JP2000225193A - Obturator for catheter and instrument for inserting obturator - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an obturator for occluding the lumen of a catheter easily and effectively, and to enable the obturator to be smoothly inserted into the catheter. SOLUTION: This obturator 12 comprises a body part 13 to be inserted into the lumen 5c of a catheter and an elastic part 14 which has elasticity. The body part 13 occludes the lumen 5c and has an outer peripheral surface, which can slide along the wall of the lumen 5c. The elastic part 14 is formed so that at least one part of the elastic part is protruded outward from the outer peripheral surface of the body part 13, when no external force is applied. If the obturator is placed in the lumen 5c of the catheter, the protruded part touches to the lumen wall of the catheter, and by elasticity produced in the elastic part 14, the obturator 12 can be stopped in the lumen.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an obturator for closing a lumen of a catheter and an instrument for introducing the obturator into the lumen of the catheter.

[0002]

2. Description of the Related Art A tubular medical device generally called a catheter is inserted into a body cavity or a tubular tissue such as a blood vessel or a digestive tract to inject a drug solution or the like into the insertion site or to discharge a liquid or contents from the site. Has been used to do. For example, in the field of chemotherapy in which a drug such as an anticancer drug is administered to an unresectable malignant tumor, a catheter is used as a supply channel for locally supplying a drug to a site of the malignant tumor. In this case, the catheter is inserted in the vicinity of the malignant tumor (typically in an artery), and is left at the insertion site in order to continuously supply a drug solution to the affected part for a long period of time. One specific example of such a catheter placement method will be described below. First, a femoral artery is punctured, a sheath (introducer) is inserted, and a desired catheter is inserted into the artery. Thus, the position of the inserted catheter is confirmed by X-ray contrast or the like, and the distal end of the catheter is guided to a target site by a guide wire, and is placed in that state. On the other hand, a so-called drug solution injection port is formed at an appropriate subcutaneous site (for example, near the inguinal ligament) and the drug solution injection port is connected to one end of the indwelling catheter. As a result, a drug solution such as an anticancer drug can be supplied to the diseased part from the opening at the distal end of the catheter via the drug solution injection port and the indwelled catheter lumen.

Recently, a side hole (including a slit-shaped opening; the same applies hereinafter) has been formed in the side wall surface of such an indwelling catheter, and a drug solution supplied to the catheter lumen is passed through the side hole. Attention has been paid to a method of releasing the disease to the affected area. For example, the "SPA-coil method" and "GDA-coil method" developed by a research group at the Aichi Cancer Center
Is a typical example of a method of placing a catheter with a side hole in the body (intravascular) and supplying a drug solution to the affected part from the side hole (IVR, Vol. 8, No. 2, pp. 61-). 6
6). That is, as schematically shown in FIG. 12, in these methods, the distal end of the blood flow (see the thick arrow in the figure) is introduced into the blood vessel 2 (for example, the hepatic artery) to be supplied with the chemical solution for the reason described later. The catheter 1 with the side hole 1b having a tapered portion is inserted, and the tip 1a is further inserted.
Is passed through another blood vessel 3 (for example, splenic artery) branched from the drug solution supply blood vessel 2. At this time, the side hole 1b is arranged in the medical solution supply blood vessel 2. Next, by inserting the metal coil 4 or the like into the branch blood vessel 3, the branch blood vessel 3 can be fixed at that position while closing the branch blood vessel 3 (see FIG. 12). As a result, the blood flow can be concentrated in the downstream direction of the drug solution supply vessel 2 without directing the blood flow to the branch vessel 3, and the catheter 1 can be fixed at that position. Thus, FIG.
As schematically shown in FIG. 1, the drug solution supplied to the lumen of the catheter 1 is released into the blood vessel 2 from the side hole 1b formed in the side wall of the catheter 1 (see the thin arrow in the figure), and thus, together with the blood flow. Can be supplied to the affected area. Furthermore, according to this method, a portion (tip portion) near the tip opening 1a of the catheter 1 does not exist in the drug solution supply blood vessel 2,
The tip does not move in the blood vessel 2 and stimulates the inner wall of the blood vessel. Therefore, the blood vessel 2 caused by the stimulus
Thrombus formation in the inside can be highly suppressed. As described above, the use of a catheter having a side hole as a drug solution discharge port has many medical advantages and is useful, and is expected to become more and more popular in the future.

Incidentally, as is well known, in order to introduce a general catheter deep into a body cavity or a tubular tissue, it is necessary to guide the catheter with a so-called guide wire. For this reason, the tip of the catheter needs to be open at the time of insertion. On the other hand, in the catheter indwelling method using a side hole as shown in FIG. 12, in order to efficiently discharge the drug solution supplied to the lumen of the catheter 1 from the side hole 1b, the opening of the catheter tip 1a is left after being indwelled. It needs to be closed. From this, the SPA-coil method,
Conventionally, in the GDA-coil method or the like, it has been necessary to use a plurality of special coils (hereinafter referred to as “embolic coils”) to close the distal end of a catheter placed in the body. At the same time, in order to close the distal end of the catheter with such an embolic coil, the distal end also needs to be tapered. For this reason, for example, the SPA-coil method and the GDA
In order to supply the medical solution to the affected part while forming the state shown in FIG. 12 based on the -coil method, a complicated and complicated operation as shown below was actually required. That is, first, the sheath is inserted by puncturing the femoral artery and the like,
From there, a relatively large diameter (eg, 0.035 inch; about 0.889 mm) guidewire is inserted. And
A guiding catheter (typically one having an outer diameter of 5.0 Fr (approximately 1.67 mm)) is inserted along the guide wire, and is introduced near the target blood vessel. Next, the guide wire is pulled out and a relatively small diameter (for example, 0.025
Inch; about 0.635 mm). Next, the guiding catheter is removed, and instead, a catheter with a side hole of the same size is inserted along the small-diameter guidewire. Thus, the catheter with side holes can be guided and arranged in the target blood vessel by being guided by the small-diameter guide wire (see FIG. 12 described above).
Thus, another catheter is inserted from another site (eg, the other femoral artery), thereby attaching an embolic coil (not shown) to the outside of the tapered tip of the side-hole catheter. As a result, the tip can be closed. Thus, the SPA-coil method and G
According to the DA-coil method, since a catheter having a tapered distal end must be used, a complicated and long operation for exchanging a guide wire and a catheter is required. In other words, the catheter body cannot be introduced into the vicinity of the target blood vessel unless it is a relatively large diameter guide wire, but the catheter having a tapered tip can be accurately introduced into the target blood vessel without a small diameter guide wire. Because it is difficult.

[0005]

However, depending on the means using the embolic coil, the complicated operation as described above is required, and the clearance between the coils cannot be completely prevented. As a result, it was difficult to completely close the opening. In addition, since the coil itself is very expensive, the use of such a coil may cause a rise in medical expenses. Therefore, SPA-coil
It has been desired to develop a quick and simple means for closing a catheter lumen (typically near the opening at the distal end) which can be suitably applied to a catheter placement method such as the GDA-coil method or the GDA-coil method.

[0006] The present invention is to solve the problem related to the obstruction of the tip of the catheter.
An object of the present invention is to provide an obturator for easily and effectively closing the lumen of a catheter and an obturator introduction device capable of smoothly introducing the obturator into the catheter.

[0007]

In order to achieve the above object, the present invention provides an obturator for occluding a lumen of a catheter according to the present invention. That is, the obturator of the present invention includes the main body and the elastic portion having elasticity, which are inserted into the catheter lumen. The main body has an outer peripheral surface that closes the lumen of the catheter and can slide along the wall surface of the lumen. on the other hand,
The elastic portion is formed such that at least a portion thereof protrudes outward from the outer peripheral surface of the main body in a state where no external force is applied (that is, in a released state). Then, when inserted into the catheter lumen, the elasticity generated in the elastic portion based on the contact between the protruding portion and the catheter lumen wall surface allows the obturator to be retained in the catheter lumen. It is configured.

[0008] The obturator of the present invention thus specified is
The inside of the lumen of the catheter can be transferred while sliding the outer peripheral surface of the main body portion against the wall surface of the catheter lumen. This allows the obturator of the present invention to be positioned anywhere within the catheter lumen. At this time, the projecting portion of the elastic portion comes into contact with the inner wall surface of the catheter lumen and bends inward. As a result, elasticity (restoring force) for restoring the original state against the bending (deformation) is generated in the elastic portion,
As a result, the elastic portion causes the bent portion (that is, the protruding portion) of the elastic portion to be strongly pressed (pressed) against the inner wall surface of the catheter lumen. Therefore, by the pressure contact of the elastic portion to the catheter lumen wall surface based on its elasticity,
The obturator of the present invention can be parked at a desired location. Therefore, by inserting the obturator of the present invention into various catheters for indwelling or other purposes, it is possible to occlude the lumen of the catheter at a desired position without special skill.

More preferably, the obturator of the present invention is the obturator according to the second aspect. In the obturator of the present invention, the elastic portion is formed of one or two or more metal pieces formed in a streak shape. As a result, a strong elasticity is generated when the protruding portion contacts the wall surface of the catheter lumen. Can be done. Therefore, the stop can be maintained at a higher level.

[0010] Further, as the obturator of the present invention, an obturator according to claim 3 is more preferable. In the obturator according to the present invention, at least a part of the main body contains an X-ray contrast material (that is, a substance that is hardly penetrable to X-rays; the same applies hereinafter). As a result, monitoring means (X The position of the obturator in the catheter can be recognized by a line image or the like. Therefore, the operation of inserting and arranging the obturator into the target site can be performed more reliably.

Further, the present invention provides an obturator introduction device according to claim 4 for introducing the obturator of the present invention into a catheter lumen and disposing the obturator at a desired site. That is, the obturator introduction device of the present invention is a guide tube that can be inserted into the lumen of the catheter to be introduced by the obturator, and the obturator of any of the above-mentioned present invention attached to the guide tube,
A movable shaft member capable of moving back and forth along the guide tube. The obturator of the present invention is mounted on the guide tube by at least a part of the elastic portion being housed in the guide tube. Further, the closing member is separated from the guide tube by advancing the movable shaft member toward the distal end of the guide tube. According to the obturator introduction device of the present invention having such a configuration, the obturator is transferred to a desired position in the lumen of the catheter together with the guide tube while sliding the outer peripheral surface of the obturator main body of the present invention. Can be. By operating the movable shaft member (typically, a wire), the elastic portion housed in the guide tube is pushed out, and the obturator of the present invention is separated from the guide tube. As described above, according to the obturator introduction device of the present invention, the obturator of the present invention can be arranged at an arbitrary position in the catheter lumen.

[0012]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Preferred embodiments of an obturator and an obturator introducing device according to the present invention will be described below with reference to the drawings.

First, as a first embodiment, specific examples of the obturator and the obturator introducing device of the present invention will be described with reference to the drawings. FIG. 1 shows the lumen 5 c of the indwelling catheter 5.
It is a figure which shows typically the external appearance of the principal part of the obturator introduction tool 10 which concerns on this embodiment constructed in order to introduce the obturator 12 of this invention in (FIG. 3). FIG. 2 is a diagram schematically illustrating the appearance of the closure 12 according to the present embodiment. FIG.
FIG. 3 is a cross-sectional view schematically showing a state where the obturator introduction device 10 according to the present embodiment is inserted into the indwelling catheter 5.

The catheter 5 into which the obturator 12 according to the present embodiment is inserted and arranged is provided with the SPA-coil.
It is a catheter 5 for indwelling in a blood vessel (such as a hepatic artery) applicable to a method or the like. The present catheter 5 is formed of a synthetic resin (fluorine resin, polyurethane resin, or the like) suitable for medical use, and has an outer diameter of 5.0 Fr (about 1.67 mm). As shown in FIG. 11, when introduced into a blood vessel 2 (for example, a hepatic artery) to be supplied with a drug solution, the present catheter 5 is fixed to the blood vessel 2 and another blood vessel 3 (for example, a splenic artery) branched therefrom. It is formed in a shape that can be performed. In other words, near the distal end of the present catheter 5, a bent portion (typically, 3 shown in FIG.
Locations P1, P2, P3) are formed in advance. Thus, the catheter 5 can be fixed at a predetermined position in the blood vessels 2 and 3 without using the metal ring 4 (see FIG. 12) for fixing separately. As shown in FIG. 3, the indwelling catheter 5 is formed with a lumen 5c having a diameter of 2.9 Fr (about 0.97 mm).
A side hole 5b is provided in the side wall portion. As a result, the various chemicals supplied to the lumen 5c are transferred to the side holes 5c.
b can be released into the desired blood vessel. Also,
In the present catheter 5, as described later, the obturator 12 of the present invention is used.
As a result, it is not necessary to make the tip portion tapered as shown in FIG. 12 (see FIG. 11). In addition, in FIG. 3 and FIGS. 4 and 5 described later, in order to more clearly explain an essential part of the present invention, a state where the catheter 5 is stretched straight (that is, the bent portions P1, P2, and P3).
Is not formed).

As shown in FIG. 1, the obturator introduction device 10 according to the present embodiment has a guide tube 16 that can be inserted into the lumen 5c of the catheter 5, and an opening at the distal end of the guide tube 16 at the distal end of the guide tube 16. The obturator 12 according to the present embodiment, which is mounted so as to close, and a wire 18 corresponding to the shaft member which is inserted into the lumen 16c of the guide tube 16 so as to be able to advance and retreat.
(FIG. 3). As shown in FIG. 3, the guide tube 16 is typically made of a synthetic resin (for example, polyethylene, polypropylene, PET (polyethylene terephthalate), PET (polyethylene terephthalate), or PEN (polyethylene naphthalate) having low adhesion and friction resistance and excellent flexibility. ), PBT
(Polybutylene terephthalate), polyolefins such as cycloolefin polymers, polyvinyl chloride, PTFE
(Polytetrafluoroethylene) and other resins, polyesters, polyamides, polyurethanes, resins such as polyacetal, various elastomers, and silicone rubber), the outer diameter of which is equal to the diameter of the catheter 5 lumen 5c. Or slightly smaller (ie, 3.0 Fr or slightly smaller).
Thereby, when inserted into the lumen 5c of the catheter 5, it can be freely moved (advance / retreat) in the front-back direction along the wall surface of the lumen 5c of the catheter 5. On the other hand, a wire 18 having a diameter slightly smaller than the diameter of the lumen is inserted into a lumen 16c (diameter: 1.5 Fr (about 0.5 mm)) of the guide tube 16. The wire 18 has sufficient strength to push a closing device 12 described later from the guide tube 16.

Next, the closure 12 according to the present embodiment will be described. As shown in FIG. 2, the closing device 12 includes a main body 13 and an elastic portion 14. The main body portion 13 of the main obturator 12 has a bullet-shaped outer shape with a length of 8.0 mm, which is formed in a tapered shape that is gentle from the base portion 13a toward the distal end. Here, the outer diameter of the base portion 13a is substantially equal to the diameter of the lumen 5c of the catheter 5 (that is, 3.0 Fr), and is shaped to close the entire lumen. Accordingly, the outer peripheral surface of the base portion 13a can be slid with respect to the inner wall surface of the catheter 5, and the inner lumen can be closed to block the flow of a drug solution or the like. In addition,
The main body 13 having such a shape is molded from a mixed material in which an X-ray contrast material is contained in a molding material having high safety for medical use. Examples of such a molding material include polyethylene, polypropylene, PET (polyethylene terephthalate), PEN (polyethylene naphthalate),
PBT (polybutylene terephthalate), polyolefin such as cycloolefin polymer, polyvinyl chloride, P
Examples include fluororesins such as TFE (polytetrafluoroethylene), resins such as polyester, polyamide, polyurethane and polyacetal, various elastomers, silicone rubber, latex rubber, natural rubber, fibers, and composite materials thereof. Those having low adhesiveness and friction resistance are preferable for sliding inside the catheter 5 lumen 5c. Alternatively, the surface of the main body may be subjected to a surface treatment with various kinds of coatings so that the adhesiveness and the friction resistance can be further reduced. Further, as the X-ray contrast material to be contained, for example, a metal fine powder made of gold, platinum, tungsten, bismuth trioxide, barium sulfate or the like can be mentioned. The main body portion 13 (here, made of polyethylene resin containing platinum fine powder dispersed therein) molded from such a material containing an X-ray contrast material can be used even after being placed in the indwelling catheter 5.
The position can be confirmed by the line. The main body 13 does not need to be a so-called microscopic composite molded body in which the X-ray contrast material is dispersed and contained, but may be, for example, a portion made of the molding material (for example, any of the above synthetic resin portions). ) And a portion (for example, a portion made of gold, platinum, tungsten, or an alloy thereof) made of the above metal may be a so-called macroscopic composite molded body.

On the other hand, as shown in FIG. 2, the elastic portion 14 of the main obturator 12 has two thin strip-shaped metal pieces 14a and 14b.
(Diameter: 0.3 mm, length: 10.0 mm). In the present embodiment, the metal pieces 14a and 14b are formed of stainless steel, but are not limited to this. Other materials having high rigidity capable of exhibiting high elasticity can also be used as the material forming the elastic portion of the present invention. As such a material, nickel-
Metal materials such as titanium alloy, tungsten, phosphor bronze, piano wire (steel wire with a high carbon content), or polytetrafluoroethylene, polyethylene terephthalate, polyvinyl chloride, polyamide, polysulfone, polycarbonate, polyacrylate, polyimide, polyacetal, etc. Can be suitably used. In particular, stainless steel and nickel-titanium alloy are preferable because they can be formed into various shapes while maintaining high rigidity.

Thus, these metal pieces 14a and 14b are
It is attached to the base portion 13a such that its front end is widened outward. As a result, as shown in FIG. 2, the tip portions of the metal pieces 14a and 14b protrude outward from the outer edge of the base portion 13a of the main body 13. The tips of the metal pieces 14a and 14b are bent in an L-shape, and are directed further outward.
As a result of this configuration, the metal pieces 14a, 14
b has flexibility with respect to external force. That is, when a force is applied to the metal pieces 14a and 14b from the outside (that is, from the outer peripheral surface including the outer edge of the base 13a of the main body 13), the metal pieces 14a and 14b are constricted inward. To bend. At the same time, elasticity (restoring force) is generated in the metal pieces 14a and 14b themselves.

Thus, the main closure 12 capable of exhibiting such elasticity is mounted on the tip of the guide tube 16. That is, as shown in FIG. 3, the elastic portion 14 (metal pieces 14a, 14b) is accommodated in the inner cavity 16c of the guide tube 16 with its protruding portion (tip portion) narrowed and accommodated.
The main body 13 is disposed at the tip. At this time, elasticity is generated in the narrowed metal pieces 14a and 14b as described above. Therefore, the distal ends of the metal pieces 14a and 14b are strongly pressed (pressed) against the wall surface of the inner cavity 16c of the guide tube 16, whereby the main closure 12 is retained at the relevant portion of the guide tube 16. Can be.

Hereinafter, the obturator 12 is introduced into the catheter 5 using the obturator introducing device 10 with reference to the drawings.
The procedure for arranging will be described. 4 and 5 are explanatory diagrams schematically showing one mode of a procedure for introducing and arranging the obturator 12. As shown in FIG. 11 described above, the indwelling catheter 5 for introducing the obturator 12 of the present invention is actually
It is inserted into a blood vessel 2 (a hepatic artery or the like) to which a drug solution is supplied by various methods, and is fixed at a desired position.
Typically, it is inserted into the target blood vessel 2 as follows while confirming the position by angiography. That is,
First, a sheath is inserted by puncturing a femoral artery or the like, and a relatively large diameter (for example, 0.035 inch; about 0.889) is inserted therefrom.
mm) of a guide wire. Then, the present catheter 5 can be inserted along the guide wire and guided and arranged in a target blood vessel (FIG. 11). At this time, the side hole 5b is arranged in the medical solution supply blood vessel 2 and the distal end portion is made to enter the blood vessel 3 branched from the medical solution supply blood vessel 2. Thus, as described above, the catheter 5 is fixed at that position by the bent portions P1, P2, and P3 contacting the inner wall of the blood vessel. in this way,
If the obturator 12 of the present invention is intended for use, there is no need to use multiple guidewires or other catheters as described in the Background section above (ie, a tapered tip catheter). It is not necessary), and the introduction operation of the catheter 5 itself can be simplified and speeded up.
For example, when introducing the drug supply catheter 5 to the hepatic artery, the introduction operation itself can be shortened by about one hour as compared with the case where the introduction operation described in the section of the related art is performed. Note that the obturator 12 of the present invention is not applied only to the catheter 5 having the above-described bent portion, but is inserted into a normal catheter (for example, a metal coil 4 or the like as shown in FIG. By doing so, it is needless to say that the present invention can also be suitably used for a type in which the branch blood vessel 3 is fixed at the position by the coil while closing the branch blood vessel 3).

As shown in FIG. 3, the guide tube 16 with the obturator 12 attached to the distal end is inserted into the lumen 5c from one end of the indwelling catheter 5. And the obturator 12
The guide tube 16 is moved while sliding the outer peripheral surface of the main body portion 13 (here, around the outer edge of the base portion 13a) until the obturator 12 reaches a desired portion (that is, between the side hole 5b forming portion and the opening front end portion 5a). To enter. At this time, as described above, since the X-ray contrast material is contained in the main body 13 of the obturator 12, the position of the obturator 12 can be recognized from the outside by X-ray images. Therefore, the obturator 12 can be reliably transferred to a desired site. In addition, as a result of introducing the elastic portion 14 of the obturator 12 into the lumen 5c of the catheter 5 in a state of being housed in the guide tube 16, a part of the elastic portion 14 (typically, the side hole 5b of the catheter 5) It is also possible to avoid inconveniences such as intrusion of the metal pieces 14a and 14b (tips of the metal pieces 14a and 14b) or deviation from the side holes to the outside of the catheter.

Next, as shown in FIG. 4, the obturator 12 is pushed out into the lumen 5c of the catheter 5 by operating the wire 18. That is, by strongly pushing the wire 18 inserted into the lumen 16c of the guide tube 16, the elastic portion 14 of the obturator 12 is pushed out of the guide tube 16 lumen 16c, and the guide tube 16 and the obturator 12 are separated. The obturator 12 is arranged at that position. Next, the unnecessary guide tube 16 is pulled out of the catheter 5. In this state, the metal pieces 14a,
The protruding portion (tip portion) of 14b is still maintained in the above-mentioned constricted state except that the target is different from the inner wall surface of the guide tube 16 to the inner wall surface of the catheter 5, and the metal pieces 14a, 14b Has elasticity. As a result, the distal end portions of the metal pieces 14a and 14b are strongly pressed (pressed) against the inner wall surface of the catheter 5, and the repulsive force causes the main obturator 1 to come into contact with the relevant site of the catheter 5.
2 is realized (see FIG. 5). As described above, the lumen 5c of the catheter 5 is closed by the main body 13 (base 13a) of the main obturator 12, and the medicinal solution or the like supplied to the lumen 5c is supplied to the opening tip 5a of the catheter. You can prevent going. As a result, all of the drug solution and the like supplied to the lumen 5c are
b can be released into the blood vessel (see FIG. 11). As described above, according to the obturator 12 and the obturator introduction device 10 according to the present embodiment, a desired portion of the lumen 5c of the catheter 5 can be closed without requiring a complicated operation or a skilled skill.

Although the preferred embodiment of the obturator and the obturator introduction device of the present invention has been described above, the obturator provided by the present invention is not intended to be limited to the above-described embodiment. Hereinafter, the obturator 12 of the above embodiment will be described.
Another preferred form of the obturator of the present invention which can obstruct the lumen 5c of the catheter 5 will be described with reference to the drawings. The obturator 22 shown in FIG. 6 has a main body 23 having the same shape as the main body 13 in the first embodiment,
The base 23a is provided with an elastic portion 24 composed of four metal pieces 24a, 24b, 24c, 24d (typically made of stainless steel) having the same shape as the metal pieces 14a, 14b. As shown, these metal pieces 24
The tips of a, 24b, 24c, and 24d are each bent outwardly (in four directions) into an L-shape, and the base 2
3a is formed so as to project radially outward from the outer peripheral surface including the outer edge. Thereby, similarly to the metal pieces 14a and 14b of the above embodiment, when inserted into the lumen 5c of the catheter 5, the metal pieces 24a, 24b, 24c, 2
4d bends in the shape of narrowing inward, generating elasticity (restoring force). Then, the metal pieces 24a, 24b, 24c,
Since four 24d's are provided, twice as large as those in the first embodiment, the ability to retain the obturator 22 can be made higher than that described above.

Alternatively, an obturator 32 as shown in FIG. 7 as another embodiment is also preferable as the obturator of the present invention for solving the above-mentioned problem. That is, the obturator 32 shown in FIG. 7 has a main body portion 33 having the same shape as the main body portion 13 in the first embodiment, and the base portion 33 a has four metal pieces 34.
a, 34b, 34c, 34d (typically made of stainless steel). As shown, the strip-shaped metal pieces 3 constituting the main elastic portion 34
4a, 34b, 34c, 34d are two relatively short metal pieces 34a, 34b (here, about 5 mm) and two relatively long metal pieces 34c, 34d (here, about 10 mm).
And these tip portions are located at the base portion 33.
a is formed so as to project radially outward from the outer peripheral surface including the outer edge. By configuring the elastic portion 34 in this manner, the contact positions between the metal pieces 34a, 34b, 34c, 34d and the inner wall surface of the catheter 5 are changed in a plurality of sections (here, the base 33a).
(An area relatively close to and an area farther from the area). Thereby, the stationary state of the obturator 33 in the catheter lumen 5c can be more stably maintained.

Further, as another embodiment, an obturator 42 as shown in FIG. 8 is also preferable as the obturator of the present invention for solving the above-mentioned problem. That is, the obturator 42 shown in FIG. 8 has a main body 4 having the same shape as the main body 13 in the first embodiment.
3, the base 43a of which has two metal pieces 44a,
An elastic portion 44 made of 44b (typically made of stainless steel) is provided. As shown in the figure, the metal pieces 44a and 44b are formed so as to be curved outward and project radially from the outer peripheral surface including the outer edge of the base 43a. As a result of configuring the elastic portion 44 in this manner, when the metal pieces 44a, 44b are inserted into the lumen 5c of the catheter 5, the metal pieces 14a,
As in the case of 14b, the metal pieces 44a and 44b bend in the shape of narrowing inward, and elasticity (restoring force) is generated. At this time,
In the metal pieces 44a and 44b of the present embodiment, as a result of the formation of the curvature, the generated elasticity (repulsive force) is stronger than the metal pieces 14a and 14b of the first embodiment. Thereby, the stopping state of the closure device 43 in the catheter lumen 5c can be maintained at a higher level.

Further, as another embodiment, an obturator 52 as shown in FIG. 9 is also preferable as the obturator of the present invention for solving the above-mentioned problem. That is, the obturator 52 shown in FIG. 9 has a main body 5 having the same shape as the main body 13 in the first embodiment.
3 and a single metal strip 54 on its base 53a.
a (typically made of stainless steel) elastic portion 5
4 are provided. As shown, this metal piece 5
4a forms a spiral such that a continuous multiple loop is formed, and the diameter of each loop is slightly larger than the lumen 5c of the catheter 5 for inserting the obturator 52 (that is, the diameter of the base 53a). ing. That is, the loop component corresponds to the protruding portion. Thus, the elastic portion 54
As a result, the obturator 52 is inserted into the lumen 5 of the catheter 5.
When inserted into the spiral metal piece 54a, the spiral metal piece 54a bends in such a manner that each loop contracts inward, and elasticity (restoring force) is generated.
At this time, in the spiral metal piece 54a of the present embodiment, the entire area of the loop component comes into contact with the inner wall surface of the catheter 5. Therefore, the contact area between the metal piece and the wall surface of the catheter lumen is increased as compared with the other embodiments, and the frictional resistance is increased, so that the occluding device 53 is more stationary in the catheter lumen 5c. Can be maintained at a high altitude.

Although several preferred embodiments of the obturator according to the present invention have been described above, the surface of each metal piece may be coated with a resin having high frictional resistance. Thereby, slippage of the metal piece at the time of contact with the wall surface of the catheter lumen can be suppressed, and the stationary state in the catheter lumen can be further stabilized. As such a resin,
Polyurethane, latex, silicone rubber and the like can be used.

The obturator introduction device of the present invention is not limited to the first embodiment. For example, the obturator introduction device 60 having the configuration shown in FIG. 10 is also preferable as the obturator introduction device of the present invention. That is, as shown in FIG. 10, the obturator 62 constituting the obturator introduction device 60 according to the present embodiment has the same main body 63 as the obturator 42 shown in FIG. Is provided with an elastic portion 64 composed of two metal pieces 64a and 64b having the same curvature as that shown in FIG.
Further, the tips of the metal pieces 64a and 64b extend rearward so as to be parallel to each other. On the other hand, in a part of the inner wall surface of the guide tube 66 constituting the obturator introduction device 60 according to the present embodiment, a concave portion 66a having a size capable of accommodating the distal end extended portions of the metal pieces 64a and 64b is formed in an annular shape. Have been. As shown in FIG. 10, when the closing member 62 is attached to the opening end of the guide tube 66, the extended portions of the metal pieces 64a and 64b extend into the recess 66a while generating elasticity. Will be accommodated. This makes it possible to further stabilize the state of attachment of the distal end of the guide tube 66 in the main obturator 62. In this case, similarly to the first embodiment, the obturator can be pushed into the lumen 5c of the catheter 5 by the wire 68 inserted into the lumen of the guide tube 66. In the above embodiment, the wires 18, 68 are connected to the guide tubes 16, 6, respectively.
6, the movable shaft members such as the wires 18 and 68 may be provided so as to be able to advance and retreat along the guide tubes 16 and 66 in the present invention, and are not limited to this mounting form. . For example, a moving groove is separately provided on the outer wall portion (outside) of the guide tube, and the wires 18 and 68 are provided there.
And the like may be mounted so as to be able to advance and retreat in the front-rear direction of the guide tube.

Although the preferred embodiment of the obturator and the obturator introducing device of the present invention has been described above as being applied to the intravascular indwelling catheter 5, the present invention is applicable only to such an indwelling catheter. The present invention is not limited thereto, and can be applied to catheters having various uses and shapes (for example, those having a tapered tip or a stepwise reduced diameter).
For example, the obturator according to each of the above-described embodiments can be used to occlude the lumen of a catheter (such as a so-called pigtail-shaped catheter with a side hole) used for releasing an angiographic agent from a side hole (side hole). . For example, a pigtail-shaped catheter with multiple side holes,
When the tip is inserted into the ventricle for angiography, the obturator of the present invention can be used for closing the opening of the tip. By using the obturator of the present invention for such a purpose, it is possible to prevent a large amount of angiographic agent from being released into the ventricle from the opening at the catheter tip end, which could not be realized by conventional occluding means. Therefore, the use of the obturator of the present invention makes it possible to optimize the release of the contrast agent from the plurality of side holes (that is, to obtain a good image), and also to use a large amount of the contrast agent in the ventricle. PVC (ventricular extrasystole) due to release can be prevented beforehand.

Alternatively, the obturator of the present invention can also be used effectively when angiography is performed by supplying an angiographic agent from the pigtail-shaped catheter inserted through the femoral artery. That is, according to such insertion, since the distal opening of the catheter is directed to the upper part (that is, the aortic arch side), it is difficult to image the lower part (that is, the common iliac artery). However, by closing the distal opening of the inserted catheter with the obturator of the present invention, it is possible to effectively discharge the contrast agent from the side hole formed in the lower direction. Thereby, a good image near the common iliac artery can be obtained.

Alternatively, the obturator of the present invention can be effectively used for closing the opening at the distal end of a so-called balloon catheter (with side holes). That is,
The catheter with a balloon is inserted into a target site by a guide wire, and the blood flow at the site is blocked by the balloon. Thereafter, the distal end opening of the catheter is completely closed by the closing device (closing device introducing device) of the present invention. As a result, it is possible to inject the chemical solution without leaking from the side holes. Further, according to the obturator of the present invention, the distal end opening of the catheter can be completely and simply closed after the catheter is inserted into the body cavity. Therefore, by using the obturator of the present invention, it is possible to create a new treatment method that focuses on the side hole (side hole) of the catheter. Further, the shape of the catheter itself can be improved as compared with the conventional one. For example, if the obturator of the present invention is used, a drug solution can be injected into a diseased part from one lumen (main lumen) through a side hole after insertion of a catheter, so that a drug injection lumen (sublumen) is separately provided. Need not be deployed. For this reason, for example, the diameter of the balloon-equipped catheter can be reduced.

[0032]

According to the present invention, there is provided an obturator for simply and effectively closing the lumen of a catheter, and an obturator introducing device capable of smoothly introducing such an obturator into the catheter. can do. That is, according to the obturator introduction device of the present invention, the obturator can be introduced and transferred to a desired site in the lumen of the catheter, and can be arranged at that position. In addition, the obturator of the present invention can be stopped at the disposition position by the elastic portion, and can close the catheter lumen by the main body. Therefore, according to the obturator of the present invention, it is possible to simply and effectively shut off the flow path of the drug solution or the like supplied into the catheter lumen at the stop position. Further, by using the obturator of the present invention, the catheter introduction operation itself can be simplified and speeded up.

[Brief description of the drawings]

FIG. 1 is a side view schematically showing a main part of an obturator introduction device according to an embodiment of the present invention.

FIG. 2 is a perspective view schematically showing a configuration of the obturator according to the embodiment of the present invention.

FIG. 3 is a cross-sectional view schematically showing a state in which the obturator introduction device of the present invention according to one embodiment is inserted into a catheter.

FIG. 4 is a cross-sectional view schematically showing a usage example of the obturator introduction device of the present invention according to one embodiment.

FIG. 5 is a cross-sectional view schematically showing a usage example of the obturator introduction device of the present invention according to one embodiment.

FIG. 6 is a perspective view schematically showing a configuration of the obturator according to the embodiment of the present invention.

FIG. 7 is a perspective view schematically showing a configuration of the obturator according to the embodiment of the present invention.

FIG. 8 is a perspective view schematically showing the configuration of the obturator according to the embodiment of the present invention.

FIG. 9 is a perspective view schematically showing a configuration of the obturator according to the embodiment of the present invention.

FIG. 10 is a cross-sectional view schematically showing a main part of the obturator introduction device of the present invention according to one embodiment.

FIG. 11 is an explanatory view schematically showing an example of indwelling a catheter in a blood vessel when the obturator of the present invention according to one embodiment is used.

FIG. 12 is an explanatory view schematically showing an example of a conventional catheter indwelling in a blood vessel.

[Explanation of symbols]

1,5 catheter 10,60 obturator introduction device 12,22,32,42,52,62 obturator 13,23,33,43,53,63 main body 14,24,34,44,54,64 elastic part 14a, 14b, 24a, 24b, 24c, 24d, 3
4a, 34b, 34c, 34d, 44a, 44b, 54
a, 64a, 64b Metal piece 16, 66 Guide tube 18, 68 Wire

Claims (4)

[Claims] Claims: 1. An obturator for closing a lumen of a catheter, comprising: a main body inserted into the catheter lumen; and an elastic portion having elasticity. The elastic portion has an outer peripheral surface that can close and slide along the wall surface of the lumen, and at least a part of the elastic portion protrudes outward from the outer peripheral surface of the main body portion in a state where no external force is applied. When arranged in the catheter lumen, the elastic member generates elasticity based on the contact between the protruding portion and the catheter lumen wall surface, so that the obturator is stopped in the lumen. The realized catheter obturator. 2. The obturator according to claim 1, wherein the elastic portion is formed of one or more metal pieces formed in a streak shape. 3. The obturator according to claim 1, wherein the main body contains an X-ray contrast material. 4. A device for introducing the obturator according to any one of claims 1 to 3 into a lumen of a catheter, comprising: a guide tube which can be inserted into the lumen of the catheter; The obturator according to any one of claims 1 to 3, which is mounted, and a movable shaft member that can advance and retreat along the guide tube. Here, the obturator according to any one of claims 1 to 3, The obturator is
At least a part of the elastic portion of the obturator is accommodated in the guide tube by being accommodated in the guide tube, and the obturator is advanced by moving the movable shaft member toward the distal end of the guide tube. An obturator introduction device configured to be separated from the guide tube.