JP5524835B2 - 生体内撮像用カテーテル - Google Patents
生体内撮像用カテーテル Download PDFInfo
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Images
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6852—Catheters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
- A61B5/0062—Arrangements for scanning
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
- A61B5/0062—Arrangements for scanning
- A61B5/0066—Optical coherence imaging
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
- A61B8/4444—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
- A61B8/4461—Features of the scanning mechanism, e.g. for moving the transducer within the housing of the probe
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M2025/0183—Rapid exchange or monorail catheters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0043—Catheters; Hollow probes characterised by structural features
- A61M25/005—Catheters; Hollow probes characterised by structural features with embedded materials for reinforcement, e.g. wires, coils, braids
- A61M25/0052—Localized reinforcement, e.g. where only a specific part of the catheter is reinforced, for rapid exchange guidewire port
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- Pathology (AREA)
- Engineering & Computer Science (AREA)
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Description
図3aに示されるように、モノリシック外側シース20の1つの実施形態は、積層構造100を形成するために、外側層110および内側層120を含んでもよい。外側層110は、カテーテルシースの近位部分に沿って実質的に長さ方向に延出するPebax(登録商標)から作られてもよく、外側層110は、内側層120に対してより大きな構造的剛性を提供する。内側層120は、PTFEから作られてもよく、PTFE内側層120は、Pebax(登録商標)外側層110から遠位に延出しもっとも遠位のセクションを形成し、これは、光学的に透明かつ可撓性であり、試料への光学的連通を可能にし、解剖学的通路内での挿入または引き込み中にカテーテルのより大きな通過可能性を可能にする。あるいは、所与の例では、様々な他の材料、たとえばFEPを、PTFEの代わりに使用することができる。図3bは、中実のモノリシックに形成された先端28、および、基部層130および頂部層140を示す。基部層130は、実質的にカテーテルシースの基部に沿ってPebax(登録商標)から作られてもよく、頂部層140に対してより大きな構造的剛性を提供する。より大きな構造的剛性は、モノリシック外側シースに、モノリシック外側シースの近位部分に沿ったより大きな押しやすさを可能にする。あるいは、基部層130は、プラグ132を含んでもよい。プラグ132は、保護軸受70がモノリシック外側シース20に係合するときに、保護軸受70の間に空間を含んでもよい。プラグ132は、モノリシック外側シース20の遠位端へ可撓性を増加させるために、シースルーメンの遠位部分との斜め係合を含んでもよい。プラグ132は、PTFE、FEP等を含むがそれらに限定されないポリマー材料を含んでもよい。頂部層140は、PTFEから作られてもよく、PTFE頂部層140は、Pebax(登録商標)基部層130から遠位に延出し、これは、曲がりくねった経路を進むためにモノリシック外側シースの遠位端に沿ってより大きな可撓性を提供する。あるいは、モノリシックシース20の層は、進む間の滑らかな移行のため且つ摩擦が少ないように、外側層または内側層のいずれかにコーティングを含む。そのようなコーティングは、生体適合性であってもよく、重合体でも、食塩水等であってもよい。
次に、図9〜11を参照すると、回転駆動シャフト40の代替の実施形態が例示される。上で検討されたように、回転駆動シャフト40は、NURDを最小限にしながら、遠位端光学装置および光学機器を回転モータに接続し、回転トルクを遠位端光学機器に伝達する。図9aに示されるように、回転駆動シャフト40は、全体が、ハイポチューブメタル駆動シャフト400、撚線中空コアシャフト500、または、撚線中空コアシャフト500が結合されたハイポチューブメタル駆動シャフト400の組み合わせ、または、ハイポチューブメタル駆動シャフト400および撚線中空コアシャフト500の交互の組み合わせを備えてもよい。ハイポチューブメタル駆動シャフトは、ニチノール、すなわち、ニッケルチタン合金を含んでもよく、または、別の疑似金属生体適合性合金、たとえば、ステンレス鋼、タンタル、金、プラチナ、チタン、銅、ニッケル、バナジウム、その亜鉛金属合金、銅亜鉛アルミニウム合金、および、それらの組み合わせを含んでもよい。あるいは、メタルハイポチューブシャフト400は、メタルハイポチューブシャフト400の近位端上に同軸式に連結された補強入れ子型内側アセンブリを含んでもよい。補強入れ子型内側アセンブリは、座屈、曲げまたは剪断を防止するのに、メタルハイポチューブシャフト400よりも強い。補強入れ子型内側アセンブリは、センタリングブートに連結された金属チューブステンレス鋼設計を含み、より長い推進能力を可能にし、フラッシ中に改良された液体シールを提供する。
一般的に言えば、断面を含む均質な中空チューブのNURD用の角偏向(θ)は、方程式(1)によって与えられる。
カテーテル10の回転位置の測定を、NURD減少ソフトウェアアプローチ用の入力として使用することができる。図18に示されるように、カテーテル10は、トルクセンサ710と、回転モータ720と、リニアモータ730とを含む近位モータシステム700、およびモータシステム700に操作可能に連結されたコンピュータ/ソフトウェアプログラム740に連結される。回転撮像カテーテル10におけるNURDを推定する方法は、カテーテル10の近位端のトルクをトルクセンサ710で測定することによる。NURDが(たとえば、方程式、または、時間に対する撮像トランデューサの角位置を表すデータ点の形態で)特性化される場合には、画像の後処理を経てNURDを除去するまたは訂正することは容易である。真にNURDを特性化するためには、回転撮像トランデューサの角位置を知らなければならない。
下記の実施例は、ここで特許請求された項目、装置、システムおよび/または方法がどのように作られ評価されるかの完全な開示および記載を当業者に提供するように付加されており、また、単に例示的であることが意図され、項目、装置、システムおよび/または方法の範囲を限定する意図はない。数(たとえば、量、温度等)に対する正確さを確実にするように努力されているが、エラーおよび逸脱は、斟酌されるべきである。
Claims (16)
- 中心ルーメンおよび遠位先端を画成するモノリシックカテーテルシース本体と、前記中心ルーメンで位置決めされた光学装置とを備える生体内撮像用カテーテルであって、前記中心ルーメンが、前記遠位先端で終端し、前記遠位先端は、中に形成されたガイドワイヤルーメンを有し、前記ガイドワイヤルーメンは、ガイドワイヤ入口ポートおよびガイドワイヤ出口ポートを有し、前記ガイドワイヤ入口ポートおよび前記ガイドワイヤ出口ポートは、各々が、前記中心ルーメンの前記終端の遠位に位置決めされ、前記光学装置は、光ファイバ、屈折率分布型レンズ、プリズム、前記光ファイバ、前記屈折率分布型レンズおよび前記プリズムのまわりに同心円状に係合したハウジング、ならびに、前記ハウジングの近位端に連結された回転駆動シャフトをさらに備え、前記回転駆動シャフトが、遠位の撚線中空コアシャフトに動作可能に結合した近位のハイポチューブシャフトを含む、生体内撮像用カテーテル。
- 前記モノリシックカテーテルシース本体は、前記モノリシックカテーテルシース本体の近位端から前記遠位先端の遠位端へ結合部を含まない材料の単一連続片を含む請求項1に記載のカテーテル。
- 前記ハウジングは、その壁に開口を有する金属チューブをさらに備え、前記開口は前記プリズムに光学的に整列配置する請求項1に記載のカテーテル。
- 前記回転駆動シャフトが、回転駆動シャフトルーメンを画成し、前記回転駆動シャフトの前記遠位の撚線中空コアシャフトが、前記ハウジングに連結され、前記光ファイバは、前記回転駆動シャフトルーメンを通って軸方向に進む請求項1に記載のカテーテル。
- 前記撚線中空コアシャフトは、螺旋構造に巻かれた複数のワイヤを備える請求項1に記載のカテーテル。
- 前記回転駆動シャフトの前記近位のハイポチューブシャフトに連結された第2のハウジングをさらに備える請求項1に記載のカテーテル。
- 前記モノリシックカテーテルシース本体は、少なくとも部分的に光学的に透明であるシース材料をさらに備える請求項1に記載のカテーテル。
- 前記ガイドワイヤ入口ポートは前記遠位先端の遠位端に開口し、前記ガイドワイヤ出口ポートは前記遠位先端の側壁に開口する請求項1に記載のカテーテル。
- 前記モノリシックカテーテルシース本体の遠位部分は、前記モノリシックカテーテルシース本体の近位部分よりも大きな可撓性を有する請求項1に記載のカテーテル。
- 前記モノリシックカテーテルシース本体のデュロメータは、不均一回転ゆがみを減少するために、前記モノリシックカテーテルシース本体の長さ方向に沿って変化する請求項1に記載のカテーテル。
- 前記ガイドワイヤルーメンは、前記近位部分から前記モノリシック遠位先端へ変化する直径を含む請求項1に記載のカテーテル。
- 前記回転駆動シャフトは、回転駆動シャフトルーメンを画成する請求項1に記載のカテーテル。
- 前記複数のワイヤは、金属製である請求項5に記載のカテーテル。
- 前記近位のハイポチューブシャフトがメタルハイポチューブシャフトである請求項1に記載のカテーテル。
- 前記メタルハイポチューブシャフトは、ニチノールを備える請求項14に記載のカテーテル。
- 前記回転駆動シャフトの前記近位のハイポチューブシャフトは、不均一回転ゆがみを減少するために、前記回転駆動シャフトの前記遠位の撚線中空コアシャフトに同軸式に連結される請求項14に記載のカテーテル。
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JP2010533049A (ja) | 2010-10-21 |
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US20090018393A1 (en) | 2009-01-15 |
US9622706B2 (en) | 2017-04-18 |
EP2178442A4 (en) | 2012-11-14 |
EP2178442B1 (en) | 2017-09-06 |
US20110137124A1 (en) | 2011-06-09 |
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