CN115192139A - Broken bolt driving handle, broken bolt driving device and broken bolt taking system - Google Patents
Broken bolt driving handle, broken bolt driving device and broken bolt taking system Download PDFInfo
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- CN115192139A CN115192139A CN202210094131.5A CN202210094131A CN115192139A CN 115192139 A CN115192139 A CN 115192139A CN 202210094131 A CN202210094131 A CN 202210094131A CN 115192139 A CN115192139 A CN 115192139A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320758—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
- A61B2017/00464—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable for use with different instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
- A61B2017/00469—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable for insertion of instruments, e.g. guide wire, optical fibre
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22001—Angioplasty, e.g. PCTA
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
- A61B2017/2212—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B2017/320056—Tunnelers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320758—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven
- A61B2017/320775—Morcellators, impeller or propeller like means
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Abstract
The invention provides a broken bolt driving handle, a broken bolt driving device and a broken bolt taking system; the broken bolt driving handle comprises a linkage component and a handle component; the linkage assembly comprises an input terminal and an output terminal which are connected in a rotating mode, the input terminal and the output terminal are meshed with each other, and the transmission ratio of the input terminal to the output terminal is larger than 1; the far end of the handle component is connected with the input terminal and can drive the output terminal to rotate through the input terminal; the output terminal is used for installing the bolt breaking assembly so as to drive the bolt breaking assembly to rotate. Because when input terminal drives output terminal and rotates, output terminal's rotational speed is less than input terminal's rotational speed, so after garrulous bolt subassembly docks in output terminal, can stir garrulous speed of smashing the thrombus to garrulous bolt subassembly and carry out the deceleration, the rotational speed of garrulous bolt subassembly is lower means the moment of garrulous bolt subassembly is big more, the stubborn, great harder thrombus is smashed more easily to the garrulous bolt subassembly that moment is big, and can also reduce by the winding risk of viscous thrombus tissue adhesion.
Description
The present application claims priority from a chinese patent application, entitled "embolectomy system, embolectomy device, embolectomy holder, and embolectomy device", filed by the chinese intellectual property office on 09.04.2021, CN202110384767.9, which is incorporated herein by reference in its entirety.
Technical Field
The invention relates to the technical field of medical instruments, in particular to a broken thrombus driving handle, a broken thrombus driving device and a broken thrombus taking system.
Background
Venous Thromboembolism (VTE) includes lower limb Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE).
Deep Vein Thrombosis (DVT) of the lower limb is a highly vascular surgical disease, and is mostly caused by the abnormal coagulation of blood in veins of the lower limb, which causes the obstruction of blood backflow. Pulmonary embolism has become the third leading cause of death from cardiovascular disease. One of the most important risk factors for pulmonary embolism is personal factors including age, past VTE history, tumor history, cardiopulmonary failure, congenital or acquired coagulation disorders, hormonal therapy, and the like. Acute pulmonary embolism can lead to systemic hypotension and even total heart failure, which in turn can lead to death of the patient.
Therefore, the thrombus can be quickly and effectively removed as soon as possible, the vein occlusion can be relieved, the pulmonary embolism can be effectively prevented, the valve function can be protected, and the recurrence rate of the thrombus can be reduced.
The thrombus collecting and thrombus removing devices generally comprise thrombus collecting supports for collecting and capturing thrombus, thrombus collecting supports for crushing thrombus, conveying pipes connected with the thrombus collecting supports, and motors for driving the conveying pipes to rotate circumferentially to enable the thrombus collecting supports to crush thrombus, the thrombus collecting supports are located in the thrombus collecting supports, the thrombus collecting and thrombus removing devices provide a novel and efficient blood vessel recanalization treatment method for patients with venous thrombus, mechanical thrombus collecting operation time is short, related complications are few, and the thrombus collecting and thrombus removing devices are research hotspots in the field of thrombus treatment at present; however, the existing thrombus crushing and thrombus taking device is still not ideal in thrombus crushing for intractable, large and hard thrombus, and the stability of the thrombus crushing support is poor in the mechanical thrombus crushing process, so that the thrombus crushing support and the thrombus taking support are easy to damage the inner wall of a blood vessel.
Disclosure of Invention
In order to solve the problems that the crushing and thrombus taking effects on intractable, large and hard thrombus are not ideal in the prior art, and the stability of a thrombus crushing support is poor in the mechanical thrombus crushing process, so that the thrombus crushing support and the thrombus taking support are easy to damage the inner wall of a blood vessel, the invention discloses a thrombus crushing driving handle, a thrombus crushing driving device and a thrombus crushing and thrombus taking system, so that the structure of the thrombus crushing driving handle in the prior art is optimized, and the thrombus crushing effect on thrombus is improved.
According to a first aspect of the present invention, there is provided a morcellating drive handle comprising a linkage assembly and a handle assembly: the linkage assembly comprises an input terminal and an output terminal which are connected in a rotating mode, the input terminal and the output terminal are meshed with each other, and the transmission ratio of the input terminal to the output terminal is larger than 1; the far end of the handle component is connected with the input terminal and can drive the output terminal to rotate through the input terminal; the output terminal is used for installing the broken bolt assembly so as to drive the broken bolt assembly to rotate.
According to some embodiments of the invention, the transmission ratio of the input terminal to the output terminal is 3.
According to some embodiments of the invention, the output terminal is exposed to the handle assembly to enable installation of the bolt assembly through the exposed portion of the output terminal.
According to some embodiments of the invention, the output terminal is provided with a mounting hole along an axial direction thereof, the mounting hole is used for a conveying pipe of the bolt breaking assembly to penetrate through, and the conveying pipe penetrating through the mounting hole can be limited at the output terminal in a circumferential direction.
According to some embodiments of the invention, at least one of the two opposite sides of the output terminal forms a centering groove which is communicated with the mounting hole and smoothly transits in the axial direction of the mounting hole, and the radial dimension of the centering groove gradually decreases in a direction gradually approaching the mounting hole.
According to some embodiments of the present invention, the input terminal is a driving gear, the output terminal is a driven gear, and the two are engaged with each other; the number of teeth of the driving gear is less than that of the driven gear, so that the rotating speed of the driven gear is less than that of the driving gear.
According to some embodiments of the invention, the rotation axis of the driving gear, the rotation axis of the driven gear and the length direction of the handle assembly are parallel to each other.
According to some embodiments of the invention, the driving gear and the driven gear each have external teeth, the external teeth of the driving gear meshing with the external teeth of the driven gear.
According to some embodiments of the present invention, the input terminal is a driving worm, the output terminal is an externally engaged driven worm gear, and the number of worm heads of the driving worm gear is less than the number of worm gears of the driven worm gear, so that the rotating speed of the driven worm gear is less than the rotating speed of the driving worm gear.
According to some embodiments of the invention, the handle assembly comprises: a handle body having a mounting cavity; the driving unit is arranged in the mounting cavity and comprises a driver; the two opposite ends of the linkage shaft are respectively connected to the output end of the driver and the input end of the input terminal, so that the driver can drive the input terminal to rotate through the linkage shaft.
According to some embodiments of the invention, the linkage shaft comprises a driving shaft, an intermediate flexible shaft and a driven shaft, the driving shaft is connected with the output end of the driver, the driven shaft is connected with the input end of the input terminal, and the intermediate flexible shaft is sleeved with the driving shaft and the driven shaft.
According to some embodiments of the present invention, the driving unit further includes a circuit board, the circuit board is disposed in the mounting cavity, and the driver is electrically connected to the circuit board; the circuit board is provided with a processor and a memory, the memory is stored with a computer program, and the processor can execute the computer program to control the drive rotating speed of the driver to periodically and continuously change.
According to some embodiments of the invention, the processor is further capable of executing the computer program to control the driver to rotate in reverse when there is a sharp increase in current in the circuit.
According to some embodiments of the present invention, the driving unit further includes a power supply and a control switch, wherein the power supply is disposed in the mounting cavity and electrically connected to the control switch and the circuit board; the control switch is arranged on the handle main body and used for controlling the opening and the closing of the driver.
According to some embodiments of the invention, the linkage assembly further comprises an installation shell, the installation shell comprises a linkage box and an installation pipe, the inner cavities of the linkage box and the installation pipe are mutually communicated, the linkage box is exposed out of the installation cavity and is provided with a through hole, and the installation pipe is connected to the far end of the handle main body; the input terminal and the output terminal are installed on the linkage box, the linkage shaft penetrates through the installation tube, the input terminal is opposite to the inner cavity of the installation tube, so that the far end of the linkage shaft is connected to the input terminal, and the output terminal is opposite to the through hole and at least partially exposed out of the output terminal.
According to some embodiments of the present invention, one of the outer wall of the mounting tube and the inner wall of the handle main body is provided with a stopper, and the other is provided with a stopper groove; the limiting block is clamped with the limiting groove to limit the axial movement of the mounting pipe relative to the handle main body; the mounting pipe can rotate in the limiting groove relative to the handle main body in the circumferential direction through the limiting block.
According to a second aspect of the present invention, there is provided a driving device for a deadbolt, the driving device comprising a deadbolt assembly and a deadbolt driving handle: the broken bolt assembly comprises a broken bolt bracket and a conveying pipe, and the distal end of the conveying pipe is connected with the broken bolt bracket; the broken bolt driving handle adopts the broken bolt driving handle, the output terminal is connected with the conveying pipe, and the conveying pipe is driven to rotate under the driving of the linkage assembly.
According to some embodiments of the invention, the conveying pipe penetrates through the output terminal and is circumferentially limited to the output terminal, the proximal end of the conveying pipe is provided with a mounting head, the outer wall of the mounting head is provided with a first limiting bulge and a second limiting bulge which are axially spaced, and at least one of the first limiting bulge and the second limiting bulge can penetrate through the output terminal back and forth against resistance so as to limit or release the output terminal between the first limiting bulge and the second limiting bulge.
According to a third aspect of the present invention, there is provided a morcellal embolectomy system, the morcellal driving system comprising an external sheath, an embolectomy assembly, and a morcellal driving device; the thrombus taking assembly comprises a thrombus taking support and a traction catheter, wherein the thrombus taking support is a support structure capable of contracting and expanding along the radial direction, the proximal end of the thrombus taking support is provided with an opening, and the distal end of the thrombus taking support is closed; the far end of the traction catheter is connected with the embolectomy bracket and movably penetrates through the outer sheath so as to be capable of moving relative to the outer sheath along the axial direction; the broken bolt driving device adopts the broken bolt driving device, the conveying pipe of the broken bolt assembly in the broken bolt driving device movably penetrates through the traction guide pipe, and the conveying pipe can move relative to the traction guide pipe along the axial direction; the conveying pipe can also be driven by the linkage assembly to rotate relative to the traction guide pipe along the circumferential direction so as to drive the broken bolt support to rotate circumferentially in the internal space of the bolt taking support.
According to some embodiments of the invention, the delivery tube is further capable of driving the thrombus support to completely withdraw from the traction catheter so as to suck thrombus in the thrombus support through the inner cavity of the traction catheter.
According to the technical scheme, the embodiment of the invention at least has the following advantages and positive effects:
the driving handle of the bolt breaking device can be used as an independent driving device and is used for butting bolt breaking components with various specifications through a quick interface (a part of an output terminal for mounting the bolt breaking components). Because the input terminal is engaged with the output terminal and the transmission ratio of the input terminal to the output terminal is greater than 1, when the input terminal drives the output terminal to rotate, the rotating speed of the output terminal is less than that of the input terminal. Therefore, after the thrombus assembly is butted on the output terminal, the stirring speed for stirring the thrombus by the thrombus assembly can be reduced, the lower the rotating speed of the thrombus assembly means that the larger the moment of the thrombus assembly is, the more easily the intractable, larger and harder thrombus is crushed by the thrombus assembly with larger moment, and the risk of adhesion and winding of the viscous thrombus tissue can be reduced.
Drawings
FIG. 1 is a schematic diagram of the overall structure of a system for breaking and removing thrombus according to an embodiment of the present invention;
FIG. 2 is a partial perspective view of the morcellating embolectomy drive system of FIG. 1;
FIG. 3 is a schematic view of the driving device of FIG. 1;
FIG. 4 is a perspective view of the drive handle of FIG. 3;
FIG. 5 is a schematic view of a diseased portion of a human inferior vena cava;
FIG. 6 is a schematic view of the morcellating embolectomy system of FIG. 1 penetrating into a lesion;
FIG. 7 is a schematic view of the initial release of the thrombectomy stent;
FIG. 8 is a schematic view of the thrombectomy stent being released and adjusted;
FIG. 9 is a schematic illustration of the thrombectomy stent after release;
FIG. 10 is a schematic view of the thrombectomy stent separating and collecting thrombus within the blood vessel;
FIG. 11 is an operational view of the thrombus removal stent being thrombus-broken by the thrombus breaking assembly;
FIG. 12 is a schematic illustration of the retraction of the broken bolt assembly after completion of the broken bolt;
FIG. 13 is a schematic view of aspiration of a thrombus;
FIG. 14 is a perspective structural view of the drive handle of FIG. 4 from another perspective;
FIG. 15 is a perspective view of the distal end of the linkage assembly of FIG. 14;
FIG. 16 is a schematic view of the distal end of the communication assembly of FIG. 14;
FIG. 17 is a graph illustrating a driving rate variation of a driver according to an embodiment;
FIG. 18 is a cross-sectional view of the drive handle with the distal housing cover of the mounting housing removed;
FIG. 19 is a cross-sectional view of the drive handle with the distal housing cover mounted to the housing;
FIG. 20 is a schematic view of the output terminal of FIG. 19 connected to a mounting head at the proximal end of a delivery tube;
FIG. 21 is a schematic view of the connection of the proximal end of the delivery tube of the crash bolt assembly to the output terminal at the distal end of the drive handle;
FIG. 22 is a schematic view of the drive handle rotating the bolt assembly;
FIG. 23 is a schematic structural view of another embodiment of a drive handle;
fig. 24 is a schematic view of the internal structure of fig. 23.
The reference numerals are explained below: 01. inferior vena cava; 02. thrombus tissue; 03. a guide wire; 04. a puncture hole; 100. a broken thrombus removal system; 1. an outer sheath tube; 11. a sheath pipe joint; 12. a connector conduit; 121. screwing a cover; 13. a suction syringe; 14. a branch conduit; 15. a branch switch; 2. a bolt taking assembly; 21. a traction catheter; 22. a thrombus taking support; 23. a guide head; 3. a bolt breaking assembly; 31. a delivery pipe; 32. a broken bolt support; 33. a loading tube; 34. a mounting head; 341. a first limit protrusion; 342. a second limit bulge; 4. a drive handle; 40. a drive interface; 41. a control switch; 42. a linkage assembly; 421. an input terminal; 422. an output terminal; 4221. centering the groove; 44. a handle assembly; 44a, a mounting cavity; 441. a handle body; 441a, a first housing; 442. a drive unit; 4421. a driver; 4422. a circuit board; 4424. a built-in power supply; 443. a linkage shaft; 4431. a drive shaft; 4432. a middle flexible shaft; 4433. a driven shaft; 423. mounting a shell; 424. a linkage box; 4241. a through hole; 425. installing a pipe; 51. a limiting block; 52. a limiting groove.
Detailed Description
To facilitate an understanding of the present application, the present application will now be described more fully with reference to the accompanying drawings.
In the description of the present application, it should be noted that, unless otherwise explicitly stated or limited, the terms "mounted," "connected," and "disposed" are to be construed broadly and may be, for example, fixedly connected, detachably connected, or integrally connected; can be mechanically or electrically connected; they may be connected directly or indirectly through intervening media, or they may be interconnected between two elements. The specific meaning of the above terms in this application will be understood to be a specific case for those of ordinary skill in the art.
For convenience of expression, in the context of endoluminal interventions, proximal refers to the end of the instrument that is closer to the operator after the intervention and distal refers to the end of the instrument that is further from the operator after the intervention.
According to the prior art, the problems that the intractable, large and hard thrombus is not ideal in crushing and thrombus taking effects, and the stability of a thrombus crushing support is poor in the mechanical thrombus crushing process, so that the thrombus crushing support and the thrombus taking support are easy to damage the inner wall of a blood vessel are solved; simultaneously, the direct rotational speed of output of motor is higher, and the torque is less, and motor and the coaxial direct connection of bits of broken glass support lead to bits of broken glass support's rotational speed on the high side, and the torque is less, and adaptability is relatively poor, consequently smash and get a tie effect unsatisfactory to intractable, great harder thrombus. In order to solve the above problems, the present application provides a morcellation driving handle, a morcellation driving device and a morcellation embolectomy system.
Referring to FIG. 1, one embodiment of the present invention provides a morcellating embolectomy system 100, wherein the morcellating embolectomy system 100 may be used to rapidly and more thoroughly remove occluded thrombi within a vessel to open the vessel. The broken bolt taking system 100 of the embodiment of the invention mainly comprises an outer sheath tube 1, a bolt taking assembly 2, a broken bolt assembly 3 and a driving handle 4.
The sheath tube 1 is used as a loading container, is mainly used for accommodating the embolectomy component 2 and the embolus breaking component 3, and is used for drawing or guiding the embolectomy component 2 and the embolus breaking component 3 to enter a lesion part in a blood vessel so as to realize the removal of thrombus. The thrombectomy assembly 2 is used for collecting and capturing thrombus attached in the blood vessel, and the driving handle 4 is used for driving the thrombectomy assembly 3 to crush the thrombus collected and captured in the thrombectomy assembly 2.
With reference to fig. 1 and 2, the embolectomy assembly 2 includes a distraction catheter 21 and an expandable embolectomy stent 22.
The traction catheter 21 is movably inserted into the outer sheath 1 and is movable in the axial direction relative to the outer sheath 1.
The thrombus taking support 22 is arranged at the far end of the traction catheter 21, and the thrombus taking support 22 can be driven by the traction catheter 21 to move axially in the sheath tube, so that the thrombus taking support 22 extends out or retracts into the sheath tube 1.
Wherein, the thrombus removal support 22 is a support structure which can contract and expand along the radial direction, so that the thrombus removal support 22 can be compressed into the sheath tube 1. Meanwhile, when the thrombus taking support 22 extends out of the sheath tube 1, the thrombus taking support 22 can be naturally expanded and is attached to the inner wall of the blood vessel. It should be understood that the thrombus extraction stent 22 may not be expanded naturally when the thrombus extraction stent 22 extends out of the sheath tube 1, for example, an inner sheath core or a pull guide wire may be further provided in the thrombus extraction system 100, and the inner sheath core or the pull guide wire is connected with the distal end of the thrombus extraction stent 22, and the external force pulls and pulls the proximal end and the distal end of the thrombus extraction stent 22, thereby controlling the contraction and the expansion of the thrombus extraction stent 22. By adopting the mode, when the thrombus taking support 22 is misaligned with the target release position in the blood vessel, the thrombus taking support 22 released in the blood vessel can be finely adjusted, so that the thrombus taking support 22 is prevented from scratching the blood vessel wall in the natural expansion and release process of the thrombus taking support 22.
The proximal end of the thrombectomy stent 22 has an opening and engages the circumferential wall of the thrombectomy stent 22 to perform thrombectomy, so that thrombi in the blood vessel can enter the inner space of the thrombectomy stent 22 through the opening. It is to be understood that the opening may be provided in plural, and the shape of the opening is not limited in any way. At the same time, the distal end of the thrombectomy stent 22 is closed to facilitate the collection and capture of the thrombus, which collects in the interior space of the thrombectomy stent 22. It should be explained that "distal end is closed" means that the distal end closed thrombectomy support 22 can block the escape of thrombus, does not mean that the distal end of thrombectomy support 22 can not pass through after closing, and the mesh structure of thrombectomy support 22 distal end can block the escape of thrombus, all in the explanation category of "distal end is closed", and the through-hole that supplies the seal wire to wear to establish that the distal end that thrombectomy support 22 distal end set up does not influence the explanation of this application scheme to "distal end is closed". Alternatively, the distal end of the thrombectomy stent 22 is provided with a capture net structure, which is understood to mean that the distal end of the thrombectomy stent 22 is closed.
The structure of the embolectomy support 22 is not limited in the present application, and the specific structure of the embolectomy support 22 can be, for example, the embolectomy support 22 described in the priority document with the application number CN202110384767.9 and the title of the invention, "embolectomy system, embolectomy device, embolectomy support and embolectomy device", which is not described herein again.
Referring to fig. 2 and 3, the morcellating assembly 3 includes a delivery tube 31 and an expandable morcellating stent 32.
The thrombus support 32 is arranged at the far end of the conveying pipe 31, and the conveying pipe 31 can drive the thrombus support 32 to axially move in the traction catheter 21 so that the thrombus support 32 extends out of the far end of the traction catheter 21 and is released in the thrombus taking support 2, or the thrombus support 32 is contracted into the traction catheter 21, and the thrombus support 32 can be driven to completely exit the traction catheter 21. Meanwhile, when the delivery pipe 31 rotates in the circumferential direction, the delivery pipe 31 can also drive the thrombus-crushing support 32 to rotate in the circumferential direction synchronously in the internal space of the expanded thrombus-taking support 22 so as to cut and crush the thrombus in the thrombus-taking support 22, thereby ensuring that large-particle thrombus can be removed.
The structure of the thrombus removal support 32 is not limited in the present application, and the specific structure of the thrombus removal support 32 can be, for example, the thrombus removal support 32 described in the priority document with the application number of CN202110384767.9 and the title of the invention, "thrombus removal system, thrombus removal device, thrombus removal support and thrombus removal device", which is not described herein again.
In one embodiment, the plug assembly 3 further comprises a loading tube 33, the loading tube 33 is movably sleeved on the conveying tube, and the loading tube 33 is used for loading the plug support 32. The loading tube 33 can move to the distal end of the delivery tube 31 and is sleeved on the plug support 32, so that the plug support 32 is accommodated in the loading tube 33.
When it is desired to use the thrombi support 32, the loading tube 33 can be moved to the proximal end of the delivery tube 31, so that the distal end of the delivery tube 31 and the thrombi support 32 together extend into the traction catheter 21 for use, and the loading tube 33 stays outside the traction catheter 21. When the plug support 32 is used, the conveying pipe 31 and the plug support 32 can be completely withdrawn from the traction guide pipe 21, and the loading pipe 33 is sleeved on the plug support 32 again, so that the plug support 32 is prevented from contacting with the external environment as much as possible.
The bolt assembly 3 further comprises a mounting head 34, the mounting head 34 being disposed at the proximal end of the delivery tube 31. In other embodiments, the mounting head 34 may be disposed at other positions of the delivery pipe 31, such as the middle of the delivery pipe 31. The delivery tube 31 is secured to the drive handle 4 by a mounting head 34 provided at its proximal end so that the two combine to form a slug driving apparatus. The driving handle 4 is used as a power output source (which can be manual or electric), and can drive the delivery pipe 31 and the thrombus breaking support 32 to rotate circumferentially, so as to cut and break thrombus in the thrombus taking support 22.
Referring to fig. 3 and 4, the driving handle 4 is detachably provided to the proximal end of the delivery tube 31. Wherein, the distal end of the driving handle 4 is provided with a driving interface 40, and the driving interface 40 at the distal end of the driving handle 4 can be butted with the mounting head 34 at the proximal end of the delivery pipe 31. The driving interface 40 can rotate fast under the driving of the power source (which can be driven by manpower or electric power), and then the mounting head 34 which is butted with the driving interface 40 is driven to rotate, and then the delivery pipe 31 which is connected with the mounting head 34 and the thrombus-crushing support 32 at the far end of the delivery pipe 31 are driven to rotate in the circumferential direction, so that the thrombus tissue which is wrapped in the thrombus-taking support 22 is cut and crushed. For example, by pressing a control switch 41 arranged on the driving handle 4, the driving interface 40 is started to rotate, so as to drive the thrombus support 32 to rotate, and the thrombus tissue wrapped in the thrombus removal support 22 is cut and crushed.
For the thrombus removal system 100 of the present application, the delivery tube 31 can also drive the thrombus support 32 to completely exit the traction catheter 21, so as to suck the thrombus in the thrombus removal support 22 through the inner cavity of the traction catheter 21.
The operation of the present fragment bolt removal system 100 will now be described with reference to FIGS. 5-13.
Referring to fig. 5, fig. 5 is a schematic view of a human inferior vena cava vessel 01. Within the inferior vena cava vessel 01 there is thrombus tissue 02. A guide wire 03 is introduced through a femoral vein or popliteal vein puncture 04, so that a surgical path for crushing and removing the thrombus is established.
Referring to fig. 6, the guide wire 03 passes from the mounting head 34 into the delivery tube and out of the guide head 23 at the distal end of the embolectomy assembly 2. The distal end of the morselized embolectomy system 100 is advanced along the guidewire 03 from the puncture 04 into the venous vessel 01, gradually advancing.
Referring to fig. 7, the distal end of the morcellating embolectomy system 100 is advanced stepwise along the guidewire 03 until the distal end of the sheath 1 passes through the thrombus tissue 02.
Referring to fig. 8, the proximal end of the outer sheath 1 is provided with a sheath connector 11, the sheath connector 11 is fixed (the distal end of the sheath connector 11 is used for fixing the proximal end of the outer sheath 1), the traction catheter 21 and the connector catheter 12 (the distal end of the connector catheter is used for fixing the proximal end of the traction catheter 21) are pushed continuously, and the thrombus extraction stent 22 is extended out of the distal end of the outer sheath 1, so that the thrombus extraction stent 22 can be released gradually in the blood vessel. And when the proximal end of the embolectomy stent 22 completely extends out of the distal end port of the sheath catheter 1, the pushing of the traction catheter 21 and the joint catheter 12 is stopped.
During release of the thrombectomy stent 22, the delivery tube 31 may be moved axially relative to the traction catheter 21. And the distal end of the delivery pipe 31 is abutted against the guide head 23 at the distal end of the embolectomy support 22 by pushing the delivery pipe 31 towards the distal end, so as to drive the embolectomy support 22 to extend out of the outer sheath tube 1, and when the proximal end of the embolectomy support 22 completely extends out of the distal end port of the outer sheath tube 1, the embolectomy support 22 is completely released in the blood vessel by fixing the traction catheter 21 and the joint catheter 12 and withdrawing the delivery pipe 31, so that the embolectomy support 22 is arranged in a wall-attached manner in the blood vessel.
It should be noted that the thrombus support 32 can extend out of the traction catheter 21 and into the thrombus removal support 22 during the forward pushing of the delivery tube 31. During withdrawal of the delivery tube 31, the embolic stent 32 may be forced to compress into the interior of the traction catheter 21. It will be appreciated that the pull catheter 21 and adapter catheter 12 may also be secured and the thrombectomy stent 22 released by withdrawal of the sheath 1.
Referring to fig. 9, a schematic view of the thrombus removal stent 22 fully released at the distal end of the thrombus tissue 02 is shown.
Referring to fig. 10, the thrombus taking out system 100 is withdrawn integrally, that is, the sheath tube 1, the traction catheter 21 and the delivery tube 31 are withdrawn integrally, so as to drive the thrombus taking out support 22 to withdraw. The thrombus tissue 02 is peeled off from the inner wall of the vein vessel 01 by using the opening and the stent structure at the proximal end of the embolectomy stent 22, enters the embolectomy stent 22, and is wrapped and collected by the distal end of the embolectomy stent 22.
Referring to FIG. 11, the delivery tube 31 is pushed forward to re-enter the thrombus support 32 into the thrombus support 22. The driving interface 40 arranged at the far end of the driving handle 4 is butted with the mounting head 34 at the near end of the delivery pipe 31, the driving interface 40 is started to rotate by pressing the control switch 41 arranged on the driving handle 4, and then the thrombus support 32 is driven to rotate, so that the thrombus tissue 02 wrapped in the thrombus taking support 22 is cut and crushed.
Referring to FIG. 12, after completion of the morcellation, the entirety of the morcellation assembly 3, such as the morcellation holder 32, the delivery tube 31, etc., is withdrawn proximally of the morcellation drive device and completely withdrawn proximally of the adapter catheter 12. After the thrombus support 32 is withdrawn from the adapter catheter 12, the loading tube 33 is sleeved on the thrombus support 32, so that the thrombus support 32 is compressed into the loading tube 33.
Referring to fig. 13, the cap 121 on the proximal end of the adapter catheter 12 is rotated to compress an internal sealing ring (not shown) to close the proximal port of the adapter catheter 12. The suction cylinder 13 is communicated with the branch catheter 14. By pulling the suction syringe 13, the broken thrombus can be sucked into the suction syringe 13 through the traction catheter 21 and the branch catheter 14 and taken out. A branch switch 15 is provided between the suction cylinder 13 and the branch catheter 14, and the branch switch 15 controls whether or not the branch catheter 14 and the suction cylinder 13 communicate with each other. It will be appreciated that branch switch 15 may also be used to control whether branch conduit 14 is in communication with the outside.
The above is a brief description of the present application of the overall morcellating embolectomy system 100. The principle of the driving handle 4 for rotating the tumbler assemblies 3 according to the embodiments of the present application will be described in detail with reference to the following embodiments.
Reference is now made to fig. 4 and 14, where fig. 14 is a perspective view of the break bolt drive handle 4 of fig. 4 from another perspective. The morcellating drive handle 4 of various embodiments of the present application includes a linkage assembly 42 and a handle assembly 44.
The linkage assembly 42 is disposed at the distal end of the handle assembly 44, the linkage assembly 42 including an input terminal 421 and an output terminal 422 rotatably connected thereto. The input terminal 421 is used to connect a power source, for example, the proximal end of the input terminal 421 can be connected to a power input rod, and the power input rod can be operated by human hand to infuse power to realize manual driving. The proximal end of the input terminal 421 can also be directly connected to the motor to achieve electric drive. The output terminal 422 is used for connecting the mounting head 34 at the proximal end of the delivery pipe 31, and the handle assembly 44 can drive the output terminal 422 to rotate through the input terminal 421, so as to drive the mounting head 34, the delivery pipe 31 and the distal plug support 32 to rotate.
When the input terminal 421 drives the output terminal 422 to rotate, the rotation speed of the output terminal 422 is lower than that of the input terminal 421, which means that the rotation speed of the power input source is reduced under the operation mechanism of the linkage assembly 42. Moreover, the smaller the rotation speed of the output terminal 422 is, the lower the stirring rate of the thrombus by the thrombus crushing assembly 3 connected to the output terminal 422 is, the lower the rotation speed of the thrombus crushing assembly 3 is, the larger the torque is, the more easily the thrombus crushing assembly 3 crushes the intractable, larger and harder thrombus, and the risk of adhesion and winding of the viscous thrombus tissue can be reduced, and the safety factor of the operation can be increased.
In one embodiment, the input terminal 421 and the output terminal 422 are engaged with each other, and the transmission ratio of the input terminal 421 and the output terminal 422 is greater than 1. In one embodiment, the transmission ratio of the input terminal 421 to the output terminal 422 is 3. The transmission ratio of the input terminal 421 and the output terminal 422 can be understood as a rotation ratio therebetween, that is, a rotation ratio of the input terminal 421 to the output terminal 422. Referring to fig. 15, the input terminal 421 in this embodiment may be a driving gear, the output terminal 422 may be a driven gear, and the driving gear and the driven gear are engaged with each other. And the number of teeth of the driving gear is less than that of the driven gear, so that the rotating speed of the driven gear is less than that of the driving gear. Specifically, in this embodiment, the number of teeth of the driving gear is 12, the number of teeth of the driven gear is 32, and the reduction ratio is about 1. Specifically, the number of teeth of the driving gear and the driven gear may be set according to a target deceleration degree.
It should be noted that fig. 15 illustrates that the driving interface 40 is formed on the driven gear, and the driving interface 40 is represented by a mounting hole axially opened on the driven gear, and the mounting hole is used for the proximal end of the conveying pipe 31 of the breaking bolt assembly 3 to penetrate through, and can make the conveying pipe 31 penetrating through the mounting hole circumferentially limited on the driven gear, so that the proximal end of the conveying pipe 31 can synchronously rotate along with the driven gear. Of course, the driving interface 40 according to the embodiments of the present application is not limited in any way, and the driving interface 40 may be a mounting groove, or the driving interface 40 may be an attaching surface (adhesive surface, magnetic attraction surface, etc.) capable of attaching to the proximal end of the delivery tube 31.
The driving gear and the driven gear are in an external meshing relationship, namely the driving gear and the driven gear are both provided with external teeth, and the external teeth of the driving gear are meshed with the external teeth of the driven gear. It will be appreciated that in other embodiments, the driving gear and the driven gear may be in inter-meshing relationship, i.e., the external teeth of the driving gear mesh with the internal teeth of the driven gear, and the inter-meshing structure will be more compact. The externally engaged driving gear and driven gear will release the space inside the driven gear based on the size of the driving gear being smaller than the driven gear, and therefore, the drive interface 40 will be sized larger to facilitate docking the mounting head 34 at the proximal end of the delivery tube 31 through the drive interface 40.
It should be noted that, the driving gear and the driven gear can adopt helical gear meshing, so as to increase the meshing effect of the driving gear and the driven gear and reduce the working noise. And the driving gear is used as an input end, the driven gear is used as an output end, and at least one intermediate gear can be arranged between the driving gear and the driven gear for transmission.
In one embodiment, the rotational axis of the drive gear, the rotational axis of the driven gear, and the length of the handle assembly 44 are parallel to each other. Thus, the operation habit of pushing the catheter in the interventional operation of a doctor can be met.
Referring to fig. 14, the handle assembly 44 is capable of rotating the output terminal 422 via the input terminal 421. Handle assembly 44 includes a handle body 441, a drive unit 442, and a linkage shaft 443. The handle body 441 has a mounting cavity 44a, and the mounting cavity 44a is used for mounting components such as the driving unit 442 and the linkage shaft 443. The handle body 441 is used as a structural body for being held by hands of an operator during use, so that the operation is convenient. The handle body 441 can be formed by injection molding of ABS or PC and other materials, so that the hand feeling of a user in holding is improved, and the comfort level is improved. The appearance of the handle body 441 can adapt to human engineering so as to meet the requirements of human-computer interaction.
In one embodiment, the handle body 441 includes a first shell 441a and a second shell (not shown), and the first shell 441a and the second shell are buckled to form the mounting cavity 44a. Fig. 14 shows only the first housing 441a for the convenience of describing the structure in the mounting chamber 44a. The first housing 441a and the second housing are detachably connected, so that the components inside the driving handle 44 can be more conveniently assembled and disassembled in terms of the assembly process.
The driving unit 442 includes a driver 4421 and a circuit board 4422, the driver 4421 may be a motor, the driver 4421 is electrically connected to the circuit board 4422, and the circuit board 4422 is used for controlling the operation of the driver 4421. In this embodiment, the driver 4421 is disposed at a distal end of the circuit board 4422 to facilitate connection of the output terminal of the driver 4421 to the input terminal 421, and the circuit board 4422 is disposed at a proximal end of the driver 4421 to facilitate connection of the circuit board 4422 to an external power source or an internal power source, so as to supply power to the circuit board 4422 and the driver 4421. The driving unit 442 in this embodiment further includes a built-in power supply 4423, the built-in power supply 4423 is disposed in the mounting cavity 44a, and the built-in power supply 4423 is located at the proximal end of the circuit board 4422.
The two opposite ends of the linkage shaft 443 are respectively connected to the output end (distal end) of the driver 4421 and the input end (proximal end) of the input terminal 421, so that the driver 4421 can drive the input terminal 421 to rotate through the linkage shaft 443. In one embodiment, the linkage shaft 443 includes a driving shaft 4431, an intermediate flexible shaft 4432 and a driven shaft 4433, the driving shaft 4431 is connected with the output end of the driver 4421, the driven shaft 4433 is connected with the input end of the input terminal 421, and the intermediate flexible shaft 4432 is sleeved on the driving shaft 4431 and the driven shaft 4433. The driving shaft 4431 and the driven shaft 4433 can be stainless steel shafts, the middle flexible shaft 4432 can be a silica gel flexible shaft, and the middle flexible shaft 4432 has the function of a coupler, so that the coaxiality requirement of the integral assembly of the driving shaft 4431 and the driven shaft 4433 can be improved. In order to enhance the connection strength between the shafts, glue can be injected between the shafts for fixation. It should be noted that, in other embodiments, the intermediate flexible shaft 4432 may also be a coupler.
The circuit board 4422 has a processor and a memory integrated therein, and the memory stores a computer program, so that the processor can execute the computer program to control the driver 4421 to rotate according to a rule preset by the computer program. Where the drive 4421 may be an electric motor, the computer program comprises computer instructions stored in a computer readable storage medium. The processor of the computer device reads the computer instructions from the computer-readable storage medium, and the processor executes the computer instructions, so that the computer device performs the step of the driver 4421 performing rotation according to the preset rule. In one embodiment, the processor can execute the computer program to control the driving rotation speed of the driver 4421 to be continuously changed periodically. The periodic continuous variation law may be expressed as a periodic variation of the rotation speed with time after the start of the driver 4421. For example, referring to fig. 17, the rotational speed of the driver 4421 is directly converted at 80% to 100% of the peak rotational speed, which is visualized as a periodic variation of acceleration-deceleration of the output shaft of the driver 4421, and the input terminal 421. The acceleration and deceleration setting of the driver 4421 is to achieve a better bolt breaking effect by using the impact force of the speed change.
In one embodiment, the processor is further capable of executing the computer program to control the driver 4421 to rotate in reverse when the current in the circuit increases sharply. Since the bolt assembly 3 encounters too much resistance or a stuck state during operation, the output shaft of the driver 4421 cannot rotate, which causes the driver 4421 to short-circuit, the short-circuited driver 4421 will cause the current in the circuit to increase sharply, and the driving unit 442 will sense the current in the circuit to increase sharply, so as to control the driver 4421 to rotate reversely when the current in the circuit increases sharply. This function can effectively protect the driver 4421 and the vascular tissue in the patient's body, and can quickly and automatically release the seizure failure.
With reference to fig. 14, the driving unit 442 further includes a control switch 41, the control switch 41 is electrically connected to the circuit board 4422, the control switch 41 is used for controlling the on/off of the driver 4421, and the control switch 41 is disposed on the handle body 441 and exposed from the mounting cavity 44a for the user to operate and control. The control switch 41 is configured as a button disposed on the handle body 441, and it is understood that the control switch 41 may also be a toggle button disposed on the handle body 441 or a touch display screen disposed on the handle body 441.
With reference to fig. 15 and 16, at least a portion of the output terminal 422 is exposed out of the handle assembly 44, so that the bolt assembly 3 can be directly mounted through the exposed portion of the output terminal 422, thereby facilitating the operation of a human hand. The driving interface 40 at the distal end of the handle assembly 44 is formed on the output terminal 422, and the driving interface 40 on the output terminal 422 can be understood as a partial structure of the output terminal 422, which is exposed out of the handle assembly 44 to facilitate the installation of the installation head 34 at the proximal end of the delivery tube 31 and to facilitate the threading of the guide wire. It is understood that the output terminal 422 may be disposed in the handle assembly 44, and the driving interface 40 may not be exposed from the handle assembly 44. In the case where the output terminal 422 is provided in the handle assembly 44, the handle body 441 may be provided with a hole site through which the guide wire and the carrier tube 31 are inserted, so as to facilitate the insertion of the guide wire and the installation of the carrier tube 31.
In order to avoid direct exposure of the input terminal 421 and the output terminal 422 to the air, the input terminal 421 and the output terminal 422 are easily attached and detached. The linkage assembly 42 of the present application further includes a mounting shell 423, wherein fig. 15 illustrates an internal schematic view of the mounting shell 423 without a distal end shell cover, fig. 16 illustrates a schematic view of the mounting shell 423 having the distal end shell cover, the mounting shell 423 is connected to the distal end of the handle main body 441, the mounting shell 423 has a receiving cavity 4231, and the receiving cavity 4231 of the mounting shell 423 is used for mounting the input terminal 421 and the output terminal 422, so that the input terminal 421 and the output terminal 422 can rotate relative to the mounting shell 423.
Referring to fig. 18 and 19, the mounting case 423 includes a link box 424 and a mounting tube 425 having inner cavities communicating with each other, the link box 424 is exposed to the mounting cavity 44a and is opened with a through hole 4241, and the mounting tube 425 is connected to the distal end of the handle body 441. The input terminal 421 and the output terminal 422 are mounted on the linkage box 424, and the linkage shaft 443 is inserted into the mounting tube 425 and can rotate relative to the mounting tube 425 in the mounting tube 425. The input terminal 421 opposes the inner cavity of the mounting tube 425 such that the distal end of the linkage shaft 443 is connected to the input terminal 421, and the driver 4421 rotates the input terminal 421 via the linkage shaft 443. The output terminal 422 is opposite to the through hole 4241 to expose at least a portion of the output terminal 422, i.e., the driving interface 40 on the output terminal 422.
One of the outer wall of the mounting tube 425 and the inner wall of the handle body 441 is provided with a stopper 51, and the other is provided with a stopper groove 52. In this embodiment, the limiting block 51 is disposed on the mounting tube 425, the limiting groove 52 is disposed on the handle body 441, and the limiting block 51 is clamped in the limiting groove 52 to limit the axial movement of the mounting tube 425 relative to the handle body 441, so that the mounting tube 425 can rotate circumferentially relative to the handle body 441 in the limiting groove 52 via the limiting block 51. The mounting tube 425 which cannot move axially can ensure that the mounting shell 423 is fixed relative to the handle body 441, so that the mounting shell 423 can be prevented from carrying the bolt assembly 3 to separate from the handle body 441 when the output terminal 422 drives the bolt assembly 3 to rotate, and the safety coefficient of the operation is improved. In addition, the mounting tube 425 can rotate circumferentially in the limiting groove 52 through the limiting block 51, so that the orientation of the side where the output terminal 422 is located can be adjusted according to the actual application environment and the use requirement, and the mounting head 34 at the proximal end of the delivery tube 31 of the bolt breaking assembly 3 can be more favorably abutted to the output terminal 422.
Referring to fig. 20, the transmission tube 31 penetrates through the output terminal 422 and is circumferentially limited on the output terminal 422, so that the output terminal 422 can drive the transmission tube 31 to synchronously rotate. In order to realize the synchronous rotation of the output terminal 422 with the conveying pipe 31, the present embodiment sets the driving interface 40 as a non-circular mounting hole (40 in the figure). In one embodiment, the cross-sectional shape of the mounting hole is a polygon, such as a regular hexagon, and the cross-section of the delivery pipe 31 for fitting the mounting head 34 to the mounting hole is also configured as a regular hexagon.
The outer wall of the mounting head 34 at the proximal end of the delivery tube 31 is provided with axially spaced first and second stop projections 341, 342, the first stop projection 341 being closer to the distal end of the delivery tube 31 than the second stop projection 342. At least one of the first and second restriction protrusions 341 and 342 can pass back and forth through the mounting hole of the output terminal 422 against resistance to restrict or release the output terminal 422 between the first and second restriction protrusions 341 and 342.
Fig. 21 illustrates a schematic view of mounting the mounting head 34 to the output terminal 422. For ease of understanding, each embodiment will be described below in conjunction with fig. 20 and 21.
When the first limiting protrusion 341 and the second limiting protrusion 342 can overcome the resistance and pass through the mounting hole of the output terminal 422 back and forth, in order to connect the delivery tube 31 of the bolt-breaking component 3 with the output terminal 422, before the interventional operation, the distal end of the delivery tube 31 is first inserted from one side of the proximal end of the mounting hole and leads to the distal end of the mounting hole, so that the first limiting protrusion 341 at the proximal end of the delivery tube 31 overcomes the resistance and passes through the mounting hole of the output terminal 422, and further the first limiting protrusion 341 and the second limiting protrusion 342 are located at two opposite sides of the mounting hole, and at this time, the mounting head 34 is mounted on the output terminal 422. Of course, the proximal end of the delivery tube 31 may be inserted from the distal side of the mounting hole and led to the proximal end of the mounting hole after/before the interventional operation, so that the second limiting protrusion 342 at the proximal end of the delivery tube 31 passes over the mounting hole of the output terminal 422 against the resistance, and the first limiting protrusion 341 and the second limiting protrusion 342 are located at two opposite sides of the mounting hole.
When the first limiting protrusion 341 can overcome the resistance and pass through the mounting hole of the output terminal 422 back and forth, and the second limiting protrusion 342 cannot overcome the resistance and pass through the mounting hole of the output terminal 422 back and forth, in order to connect the delivery tube 31 of the bolt breaking assembly 3 with the output terminal 422, before an interventional operation, the distal end of the delivery tube 31 is first penetrated through from one side of the proximal end of the mounting hole and led to the distal end of the mounting hole, so that the first limiting protrusion 341 at the proximal end of the delivery tube 31 overcomes the resistance and passes through the mounting hole of the output terminal 422, and the first limiting protrusion 341 and the second limiting protrusion 342 are located at two opposite sides of the mounting hole.
When the second limiting protrusion 342 can overcome the resistance to pass through the mounting hole of the output terminal 422 back and forth, and the first limiting protrusion 341 cannot overcome the resistance to pass through the mounting hole of the output terminal 422 back and forth, in order to connect the delivery tube 31 of the bolt-breaking assembly 3 with the output terminal 422, the proximal end of the delivery tube 31 can also be penetrated from the distal end side of the mounting hole and led to the proximal end of the mounting hole after/before the interventional operation, so that the second limiting protrusion 342 at the proximal end of the delivery tube 31 overcomes the resistance to pass through the mounting hole of the output terminal 422, and the first limiting protrusion 341 and the second limiting protrusion 342 are located at two opposite sides of the mounting hole.
The limiting protrusion may be a convex point on the outer surface of the mounting head 34, or may be a convex ring on the outer surface of the mounting head 34. When the limiting protrusion can overcome the resistance and pass through the mounting hole of the output terminal 422 back and forth, the limiting protrusion or the hole wall of the mounting hole abutted against the limiting protrusion can be regarded as being capable of generating elastic deformation, and the limiting protrusion can be made of an elastic material. When the bolt breaking work is completed, if the bolt breaking assembly 3 needs to be unlocked from the output terminal 422, the output terminal 422 and the mounting head 34 at the proximal end of the delivery pipe 31 can be disconnected by only increasing the pulling force appropriately toward the side where the limit projection capable of overcoming the above resistance is located.
In addition, as shown in fig. 20, in an embodiment, the distance between the first limiting protrusion 341 and the second limiting protrusion 342 in the axial direction of the delivery pipe 31 is greater than the depth of the mounting hole in the axial direction, which means that the delivery pipe 31 can move/slip in the axial direction by a small distance relative to the output terminal 422, the movement/slip can be generated by vibration, the movement/slip of the small distance can be performed simultaneously along with the rotation of the output terminal 422 driving the delivery pipe 31 to rotate, so that the circumferential rotation of the axial movement and the circumferential rotation of the delivery pipe 31 driving the bolt support 32 at the distal end of the delivery pipe 31 to move axially and synchronously can be performed, the relative movement of the bolt support 32 in the axial direction and the circumferential direction can be performed to cut the thrombus, compared with the cutting of the thrombus only in the axial direction punching mode and the circumferential direction rotary cutting mode, the efficiency and the success rate of cutting and crushing thrombus are not only depended on the magnitude of the punching force of the bolt support 32 in the axial direction and the circumferential direction.
In one embodiment, at least one of two opposite sides of the output terminal 422 in the axial direction of the mounting hole is formed with a smoothly transitional centering groove 4221 communicated with the mounting hole, and the radial dimension of the centering groove 4221 is gradually reduced in a direction gradually approaching the mounting hole. The groove surface of the centering groove 4221 may be a plurality of inclined surfaces or an arc surface. In this embodiment, both the proximal and distal sides of the mounting hole are provided with centering slots 4221. The centering grooves 4221 on two sides have a certain gradient, so that a guide effect in disassembly and assembly can be achieved.
FIG. 22 illustrates the rotation of the driving handle 4 with the tumbler assembly 3 mounted on the output terminal 422. Referring to fig. 21, when the thrombi breaking assembly 3 is installed in place, the control switch 41 arranged on the handle body 441 is triggered, so that the rotation of the thrombi breaking assembly 3 can be realized, and the cutting of the thrombus in the blood vessel can be completed.
Fig. 23 and 24 are schematic views showing the structure of a driving handle according to another embodiment of the present invention.
Referring to fig. 23 and 24, in this embodiment, a worm gear version of the linkage assembly 42 is provided. The drive handle 4 of the present embodiment is different in the structure of the linkage assembly 42 provided at the distal end of the drive handle 4.
In this embodiment, the input terminal 421 is a driving worm, the output terminal 422 is an externally engaged driven worm gear, and the number of worm heads of the driving worm gear is less than the number of worm gears of the driven worm gear, so that the rotating speed of the driven worm gear is less than that of the driving worm gear. It should be noted that the number of worm heads is the number of spiral lines on the worm. If the spiral line on the worm is one, the worm is called a single-head worm, and for the single-head worm, the worm rotates for one circle, and the worm wheel rotates for one tooth. If the spiral line on the worm is two, the worm is called a double-headed worm, and for the double-headed worm, the worm rotates for one circle, and the worm wheel rotates for two teeth.
For the structural design adopting the worm gear, the rotating direction of the output terminal 422 can be changed, and at the moment, the rotating axis of the output terminal 422 is not parallel to the rotating axis of the input terminal 421 any more, but the rotating axis and the rotating axis are perpendicular to each other, so that the installation direction of the bolt breaking assembly 3 is changed, and the bolt breaking assembly can be flexibly selected according to the actual use requirement.
In the link assembly 42 of the present embodiment, the mounting case 423 for mounting the input terminal 421 and the output terminal 422 is formed integrally with the handle body 441. It is understood that, in other embodiments, the mounting case 423 may be detachably connected to the handle body 441 and may be rotated with respect to the handle body 441 to change the mounting orientation of the output terminal 422, as described with reference to the previous embodiments.
Based on the technical scheme, the embodiment of the invention at least has the following advantages and beneficial effects:
the bolt driving handle 4 of the embodiment of the invention can be used as an independent driving device for butting various specifications of bolt assemblies 3 through the driving interface 40 (the part of the output terminal 422 for installing the bolt assemblies 3). Because when the input terminal drives the output terminal and rotates, the rotational speed of output terminal is less than the rotational speed of input terminal, so after garrulous bolt subassembly 3 docks in output terminal 422, compare coaxial direct-connected mode, can stir garrulous speed of garrulous thrombus to garrulous bolt subassembly 3 and carry out the deceleration, the rotational speed of garrulous bolt subassembly 3 is lower means that the moment of garrulous bolt subassembly 3 is big more, the stubborn, great harder thrombus is smashed more easily to garrulous bolt subassembly 3 that moment is big more, and can also reduce by the winding risk of viscous thrombus tissue adhesion, improve the factor of safety of operation, ensure the success probability of operation. Simultaneously, utilize linkage subassembly 42's non-coaxiality, when can satisfying the transmission effect to shredded bolt subassembly 3, make a cavity that supplies the seal wire to wear to establish shredded bolt and get bolt system 100, play fine direction and stable effect to shredded bolt subassembly 3 and get bolt subassembly 2, be favorable to avoiding getting bolt subassembly 2 and shredded bolt subassembly 3 and get the in-process of tying and garrulous bolt and cause the damage to the vascular wall, reach the effect that effectively improves the stability of shredded bolt, security and validity.
The above-mentioned embodiments only express several embodiments of the present application, and the description thereof is more specific and detailed, but not construed as limiting the claims. It should be noted that, for a person skilled in the art, several variations and modifications can be made without departing from the concept of the present application, and these are all within the scope of protection of the present application. Therefore, the protection scope of the present patent shall be subject to the appended claims.
Claims (20)
1. A deadbolt actuation handle, comprising:
the linkage assembly comprises an input terminal and an output terminal which are connected in a rotating mode, the input terminal and the output terminal are meshed with each other, and the transmission ratio of the input terminal to the output terminal is larger than 1; and
the remote end of the handle component is connected with the input terminal and can drive the output terminal to rotate through the input terminal; the output terminal is used for installing the broken bolt assembly so as to drive the broken bolt assembly to rotate.
2. The deadbolt drive handle of claim 1, wherein a gear ratio of the input terminal to the output terminal is 3.
3. A deadbolt actuation handle according to claim 1, wherein the output terminal is exposed to the handle assembly to enable partial installation of the deadbolt assembly through the output terminal exposure.
4. A driving handle for a tumbler according to claim 1, wherein the output terminal is provided with a mounting hole along an axial direction thereof, the mounting hole is used for a transmission pipe of the tumbler assembly to pass through, and the transmission pipe passing through the mounting hole can be limited to the output terminal in a circumferential direction.
5. A deadbolt driving handle as recited in claim 4 wherein at least one of said opposite sides of said output terminal defines a smoothly transitioning centering slot communicating with said mounting aperture in the axial direction of said mounting aperture, said centering slot having a decreasing radial dimension in a direction progressively closer to said mounting aperture.
6. The morcellating drive handle of claim 1 wherein the input terminal is a drive gear and the output terminal is a driven gear, with gear mesh therebetween; the number of teeth of the driving gear is less than that of the driven gear, so that the rotating speed of the driven gear is less than that of the driving gear.
7. A deadbolt actuation handle as recited in claim 6 wherein the axis of rotation of the drive gear, the axis of rotation of the driven gear, and the length of the handle assembly are parallel to one another.
8. The morcellating drive handle of claim 6, wherein the drive gear and the driven gear each have external teeth, the external teeth of the drive gear meshing with the external teeth of the driven gear.
9. The deadbolt driving handle of claim 1, wherein the input terminal is a drive worm and the output terminal is an externally-engaged driven worm gear, the drive worm having fewer worm heads than the driven worm gear such that the driven worm gear rotates at a speed less than the drive worm.
10. A morcellating drive handle according to claim 1, wherein the handle assembly comprises:
a handle body having a mounting cavity;
the driving unit is arranged in the mounting cavity and comprises a driver;
the two opposite ends of the linkage shaft are respectively connected to the output end of the driver and the input end of the input terminal, so that the driver can drive the input terminal to rotate through the linkage shaft.
11. A driving handle for driving deadbolts according to claim 10, wherein said linkage shaft comprises a driving shaft, an intermediate flexible shaft and a driven shaft, said driving shaft is connected to the output end of said driver, said driven shaft is connected to the input end of said input terminal, said intermediate flexible shaft is sleeved on said driving shaft and said driven shaft.
12. A morcellating drive handle according to claim 10, wherein the drive unit further comprises a circuit board, the circuit board being disposed within the mounting cavity, the driver being electrically connected to the circuit board;
the circuit board is provided with a processor and a memory, the memory is stored with a computer program, and the processor can execute the computer program to control the drive rotating speed of the driver to periodically and continuously change.
13. A deadbolt driver handle according to claim 12, wherein the processor is further capable of executing the computer program to control the driver to reverse rotation when the current in the circuit increases sharply.
14. A morcellating drive handle according to claim 12, wherein the drive unit further comprises a power source and a control switch, the power source being disposed in the mounting cavity and electrically connecting the control switch and the circuit board; the control switch is arranged on the handle main body and used for controlling the opening and the closing of the driver.
15. A morcellating drive handle according to claim 10 wherein the linkage assembly further comprises a mounting housing including a linkage box and a mounting tube, the linkage box and the mounting tube having interconnected internal cavities, the linkage box being exposed from the mounting cavity and having a through hole, the mounting tube being connected to the distal end of the handle body;
the input terminal and the output terminal are installed on the linkage box, the linkage shaft penetrates through the installation tube, the input terminal is opposite to the inner cavity of the installation tube, so that the far end of the linkage shaft is connected to the input terminal, and the output terminal is opposite to the through hole and at least partially exposed out of the output terminal.
16. A morcellating driving handle according to claim 15, wherein one of the outer wall of the mounting tube and the inner wall of the handle body is provided with a limit block, and the other is provided with a limit groove;
the limiting block is clamped with the limiting groove to limit the axial movement of the mounting pipe relative to the handle main body; the mounting pipe can rotate in the limiting groove relative to the handle main body in the circumferential direction through the limiting block.
17. A deadbolt actuation assembly, comprising:
the bolt breaking assembly comprises a bolt breaking bracket and a conveying pipe, and the distal end of the conveying pipe is connected with the bolt breaking bracket;
a deadbolt drive handle as claimed in any one of claims 1-16 wherein said output terminal is connected to said feed tube for rotation of said feed tube by said linkage assembly.
18. The driving device for the crumbling bolt of claim 17, wherein the conveying pipe penetrates through the output terminal and is circumferentially limited to the output terminal, a mounting head is disposed at a proximal end of the conveying pipe, an outer wall of the mounting head is provided with a first limiting protrusion and a second limiting protrusion which are axially spaced, and at least one of the first limiting protrusion and the second limiting protrusion can pass through the output terminal back and forth against resistance so as to limit or release the output terminal between the first limiting protrusion and the second limiting protrusion.
19. A fragmented embolectomy system, comprising:
an outer sheath tube;
the thrombus removal assembly comprises a thrombus removal support and a traction catheter, wherein the thrombus removal support is a support structure capable of contracting and expanding along the radial direction, the proximal end of the thrombus removal support is provided with an opening, and the distal end of the thrombus removal support is closed; the far end of the traction catheter is connected with the embolectomy bracket and movably penetrates through the outer sheath so as to be capable of moving relative to the outer sheath along the axial direction;
a morcellating drive device according to claim 17 or 18, wherein the delivery tube is movably disposed within the traction guide tube and is axially movable relative to the traction guide tube;
the conveying pipe can also be driven by the linkage assembly to rotate relative to the traction guide pipe along the circumferential direction so as to drive the broken bolt support to rotate circumferentially in the internal space of the bolt taking support.
20. A morcellating embolectomy system of claim 19, wherein the delivery tube is further configured to advance the morcellating stent completely out of the traction catheter to aspirate thrombi within the embolectomy stent through a lumen of the traction catheter.
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CN202110820049.1A Active CN113729852B (en) | 2021-04-09 | 2021-07-20 | Bolt taking system |
CN202110820054.2A Active CN113729853B (en) | 2021-04-09 | 2021-07-20 | Bolt breaking support, bolt breaking device and bolt taking system |
CN202110821331.1A Active CN113729854B (en) | 2021-04-09 | 2021-07-20 | Bolt taking support, bolt taking device and bolt taking system |
CN202210094131.5A Pending CN115192139A (en) | 2021-04-09 | 2022-01-26 | Broken bolt driving handle, broken bolt driving device and broken bolt taking system |
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CN202110820049.1A Active CN113729852B (en) | 2021-04-09 | 2021-07-20 | Bolt taking system |
CN202110820054.2A Active CN113729853B (en) | 2021-04-09 | 2021-07-20 | Bolt breaking support, bolt breaking device and bolt taking system |
CN202110821331.1A Active CN113729854B (en) | 2021-04-09 | 2021-07-20 | Bolt taking support, bolt taking device and bolt taking system |
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WO (1) | WO2022214020A1 (en) |
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CN116784943A (en) * | 2023-08-18 | 2023-09-22 | 浙江归创医疗科技有限公司 | Thrombus removal system |
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- 2021-07-20 CN CN202110820054.2A patent/CN113729853B/en active Active
- 2021-07-20 CN CN202110821331.1A patent/CN113729854B/en active Active
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2022
- 2022-01-26 CN CN202210094131.5A patent/CN115192139A/en active Pending
- 2022-04-07 WO PCT/CN2022/085491 patent/WO2022214020A1/en active Application Filing
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CN116784943A (en) * | 2023-08-18 | 2023-09-22 | 浙江归创医疗科技有限公司 | Thrombus removal system |
CN116784943B (en) * | 2023-08-18 | 2023-11-14 | 浙江归创医疗科技有限公司 | thrombus removal system |
CN117503273A (en) * | 2023-12-11 | 2024-02-06 | 广东博迈医疗科技股份有限公司 | Thrombus clearing device and thrombus clearing system |
CN117503273B (en) * | 2023-12-11 | 2024-10-01 | 广东博迈医疗科技股份有限公司 | Thrombus clearing device and thrombus clearing system |
Also Published As
Publication number | Publication date |
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CN113729853B (en) | 2023-11-07 |
CN113729854B (en) | 2023-05-26 |
CN113729852A (en) | 2021-12-03 |
WO2022214020A1 (en) | 2022-10-13 |
CN113729854A (en) | 2021-12-03 |
CN113729853A (en) | 2021-12-03 |
CN113729852B (en) | 2023-06-23 |
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