An improved percutaneous device for constricting blood vessels

Abstract

The percutaneous device (100) for constricting a blood vessel according to the present invention comprises: a body (1) which is hollow inside; a distal clip (2) and a proximal clip (3) housed in the body (1); a tie rod (4) on which the distal clip (2) is fixed and the proximal clip (3) slides; a contact element (5) housed in the body (1); and a handle (7) connected to the body (1). Preferably, the distal clip (2) comprises a pointed distal perforation portion (26) that protrudes from a distal opening (12) of the body (1) to form the tip of the device (1). Furthermore, the distal clip (2) comprises a smaller proximal portion (27) having a smaller diameter and comprising at least one reinforcing ridge (9) that provides support and rigidity to the smaller proximal portion (27).

Description

Technical Field

[0001] The subject of the present invention is an improved device for the interruption of the function of a superficial vein collector using percutaneous access and ultrasonic guidance.

Background Art

[0002] Surgical treatment for superficial venous insufficiency of the lower extremities has seen dramatic development in recent decades. The extensive need for less invasive surgeries, combined with technological evolution, has led to the complete abandonment of highly traumatic procedures (such as the Linton operation) and a significant reduction in standard procedures (such as saphenous vein stripping). In addition to surgical strategies such as endoscopic subfascial ligation of perforator veins or saphenous reflux division, less invasive procedures such as ablation of superficial vein collectors by thermal techniques (laser; radio wave) or non-thermal techniques (sclerotherapy using foam; mechanochemical ablation; cyanoacrylate adhesive) are being used.

[0003] As is well known, "surgical" techniques are associated with significant risks of invasiveness and complications, while endovascular ablation techniques are associated with a cause of long-term failure (recanalization) and, although very low, the possibility of significant complications. Examples of percutaneous devices for the functional interruption of blood vessels are known from European Patent Application Publication No. 3936059 and International Patent Publication No. 2019 / 109029.

Summary of the Invention

[0004] To overcome the typical shortcomings of these known technologies, the holder designed a percutaneous device that allows for functional interruption of the venous collector through a percutaneous puncture access and allows for mechanical occlusion of the venous vessel in a safe and rapid manner. This device is described in the document European Patent Application Publication No. 3936059. Despite the effectiveness of the device, the applicant felt the need to improve the device in relation to its technical and functional aspects in order to provide the industry with a smaller and more powerful device, as well as a device that is easy and intuitive for physicians to use.

[0005] The object of the present invention is to provide an improved percutaneous device for interrupting the function of a venous collector that provides minimal spatial requirements and maximum strength, and is easy and intuitive to use, and allows for mechanical occlusion of a venous vessel by percutaneous puncture access.

[0006] This objective is achieved by a percutaneous device for interrupting the function of a venous collector according to claim 1. Other embodiments of the percutaneous device according to the present invention are described in the dependent claims.

[0007] The apparatus according to the present invention allows for the performance of procedures to occlude and / or constrict blood vessels in a simplified manner using percutaneous access, thereby requiring less manual labor. The impact on surgical time and patient acceptability (or compliance) is dramatically reduced compared to surgical techniques. Further advantages of the percutaneous apparatus according to the present invention will become apparent from the following description, given as non-limiting examples and in accordance with the accompanying drawings. [Brief explanation of the drawing]

[0008] [Figure 1] This shows the distal portion of the device according to the present invention in an exemplary embodiment, in a configuration for percutaneous insertion; [Figure 2] Figure 1 shows an exploded view of the apparatus; [Figure 3]A distal portion of the device according to the present invention in a percutaneous insertion configuration in a further exemplary embodiment is shown; [Figure 4] Figure 1 is an exploded view of the apparatus in the first exemplary configuration; [Figure 5] This is an exploded view of the apparatus in Figure 1 in a second exemplary configuration; [Figure 6] An exemplary embodiment shows the distal portion of the device according to the present invention in a percutaneous insertion configuration, with the main body partially removed to show the components housed inside; [Figure 7] Figure 6 shows the apparatus in a closed configuration between clips on a venous vessel; [Figure 8] The apparatus according to the present invention, in an exemplary embodiment, is shown in a configuration for percutaneous insertion, which includes a handle; [Figure 9A] Figure 8 shows various configurations of the apparatus during the process of constricting a venous vessel, in particular: 9A: configuration for puncturing a venous vessel; 9B: configuration for releasing distal and proximal clips; 9C: configuration for locking the clips to close the venous vessel; [Figure 9B] Figure 8 shows various configurations of the apparatus during the process of constricting a venous vessel, in particular: 9A: configuration for puncturing a venous vessel; 9B: configuration for releasing distal and proximal clips; 9C: configuration for locking the clips to close the venous vessel; [Figure 9C] Figure 8 shows various configurations of the apparatus during the process of constricting a venous vessel, in particular: 9A: configuration for puncturing a venous vessel; 9B: configuration for releasing distal and proximal clips; 9C: configuration for locking the clips to close the venous vessel; [Figure 10] The apparatus according to the present invention is shown in a configuration for percutaneous insertion, in a further exemplary embodiment, which includes a handle; [Figure 11A]Figure 8 shows various configurations of the apparatus during the process of constricting a venous vessel, in particular: Figure 11A; configuration for puncturing a venous vessel; Figure 11B; configuration for releasing distal and proximal clips; Figure 11C; configuration for locking the clips to constrict the venous vessel; [Figure 11B] Figure 8 shows various configurations of the apparatus during the process of constricting a venous vessel, in particular: Figure 11A; configuration for puncturing a venous vessel; Figure 11B; configuration for releasing distal and proximal clips; Figure 11C; configuration for locking the clips to constrict the venous vessel; [Figure 11C] Figure 8 shows various configurations of the apparatus during the process of constricting a venous vessel, in particular: Figure 11A; configuration for puncturing a venous vessel; Figure 11B; configuration for releasing distal and proximal clips; and Figure 11C; configuration for locking the clips to constrict the venous vessel. [Modes for carrying out the invention]

[0009] In the aforementioned drawings, similar components are identified by the same reference numeral in different drawings.

[0010] Reference numeral 100 denotes a percutaneous device for interrupting the function of a superficial venous collector according to the present invention. This device is suitable for occluding and constricting blood vessels, such as saphenous veins.

[0011] The device 100 comprises a body 1 that extends along the longitudinal axis X and is hollow inside to accommodate a pair of clamping clips 2, 3 and contact elements 5 and a tie rod 4 for the clips 2, 3. The pair of clips comprises a distal clip 2 for occluding a blood vessel and a proximal clip 3 for constricting a blood vessel. Both clips 2, 3 are fitted onto the tie rod 4. It should be noted that the tie rod 4 is omitted in Figures 1 to 5 for reasons of visual simplification; instead, the tie rod 4 is visible in the remaining drawings.

[0012] The body 1 is a cannula, preferably a metallic cannula, which may be inserted percutaneously, and is provided with a distal end portion 11 having a distal opening 12 for the release of clips 2, 3. In one embodiment, shown in FIG. 1, the distal end portion 11 of the body has a rough surface 119 which increases its echo-generating properties.

[0013] As shown in FIG. 2, at the distal end portion 11, the end wall defining the distal opening 12 of the body 1 is substantially orthogonal to the longitudinal axis X. This solution makes it possible to provide an optimal abutment surface at the distal end portion 11 of the body 1 and assists in pushing the distal clip 2 during the step of rotating and orienting the distal clip 2.

[0014] The abutting element 5 is preferably a rod having a cylindrical, or oval, or semi-circular shape. The abutting element 5 extends along the longitudinal axis X and is provided with a passage for the tie rod 4 on which the clips 2, 3 are fitted. The passage for the tie rod 4 is, for example, a central hole such that the tie rod 4 slides inside the abutting element 5, or a lateral groove such that the tie rod 4 slides outside the abutting element 5. The abutting element 5 is provided with a distal zone 51 adapted to push the proximal clip 3.

[0015] The device 100 comprises a handle 7 which is connected to the proximal portion of the body 1 and is adapted to operate the clips 2, 3 and the tie rod 4.

[0016] The overall configuration of the device 100 is such that a pair of clamping clips 2, 3 and the abutting element 5 may be slidably inserted inside the body 1, and the pair of clips 2, 3 may be disengaged from the distal opening 12 and operated externally by the handle 7.

[0017] Preferably, the clips 2, 3 are substantially in the form of bars or rods, i.e., they have a substantially cylindrical and elongated shape. For example, the clips have a circular or variable cross-section as in FIGS. 4 and 5.

[0018] For example, as shown in FIG. 6, the facing ends 211, 311 of the clips 2, 3 are shaped to allow for some overlap of the clips once inserted into the body 1. In this example, the clips 2, 3 have diagonal, inclined, and parallel surfaces. This solution allows the clips 2, 3 to be accurately aligned with respect to the plane of rotation and thus facilitates their lateral placement during release.

[0019] The distal clip 2 has a distal portion and an opposite proximal portion. The distal clip 2 has a pointed distal piercing portion 26 that is substantially the tip for first piercing the subcutaneous tissue and then the wall of the blood vessel to pass through the blood vessel from one side to the other. Due to the fact that the distal clip 2 is provided with the pointed distal piercing portion 26, the distal end 11 of the body 1 may be provided with a substantially orthogonal abutment surface for optimal extrusion of the distal clip 2.

[0020] The distal clip 2 has a small proximal portion 27, i.e., a diameter smaller than the diameter of the distal piercing portion 26. In fact, during the step of percutaneous insertion of the device 100, only the distal piercing portion 26 extends out of the distal opening 12 of the body 1 to form the tip of the needle of the device 100; conversely, the small proximal portion 27 is fully inserted inside the body 1.

[0021] The abutment wall 28 is defined between the distal piercing portion 26 and the small proximal portion 27 against which the distal end 11 of the body 1 abuts.

[0022] As mentioned above, one of the objects of the present invention is to miniaturize the clip as much as possible to facilitate the percutaneous insertion of the device 100.

[0023] Therefore, at least the distal clip 2 is provided with at least one reinforcing ridge 9 that extends longitudinally at least partially to the proximal portion. In fact, the proximal portion is a small proximal portion 27 having a smaller diameter than the diameter of the distal perforation portion 26. The reinforcing ridge 9 allows the small proximal portion 27 to be given greater support and rigidity.

[0024] The reinforcing ridge 9 may be a single continuous ridge, interrupted by an open space, or a series of ridges arranged in the longitudinal direction, as shown in the drawing.

[0025] The reinforcing raised portion 9 preferably starts from the abutment wall 28 and extends in the proximal direction.

[0026] Preferably, the reinforcing ridge 9 extends to at least the seat portions 21 and 31 into which the tie rod 4 is inserted.

[0027] In the example shown in Figure 4, the distal clip 2 comprises a single reinforcing ridge 9. In the examples shown in Figures 2 and 5, the distal clip 2 comprises two reinforcing ridges 9 located on the opposite side of the clip.

[0028] In the examples in Figures 1 and 2, the reinforcing ridge 9 is a short ridge, i.e., it occupies only a portion of the small proximal portion 27. In the examples in Figures 3 and 4, the reinforcing ridge 9 is a long ridge, i.e., it occupies the entire small proximal portion 27.

[0029] In the preferred exemplary embodiment shown in Figures 3 to 5, the proximal clip 3 is also provided with at least one longitudinally extending reinforcing ridge 9. In practice, the distal clip 3, which is always fully housed inside the main body 1 during the percutaneous insertion step of the device 100, has a smaller diameter than the diameter of the distal perforation portion 26 of the distal clip 2. The reinforcing ridge 9 allows the proximal clip 3 to be given greater support and rigidity.

[0030] In the example shown in Figure 4, the proximal clip 3 comprises a single reinforcing ridge 9. In the example shown in Figure 5, the proximal clip 3 comprises two reinforcing ridges 9 located on the opposite side of the clip.

[0031] In the proximal clip 3, the reinforcing ridge 9 starts from the oblique end 311 and extends in the proximal direction.

[0032] In one embodiment, the reinforcing ridge 9 is a short ridge, i.e., it occupies only a portion of the proximal clip 3. In the example shown in Figures 4 and 5, the reinforcing ridge 9 is a long ridge, i.e., it occupies the entire proximal clip 3.

[0033] Preferably, the reinforcing ridges 9 are inserted into respective tracks 91 that are made to penetrate the body 1 of the device 100 in the longitudinal direction. The tracks 91 are longitudinal notches made starting from the distal opening 12. This solution allows the clips 2, 3 to be locked in rotation when inserted into the body 1, and avoids undesirable rotation between the clips and the body.

[0034] In the example shown in Figure 4, the main body 1 comprises only one track 91. In the examples shown in Figures 2 and 5, the main body 1 comprises two tracks 91 located on the opposite side of the main body.

[0035] In the example in Figure 1, track 91 is a short track, i.e., it extends from a portion of the distal clip 2. In the example in Figure 3, track 91 is a long track, i.e., it extends to the proximal clip 3 as well.

[0036] Each clip 2, 3 preferably has a length determined by the specific surgical requirements and the dimensions of the blood vessel to be treated, for example, in the range of approximately 6 to 12 mm. Clips 2, 3 may be the same length or different lengths.

[0037] Clips 2 and 3 are connected to each other by tie rods 4 or equivalent means. Tie rods 4 preferably have a circular cross-section, a semicircular cross-section, or a flat ribbon cross-section.

[0038] It should be noted that the tie rod 4 is provided with a radial dimension such that, for example, a flattened or thickened portion at a proximal position prevents the tie rod from re-entering the seat 31 of the proximal clip 3 after the radial dimension has disengaged from the seat 31 of the proximal clip 3. This solution allows for proper constriction of the vessel between the distal clip 2 and the proximal clip 3, thereby avoiding the need to form a knot on the tie rod that must be pushed into place. In a further exemplary embodiment, the tie rod 4, and in particular at least the intermediate portion 42 positioned between the two clips, is provided with a protruding fastening tab adapted to prevent the proximal clip 3 from retracting during the step of constricting the vessel.

[0039] In an alternative embodiment, as shown in Figure 6, the retainer 84 is positioned on the slidable tie rod 4 when pressed by the contact element 5. In one embodiment, the retainer 84 is made of a soft material that creates friction with the tie rod 4. In another exemplary embodiment, the retainer 84 is provided with an inner hole having a diameter slightly smaller than the outer diameter of the tie rod in order to engage with the tie rod by friction.

[0040] Clips 2 and 3 are preferably made of a biocompatible metallic material or a bioabsorbable material.

[0041] The tie rod 4 is preferably made of nylon or polyester, or of an absorbent material.

[0042] Depending on the specific application, the tie rod 4 and clips 2 and 3 may be made of non-absorbent or absorbent materials.

[0043] Clips 2 and 3 are provided with seats 21 and 31 into which the tie rod 4 is inserted. The distal clip 2 is provided with a distal seat 21 into which the tie rod 4 is fixed. The distal seat 21 is preferably a through hole having a circular or rectangular cross-section. The distal seat 21 preferably crosses the distal clip 2 perpendicularly in the lateral direction. This solution allows the distal clip 2 to be precisely oriented and reversed after it has been released. The proximal clip 3 is provided with a proximal seat 31 into which the tie rod 4 is slidably inserted. The proximal seat 31 is preferably a through hole having a circular, elliptical, or other rectangular cross-section. The proximal seat 31 preferably crosses the proximal clip 3 obliquely in the lateral direction. This solution allows the proximal clip 3 to be precisely oriented after it has been released, and allows the tie rod 4 to slide precisely.

[0044] For example, as shown in Figure 9B, the distal end 41 of the tie rod 4 is fixed within the seat 21 of the distal clip 2. The tie rod 4 is further slidably inserted into the seat 31 of the proximal clip 3 such that the middle portion 42 of the tie rod 4 is positioned between the clips 2 and 3. The proximal end 43 of the tie rod 4 may be manipulated by the surgeon directly or by a handle 7.

[0045] Clips 2 and 3 preferably have lateral dimensions (i.e., diameters) that allow them to slide freely inside the body 1 to prevent slippage with minimal friction if possible. When clips 2 and 3 are inserted into the body 1, the longitudinal axes of clips 2 and 3 are aligned with the longitudinal axis of the body 1.

[0046] For the proper functioning of the device 100, it is important that the tie rod 4 inside the main body 1 does not interfere with the proper sliding of the clips 2 and 3. Therefore, it is preferable that the clips 2 and 3 are provided with at least one housing 22, 32, or 33 in which the tie rod 4 is positioned when the clips 2 and 3 are inside the main body 1.

[0047] The housings 22, 32, and 33 are longitudinal grooves formed on the outer surfaces of the clips 2 and 3 such that the tie rod 4 is inserted into such grooves and thus fits within the volume of the space occupied by the clips 2 and 3. The distal clip 2 is provided with a proximal housing 22 and, optionally, a distal housing for securing the tie rod. The proximal clip 3 is provided with both a distal housing 32 and a proximal housing 33.

[0048] The housing portion is preferably a longitudinal groove on the outer surface of clips 2 and 3, where the proximal housing portion 22 of distal clip 2 occupies at least the proximal portion of distal clip 2, the distal housing portion 32 of proximal clip 3 occupies at least the distal portion of proximal clip 3, and the proximal housing portion 33 of proximal clip 3 occupies at least the proximal portion of proximal clip 3.

[0049] It should be noted that the distal and proximal housings are located on opposite sides of the clip. Thus, the distal clip 2 has a passage for the tie rod 4, starting from the seat 21 and continuing along the housing 22. The passage for the tie rod 4 occupies approximately half the length of the distal clip 2. The proximal clip 3 has a passage for the tie rod 4, starting from the housing 32 and continuing through the clip and along the seat 31, detaching from the opposite side and continuing along the housing 33. The passage for the tie rod 4 occupies the entire length of the proximal clip 3.

[0050] Preferably, the opposing ends 211, 311 of clips 2, 3 are further provided with lateral accommodates 24, 34 to allow for better alignment of the clips when inserted into the body 1. The lateral accommodates 24, 34 are grooves that traverse the inclined surface of the clip laterally, as shown in Figure 4. The lateral accommodates 24, 34 are opposite to each other.

[0051] The device 100 is formed by two split shells that extend mainly in the longitudinal direction and are mechanically connected to each other, and includes a handle 7 that is connected to the proximal portion of the main body 1.

[0052] The handle 7 comprises a handle body 71 equipped with a track 73 that slidably houses an operating lever 72 for operating the clips 2, 3 and the tie rod 4.

[0053] As shown in detail in Figure 9A, the operating lever 72 extends mainly in the longitudinal direction and preferably includes a molded slider 721 for facilitating gripping and sliding within the track 73. The slider 721 is located above the handle 7.

[0054] The operating lever 72 slides longitudinally in steps, allowing the physician to understand, without looking, when the correct release of the first distal clip 2 and then the proximal clip 3 has been achieved.

[0055] In the embodiment shown in Figure 8, the stepwise sliding of the operating lever 72 is achieved by acting on a track 73, which has a longitudinal extension but also a laterally advancing portion. The track 73 actually includes a first contact portion 661, which stops the slider 721 and thereby indicates the correct release of the distal clip 2, and a second contact portion 662, which stops the slider 721 and thereby indicates the correct release of the proximal clip 3. In order to continue advancing the slider 721, it is necessary to move the slider laterally and pass the first contact portion 661.

[0056] In the exemplary embodiment shown in Figure 10, the stepwise sliding of the operating lever 72 is achieved by acting on the slider 721 and the track 73. The slider 721 is provided with a release button 722 that stops the slider 721 from retracting, thereby indicating the correct release of the distal clip 2, and the track 73 is provided with a second contact portion 662 that stops the slider 721, thereby indicating the correct release of the proximal clip 3. To continue retracting the slider, it is necessary to press the release button 722.

[0057] The main body 1 is integrated with the operating lever 72, which means that, for example, as shown in Figure 16B, when the operating lever 72 is retracted, the main body 1 also retracts.

[0058] During the initial operating step shown in Figures 9A and 11A, the operating lever 72 is slidable relative to the tie rod 4, i.e., nothing happens to the tie rod 4 when the operating lever 72 is retracted. The operating lever 72 is operably connected to the tie rod 4 and includes a tie rod hook 725 adapted to engage with a tie rod ratchet 45, which is integral to the tie rod 4, such that advancing the operating lever 72 results in the retraction of the tie rod 4, as may be shown in Figures 9B and 9C. The engagement between the operating lever 72 and the tie rod 4 occurs at a second contact portion 662, which causes the slider 721 to stop, thereby indicating the correct release of the proximal clip 3.

[0059] In the example shown in Figures 11A to 11C, the operating lever 72 is always slidable relative to the contact element 5; that is, nothing happens to the contact element 5 when the operating lever 72 is retracted. In this example, the contact element 5 is actually equipped with a contact portion 510 and is integrated with the handle 7.

[0060] In the example shown in Figures 9A and 9C, on the other hand, during the initial operating step shown in Figure 9A, the operating lever 72 is slidable relative to the contact element 5, i.e., when the operating lever 72 is pulled out, nothing happens to the contact element 5. The operating lever 72 also includes a contact hook 726 adapted to engage with a contact ratchet 46, which is integral to the contact element 5, such that the operating lever 72 is operationally connected to the contact element 5, and advancing the operating lever 72 results in the advancement of the contact element 5, as shown in Figures 9B and 9C. The possibility of advancing the contact element 5 allows the retainer 84 to be pushed, if present. The engagement between the operating lever 72 and the contact element 5 occurs at the second contact portion 662, which causes the slider 721 to stop, thereby indicating the correct release of the proximal clip 3.

[0061] The handle 7 includes a cutting button 723 equipped with a blade 724 adapted for cutting the tie rod 4. The cutting button 723 is vertically slidable between a stationary position in which the blade 724 is positioned at a distance from the tie rod 4 and a cutting position in which the blade 724 is pressed against the tie rod 4 to cut.

[0062] In a modified embodiment (not shown), the tie rod 4 is provided with a predetermined fracture point, such as a pre-cut or weakened section, located proximal to the proximal clip 3, which is adapted to deform in response to a certain amount of tensile force applied to the tie rod 4. The predetermined fracture point is a calibrated weakened section that allows the pair of clips to be released only after the optimal tensile force for constricting, and thus occluding, the blood vessel has been applied. This solution allows the tie rod 4 to remain in the patient's body as little as possible after the blood vessel has been closed.

[0063] The sequence of figures from Figures 9A-9C and 11A-11C illustrates the use of the device 100 for constricting blood vessels.

[0064] Figures 9A and 11A show the device 100 in a percutaneous insertion configuration. First, the main body 1 is introduced percutaneously through the tip of the needle, which consists of the distal perforation portion 26 of the distal clip 2. Next, the tip punctures the wall of a blood vessel and passes through the vessel from one side to the other.

[0065] Figures 9B and 11B show the device 100 in a configuration for releasing the distal clip 2 and the proximal clip 3. The distal clip 2 is designed to disengage from the distal opening 12 of the body 1 by retracting the slider 721 until it reaches the first contact portion 661. In fact, retracting the slider 721 retracts the operating lever 72, and the body 1 retracts with it, while the proximal clip 3 and the contact element 5 are instead held in place. The slider 721 is then moved laterally to overcome the first contact portion 661. The proximal clip 3 is also designed to disengage from the distal opening 12 of the body 1 by retracting the slider 721 until it reaches the second contact portion 662. Retracting the slider 721 actually retracts the operating lever 72 and the body 1 with it, while the contact element 5 is instead held in place. In the modified examples in both Figure 9B and Figure 11B, engagement is achieved between the operating lever 72 and the tie rod 4 at the second contact portion 662 where the slider 721 stops. At this point, moving the operating lever 72 forward causes the tie rod 4 to retract. In the modified example in Figure 9B only, engagement is also achieved between the operating lever 72 and the contact element 5. At this point, moving the operating lever 72 forward causes the tie rod 4 to retract and the contact element 5 to advance.

[0066] Figures 9C and 11C show the device 100 in a configuration for locking clips 2 and 3 to close a venous vessel. By advancing the slider 721, the tie rod 4 is retracted in such a manner that the distal clip 3 is retracted, and at the same time the body 1 is advanced, thus pushing the proximal clip 3 forward to achieve proper constriction of the vessel between the distal clip 2 and the proximal clip 3. In the modification shown only in Figure 9B, advancing the slider 721 also results in the advancement of the contact element 5. This solution is particularly advantageous in modifications of those embodiments having a long track 91, i.e., extending to the proximal clip 3 as in Figure 3. Indeed, the advancement of the contact element 5 imparts rigidity and structural strength to the body 1, which would otherwise be weakened by the long track 91. Furthermore, the advancement of the contact element 5 allows the retainer 84, if present, to be pushed.

[0067] At this point, the tie rod 4 can be cut by activating the cutting button 723 located on the handle, or by pulling further if a predetermined breaking point 44 on the tie rod 4 is used.

[0068] Innovatively, the percutaneous device according to the present invention provides minimal spatial requirements and maximum strength. In fact, the presence of the reinforcing ridge 9 allows for minimizing the outer diameter of the distal clip 2 (in the small proximal portion 27) and the proximal clip 3 without compromising the functionality of the device 100, insofar as the reinforcing ridge 9 provides support and rigidity, and as a result, the diameter of the main body 1 into which the clips 2 and 3 are inserted can be minimized.

[0069] Preferably, the percutaneous device according to the present invention is easy to use and intuitive. In fact, the handle 7 houses an operating lever 72 that slides longitudinally in steps, allowing the physician to understand, without looking, when the release of the first distal clip 2 and then the proximal clip 3 has been achieved. Furthermore, by a tie rod hook 725 that engages with a tie rod ratchet 45, advancing the operating lever 72 results in the retraction of the tie rod 4.

[0070] Those skilled in the art will understand that modifications can be made to the products described above, all of which fall within the scope of protection defined by the following claims.

Claims

1. A percutaneous device (100) for constricting blood vessels: A body (1) having a hollow interior and a distal tip having a distal opening (12); A distal clip (2) and a proximal clip (3) are slidably housed inside the main body (1); A tie rod (4) on which the distal clip (2) is fixed and the proximal clip (3) slides, wherein the tie rod is provided with means for locking the sliding of the proximal clip (3); A contact element (5) located proximal to the proximal clip (3) and housed inside the main body (1); A handle (7) connected to the main body (1); The distal clip (2) is: A distal pointed perforated portion (26) protruding from the distal opening (12) of the main body (1); A smaller proximal portion (27) having an outer diameter smaller than the outer diameter of the distal perforated portion (26), and provided with at least one reinforcing ridge (9) extending in the longitudinal direction, A transdermal device (100) characterized by comprising the above.

2. The percutaneous device (100) according to claim 1, wherein the reinforcing raised portion (9) extends longitudinally over only a portion of the small proximal portion (27).

3. The percutaneous device (100) according to claim 1 or 2, wherein the reinforcing raised portion (9) extends longitudinally over the entire small proximal portion (27).

4. The percutaneous device (100) according to any one of the preceding claims, wherein the proximal clip (3) has an outer diameter smaller than the outer diameter of the distal perforation portion (26) of the distal clip (2), and the proximal clip (3) is provided with at least one longitudinally extending reinforcing ridge (9).

5. The percutaneous device (100) according to claim 4, wherein the reinforcing raised portion (9) extends longitudinally over the entire proximal clip (3).

6. The percutaneous device (100) according to claim 4 or 5, wherein the distal clip (2) comprises two reinforcing protrusions (9) located on the opposite side, and / or the proximal clip (3) comprises two reinforcing protrusions (9) located on the opposite side.

7. The percutaneous device (100) according to any one of the preceding claims, wherein the reinforcing protrusion (9) is slidably inserted into a track (91) made in the main body (1), and the track (91) is a longitudinal cut made starting from the distal opening (12).

8. The percutaneous device (100) according to any one of the preceding claims, wherein the means for locking the sliding of the proximal clip (3) is flattening or thickening the tie rod (4), or a retainer (84) fitted to the tie rod (4), or a protruding fastening tab.

9. The percutaneous device (100) according to any one of the preceding claims, wherein the handle (7) houses an operating lever (72) equipped with a slider (721), the operating lever (72) slides in steps inside a track (73), and the track (73) includes a first contact portion (661) on which the slider (721) stops when the distal clip (2) is fully released, and a second contact portion (662) on which the slider (721) stops when the proximal clip (3) is fully released.

10. The percutaneous device (100) according to any one of claims 1 to 8, wherein the handle (7) houses an operating lever (72) equipped with a slider (721) together with a release button (722), the operating lever (72) slides in stages inside a track (73), the release button (722) stops the sliding of the operating lever (72) when the distal clip (2) is fully released, and the track (73) has a second contact portion (662) on which the slider (721) stops when the proximal clip (3) is fully released.

11. The percutaneous device (100) according to any one of the preceding claims, wherein the handle (7) houses an operating lever (72) having a tie rod hook (725) integrated with the tie rod (4) and adapted to engage with a tie rod ratchet (45), so that the operating lever (72) is operably integrated with the tie rod (4).

12. The percutaneous device (100) according to any one of the preceding claims, wherein the handle (7) houses an operating lever (72) having a contact hook (726) integrated with the contact element (5) and adapted to engage with a contact ratchet (46), and as a result the operating lever (72) is operationally connected to the contact element (5), and by moving the operating lever (72) forward, the contact element (5) also moves forward.

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