Coronary sinus constriction system and delivery device thereof

Abstract

The utility model provides a coronary sinus constriction system and a conveying device thereof, the conveying device comprises a line and a conveying mechanism, the line is used for penetrating and winding on a near-end opening along the circumferential direction of the near-end opening of the coronary sinus constriction device, and the conveying mechanism is connected with the line; the conveying mechanism can control the line to be separated from the near-end opening, or the conveying mechanism is controlled to be separated from the line, or the conveying mechanism is provided with a first catheter, the first catheter is provided with a first hollow channel, and the two ends of the line penetrate into the first hollow channel from the far end of the first catheter and penetrate out of the first hollow channel from the near end of the first catheter; the wire is separated from the proximal opening. The coronary sinus constriction system comprises the conveying device, and the conveying device can load, convey, recycle and release the coronary sinus constriction device.

Description

Technical Field

[0001] This utility model relates to the field of medical device technology, specifically to a delivery device and a coronary sinus constriction system equipped with the delivery device. Background Technology

[0002] Angina pectoris is a clinical syndrome characterized by paroxysmal chest pain or discomfort, caused by insufficient blood supply to the coronary arteries and acute, temporary ischemia and hypoxia of the myocardium. Traditional treatments include drug therapy, interventional therapy, and surgical bypass surgery. However, some patients still face the dilemma of recurrent and difficult-to-control angina pectoris after treatment. Clinically, chronic angina-type chest pain (lasting for more than 3 months) with reversible ischemia despite adequate treatment is called refractory angina (RA), which severely affects the quality of life of patients.

[0003] In recent years, coronary sinus reducers (CSRs) have emerged as a novel treatment option to improve myocardial perfusion and thus alleviate angina symptoms. Their feasibility, safety, and effectiveness have been continuously confirmed, providing a new treatment choice for patients with refractory angina. A CSR is an hourglass-shaped stent implanted in the coronary sinus via minimally invasive interventional surgery. The narrowed segment in the middle of the stent alters the blood flow pressure in the coronary sinus, diverting blood from areas of higher myocardial perfusion to areas of lower perfusion, thereby reducing angina.

[0004] During coronary sinus narrowing device implantation, a delivery device is used to transport the device to the predetermined dilation position. The delivery device is then withdrawn, and the device is then dilated by a balloon or self-dilated and anchored to the vessel wall. The placement of the coronary sinus narrowing device has specific requirements, generally located 1-2 cm distal to the coronary sinus ostium. If improper operation or other reasons occur, the device may shift during or immediately after delivery, causing the final implantation position to deviate from the intended location. In such cases, retrieval and adjustment of the coronary sinus narrowing device are necessary. However, most coronary sinus stenosis devices cannot be adjusted or retrieved after being inserted through the delivery catheter. Only a small number of coronary sinus stenosis devices have a nut or similar connector at their proximal end for connection to the delivery device, allowing for adjustment and retrieval. However, since coronary sinus stenosis devices are very small, adding a nut or similar connector would increase their size. To accommodate such a connector, a larger diameter delivery sheath would be required. Furthermore, the connector would remain in the body after the coronary sinus stenosis device is implanted, potentially leading to complications. Summary of the Invention

[0005] To address the aforementioned problems, the main objective of this invention is to provide a delivery device capable of loading, transporting, retrieving, and releasing a coronary sinus constriction device.

[0006] Another objective of this invention is to provide a coronary sinus constriction system equipped with the aforementioned delivery device.

[0007] To achieve the main objective of this utility model, this utility model provides a delivery device, which includes a wire and a delivery mechanism. The wire is used to circumferentially wrap around the proximal opening of the coronary sinus constriction device. The delivery mechanism is connected to the wire. The delivery mechanism can control the separation of the wire from the proximal opening, or the delivery mechanism can be controlled to separate from the wire. Alternatively, the delivery mechanism has a first catheter with a first hollow channel. Both ends of the wire enter the first hollow channel from the distal end of the first catheter and exit the first hollow channel from the proximal end of the first catheter. When either end of the wire is pulled, the wire separates from the proximal opening.

[0008] As can be seen from the above, the suture delivery mechanism, guided by the sheath, can deliver the coronary sinus narrowing device to the preset implantation position. Since the suture is wound around the proximal opening of the coronary sinus narrowing device, when it is necessary to adjust the implantation position of the coronary sinus narrowing device, the delivery mechanism or the suture itself can first pull the proximal opening of the suture to contract and retract it into the sheath, and then the coronary sinus narrowing device can be repositioned to adjust the implantation position of the coronary sinus narrowing device, thereby ensuring the accurate implantation position of the coronary sinus narrowing device. Furthermore, once the coronary sinus constriction device is accurately implanted, the delivery mechanism can control the separation of the suture from the device, allowing the suture to be withdrawn from the patient's body along with the delivery mechanism and sheath; or it can control the separation of the delivery mechanism from the suture, leaving the suture inside the patient's body. In this case, because the suture is much smaller than the nuts or other connectors in existing coronary sinus constriction devices, and even thinner than the frame of the device, the suture will not affect the patient's health; or the surgeon can manually pull one end of the suture to separate it from the device, thus withdrawing the suture from the patient's body.

[0009] A preferred embodiment is that, when the conveying mechanism can control the separation of the wire from the proximal opening: the wire has a winding section, a locking section, and an unlocking section. The winding section is wound around the proximal opening and is located between the locking section and the unlocking section. The locking section and the unlocking section are intertwined to form a first knot, which is a slip knot. The conveying mechanism includes a second conduit and a first pull rod. The second conduit has a second hollow channel. The second conduit is provided with a first limiting part at the distal end of the second hollow channel. The first pull rod is movably inserted into the second hollow channel. The distal end of the first pull rod can form a first clamping position with the first limiting part. The winding section and / or the locking section can be clamped and fixed in the first clamping position. The unlocking section is connected to the distal end of the first pull rod, and the proximal end of the first pull rod is located outside the second conduit.

[0010] As can be seen from the above, the coronary sinus constriction device can be delivered or its position adjusted by clamping and fixing the thread through the winding section and / or locking section of the delivery mechanism. When it is necessary to release the coronary sinus constriction device, as the first pull rod is pulled towards the proximal end of the second catheter, the delivery mechanism releases the clamping and fixing of the thread. At the same time, the first pull rod will pull the unlocking section of the thread, causing the slipknot to open, thereby allowing the thread to detach from the coronary sinus constriction device and be withdrawn from the patient's body along with the delivery mechanism.

[0011] A further embodiment is that the first limiting part has a connecting section, a supporting section and a limiting section. The connecting section extends along the first extension direction of the second conduit. The supporting section extends from the protruding end of the connecting section. The supporting section and the connecting section are bent. A first clamping position can be formed between the supporting section and the distal end of the first pull rod. The limiting section extends from the protruding end of the supporting section toward the body of the second conduit in the first extension direction. An avoidance opening is formed between the limiting section and the body.

[0012] As can be seen from the above, the cooperation between the support section and the first tie rod can reliably clamp and fix the wire winding section and / or locking section to prevent the wire from separating from the delivery mechanism during the delivery or position adjustment of the coronary sinus constriction device, thereby ensuring the reliability of the operation of the coronary sinus constriction device delivery and position adjustment; the limiting section can limit the wire to better prevent the wire from detaching from the delivery mechanism.

[0013] A further proposed solution is that the unlocking section is provided with a first connecting part, and the far end of the first pull rod is provided with a second connecting part, and the first connecting part and the second connecting part are detachably connected.

[0014] As can be seen from the above, this design can improve the reliability and strength of the connection between the unlocking section and the first pull rod, while also enabling the conveying mechanism to be reused and reducing the cost of use.

[0015] Another preferred embodiment is that, when the conveying mechanism is controllably separable from the line, the conveying mechanism includes a third conduit, a locking slider, and a second pull rod. The third conduit has a third hollow channel, and the wall at the distal end of the third conduit is provided with a guide hole communicating with the third hollow channel. The locking slider has a sliding insertion part and a pushing part. The sliding insertion part passes through the guide hole and has a relief groove and a perforation that penetrate itself in the second extension direction of the third conduit. The two ends of the line are intertwined to form a second knot. The second knot passes through the perforation from the distal end side of the perforation. The line is located outside the third conduit, and the pushing part is located inside the third hollow channel. The second pull rod is movably inserted into the third hollow channel and passes through the relief groove. The distal end of the second pull rod is provided with a driving block. The proximal end of the second pull rod is located outside the third conduit, and the driving block is located at the distal end side of the pushing part. The driving block can move towards the proximal end of the third conduit and drive the pushing part to move the sliding insertion part into the third hollow channel, so that the perforation and the outer wall of the third conduit form a second clamping position to clamp the line.

[0016] As can be seen from the above, when delivering or adjusting the position of the coronary sinus constriction device, the second pull rod controls the locking slider to move into the third hollow channel through the drive block, thereby clamping and fixing the end of the wire in the second clamping position. Due to the presence of the second knot, the wire can be effectively prevented from coming out of the second clamping position. When it is necessary to release the coronary sinus constriction device, the second pull rod controls the drive block to contact the restriction on the locking slider, so that the locking slider moves out of the third catheter under its own weight. At this time, the gap of the perforation outside the third catheter becomes larger until it is larger than the second knot. Then, when the delivery mechanism is withdrawn, the second knot moves from the proximal side to the distal side of the sliding part to dislodge from the perforation, thereby leaving the wire in the patient's body along with the coronary sinus constriction device.

[0017] A further embodiment is that the pushed portion extends from the sliding insertion portion to the distal end of the third conduit in the second extension direction, and the extended end of the pushed portion has a second limiting portion protruding toward the second pull rod, and the second limiting portion has a first guide surface; the end of the drive block near the pushed portion has a second guide surface, and the second guide surface can cooperate with the first guide surface.

[0018] As can be seen from the above, this design enables the drive block to better control the movement of the pushed part, and also enables the pushed part to limit the drive block to a certain extent under the action of the limiting part, thereby reducing the risk of the line separating from the delivery mechanism during the delivery and position adjustment of the coronary sinus constriction device.

[0019] A further option is to make the thread from a biodegradable material; or to make the thread from a non-biodegradable material with a hemophobic coating on the surface.

[0020] As can be seen from the above, using biodegradable materials to make the sutures allows them to be degraded and absorbed after the operation, thus ensuring the patient's postoperative safety; while if the sutures are made of non-biodegradable materials, a hemophobic coating can be applied to the surface of the sutures to prevent thrombosis, which can also ensure the patient's postoperative safety.

[0021] Another preferred embodiment is that when the delivery mechanism has a first conduit: the line has a rigid portion and a flexible portion, a portion of which is wrapped around the proximal opening.

[0022] As can be seen from the above, the rigid part of the wire makes it easier for the wire to pass through the first catheter, while the flexible part of the wire makes it easier for the wire to be wrapped around the proximal opening of the coronary sinus narrowing device, and makes the wire easier to remove from the proximal opening, so as to prevent the implantation position of the coronary sinus narrowing device from shifting.

[0023] A further option is to use an expander or steel cable as the conveying mechanism.

[0024] As can be seen from the above, when the delivery mechanism uses an expander, the surgical cost is also reduced more effectively.

[0025] To achieve another objective of this utility model, this utility model provides a coronary sinus constriction system, including a sheath and a coronary sinus constriction device, wherein the system further includes the aforementioned delivery device, with a line passing around the proximal opening of the coronary sinus constriction device circumferentially, and the delivery device delivering the coronary sinus constriction device via the sheath.

[0026] As can be seen from the above, the coronary sinus constriction system, by employing the aforementioned delivery device, enables the adjustment of the implantation position of the coronary sinus constriction device, thereby ensuring accurate implantation, improving treatment efficacy, and reducing the incidence of postoperative complications. Attached Figure Description

[0027] Figure 1 This is a schematic diagram showing the usage status of the first embodiment of the coronary sinus narrowing system of this utility model.

[0028] Figure 2 This is a schematic diagram of the delivery device of the first embodiment of the coronary sinus constriction system of this utility model.

[0029] Figure 3 This is an exploded view of the delivery device of the first embodiment of the coronary sinus constriction system of this utility model.

[0030] Figure 4 This is a reference schematic diagram of the first usage state of the second embodiment of the coronary sinus narrowing system of this utility model.

[0031] Figure 5 This is a reference schematic diagram of the second usage state of the second embodiment of the coronary sinus narrowing system of this utility model.

[0032] Figure 6 This is a reference schematic diagram of the first usage state of the third embodiment of the coronary sinus narrowing system of this utility model.

[0033] Figure 7 This is a reference diagram of the second usage state of the third embodiment of the coronary sinus constriction system of this utility model, with some components omitted.

[0034] Figure 8 This is a schematic diagram of the locking slider in the third embodiment of the coronary sinus constriction system of this utility model.

[0035] The present invention will be further described below with reference to the accompanying drawings and embodiments. Detailed Implementation

[0036] To make the objectives, advantages, and features of this invention clearer, the invention will be further described in detail below with reference to the accompanying drawings and specific embodiments. It should be noted that the drawings are all in a very simplified form and are not drawn to scale, and are only used to facilitate and clarify the explanation of the embodiments of this invention. Furthermore, the structures shown in the drawings are often part of the actual structures. In particular, different figures may emphasize different aspects and may sometimes use different scales.

[0037] In this invention, the terms "one end" and "the other end," as well as "proximal end" and "distal end," generally refer to two corresponding parts, including not only the endpoints. The terms "proximal end" and "distal end" are defined herein with respect to a delivery device having one end for insertion into the human body and a control end extending outside the body. The term "proximal end" refers to the position of the element closer to the control end extending outside the body of the delivery device, and the term "distal end" refers to the position of the element closer to the insertion end of the delivery device into the human body and therefore further away from the control end of the delivery device. Optionally, in manual or hand-operated applications, the terms "proximal end" and "distal end" are defined herein with respect to the operator, such as a surgeon or clinician. The term "proximal end" refers to the position of the element closer to the operator, and the term "distal end" refers to the position of the element closer to the delivery device and therefore further away from the operator. The proximal end is shown as end A in the accompanying drawings, and the distal end is shown as end B in the accompanying drawings.

[0038] First embodiment of the coronary sinus constriction system

[0039] Reference Figure 1 The coronary sinus constriction system 100 includes a coronary sinus constriction device 1, a delivery device 2, and a sheath 3, etc.

[0040] The coronary sinus constriction device 1 is roughly hourglass-shaped. Specifically, it includes a proximal support segment 11, a distal support segment 12, and a constriction segment 13. The constriction segment 13 connects the proximal support segment 11 and the distal support segment 12. When the coronary sinus constriction device 1 is pushed out of the sheath 3, it expands and unfolds, with the proximal support segment 11 and the distal support segment 12 adhering to and fixing to the vessel wall to prevent displacement. The function of the constriction segment 13 is to narrow the coronary sinus blood flow channel and control the blood flow at that point. Based on the conical anatomy of the coronary sinus, the coronary sinus constriction device 1 is generally hourglass-shaped, with large ends and a small middle. The narrow passage of the narrowing segment 13 of the coronary sinus constriction device 1 achieves local narrowing of the coronary sinus, increases the pressure of the venous sinus, reduces the amount of blood pumped out of the coronary venous sinus of the heart, redistributes blood flow, and increases the proportion of blood supplied to the ventricular wall, thereby relieving angina symptoms caused by insufficient coronary blood supply.

[0041] The coronary sinus narrowing device 1 is a porous tubular channel with a certain amount of compression and expansion space, thus it can be inserted into the sheath 3 used in interventional surgery. Depending on the material used, the coronary sinus narrowing device 1 can expand on its own or be expanded to the required size using other instruments after being transported to the target location. In some embodiments, the coronary sinus narrowing device 1 is made of nickel-titanium wire woven using techniques familiar to the art; in other embodiments, the coronary sinus narrowing device 1 can also be cut from nickel-titanium tubing; in some embodiments, the coronary sinus narrowing device 1 can also be made from other metals or polymers with good resilience through weaving or cutting.

[0042] Combination Figure 2 and Figure 3 The delivery device 2 includes a wire 21 and a delivery mechanism 22, which are connected. When the wire 21 is connected to the coronary sinus constriction device 1, the wire 21 is circumferentially wound around the proximal opening of the proximal support segment 11 of the coronary sinus constriction device 1 (which can be understood as the edge of the opening of the proximal support segment 11 away from the constriction segment 13). Since the coronary sinus constriction device 1 is a porous lumen channel, the wire 21 can be wound around the proximal opening of the proximal support segment 11 in a serpentine manner. For example, it can pass through a hole from the outer wall of the proximal opening to the inner wall of the proximal opening, and then through another hole to the outer wall of the proximal opening. This cycle continues until the wire 21 has basically wound around the proximal opening once. It is understandable that line 21 can either pass through the hole from the outer wall of the proximal opening to the inner wall of the proximal opening, or pass through the hole from the inner wall of the proximal opening to the outer wall of the proximal opening; similarly, line 21 can ultimately pass through the hole from the inner wall of the proximal opening to the outer wall of the proximal opening, or pass through the hole from the outer wall of the proximal opening to the inner wall of the proximal opening.

[0043] In this embodiment, the thread 21 is flexible, allowing it to be bent and knotted; and the conveying mechanism 22 can control the separation of the thread 21 from the proximal opening of the proximal support section 11 of the coronary sinus constriction device 1. After the thread 21 has basically wrapped around the proximal opening of the proximal support section 11, the two ends of the thread 21 converge and intertwine to form a first knot 214, which is a slip knot. Specifically, the wire 21 has a winding section 211, a locking section 212, and an unlocking section 213. The winding section 211 is located between the locking section 212 and the unlocking section 213. The winding section 211 is connected to the proximal support section 11 of the coronary sinus constriction device 1, that is, the winding section 211 is wound around the proximal opening of the proximal support section 11. The locking section 212 and the unlocking section 213 are intertwined to form the first knot 214. Through the first knot 214, the first knot 214 cannot be untied when the winding section 211 and the locking section 212 of the wire 21 are pulled. However, the first knot 214 can be untied when the unlocking section 213 is pulled. Then, by continuously pulling the unlocking section 213, the winding section 211 and the locking section 212 are separated from the proximal support section 11, that is, the wire 21 is removed from the coronary sinus constriction device 1. At this time, the coronary sinus constriction device 1 can be released. It should be noted that there are no restrictions on the way the slip knot is tied, as long as the method meets the above requirements. All kinds of slip knot tying methods are conventional technical means for those skilled in the art, so no examples will be given here. In addition, after the line 21 is wrapped around the near-end support section 11, it has a certain amount of room for movement in the circumference of the near-end support section 11, that is, the wrapping of the line 21 and the near-end support section 11 is not completely fixed.

[0044] The conveying mechanism 22 includes a second conduit 221 and a first pull rod 222. The second conduit 221 may be made of steel cable. The second conduit 221 has a second hollow channel 2211, and the second conduit 221 is provided with a first limiting part 2212 at the distal end of the second hollow channel 2211.

[0045] The first pull rod 222 is movably inserted into the second hollow channel 2211, allowing the first pull rod 222 to move relative to the second catheter 221 in the first extension direction. The distal end of the first pull rod 222 can extend beyond the distal end of the second hollow channel 2211, forming a first clamping position with the first limiting part 2212. This first clamping position is used to clamp and fix the winding section 211 and / or locking section 212 of the wire 21, so that the delivery mechanism 22 can control the proximal support section 11 of the coronary sinus narrowing device 1 to contract and deform through the wire 21 and retract the coronary sinus narrowing device 1 into the sheath 3. This facilitates the adjustment and repositioning of the implantation position of the coronary sinus narrowing device 1, ensuring the accurate implantation position of the released coronary sinus narrowing device 1 and guaranteeing the treatment effect.

[0046] In some embodiments, the first limiting portion 2212 has a connecting section 22121, a supporting section 22122, and a limiting section 22123. The connecting section 22121 extends from the body of the second catheter 221 to the distal end of the second catheter 221 in a first extending direction; the supporting section 22122 extends from the protruding end of the connecting section 22121, and the supporting section 22122 is bent relative to the connecting section 22121. Preferably, the supporting section 22122 is approximately perpendicular to the connecting section 22121 to better support and limit the winding section 211 and / or locking section 212 of the wire 21, and cooperates with the distal end of the first pull rod 222 to reliably clamp and fix the winding section 211 and / or locking section 212, preventing the wire 21 from colliding with the conveyor during the delivery or position adjustment of the coronary sinus constriction device 1. The separation of the structure 22 ensures the reliability of operations such as delivery and position adjustment of the coronary sinus constriction device 1. It can be understood that the first clamping position can be formed between the support section 22122 and the distal end of the first pull rod 222. The limiting section 22123 extends from the protruding end of the support section 22122 toward the body of the second catheter 221 in the first extension direction, and the limiting section 22123 forms a clearance opening 2210 with the body. The clearance opening 2210 is used for the winding section 211 and / or locking section 212 of the wire 21 to pass into the first clamping position. The limiting section 22123 can limit the wire 21 to further prevent the wire 21 from falling off the delivery mechanism 22.

[0047] The distal end of the first lever 222 is also used to connect with the unlocking section 213 of the line 21, so that when the coronary sinus constriction device 1 needs to be released, the first lever 222 is pulled towards the proximal end of the second catheter 221, so that the distal end of the first lever 222 and the support section 22122 of the first limiting part 2212 first release the clamping of the winding section 211 and locking section 212 of the line 21; as the distal end of the first lever 222 is continuously pulled towards the proximal end of the second catheter 221, the distal end of the first lever 222 will drive the unlocking section 213 to move towards the proximal end of the second catheter 221, thereby untying the first knot 214; as the distal end of the first lever 222 continues to be pulled towards the proximal end of the second catheter 221, the winding section 211 and locking section 212 of the line 21 are both disengaged from the connection of the proximal support section 11 of the coronary sinus constriction device 1, thereby realizing the synchronous withdrawal of the line 21 and the delivery mechanism 22 from the patient's body.

[0048] In some embodiments, the unlocking segment 213 is provided with a first connecting portion 2131, and correspondingly, the distal end of the first pull rod 222 is provided with a second connecting portion 2221, and the first connecting portion 2131 and the second connecting portion 2221 are detachably connected. This design can improve the reliability and firmness of the connection between the unlocking segment 213 and the first pull rod 222, while also allowing the conveying mechanism 22 to be reused, reducing operating costs. The detachable connection between the first connecting part 2131 and the second connecting part 2221 includes, but is not limited to, threaded connection, snap-fit ​​connection, and magnetic connection. For example, one of the first connecting part 2131 and the second connecting part 2221 can be a stud and the other can be a nut, with the stud and nut being threadedly connected. Another example is that one of the first connecting part 2131 and the second connecting part 2221 has a slot and the other has a snap-fit, with the slot and snap-fit ​​engaging. Yet another example is that the first connecting part 2131 has a first magnet and the second connecting part 2221 has a second magnet, with the first magnet and the second magnet generating an attractive magnetic force, causing the first connecting part 2131 and the second connecting part 2221 to connect together under the attractive magnetic force of the first magnet and the second magnet. It should be noted that the attractive magnetic force between the first magnet and the second magnet is greater than the pulling force required to separate the pulling wire 21 from the proximal support segment 11 of the coronary sinus constriction device 1.

[0049] The following is a brief description of the use of the coronary sinus constriction system 100 in this embodiment:

[0050] During the preoperative preparation stage, the suture 21 is threaded around the proximal opening of the proximal support segment 11 of the coronary sinus constriction device 1, and then the locking segment 212 and unlocking segment 213 of the suture 21 are tied to form the first knot 214.

[0051] Next, the first connecting part 2131 on the locking section 212 is connected to the second connecting part 2221 of the first pull rod 222, and the loop formed by the knot of the line 21 is placed into the first clamping position, so that the far end of the first pull rod 222 cooperates with the second connecting part 2221, the first connecting part 2131, and the support section 22122 of the first limiting part 2212 to clamp and fix the line 21.

[0052] Next, the femoral vein is percutaneously punctured, and the sheath 3 with the dilator is advanced along the guidewire to the intended site. Then, the guidewire and dilator are withdrawn.

[0053] The coronary sinus constriction device 1 and the delivery device 2 are inserted into the sheath 3 proximal to the sheath 3 via a loader, and the delivery device 2 is pushed towards the distal end of the sheath 3, causing the delivery device 2 to push the coronary sinus constriction device 1 into the sheath 3 and place it in the desired implantation position. At this time, the delivery mechanism 22 maintains the clamping and fixation of the wire 21. If the implantation position of the coronary sinus constriction device 1 needs to be adjusted, the entire delivery device 2 is pulled towards the proximal end of the sheath 3, causing the wire 21 to pull the proximal opening of the proximal support section 11 of the coronary sinus constriction device 1 to contract, so that the coronary sinus constriction device 1 can be retracted back into the sheath 3. Then, the position of the sheath 3 is readjusted, and the coronary sinus constriction device 1 is pushed out of the sheath 3 and placed in the desired implantation position again via the delivery device 2. If the implantation position of the coronary sinus constriction device 1 is still not ideal, the aforementioned adjustment operation is repeated until the implantation position of the coronary sinus constriction device 1 is ideal. It can be understood that, with the assistance of the delivery device 2, the coronary sinus constriction device 1 can be repeatedly retracted and repositioned.

[0054] When the coronary sinus constriction device 1 is inserted to the ideal implantation position, the first pull rod 222 is pulled towards the proximal end of the sheath 3, releasing the clamping fixation of the first pull rod 222 and the second catheter 221 on the suture 21. The first pull rod 222 then pulls the unlocking section 213 of the suture 21 until the first knot 214 is untied, and the suture 21 is released from the coronary sinus constriction device 1. This completes the implantation and release of the coronary sinus constriction device 1. Subsequently, the delivery device 2 and sheath 3 are withdrawn from the patient's body, while the suture 21 is withdrawn along with the delivery mechanism 22, instead of remaining in the patient's body with the coronary sinus constriction device 1, reducing the incidence of postoperative complications and postoperative risks. Furthermore, because the suture 21 is generally flexible, it is less likely to cause positional displacement of the coronary sinus constriction device 1 during separation.

[0055] In summary, the coronary sinus constriction system 100, through the design of the delivery device 2, enables the adjustment of the implantation position of the coronary sinus constriction device 1, thereby ensuring the accurate implantation position of the coronary sinus constriction device 1, improving the treatment effect, and reducing the incidence of postoperative complications.

[0056] Second embodiment of the coronary sinus constriction system

[0057] The difference between this embodiment and the first embodiment of the coronary sinus constriction system lies in the connection method of the wire itself, the connection method between the wire and the delivery mechanism, and the structure of the delivery structure. Specifically, in this embodiment:

[0058] Reference Figure 4 and Figure 5The delivery mechanism 42 has a first conduit 421, which has a first hollow channel 4211. Both ends of the wire 41 pass through the first hollow channel 4211 from the distal end of the first conduit 421 and exit from the proximal end of the first conduit 421. In some embodiments, the delivery mechanism 42 can be a steel cable, i.e., the first conduit 421 is a steel cable; in other embodiments, the delivery mechanism 42 can be an expander. When the delivery mechanism 42 is an expander, a steel cable is not needed during the procedure, thus saving costs. Using an expander as the delivery mechanism 42 is a preferred choice.

[0059] Furthermore, in this embodiment, the wire 41 has a rigid portion 411 and a flexible portion 412. It is understood that the rigid portion 411 has a higher stiffness than the flexible portion 412; therefore, the rigid portion 411 can be made of a rigid material. The flexible portion 412, due to its high flexibility, facilitates insertion into the proximal opening of the proximal support segment 431 of the coronary sinus constriction device 43. The flexible portion 412 also makes it easier for the wire 41 to disengage from the proximal opening of the proximal support segment 431, reducing the likelihood of displacement of the implantation position of the coronary sinus constriction device 43. The rigid portion 411 of the wire 41 makes it more convenient for both ends of the wire 41 to pass through the first hollow channel 4211 from the distal end of the first catheter 421 and exit the first hollow channel 4211 from the proximal end of the first catheter 421.

[0060] Of course, as another alternative, in other embodiments, the line 41 as a whole can also be flexible, that is, the line 41 can only have a flexible part 412.

[0061] The following is a brief description of the use of the coronary sinus constriction system in this embodiment:

[0062] The thread 41 is threaded around the proximal opening of the proximal support segment 431 of the coronary sinus narrowing device 43, and then both ends of the thread 41 are inserted from the distal end of the first catheter 421 into the first hollow channel 4211 and exited from the proximal end of the first catheter 421 into the first hollow channel 4211.

[0063] Next, an implantation channel is established by inserting the sheath 44 into the patient's body. At this point, the sheath 44 is already within the implantation path. This step can be interchanged with the steps mentioned above.

[0064] The coronary sinus constriction device 43 and the delivery device are inserted into the sheath 44 proximally through the loader, and the delivery device is pushed toward the distal end of the sheath 44, causing the delivery device to push the coronary sinus constriction device 43 into the sheath 44 and place it in the desired implantation position. At this time, if the implantation position of the coronary sinus constriction device 43 needs to be adjusted, the entire delivery device is pulled toward the proximal end of the sheath 44, causing the line 41 to pull the proximal opening of the proximal support section 431 of the coronary sinus constriction device 43 to contract, so as to facilitate the retraction of the coronary sinus constriction device 43 back into the sheath 44. Then, the position of the sheath 44 is readjusted, and the coronary sinus constriction device 43 is pushed out of the sheath 44 and placed in the desired implantation position by the delivery device. If the implantation position of the coronary sinus constriction device 43 is still not ideal, the above adjustment operation is repeated until the implantation position of the coronary sinus constriction device 43 is ideal. It can be understood that, with the assistance of the delivery device, the coronary sinus constriction device 43 can be repeatedly retrieved and repositioned.

[0065] When the coronary sinus constriction device 43 is inserted to the ideal implantation position, one end of the wire 41 (in this embodiment, the rigid part 411 of the wire 41 is pulled towards the proximal end of the sheath 44; if the wire 41 is flexible as a whole, either end of the wire 41 can be used) is pulled until the other end of the wire 41 (in this embodiment, the flexible part 412 of the wire 41 is pulled away from the proximal support section 431 of the coronary sinus constriction device 43), thereby separating the wire 41 from the coronary sinus constriction device 43. Then, the wire 41, the delivery mechanism 42 (in this embodiment, the dilator), and the sheath 44 are withdrawn from the patient's body.

[0066] As can be seen, this embodiment can also prevent the thread 41 from being left in the patient's body, reduce foreign body retention, and lower postoperative risks.

[0067] Third embodiment of the coronary sinus constriction system

[0068] The difference between this embodiment and the first embodiment of the coronary sinus constriction system lies in the connection method of the wire itself, the connection method between the wire and the delivery mechanism, and the structure of the delivery structure. Specifically, in this embodiment:

[0069] Reference Figure 6 and Figure 7 When the delivery mechanism 52 is under the control of the doctor, it can be separated from the line 51.

[0070] The thread 51 is flexible, allowing it to be bent and knotted. After the thread 51 is basically wrapped around the proximal opening of the proximal support section 531 of the coronary sinus constriction device 53, the two ends of the thread 51 converge and intertwine to form a second knot 511. The second knot 511 can be a dead knot or a slip knot.

[0071] The conveying mechanism 52 includes a third conduit 521, a locking slider 5221, and a second pull rod 523. The third conduit 521 has a third hollow channel 5211. The third conduit 521 can be made of steel cable. The wall of the third conduit 521 is provided with a guide hole 5212, which is located at the far end of the third conduit 521 and is connected to the third hollow channel 5211.

[0072] Combination Figure 8 The locking slider 5221 has a sliding portion 5221 and a pushing portion 5222. The sliding portion 5221 passes through a guide hole 5212 and has a relief groove 52211 and a through hole 52212. Both the relief groove 52211 and the through hole 52212 penetrate the sliding portion 5221 in the second extending direction of the third conduit 521. The second knot 511 of the wire 51 passes through the through hole 52212 from the distal end side and is located on the proximal end side of the through hole 52212, and the wire 51 is located outside the third conduit 521. The pushing portion 5222 is located inside the third hollow channel 5211 and extends from the sliding portion 5221 towards the distal end of the third conduit 521 in the second extending direction.

[0073] The second pull rod 523 is movably inserted into the third hollow channel 5211 and passes through the clearance groove 52211. The distal end of the second pull rod 523 is provided with a drive block 5231. When the conveying mechanism 52 clamps the line 51, the drive block 5231 is located on the proximal side of the push portion 5222. When the conveying mechanism 52 releases the clamp on the line 51, the drive block 5231 is located on the distal side of the push portion 5222. The proximal end of the second pull rod 523 is located outside the third conduit 521. When the drive block 5231 is located at the distal end of the push portion 5222 and pulls the second pull rod 523 towards the proximal end of the third conduit 521, the drive block 5231 can move towards the proximal end of the third conduit 521 and drive the push portion 5222 to move the sliding portion 5221 into the third hollow channel 5211, thereby forming a second clamping position between the perforation 52212 and the outer wall of the third conduit 521 to clamp the line 51; conversely, when the drive block 5231 is located at the proximal end of the push portion 5222 and pushes the second pull rod 523 towards the distal end of the third conduit 521, the drive block 5231 can move towards the distal end of the third conduit 521 and release the restriction on the push portion 5222, causing the sliding portion 5221 to move outward from the third hollow channel 5211 to release the clamping of the line 51.

[0074] When the delivery mechanism 52 is placed inside the sheath 54, the guide hole 5212 of the third catheter 521 is always located below the current orientation of the third catheter 521. The orientation of the guide hole 5212 can be confirmed by setting relevant marks on the proximal end of the third catheter 521 for quick identification by the doctor. This design allows the locking slider 5221 to move out of the third catheter 521 through the sliding part 5221 when the locking slider 5221 is only subjected to gravity. This makes the gap of the perforation 52212 outside the third catheter 521 larger than the second knot 511. At this time, the second knot 511 of the thread 51 can pass through the perforation 52212 from the proximal side of the perforation 52212 and be located on the distal side of the perforation 52212. Therefore, the thread 51 can be separated from the delivery mechanism 52.

[0075] In some embodiments, the drive block 5231 has a second guide surface 52311 at one end near the pushed portion 5222, so that the drive block 5231 can push the locking slider 5221 to move into the third conduit 521 more smoothly.

[0076] Furthermore, the extended end of the push-receiving part 5222 has a second limiting part 52221, which protrudes toward the second pull rod 523. The second limiting part 52221 has a first guide surface 52222, which can cooperate with the second guide surface 52311. This design can further enable the drive block 5231 to push the locking slider 5221 more smoothly into the third catheter 521. At the same time, the push-receiving part 5222 can also limit the drive block 5231 to a certain extent under the action of the limiting part, so as to reduce the risk of the line 51 and the delivery mechanism 52 disengaging during the delivery and position adjustment of the coronary sinus constriction device 53.

[0077] The following is a brief description of the use of the coronary sinus constriction system in this embodiment:

[0078] The thread 51 is threaded around the proximal opening of the proximal support section 531 of the coronary sinus constriction device 53, and then the two ends of the thread 51 are tied to form a second knot 511. The second knot 511 is then passed through the perforation 52212 of the locking slider 5221 of the delivery mechanism 52, wherein the thread 51 is located outside the third catheter 521.

[0079] Next, an implantation channel is established by inserting the sheath 54 into the patient's body. At this point, the sheath 54 is already within the implantation path. This step can be interchanged with the steps mentioned above.

[0080] The coronary sinus constriction device 53 and the delivery device are inserted into the sheath 54 proximally through the loader, and the delivery device is pushed toward the distal end of the sheath 54, causing the delivery device to push the coronary sinus constriction device 53 into the sheath 54 and place it in the desired implantation position. At this time, the drive block 5231 of the second pull rod 523 is located on the proximal side of the second limiting part 52221 of the locking slider 5221. The drive block 5231 limits the pushed part 5222, so that the perforation 52212 and the outer wall of the third catheter 521 form a second clamping position to clamp the wire 51, and the second knot 511 of the wire 51 cannot move from the proximal side of the perforation 52212 to the distal side of the perforation 52212. If it is necessary to adjust the implantation position of the coronary sinus constriction device 53, the entire delivery device is pulled toward the proximal end of the sheath 54, so that the wire 51 Pulling the proximal opening of the proximal support segment 531 of the coronary sinus constriction device 53 to retract the coronary sinus constriction device 53 back into the sheath 54, then readjusting the position of the sheath 54 and pushing the coronary sinus constriction device 53 out of the sheath 54 and placing it in the desired implantation position via the delivery device; if the implantation position of the coronary sinus constriction device 53 is still not ideal, repeat the aforementioned adjustment operation until the implantation position of the coronary sinus constriction device 53 is ideal; it can be understood that, with the assistance of the delivery device, the coronary sinus constriction device 53 can be repeatedly retracted and repositioned multiple times.

[0081] When the coronary sinus constriction device 53 is inserted to the ideal implantation position, the second pull rod 523 is pushed towards the distal end of the sheath 54. The drive block 5231 moves towards the distal end of the second limiting part 52221 of the locking slider 5221 and passes over the second limiting part 52221, thereby releasing the limitation on the locking slider 5221. Under the action of gravity, the locking slider 5221 moves out of the third catheter 521. At this time, the gap of the perforation 52212 outside the third catheter 521 is larger than the second knot 511, so that the second knot 511 can be inserted from the proximal end of the perforation 52212. The second thread 511 passes through the perforation 52212 and moves to the distal end of the perforation 52212. Based on this, while keeping the drive block 5231 in the distal end of the second limiting part 52221, the delivery mechanism 52 continues to pull towards the distal end of the sheath 54 (i.e., the third catheter 521 and the second pull rod 523 move synchronously), the second knot 511 passes through the perforation 52212 from the proximal end and moves to the distal end of the perforation 52212. Then the thread 51 separates from the locking slider 5221, thus completing the implantation and release of the coronary sinus constriction device 531.

[0082] Subsequently, the delivery mechanism 52 and sheath 54 are withdrawn from the patient's body, while the suture 51 remains in place with the coronary sinus constriction device 53. Since the suture 51 is much smaller than the nuts or other connectors in existing coronary sinus constriction devices 53, and even thinner than the skeleton of the device, it will not affect the patient's health. Furthermore, due to the presence of the second knot 511, the suture 51 will not detach from the device and become free in the bloodstream. Moreover, because the gap at the perforation 52212 outside the third catheter 521 is larger than the second knot 511, the suture 51 will not cause the coronary sinus constriction device 53 to move when it separates from the delivery device, thus ensuring the accurate implantation position of the device.

[0083] In some embodiments, the thread 51 is made of a biodegradable material; the use of a biodegradable material to make the thread 51 allows it to be degraded and absorbed after surgery, thereby ensuring the patient's postoperative safety.

[0084] In some embodiments, the thread 51 is made of a non-degradable material, but the surface of the thread 51 is coated with a hemophobic coating to prevent thrombosis and thus ensure the patient's postoperative safety.

[0085] Finally, it should be emphasized that the above description is only a preferred embodiment of the present utility model and is not intended to limit the present utility model. For those skilled in the art, the present utility model can have various changes and modifications. Any modifications, equivalent substitutions, improvements, etc., made within the spirit and principles of the present utility model should be included within the protection scope of the present utility model.

Claims

1. A conveying device, characterized in that: It includes a wire and a delivery mechanism, the wire being used to circumferentially wrap around the proximal opening of the coronary sinus constriction device, and the delivery mechanism being connected to the wire; The conveying mechanism can control the separation of the line from the proximal opening, or The conveying mechanism is controllable and can be separated from the line, or The conveying mechanism has a first conduit with a first hollow channel. Both ends of the line enter the first hollow channel from the distal end of the first conduit and exit the first hollow channel from the proximal end of the first conduit. When either end of the line is pulled, the line separates from the proximal opening.

2. The conveying device according to claim 1, characterized in that: When the conveying mechanism can control the separation of the line from the proximal opening: The line has a winding section, a locking section, and an unlocking section. The winding section is wound around the proximal opening. The winding section is located between the locking section and the unlocking section. The locking section and the unlocking section are intertwined to form a first knot. The first knot is a slip knot. The delivery mechanism includes a second conduit and a first pull rod. The second conduit has a second hollow channel. The second conduit has a first limiting part at the distal end of the second hollow channel. The first pull rod is movably inserted into the second hollow channel. The distal end of the first pull rod can form a first clamping position with the first limiting part. The winding section and / or the locking section can be clamped and fixed in the first clamping position. The unlocking section is connected to the distal end of the first pull rod. The proximal end of the first pull rod is located outside the second conduit.

3. The conveying device according to claim 2, characterized in that: The first limiting portion has a connecting section, a supporting section, and a limiting section. The connecting section extends along a first extending direction of the second conduit. The supporting section extends from the protruding end of the connecting section. The supporting section and the connecting section are bent. A first clamping position can be formed between the supporting section and the distal end of the first pull rod. The limiting section extends from the protruding end of the supporting section toward the body of the second conduit in the first extending direction. An avoidance opening is formed between the limiting section and the body.

4. The conveying device according to claim 2 or 3, characterized in that: The unlocking section is provided with a first connecting part, and the distal end of the first pull rod is provided with a second connecting part, and the first connecting part and the second connecting part are detachably connected.

5. The conveying device according to claim 1, characterized in that: When the conveying mechanism is controllably detachable from the line, the conveying mechanism includes: The third conduit has a third hollow channel, and the distal end of the third conduit has a guide hole communicating with the third hollow channel. A locking slider has a sliding part and a pushing part. The sliding part passes through the guide hole and has a relief groove and a through hole that extend through itself in the second extension direction of the third conduit. The two ends of the line are intertwined to form a second knot. The second knot passes through the through hole from the distal end side. The line is located outside the third conduit, and the pushing part is located inside the third hollow channel. The second pull rod is movably inserted into the third hollow channel and passes through the clearance groove. The distal end of the second pull rod is provided with a driving block. The proximal end of the second pull rod is located outside the third conduit. The driving block is located on the distal side of the pushed part. The driving block can move towards the proximal end of the third conduit and drive the pushed part to move the sliding part into the third hollow channel, so that the perforation and the outer wall of the third conduit form a second clamping position to clamp the wire.

6. The conveying device according to claim 5, characterized in that: The pushed portion extends from the sliding portion toward the distal end of the third conduit in the second extension direction, and the extended end of the pushed portion has a second limiting portion protruding toward the second pull rod, and the second limiting portion has a first guide surface; The drive block has a second guide surface at one end near the pushed part, and the second guide surface can cooperate with the first guide surface.

7. The conveying device according to claim 5 or 6, characterized in that: The line is made of a biodegradable material; or The line is made of a non-degradable material and its surface is coated with a blood-repellent coating.

8. The conveying device according to claim 1, characterized in that: When the delivery mechanism has a first conduit: The line has a rigid portion and a flexible portion, a portion of which is wound around the proximal opening.

9. The conveying device according to claim 8, characterized in that: The conveying mechanism is an expander or a steel cable.

10. A coronary sinus constriction system, comprising a sheath and a coronary sinus constriction device, characterized in that: It also includes a delivery device as described in any one of claims 1 to 9, wherein the wire passes circumferentially around the proximal opening of the coronary sinus constrictor, and the delivery device delivers the coronary sinus constrictor via the sheath.

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