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WO2024228639A1 - Pinces d'occlusion pour structures anatomiques - Google Patents

Pinces d'occlusion pour structures anatomiques Download PDF

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Publication number
WO2024228639A1
WO2024228639A1 PCT/RU2024/050093 RU2024050093W WO2024228639A1 WO 2024228639 A1 WO2024228639 A1 WO 2024228639A1 RU 2024050093 W RU2024050093 W RU 2024050093W WO 2024228639 A1 WO2024228639 A1 WO 2024228639A1
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WO
WIPO (PCT)
Prior art keywords
spring
clamping elements
clamp
loaded levers
anatomical structures
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
PCT/RU2024/050093
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English (en)
Russian (ru)
Inventor
Амиран Шотаевич РЕВИШВИЛИ
Вадим Анатольевич ПОПОВ
Егор Сергеевич МАЛЫШЕНКО
Владислав Сергеевич РАСПОПИН
Андрей Юрьевич ГРАЧЁВ
Александр Сергеевич ЕВДОКИМОВ
Сергей Васильевич ЕВДОКИМОВ
Владлен Владленович БАЗЫЛЕВ
Павел Александрович БАТРАКОВ
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Federal'noe Gosudarstvennoe Byudzhetnoe Uchrezhdenie <<natsional'nyj Meditsinskij Issledovatel'skij Tsentr Hirurgii Imeni AV Vishnevskogo>> Ministerstva Zdravoohraneniya Rossijskoj Federatsii Fgbu "nmits Hirurgii Im AVVishnevskogo" Minzdrava Rossii
Zakrytoe Aktsionernoe Obshchestvo Nauchno Proizvodstvennoe Predpriyatie <<medinzh>>
Original Assignee
Federal'noe Gosudarstvennoe Byudzhetnoe Uchrezhdenie <<natsional'nyj Meditsinskij Issledovatel'skij Tsentr Hirurgii Imeni AV Vishnevskogo>> Ministerstva Zdravoohraneniya Rossijskoj Federatsii Fgbu "nmits Hirurgii Im AVVishnevskogo" Minzdrava Rossii
Zakrytoe Aktsionernoe Obshchestvo Nauchno Proizvodstvennoe Predpriyatie <<medinzh>>
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from RU2023111221A external-priority patent/RU2800578C1/ru
Application filed by Federal'noe Gosudarstvennoe Byudzhetnoe Uchrezhdenie <<natsional'nyj Meditsinskij Issledovatel'skij Tsentr Hirurgii Imeni AV Vishnevskogo>> Ministerstva Zdravoohraneniya Rossijskoj Federatsii Fgbu "nmits Hirurgii Im AVVishnevskogo" Minzdrava Rossii, Zakrytoe Aktsionernoe Obshchestvo Nauchno Proizvodstvennoe Predpriyatie <<medinzh>> filed Critical Federal'noe Gosudarstvennoe Byudzhetnoe Uchrezhdenie <<natsional'nyj Meditsinskij Issledovatel'skij Tsentr Hirurgii Imeni AV Vishnevskogo>> Ministerstva Zdravoohraneniya Rossijskoj Federatsii Fgbu "nmits Hirurgii Im AVVishnevskogo" Minzdrava Rossii
Publication of WO2024228639A1 publication Critical patent/WO2024228639A1/fr
Anticipated expiration legal-status Critical
Pending legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
    • A61B17/122—Clamps or clips, e.g. for the umbilical cord

Definitions

  • the present invention relates to medical equipment, namely to occlusion clamps that can be used, for example, in cardiovascular surgery for mechanical isolation of the left atrial appendage (LAA) in patients with atrial fibrillation (AF), aimed at preventing embolic stroke, as well as in other areas where clamping or occlusion of anatomical structures is required.
  • LAA left atrial appendage
  • AF atrial fibrillation
  • Atrial fibrillation is one of the most common heart rhythm disorders.
  • the absence of atrial contractions predisposes to the formation of blood clots, causing the risk of thromboembolic complications, in particular, stroke.
  • Embolic stroke is the third leading cause of death in adults in the country, the main cause of disability.
  • the most common cause of embolic stroke is thrombus formation in the left atrial appendage.
  • AF atrial fibrillation
  • a thrombus forms in the atrial appendage (up to 90% of thrombi forming in the left atrial appendage are localized in its appendage). This is facilitated by the curved shape of the appendage and its narrow base.
  • thromboembolic thromboembolic
  • Traditional drug prevention of TE complications is based on the appointment of continuous intake of anticoagulants.
  • drug therapy may be contraindicated for certain groups of patients.
  • Contraindications include age, hypertension, and a history of stroke, which are both risk factors for thrombosis and risk factors for bleeding.
  • An alternative method aimed at preventing embolic stroke is the use of surgical methods based on mechanical isolation of the left atrial appendage by clipping or endovascular occlusion using implantable devices.
  • active development of such devices occluders, occlusive clamps, clips, etc.
  • devices for endovascular occlusion of the left atrial appendage are known from the prior art, for example, Watchman devices used for prevention of thromboembolic complications in patients with atrial fibrillation (O.O. Shakhmatova, A.L.
  • the Watchman device (Boston Scientific) is a self-expanding nitinol frame with "antennae” for fixation, covered with a water-permeable polyethyl terephthalate (PET) fabric with a pore diameter of 160 ⁇ m.
  • PET water-permeable polyethyl terephthalate
  • the properties of this coating provide accelerated endothelialization of the device surface.
  • the structure of the occluder is such that it fits almost any anatomy of the left atrial appendage.
  • the device is implanted under fluoroscopy and transesophageal echocardiography control. The procedure is performed under local or general anesthesia.
  • Occluder placement is a minimally invasive procedure that does not require open cardiac surgery in a cath lab.
  • long-term follow-up studies in some studies have not confirmed the benefits of this method of LAA isolation compared to anticoagulant therapy (Naksuk N, Padmanabhan D, Yogeswaran V, Asirvatham SJ. Left Atrial Appendage: Embryology, Anatomy, Physiology, Arrhythmia and Therapeutic Intervention. JACC Clin Electrophysiol. 2016 Aug;2(4):403-412. doi: 10.1016/j.jacep.2016.06.006. Epub 2016 Aug 15. PMID: 29759858).
  • the main disadvantages of using the Watchman device for LAA isolation are the need for the occluder diameter to precisely match the LAA lumen and the appropriate anatomical structure of the LAA. Otherwise, incomplete occlusion of the LAA may occur, which is associated with higher risks of thromboembolism.
  • the prior art includes devices for surgical epicardial isolation of the LAA, such as the LAA Clip System (Atriclip, Atricure). Surgical epicardial isolation of the LAA using this device (clamp) requires open heart surgery, but demonstrates higher efficiency and long-term reliability.
  • these devices can be used with any anatomical structure of the LAA, and there is no critical dependence of the effectiveness of therapy on the accuracy of device size selection (Emmert MY, Puippe G, Baumuller S, Alkadhi H, Landmesser U, Plass A, Bettex D, Scherman J, Grunenfelder J, Genoni M, Falk V, Salzberg SP.
  • LAA Clip System devices (Atriclip, Atricure) for mechanical isolation of the LAA demonstrates the best results compared to anticoagulant therapy and other means and methods of LAA isolation. However, this device has a number of disadvantages.
  • the said clamp in the proximal part is characterized by a limited ability to open, which in some cases, due to the anatomical features of the patient, for example, associated with a large thickness of the LAA base wall, can lead to insufficiently reliable compression of the anatomical structures in the distal part of the device, and, as a consequence, to inadequate functioning of the device.
  • the lack of a movable connection of the proximal ends of the clamping elements with the spring base of the clamp can lead to transverse instability of the device, which can also lead to its inadequate functioning.
  • an occluding clamp (RU661273C1 or US1266413B2, see Figures 32-37), including a spring containing a U-shaped part equipped with two levers, the distal ends of which are connected to two clamping jaws (pads) using a pair of pins.
  • the U-shaped part of the spring has a rectangular cross-section, contains protruding sections on opposite sides from the plane of symmetry, between which the spring levers are enclosed, and rounded distal ends.
  • the spring levers have a rectangular or round cross-section and rounded distal ends, in which holes are made for the pins.
  • the clamping jaws are made in the form of an elongated cylindrical part with a longitudinal channel and a longitudinal elongated slot.
  • the channel and the slot are limited by the inner walls of the part and are configured to accommodate a U-shaped part and spring levers with protruding parts, wherein the cylindrical part is made with an open proximal end and a closed rounded distal end.
  • the inner walls of the cylindrical part comprise a pair of spaced inclined linear shelves with increasing height in the proximal-distal direction, which provide a support surface for movement the distal end of the U-shaped part of the spring.
  • the inclined shelves at the distal end pass into recesses for fixing the protruding rounded distal ends of the U-shaped part of the spring in the clamping pads (jaws).
  • the bottom of the axial channel is made with a support surface for moving the distal end of the spring lever.
  • the support surface is made with an increasing height in the proximal-distal direction, which at the distal end passes into recesses made on opposite sides from the longitudinal channel, wherein the shape of the recesses corresponds to the shape of the rounded distal end of the lever, which provides the possibility of fixing the spring levers in the clamping jaws.
  • the holes in the walls of the cylindrical part for the fixing pins are made in the projection of these recesses closer to the distal end of the clamping pads at a distance.
  • this occluding clamp is characterized by a design complexity due to the design complexity of the spring and the complex profile of the inner surface of the clamping jaw.
  • the occluding clamp uses separate fasteners to connect the spring to the jaws, which also complicates the clamp design and makes it less reliable.
  • the proximal ends of the jaws are not fixed in the plane of the U-shaped spring, which reduces the clamp's resistance to distortion and can lead to ineffective occlusion of the ULL.
  • the technical problem solved by the claimed invention is the development of a clip design for clamping anatomical structures that eliminates the above-mentioned disadvantages of analogs and is capable of providing reliable and atraumatic clamping of the ULL tissue during cardiac surgery.
  • the clip design provides fast and convenient implantation of the device for the doctor during an open surgery with epicardial access to the ULL.
  • the claimed device can be manufactured in a range of sizes due to the variability of the anatomical structure of the ULL.
  • the technical result which the claimed invention is aimed at achieving, is the creation of an implantable occlusion clamp (clip) having a mechanism for reliable mechanical compression of anatomical structures, for example, mechanical isolation of the left atrial appendage (LAA) in patients with atrial fibrillation (AF), while simplifying the stent design.
  • the claimed solution allows the clamp to be opened with a larger distance between the branches (clamping elements) compared to the prototype with the same overall width. This reduces the risk of damage to surrounding tissues during implantation.
  • an occluding clamp including two clamping elements, which are in the initial closed position under the action of the force of a flat spring, containing two spring-loaded levers connected by a jumper, wherein the clamping elements contain channels for placing the distal ends of the spring-loaded levers of the spring in them.
  • the section of the spring bridge that functions as a guide is preferably made rectilinear.
  • the clamping elements are provided with grooves, the geometry of which ensures placement of the corresponding section of the bridge in said grooves.
  • the sections of the spring-loaded levers which are predominantly arranged in parallel, may be provided with a sleeve with the possibility of being placed in the channels of the clamping elements.
  • the distal ends of the spring-loaded levers are fixedly fixed in the sleeve, which in turn is fixedly fixed in the channels of the clamping elements.
  • the angle between the crossbar and the levers is less than 90 degrees, preferably from 30 to 85 degrees.
  • the occluding clamp can be made with a coating made of a material capable of biological integration with anatomical structures in the area of contact with the clamp, or provided with a cover also made of a material capable of biological integration with anatomical structures, wherein the cover contains sleeves for placing clamping elements with spring-loaded levers in them.
  • the cover can be made of interwoven polyester threads, for example, in the form of a tube, the end parts of which are tucked inside to form a two-layer structure containing an outer and inner layer located along the length of the clamping elements with spring-loaded levers, while the distal ends of the cover in the transition zone of the outer layer of the cover to the inner one are pulled together with a thread.
  • connection zone of the spring-loaded levers with the clamping elements increases, which leads to an increase in the stability of the force transmission to the proximal ends of the clamping elements when the clamp is opened. This in turn ensures a stable value of the compression force of the anatomical structure, for example, the LAA, by the proximal ends of the clamping elements.
  • the configuration of the clamping elements from the side of the proximal ends with the ability to move along a guide, which is a spring bridge ensures additional stability of the clamp in the transverse direction, which also increases the reliability of clamping the anatomical structures.
  • Providing the clamping elements with grooves for movement along the bridge guide limits the degree of freedom in the direction perpendicular to the clamp plane, which ensures a stable arrangement of the proximal ends of the clamping elements in the clamp plane and forms a localized compression zone of the anatomical structures in the working state of the clamp.
  • the fixed fixation of the distal ends of the spring-loaded levers in the sleeve limits the possibility of turning the spring-loaded levers relative to the clamping elements, which ensures a stable position of the distal ends of the clamping elements and forms a localized compression zone of the anatomical structures in the working state of the clamp.
  • Making the angle between the bridge and the spring-loaded levers less than 90 degrees ensures the necessary bridge length, ensuring the required value of clamp opening when installed on anatomical structures, while maintaining the necessary compression force at the minimum possible thickness of the occluded anatomical structures.
  • Producing a clamp with a coating made of a material capable of biological integration with anatomical structures in the area of contact with the clamp ensures additional clamp fixation on the occluded tissues over time, eliminating the risk of clamp detachment in the event of remote atrophy of the occluded anatomical structures.
  • Providing the clamp with a cover made of a material capable of biological integration with the anatomical structures in the area of contact with the clamp when the said cover contains sleeves for placing clamping elements with spring-loaded levers in them, additional indirect clamp fixation on the occluded tissues over time, eliminating the risk of clamp detachment in the event of remote atrophy of the occluded anatomical structures.
  • the design of the claimed clamp is characterized by stable operating parameters and ease of manufacture.
  • Fig. 1 shows a general view of the occluding clamp
  • Fig. 2 shows a protective cover intended for use together with the occluding clamp
  • Figs. 3-8 show different views of the occluding clamp spring in the initial position, in which the distal ends of the spring levers are closed: general view, longitudinal section, side view, top view, view from the proximal end, view from the distal end, respectively;
  • Figs. 1 shows a general view of the occluding clamp
  • Fig. 2 shows a protective cover intended for use together with the occluding clamp
  • Figs. 3-8 show different views of the occluding clamp spring in the initial position, in which the distal ends of the spring levers are closed: general view, longitudinal section, side view, top view, view from the proximal end, view from the distal end, respectively;
  • Figs. 1 shows a general view of the occluding clamp
  • Fig. 2
  • FIG. 9-13 show different views of the occluding clamp spring in the position, in which the distal ends of the spring levers are open (the levers are spread apart to the maximum possible distance), for example, before installation on the left atrial appendage: general view, longitudinal section, side view, top view, view from the proximal end, view from the distal end, respectively;
  • Fig. 14 - 19 show different views of the assembled occlusion clamp in the initial position, in which the distal ends of the clamping elements are closed: general view, longitudinal section, side view, top view, view from the side of the proximal end, view from the side of the distal end, respectively;
  • Fig. 14 - 19 show different views of the assembled occlusion clamp in the initial position, in which the distal ends of the clamping elements are closed: general view, longitudinal section, side view, top view, view from the side of the proximal end, view from the side of the distal end, respectively;
  • 20 - 24 show different views of the assembled occlusion clamp in the position, in which the distal ends of the clamping elements are open (the clamping elements are spread apart to the maximum possible distance) before installation, for example, on the left atrial appendage: general view, longitudinal section, side view, top view, view from the side of the proximal end, view from the side of the distal end, respectively.
  • LAA left atrial appendage
  • AF atrial fibrillation
  • the claimed device can be easily adapted for clamping any other anatomical structures.
  • distal and proximal are used, which indicate the location of its individual elements in relation to the central part of the occluding clamp.
  • the occluding clamp (Fig. 1) (hereinafter referred to as the clamp), which in the literature may also be called a clip for clamping anatomical structures, includes two clamping elements 2, which in the literature and in the present description may be referred to as branches or pressing jaws, made with the possibility of connecting to each other (closing and opening) by means of a spring (or elastic element) 1.
  • the clamp may be made in the form of a size range depending on the geometry of the biological structure, the occlusion of which must be ensured. In particular, for occlusion of the LAA, the clamp may have a length (predominant size) L from 30 to 50 mm, a width from 5 to 15 mm, a height from 3 to 10 mm.
  • Spring 1 (Fig. 3 - 13) is a tension spring, preferably having a bracket-shaped, or U-shaped, or U-shaped form, comprising two spring-loaded levers 3 connected by a cross member 4 in the form of a bridge.
  • the spring 1 can be made of a cylindrical rod, for example, of a cobalt-chromium alloy, stainless steel or nitinol, with a diameter d for use in cardiac surgery, preferably from 0.3 to 1.5 mm, wherein the lever 3 of the spring 1 comprises a distal 5 and a proximal 6 section.
  • the distal section 5 of the lever 3 of the spring 1 is preferably provided with a sleeve 7 to provide a gap between the levers
  • the proximal section 6, having a length h - h, is connected to the transverse element
  • the jumper 4 is made with a straight section 8, which functions as a guide when the clamping elements 2 move along it.
  • the clamping elements 2 are designed to interact with the distal ends of the spring 1.
  • the clamping elements 2 are designed in the form of an extended housing with a channel 11 or an area for inserting and placing the distal end of the spring 1.
  • the housing preferably has an external rounded surface shape, for example, a circle or ellipse in cross section, and can be made of titanium.
  • the clamping elements 2 are made in the form of two identical extended cylindrical bushings, the surfaces of which, facing each other, are intended to interact with the clamped tissues (biological structures).
  • the bushings have an internal diameter corresponding to the external diameter of the distal section 5 of the lever 3 of the spring 1.
  • Each of the bushings is provided with an extended longitudinal slot 12 made in the wall from the outside in the projection of the proximal section of the spring lever.
  • the length of the said slot 12 corresponds to the length of the straight line, which is projection of the proximal section onto the axis of symmetry of the clamp.
  • the slot 12 has a width not less than the diameter d of the lever 3 in the area of its insertion into the clamping element 2.
  • the section of the clamping element 2 from the side of its distal end without the slot corresponds to the length of the distal section 5 of the lever 3 of the spring 1.
  • grooves 13 are made, configured with the possibility of placing in them a rectilinear section 8 of the transverse element (crossbar) 4 of the spring 1.
  • this rectilinear section 8 of the spring 1 performs the function of a guide for the clamping elements during their movement when the spring levers are spread apart by the amount necessary for inserting the tissues to be clamped.
  • the implementation of this unit of interaction of the spring 1 with the clamping element 2 increases the reliability and stability of the clamp during its installation, while in comparison with the prototype it allows to increase the length of the branches, and, consequently, the length of the clamping of the ULA.
  • Uniform force on the clamped tissues along the entire length of the clamping elements is achieved by simultaneous action on the proximal and distal ends of the clamping elements.
  • the proximal ends of the clamping elements are acted upon by a force arising as a result of elastic deformation of the spring-loaded levers in the transition zone to predominantly parallel sections.
  • the distal ends of the clamping elements are acted upon by a force arising as a result of elastic deformation of the spring-loaded levers in the zone of their connection with the spring bridge.
  • the claimed clamp (clip) can be made with a carbon (carbon) coating, reducing the severity of the inflammatory reaction of tissues in the area of its installation.
  • the occlusive clamps can be provided with a cover, as shown in Fig. 2, containing sleeves for the corresponding levers with clamping elements.
  • the cover can be made of a biologically degradable material, for example, Gore Dualmesh (offered by W.L. Gore & Associates, www. gore. com).
  • the spring may be cast, punched, cut from a sheet by electrical discharge, laser or plasma cutting, bent from a rod (wire), manufactured according to the shape shown in Fig. 3 - 8.
  • the spring may be manufactured from the original rod by bending, after which it undergoes heat treatment in accordance with the modes recommended for the specific spring material used.
  • the clamping elements and bushings are cut from tubes of the corresponding diameter, for example, by laser cutting. After assembling the clamping elements, bushings and spring, the distal ends of the spring levers are connected to the bushing and the distal ends of the clamping elements by welding. Then, a cover made of a cord formed by interlacing polyester threads is put on the assembled clamp base.
  • the finished clamp can be installed on a holder for convenient connection with the installation tool during implantation.
  • the clamping elements of the clamp are attached to the legs of the mounting device, for example, using a thread, directly or through a holder in such a way that when the legs diverge, the clamping elements of the clamp move in a connected manner.
  • the clamp is positioned in the plane of the LAA dissection.
  • the clamp is opened by spreading the tabs of the installation tool.
  • the clamp is carefully positioned at the base of the LAA, monitoring the surrounding anatomical structures.
  • the tabs of the installation tool are brought together.
  • the spring element brings the clamping elements together, ensuring their tight pressure against the base of the LAA. If necessary, the tabs of the installation tool can be spread apart and the clamp installation procedure can be repeated.
  • the clamp After placing the clamp in the required position, ensuring the isolation of the LAA, the installation tool and the holder (if any) are separated from the clamp, for example, by cutting the fastening threads.
  • spring 1 When implanting the clip, spring 1 ensures the clamping elements are pressed towards each other with occlusive pressure on the LAA tissues, captured by the clamp between the clamping elements.
  • the spring design has a certain rigidity, strength, and stretch coefficient, ensuring reliable and atraumatic clamping of the LAA tissue.
  • the spreading of the spring levers requires overcoming a certain force. In the initial position, without applying force to the clamp, the spring levers are by default in the position shown in Fig. 1, 3 - 8, and the clamping elements in the position shown in Fig. 14-19.
  • the clamping elements are spread apart, applying the required force, with the formation of a gap between them by an amount sufficient for introducing the tissues to be clamped, as shown in Fig. 10-13 and Fig. 21-24.
  • the clamping elements are pressed towards each other, blocking the blood flow through the tissue located between them. The absence of blood flow in the corresponding part of the LAA tissue leads to its gradual atrophy.
  • the occlusion of the LAA tissue is performed by transmitting forces from the spring levers through the clamping elements to the tissue, ensuring uniform pressure along the entire length of the clamping elements (from the side of the proximal and distal ends of the clamp).
  • the required pressure can be obtained by adjusting the spring force.
  • the spring force depends on the material, shape, thickness and width of the spring, as well as on giving the initial shape that provides prestressing, and can be adjusted depending on the task at hand.
  • the occlusion clamps are made of titanium or stainless steel, but they can also be made of other biocompatible materials, including plastics, composites, metals and ceramics.
  • the springs can be made of nitinol or another material with sufficient elastic properties
  • the branches can be made of polyetheretherketone (PEEK).
  • An experiment on a biological model can serve as an illustration of the efficiency of using the manufactured clamps.
  • Experiment type chronic three-stage experiment, including clamp installation on the left atrial appendage, control during the observation period of 90 days, and withdrawal from the experiment.
  • An 8-month-old Russian White pig weighing 74 kg was used as an experimental animal.
  • the blood flow in the left atrial appendage was visualized using ultrasound at a speed of 35 cm/sec.
  • lateral thoracotomy was performed along the IV intercostal space on the left (the animal is on its right side).
  • the pericardial cavity was opened. The edges of the pericardium were taken on holders.
  • An occluding clamp (clip) was applied to the base of the left atrial appendage using a clip-clip system.
  • Ultrasound control of the blood flow in the excluded section of the left atrial appendage was performed. According to the ultrasound data, blood flow was not determined.
  • the pericardial cavity was sutured and the postoperative wound was sutured layer by layer.
  • a control examination of the implanted clamp was performed 60 days later. Before the operation, ultrasound monitoring of blood flow in the left atrial appendage was performed. Blood flow was not detected. Lateral thoracotomy was performed along the fourth intercostal space on the right with resection of the fifth rib (the animal was on its left side).
  • the left atrial appendage with a fixed clamp was located practically at the bottom of the surgical wound.
  • the claimed occlusive clamp provides convenient, reliable and atraumatic compression of the ULL tissues during cardiac surgery.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Reproductive Health (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention se rapporte aux techniques médicales et concerne notamment des pinces d'occlusion qui peuvent être utilisées, par exemple, en chirurgie cardiovasculaire lors de l'isolation mécanique de l'oreillette du ventricule gauche (OVG) chez des patients souffrant d'une fibrillation des ventricules (FV) en vue de prévenir une attaque embolique, ainsi que dans d'autres domaines où il est nécessaire de comprimer ou de bloquer des structures anatomiques. Ces pinces d'occlusion pour structures anatomiques comprennent deux éléments de pince se trouvant dans une position initiale fermée sous l'action de la force d'un ressort comprenant deux leviers à ressort connectés par un pontet; les éléments de pince comprennent des canaux pour y placer les extrémités distales des leviers à ressort du ressort; les leviers à ressort comprennent du côté des extrémités distales des sections ayant une disposition essentiellement parallèle, et les éléments de pince du côté des extrémités proximales sont configurés pour se déplacer le long d'un guide en qualité duquel on utilise le pontet du ressort. Ces pinces d'occlusion assurent un serrement fiable et non traumatique des tissus de l'OVG lors d'opérations de chirurgie cardiaque.
PCT/RU2024/050093 2023-04-30 2024-04-29 Pinces d'occlusion pour structures anatomiques Pending WO2024228639A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
RU2023111221 2023-04-30
RU2023111221A RU2800578C1 (ru) 2023-04-30 Окклюзирующий зажим для анатомических структур

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WO2024228639A1 true WO2024228639A1 (fr) 2024-11-07

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2218883C1 (ru) * 2002-07-01 2003-12-20 Российский Университет Дружбы Народов Клипса для перекрытия кровеносных сосудов
US20110313437A1 (en) * 2010-06-16 2011-12-22 Top-Bound Enterprise Co., Ltd. Vascular clamp structure
US20140142597A1 (en) * 2012-11-21 2014-05-22 Atricure, Inc. Occlusion clip
US20160008001A1 (en) * 2013-11-21 2016-01-14 Atricure, Inc. Occlusion clip

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2218883C1 (ru) * 2002-07-01 2003-12-20 Российский Университет Дружбы Народов Клипса для перекрытия кровеносных сосудов
US20110313437A1 (en) * 2010-06-16 2011-12-22 Top-Bound Enterprise Co., Ltd. Vascular clamp structure
US20140142597A1 (en) * 2012-11-21 2014-05-22 Atricure, Inc. Occlusion clip
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