Cancer thrombus assisted removal device

Abstract

The present application provides a cancer thrombus assisted removal device, which mainly includes an outer sheath, a filtering device and a blocking device slidably arranged in the outer sheath. Among them, the filtering element of the filtering device and the blocking element of the blocking device can be received in the lumen of the outer sheath in a contracted state, and the filtering element and the blocking element can extend out of the lumen of the outer sheath and be switched from the contracted state to the deployed state respectively, so as to filter cancer thrombi in blood vessels and simultaneously block blood flow in blood vessels, thereby improving the safety of cancer thrombus removal surgical operations.

Description

Technical Field

[0001] The embodiments of the present application relate to the field of medical technology equipment, and particularly to an instrument for assisting in removing cancer thrombi. Background Art

[0002] According to statistics, renal cancer accounts for 2%-3% of adult malignant tumors, and the fatality rate exceeds 40%. A prominent feature of renal cancer is its tendency to spread into the lumen of blood vessels in the renal vein system, forming venous cancer thrombi. Among all renal cancer patients, 4%-10% of cases have cancer thrombi extending into the renal vein or even the inferior vena cava, and there is a possibility of migrating towards the proximal end until the right atrium.

[0003] According to the statistical results of each center, 50%-70% of renal cancer patients with inferior vena cava cancer thrombi can achieve good prognosis through radical nephrectomy and removal of inferior vena cava cancer thrombi.

[0004] Existing cancer thrombus filters are placed between the hepatic vein and the renal vein through the jugular vein before surgery. The placement position is low, and the existing structure of the cancer thrombus filter is only for intraoperative filtration. However, the filter mesh aperture is too large, and the filter is not convenient to remove during the operation. Clinicians have to abandon the placement of the filter. Once the cancer thrombus detaches without protection, the risk of pulmonary metastasis and sudden death is high. In addition, the existing filter structure makes it difficult to block the blood flow in the inferior vena cava during the operation. Problems such as incomplete blockage (using a blocking clip or rubber tube) or the filter piercing the inferior vena cava resulting in massive bleeding may occur. Under pneumoperitoneum conditions, a large amount of gas may enter the lungs through the blood circulation, and the consequences would be unimaginable. For Mayo grade 3 cancer thrombus cases, combined blocking of the first hepatic hilum and the inferior vena cava severely damages liver function.

[0005] In addition, the harm of using external blockage also lies in that during the operation, as the intravascular pressure increases, and intraoperative operations are prone to accidental touch, often the blockage is incomplete, and it is necessary to re-place the blocking clip, which is time-consuming and laborious.

[0006] In view of this, how to provide a surgical instrument for assisting in removing cancer thrombi from blood vessels to overcome various problems existing in the prior art is the technical problem to be solved by the present application. Summary of the Invention

[0007] In view of the above problems, the main purpose of the present application is to provide an instrument for assisting in removing cancer thrombi and its operation method, which uses an internal blocking method to block the blood flow in the blood vessels and can assist in discharging the residual gas in the blood vessels, thereby improving the safety of the cancer thrombus removal operation.

[0008] Another purpose of the present application is to provide an instrument for assisting in removing cancer thrombi and its operation method, which can improve the positioning effect of the filter element and the sealing element in the blood vessel.

[0009] To achieve the above and other related objectives, the present application provides a cancer thrombus assisted removal device for assisting in removing cancer thrombi in blood vessels. It includes an outer sheath that is positioned at a preset position within the blood vessel and has an outer sheath lumen axially penetrating the outer sheath, as well as an outer sheath distal end and an outer sheath proximal end located at opposite ends of the outer sheath; a filtering device that slides within the outer sheath lumen and has a filter element that can be switched between a first contracted state and a first expanded state. The filter element can be in the first contracted state and housed within the outer sheath lumen, and the filtering device can move relative to the outer sheath in the direction from the outer sheath proximal end towards the outer sheath distal end, so that the filter element in the first contracted state extends out and is exposed from the outer sheath lumen, and the exposed filter element can be switched from the first contracted state to the first expanded state to filter the cancer thrombi in the blood vessel; and a blocking device that slides within the outer sheath lumen and has a blocking element that can be switched between a second contracted state and a second expanded state. The blocking element can be in the second contracted state and housed within the outer sheath lumen, and the blocking device can move relative to the outer sheath in the direction from the outer sheath proximal end towards the outer sheath distal end, so that the blocking element in the second contracted state extends out and is exposed from the outer sheath lumen, and the exposed blocking element can be switched from the second contracted state to the second expanded state to block the blood flow in the blood vessel.

[0010] Optionally, in an embodiment of the present application, the blocking device further includes a first sliding member that slides within the outer sheath lumen and has a blocking lumen penetrating the first sliding member, a first sliding member distal end connecting the blocking element, and an infusion lumen communicating with the inside of the blocking element; the filtering device further includes a second sliding member that slides within the blocking lumen and has a second sliding member distal end, and the second sliding member distal end extends out of the blocking lumen via the first sliding member distal end; wherein, opposite sides of the filter element are respectively connected to the first sliding member distal end and the second sliding member distal end, and the blocking element connected to the first sliding member distal end is nested within the filter element, and the filter element in the first contracted state and the blocking element in the second contracted state provided therein can be housed within the outer sheath lumen, and the filter element and the blocking element can move relative to the outer sheath in the direction from the outer sheath proximal end towards the outer sheath distal end to synchronously extend out and be exposed from the outer sheath lumen via the outer sheath distal end; and wherein, the first sliding member can move relative to the outer sheath lumen and the second sliding member in the direction from the outer sheath proximal end towards the outer sheath distal end, such that the relative distance between the second sliding member distal end and the first sliding member distal end is shortened, and the filter element is switched from the first contracted state to the first expanded state; air or liquid is injected into the exposed blocking element through the infusion lumen to cause the blocking element to be switched from the second contracted state to the second expanded state.

[0011] Optionally, in an embodiment of the present application, the plugging member is a balloon plugging device, and the filtering member is a filter net formed by braiding or laser cutting multiple strands of nitinol alloy wires.

[0012] Optionally, in an embodiment of the present application, the plugging device further includes a first sliding member that slides in the outer sheath cavity and has a plugging cavity passing through the first sliding member, a distal end of the first sliding member connected to the plugging member, and an infusion cavity communicating with the inside of the plugging member; the filtering device further includes a second sliding member that slides in the plugging cavity and has a distal end of the second sliding member connected to the filtering member; wherein, the filtering member can be in the first contracted state and be received in the plugging cavity, and the second sliding member can move relative to the plugging device in a direction from the proximal end of the outer sheath towards the distal end of the outer sheath, so that the filtering member in the first contracted state extends out of the plugging cavity through the distal end of the first sliding member and switches from the first contracted state to the first expanded state; the plugging member can be in the second contracted state and be received in the outer sheath cavity, and the first sliding member can move relative to the outer sheath in a direction from the proximal end of the outer sheath towards the distal end of the outer sheath, so that the plugging member in the second contracted state extends out and is exposed from the outer sheath cavity through the distal end of the outer sheath, and air or liquid is injected into the exposed plugging member through the infusion cavity, so that the plugging member switches from the second contracted state to the second expanded state; and wherein, the plugging member in the second expanded state is located between the filtering member in the first expanded state and the distal end of the outer sheath.

[0013] Optionally, in an embodiment of the present application, when the filtering member extends out of the plugging cavity, by controlling the set position of the filtering member relative to the plugging cavity, the expansion degree of the filtering member in the first expanded state is adjusted.

[0014] Optionally, in an embodiment of the present application, when the filtering device moves relative to the plugging device in a direction from the distal end of the outer sheath towards the proximal end of the outer sheath, the filtering member can automatically switch from the first expanded state to the first contracted state, so that the filtering device can be partially withdrawn or completely withdrawn from the plugging cavity, and at least a part of the inside of the plugging cavity forms a cavity.

[0015] Optionally, in an embodiment of the present application, the filtering member is a claw-type filter, and the plugging member is a balloon plugging device.

[0016] Optionally, in an embodiment of the present application, the cancer thrombus auxiliary removal instrument further includes a suction device that communicates with the plugging cavity to discharge the gas in the blood vessel through the plugging cavity.

[0017] Optionally, in an embodiment of the present application, the filtering device further includes a third sliding member sleeved between the first sliding member and the second sliding member.

[0018] Optionally, in an embodiment of the present application, the blocking device further includes: a blocking outer core slidably disposed in the outer sheath lumen, having a blocking outer core lumen axially penetrating the blocking outer core, and a blocking outer core distal end at one end of the blocking outer core; and a blocking inner core slidably disposed in the blocking outer core lumen, having a blocking inner core lumen axially penetrating the blocking inner core, and a blocking inner core distal end at one end of the blocking inner core; wherein, opposite sides of the blocking member are respectively connected to the blocking outer core distal end and the blocking inner core distal end, and the blocking member can be deformed according to the change in the relative distance between the blocking outer core distal end and the blocking inner core distal end to be in the second deployed state or the second contracted state; the filtering device is slidably disposed in the blocking inner core lumen.

[0019] Optionally, in an embodiment of the present application, the filtering member is a claw-type filter. When the filtering device moves relative to the blocking device along the proximal end of the outer sheath towards the distal end of the outer sheath, the filtering member in the first contracted state can be extended from the blocking inner core lumen and switched from the first contracted state to the first deployed state; when the filtering device moves relative to the blocking device along the distal end of the outer sheath towards the proximal end of the outer sheath, the filtering member can be automatically switched from the first deployed state to the first contracted state, so that the filtering device can be partially withdrawn or completely withdrawn from the blocking inner core lumen, and at least a part of the interior of the blocking inner core lumen forms a cavity.

[0020] Optionally, in an embodiment of the present application, the cancer thrombus auxiliary removal instrument further includes a suction device communicated with the blocking inner core lumen to discharge the gas in the blood vessel through the blocking inner core lumen.

[0021] Optionally, in an embodiment of the present application, the blocking device is slidably disposed in the outer sheath lumen and has a blocking lumen penetrating the blocking device. The filtering device further includes: a filtering outer core slidably disposed in the blocking lumen, having a filtering outer core lumen axially penetrating the filtering outer core, and a filtering outer core distal end at one end of the filtering outer core; and a filtering inner core slidably disposed in the filtering outer core lumen, and a filtering inner core distal end at one end of the filtering inner core; wherein, opposite sides of the filtering member are respectively connected to the filtering outer core distal end and the filtering inner core distal end, and the filtering member can be deformed according to the change in the relative distance between the filtering outer core distal end and the filtering inner core distal end to be in the first deployed state or the first contracted state.

[0022] Optionally, in an embodiment of the present application, the plugging member is a balloon plugging device, and the plugging device further includes an infusion channel communicating with the plugging member to inject gas or liquid into the plugging member through the infusion channel, so that the plugging member is switched from the second contracted state to the second deployed state.

[0023] Optionally, in an embodiment of the present application, the filtering device can be partially withdrawn or completely withdrawn from the plugging channel, so that at least a part of the inside of the plugging channel forms a cavity, and the cancer embolism auxiliary removal instrument further includes a suction device communicating with the plugging channel to discharge the gas in the blood vessel through the plugging channel.

[0024] The present application also provides an operation method of a cancer embolism auxiliary removal instrument, which is applied to the cancer embolism auxiliary removal instrument described in the above embodiments. The operation method includes: positioning the outer sheath at a preset position in the blood vessel, threading the filtering device through the plugging device, and threading the plugging device through the outer sheath; causing the filter element in the first contracted state to extend and be exposed from the plugging device and the outer sheath, and causing the exposed filter element to be switched from the first contracted state to the first deployed state to filter the cancer embolism in the blood vessel; causing the plugging member in the second contracted state to extend and be exposed from the outer sheath, and causing the exposed plugging member to be switched from the second contracted state to the second deployed state to block the blood flow in the blood vessel; after the cancer embolism in the blood vessel is removed, causing the filter element to return from the first deployed state to the first contracted state, and partially withdrawing or completely withdrawing the filtering device from the plugging device, so that at least a part of the inside of the plugging device forms a cavity; discharging the gas in the blood vessel through the cavity formed inside the plugging device; and causing the plugging member to return from the second deployed state to the second contracted state, and withdrawing the plugging device from the outer sheath.

[0025] As can be seen from the above technical solutions, the cancer embolism auxiliary removal instrument provided by the present application integrates a filter and a plugging device to filter the cancer embolism in the blood vessel while blocking the blood flow in the blood vessel in an intravascular blocking manner, can assist in performing the operation of removing blood vessel cancer embolism, and can improve the safety of the operation. Description of the Drawings

[0026] In order to more clearly illustrate the technical solutions in the embodiments of the present application or the prior art, the following will briefly introduce the drawings required for the description of the embodiments or the prior art. Obviously, the drawings in the following description are only some embodiments recorded in the embodiments of the present application. For those of ordinary skill in the art, other drawings can also be obtained based on these drawings.

[0027] Figures 1A to 1D Structural schematic diagram of the cancer thrombus auxiliary removal device according to the first embodiment of the present application;

[0028] Figures 2A to 2C Structural schematic diagram of the cancer thrombus auxiliary removal device according to the second embodiment of the present application;

[0029] Figure 3 Structural schematic diagram of the cancer thrombus auxiliary removal device according to the third embodiment of the present application;

[0030] Figure 4 Structural schematic diagram of the cancer thrombus auxiliary removal device according to the fourth embodiment of the present application;

[0031] Figure 5 Structural schematic diagram of the cancer thrombus auxiliary removal device according to the fifth embodiment of the present application;

[0032] Element reference numerals

[0033] 1: Cancer thrombus auxiliary removal device; 2: Outer sheath; 20: Outer sheath lumen; 21: Distal end of the outer sheath; 22: Proximal end of the outer sheath; 3: Filtering device; 31: Filtering element; 32: Second sliding member; 321: Distal end of the second sliding member; 33: Third sliding member; 34: Filtering outer core; 340: Filtering outer core lumen; 341: Distal end of the filtering outer core; 35: Filtering inner core; 351: Distal end of the filtering inner core; 4: Sealing device; 41: Sealing member; 42: First sliding member; 420: Sealing lumen; 421: Distal end of the first sliding member; 422: Perfusion lumen; 43: Sealing outer core; 430: Sealing outer core lumen; 431: Distal end of the sealing outer core; 44: Sealing inner core; 440: Sealing inner core lumen; 441: Distal end of the sealing inner core; Detailed implementation manners

[0034] In order to enable those skilled in the art to better understand the technical solutions in the embodiments of the present application, the technical solutions in the embodiments of the present application will be clearly and completely described below in conjunction with the accompanying drawings in the embodiments of the present application. Obviously, the described embodiments are only a part of the embodiments of the present application, rather than all of the embodiments. Based on the embodiments in the embodiments of the present application, all other embodiments obtained by those of ordinary skill in the art shall fall within the protection scope of the embodiments of the present application.

[0035] In the present application, the so-called "distal end" refers to the end of the operating device that is far from the operator during the actual operation process, and the so-called "proximal end" refers to the end of the operating device that is close to the operator during the actual operation process.

[0036] The present application provides a cancer thrombus auxiliary removal device, which is applicable to the removal operation of vascular cancer thrombi. When filtering cancer thrombi in blood vessels (such as the inferior vena cava) during the operation, it can also block the blood flow in the blood vessel in an intravascular occlusion manner to facilitate the smooth execution of the cancer thrombus removal operation. Specifically, the cancer thrombus auxiliary removal device provided by the present application mainly includes an outer sheath, a filtering device, and a blocking device. Among them, the outer sheath is positioned at a preset position in the patient's blood vessel, and has an outer sheath lumen axially penetrating the outer sheath, and an outer sheath distal end and an outer sheath proximal end located at opposite ends of the outer sheath. The filtering device is slidably disposed in the outer sheath lumen and has a filtering element that can be switched between a first contracted state and a first expanded state. Among them, the filtering element can be in the first contracted state and received in the outer sheath lumen, and the filtering device can move relative to the outer sheath in the direction from the outer sheath proximal end to the outer sheath distal end, so that the filtering element in the first contracted state extends out of the outer sheath lumen and is exposed, and the exposed filtering element can be switched from the first contracted state to the first expanded state to filter the cancer thrombi in the blood vessel. The blocking device is slidably disposed in the outer sheath lumen and has a blocking element that can be switched between a second contracted state and a second expanded state. Among them, the blocking element can be in the second contracted state and received in the outer sheath lumen, and the blocking device can move relative to the outer sheath in the direction from the outer sheath proximal end to the outer sheath distal end, so that the blocking element in the second contracted state extends out of the outer sheath lumen and is exposed, and the exposed blocking element can be switched from the second contracted state to the second expanded state to block the blood flow in the blood vessel.

[0037] In practical applications, the filtering device and the blocking device used to form the cancer thrombus auxiliary removal device can each have various variations. For example, the filtering device 3 can be designed as a wire mesh filter, a claw filter, an umbrella-shaped framework filter, etc., and the blocking device 4 can be designed as a wire mesh occluder or a balloon occluder, etc. Several exemplary embodiments of the cancer thrombus auxiliary removal device will be described in detail below with reference to the accompanying drawings. It should be emphasized that the variations of the cancer thrombus auxiliary removal device are not limited to the embodiments shown in the drawings.

[0038] Please refer to Figures 1A to 1D , which is a schematic diagram showing the first embodiment of the cancer thrombus auxiliary removal device 1 of the present application.

[0039] As shown in the figure, the cancer thrombus assisted removal device 1 of this embodiment mainly includes an outer sheath 2, a filtering device 3, and a blocking device 4. Among them, the outer sheath 2 has an outer sheath cavity 20 axially penetrating the outer sheath 2, and an outer sheath distal end 21 and an outer sheath proximal end 22 located at opposite ends of the outer sheath 2. The blocking device 4 includes a first sliding member 42 and a blocking member 41 that can be switched between a second contracted state and a second deployed state. Among them, the first sliding member 42 is slidably disposed in the outer sheath cavity 20 of the outer sheath 2, and has a blocking cavity 420 penetrating the first sliding member 42, a first sliding member distal end 421 connecting the blocking member 41, and an infusion cavity 422 internally communicating with the blocking member 41. The filtering device 3 includes a second sliding member 32 and a filtering member 31 that can be switched between a first contracted state and a first deployed state. Among them, the second sliding member 32 is slidably disposed in the blocking cavity 420 of the first sliding member 42, and has a second sliding member distal end 321, and the second sliding member distal end 321 of the filtering device 3 extends out of the blocking cavity 420 via the first sliding member distal end 421.

[0040] In this embodiment, opposite sides of the filtering member 31 are respectively connected to the first sliding member distal end 421 and the second sliding member distal end 321, and the blocking member 41 connecting the first sliding member distal end 421 is nested inside the filtering member 31. That is, the filtering member 31 is sleeved on the outer layer of the blocking member 41 to form an integral body. Among them, the filtering member 31 in the first contracted state and the blocking member 41 disposed inside it in the second contracted state can be integrally received in the outer sheath cavity 20 of the outer sheath 2. The filtering member 31 and the blocking member 41 can also move relative to the outer sheath 2 along the direction from the outer sheath proximal end 22 to the outer sheath distal end 21, so as to synchronously extend out of the outer sheath cavity 20 and be exposed via the outer sheath distal end 21 (that is, the second sliding member distal end 321 and the first sliding member distal end 421 are exposed outside the outer sheath cavity 20). In this state, the first sliding member 42 of the blocking device 4 can be first moved relative to the outer sheath cavity 20 and the second sliding member 32 along the direction from the outer sheath proximal end 22 to the outer sheath distal end 21, so that the relative distance between the second sliding member distal end 321 and the first sliding member distal end 421 is shortened, so that the exposed filtering member 31 is first switched from the first contracted state to the first deployed state. In this state, since the blocking member 41 inside the filtering member 31 is still in the second contracted state, the cancer thrombus in the blood vessel can be filtered by the filter screen formed by the filtering member 31 in the first deployed state. Then, after the cancer thrombus filtering operation is completed by the filtering member 31, the exposed blocking member 41 can be inflated or injected with liquid through the infusion cavity 422, so that the blocking member 41 inside the filtering member 31 expands and is switched from the second contracted state to the second deployed state, thereby blocking the blood flow in the blood vessel.

[0041] In this embodiment, the blocking member 41 is, for example, a balloon type blocker, and the filtering member 31 is, for example, a filter screen formed by braiding or laser cutting multiple strands of nitinol wires.

[0042] Please continue to refer to Figures 2A to 2C , which is a schematic diagram showing a second embodiment of the cancer thrombus auxiliary removal device 1 of the present application.

[0043] As shown in the figure, in this embodiment, the cancer thrombus auxiliary removal device 1 of this embodiment mainly includes an outer sheath 2, a filtering device 3, and a blocking device 4. Among them, the outer sheath 2 has an outer sheath cavity 20 axially penetrating the outer sheath 2, and an outer sheath distal end 21 and an outer sheath proximal end 22 located at opposite ends of the outer sheath 2. The blocking device 4 includes a blocking member 41 and a first sliding member 42. Among them, the first sliding member 42 slides in the outer sheath cavity 20 of the outer sheath 2 and has a blocking cavity 420 penetrating the first sliding member 42, a first sliding member distal end 421 connecting the blocking member 41, and an infusion cavity 422 communicating with the inside of the blocking member 41. The filtering device 3 includes a filtering member 31 and a second sliding member 32. Among them, the second sliding member 32 slides in the blocking cavity 420 of the first sliding member 42 and has a second sliding member distal end 321 connecting the filtering member 31.

[0044] Specifically, the filtering member 31 can be in a first contracted state and stored in the blocking cavity 420 (as shown in Figure 2A ), and the second sliding member 32 can move relative to the blocking device 4 in the direction from the outer sheath proximal end 22 to the outer sheath distal end 21, so that the filtering member 31 in the first contracted state extends out of the blocking cavity 420 through the first sliding member distal end 421 and switches from the first contracted state to the first expanded state. In this embodiment, the filtering member 31 is, for example, a claw-type filter and can be formed, for example, by a heat setting process. Among them, when the filtering member 31 extends out of the blocking cavity 420 through the first sliding member distal end 421, the filtering member 31 can automatically switch from the first contracted state to the first expanded state. Furthermore, by controlling the setting position of the filtering member 31 relative to the blocking cavity 420, the expansion degree of the filtering member 31 in the first expanded state can be adjusted. For example, as shown in Figure 2B , when the whole of the filtering member 31 has not completely extended out of the blocking cavity 420, the overall diameter of the filtering member 31 in the first expanded state is smaller. As shown in Figure 2C , when the whole of the filtering member 31 completely extends out of the blocking cavity 420, the overall diameter of the filtering member 31 in the first expanded state will increase accordingly, thereby being applicable to blood vessels of different diameters to improve the filtering effect of cancer thrombi. However, it is not limited thereto, and the filtering member 31 can also be designed as an umbrella-shaped frame filter.

[0045] Furthermore, the blocking member 41 can be in the second contracted state and stored in the outer sheath cavity 20 (as shown in Figure 2AAs shown, when the first sliding member 42 moves relative to the outer sheath 2 in the direction from the proximal end 22 of the outer sheath towards the distal end 21 of the outer sheath, the occluder 41 in the second contracted state can protrude from the inner cavity 20 of the outer sheath through the distal end 21 of the outer sheath and be exposed. In this state, air or liquid can be injected into the exposed occluder 41 through the perfusion channel 422 of the first sliding member 42, so that the occluder 41 switches from the second contracted state to the second deployed state, and the occluder 41 in the second deployed state is located between the filter 31 in the first deployed state and the distal end 21 of the outer sheath, thereby blocking the blood flow in the blood vessel at the rear end of the filter 31. In this embodiment, the occluder 41 is, for example, a balloon occluder.

[0046] In another embodiment, when the filtering device 3 moves relative to the occluding device 4 in the direction from the distal end 21 of the outer sheath towards the proximal end 22 of the outer sheath, the filter 31 can automatically switch from the first deployed state to the first contracted state, so that the filtering device 3 can be partially withdrawn or completely withdrawn from the occluding cavity 420, and at least a part inside the occluding cavity 420 forms a cavity. Furthermore, in this embodiment, the cancer thrombus auxiliary removal instrument 1 may further include a suction device (not shown), which can communicate with the occluding cavity 420 (for example, communicate with the cavity part formed inside the aforementioned occluding cavity 420), so as to provide the suction device to suck the gas that may remain in the blood vessel through the occluding cavity 420, thereby preventing the formation of air embolism and improving the safety of the operation.

[0047] As Figure 3 shown, it is a schematic diagram showing the third embodiment of the cancer thrombus auxiliary removal instrument 1 of the present application. Among them, the composition structure of the cancer thrombus auxiliary removal instrument 1 in this embodiment is basically the same as that in the second embodiment, the difference being that the filtering device 3 further includes a third sliding member 33, which is sleeved between the first sliding member 42 and the second sliding member 32. Compared with the second embodiment, the cancer thrombus auxiliary removal instrument 1 in this embodiment can accurately control and adjust the specific fixed positions of the filter 31 and the occluder 41 in the blood vessel, and at the same time can also improve the positioning effect of the filter 31 and the occluder 41 in the blood vessel.

[0048] As Figure 4 shown, it is a schematic diagram showing the fourth embodiment of the cancer thrombus auxiliary removal instrument 1 of the present application.

[0049] As shown in the figure, in this embodiment, the cancer thrombus auxiliary removal device 1 of this embodiment mainly includes an outer sheath 2, a filtering device 3, and a blocking device 4. Among them, the outer sheath 2 has an outer sheath lumen 20 that axially penetrates the outer sheath 2, and an outer sheath distal end 21 and an outer sheath proximal end 22 located at opposite ends of the outer sheath 2. The blocking device 4 includes a blocking member 41, a blocking outer core 43, and a blocking inner core 44. Among them, the blocking outer core 43 is slidably disposed in the outer sheath lumen, and has a blocking outer core lumen 430 that axially penetrates the blocking outer core 43, and a blocking outer core distal end 431 located at one end of the blocking outer core 43; the blocking inner core 44 is slidably disposed in the blocking outer core lumen 430, and has a blocking inner core lumen 440 that axially penetrates the blocking inner core 44, and a blocking inner core distal end 441 located at one end of the blocking inner core 44; opposite sides of the blocking member 41 are respectively connected to the blocking outer core distal end 431 and the blocking inner core distal end 441, and the blocking member 41 can deform according to the change in the relative distance between the blocking outer core distal end 431 and the blocking inner core distal end 441, so as to be in a second expanded state or a second contracted state. For example, by moving the blocking outer core 43 relative to the outer sheath 2 and the blocking inner core 44, the relative distance between the blocking outer core distal end 431 and the blocking inner core distal end 441 can be adjusted, and then the diameter of the blocking member 41 in the second expanded state can be adjusted.

[0050] The filtering device 3 is slidably disposed in the blocking inner core lumen 440. In this embodiment, the filtering member 31 is, for example, a claw-type filter. Furthermore, the filtering device 3 can be designed as a single-core structure or a double-core structure. In this embodiment, the shown filtering device 3 is a double-core structure (i.e., a double-layer sleeve design), whereby the specific fixing position of the filtering member 31 in the blood vessel can be precisely controlled and adjusted.

[0051] Specifically, when the filtering device 3 moves relative to the blocking device 4 in the direction from the outer sheath proximal end 22 to the outer sheath distal end 21, the filtering member 31 in the first contracted state can be made to extend out of the blocking inner core lumen 440. In this embodiment, when the filtering member 31 extends out of the blocking inner core lumen 440, it automatically switches from the first contracted state to the first expanded state, and by controlling the setting position of the filtering member 31 relative to the blocking inner core lumen 440, the expansion degree of the filtering member 31 in the first expanded state (i.e., the diameter of the filtering member 31 when in the expanded state) can be adjusted.

[0052] In another embodiment, when the filtering device 3 moves relative to the occlusion device 4 in the direction from the distal end 21 of the outer sheath towards the proximal end 22 of the outer sheath, the filter element 31 can automatically switch from the first deployed state to the first contracted state, so that the filtering device 3 can be partially withdrawn or completely withdrawn from the occlusion inner core channel 440, causing at least a part inside the occlusion inner core channel 440 to form a cavity. Preferably, the cancer thrombus auxiliary removal instrument 1 may further include a suction device (not shown), which can communicate with the occlusion inner core channel 440 (for example, communicate with the cavity part formed inside the occlusion inner core channel 440), so as to provide the suction device to suck the gas that may remain in the blood vessel through the occlusion inner core channel 440, thereby preventing the formation of air embolism and improving the safety of the operation.

[0053] As Figure 5 shown, it is a schematic diagram showing the fifth embodiment of the cancer thrombus auxiliary removal instrument 1 of the present application.

[0054] As shown in the figure, in this embodiment, the cancer thrombus auxiliary removal instrument 1 of this embodiment mainly includes an outer sheath 2, a filtering device 3, and an occlusion device 4. Among them, the outer sheath 2 has an outer sheath channel 20 axially penetrating the outer sheath 2, and an outer sheath distal end 21 and an outer sheath proximal end 22 located at opposite ends of the outer sheath 2.

[0055] The occlusion device 4 is slidably disposed in the outer sheath channel 20 and has an occlusion member 41 and an occlusion channel 420 penetrating the occlusion device 4. In this embodiment, the occlusion member 41 is, for example, a balloon occluder, and the occlusion device 4 may further include an infusion channel 422 communicating with the occlusion member 41 to inject gas or liquid into the occlusion member 41 through the infusion channel 422, so that the occlusion member 41 switches from the second contracted state to the second deployed state.

[0056] The filtering device 3 includes a filter element 31, a filter outer core 34, and a filter inner core 35. Among them, the filter outer core 34 is slidably disposed in the occlusion channel 420 and has a filter outer core channel 340 axially penetrating the filter outer core 34, and a filter outer core distal end 341 located at one end of the filter outer core 34; the filter inner core 35 is slidably disposed in the filter outer core channel 340, and a filter inner core distal end 351 located at one end of the filter inner core 35; the opposite sides of the filter element 31 are respectively connected to the filter outer core distal end 341 and the filter inner core distal end 351, and the filter element 31 can be deformed according to the change in the relative distance between the filter outer core distal end 341 and the filter inner core distal end 351 to be in the first deployed state or the first contracted state. For example, by moving the filter outer core 34 relative to the occlusion device 4 and the filter inner core 35, the relative distance between the filter outer core distal end 341 and the filter inner core distal end 351 is adjusted, and then the diameter of the filter element 31 in the first deployed state is adjusted.

[0057] In addition, in this embodiment, the filtering device 3 can also move relative to the occlusion device 4 in the direction from the distal end 21 of the outer sheath towards the proximal end 22 of the outer sheath, so that the filtering device 3 can be partially or completely withdrawn from the occlusion cavity 420, causing at least a part inside the occlusion cavity 420 to form a cavity. And by connecting a suction device (not shown) to the cavity part formed inside the occlusion cavity 420, the gas that may remain in the blood vessel can be aspirated through the occlusion cavity 420.

[0058] In addition, the present application also provides an operation method for a cancer embolism auxiliary removal instrument, which can be applied to the cancer embolism auxiliary removal instrument described in any one of the above-mentioned second to fifth embodiments. The operation method mainly includes:

[0059] First, place the outer sheath at the upper level of the renal vein via the patient's jugular vein (that is, position the outer sheath at a preset position in the blood vessel), then fix the outer sheath on the patient's body surface (for example, by suturing or pasting), thread the filtering device through the occlusion device, and insert the occlusion device into the patient's body through the outer sheath lumen of the outer sheath until it reaches near the cancer embolism.

[0060] Cause the filter element in the first contracted state to extend and be exposed from the occlusion device and the outer sheath, and cause the exposed filter element to switch from the first contracted state to the first expanded state and fit against the inner wall of the blood vessel to filter the cancer embolism in the blood vessel.

[0061] Cause the occlusion element in the second contracted state to extend and be exposed from the outer sheath, and cause the exposed occlusion element to switch from the second contracted state to the second expanded state to fit against the inner wall of the blood vessel, thereby occluding the blood flow in the blood vessel.

[0062] After the cancer embolism in the blood vessel is removed, cause the filter element to return from the first expanded state to the first contracted state, and partially or completely withdraw the filtering device from the occlusion device, so that at least a part inside the occlusion device forms a cavity. In other embodiments, after withdrawing the filtering device, according to the actual surgical operation requirements, the fixed position of the occlusion element in the blood vessel can be further adjusted by moving the occlusion element relative to the outer sheath.

[0063] Then, the lower blood supply (that is, the blood flow at the lower end of the renal vein) can be opened, and the gas in the blood vessel can be discharged through the cavity formed inside the occlusion device (for example, by connecting an external suction device).

[0064] Cause the occlusion element to return from the second expanded state to the second contracted state, and withdraw the occlusion device from the outer sheath, thereby ending the surgical operation.

[0065] In summary, the cancer embolus auxiliary removal device provided by the present application can filter cancer emboli in blood vessels while blocking blood flow in the blood vessels in an internal blocking manner, improve the positioning effect of the filter element and the blocking element in the blood vessels, and adjust the positions of the filter element and the blocking element in the blood vessels during the operation, which can improve the safety of the operation for removing blood vessel cancer emboli and meet the requirements of higher-difficulty surgical operations.

[0066] Furthermore, the cancer embolus auxiliary removal device of the present application can assist in discharging the residual gas in the blood vessels to effectively prevent the formation of air embolism.

[0067] Finally, it should be noted that the above embodiments are only used to illustrate the technical solutions of the embodiments of the present application, and are not intended to limit them; although the present application has been described in detail with reference to the foregoing embodiments, those of ordinary skill in the art should understand that they can still modify the technical solutions described in the foregoing embodiments, or perform equivalent replacements for some of the technical features; and these modifications or replacements do not make the essence of the corresponding technical solutions deviate from the spirit and scope of the technical solutions of the embodiments of the present application.

Claims

1. A cancer thrombus assisted removal device for assisting in removing cancer thrombi in blood vessels, characterized in that, it includes: An outer sheath positioned at a preset position in the blood vessel, having an outer sheath lumen axially penetrating the outer sheath, and an outer sheath distal end and an outer sheath proximal end located at opposite ends of the outer sheath; A filtering device slidably disposed in the outer sheath lumen, and having a filter element capable of switching between a first contracted state and a first expanded state. The filter element can be received in the outer sheath lumen in the first contracted state, and the filtering device can move relative to the outer sheath in the direction from the outer sheath proximal end towards the outer sheath distal end, so that the filter element in the first contracted state extends out of the outer sheath lumen and is exposed, and the exposed filter element can switch from the first contracted state to the first expanded state to filter the cancer thrombi in the blood vessel; and A blocking device slidably disposed in the outer sheath lumen, and having a blocking member capable of switching between a second contracted state and a second expanded state. The blocking member can be received in the outer sheath lumen in the second contracted state, and the blocking device can move relative to the outer sheath in the direction from the outer sheath proximal end towards the outer sheath distal end, so that the blocking member in the second contracted state extends out of the outer sheath lumen and is exposed, and the exposed blocking member can switch from the second contracted state to the second expanded state to block the blood flow in the blood vessel.

2. The cancer thrombus assisted removal device according to claim 1, characterized in that, The blocking device further includes a first sliding member slidably disposed in the outer sheath lumen, having a blocking lumen penetrating the first sliding member, a first sliding member distal end connecting the blocking member, and an infusion lumen communicating with the inside of the blocking member; The filtering device further includes a second sliding member slidably disposed in the blocking lumen, having a second sliding member distal end, and the second sliding member distal end extends out of the blocking lumen through the first sliding member distal end; wherein, Opposite sides of the filter element are respectively connected to the first sliding member distal end and the second sliding member distal end, and the blocking member connected to the first sliding member distal end is nested inside the filter element, and the filter element in the first contracted state and the blocking member in the second contracted state disposed therein can be received in the outer sheath lumen, and the filter element and the blocking member can move relative to the outer sheath in the direction from the outer sheath proximal end towards the outer sheath distal end to synchronously extend out of the outer sheath lumen and be exposed through the outer sheath distal end; and wherein, The first sliding member can move relative to the outer sheath lumen and the second sliding member in the direction from the outer sheath proximal end towards the outer sheath distal end, so that the relative distance between the second sliding member distal end and the first sliding member distal end is shortened, and the filter element is switched from the first contracted state to the first expanded state; Air or liquid is injected into the exposed blocking member through the infusion lumen to make the blocking member switch from the second contracted state to the second expanded state.

3. The cancer embolism auxiliary removal device according to claim 2, characterized in that, the blocking member is a capsule-type blocker, and the filtering member is a filter screen formed by braiding or laser cutting a plurality of nickel-titanium alloy wires.

4. The cancer embolism auxiliary removal device according to claim 1, characterized in that, the blocking device further includes a first sliding member slidably disposed in the outer sheath channel, and having a blocking channel penetrating through the first sliding member, a distal end of the first sliding member connecting the blocking member, and an infusion channel communicating with the inside of the blocking member; the filtering device further includes a second sliding member slidably disposed in the blocking channel, and having a distal end of the second sliding member connecting the filtering member; wherein, the filtering member can be received in the blocking channel in the first contracted state, and the second sliding member can move relative to the blocking device in the direction from the proximal end of the outer sheath to the distal end of the outer sheath, so that the filtering member in the first contracted state extends out of the blocking channel through the distal end of the first sliding member and switches from the first contracted state to the first expanded state; the blocking member can be received in the outer sheath channel in the second contracted state, and the first sliding member can move relative to the outer sheath in the direction from the proximal end of the outer sheath to the distal end of the outer sheath, so that the blocking member in the second contracted state extends out and is exposed from the outer sheath channel through the distal end of the outer sheath, and the exposed blocking member is inflated or injected with liquid through the infusion channel, so that the blocking member switches from the second contracted state to the second expanded state; and wherein, the blocking member in the second expanded state is located between the filtering member in the first expanded state and the distal end of the outer sheath.

5. The cancer embolism auxiliary removal device according to claim 4, characterized in that, when the filtering member extends out of the blocking channel, by controlling the setting position of the filtering member relative to the blocking channel, the expansion degree of the filtering member in the first expanded state is adjusted.

6. The cancer embolism auxiliary removal device according to claim 5, characterized in that, when the filtering device moves relative to the blocking device in the direction from the distal end of the outer sheath to the proximal end of the outer sheath, the filtering member can automatically switch from the first expanded state to the first contracted state, so that the filtering device can be partially withdrawn or completely withdrawn from the blocking channel, and at least a part of the inside of the blocking channel forms a cavity.

7. The cancer embolism auxiliary removal device according to claim 6, characterized in that, the filtering member is a claw-type filter, and the blocking member is a capsule-type blocker.

8. The cancer embolism auxiliary removal device according to claim 6, characterized in that, the cancer embolism auxiliary removal device further includes a suction device communicated with the blocking channel to discharge the gas in the blood vessel through the blocking channel.

9. The cancer embolism auxiliary removal device according to claim 4, characterized in that, the filtering device further includes a third sliding member sleeved between the first sliding member and the second sliding member.

10. The cancer thrombus auxiliary removal device according to claim 1, characterized in that, the blocking device further includes: a blocking outer core, which is slidably disposed in the outer sheath cavity, and has a blocking outer core cavity axially penetrating the blocking outer core, and a distal end of the blocking outer core located at one end of the blocking outer core; and a blocking inner core, which is slidably disposed in the blocking outer core cavity, and has a blocking inner core cavity axially penetrating the blocking inner core, and a distal end of the blocking inner core located at one end of the blocking inner core; wherein, opposite sides of the blocking member are respectively connected to the distal end of the blocking outer core and the distal end of the blocking inner core, and the blocking member can be deformed according to the change of the relative distance between the distal end of the blocking outer core and the distal end of the blocking inner core, so as to be in the second deployed state or the second contracted state; the filtering device is slidably disposed in the blocking inner core cavity.

11. The cancer thrombus auxiliary removal device according to claim 10, characterized in that, the filtering member is a claw-type filter, wherein, when the filtering device moves relative to the blocking device along the proximal end of the outer sheath towards the distal end of the outer sheath, it can cause the filtering member in the first contracted state to extend out of the blocking inner core cavity and switch from the first contracted state to the first deployed state; when the filtering device moves relative to the blocking device along the distal end of the outer sheath towards the proximal end of the outer sheath, the filtering member can automatically switch from the first deployed state to the first contracted state, so that the filtering device can be partially withdrawn or completely withdrawn from the blocking inner core cavity, and at least a part of the inside of the blocking inner core cavity forms a cavity.

12. The cancer thrombus auxiliary removal device according to claim 11, characterized in that, the cancer thrombus auxiliary removal device further includes a suction device, which is communicated with the blocking inner core cavity to discharge the gas in the blood vessel through the blocking inner core cavity.

13. The cancer thrombus auxiliary removal device according to claim 1, characterized in that, the blocking device is slidably disposed in the outer sheath cavity and has a blocking cavity penetrating the blocking device, and the filtering device further includes: a filtering outer core, which is slidably disposed in the blocking cavity, and has a filtering outer core cavity axially penetrating the filtering outer core, and a distal end of the filtering outer core located at one end of the filtering outer core; and a filtering inner core, which is slidably disposed in the filtering outer core cavity, and a distal end of the filtering inner core located at one end of the filtering inner core; wherein, opposite sides of the filtering member are respectively connected to the distal end of the filtering outer core and the distal end of the filtering inner core, and the filtering member can be deformed according to the change of the relative distance between the distal end of the filtering outer core and the distal end of the filtering inner core, so as to be in the first deployed state or the first contracted state.

14. The cancer thrombus auxiliary removal device according to claim 13, characterized in that, the blocking member is a capsule-type blocker, and the blocking device further includes an infusion cavity communicating with the blocking member to inject gas or liquid into the blocking member through the infusion cavity, so that the blocking member is switched from the second contracted state to the second deployed state.

15. The cancer thrombus auxiliary removal device according to claim 13, characterized in that, the filtering device can be partially withdrawn or completely withdrawn from the blocking cavity, so that at least a part inside the blocking cavity forms a cavity, and the cancer thrombus auxiliary removal device further includes a suction device, which is communicated with the blocking cavity to discharge the gas in the blood vessel through the blocking cavity.

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