Intracranial blood vessel blood pressure detection method

Abstract

The invention provides an intracranial blood vessel blood pressure detection method, and relates to the technical field of blood pressure detection methods, the intracranial unruptured cranial aneurysm volume of a detected object is judged according to a medical image of the detected object, and if it is judged that the volume is large and / or huge, the average arterial pressure M1 of a tumor-carrying artery is measured, and a micro catheter is placed into an aneurysm cavity; the micro catheter is connected with the invasive arterial pressure monitoring sensor; measuring the average arterial pressure P1 of the aneurysm cavity after the micro-catheter is placed; placing the dense net stent at the intracranial artery, covering the neck of the aneurysm, and respectively measuring the average arterial pressure M2 of the artery carrying the aneurysm and the average arterial pressure P2 in the aneurysm cavity; spring ring filling is conducted on the aneurysm cavity, and the average arterial pressure M3 of the aneurysm-carrying artery and the average arterial pressure P3 of the aneurysm cavity after spring ring filling are measured respectively; and obtaining an intracranial blood vessel blood pressure value change curve of the detected object according to the measurement result. A patient and a doctor can directly obtain the change condition of the blood pressure value in a mode that the micro-catheter extends into the measurement position for direct measurement.

Description

Technical Field

[0001] The present invention belongs to the technical field of blood pressure detection methods, and particularly relates to a method for detecting intracranial vascular blood pressure. Background Art

[0002] Intracranial aneurysms are local vascular wall dilations that gradually become abnormal, caused by congenital dysplasia or acquired injury to the intracranial arterial lumen. The overall incidence of intracranial aneurysms in the global adult population (average age 50 years) is approximately 3.2%. Existing surveys show that the annual rupture risk of intracranial aneurysms in the general adult population is at least 1%. Ruptured intracranial aneurysms cause subarachnoid hemorrhage (SAH), with a mortality rate as high as 45%, and more than half of the survivors experience irreversible neurological deficits. Therefore, it is particularly important to predict the rupture risk after the detection of intracranial aneurysms to guide treatment.

[0003] In recent years, the rupture risk factors of UIAs (Unruptured Intracranial Aneurysms) have been widely studied. Currently, the main means of assessing the rupture risk of intracranial aneurysms is an assessment method based on PHASES scores. This assessment method analyzes aneurysms statistically from the aneurysm location, aneurysm size, patient population, patient's past medical history, and patient age, so as to infer the five-year rupture risk of the aneurysm. However, it has been found in practice that this assessment method only conducts statistical analysis on the patient population with aneurysms and ignores the analysis of the actual situation of individual aneurysm patients. Therefore, the accuracy of assessing the rupture risk of aneurysms is relatively low.

[0004] Therefore, an improved technical solution is needed to address the deficiencies of the above-mentioned existing technologies. Summary of the Invention

[0005] The purpose of the present invention is to provide a method for detecting intracranial vascular blood pressure. By connecting an invasive arterial pressure monitoring sensor through a microcatheter and directly measuring with the microcatheter extended into the measurement position, doctors can directly obtain the change situation of blood pressure values, which is more intuitive and the data accuracy is better.

[0006] To achieve the above purpose, the present invention provides the following technical solution:

[0007] A method for detecting intracranial vascular blood pressure, comprising:

[0008] S101: Judging the volume of unruptured intracranial aneurysms in the detection object according to the medical image of the detection object. If it is judged to be large and / or giant, execute S102;

[0009] S102: Measuring the mean arterial pressure M1 of the parent artery, inserting the microcatheter into the aneurysm cavity, connecting the microcatheter to an invasive arterial pressure monitoring sensor; measuring the mean arterial pressure P1 in the aneurysm cavity after the microcatheter is inserted;

[0010] S103: Place the fenestrated stent at the intracranial artery and cover the aneurysm neck, and measure the mean arterial pressure M2 of the parent artery and the mean arterial pressure P2 in the aneurysm cavity respectively;

[0011] S104: Fill the aneurysm cavity with coils, and measure the mean arterial pressure M3 of the parent artery and the mean arterial pressure P3 in the aneurysm cavity after coil filling respectively;

[0012] S105: According to the results in S102 / S103 / S104, obtain the change curve of the intracranial blood pressure value of the detection object.

[0013] Preferably, when measuring the mean arterial pressure, record the change of the mean arterial pressure once every 30 seconds, and record it 10 times in total.

[0014] Preferably, before the steps S102, S103 and S104, place the patient in the supine position, puncture the bilateral femoral arteries, insert the arterial sheath into the right femoral artery, advance the guiding catheter through the arterial sheath to the C5 segment of the intracranial artery, and insert the fenestrated stent catheter into the ipsilateral middle cerebral artery.

[0015] Preferably, place a microcatheter in the left femoral artery, insert the microcatheter into the aneurysm cavity, and connect the microcatheter to an invasive arterial pressure monitoring sensor.

[0016] Preferably, the arterial sheath is an 8F catheter.

[0017] Preferably, the guiding catheter is a 6F catheter.

[0018] Preferably, the microcatheter is inserted into the aneurysm cavity through a 5F catheter.

[0019] Preferably, the stent catheter is used to place a fenestrated stent, and the fenestrated stent is a flexible stent of 4.0mm*30mm.

[0020] Preferably, the coil is made of a metal wire and is helical.

[0021] Preferably, after the monitoring is completed, withdraw the microcatheter and the invasive arterial pressure monitoring sensor out of the body, and compress the puncture site to stop bleeding.

[0022] Beneficial effects:

[0023] (1) In the present invention, a microcatheter for monitoring blood pressure is placed into the aneurysm cavity to measure the mean arterial pressure (MAP) of the aneurysm cavity and the intracranial artery after the microcatheter is placed, the mean arterial pressure (MAP) after coil packing, and the mean arterial pressure (MAP) at the neck of the aneurysm after the placement of the flow-diverter stent. According to the measurement results, the blood pressure change of the intracranial aneurysm in the subject sample after treatment is obtained. By directly measuring through the microcatheter extending into the measurement position, the patient and the doctor can directly obtain the change of the blood pressure value, which is more intuitive and has better data accuracy.

[0024] (2) In the present invention, bilateral femoral artery puncture is adopted, and the flow-diverter stent microcatheter and the coil microcatheter are delivered through different side channels, reducing the mutual interference between the instruments and the operation difficulty of the surgery. BRIEF DESCRIPTION OF THE DRAWINGS

[0025] The accompanying drawings forming a part of this application are used to provide a further understanding of the present invention. The schematic embodiments and descriptions thereof of the present invention are used to explain the present invention and do not constitute an improper limitation to the present invention. Among them:

[0026] Figure 1 The step flow chart of a method for detecting blood pressure in intracranial blood vessels of the present invention;

[0027] Figure 2 The curve graph of the change of the mean arterial pressure in the aneurysm cavity of the present invention;

[0028] Figure 3 The curve graph of the change of the mean arterial pressure of the parent artery carrying the aneurysm of the present invention. DETAILED DESCRIPTION OF THE EMBODIMENTS

[0029] The technical solutions in the embodiments of the present invention will be clearly and completely described below. Obviously, the described embodiments are only a part of the embodiments of the present invention, rather than all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those of ordinary skill in the art belong to the scope of protection of the present invention.

[0030] In the description of the present invention, it should be understood that the orientation or positional relationship involved, such as up, down, front, back, left, right, etc., indicates the orientation or positional relationship based on the orientation or positional relationship shown in the drawings, and is only for the convenience of describing the present invention and simplifying the description, rather than indicating or implying that the device or element referred to must have a specific orientation, be constructed and operated in a specific orientation, and therefore should not be construed as a limitation to the present invention.

[0031] In the description of the present invention, the meaning of "several" is one or more, the meaning of "multiple" is more than two, and understandings such as "greater than", "less than", "exceeding", etc. do not include the corresponding number, and understandings such as "above", "below", "within", etc. include the corresponding number. If there is a description of "first" and "second", it is only for the purpose of distinguishing technical features and cannot be understood as indicating or implying relative importance or implicitly indicating the quantity of the indicated technical features or implicitly indicating the sequence relationship of the indicated technical features.

[0032] In addition, the terms "first" and "second" are only used for descriptive purposes and cannot be understood as indicating or implying relative importance or implicitly indicating the quantity of the indicated technical features. Thus, the features defined with "first" and "second" may explicitly or implicitly include one or more features.

[0033] In the description of the present invention, it should be noted that unless otherwise clearly defined and limited, the term "connection" should be understood in a broad sense. For example, it can be a fixed connection or a movable connection, or a detachable connection or a non-detachable connection, or an integral connection; it can be a mechanical connection, an electrical connection or a connection capable of mutual communication; it can be directly connected or indirectly connected through an intermediate medium, and can be the communication inside two components, indirect communication or the interaction relationship between two components.

[0034] In the description of the present invention, the "distal end" refers to the end farther from the doctor during the operation, and the "proximal end" refers to the end closer to the doctor during the operation.

[0035] In the description of the present invention, the "in-vivo environment" refers to the environment below the epidermis of the skin where body fluids exist, such as the dermis layer and subcutaneous tissue, or inside blood vessels, organs, etc.

[0036] The present invention will be described in detail below with reference to embodiments. It should be noted that, without conflict, the embodiments in the present invention and the features in the embodiments can be combined with each other.

[0037] The present invention aims at the problem that in the prior art, the blood flow in an aneurysm is often turbulent, its blood pressure change is complex, and it may be difficult to be manifested in the blood pressure measured by a sphygmomanometer, resulting in the risk of aneurysm rupture after surgery not being detected.

[0038] The present invention provides an intracranial blood vessel blood pressure detection method. Refer to Figure 1 、 Figure 2 and Figure 3 , S101: Judge the volume of the unruptured intracranial aneurysm in the detection object according to the medical image picture of the detection object. If it is judged to be large and / or huge, execute S102;

[0039] S102: Measure the mean arterial pressure M1 of the parent artery, insert a microcatheter into the aneurysm cavity, and connect the microcatheter to an invasive arterial pressure monitoring sensor; measure the mean arterial pressure P1 in the aneurysm cavity after the microcatheter is inserted.

[0040] S103: Place a flow-diverting stent at the intracranial artery and cover the aneurysm neck, and measure the mean arterial pressure M2 of the parent artery and the mean arterial pressure P2 in the aneurysm cavity respectively.

[0041] S104: Embolize the aneurysm cavity with coils, and measure the mean arterial pressure M3 of the parent artery and the mean arterial pressure P3 in the aneurysm cavity after coil embolization respectively.

[0042] S105: According to the results in S102 / S103 / S104, obtain the change curve of the intracranial vascular blood pressure value of the detection object, as Figure 2 and Figure 3 shown.

[0043] More specifically, when judging the volume of a cranial aneurysm, the judgment criteria are as follows: an aneurysm with a diameter less than 5 mm is a small aneurysm, an aneurysm with a diameter of 5 mm - 10 mm is a medium-sized aneurysm, an aneurysm with a diameter of 11 mm - 25 mm is a large aneurysm, and an aneurysm with a diameter greater than 25 mm is a giant aneurysm. The method of the present invention mainly targets large aneurysms and giant aneurysms with a diameter of more than 10 mm.

[0044] After the microcatheter is inserted into the aneurysm cavity, since the invasive arterial pressure monitoring sensor is connected to the microcatheter, the blood pressure in the aneurysm cavity is applied to the tip of the microcatheter and transmitted to the sensor through the microcatheter. The sensor measures the blood pressure at the tip of the microcatheter, which is the real-time blood pressure in the cranial aneurysm. During the measurement, the arterial blood pressure changes are monitored 10 times at intervals of 30 seconds.

[0045] When measuring the intracranial arterial pressure, since the intracranial arterial pressure is consistent with the blood pressure data in other parts, a real-time blood pressure measurement method is used to monitor the intracranial arterial pressure. During the measurement, the arterial blood pressure changes are also monitored 10 times at intervals of 30 seconds.

[0046] By measuring the mean arterial pressure (MAP) in the aneurysm cavity after the microcatheter is inserted, it is possible to assist in judging the change in blood pressure value after the microcatheter is inserted.

[0047] After filling the affected area of the subject sample with coils, the mean arterial pressure (MAP) of the cranial aneurysm after coil filling can be measured through the microcatheter. It should be noted that during the measurement, the arterial blood pressure changes are also monitored 10 times at intervals of 30 seconds.

[0048] According to the results of the above measurements, a table of the blood pressure changes of the intracranial aneurysm in the subject sample after treatment is obtained to compare and understand the changes in blood pressure values. Patients and doctors can directly understand the changes in blood pressure values through comparison. By observing the changes in MAP before and after treatment, they can further realize the importance of blood pressure management.

[0049] At the same time, for the aneurysm neck, due to the complex hemodynamic structure of the aneurysm opening, in the above steps, after the coil is filled into the aneurysm neck, the microcatheter will move towards the aneurysm neck until it exits the aneurysm cavity. By inserting the microcatheter into the aneurysm cavity, the MAP data of the aneurysm neck can be directly obtained, which is more intuitive and has a small result deviation.

[0050] In the preferred embodiment of the present invention, in S102 / S103 / S104, during detection, the change in MAP is recorded once every 30 seconds for a total of 10 times; by collecting multiple groups of data over 5 minutes, the data accuracy is improved.

[0051] In the preferred embodiment of the present invention, before the steps S102, S103, and S104, after endotracheal intubation and general anesthesia induction, the patient is placed in the supine position, bilateral femoral arteries are punctured, an arterial sheath is inserted into the right femoral artery, a guiding catheter is advanced through the arterial sheath to the C5 segment of the internal carotid artery, and a stent catheter is inserted into the ipsilateral middle cerebral artery for later use.

[0052] By using bilateral femoral artery puncture, the mutual interference during the instrument placement process is reduced, and the difficulty of instrument placement is lowered. After the guiding catheter is in place, the coil can be placed into the aneurysm cavity through the microcatheter to fill the aneurysm to prevent the aneurysm from rupturing.

[0053] In the preferred embodiment of the present invention, a microcatheter is placed on the left side, the microcatheter is inserted into the aneurysm cavity, and the microcatheter is connected to an invasive arterial pressure monitoring sensor. The microcatheter, arterial sheath, and dense mesh stent are located in blood vessels on different sides, reducing the mutual interference between the instruments.

[0054] Further, the arterial sheath uses an 8F catheter. Preferably, the 8F catheter uses a Cordis catheter from Santa Clara, California.

[0055] In the present invention, the guiding catheter uses a 6F catheter. Preferably, the 6F catheter uses a Navien catheter (Medtronic Neurovascular, USA).

[0056] In the preferred embodiment of the present invention, the microcatheter is inserted into the aneurysm cavity through a 5F catheter. Preferably, the 5F catheter uses a Cordis catheter from Santa Clara, California.

[0057] Specifically, the stent-graft is a flexible stent with a size of 4.0mm * 30mm. The stent-graft is woven from nitinol wires and is provided with a plurality of mesh openings. The stent-graft has a shape memory function. After being released into the intracranial artery, it automatically bulges and adheres tightly to the blood vessel wall, covering the neck of the aneurysm.

[0058] In a preferred embodiment of the present invention, the coil is wound from a metal wire and is helical. The coil is preferably made of platinum, which has good biocompatibility and radiopacity and can be clearly visualized under a radiological device, facilitating understanding whether the aneurysm cavity is filled with coils.

[0059] The following provides a detailed description of a method for detecting intracranial blood vessel blood pressure according to the present invention through specific embodiments.

[0060] Embodiment 1

[0061] This embodiment provides a method for detecting intracranial blood vessel blood pressure, referring to Figure 1 、 Figure 2 and Figure 3 , including S101: Judging the volume of the unruptured intracranial aneurysm in the subject sample. If the judgment is large and / or giant, execute S102; an aneurysm with a diameter of 11 - 25mm is judged as a large aneurysm, and an aneurysm with a diameter greater than 25mm is judged as a giant aneurysm.

[0062] S102: Measuring the mean arterial pressure M1 of the parent artery. Insert a microcatheter into the aneurysm cavity, and connect the microcatheter to an invasive arterial pressure monitoring sensor; measure the mean arterial pressure P1 in the aneurysm cavity after the microcatheter is inserted; specifically, after puncturing the left femoral artery, the microcatheter is sent into the blood vessel and inserted into the aneurysm cavity, and the MAP (mean arterial pressure) P1 in the aneurysm cavity after the microcatheter is inserted is measured; during the measurement, the arterial blood pressure changes are monitored 10 times at intervals of 30 seconds.

[0063] S103: Placing the stent-graft at the intracranial artery and covering the neck of the aneurysm. Specifically, the stent-graft is laser engraved or woven from nitinol wires. In the natural state, the stent-graft is a flexible stent with a size of 4.0mm * 30mm. Measure the mean arterial pressure M2 of the parent artery and the mean arterial pressure P2 in the aneurysm cavity respectively.

[0064] S104: Filling the aneurysm cavity with coils, and measuring the mean arterial pressure M3 of the parent artery and the mean arterial pressure P3 in the aneurysm cavity respectively after the coil filling; after the coil filling, the microcatheter is extruded by the coils and located at the neck of the aneurysm. At this time, the microcatheter is used to measure the mean arterial pressure at the neck of the aneurysm.

[0065] S105: According to the results in S102 / S103 / S104, obtain the blood pressure value change curve and table of the intracranial blood vessels of the detection object.

[0066] The tabular data of M1, M2, M3 and P1, P2, P3 are as follows:

[0067]

[0068] Measurement result table of M1, M2 and M3

[0069]

[0070]

[0071] Measurement result table of P1, P2 and P3

[0072] After the monitoring is completed, the microcatheter and the invasive arterial pressure monitoring sensor are withdrawn from the body, and the puncture site is compressed to stop bleeding.

[0073] In summary, in the present invention, through bilateral femoral artery punctures, a microcatheter for blood pressure monitoring is placed into the aneurysm cavity, and the mean arterial pressure (MAP) of the aneurysm cavity and the intracranial artery after placement, the mean arterial pressure (MAP) after coil packing, and the mean arterial pressure (MAP) at the aneurysm neck after the placement of the flow-diverter stent are measured. According to the results of the above measurements, the blood pressure changes of the intracranial aneurysm in the subject sample after treatment are obtained. By directly measuring through the microcatheter extending into the measurement position, the patient and the doctor can directly obtain the change of the blood pressure value, which is more intuitive and the data accuracy is better.

[0074] The above are only the preferred embodiments of the present invention and are not used to limit the present invention. For those skilled in the art, the present invention can have various modifications and changes. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of the present invention shall be included within the protection scope of the present invention.

Claims

1. A method for detecting intracranial blood pressure, characterized in that: include: S101: Determine the volume of an unruptured intracranial aneurysm of the subject according to the medical image of the subject, and if it is determined to be large and / or huge, execute S102; S102: measuring the mean arterial pressure M1 of the parent artery, inserting a microcatheter into the aneurysm cavity, and connecting the microcatheter to an invasive arterial pressure monitoring sensor; The mean arterial pressure P1 in the aneurysm cavity was measured after microcatheter placement; S103: Place the dense mesh stent in the intracranial artery and cover the neck of the aneurysm, and measure the mean arterial pressure M2 of the parent artery and the mean arterial pressure P2 in the aneurysm cavity; S104: filling the aneurysm cavity with a coil, and measuring the mean arterial pressure M3 of the parent artery and the mean arterial pressure P3 of the aneurysm cavity after coil filling; S105: According to the results of S102 / S103 / S104, a blood pressure change curve of the intracranial blood vessels of the detected object is obtained.

2. A method for detecting intracranial blood pressure according to claim 1, characterized in that: When measuring mean arterial pressure, record the change in mean arterial pressure once every 30 seconds for a total of 10 times.

3. The method for detecting intracranial blood pressure according to claim 1, characterized in that: Before steps S102, S103 and S104, the patient is placed in a supine position, bilateral femoral arteries are punctured, an arterial sheath is inserted into the right femoral artery, a guide catheter is advanced through the arterial sheath to the C5 segment of the intracranial artery, and a dense mesh stent catheter is inserted into the ipsilateral middle cerebral artery.

4. The method for detecting intracranial blood pressure according to claim 3, characterized in that: A microcatheter was placed in the left femoral artery and inserted into the aneurysm cavity. The microcatheter was connected to an invasive arterial pressure monitoring sensor.

5. The method for detecting intracranial blood pressure according to claim 3, characterized in that: The arterial sheath tube adopts 8F catheter.

6. A method for detecting intracranial blood pressure according to claim 5, characterized in that: The guide catheter adopts a 6F catheter.

7. A method for detecting intracranial blood pressure according to claim 6, characterized in that: The microcatheter is inserted into the aneurysm cavity through a 5F catheter.

8. The method for detecting intracranial blood pressure according to claim 3, characterized in that: The stent catheter is used for placing a dense mesh stent, and the dense mesh stent is a flexible stent of 4.0 mm*30 mm.

9. A method for detecting intracranial blood pressure according to any one of claims 1 to 8, characterized in that: The spring coil is wound by metal wire and is in a spiral shape.

10. A method for detecting intracranial blood pressure according to any one of claims 1 to 8, characterized in that: After the test, the microcatheter and invasive arterial pressure monitoring sensor were removed from the body, and pressure was applied to the puncture site to stop bleeding.

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