Ring for eversion carotid endarterectomy

Abstract

Everzional carotid endarterectomy represents the main surgical procedure intended for the treatment of atherosclerosis in the carotid arteries. One of the key challenges of this operation is ensuring adequate control of the distal part of the atherosclerotic plaque. Inadequate control in this part of the procedure can result in the retention of small plaque fragments, significantly increasing the risk of postoperative ischemic stroke. To address this issue, our medical instrument allows for better control and reduces the risk of complications after surgery. Our technique involves visual inspection of the hard-to-reach segment of the distal part of the artery using an everzional ring during standard everzional carotid endarterectomy. This innovative approach uses a specially designed ring on a curved support through which the carotid artery is threaded and rotated around the entire circumference of the ring, allowing for more precise and efficient removal of the atherosclerotic plaque.

Description

[0001] RING FOR EVERSION CAROTID ENDARTERECTOMY

[0002] AREA OF TECHNIQUE

[0003] The presented patent is used exclusively in vascular surgery as an auxiliary tool during eversion carotid endarterectomy, to achieve better visualization and control of the distal part of the internal carotid artery after the removal of atherosclerotic plaque using the eversion technique.

[0004] TECHNICAL PROBLEM

[0005] The technical problem that is overcome by this patent is better control of the distal part of the plaque during eversion carotid endarterectomy. The most delicate and demanding part of the eversion carotid endarterectomy is the control of the distal parts of long and high plaques, due to the small operative field, as well as the difficult-to-access lumen of the distal carotid artery. During the mentioned procedure, there may be a retention of smaller plaque particles, which can lead to an increase in neurological complications due to distal embolization. According to the subject discovery, the distal parts of the carotid artery, which are everted through the ring, become exposed, allowing for their extraction from the artery, and, after declamping the arteries, minimizing the possibility of distal embolization.

[0006] STATE OF THE TECHNIQUE

[0007] At this moment, there are no similar instruments used for the aforementioned purpose. Currently, in carotid surgery, the 'Vollmar ring' is used, which is applied for endarterectomy of large, long, circumferential plaques, but from the common carotid artery, which has a completely different purpose than the instrument according to the subject discovery, whose uniqueness lies in facilitating eversion, which makes it unique.

[0008] ESSENCE OF THE DISCOVERY

[0009] The essence of the discovery is to facilitate eversion carotid endarterectomy and reduce the rate of perioperative strokes and mortality of the operated patients. The technique is based on additional verification of the poorly accessible segment of the endarterectomized carotid artery, by passing through the instrument.

[0010] DESCRIPTION OF THE IMAGES FROM THE DRAWING

[0011] Image 1 contains a technical drawing in three projections. Projection (a) and (b) show the ring (1), ring carrier (2), and handle (3). Drawing (c) depicts the detail of the junction between the ring and the ring carrier in projection b at a scale of 3:1. Projection (d) shows a top view of the instrument, at a scale of 2:1. Image 2 contains a 3D image that presents an axonometric view of the instrument from different angles in projections (a) and (b), while projection (c) shows an enlarged detail of the junction between the ring and the ring carrier itself. Image 3 contains three drawings of the use of the subject invention in clinical practice. Drawing (a) shows the removal of plaque from the internal carotid artery using an eversion technique. Drawing ^b) depicts the procedure of threading the internal carotid artery through the ring, and drawing ^(c) shows the turned inside of the internal carotid artery over the outer edge of the ring.

[0012] DETAILED DESCRIPTION OF THE INVENTION

[0013] The invention consists of a circular-shaped ring (1), a ring holder (2), and a handle (3). All parts are made of stainless steel for medical use C.4580 (JUS) or other stainless steel with similar characteristics. The ring holder (2) and the circular-shaped ring (1) are made from wire with a circular cross-section of 1 millimeter in thickness. The circular-shaped ring comes in four different sizes, depending on the outer diameter d - 5, 6, 7, 8, and 9 mm. The ring holder itself consists of three components fused into a single unit, created by bending a straight wire of 120.3 mm in length at an angle of 180 degrees, so that the ring holder has two parallel legs spaced 5 mm apart measured from the outer edges, connected by a semicircular arc with an outer radius of 2.5 mm. The shorter leg of the ring holder is 16.5 mm long measured from the semicircular arc, while the longer leg of the ring holder is 97.5 mm long, also measured from the outer arc. The circular-shaped ring is attached at a 90-degree angle to the tip of the shorter leg of the ring holder. The tip of the longer arm of the ring holder is connected in a straight line to the third part of the instrument, namely the handle. The handle has the shape of a regular cylinder with a diameter of 5 mm and a height, or length, of 100 mm. The surface of the cylinder is rough for better grip and manipulation of the instrument. The ends, or the edges of the cylinder are beveled at an angle of 45° (1 / 45°) and are processed so that there are no sharp edges. A longer arm of the ring holder extends from the center, or the axis of the cylinder, to align the axis of the handle and the longer arm of the holder. At the junction of the longer arm of the ring holder and the handle, there is a rounding radius of 0.5 mm, as well as at the junction of the shorter arm of the ring holder and the ring itself. After the removal of atherosclerotic plaque from the internal carotid artery (ICA) using the eversion technique (Figure 3, drawing (a)), the proximal end of the ICA is passed through the opening of the ring (Figure 3, drawing (b)), and then the ICA is turned outward over the outer edge of the ring to better visualize the distal part of it (Figure 3, drawing (v)). With this method, it is possible to detect even the smallest particles of residual atherosclerotic plaque, which can then be safely removed by the operator.

Claims

CLAIMS1. A tool, or product for use exclusively in vascular surgery as an auxiliary means during eversipn carotid endarterectomy, aimed at better visualization and removal of any residual parts of atherosclerotic plaque, characterized by consisting of a ring of circular shape with an outer diameter of 5 mm connected at an angle of 90 degrees to the tip of the shorter leg of the ring holder, the ring holder composed of three components cast into a single entity created by bending a straight wire at an angle of 180 degrees and a handle in the shape of a regular cylinder with edges beveled at an angle of 45 degrees to which the longer leg of the ring holder is continued starting from the axis of the cylinder so that the axis of the handle and the longer leg of the holder coincide.

2. The tool according to patent application number 1, characterized by the length of the outer diameter of the circular-shaped ring being 6 mm.

3. The tool according to patent application number 1, characterized by the length of the outer diameter of the circular-shaped ring being 7 mm.

4. The instrument according to patent claim number 1, specified as having an external diameter length of the circular ring of 8 mm.

5. The instrument according to patent claim number 1, specified as having an external diameter length of the circular ring of 9 mm.

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