JP2006094876A - Medical treatment instrument - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a high-quality medical treatment instrument which can execute a therapy to remove a foreign substance in a celom or a thrombus rapidly, accurately and simply. <P>SOLUTION: This medical treatment instrument is so constituted that a therapy section in the celom is disposed at a pointed head region of a slender and flexible main linear section 2, wherein the main linear section 2 comprises a hollow stranded wire coil 4 in which a core material for an operation 3 is inserted, and the therapy section in the celom is so constituted that it is a plurality of spans arrangement of expanded and contracted diameter sections 5A and 5B with the length L comprising the coiled wires 7 of the hollow stranded wire coil 4, and the expanded and contracted diameter sections 5A and 5B can be basket-type expanded diameter variants 6A and 6B comprising the coiled wires 7 and can become contracted diameter variants changed from the expanded diameter variants by a pulling/pushing operation of the core material for the operation 3. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a medical treatment instrument used for removal of foreign matter in a body cavity such as a blood clot or a gallstone in a bile duct, a pulmonary embolism treatment, a hemodialysis treatment, or the like.

  As a medical treatment tool used for removal treatment of foreign matter in a body cavity such as a blood vessel, the distal end portion of an elongated flexible striate body inserted into the body cavity is provided with a foreign matter removal means, and a hand operating part that has been brought out of the body is pushed. There are background arts exemplified in Patent Documents 1 to 3 for medical treatment tools that perform pulling and rotating operations to remove the foreign substances.

  That is, the one disclosed in Patent Document 1 includes a foreign substance removing means composed of an “elastic disc-shaped or radial projecting elastic removing brush” at the distal end portion of the striate body. It is set to a structure that easily scrapes and removes foreign matter in a body cavity such as a thrombus.

  Patent Document 2 uses a blood clot treatment device in a blood vessel, and has a structure in which “two ball parts that can be expanded and contracted by cross-knitting strands of a ribbon and a wire” are arranged at the distal end portion of a striatum. The ball portion removes and collects the thrombus or injects a thrombolytic agent to perform blood flow resumption treatment.

  And the thing of patent document 3 presents the expansion blade | wing in the front-end | tip part of the sheath body of a flexible linear body in the state which protrudes from this sheath, and can draw in and accommodate in this sheath It is characterized by a structure that captures and removes foreign matter in a body cavity such as a calculus in the ureter and bile duct.

JP 2003-38500 A Special table 2003-521259 Special Table 2002-516139

  Patent Documents 1 and 2 of the background art described above have a structure in which a thrombus or the like is removed and treated by an intracorporeal treatment portion of a removal brush / ball-shaped portion provided at a distal end portion of a striatum inserted into a body cavity. Although it cannot be adjusted and set to a size suitable for the shape of the individual pieces, and is not limited to simply rubbing, the basket portion of Patent Document 3 can be slightly deformed by entering and exiting the sheath, It is impossible to accurately change the size to match the individual form of the lesion, and any of them lacks the therapeutic ability to quickly and easily remove foreign bodies in the body cavity.

  And in any of the above background technologies, the main part constituting the treatment part in the body cavity has a complicated structure and is inferior in molding processability, and it is necessary to prepare various sizes suitable for individual lesions. In addition to being inferior in molding processability, the cost is high, and daily management / preparation before treatment (operation to select a size suitable for individual lesions) becomes complicated. There are the above difficulties.

  The present invention provides a high-quality and high-performance “medical treatment tool with an intracorporeal treatment unit” that solves the above-described problems of the background art and improves the therapeutic properties, and is excellent in processing productivity. Is.

  The present invention that solves the above technical problems (see FIG. 1 showing the basic form) “in the medical treatment instrument provided with a treatment part in the body cavity at the distal end portion of the elongated flexible main line part 2, the main line part 2 includes a hollow stranded wire coil body 4 having an operation core 3 inserted therein, and a body cavity treatment portion is formed of a coil strand 7 of the hollow stranded wire coil body 4 and has an inflated / reduced diameter portion 5A, 5B. The plurality of spans are arranged, and by pulling / pushing the operation core material 3, the basket-like expanded diameter deformed bodies 6A and 6B by the coil wire 7 of the expanded / contracted diameter sections 5A and 5B, and the expanded diameter deformed bodies A medical treatment instrument 1A according to the first invention, characterized in that it has a "structure with a reduced diameter variation";

  (Refer to FIG. 2 showing the basic configuration) Similarly, in the case where the treatment portion in the body cavity is provided in the main striated portion, “the main striated portion 2 is composed of a hollow stranded wire coil body 4 in which the operation core material 3 is inserted. 2A and the inner main striated portion 2B have a two-layered tube structure, and the body cavity treatment section has two layers of inner and outer bulges of length L1 and L2 made of the coil wire 7 of the two-layer hollow stranded coil body 4. Two-layered basket-like expanded diameter deformed bodies 6C and 6D in the form of inner and outer envelopes by the coil wire 7 of the expanded and contracted diameter parts 5C and 5D by the pull-push operation of the operation core 3 as the reduced diameter parts 5C and 5D, The medical treatment tool 1B according to the second invention is characterized in that it has a structure in which the diameter-changed body is freely changed from the expanded-diameter body. The relative form of the expanded diameter deformed bodies 6C and 6D is either a substantially similar form indicated by a solid line in the drawing, or a non-substantially similar shape in which the apex of the expanded diameter deformed body 6D is inscribed and close to the inner periphery of the expanded expanded diameter deformed body 6C. But it ’s okay.

  That is, the medical treatment tools 1A and 1B having the above-described configuration are mainly used for the treatment of thrombus / clot lesions and the treatment of pulmonary embolism, and the elongated flexible main striated portion 2 to be inserted into the blood vessel is used. It is formed of “a hollow stranded wire coil body 4 with an outer layer coating C” and “inflated / reduced diameter portions 5A to 5D in which the outer layer coating C is slightly peeled and the coil wire 7 is exposed at the tip portion of the main wire portion 2”. ”And pulling the operating core 3 with the hand operating unit 10 that is brought out of the body during treatment, the inflated / reduced diameter portions 5A to 5D are forcibly shortened, and the inflated / reduced diameter portions 5A to 5D coil elements The wire 7 is formed into an “inflated diameter variant 6A to 6D in the form of an arbitrary-diameter basket composed of a group of 7 spiral strands” in which the diameter of the wire 7 is spirally outwardly divided into individual pieces, and the expanded diameter variants 6A to 6D Treatment of thrombus / clot lesion P etc., and after the treatment, pull operation The expansion / contraction deformation body which is reduced in diameter and restored to a straight expansion / contraction diameter portion 5A to 5D by a restoring force due to self-elasticity of the coil wire 7 by making it free or a push operation of the operation core 3 It consists of free thoughts.

  Both the first and second inventions have a common high-level concept configuration in which a plurality of expansion / contraction diameter portions 5 are set, and the first invention is the “span arrangement of expansion / contraction diameter portions 5”. The invention of 2 invention is characterized by the subordinate conceptual configuration of “double arrangement of expansion / contraction diameter part 5 at the same point”. The hollow stranded coil body 4 is a flexible stranded hollow stranded coil body in which a number of coil strands disclosed in JP-A-2002-275774 are twisted on the same circumference. The portions other than the expansion / contraction diameter portions 5A to 5D are configured to maintain the normal flexible tubular body regardless of the operation force of the operation core member 3 by having the outer layer coating C present, The core material 3 is fixed to the front end of the main line portion 2 and is set so as to be slidable relative to the main line portion 2 and the inner main line portion 2B. Then, one or more of the inner circumferences of the main line portions 2, 2 A, and 2 B and the hollow portion of the operation core material 3 are caused to function as the fluid flow path 9 for the drug solution / blood.

  The medical treatment instruments 1A and 1B having the above-described basic configuration adopt the following modes as necessary for the purpose of further improving the operational effects. That is, the first invention adopts a mode in which the lengths L1 and L2 of the inflated / reduced diameter portions 5A and 5B are set to different sizes, and the enlarged diameter deformed body 6 having a different enormous diameter D is adopted. In this embodiment, the expanded / contracted diameter portions 5C and 5D are in the form of a hollow stranded coil body 4 in which the twisting directions are opposite to each other.

  Furthermore, in both the first and second inventions, “a mode in which the inner periphery of the hollow stranded wire coil body 4 is formed as a liquid flow path for a therapeutic drug solution” “attachment of a set lock means of the swelled diameter of the swelled deformed body 6” "Attachment of elastic coating covering all or part of expanded diameter deformed body 6" "Wire 7 of hollow stranded wire coil body 4 is a single wire or stranded wire stranded wire form, combination of dissimilar metals, deformed cross section wire “The shape in which the outer circumference of the hollow stranded wire coil body 4 is forcibly reduced in diameter” “the elastic sheath tube is provided in the main wire portion 2 and the outer main wire portion 2A” is adopted.

  The medical treatment tool 1A of the present invention having the above-described configuration (see FIGS. 1C and 1D) is inserted into the blood vessel T with the inflated / reduced diameter portions 5A and 5B having a straight reduced diameter, and the lesioned portion P is pushed. Then, the rear expanded / contracted diameter part 5B is set in the lesioned part P, and then the expanded / contracted diameter parts 5A, 5B are formed into the expanded diameter deformed bodies 6A, 6B of the required diameter, and from the chemical injection / inhalation part 12 as necessary. A drug solution M of a clot lysing agent (urokinase / TPA) is injected from the liquid channel 9 on the inner periphery of the hollow stranded coil body 4 and “push / pull / rotate” is operated to treat the lesioned part P.

  In the above treatment method, the swelled deformed body 6 has various deformed shapes ranging from a small diameter suitable for the individual state of the lesioned part P to a petal-like enlarged form shown in FIG. Since it can be set freely and consists of a set of spiral rib wires, it has excellent mechanical shape stability against external force, and can be pushed, pulled and rotated, so it consists of 7 groups of spiral coil wires. A beautiful clot removal treatment can be achieved very efficiently by the combination of the bite into the lesioned part P of the basket-shaped expanded diameter deformed body 6B and the clot scratching action of seven coil strands.

  And the blood flow F of the lesioned part P is ensured by the presence of the swelled deformed body 6, and the front swelled deformed body 6A functions as a receiving basket part for a body cavity foreign body such as a thrombus separated by the rear swelled deformed body 6B. Thus, the foreign substance is captured by the blood flow F, and the peripheral blood vessels are prevented from being troubled by the foreign substance.

  Furthermore, since the injected medicinal solution M generates a spiral flow by the group of spiral strands 7 on the inlet side of the expanded diameter deformable body 6B on the outlet side, the contact of the medicinal solution M with the lesion is effective and effective. Clot lysis is possible. There are the above-mentioned main specific effects.

  On the other hand, the medical treatment instrument 1B having the above-described configuration (see FIG. 2D) sets the expansion / contraction diameter portions 5C and 5D in the narrowed lesion portion P of the blood vessel T in the same manner as the medical treatment instrument 1A. There are the following specific effects in the treatment by transforming into the swelled deformed body 6C and 6D having the required diameter and injecting a chemical as necessary. That is, the expanded diameter deformed bodies 6C and 6D are also good in shape stability to withstand pressing external force, and the smooth expanded diameter deformed body 6C of the outer expanded / contracted diameter section 5C is difficult due to the resistance of blood clots and blood clots of the stenotic lesion P. Even when a case or a case where a deformed bulge deformed body 6C that has been smoothly expanded and deformed is pushed, pulled or rotated for treatment, the inner expanded diameter deformed body 6D supports the expanded diameter deformed body 6C from the inside. Thus, mechanical strength is replenished to prevent large deformation and collapse, and blood clot and blood clot can be quickly and well dissolved and removed while ensuring blood flow F.

  And since the hollow twisted wire coil body 4 that forms the inner and outer double expanded diameter deformed bodies 6C and 6D is in the form of a double pipe, it becomes possible to release the drug solution M from the respective inner circumferences of the double pipe, The therapeutic effect can be further improved. In addition, the medical treatment tools 1A and 1B of the present invention described above can be usefully used for hemodialysis treatment and pulmonary embolism treatment (this usage and the effects thereof will be described in detail in Examples).

Furthermore, the medical treatment instrument 1A or 1B according to the present invention can be molded by simply peeling the outer layer coating C at an arbitrary point of the hollow stranded coil body 4 from the main part of the intracorporeal treatment part, so that the processing is possible. Molding processability is significantly improved compared to the above, and various forms of lesion treatment are possible with a single medical treatment instrument 1A, 1B, and particularly low cost and daily management are ensured. There are unique main effects that can improve treatment performance and reduce treatment costs.

  Hereinafter, preferred embodiment specifications of the basic form and preferred embodiments based on the basic form will be described.

  First, the specifications of one embodiment of the basic form shown in FIG. 1 are as follows. That is, the specifications of the preferred embodiment of the medical treatment instrument 1A for treating the thrombus / clot lesion of the basic form are as follows: “main wire 2 is“ 1 × 7 twisted coil coil 7 ” A hollow twisted wire coil body 4 having an inner diameter of 0.2 mm and an outer diameter of 0.55 mm obtained by applying an outer layer coating C of polyethylene, polypropylene, polyamide, etc. The outer diameter = 0.12 mm and the expansion / contraction diameter portions 5A and 5B are the length L = 5.0 mm and the span S = 6 mm. In the embodiment of the above specifications, the main effects can be fully enjoyed.

  Next, another embodiment of the medical treatment instrument 1A will be described with reference to FIGS. That is, in the example shown in FIG. 3, the expansion / contraction diameter portions 5A and 5B are spanned, and the lengths L1 and L2 of the expansion / contraction diameter portions 5A and 5B are set to be unequal in size such that L1 <L2. It is composed of a combination of an expanded diameter variant 6B having a diameter and an expanded diameter variant 6A having a small front diameter. In this configuration, the 360 ° twisting span of each of the coil wires 7 of L1 and L2 has a larger diameter changing action by using a hollow stranded coil body 4 having the same length as that of L1 and L2. It is good also as a structure made easily.

  In this type of unequal configuration, the swelled diameter deformed body 6A located on the peripheral side of the blood vessel in endovascular treatment has a small diameter, so that the form of intravascular placement is preferable (see FIG. 3C) and the swelled diameter behind The deformed body 6B can be made into an elongated form and fit-set to a long lesion.

  And the thing of the expansion / contraction diameter part 5 of the thing of FIG. 4 is formed in the continuous span arrangement | positioning form. In FIG. 4, the expanded diameter of the expanded diameter deformable body 6 is enlarged to form a flat brush shape, thereby functioning as a brush for removing foreign substances in the blood vessel. By “attaching”, it is possible to “pinch and capture the foreign substance D in the body cavity after brushing”. In this embodiment, in order to improve the trapping and trapping action of the foreign matter D (see FIG. 4C), the length of the expansion / contraction diameter portion 5 is set to the 360 ° twisted span of the coil wire 7 to catch the foreign matter. A form in which the force is increased is preferable. In addition, since the mechanical strength of the expanded diameter deformed bodies 6A to 6C is remarkably improved in the form shown in FIG. 4 (C), the clot and blood clot stuck to the blood vessel wall can be scraped and collected, and the captured foreign matter D can be prevented from dropping while being taken out of the body.

  Next, referring to FIG. 5, an embodiment of a medical treatment instrument 1A applied for dialysis treatment will be described. That is, this dialysis treatment is made to function as “the expanded diameter deformed bodies 6A and 6B function as blood intake portions” and “the hollow portion of the operation core 3 as the blood return portion”. The diameter portions 5A and 5B are inserted and set at the required points of the brachial artery to form the swelled deformed body 6A and 6B of the required size, and then the liquid flow path 9 on the inner periphery of the main striated portion 2 is used as the forward suction path. Blood F is sucked from the liquid injection / inhalation section 12 and dialyzed through the hemodialysis section 23, and the dialyzed blood F is injected into the rear end of the hollow portion of the operation core 3 that is out of the body. The hollow portion 3 is made to function as the liquid passage 9 for the return path, and the dialysis treatment is performed by returning to the blood vessel T from the tip opening.

  The specifications of the preferred embodiment of the medical treatment instrument 1A for dialysis treatment are as follows: "The main wire 2 is a coil body composed of seven strands of coil wire 7 and the outer layer coating C is also applied. “A hollow stranded wire coil body 4 having an inner diameter of 3.2 mm and an outer diameter of 4.0 mm” “The operation core material 3 is a hollow wire material such as stainless steel and Ni—Ti material, or a twist of extra fine wire. It is a hollow striated body composed of merged wires, the outer diameter is 2.0 mm, the inner diameter is 1.6 mm, and the expansion / contraction diameter portions 5A and 5B are each of length L = 14 mm and span S = 8 mm. Is.

  For the above dialysis treatment (see FIG. 5 (B)), the enlarged diameter change body 6 is set at a key point in the blood vessel, and the blood to be dialyzed is sent from the liquid injection / inhalation section 12 to the “inside of the main line section 2”. The dialysis blood is sucked through the peripheral liquid flow path 9 ", passed through a hemodialysis part (not shown) and dialyzed, and the dialyzed blood is passed through the" liquid flow path 9 in the hollow part of the control core 3 "for the return path. Hemodialysis treatment is performed by refluxing into the blood vessel T from the distal end opening of the material 3.

  In the above usage, the expanded diameter deformable body 6 can be freely set at an arbitrary point of the blood vessel and is excellent in mechanical shape stability, so that it is possible to efficiently absorb blood without being easily deformed by the blood vessel wall, Since the hollow stranded coil body 4 is a high tensile strength body formed of a stranded wire of metal wires over its entire length, for example, an abnormality of the blood vessel spasm phenomenon (convulsions) occurs during the treatment, and the site is When restrained within the blood vessel, it is possible to immediately withdraw from the restraint due to the high tensile strength, thereby effectively preventing the occurrence of treatment trouble.

  Further, since the expanded diameter deformed bodies 6A and 6B of the blood intake portion exist in parallel through the small span S, the blood F intake property becomes remarkable, and the blood flow passing through the expanded diameter deformed body 6 is in an expanded state. Since the spiral flow is guided along the spiral shape of the coil wire 7, it prevents the generation of harmful blood turbulence that occurs in the blood suction part and the like and “the occurrence of vibration of the relevant part of the treatment instrument”. Therefore, it is possible to remove blood smoothly and efficiently, and an extremely effective and highly efficient hemodialysis treatment can be performed.

  Next, specifications of a preferred embodiment of the medical treatment tool 1B for removing foreign matter in the body cavity of the basic form will be described. That is, the outer main wire portion 2A is formed by applying an outer layer coating C to a coil body made of a coil wire of “0.04 mm diameter wire rod 1 × 7 twist diameter = 0.12 mm twisted wire”. Diameter = 1.8 mm, inner diameter = 1.2 mm ”, inner main wire portion 2B is“ coil body composed of seven coil strands having a diameter = 0.04 mm ”, and outer diameter C is similarly applied with outer layer coating C = "1.0 mm, inner diameter = 0.5 mm" The operation core material 3 is "0.12 mm diameter wire rod 1x7 twisted wire, outer diameter = 0.36 mm solid line" The lengths of the expansion / contraction diameter portions 5C and 5D are 26 mm and 14 mm ”. The above-described medical treatment instrument 1B can enjoy the above-mentioned effects fully.

  Next, another embodiment of the medical treatment tool 1B will be described with reference to FIG. That is, in FIG. 6, the coil wires 7 of the outer main wire portion 2 </ b> A and the inner main wire portion 2 </ b> B are set in opposite twist directions. In FIG. 6, the twist direction of the coil wire 7 of the two-layer expanded diameter deformed bodies 6C and 6D is reversed, and thus the discharge is released from the inner peripheral fluid flow paths of the outer and inner main wire portions 2A and 2B. The spiral flow by the spiral strands of the expanded diameter deformed bodies 6C and 6D of the drug solution M becomes opposite to each other, and the drug solution administration effect of dissolving the thrombus, blood clot and the like by causing the turbulent flow and diffusion action of the drug solution M is further improved.

  Furthermore, the medical treatment instrument 1B can be usefully used for the following treatment in addition to the treatment for removing foreign matter in the body cavity. That is, it can be utilized for dialysis treatment by using similar specifications to the medical treatment tool 1A for dialysis treatment, and the same effects as the dialysis treatment treatment tool 1A can be enjoyed. And any of medical treatment tool 1A * 1B can be utilized effectively for the pulmonary embolism treatment of the following description.

  In other words, traveler's thrombosis called airplane economy class syndrome and thrombus formed in the veins in the lower limbs or pelvis due to bedridden for a long time during or after surgery are carried to the lungs and clogged into the pulmonary artery to stop cardiopulmonary arrest In the symptom to be brought about, the treatment for preventing movement of the thrombus to the lung can be made possible by inserting the expansion / contraction diameter portion of the therapeutic treatment tool 1A or 1B of the present invention into the vein and capturing and collecting the thrombus. In the treatment tool 1B having a double structure of the expanded diameter deformed bodies 6C and 6D, the capture and recovery action can be made particularly accurate.

  Next, with reference to FIG. 7 to FIG. 10, another embodiment of the medical treatment instrument 1A / 1B common will be described. That is, FIG. 7 shows that the entire outer circumference of the expanded diameter deformable body 6 of each of the above embodiments or a part of 2/3, etc. is made “non-porous with a film thickness of 50-60 μm made of polyurethane, polyester, silicon rubber, etc. A sheet or microporous sheet of elastic covering 20 "is provided. In this embodiment, the fine foreign matter separated from the lesioned part P by the coating 20 can be captured and collected with high efficiency and there is no possibility of damaging the blood vessel wall.

  Next, with reference to FIG. 8, an embodiment of the set lock means for the degree of expansion of the expanded diameter deformable body 6 provided in the medical treatment instrument 1A or 1B of the basic form will be described.

  Specifically, the rear end of the main striated portion 2 is connected to a hand operating unit 10 that is brought out of the body at the time of treatment. A hollow boss portion 15 having a hollow tube body connected to the ends and a female screw portion 17 screwed into the male screw portion 16 of the boss portion 15 on the inner periphery of the front end, and the operating core material 3 inserted through the hollow portion. It consists of a combination of two members with the tube advance / retreat operation part 14, and the operation core material 3 advances / retreats (advance / retreat operation with respect to the main line part 2) by relative advance / retreat with the boss part 15 by the rotation operation of this advance / retreat operation part 14. Can do.

  That is, the operation core material 3 inserted in the main wire portion 2 has a rear end connected to the advance / retreat operation portion 14 of the hand operation portion 10, and the push-pull operation of the advance / retreat operation portion 14 causes the inner portion of the operation core material 3 to be inserted into the main wire portion 2. The inserted core 3 for operation is advanced and retracted, and the expansion diameter change body 6 and the diameter reduction deformation body by the length change of the expansion / contraction diameter part 5 are made. A lock nut 18 is screwed into the male threaded portion 16 of the boss portion 15, and the lock nut 18 is joined to the front end of the advance / retreat operation portion 14 and tightened to thereby tighten the boss portion 15 and the advance / retreat operation portion 14. Set lock means is provided that locks the relative position and optimally maintains the degree of expansion of the expanded diameter deformable body 6 or releases it.

  Those having the above set lock means enable the set lock and release of the relative positions of the operation core material 3 and the main striate portion 2, and the size of the expanded diameter deformed body 6 can be set to the required sizes of various sizes of the lesioned portion. Since the treatment can be performed by matching with the set lock, the therapeutic properties can be improved and the treatment can be performed for a long time. This set lock means is also applied to the medical treatment instrument 1B by connecting the outer / inner main line portions 2A and 2B to the boss portion 15.

  Next, what is shown in FIG. 9 is that the main portion of the main filaments 2 and 2A other than the expansion / contraction diameter portion 5 is loosely inserted into an elastic thin-walled sheath 21 in the basic configuration. 21 forms the outer periphery and is inserted into the blood vessel. The one with the sheath tube 21 brings about a slightly larger diameter, but the inner periphery of the sheath tube 21 is also used as the liquid flow path 9 of the drug solution M, or the suction and collection of a small clot piece etc. from which the inner play of the sheath tube 21 is peeled off. It can be used as a road.

  Next, another embodiment shown in FIG. 10 will be described. That is, first, as shown in FIG. 10A, the coil wire of the hollow stranded wire coil body 4 of the main wire portion 2 is made of stainless steel wire, Ni—Ti alloy wire, tungsten wire, etc. as shown in FIGS. 7A and 7B. It consists of a combination of different metals. This Ni-Ti alloy wire can prevent the occurrence of bending due to repeated use and special shape stability by the shape memory property and superelastic property of the expanded diameter deformable body 6.

  Next, in FIG. 10B, the outer periphery of the hollow stranded wire coil body 4 of the main wire portion 2 is subjected to forced diameter reduction by swaging or outer peripheral die drawing after circular processing. This reduced diameter processed form has the effect of increasing the rigidity by reducing the diameter and reducing the diameter, and adjusting the longitudinal or radial reduced diameter portion and the degree of diameter reduction of the longitudinal flexure after bending. Preferred configuration is possible.

  In the case of FIG. 10 (C), the coil wire 7C of the hollow stranded wire coil body 4 of the main wire portion 2 is set in an irregular shape having a rectangular cross section. Use of this flat wire has the merit effect that the outer diameter of the main wire portion 2 can be reduced or the flow path can be expanded by increasing the inner diameter utilized as the liquid flow path 9.

  On the other hand, the one shown in FIG. 10D is a “coil body / ring body” that presses and locks the outer periphery of the main wire portion 2 at both ends of the expanded / contracted diameter portion 5 to press and lock the outer periphery that receives the stress of repeated deformation of the expanded / contracted diameter portion 5. A bundling portion 22 for preventing deformation is provided. 10D prevents "deformation and loosening" due to repeated deformation of the outer tube body 2 at the site, so that the deformed shape of the inflated and contracted diameter portion 5 is stabilized and the deformable repeatability is improved. If the bundling portion 22 is made of a radiopaque material, the visibility of the expanded diameter deformable body 6 in the body cavity can be ensured.

  The coil wire 7 of the hollow stranded coil body 4 of the main wire portion 2 may be a radiopaque wire such as gold, platinum, tungsten or the like that ensures visibility during treatment, a combination of different materials, or a single wire In addition, the hand operating unit 10 (see FIG. 1) may be in the form of a fingertip operating piece 11 that is slid by a fingertip, etc. A clamp pin set lock may be used.

  Furthermore, the outer layer coating C of the hollow stranded coil body 4 is preferably a relatively hard material in order to smoothly enjoy the compression reaction force due to the tension of the operation core material 3 at the time of expansion, and is not limited to a thermoplastic resin. A thermosetting resin such as a phenol resin or an epoxy resin "may be used, or a stainless steel tube, an aluminum tube, or the like may be used. The operation core material 3 may be in the form of either a flexible hollow line or a flexible solid line. And (refer to FIG. 5) In the above-described use for hemodialysis treatment or the like, when the inside of the operation core 3 is used as a fluid flow path, the operation core 3 is elongated as shown by the dotted line in the drawing, The connection part 24 fixed to the advance / retreat operation part 14 may be provided in the part and connected to the hose 25 drawn from the hemodialysis part 23.

The basic form of the medical treatment tool of 1st invention is shown, (A) is the front view, (B) is explanatory drawing of the expansion diameter change body, (C) is structure explanatory drawing of the expansion / contraction diameter part, (D) (E) is an explanatory diagram of its operation. The basic form of the medical treatment tool of 2nd invention is shown, (A) is the front view, (B) is explanatory drawing of the expansion diameter change body, (C) is structure explanatory drawing of the expansion / contraction diameter part, (D) Is an illustration of its function The Example of the medical treatment tool of 1st invention is shown, (A) is the principal part front view, (B) (C) is the action explanatory drawing. The other example of the medical treatment tool of 1st invention is shown, (A) is the principal part front view, (B) (C) is the effect explanatory drawing. The other Example of the medical treatment tool of 1st invention is shown, (A) is the whole front view, (B) is the effect explanatory drawing. Explanatory drawing of the principal part of the other embodiment of the medical treatment instrument of the second invention Explanatory drawing of the principal part of the other Example of the medical treatment tool of this invention Explanatory drawing of one Example of the set lock means of the medical treatment tool of this invention Explanatory drawing of the principal part of the other Example of the medical treatment tool of this invention The other example of the medical treatment tool of the present invention is shown, and (A)-(D) are the principal part explanatory views.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1A Medical treatment tool 1B of 1st invention Medical treatment tool 2 of 2nd invention 2 Main wire part 2A Outer main wire part 2B Inner main wire part 3 Operation core material 4 Hollow stranded wire coil body 5 Expansion / contraction diameter part 6 Expansion Diameter change body 7 Coil wire 9 Liquid flow path 10 Hand operation part 14 Advance / retreat operation part 15 Boss part 18 Lock nut 20 Elastic coating 21 Sheath tube 22 Bundling part C Outer layer covering D Body cavity foreign substance F Blood flow M Drug solution P Diseased part T Blood vessels

Claims (12)

  In a medical treatment instrument in which a body cavity treatment part is provided at a distal end portion of an elongated flexible main wire part, the main wire part is formed of a hollow stranded wire coil body in which an operation core material is inserted, and the body cavity The treatment portion is formed by connecting a plurality of spans of the expansion / contraction diameter portion composed of the coil wire of the hollow stranded wire coil body, and by pull / push operation of the operation core material, the coil wire of the expansion / contraction diameter portion A medical treatment instrument characterized by having a structure in which a basket-like expanded diameter deformable body and a reduced diameter deformed body from the basket-shaped expanded diameter deformable body are made freely.   The medical treatment tool according to claim 1, wherein the expansion / contraction diameter portions arranged in a plurality of spans are set to different lengths.   In a medical treatment instrument in which a body cavity treatment part is provided at a distal end portion of an elongated flexible main line part, the main line part is composed of a hollow stranded coil body in which an operation core material is inserted. And the inner main striated portion has a two-layer tube structure, and the body cavity treatment portion has an inner and outer two-layer expansion / contraction diameter portion made of a coil wire of the two-layer hollow stranded coil body, and the operation core Characterized by a structure in which a two-layer basket-like enlarged diameter deformed body is formed by a coil wire of the expanded / contracted diameter portion by pulling and pushing the material, and a reduced diameter deformed form from the basket-shaped expanded diameter deformable body is made freely. Medical treatment tool.   The medical treatment tool according to claim 3, wherein the coil twist directions of the hollow stranded coil body of the outer main wire portion and the inner main wire portion are a combination opposite to each other.   The medical treatment tool according to any one of claims 1 to 4, wherein a flexible sheath tube is provided on the main line portion or the outer main line portion.   The medical treatment instrument according to any one of claims 1 to 5, wherein an inner periphery of the hollow stranded wire coil body or a hollow portion of the core material for operation is formed in a liquid channel.   The medical treatment instrument according to any one of claims 1 to 6, wherein a set lock means for the relative position between the main striated portion and the operation core material is provided in a hand operation unit for pull / push operation of the operation core material. .   The medical treatment tool according to any one of claims 1 to 7, wherein an elastic coating that covers the entire circumference or a part of the enormous deformed body is provided on the expansion / contraction diameter portion.   The medical treatment tool according to any one of claims 1 to 8, wherein the coil wire of the hollow stranded coil body is formed of a single wire or a stranded wire of a stranded wire.   The medical treatment instrument according to any one of claims 1 to 8, wherein the coil strand of the hollow stranded coil body is formed of a combination of different metals.   The medical treatment instrument according to any one of claims 1 to 8, wherein the coil strand of the hollow stranded coil body has an irregular cross-sectional shape. The medical treatment instrument according to any one of claims 1 to 8, wherein a coil outer periphery of the hollow stranded coil body has a reduced diameter shape.

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