

[0040] 1) Device implantation

[0041] After the patient is anesthetized, a peripheral artery puncture is performed, a vascular sheath is delivered along the puncture route, and a visceral artery that needs to be reconstructed is superselected. The in-situ window opening positioning device provided by the utility model is delivered along the vascular sheath.

[0042] The locator marking portion 6 is in an unreleased state within the locator delivery sheath 4. When the physician turns the locator adjustment roller 2, the locator delivery rod 5 can be driven to move forward, so that the locator marking portion 6 extends from the front end of the locator delivery sheath 4 and is released at a predetermined position. The locator marking portion 6 can be deformed from a compressed state to a state of fitting with the target artery wall, thereby completing the positioning of the device.

[0043] 2) In-situ window opening

[0044] After positioning is completed, the vascular sheath and the locator delivery assembly are withdrawn, leaving only the locator delivery rod 5 and the locator marker 6. Then, the main stent is delivered to the predetermined position for release, and the laser fiber is delivered to the in-situ windowing area. Since the locator marker 6 is a spiral structure that fits the target artery, the annular mark near the aorta can be observed during intraoperative imaging, and laser in-situ windowing can be performed on this area.

[0045] 3) Locator recovery

[0046] After the window is opened, the positioner delivery sheath 4 is inserted along the positioner delivery rod, and the positioner adjustment roller 2 is turned in the reverse direction to retract the positioner marking part 6 into the positioner delivery sheath 4 to complete the recovery of the positioner.

[0047] 4) Implantation of branch stents

[0048] The guide wire and catheter are passed through the openings on the aortic stent graft, the target artery is super-selected, and the branch stent is implanted to complete the treatment.

[0049] The above describes the preferred embodiments of the utility model. It should be understood that the utility model is not limited to the above-mentioned specific implementation methods, and the devices and structures that are not described in detail should be understood to be implemented in a common manner in the art; any technician familiar with the art can use the above-disclosed methods and technical contents to make many possible changes and modifications to the technical solutions of the utility model without departing from the scope of the technical solution of the utility model, or modify them into equivalent embodiments of equivalent changes, which does not affect the essential content of the utility model. Therefore, any simple modification, equivalent change and modification made to the above embodiments based on the technical essence of the utility model without departing from the content of the technical solution of the utility model still falls within the scope of protection of the technical solution of the utility model.

Claims

1. A retrievable visceral artery in situ fenestration positioning device, characterized in that: The retrievable visceral artery in situ window positioning device comprises an operating handle (1), a positioner delivery sheath (4), a positioner delivery rod (5), and a positioner marking portion (6); the operating handle (1) and the positioner delivery sheath (4) are both tubular and the operating handle (1) is mounted at the rear end of the positioner delivery sheath (4); the positioner marking portion (6) is mounted at the front end of the positioner delivery rod (5); the positioner marking portion (6) is a spiral alloy part with shape memory and elasticity; the positioner delivery rod (5) is axially slidably arranged in the operating handle (1) and the positioner delivery sheath (4); the positioner marking portion (6) located in the positioner delivery sheath (4) is in a compressed state; The operating handle (1) is provided with a positioner adjustment roller (2) and a positioner fixing button (3); the positioner adjustment roller (2) and the positioner conveying rod (5) are rollingly frictionally matched to drive the positioner conveying rod (5) to slide in the operating handle (1) and the positioner conveying sheath (4); the positioner fixing button (3) is used to lock the positioner conveying rod (5).

2. A retrievable visceral artery in situ fenestration positioning device as claimed in claim 1, characterized in that: The upper side wall of the operating handle (1) is provided with a first opening, in which the positioner adjustment roller (2) is rotatably installed, the lower edge of the positioner adjustment roller (2) rollingly and frictionally engages with the positioner conveying rod (5) in the operating handle (1), and the upper edge of the positioner adjustment roller (2) is exposed outside the operating handle (1).

3. The retrievable visceral artery in situ fenestration positioning device according to claim 2, characterized in that: The upper side wall of the operating handle (1) is provided with a second opening, in which a push-type positioner fixing button (3) is installed. The positioner fixing button (3) is pressed downward to tighten the positioner conveying rod (5) in the operating handle (1).

4. A retrievable visceral artery in situ fenestration positioning device as claimed in claim 1 or 2, characterized in that: The outer diameter of the positioner adjustment roller (2) is provided with a rubber ring or racks distributed along the thickness direction.

5. A retrievable visceral artery in situ fenestration positioning device as claimed in claim 1 or 2, characterized in that: The positioner fixing button (3) is arranged between the positioner adjusting roller (2) and the positioner conveying sheath (4).

6. The retrievable visceral artery in situ fenestration positioning device according to claim 1, characterized in that: The positioner delivery sheath (4) and the positioner delivery rod (5) are both made of flexible materials.

7. The retrievable visceral artery in situ fenestration positioning device according to claim 1, characterized in that: The outer wall of the operating handle (1) is provided with anti-slip stripes or convex points.

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