CN101773699A - 防止导管冲洗管扭结的方法与装置 - Google Patents

防止导管冲洗管扭结的方法与装置 Download PDF

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CN101773699A
CN101773699A CN200910253602A CN200910253602A CN101773699A CN 101773699 A CN101773699 A CN 101773699A CN 200910253602 A CN200910253602 A CN 200910253602A CN 200910253602 A CN200910253602 A CN 200910253602A CN 101773699 A CN101773699 A CN 101773699A
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A·戈瓦里
A·加西亚
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Abstract

本发明涉及防止导管冲洗管扭结的方法与装置。一种包括插入管的医疗装置，所述插入管具有用于插入受试者体内的远端并且在所述远端上具有开口。一种管腔，所述管腔包括柔性管，所述柔性管纵向穿过所述插入管从而连通所述插入管远端上的所述开口，并且由所述插入管内部的张力来固定所述柔性管。

Description

防止导管冲洗管扭结的方法与装置
技术领域
本发明整体涉及医疗装置，具体地讲涉及通过刺入式医疗探针来输送流体的管子。
背景技术
在一些医疗程序中，将能量以浓缩剂量局部地施加到身体组织，并且希望将处理区域冷却以减少附带的组织损伤。
例如，使用心脏消融疗法来治疗心律失常，方法为通过用射频(RF)电能加热组织以在心肌内产生不导电的损伤。已经发现的是，冷却消融位点区域会减少组织焦化和血栓形成。出于此目的，Biosense WebsterInc.(Diamond Bar，California)提供了作为其集成式消融系统一部分的
Figure G2009102536027D00011
冲洗顶端导管。该金属导管顶端以RF电流供能来消融组织，并且具有若干个用于冲洗处理位点的周边孔，这些孔环绕该顶端周边分布。连接到导管的泵将盐水溶液输送到导管顶端，并且该溶液在所述过程中经周边孔流出，从而冷却导管顶端和组织。
导管容易扭结，本领域中已知有若干用于避免扭结的方法。例如，美国专利5,460,608描述了具有外轴和内轴的气囊导管，其中将内轴构造成能在其整个长度上自我保护(尤其在其最易损坏的区域内)，同时保持柔韧性。可以将内轴加固，在整个长度上防止其塌陷或破裂，同时改善气囊的放气时间。
发明内容
在下文中描述的本发明实施方案提供用于组装医疗探针的新型方法。这些方法提供简单廉价的方式来制备更加可靠和安全的探针。
因此，根据本发明的实施方案，提供了包括插入管的医疗装置，该插入管具有用于插入受试者体内的远端，并且在远端具有开口。一种管腔，该管腔包括柔性管，该柔性管纵向穿过插入管，与插入管远端上的开口连通，由插入管内部张力来固定。
通常，将管腔配置成通过开口向远端附近的身体组织输送冲洗流体。在本发明所公开的实施方案中，该装置包括由导电材料制成的远部顶端，远部顶端设置在插入管远端，配置成与组织接触并对组织施加电能以消融该组织，同时冲洗流体冷却该组织。
根据本发明的实施方案，还提供了用于制备医疗装置的方法，包括提供插入管，该插入管具有用于插入受试者体内的远端并且在远端具有开口。将柔性管纵向插入并穿过插入管，从而连通插入管远端上的开口，并且该柔性管通过插入管的内部张力来固定。
在本发明所公开的实施方案中，柔性管的固定包括使插入管形成弯曲，以及沿该弯曲的内侧将该柔性管固定在插入管内。
结合本发明实施方案的以下详细说明和附图，能更完整地理解本发明：
附图说明
图1为根据本发明实施方案的用于心脏消融疗法的系统的示意性说明图；
图2为根据本发明实施方案的与心脏组织接合的导管远端的示意性截面图；以及
图3为根据本发明实施方案的导管的示意性侧视图，示出了用于在导管内组装冲洗管的方法。
具体实施方式
图1为根据本发明实施方案的用于心脏消融疗法的系统20的示意性说明图。此处示出系统20的目的在于提供环境的实例，在该环境中可以采用下文描述的制备技术和组件。这些技术和组件同样可以应用于其他类型的医疗装置和系统。
系统20的操作员26将导管28穿过血管插入受试者22的心脏24的腔室内，操纵该导管以使导管的远端32接触心内膜待处理的区域。导管的远部顶端具有一个或多个开口，以使其能够冲洗处理区域并且使受拉管腔能将冲洗流体输送到该远部顶端，如下文所示及所述。然而，在其他方面，系统20类似于本领域中已知的用于心脏消融处理的系统(例如上述Biosense Webster系统)，并且此类系统的组件可适用于系统20。
将远端32定位在消融位点并且确保该顶端在该位点接触心内膜后，操作员26启动控制台42中的射频(RF)能量产生器44，以通过电缆38向远端32提供RF能量。与此同时，冲洗泵48通过管40和导管28中的管腔向远端供应冷却流体(例如盐水溶液)。可调节RF能量产生器和冲洗泵的操作，以在消融过程中提供适当体积的冲洗液来冷却导管顶端和组织，而不会向心脏加入过多的冲洗液。远端32中的温度传感器(图中未示出)可以向控制台42提供反馈信息用于控制RF能量剂量和/或冲洗流体体积。
图2为根据本发明实施方案的导管28的示意性截面图，其中导管28的远端32与心脏24中的心内膜组织接合。该导管止于远部顶端50处，其固定到导管的插入管60的远端。远部顶端通常包含导电材料(例如铂)，而插入管具有绝缘的柔韧性外皮。内部电缆52(近端连接到外部电缆38(图1))向远部顶端输送RF能量以消融心脏组织。
远部顶端50的外表面由若干开口54穿透。管腔(以纵向贯穿插入管60的柔韧冲洗管56的形式出现)通过泵48和管子50向开口54输送冲洗流体，以冲洗受消融位点附近的组织。虽然出于简洁明了的原因，图2中仅示出了部分的开口54，但远部顶端表面上可纵向和环向地分布更多数目的开口。
通常，在心脏病的应用中，插入管60的直径不超过3mm。冲洗管56通常包含柔韧的塑性材料，例如聚酰亚胺。为适应插入管60，并且为电缆和其他元件留出空间，管56的直径通常小于1mm(通常为大约800μm)，并且其壁厚通常不超过约60μm。因此，当导管弯曲时，管56很可能扭结并堵塞，以至于中断冲洗流体的流动，这可能带来严重后果。
为更好地防范此类扭结，通过插入管60内部张力来保持冲洗管56。当弯曲时，此张力使管56的壁的变形相对于松弛的管而言在其长度上更加均匀，因此使得管能抵抗扭结，除非导管28受到猛烈弯曲。因此，导管28中的流体输送管腔的机械属性和安全性得到加强。
图3为插入管60的示意性侧视图，示出了根据本发明实施方案，用于在承受导管28内部张力情况下组装冲洗管56的方法。制备时，将冲洗管56插入并穿过插入管60，并且使该插入管弯折而形成弯曲，如图中所示。然后，使用合适的粘结剂(例如聚氨酯接合剂)在两个或更多个点(例如，在远端和近端)处使冲洗管56与该弯曲的内侧粘合。因此，当随后使导管28变直(处于其正常操作构型)时，冲洗管56将承受张力，但不存在当导管弯曲时可能伸缩的松驰部分。
虽然图3示出的技术提供了简单方便的方法来拉紧冲洗管56，但也可以使用其他方法实现该目的，并且认为这些方法是在本发明的范围之内。此外，虽然上述实施方案具体涉及用于在心脏内进行RF消融处理的导管，但本发明的原理可以同样适用于其他器官和其他类型的探针，以及适用于涉及向身体组织输送流体或从身体组织移除流体的其他治疗性和诊断性模式。
因此，应理解的是，上述实施方案是以举例的方式进行阐述，并且本发明不受上文特别所示及所述内容的局限。并且，本发明的范围包括上述各种特征的组合和次组合、以及本领域技术人员在阅读上述说明书时可能想到的并且现有技术中未公开的变型形式和修改形式。

Claims (5)

1.一种医疗装置，所述医疗装置包括：
插入管，所述插入管具有用于插入受试者体内的远端和远端上的开口；以及
管腔，所述管腔包括柔性管，所述柔性管纵向穿过所述插入管从而与所述插入管远端的所述开口连通并且由所述插入管内部张力固定。
2.根据权利要求1所述的装置，其中将所述管腔配置成通过所述开口向所述远端附近的所述身体组织输送冲洗流体。
3.根据权利要求2所述的装置，所述装置包括由导电材料制成的远部顶端，所述远部顶端设置在所述插入管的远端，并且配置成与所述组织接触并对所述组织施加电能以消融所述组织，同时所述冲洗流体冷却所述组织。
4.一种用于制备医疗装置的方法，所述方法包括：
提供插入管，所述插入管具有用于插入受试者体内的远端并且远端上具有开口；
将柔性管纵向插入并穿过所述插入管从而连通所述插入管远端上的所述开口；以及
在所述插入管内部张力作用下固定所述柔性管。
5.根据权利要求4所述的方法，其中柔性管的固定包括使所述插入管形成弯曲，并且沿所述弯曲的内侧将所述柔性管固定在所述插入管内。
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Cited By (8)

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CN103619275A (zh) * 2011-04-12 2014-03-05 热医学公司 用于对流体增强型消融装置使用除气流体的方法和装置
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US20170325884A1 (en) 2017-11-16
US10350006B2 (en) 2019-07-16
CA2686882C (en) 2016-08-09
IL202453A (en) 2013-03-24
CA2686882A1 (en) 2010-06-03
US20100137837A1 (en) 2010-06-03
EP2193819A1 (en) 2010-06-09
EP2193819B1 (en) 2012-03-21
JP5657236B2 (ja) 2015-01-21
US9757189B2 (en) 2017-09-12
CN101773699B (zh) 2013-07-17
AU2009238299A1 (en) 2010-06-17
IL202453A0 (en) 2010-06-30
JP2010131391A (ja) 2010-06-17

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