JP2000000310A - Intervention therapeutic system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To lead a penetrator such as a catheter into a desired site in a subject safely, positively and easily through tubular tissue of blood vessels, digestive organs, and the like. SOLUTION: A magnetic field generating part 1 for generating the inclined magnetic field is disposed at a subject and driven by supplying a current through a controller and a coil driver 8. The inclined magnetic field is therefore applied to the subject. In this state, x-ray photographing is performed, and while observing an x-ray photographed image, a catheter with a magnetic substance provided at a distal and is fed into the subject. The inclined magnetic field pulls the magnetic substance along the formed direction of tubular tissue. A penetrator such as the catheter can be led into a desired site safely, positively and easily by operating an inclined magnetic field applying direction by the controller.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION The present invention relates to a method for obtaining an invader such as a catheter or a capsule of a drug through a tubular tissue such as a blood vessel or an esophagus of a subject, provided with a magnetically induced magnetic guide. With regard to an interventional treatment system for guiding to a site, in particular, a gradient magnetic field,
The present invention relates to an interventional treatment system that improves safety, speed, easiness, and the like by guiding using a non-convergent magnetic field such as a uniform magnetic field and a focus magnetic field.

[0002]

2. Description of the Related Art Conventionally, there has been known a catheter which is introduced into a blood vessel of a subject and performs, for example, treatment of an occluded blood vessel. This catheter has an elastic member at the tip,
The middle part is formed of a member having a certain rigidity. In use, the catheter is fed into the blood vessel from the distal end portion, and the catheter and the blood vessel are imaged by, for example, an X-ray fluoroscope. Then, while observing the movement of the catheter and the blood vessel, the catheter is guided into the target blood vessel portion based on the X-ray fluoroscopic image, and treatment of the occluded blood vessel is performed.

However, such a conventional catheter is
By manipulating the mid-portion that has not been delivered into the subject, the distal end portion that has been delivered into the subject is to be remotely operated, so that the catheter within the subject can be obtained using an X-ray fluoroscopic image. Although it is an operation while watching the state of, it is not much different from an operation by groping. For this reason, when the distal end portion abuts against the blood vessel wall and the catheter is bent in the blood vessel, or cannot be introduced into the target blood vessel at the branch part of the blood vessel, or when trying to guide the blood vessel into a thin blood vessel, the rigidity of the catheter is reduced. For this reason, there is a problem in that a large frictional resistance is generated and the blood vessel does not enter, or at a place where the blood vessel is in a semicircular arc shape, the force is not sufficiently transmitted to the distal end portion. In such a case, for example, if a forcible force is applied to the catheter, the distal end portion is formed of an elastic member,
The tip portion absorbs the torsional force up to a predetermined force, and when the torsional force exceeding the predetermined force is applied, the tip portion rapidly rotates in response to the torsional force applied so far. Become. For this reason, there is a possibility that the distal end portion moves unintended by the operator, and the distal end portion is fed into a blood vessel other than the intended one, or the blood vessel is damaged.

[0004] On the other hand, conventionally, an active catheter having a distal end portion capable of being actively bent has been known by applying micromachine technology. In this active catheter, the distal end portion can be bent in accordance with an operation, so that the catheter can be easily fed into a desired blood vessel.

[0005] However, active catheters which can be realized in the current state of the art have a diameter of several millimeters or more at the tip. Therefore, it can inevitably be delivered only to a thick blood vessel having a diameter of several millimeters or more. Further, it is expected that a considerable development period will be required until the technology and software for guiding a catheter to a desired blood vessel in a branch portion of a blood vessel are completed. Furthermore, even if a very fine tip having a diameter of several millimeters or less is formed, it is expected that the force is not sufficiently transmitted to the tip in a portion where the blood vessel is in a semicircular arc shape.

As a solution to such a problem, Japanese Patent Laid-Open Publication No. Hei 8-89582 discloses a “medical catheter and a method for guiding the same”.
A method for guiding a medical catheter has been proposed in Japanese Patent Publication No. 89583. In each of these proposals, a catheter 100 provided with a magnetic body 102 at a distal end portion 101 as shown in FIG.
To guide the catheter 100 to a desired location by pulling and guiding the distal end portion 101 on which the magnetic body 102 is provided by the magnet 105 disposed outside the subject 103 by the magnet 105 disposed outside the subject 103. It is. According to these proposals, since the force can be directly transmitted to the distal end portion 101, the catheter 100 can be guided to a desired direction to some extent. In addition, since rigidity is not required for the forming members at the distal end and the middle, the catheter can be formed using a very flexible member, and the above-described problems can be solved.

[0007]

SUMMARY OF THE INVENTION However, Japanese Patent Application Laid-Open No.
“Medical catheter and its guiding method” described in Japanese Patent Publication No. 9582, and Japanese Patent Application Laid-Open No. H8-8958.
The method for guiding a medical catheter described in Japanese Patent Publication No. 3 has the following serious problems and is considered to be difficult to put into practical use.

That is, first, according to each of these proposals,
Since the catheter 100 is moved while pulling the distal end portion 101 by the attractive force of the magnet 105, the distal end portion 101 is moved by the attractive force of the magnet 105 to the blood vessel 10.
4 moves while being strongly pressed against the blood vessel wall, which may damage the blood vessel wall. Unnecessary friction on the blood vessel wall causes serious complications such as bleeding, detachment of vascular endothelium, occurrence of thrombus, vasospasm (phenomenon in which blood vessels contract abnormally locally) in addition to bleeding. The proposal has a major security problem.

In order not to damage the blood vessel wall, an appropriate suction force that does not damage the blood vessel wall is applied to the distal end portion 1.
It is sufficient to guide the catheter 100 by multiplying it by 01, but if the suction force is insufficient, the catheter 100 does not move due to static friction. Further, the attraction force of the magnet is not uniform, but increases sharply as it approaches the magnet. For this reason, it is practically difficult to move the catheter 100 while continuously applying the optimal suction force to the distal end portion 101 without damaging the blood vessel wall.

Next, according to each of these proposals, the magnet 105
, The tip portion 101 can be moved in a desired direction to some extent by changing the direction of the attractive force, but the attractive force of the magnet 105 is not uniform as described above. Therefore, the feeding direction of the distal end portion 101 cannot be finely operated. For example, when the blood vessel for feeding the catheter 100 is finely bent, the feeding direction is changed according to the bending. Can not.

The moving speed of the distal end portion 101 is mainly determined by the attractive force of the magnet 105 and the static friction of the catheter 100 in the blood vessel 104. For this reason, the closer the magnet 105 is to the tip portion 101, the more the tip portion 10
The suction force received by 1 increases and its movement speed increases, and the tip portion 101 that has begun to move rapidly accelerates and moves, so that the tip portion 101 moves in an unexpected direction and damages the blood vessel or damages the blood vessel. In the branch part, there is a possibility that the inconvenience of feeding the catheter 100 to a blood vessel other than the intended one may occur. For this reason, each of the above proposals has a major problem in terms of operability.

[0012] For these reasons, it is difficult to put the above proposals into practical use due to the above-described problems of safety and operability.

SUMMARY OF THE INVENTION The present invention has been made in view of the above-mentioned problems, and has been made in consideration of the above circumstances. The purpose is to provide an interventional treatment system.

[0014]

According to the present invention, there is provided an interventional treatment system comprising: a magnetic field generating means for applying a non-converging magnetic field to a subject; And a penetrator that moves within the subject according to the non-converged magnetic field.

In such an interventional treatment system, the magnetic field generating means applies a non-convergent magnetic field, for example, a gradient magnetic field to the subject. The direction in which the gradient magnetic field is applied can be easily set, and the penetrator such as a magnetic material in the gradient magnetic field is pulled in the direction of the set gradient magnetic field. Therefore, by setting the direction in which the gradient magnetic field is applied to, for example, the direction in which a blood vessel is formed, the penetrator can be moved in the direction in which a blood vessel is formed.
Therefore, by using such a non-focusing magnetic field, the penetrator can be guided safely, reliably, and easily inside the subject.

[0016]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Preferred embodiments of the interventional treatment system according to the present invention will be described below in detail with reference to the drawings.

[First Embodiment] (Configuration of First Embodiment) As shown in FIG. 1, an interventional treatment system according to a first embodiment of the present invention uses one of non-focusing magnetic fields. A magnetic field generator 1 which is an electromagnet for generating a certain gradient magnetic field or a magnetic field having substantially uniform strength;
An X-ray image obtained by irradiating the X-ray from the X-ray tube 2 is converted into an optical image by the image intensity fire 2, and the optical image is captured by the television camera 4 to obtain a fluoroscopic image of the subject. And the I.I.-TV system 5 which forms
A display unit 6 for displaying a fluoroscopic image formed by the I-TV system 5 and a coil driver 7 for driving the magnetic field generating unit 1
The drive of the magnetic field generator 1 is controlled via the coil driver 7 in accordance with the operation of the operation unit 8 such as a joystick, etc., and the overall voltage of the X-ray tube 2 including the tube voltage, tube current, irradiation timing, etc. And a controller 9 for controlling the operation of.

The magnetic field generating unit 1 has a rectangular coordinate system (x-
y-z) is a magnetic field directed in the x direction, mainly x
A double saddle coil 1a as shown in FIG. 2A for forming a gradient magnetic field in which the magnetic field intensity changes depending on the difference in the position in the direction, and a magnetic field heading in the y direction, mainly the position in the y direction. A double saddle coil 1 as shown in FIG. 1B for forming a gradient magnetic field whose magnetic field intensity changes due to a difference.
b and a double circular coil 1c as shown in FIG. 3C, which forms a gradient magnetic field which is a magnetic field directed in the z direction and whose magnetic field intensity changes mainly depending on the position in the z direction. Thus, the magnetic field generating unit 1 is configured as a cylindrical magnetic field generating unit 1 as shown in FIG.

The magnetic field generator 1 shown in FIG. 1 has a size that covers the head of the subject, but this is merely an example, and it is assumed that it has a size that covers, for example, the entire body of the subject. Alternatively, the size may be set according to the purpose, such as a size that covers the arms and legs of the subject.

Each of the coils 1a to 1c is shown in FIG.
As shown in (c), a gradient magnetic field is generated, which is composed of a pair of coils opposed to each other, and whose magnetic field intensity changes depending on the position according to the current supplied from the coil driver 7. . Specifically, for example, a double-circle shown in FIG. 2C that forms a gradient magnetic field that is a magnetic field directed in the z-direction and in which the magnetic field strength (density of the lines of magnetic force) changes depending on the position in the z-direction. Coil 1
In the case of c, as shown in FIG. 3, near the center of the coil 1c, the magnetic field intensity does not change so much in the x and y directions, and in the z direction, the magnetic field intensity is almost proportional to the value of the z coordinate. A gradient magnetic field whose intensity changes is generated.

Each of the coils 1a to 1c is connected to each of the coils 1a to 1c.
By increasing or decreasing the current flowing through 1c, it is possible to arbitrarily vary the rate of change of the magnetic field strength (derivative of the magnetic field strength) depending on the position. Then, by applying an appropriate current to each of the coils 1a to 1c, the magnetic fields generated by the coils 1a to 1c are added in a vector manner, and a gradient magnetic field oriented in an arbitrary direction can be formed. The rate of change of the magnetic field strength depending on the position (the derivative of the magnetic field strength) can also be set arbitrarily.

Next, in the interventional treatment system, a cylindrical magnetic ring 14 as shown in the sectional view of FIG. It has a catheter 16 provided. The catheter 16 is entirely formed of a flexible member, and is deformed according to the thickness and shape of the tubular tissue, so that the catheter 16 can be pulled without damaging the tubular tissue.

The cylindrical magnetic ring 14 is provided at the distal end of the catheter 16, but may be of any type as long as it can be guided by the gradient magnetic field. For example, a magnetic ring 15 having a semicylindrical cross section as shown in FIG. 4B, an elastic magnetic wire 17 which is rounded as shown in FIG. 4C, a balloon containing a magnetic fluid, and the like are provided. You may do so. If the magnetic body provided at the distal end of the catheter 16 is substantially spherical, the magnetic body can be less likely to receive a couple of a magnetic field. For this reason,
The inconvenience that the distal end of the catheter 16 is directed in an unintended direction by a couple can be prevented, and the distal end can be pulled in an arbitrary direction with an arbitrary force.
It is possible to maintain a substantially constant force even if the tip of the member slightly moves.

When an elastic magnetic wire 17 is provided as a magnetic material as shown in FIG. 4 (c), the magnetic wire 17 is pulled into the catheter 16 when it is no longer necessary. The magnetic material can be removed. Therefore, after delivery of the catheter 16,
It can be used when performing imaging with an MRI apparatus.

As shown in FIG. 4 (d), a coil 18 is wound around the distal end of the catheter 16 and an electric current is applied to the coil 18 via an electric wire 19 to form an electromagnet. ), Three coils 20 a to 20 orthogonal to each other around the distal end of the catheter 16.
The coils 20a to 20c may be wound, and an electric current may be applied to each of the coils 20a to 20c to form an electromagnet, which may be used as a magnetic member.

The magnetic wire 17 and the coils 18, 2
Since 0a to 20c can be guided by the gradient magnetic field, the catheter 16 can be pulled by the gradient magnetic field as described later.

(Operation of the First Embodiment) Next, the operation of the interventional treatment system of the first embodiment having such a configuration will be described.

First, when treatment is performed using this interventional treatment system, for example, as shown in FIG.
The subject to which the catheter 16 shown in (b) is sent is inserted, and in this state, X-rays are emitted and a fluoroscopic image is displayed on the display unit 6. Thus, the display unit 6 displays the catheter 16 transmitted into the subject together with the fluoroscopic image of the subject.
Will be displayed.

Next, the doctor operates the operation unit 8 such as a joystick while watching the fluoroscopic image displayed on the display unit 6 to generate a gradient magnetic field having an appropriate strength in a direction corresponding to the running direction of the blood vessel. The operation unit 8 is operated to perform the operation. As a result, a current is supplied to the magnetic field generating unit 1 via the coil driver 7 under the control of the controller 9, and the subject in the magnetic field generating unit 1 is moved in a direction corresponding to the running direction of the blood vessel.
A gradient magnetic field of an appropriate intensity will be applied.

Then, the magnetic ring 15 provided at the distal end of the catheter 16 is pulled by the gradient magnetic field, and the catheter 16 is guided in the direction corresponding to the running direction of the blood vessel. The physician checks the movement of the catheter 16 guided in this manner while looking at the see-through image displayed on the display unit 6, and operates the operation unit 8 to guide the catheter 16 in a desired direction, thereby generating a magnetic field. By supplying an appropriate current to each of the coils 1a to 1c of the section 1, the catheter 16 is guided to a desired blood vessel.

Here, for example, as shown in FIG. 5 (a), a magnetic field having a uniform magnetic field strength such as the inner cavity of a very long solenoid electromagnet 25 is applied to a magnetic field as shown in the sectional view of FIG. 5 (b). When the body 26 is inserted, the center of gravity of the magnetic body 26 does not receive any force from the magnetic field, so that the magnetic body 26 simply falls by gravity. If the magnetic body 26 is slender, the center of gravity of the magnetic body 26 does not receive any force at all. However, as shown in FIG. 5B, the longitudinal direction of the magnetic body 26 is parallel to the direction of the line of magnetic force. A force is applied to the magnetic body 26 (when a small magnet is inserted in place of the magnetic body 26, the center of gravity does not receive any force, but a couple is applied to this magnet regardless of the shape). In a magnetic field in which the magnetic field strength changes depending on the position, for example, around the ordinary permanent magnet 27 as shown in FIG. 6, a traction force is applied to the center of gravity of the magnetic body 28 in the direction in which the magnetic field strength increases. If the magnetic body 28 is elongated, a couple is applied to the magnetic body 28 so that the longitudinal direction of the magnetic body 28 is parallel to the direction of the line of magnetic force. Anyway, a couple is applied to this magnet.)

As described above, the magnet is made of a magnetic material (or another magnet).
Is attracted not only because of the presence of the magnetic field, but also because the strength of the magnetic field varies depending on the position. That is, the rate of change of the magnetic field strength depending on the position (spatial differential of the magnetic field strength) determines the strength of the traction force. Around the ordinary permanent magnet 27, the rate of change of the magnetic field strength depending on the position (spatial differential of the magnetic field strength) rapidly increases as approaching the magnet 27. Therefore, when the magnetic body 28 approaches the magnet 27,
The force applied to the magnetic body 28 rapidly increases, and the magnetic body 28
Is difficult to guide in a desired direction.

However, the magnetic field strength of the gradient magnetic field generated by the magnetic field generator 1 provided in the interventional treatment system according to this embodiment is approximately proportional to the position coordinates. For this reason, the rate of change of the magnetic field strength depending on the position (spatial differential of the magnetic field strength) is substantially constant, and regardless of the position of the magnetic substance ring 15, the force received by the magnetic substance ring 15 is substantially constant. By increasing or decreasing the current flowing through each of the coils 1a to 1c,
The rate of change of the magnetic field intensity depending on the position of the magnetic ring 15 can be changed arbitrarily, and the strength of the force can be set arbitrarily. In addition, by reversing the direction of the current supplied to each of the coils 1a to 1c, the direction of the force applied to the magnetic ring 15 can be reversed. Furthermore, each coil 1a
By adjusting the current supplied to .about.1c, a gradient magnetic field oriented in an arbitrary direction can be formed.

Therefore, even if a force of any strength is applied to the magnetic ring 15 in an arbitrary direction and the magnetic ring 15 moves, the magnitude and direction of the force applied to the magnetic ring 15 do not substantially change. You can do so. Therefore, the distal end of the catheter 16 is pulled by an arbitrary force in an arbitrary direction without applying a forcing force (couple) to the distal end of the catheter 16 and is substantially constant even when the distal end of the catheter 16 moves. Can keep the power of. Such guidance control of the catheter 16 can be performed only by adjusting the amount of current supplied to each of the coils 1a to 1c without mechanically moving each of the coils 1a to 1c of the magnetic field generating unit 1. .

In addition, since a force can be applied in the direction along the blood vessel running, and the catheter is not moved in such a manner as to sandwich the blood vessel between the magnetic material and the magnet unlike the conventional art, the catheter 16 can be moved without damaging the blood vessel wall. Can be induced. In addition, since the force applied to the magnetic ring 15 is substantially constant even when the distal end of the catheter 16 moves, there is no possibility that the distal end of the catheter 16 will run away due to an unexpectedly large force, and the safety is high. An interventional treatment system can be provided.

Conventionally, the catheter is required to have rigidity in order to transmit a force corresponding to the operation at hand to the distal end. According to the interventional treatment system, the distal end of the catheter 16 is directly connected to the distal end of the catheter 16. Therefore, the entire catheter 16 can be formed of a rigid member having no rigidity. Therefore, since it is formed by this flexible member, unnecessary friction is not applied to the blood vessel wall, and in addition to bleeding, vascular endothelium is peeled off, thrombus is generated, vasospasm (the blood vessel is locally abnormally contracted) Phenomena) can be prevented from occurring. Therefore, in the interventional treatment system,
The distal end of the catheter 16 can be safely, quickly and reliably guided into a target blood vessel branch.

As is clear from the above description, the first
The interventional treatment system according to the embodiment includes a catheter 16 provided with a magnetically inducible object at a distal end thereof.
Into the tubular tissue of the subject, and by applying a gradient magnetic field or a uniform magnetic field generated from the magnetic field generating unit 1 thereto, the catheter 16 can be easily, quickly and safely moved to a desired tubular tissue of the subject. Can be guided.

In the description of the first embodiment, the interventional treatment system guides the delivery catheter 16 to a blood vessel.
The interventional treatment system, for example, gastrointestinal tract, bronchial, delivery of instruments to cavity organs such as otolaryngology area,
The present invention can also be applied to guiding an instrument into a real organ such as a muscle, liver, or brain.

Further, an X-ray fluoroscope is used as a means for obtaining a fluoroscopic image. However, as long as an internal image can be obtained, another imaging apparatus such as an ultrasonic tomography apparatus or an X-ray CT is used. It may be.

The magnetic field generating unit 1 includes the coils 1a to 1
Although the whole is made cylindrical by combining c, it can take various forms such as spherical, rectangular parallelepiped and the like. Further, it is not always necessary to constitute the three pairs of coils 1a to 1c, and a larger number of coils may be combined. On the contrary, in an application in which the direction to be pulled is limited, one or two pairs are used. Can be used. In this case, the configuration of the magnetic field generator 1 can be simplified.

[Second Embodiment] Next, a second embodiment of the present invention will be described.
The intervention treatment system according to the embodiment will be described. The interventional treatment system according to the first embodiment described above guides the catheter 16 to a desired tubular tissue of a subject by using a gradient magnetic field. However, the interventional treatment system according to the second embodiment is different from the interventional treatment system according to the second embodiment. ,
The direction of the catheter 16 inserted into the subject can be changed to a desired direction by a uniform magnetic field. The second embodiment is different from the first embodiment only in this point.
Therefore, only the difference will be described below, and redundant description will be omitted.

That is, in the interventional treatment system according to the second embodiment, for example, as shown in FIG.
(A) uses a catheter provided with a cylindrical magnetic substance ring 14 at the distal end thereof. When a curved part or a complicatedly branched part is approached, the operation unit 8 is operated to designate generation of a uniform magnetic field.

When this designation is made, the controller 9 sets the coils 1a to 1a of the magnetic field generator 1 as shown in FIG.
The coil driver 7 is controlled so that currents of the same magnitude in the same direction flow through the respective coils of the pair b. In addition,
FIG. 7 shows a state in which such a current is supplied to the double saddle coil 1a among the coils 1a and 1b.
When currents of the same direction and the same magnitude are supplied to the coils 1a to 1b in this manner, these coils 1a to 1b are not gradient magnetic fields but magnetic fields having substantially uniform strength (uniform magnetic fields). Occurs. The doctor can generate a uniform magnetic field having an arbitrary direction and an arbitrary intensity by adjusting the amount of current flowing through each pair of the coils 1a and 1b.

As described above, since the magnetic ring 14 has a cylindrical shape, it is almost the same as an elongated magnetic body.
Therefore, when a uniform magnetic field is applied, the tip of the catheter 16 changes its direction along the direction corresponding to the couple of the magnetic field, but is not pulled in any direction. Therefore, the doctor can direct the distal end of the catheter 16 in a desired direction in a sufficient time by adjusting the intensity of the uniform magnetic field. Therefore, even in a region where the blood vessel is significantly bent, the distal end of the catheter 16 can be directed in the direction in which the blood vessel is bent. Of the catheter 16 can be directed in the direction of the blood vessel. Therefore, for example, in a brain operation, a functionally important area (an area to be bypassed) is not damaged as shown in FIG.
Bypassing this, the catheter 16 is placed on the affected area (target).
Can be reached. Then, it is possible to perform an operation that has been difficult so far, such as an operation of injecting a drug into an affected area via the catheter 16 or an operation of feeding a flexible coagulation device to form an artificial coagulation focus.

Further, by applying a substantially uniform magnetic field along the running direction of the blood vessel, the catheter 16 can always be directed in the advancing direction. Can be prevented.

With a conventional catheter, it is particularly difficult to arbitrarily transmit the twisting force to the tip. The tip does not turn even if twisted a little, and if it is twisted too much, it will turn rapidly and will not be in the direction you expected. However, according to the interventional treatment system, since the direction of the distal end of the catheter 16 can be controlled by the uniform magnetic field, it is not necessary to twist the catheter at hand to rotate the distal end of the catheter 16. The rigidity of the catheter 16 can be reduced.

It should be noted that a small permanent magnet may be provided instead of providing the magnetic ring 14 at the distal end of the catheter 16.

Also, small coils 18 and 20a to 20c as shown in FIGS. 4D and 4E are provided, and a small current flows through the inside of the catheter or an electric wire 19 embedded in the catheter wall. By this, this coil 18,
20a to 20c may be electromagnets. Although the generated gradient magnetic field does not disappear immediately even if the current for forming the gradient magnetic field coil to be supplied to the magnetic field generator 1 is suddenly cut off, the coils 18, 20a to 2a
When 0c is provided, the magnetic field formed by applying a current to the coils 18 and 20a to 20c can be changed instantaneously. Therefore, the force applied to the tip of the catheter 16 must be changed instantaneously or set to zero. Becomes possible. For this reason,
The operability and safety of the interventional treatment system can be improved. In addition, since it is not necessary to rapidly change the current supplied to the magnetic field generator 1, even if a cheap and small coil driver 7 having a low responsiveness is provided, the coil driver 7 can sufficiently cope with it.

As a magnetic material of the catheter 16, three coils 2 orthogonal to each other as shown in FIG.
In the case where 0a to 20c are provided, by applying an appropriate current to each of the coils 20a to 20c, the direction of the couple acting on the distal end of the catheter 16 can be freely changed only by adjusting the current. Therefore, the magnitude of the indexing force and the direction of the couple can be freely changed without abruptly changing the current supplied to the magnetic field generator 1.

Further, a flexible bag containing a magnetic fluid may be provided at the distal end of the catheter 16. When this is used, when a magnetic field is applied so as to direct the tip portion in a specific direction, the bag expands and narrows in that direction, so that it is easy to guide the catheter 16 to a thin blood vessel. Can be. In addition, even if the direction of travel of the blood vessel is slightly different from the direction of the magnetic field, the bag is deformed, so that there is little possibility that a strong force is applied to the blood vessel wall. Further, the bag itself can be used for embolization treatment of blood vessels and the like. If the bag itself is used for embolization treatment, it may be preferable to provide a collecting thread in the bag in case of emergency, or to adopt a configuration in which the catheter itself can be cut off near the bag.

This bag may be a so-called balloon. That is, the bag extends to the tip of the catheter 16, and the magnetic fluid may be injected into or extracted from the bag through the catheter 16. In this case, the catheter 16 can be easily guided by changing the amount of the magnetic fluid to be injected into the bag according to the thickness of the blood vessel, and the size of the balloon can be changed when embolizing a blood vessel or the like. .

In order to change the direction in which the catheter 16 is indexed, the current flowing through each of the coils 1a to 1c is changed. This is achieved by mechanically rotating the magnetic field generator 1 around the subject. The direction of the catheter 16 to be indexed may be changed by changing the direction of the gradient magnetic field.

[Third Embodiment] Next, a third embodiment of the present invention will be described.
The intervention treatment system according to the embodiment will be described. In the interventional treatment systems according to the first and second embodiments described above, a magnetic derivative is provided at the distal end of a catheter 16 serving as an entry element, and the catheter 16 is guided in a desired direction by a gradient magnetic field or a uniform magnetic field. However, in the interventional treatment system according to the third embodiment, a magnetic substance is placed in a sustained-release capsule that gradually releases a drug, and the sustained-release capsule is placed in a gradient magnetic field or uniformly. It is designed to be guided to a desired site by a magnetic field. The third embodiment differs from the above-described embodiments only in this point, and therefore, only the difference will be described below, and redundant description will be omitted.

That is, the interventional treatment system according to the third embodiment uses a sustained-release capsule 30 as shown in FIG.
FIG. 9 is a cross-sectional view of the sustained-release capsule 30. In FIG. 9, the sustained-release capsule 30 is provided with a drug 30 and a magnetic substance 32 inside.

In the interventional treatment system according to the second embodiment, the sustained-release capsule 30 is fed into a subject, and guided to a desired site using the above-mentioned gradient magnetic field and uniform magnetic field. .

Thus, for example, if the capsule 33 covering the drug 31 of the sustained-release capsule 30 is a substance that gradually melts at body temperature, the drug inside the capsule 33 is gradually melted at body temperature. 31 will gradually penetrate into the affected area and act. Therefore, the sustained release capsule 3
The drug can be locally diffused only around the site where 0 is placed. In particular, in the treatment of a tumor, the tumor can be effectively treated by inducing such a sustained-release capsule at the tumor site to release the anticancer agent.

When a gel which absorbs water and rapidly expands is used as the drug 31, it is possible to artificially embolize blood vessels in the treatment of tumors and arteriovenous malformations (artificial embolization).

The sustained release capsule 30 is shown in FIG.
As shown in (2), ultrasonic waves may be emitted from the ultrasonic therapy apparatus 35 to generate heat and release the medicine 31. In this case, the capsule 33 is ruptured by the heat of the ultrasonic wave,
The medicine 31 can be released at a stretch.

In place of the medicine 31 and the magnetic substance 32, an embolizing agent containing magnetic powder or a magnetic fluid formed by suspending magnetic substance powder in oil or fat is used in a capsule 33, for example. Embolism treatment of an aneurysm, AVM, or tumor-feeding blood vessel may be performed. In this case, since the magnetic powder is mixed in the embolizing agent itself, by using the above-described traction force of the gradient magnetic field, the embolizing agent can be retained at the place without being washed away until it is solidified. Alternatively, a similar effect can be obtained by using a balloon containing magnetic powder and an embolizing agent instead of the capsule 33.

The magnetic body 32 guided into the body may be removed at the time of surgery. Alternatively, as shown in FIG. 9, the magnetic body 32 may be guided by attaching a thin line 34 (a thread or the like), and the thread may be pulled out when it becomes unnecessary.

[Fourth Embodiment] Next, a fourth embodiment of the present invention will be described.
The intervention treatment system according to the embodiment will be described. The interventional treatment system according to the third embodiment described above guides the sustained-release capsule into which the magnetic substance has been delivered to a desired site. The vention treatment system
The magnetic substance itself is guided to a desired site, and this is used for treatment. Since the fourth embodiment differs from the above-described embodiments only in this point, only the difference will be described below, and redundant description will be omitted.

That is, the interventional treatment system according to the fourth embodiment uses a conductive magnetic body 38 as shown in FIG. And is guided into or near a tumor or the like using the above-mentioned gradient magnetic field and uniform magnetic field. Then, an ultrasonic wave from the ultrasonic treatment device 35 is irradiated. The magnetic body 38 is formed of a conductive member such as a nichrome alloy and a magnetic member, and generates heat when irradiated with microwaves from the outside. If this heat generation temperature is maintained at about 43 ° C., normal cells can tolerate but cancer cells will die (hyperthermia effect). As a result, it is possible to treat only tumors such as cancer without affecting normal cells.

The same effect can be obtained by applying a high-frequency magnetic field instead of a microwave. In this case, a high-frequency magnetic field can be generated by passing a high-frequency alternating current through a predetermined coil of the magnetic field generation unit 1. Therefore, it is not necessary to newly provide a device for generating a high-frequency magnetic field, and such treatment can be performed only with the interventional treatment system.

Alternatively, the magnetic body 38 may be guided through a tubular tissue such as a blood vessel or into a substantial organ such as the brain or liver without being irradiated with an ultrasonic wave or a high-frequency magnetic field, and may be left as it is. Thereby, it can be used as a marker for embolization treatment of blood vessels or surgery.

Then, the magnetic body 38 placed in the subject
Can be removed at the time of surgery as described above, or
Then, a thin line (thread, etc.) may be attached to a desired portion, and the thread may be pulled out when unnecessary.

Next, as shown in FIG. 12, a covered electric wire 41 is attached to a magnetic body 38 via a fuse 40, and in this state, the electric wire 41 is guided to a desired part in the subject to supply a current from a power supply unit 42. To melt the fuse 40,
And the electric wire 41 may be separated. Thereby, embolization treatment or the like of the blood vessel can be performed by placing the magnetic body 38 at a desired site.

The electric wire 41 can be extracted by pulling it after being separated from the magnetic body 38. The electric wire 41 sent into the subject must be actively used as follows. Can be.

That is, the electric wire 41 is guided to a desired portion by the magnetic body 38 and the above-mentioned gradient magnetic field, etc.
The catheter is delivered using 1 as a delivery guide. In other words, as shown in FIG.
1 is used as the core of the catheter 16 to feed the catheter 16. Since the electric wire 41 is thinner than the catheter 16,
It is much easier to guide the wire 41 to the desired site than to guide the catheter 16 to the desired site.
For this reason, the electric wire 41 is first sent to a desired site, and the catheter 16 is fed into the subject along the electric wire 41, so that the catheter 16 can be easily moved to a desired site even in a thin blood vessel or the like. Can be sent.

For the purpose of controlling nervous pain and pain of terminal cancer, such an electric stimulation electrode implantation operation is often performed. In addition, research has been conducted to implant an electrical stimulation electrode as a so-called artificial nerve, in which artificial muscles artificially stimulate and contract voluntary muscles that have failed due to nerve failure. For this reason, the electric wire 41 is guided to a desired portion by the magnetic body 38 and the above-described gradient magnetic field and the like, and a current flows through the electric wire 41, so that the electric wire 41 can be used as an electrode for local electric stimulation. .

Further, the electric wire 41 may be formed of a substance having a high electric resistance so that a current flows. Thereby, the electric wire 41 generates heat, and the surrounding tissue is heated, so that the above-described hyperthermia effect can be obtained.

[Fifth Embodiment] Next, a fifth embodiment of the present invention will be described.
The intervention treatment system according to the embodiment will be described. In the interventional treatment system according to the fifth embodiment, a micromachine is fed into a subject to be guided. The fifth embodiment differs from the above-described embodiments only in this point, and therefore, only the difference will be described below, and redundant description will be omitted.

That is, the interventional treatment system according to the fifth embodiment uses a micro television camera device as shown in FIG. This microminiature television camera device is configured by providing a microminiature television camera 52 and a magnetic ring 53 at the end of a cable 51. With the current technology, it is possible to form a television camera having a diameter of several millimeters using, for example, a CCD image sensor.

The interventional treatment system comprises:
After sending the micro television camera device to the digestive tract or bronchi of the subject, or to a tubular tissue such as the abdominal cavity, for example,
The micro television camera device is guided to a desired portion by the above-described gradient magnetic field or uniform magnetic field and the magnetic ring 53. Thus, the inside of the tubular tissue can be imaged by the television camera 52. An imaging signal from the television camera 52 is supplied to a monitor device or the like via the cable 51. A doctor or the like performs diagnostic treatment while watching an image of the inside of the tubular tissue displayed on the monitor device. Thereby, the intervention treatment system can be used as an endoscope.

In a conventional endoscope, it is necessary to bend the distal end of the endoscope using a wire or the like in order to direct the optical system or camera device at the distal end in an arbitrary direction. However, in this method, it is necessary that the base side portion of the endoscope is fitted and fixed in the internal cavity of the organ. If the endoscope is very thin compared to the organ lumen, the intended direction cannot be directed even if the tip is bent. For this reason, the conventional endoscope required a certain thickness. For example, an endoscope for the upper gastrointestinal tract is difficult to swallow due to its thickness, and thus it is necessary to anesthetize the pharynx. Most medical accidents in the upper gastrointestinal tract endoscope are caused by this anesthesia.

On the other hand, in the present embodiment, a very small television camera 52 suspended on a thin linear cable 51 is put into, for example, the stomach, and then the television camera 52 is moved by the above-mentioned uniform magnetic field. Can be oriented in any direction. Therefore, the line can be made very thin and swallowed without anesthesia. Therefore, it is possible to provide an in-vivo monitoring system that is less invasive and highly safe.

Next, by sending forceps together with such a micro television camera device, a simple operation such as a biopsy of a tumor can be performed.

In this case, a forceps 55 is provided together with the television camera 52 at the distal end of the above-mentioned micro television camera device. The forceps 55 are provided with a shape memory alloy 56 on the side opposite to the open side. This shape memory alloy 56
Is designed to close the forceps 55 at a predetermined temperature and open the forceps 55 at a temperature higher than the predetermined temperature. As shown in FIGS. 16A and 16B, a power supply 58 and a switch 57 for supplying power from the power supply 58 to the shape memory alloy 56 are connected to the shape memory alloy 56 as shown in FIGS. Have been.

When a micro television camera device provided with such forceps 55 is used, the forceps 55 and the micro television camera device are sent to a digestive tract or the like of a subject, and the television camera 52 Searching for a tumor or the like while looking at the captured video. And if you find a tumor,
The switch 57 is turned on and off as shown in FIG. When the switch 57 is turned on, the electric power from the power supply 58 is supplied to the shape memory alloy 56 via the cable 51, and the shape memory alloy 56 generates heat and opens the forceps 55 as shown in FIG. When the switch 57 is turned off, the supply of power to the shape memory alloy 56 is stopped, the shape memory alloy 56 cools, and the forceps 55 are closed as shown in FIG.

A doctor or the like controls the opening and closing of the forceps 55 by turning on and off the switch 57 to perform excision of a tumor, collection of a tissue specimen, and the like. This allows for a simple operation such as a biopsy of a tumor.

Although the forceps 55 are controlled to be opened and closed by the shape memory alloy 56, the forceps 55 may be controlled to be opened and closed by using other means such as a micro motor.

[Sixth Embodiment] Next, a sixth embodiment of the present invention will be described.
The intervention treatment system according to the embodiment will be described. The interventional treatment system according to the sixth embodiment is provided with a window for transmitting the X-rays without blocking the magnetic field generator 1 used in each of the above embodiments. Note that the sixth embodiment differs from the above-described embodiments only in this point.
Hereinafter, only this difference will be described, and redundant description will be omitted.

Magnetic field generator 1 for generating a magnetic field such as a gradient magnetic field
Is provided close to the subject as shown in FIG.
X-rays from the ray tube 2 are emitted to the subject from a position farther than the magnetic field generating unit 1. For this reason, when each winding of each of the coils 1a to 1c of the magnetic field generating unit 1 enters the X-ray field, its shadow appears on the X-ray image, and it becomes difficult to identify a target such as a blood vessel, a catheter, or a magnetic substance. .

Thus, in the interventional treatment system according to the present embodiment, as shown by hatching in FIG.
0) is provided. The window 60 is a gap, and irradiates the subject with the X-rays without interrupting the X-rays by the windings. Thereby, the magnetic field generator 1
Can be prevented from appearing on the X-ray image due to the shadow of each winding of each of the coils 1a to 1c, and a clear X-ray image can be provided.

Although the window 60 is a void, it may be closed with a member that does not absorb much X-rays, such as a synthetic resin film. In this case, since the gap is closed by a synthetic resin film or the like, it is possible to prevent a patient from inadvertently putting a finger or a hand into the gap.

As the window 60, two windows facing each other and in the directions orthogonal to each other may be provided. Thereby, it is possible to cope with X-ray imaging by the vibrating X-ray fluoroscope.

Further, the magnetic field generator 1 provided with the window 60 may be rotated in accordance with the rotation angle of the X-ray fluoroscope. This is to provide a rotation drive system that detects the rotation angle of the X-ray fluoroscope and rotates the magnetic field generation unit 1 so that X-rays are emitted through the gap or the like according to the detected angle. And can be easily realized.

[Seventh Embodiment] Next, a seventh embodiment of the present invention will be described.
The intervention treatment system according to the embodiment will be described. In the above description of each embodiment, the magnetic field generator 1
Generates a gradient magnetic field and a uniform magnetic field, thereby inducing a magnetic body or the like. However, in the interventional treatment system according to the seventh embodiment, the magnetic field generator 1 includes the coils 1a to 1a. 1c together with a coil for generating a focusing magnetic field so that a magnetic material or the like is induced by the focusing magnetic field. Since the seventh embodiment differs from the above-described embodiments only in this point, only the difference will be described below, and redundant description will be omitted.

That is, the magnetic field generator 1 provided in this interventional treatment system is the same as that shown in FIG.
In addition to the coils 1a to 1c shown in (a) to (c), a so-called seam-shaped coil 1d of a baseball ball as shown in FIG. 18 is provided. When a current is applied to the coil 1d, a focus magnetic field is formed, which is a gradient magnetic field such that the magnetic field strength is maximized at a central point (focus) indicated by oblique lines in FIG.

When a magnetic material or the like is guided by the focus magnetic field, the magnetic field generating unit 1 is arranged so that the focal point is located inside the body of the subject, and the catheter 16 provided with the magnetic material at the distal end is connected to the subject. Send to In this state, when the focus is brought closer to the magnetic material, the magnetic material is indexed toward the focus. For this reason, the doctor moves the magnetic field generating unit 1 mechanically, or moves the position of the focal point together with the gradient magnetic field or the uniform magnetic field generated by each of the coils 1a to 1c, and moves the catheter 16 to the subject. Move to the target site within.

The focus magnetic field indexes the magnetic material to the focus when the magnetic material approaches the focus. However, when the focus is at a position very close to the magnetic material, the focus magnetic field hardly indexes the magnetic material. Power does not work. This is because the magnetic field intensity is close to the maximum value in the vicinity of the focal point, and the spatial derivative (change with position) of the magnetic field intensity is small (it becomes zero at the focal position).

Therefore, when a magnetic substance is guided using such a focus magnetic field, the indexing force is reduced when the magnetic substance moves very close to the focal point, and the magnetic substance moves more than expected. It is possible to prevent excessive danger. Therefore, the magnetic field generator 1 is set so that the focal point of the focusing magnetic field is located at the target portion.
By arranging, the guidance of the magnetic body is stopped at the focal point, which is the position of the target part, so that it is possible to clearly control the maximum amount of movement of the magnetic body that the user wants to move. For example, if it is desired to move the magnetic body by 1 cm in a certain direction, the focus may be moved by 1 cm in a target direction from the current position of the magnetic body. By using the focusing magnetic field, such fine movement control of the magnetic body can be performed, so that the operability of the interventional treatment system can be further improved.

[Conclusion] Finally, the technology of such a gradient coil is similar to the technology already used in MRI apparatuses. That is, an MRI apparatus is a static magnetic field magnet (a permanent magnet, a normal electromagnet,
In addition to the superconducting electromagnet, a gradient magnetic field coil is used to generate a gradient magnetic field having an arbitrary direction and a rate of change in magnetic field strength (differential field strength). Gradient magnetic field coils are essentially necessary for the imaging principle of MRI apparatuses, and have been improved over many years together with power supply devices for controlling the current flowing through the gradient magnetic field coils, and have very good linearity (high magnetic field strength). The rate of change is constant with high accuracy regardless of the position.) A gradient magnetic field coil and a power supply device for accurately switching the direction and intensity of the gradient magnetic field in a short time of 1/1000 second or less have been put to practical use. In the MRI apparatus, only the component parallel to the static magnetic field vector among the magnetic field vectors generated by the gradient magnetic field coil is used. Further, in the MRI apparatus, the traction force caused by the gradient magnetic field is rather regarded as an adverse effect. This is because if an unexpected magnetic substance (for example, a needle or the like) enters the human body, an unexpected accident may occur due to the movement of the magnetic substance in the human body.

However, the interventional treatment system positively utilizes the traction force caused by the gradient magnetic field, which is regarded as an adverse effect in the MRI apparatus.
It should be added that it is not easily deduced from the technology of the RI apparatus.

The above embodiments are merely examples of the present invention. Therefore, the present invention is not limited to the above embodiments, and various changes can be made according to the design and the like within a range not departing from the technical idea according to the present invention. Of course.

[0095]

The interventional treatment system according to the present invention can safely, reliably, and easily guide an invader such as a catheter to a desired site via a tubular tissue.

[Brief description of the drawings]

FIG. 1 is a diagram showing an overall configuration of an interventional treatment system according to a first embodiment of the present invention.

FIG. 2 is a diagram for explaining a configuration of a magnetic field generator of the interventional treatment system according to the first embodiment.

FIG. 3 is a diagram showing an example of a gradient magnetic field generated by the magnetic field generator.

FIG. 4 is a view showing an example of a catheter provided with a magnetic material used in the interventional treatment system according to the first embodiment.

FIG. 5 is a view for explaining a couple related to an elongated magnetic body.

FIG. 6 is a diagram for explaining a couple and a traction force related to an elongated magnetic body.

FIG. 7 is a diagram for explaining a uniform magnetic field generated by the magnetic field generator.

FIG. 8 is a diagram illustrating a state in which a catheter is guided to a target in the brain by bypassing a bypass region.

FIG. 9 is a cross-sectional view of a sustained-release capsule provided with a magnetic material and used in an interventional treatment system according to a third embodiment of the present invention.

FIG. 10 is a diagram showing a state in which the sustained-release capsule is irradiated with ultrasonic waves from outside the subject.

FIG. 11 shows that a magnetic substance used in the interventional treatment system according to the fourth embodiment of the present invention is guided into a subject, and the magnetic substance is irradiated with ultrasonic waves to perform treatment by hyperthermia. FIG.

FIG. 12 is a diagram showing a magnetic body provided with an electric wire for guiding into a subject.

FIG. 13 is a diagram showing a state where a catheter is fed along an electric wire provided on a magnetic body guided into a subject.

FIG. 14 is a diagram showing an ultra-small camera device sent into a subject in an interventional treatment system according to a fifth embodiment of the present invention.

FIG. 15 is a view showing a micro machine provided with forceps together with the micro camera device.

FIG. 16 is a diagram showing an open / close control circuit of the forceps.

FIG. 17 is a perspective view showing the appearance of a magnetic field generating unit provided with a window for X-ray irradiation used in an interventional treatment system according to a sixth embodiment of the present invention.

FIG. 18 is a diagram illustrating a shape of a focusing magnetic field generating coil provided in a magnetic field generating unit of an interventional treatment system according to a seventh embodiment of the present invention.

FIG. 19 is a view for explaining a conventional medical catheter guiding method for guiding a magnetic substance provided on a catheter by a magnet.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Magnetic field generation part, 2 ... X-ray tube, 3 ... Image intensity fire (II), 4 ... Television camera,
Reference numeral 5: I / I-TV system, 6: display unit, 7: coil driver, 8: joystick, 9: controller, 14,
15: Magnetic ring, 16: Catheter, 17: Magnetic field wire, 18, 20a-20c: Coil, 30: Sustained release capsule, 31: Drug, 32, 38: Magnetic substance, 33: Capsule, 34: Thread, 35: ultrasonic therapy device, 40: fuse, 41: electric wire, 42: power supply device, 51: cable,
52: Ultra-small television camera, 53: Magnetic ring, 55: Forceps, 56: Shape memory alloy, 57: Switch, 58: Power supply, 60: Window for X-ray exposure

Claims (10)

[Claims] 1. A magnetic field generating means for applying a non-focusing magnetic field to a subject, and an approach member moving in the subject in accordance with the non-focusing magnetic field applied by the magnetic field generating means. Intervention treatment system. 2. The magnetic field generating means according to claim 1, wherein the non-converging magnetic field is a gradient magnetic field and / or a uniform magnetic field and / or
2. A focus magnetic field is applied to a subject.
An interventional treatment system as described. 3. The apparatus according to claim 1, wherein said magnetic field generating means has an X-ray transmission window for transmitting X-rays.
Or the interventional treatment system according to claim 2. 4. The interventional treatment system according to claim 1, wherein the penetrator is a catheter provided with a magnetically guided magnetic guide. . 5. The capsule according to claim 1, wherein the penetrator is a capsule coated with a predetermined drug together with a magnetically induced magnetic substance. Intervention therapy system. 6. The magnetic head according to claim 1, wherein the penetrator is a magnetically induced magnetic member.
The intervention treatment system according to any one of the preceding claims. 7. The intervention therapy system according to claim 6, wherein the magnetic guided member is provided with a magnetic guided yarn guided together with the magnetic guided member. 8. The interventional treatment system according to claim 6, further comprising a heat generating means for promoting heat generation of the magnetically driven member as the penetrator. 9. The interventional treatment according to claim 1, wherein the penetrator is an imaging unit provided with a magnetically induced magnetic member. system. 10. The interventional treatment system according to claim 6, wherein the imaging means is provided with a forceps together with a magnetic derivative.