Ultrasonic-assisted chronic occlusion intravascular opening catheter

Abstract

The invention relates to the technical field of vascular intervention, in particular to an ultrasound-assisted chronic occlusion intravascular opening catheter which comprises a catheter body, a guide wire, an ultrasonic probe and a rotary grinding component. Guiding the catheter to reach the near end of the occluded blood vessel through the loach guide wire, withdrawing the loach guide wire, and rotating the catheter in vitro to drive the ultrasonic probe to rotate so as to find an optimal ultrasonic guiding direction; under the optimal ultrasonic guiding direction, ultrasonic identification is carried out on an occluded blood vessel true cavity or thrombus and plaque in a blood vessel, a guiding wire is guided to pass through or the guiding wire is used for guiding a rotary grinding component, and the rotary grinding component is controlled in vitro to advance so as to pass through the thrombus or plaque in the blood vessel; after the guide wire reaches the far end of the blood vessel through the occluded segment of the original occluded blood vessel, it is confirmed that the guide wire is located in the true cavity of the blood vessel, the guide wire is reserved to retreat from the rotary grinding component, and therefore ultrasonic-assisted guiding in the true cavity of the blood vessel is completed; if still in a blood vessel false cavity, the rotary grinding component can be used for puncturing a false cavity vascular membrane under ultrasonic guidance to enter a blood vessel true cavity, and then ultrasonic guidance occluded blood vessel opening reconstruction is achieved.

Description

Technical Field

[0001] The present invention relates to the technical field of vascular intervention, and in particular to an ultrasound-assisted chronically occluded blood vessel endocanalization catheter. Background Art

[0002] Studies have confirmed that endocanalization of chronically occluded blood vessels, especially endocanalization of chronically occluded carotid arteries, is of great significance in improving patients' cognitive function. With the deepening of research, studies in recent years have shown that some patients with impaired neurological function may also benefit from the endocanalization of chronically occluded blood vessels.

[0003] However, due to the lack of devices for opening chronic occluded blood vessels, only common intravascular interventional devices can be used for opening chronic occluded blood vessels. The inherent defects of common intravascular interventional devices have led to the frequent occurrence of guidewires and catheters entering the false lumen of blood vessels or even piercing blood vessels during chronic occluded blood vessel opening. Once entering the false lumen of blood vessels, vascular dissection is inevitable, and piercing blood vessels may cause intracranial and extracranial hemorrhage or jugular arteriovenous leakage in severe cases, which may lead to failure of opening chronic occluded blood vessels, or even direct disability or death of patients. The reason is that the common interventional devices cannot accurately identify the true and false lumens of blood vessels, which is the culprit.

[0004] Limited by the lack of relevant instruments, the current chronic occluded vascular recanalization surgery can only be performed based on the surgeon's experience. However, based on experience, the surgery cannot ensure the true or false vascular lumen of the surgical site, so it is difficult to ensure the smooth progress of the surgery, let alone the safety of the patient's surgery. However, with the increasing number of patients benefiting from chronic occluded vascular recanalization, chronic occluded vascular recanalization has also been supported by more and more high-level clinical evidence, so the comprehensive implementation of chronic occluded vascular recanalization is just around the corner. In order to effectively improve the safety of chronic occluded vascular recanalization surgery and improve the dimension of precision medicine, it is imperative to invent a surgical instrument specifically for chronic occluded vascular recanalization surgery. Summary of the invention

[0005] The purpose of the present invention is to provide an ultrasound-assisted chronic occluded endovascular opening catheter, which solves the problem that the current opening of chronic occluded blood vessels can only be performed based on the experience of the surgeon, and also perfectly solves the problem that the current common interventional instruments cannot accurately identify the true and false lumens of the blood vessels, which easily leads to surgery-related vascular dissection and bleeding.

[0006] To achieve the above-mentioned purpose, the present invention provides an ultrasound-assisted chronic occluded endovascular opening catheter, comprising a catheter, a guide wire, an ultrasonic probe and a rotational grinding component, wherein the catheter has a proximal end and a distal end, and the catheter also has a hollow lumen, wherein the hollow lumen of the catheter extends from the proximal end to the distal end of the catheter, and an opening is provided on the side of the distal end of the catheter 3 cm away from the tube head end, so that the hollow lumen of the catheter is connected to the outside, the guide wire is arranged inside the hollow lumen of the catheter, and the ultrasonic probe is eccentrically arranged on one side of the distal end of the catheter.

[0007] Among them, the rotary grinding component includes a drilling rod and a drilling head, the drilling rod is arranged inside the hollow tube cavity of the catheter and is sleeved on the guide wire; the drilling head is designed as a hollow pipe, and is sleeved on the outside of the guide wire and located inside the hollow tube cavity of the catheter. The drilling head is fixedly set at the end of the drilling rod.

[0008] Among them, the end of the drilling rod close to the drilling head is a hollow pipe structure with a length of 10 cm, the distal end of the drilling rod hollow pipe structure is connected to the hollow structure of the drilling head, and the proximal end of the drilling rod hollow pipe structure continues as a quick exchange port, and the quick exchange port is arranged on the side of the drilling rod.

[0009] Among them, the distal end of the ultrasound-assisted chronic occluded endovascular recanalization catheter also includes an elastic composite membrane, which is arranged on the side of the distal end of the catheter away from the ultrasound probe. When there is no content filled, the elastic composite membrane and the outer wall of the catheter form a collapsed lumen, and the collapsed lumen surrounded by the elastic composite membrane is connected to the hollow lumen of the catheter.

[0010] Among them, the ultrasonic probe includes a piezoelectric chip, a sound absorbing material, an acoustic lens, a matching layer, an acoustic head shell and a transmission cable. The piezoelectric chip is composed of a piezoelectric chip group, each piezoelectric chip group is composed of 6-8 chips arranged in a straight line, and the piezoelectric chip is arranged inside the acoustic head shell; the transmission cable is connected to the piezoelectric chip, and the matching layer is arranged on the side of the piezoelectric chip away from the transmission cable and is close to the piezoelectric chip; the acoustic lens is fixedly installed at the end of the acoustic head shell and covers the matching layer; the sound absorbing material is filled in the acoustic head shell and wraps the transmission cable; the head end of the acoustic head shell wraps the ultrasonic probe, and the proximal end continues and wraps the sound absorbing material and the transmission cable, and the transmission cable runs and participates in the formation of the partial wall structure of the catheter.

[0011] Among them, the ultrasound-assisted chronic occluded endovascular recanalization catheter also includes a proximal ultrasonic connector and a joint holder. The proximal ultrasonic connector is arranged on the catheter and is electrically connected to the transmission cable; the joint holder is arranged on the proximal ultrasonic connector.

[0012] The ultrasound-assisted chronic occluded endovascular recanalization catheter of the present invention guides the catheter to the proximal end of the occluded blood vessel through a loach guidewire, withdraws the loach guidewire, drives the ultrasound probe to rotate through an in vitro rotating catheter, and finds the best ultrasound guidance position; the true cavity of the occluded blood vessel or the thrombus and plaque in the blood vessel are ultrasonically identified under the best ultrasound guidance position, and the guidewire is guided to pass through or the atherectomy component is guided by the guidewire, and the atherectomy component is manipulated to advance through the thrombus or plaque in the blood vessel. After the guidewire passes through the occluded segment of the original occluded blood vessel and reaches the distal end of the blood vessel, and it is confirmed that the guidewire is in the true cavity of the blood vessel, the guidewire is retained and the atherectomy component is withdrawn to complete the ultrasound-assisted endovascular true cavity guidance; if it is still in the false cavity of the blood vessel, the atherectomy component can be used under ultrasound guidance to puncture the false cavity vascular membrane to enter the true cavity of the blood vessel, thereby realizing ultrasound-guided occluded blood vessel recanalization and reconstruction. This patent can solve the problem that the surgeon in the current chronic occluded endovascular recanalization operation relies entirely on experience, which is very easy to cause the surgeon to mistakenly enter the false cavity of the blood vessel, thereby causing a high risk of surgical bleeding and a high surgical failure rate. BRIEF DESCRIPTION OF THE DRAWINGS

[0013] In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the drawings required for use in the embodiments or the description of the prior art are briefly introduced below.

[0014] Figure 1 It is a schematic diagram of the overall structure of the ultrasound-assisted chronically occluded blood vessel opening catheter of the present invention.

[0015] Figure 2 It is a schematic diagram of the installation structure of the ultrasonic probe of the present invention.

[0016] Figure 3 This is a schematic diagram of the internal section structure of the ultrasonic probe of the present invention.

[0017] Figure 4 It is a schematic diagram of the structure of the collapsed lumen of the present invention.

[0018] Figure 5 It is a schematic structural diagram of the elastic composite membrane of the present invention.

[0019] Figure 6 It is a structural schematic diagram of the drilling probe of the present invention.

[0020] Figure 7 It is a schematic structural diagram of the rotational grinding component of the present invention.

[0021] In the figure: 101-catheter, 102-guide wire, 103-ultrasound probe, 104-rotational grinding component, 105-drilling rod, 106-drilling probe, 107-quick exchange port, 108-elastic composite membrane, 109-catheter hollow lumen, 110-collapsed lumen, 111-piezoelectric chip, 112-sound absorbing material, 113-acoustic lens, 114-matching layer, 115-acoustic head housing, 116-transmission cable, 201-proximal ultrasonic connector, 202-connector holder. DETAILED DESCRIPTION

[0022] Embodiments of the present invention are described in detail below. Examples of the embodiments are shown in the accompanying drawings. The embodiments described below with reference to the accompanying drawings are exemplary and are intended to be used to explain the present invention, but should not be construed as limiting the present invention.

[0023] See also Figures 1 to 7 ,in Figure 1 This is a schematic diagram of the overall structure of the ultrasound-assisted chronic occluded vascular opening catheter. Figure 2 This is a schematic diagram of the installation structure of the ultrasonic probe. Figure 3 This is a schematic diagram of the internal cross-sectional structure of the ultrasound probe. Figure 4 Schematic diagram of the structure of the collapsed lumen. Figure 5 It is a schematic diagram of the structure of the elastic composite membrane. Figure 6 This is a schematic diagram of the structure of the drilling probe. Figure 7 It is a structural schematic diagram of a rotational grinding component.

[0024] The present invention provides an ultrasound-assisted chronic occluded blood vessel opening catheter, comprising a catheter 101, a guide wire 102, an ultrasound probe 103, a laparotomy component 104, an elastic composite membrane 108, a proximal ultrasound connector 201 and a joint holder 202, wherein the laparotomy component 104 comprises a drilling rod 105 and a drilling probe 106, wherein the drilling rod 105 has a quick exchange port 107, and the ultrasound probe 103 comprises a piezoelectric chip 111, a sound absorbing material 112, an acoustic lens 113, a matching layer 114, an acoustic head housing 115 and a transmission cable 116. It can be understood that the above scheme can be used to identify true and false cavities in a blood vessel, and can also be used to identify thrombi and plaques in a blood vessel. The ultrasound probe 103 is driven to rotate by rotating the catheter 101 in vitro to find the best ultrasound guidance position for the occluded vascular segment. Under the guidance of the best ultrasound guidance position, the true lumen of the occluded vessel or the thrombus and plaque in the occluded vessel are identified, and the guide wire 102 is guided to pass through the true lumen of the occluded vessel or the inside of the thrombus, or the guide wire 102 is used to guide the grinding component 104, and the grinding component 104 is manipulated in vitro to advance so as to pass through the organized thrombus in the true lumen of the vessel. After the guide wire 102 successfully passes through the original vascular occlusion segment and reaches the distal end of the vessel, and is confirmed to be in the true lumen of the vessel, the guide wire 102 is retained and the grinding component 104 is withdrawn to complete the ultrasound-assisted guidance in the true lumen of the vessel; if it is still in the false lumen of the vessel, the grinding component 104 can be used to pierce the false lumen vascular membrane under ultrasound guidance to enter the true lumen of the vessel, thereby realizing ultrasound-guided opening and reconstruction of the occluded vessel.

[0025] In this specific embodiment, the catheter 101 has a proximal end and a distal end. The catheter 101 also has a catheter hollow lumen 109, which extends from the proximal end to the distal end of the catheter 101, and an opening is provided on the side of the distal end of the catheter 101 3 cm away from the tube head end, so that the catheter hollow lumen 109 is connected to the outside, the guide wire 102 is arranged inside the catheter hollow lumen 109, and the ultrasonic probe 103 is eccentrically arranged at the distal end of the catheter 101; the distal end of the catheter 101 is bent at 45°. In actual operation, the catheter 101 is guided to the proximal end of the occluded blood vessel by the loach guide wire, and the ultrasonic probe 103 is driven to rotate by rotating the catheter 101 in vitro. Since the distal end of the catheter 101 is bent at 45° and the ultrasonic probe 103 is eccentrically arranged, the detection range of the ultrasonic probe 103 is increased during the rotation of the catheter 101, so as to facilitate the search for the best ultrasonic guidance direction. Under the guidance of ultrasound in the best orientation, the thrombus and plaque in the true lumen or lumen of the occluded blood vessel are identified, and then the guide wire 102 is guided to pass through the thrombus inside the occluded blood vessel, or the guide wire 102 is used to guide the grinding member 104, and the extracorporeal grinding member 104 advances to pass through the organized thrombus or plaque in the occluded blood vessel, and after the guide wire 102 successfully passes through the occluded segment of the original occluded blood vessel to reach the distal end of the blood vessel, and after angiography confirms that the guide wire 102 is in the true lumen of the blood vessel, the guide wire 102 is retained and withdrawn from the grinding member 104, thereby achieving guidance of the true lumen in the blood vessel. For example, in the false lumen of a blood vessel, the atherectomy component 104 can be used to pierce the false lumen vascular membrane under ultrasound guidance to enter the true lumen of the blood vessel. After entering the true lumen of the blood vessel, the guide wire 102 is retained and the atherectomy component 104 is withdrawn. The guide wire 102 is used to send a protective umbrella microcatheter to release the protective umbrella, and then intravascular balloon dilatation and stent implantation are performed along the protective umbrella guide wire to complete the opening of the chronic occluded blood vessel. This patent can solve the problem that in the current intravascular opening of chronic occluded blood vessels, the operator's fully empirical operation is very likely to cause mistaken entry into the false lumen of the blood vessel, thereby resulting in a high risk of surgical bleeding and a high rate of surgical failure.

[0026] Among them, the drilling rod 105 is arranged inside the hollow tube cavity 109 of the catheter and is sleeved on the guide wire 102; the drilling probe 106 is designed as a hollow pipe, and is sleeved on the outside of the guide wire 102 and located inside the hollow tube cavity 109 of the catheter. The drilling probe 106 is fixedly set at the end of the drilling rod 105.

[0027] Secondly, the end of the drilling rod 105 close to the drilling head 106 has a hollow pipe structure with a length of 10 cm. The distal end of the hollow pipe structure of the drilling rod 105 is connected to the hollow pipe design of the drilling head 106, and the proximal end continues to be a quick exchange port 107, and the quick exchange port 107 is arranged on the side of the drilling rod 105.

[0028] The drilling probe 106 has a hollow tube design inside, so that the guide wire 102 can pass through. At the same time, since the drilling rod 105 has a hollow tube structure, the drilling rod 105 can be sleeved on the guide wire 102. The guide wire 102 extends out through the quick exchange port 107. The drilling probe 106 is driven to rotate by rotating the drilling rod 105 outside the body, thereby performing rotational grinding on the thrombus or plaque. The end of the drilling probe 106 has a blade grinding angle of a standard twist drill, which facilitates the rotational grinding of the thrombus or plaque.

[0029] Secondly, the elastic composite membrane 108 is arranged on the side of the distal end of the catheter 101 away from the ultrasonic probe 103. When not filled with content, the elastic composite membrane 108 and the outer wall of the catheter 101 form a collapsed lumen 110. The collapsed lumen 110 surrounded by the elastic composite membrane 108 is connected to the hollow lumen 109 of the catheter.

[0030] Then, the piezoelectric chip 111 is composed of a plurality of piezoelectric chip groups, each of which consists of 6-8 chips arranged in a straight line. Such a design can enhance the efficiency of ultrasonic emission and reception, and improve the resolution and imaging quality of the ultrasonic probe. Each piezoelectric chip can work independently, and its vibration frequency and phase are accurately controlled by an electronic control system, so as to synthesize an ultrasonic beam with good focusing performance and clear directionality. During operation, when current is applied to the piezoelectric chip 111 through the transmission cable 116, the chip deforms and generates high-frequency vibration, thereby emitting ultrasonic waves to the surrounding medium (such as blood or blood vessel walls, intravascular plaques). These ultrasonic waves will be reflected and scattered when encountering tissue interfaces of different densities. The reflected ultrasonic waves are received again by the piezoelectric chip 111 and converted into electrical signals, which are transmitted to the external processing system through the transmission cable 116 for analysis and imaging. In order to optimize the transmission and reception of ultrasonic waves, the matching layer 114 is designed to be a material with a specific acoustic impedance, which can reduce The difference in acoustic impedance between the piezoelectric chip 111 and the surrounding tissue is reduced, thereby reducing the reflection loss of ultrasound at the interface and improving the transmittance of ultrasound. At the same time, the matching layer 114 can also protect the piezoelectric chip 111 and prevent it from being directly exposed to complex environments such as blood or blood vessel walls. The acoustic lens 113 focuses the ultrasound emitted by the piezoelectric chip 111 into a fine sound beam to improve the resolution and depth of ultrasound imaging. The sound-absorbing material 112 is filled inside the acoustic head shell 115 and wraps the transmission cable 116. The sound-absorbing material has good sound absorption performance and can effectively absorb the stray waves and reflected waves generated during the transmission of ultrasound, reducing the impact of interference signals on imaging quality. At the same time, they can also play a role in sound insulation and heat insulation, protecting the piezoelectric chip 111 and the transmission cable 116 from interference and damage from the external environment. The transmission cable 116 travels and participates in the formation of the partial wall structure of the catheter, and then continues to be the electrical connection structure in the proximal ultrasound connector 201.

[0031] Finally, the proximal ultrasonic connector 201 is arranged on the proximal side of the catheter 101 and is electrically connected to the transmission cable 116; the joint holder 202 is arranged on the proximal ultrasonic connector 201, and the proximal ultrasonic connector 201 and the joint holder 202 are connected to the outside world and power the ultrasonic probe 103 and transmit signals to the computer ultrasonic analysis software. The analysis software decodes, reconstructs and displays the received ultrasonic signals in real time to generate high-quality vascular images. Through these images, doctors can clearly observe the internal structure of the blood vessels, blood flow conditions, and the location of the occluded blood vessels and the thrombus morphology, providing accurate and reliable basis for surgical decisions.

[0032] When using the ultrasound-assisted chronic occluded blood vessel opening catheter of the invention, the catheter 101 is guided to the proximal end of the occluded blood vessel by the loach guidewire, and then the loach guidewire is withdrawn, and the catheter 101 is rotated in vitro to drive the ultrasound probe 103 to rotate, and the best ultrasound guidance direction is found. Under the best ultrasound guidance direction, the true cavity of the occluded blood vessel or the thrombus and plaque in the blood vessel are ultrasonically identified, and the guidewire 102 is guided to pass through, or the guidewire 102 is used to guide the atherectomy component 104, and the atherectomy component 104 is manipulated in vitro, and the atherectomy component 104 is passed through the front of the atherectomy component 104. The end drilling probe 106 is rotated and advanced to pass through the organized occluded blood vessel thrombus. After angiography confirms that the guide wire 102 is in the true lumen of the blood vessel, the guide wire 102 can be retained to withdraw the drilling rod 105 and the drilling probe 106. If the guide wire 102 is in the false lumen of the blood vessel, the drilling probe 106 can be used for rotational grinding to pierce the vascular membrane of the false lumen under ultrasound guidance to enter the true lumen of the blood vessel. The present invention, through the combination of ultrasound guidance and rotational grinding technology, can more accurately identify the true lumen of the blood vessel, reduce blindness and risks during the operation, and thus improve the success rate of the operation.

[0033] What is disclosed above is only one or more preferred embodiments of the present application, and cannot be used to limit the scope of rights of the present application. Ordinary technicians in this field can understand that all or part of the processes of implementing the above embodiments and equivalent changes made according to the claims of the present application are still within the scope covered by the present application.

Claims

1. An ultrasound-assisted chronically occluded blood vessel opening catheter, characterized in that: The invention comprises a catheter, a guide wire, an ultrasonic probe and a rubbing component. The catheter has a proximal end and a distal end. The catheter also has a hollow lumen. The hollow lumen of the catheter extends from the proximal end to the distal end of the catheter, and an opening is provided on the side of the distal end of the catheter 3 cm away from the tube head end, so that the hollow lumen of the catheter is communicated with the outside. The guide wire is arranged inside the hollow lumen of the catheter, and the ultrasonic probe is eccentrically arranged on one side of the distal end of the catheter.

2. The ultrasound-assisted chronically occluded blood vessel opening catheter according to claim 1, characterized in that: The rotary grinding component includes a drilling rod and a drilling head. The drilling rod is arranged inside the hollow tube cavity of the catheter and is sleeved on the guide wire. The drilling head is designed as a hollow pipe and is sleeved on the outside of the guide wire and located inside the hollow tube cavity of the catheter. The drilling head is fixedly arranged at the end of the drilling rod.

3. The ultrasound-assisted chronically occluded blood vessel opening catheter according to claim 2, characterized in that: The end of the drilling rod close to the drilling head is provided with a hollow pipe structure with a length of 10 cm. The distal end of the drilling rod hollow pipe structure is connected with the hollow structure of the drilling head. The proximal end of the drilling rod hollow pipe structure continues as a quick exchange port, and the quick exchange port is arranged on the side of the drilling rod.

4. The ultrasound-assisted chronically occluded blood vessel opening catheter according to claim 3, characterized in that: The distal end of the ultrasound-assisted chronically occluded endovascular recanalization catheter also includes an elastic composite membrane, which is arranged on the side of the distal end of the catheter away from the ultrasound probe. When not filled with content, the elastic composite membrane forms a collapsed lumen with the outer wall of the catheter, and the collapsed lumen surrounded by the elastic composite membrane is connected to the hollow lumen of the catheter.

5. The ultrasound-assisted chronically occluded blood vessel opening catheter according to claim 4, characterized in that: The ultrasonic probe comprises a piezoelectric chip, a sound absorbing material, an acoustic lens, a matching layer, an acoustic head housing and a transmission cable. The piezoelectric chip is composed of a piezoelectric chip group, each piezoelectric chip group is composed of 6-8 chips arranged in a straight line, and the piezoelectric chip is arranged inside the acoustic head housing; The transmission cable is connected to the piezoelectric chip, and the matching layer is arranged on the side of the piezoelectric chip away from the transmission cable and is in close contact with the piezoelectric chip; the acoustic lens is fixedly installed at the end of the acoustic head shell and covers the matching layer; the sound absorbing material is filled inside the acoustic head shell and wraps the transmission cable; the head end of the acoustic head shell wraps the ultrasonic probe, and the proximal end continues and wraps the sound absorbing material and the transmission cable, and the transmission cable runs and participates in forming a partial wall structure of the catheter.

6. The ultrasound-assisted chronic occluded blood vessel opening catheter according to claim 5, characterized in that: The ultrasound-assisted chronically occluded endovascular recanalization catheter also includes a proximal ultrasound connector and a joint holder. The proximal ultrasound connector is arranged on the catheter and is electrically connected to the transmission cable; the joint holder is arranged on the proximal ultrasound connector.

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