JP2000083978A - Appliance for transplantation - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide such an appliance which may be folded small and inserted into a catheter, may be restored to an adequate shape after release and is capable of improving the liquid-tightness of the inside part. SOLUTION: This appliance is constituted by connecting a plurality of freely bendable and elastic annular wire parts 101, 102, 12 arranged in intermittent positions to each other by a cylindrical mounting material 7 formed of a sheet which is flexible and is tense. This mounting material 7 is formed by knitting warp along the axial direction of an artificial blood vessel A and weft along the circumferential direction of this artificial blood vessel A. Monofilalents made of polyester having a shape retaining property are used for the warp and multifilaments made of polyester having waterproofness are used for the weft.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION The present invention relates to an implanting device belonging to the medical device field (in the present specification and claims, an implanting device which is inserted into a bendable human organ having an elastic restoring force is referred to as an "implanting device". ).

[0002]

2. Description of the Related Art As an implanting device, for example, there is an artificial blood vessel. At present, for example, treatment of aortic aneurysms is currently performed by transplanting an artificial blood vessel. That is, a blood vessel portion affected by an aortic aneurysm is cut and removed by surgery, and an artificial blood vessel is connected to the cut and removed portion by a surgical operation such as suturing to perform transplantation.

[0003] In treating an aortic aneurysm, the method of implanting an artificial blood vessel by surgery as described above has a problem that the risk factor is high. Emergency surgery, especially for rupture,
The survival rate is reduced, and dissociative aneurysms are difficult to operate and have a high mortality rate. Therefore, in order to perform treatment without performing surgery, a device such as an artificial blood vessel is folded into a catheter, carried to a target position such as an affected part of a blood vessel, or a stenosis part of other organs of a human body, and placed in the catheter. A technique has been considered in which the device is securely restored by releasing the device and implanted.

[0004]

By the way, such an artificial blood vessel or the like is required to have such flexibility that it can be inserted into a catheter by being folded into a small size, and to be self-sustaining so that it does not collapse when released at a target position. In addition, liquid tightness is required to such an extent that blood or the like flowing through the inside does not leak outside.

[0005]

SUMMARY OF THE INVENTION The present invention employs the following configuration in order to meet the above demands.
That is, the implanting device of the present invention is a device in which a plurality of bendable elastic ring-shaped wire portions arranged at intermittent positions are connected by a tubular surface material formed of a flexible and stretched sheet. The outer covering material is made by knitting a warp yarn along the axial direction of the appliance and a weft yarn along the circumferential direction of the appliance, and using a monofilament made of polyester having shape retaining properties for the warp yarn. ,
It is characterized by using a polyester multifilament having waterproofness for the weft.

With such a structure, the entire device becomes flexible, the warp yarns provide the covering material with axial tension and shape retention, and the weft yarns make the surface of the covering material denser and waterproof. As a result, the device can be folded small, and has excellent resilience even when released at a target position, and can reliably prevent leakage of blood and the like.

[0007] In particular, if the sheet of the covering material is formed in a bellows shape, the whole instrument bends more easily, so that the implantation state of the instrument into a curved organ becomes better. In addition, since a polyester monofilament having shape retention properties is used for the warp, if a bellows shape is provided to the device along the warp, the bellows shape is effectively maintained for a long period of time. In addition, when the instrument attempts to restore the original shape, it can be effectively assisted by the return operation of the bellows itself.

[0008] In a preferred embodiment, there is a case in which a waterproof material is applied to a surface material.
In addition, if the monofilament is set to about 15 denier, sufficient strength can be ensured, and at the same time, it can contribute to thinning of the entire instrument. On the other hand, if the multifilament is set to about 50 denier, a sufficient leakage preventing effect can be obtained as long as it is not bulky.

[0009] As a specific embodiment of the implanting device, a ring-shaped wire portion is provided in a pair at divided positions, and a front and rear ring-shaped wire portion connected therebetween by a facing material; And an intermediate ring-shaped wire portion which is located between the wire portions and is fixed to the surface material by sewing or bonding at an appropriate position on the circumference.

[0010]

DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention will be described below in detail based on embodiments shown in the accompanying drawings. As shown in FIG. 1, the artificial blood vessel A, which is a transplantation instrument of this embodiment, includes a surface material 7, ring-shaped wire portions 10 ₁ and 10 _2, and an intermediate ring-shaped wire portion 12.

As shown in FIG. 2, the covering material 7 is formed by molding a flexible and stretched sheet into a bellows-like cylinder, and the inner diameter is set to a normal flow path cross-sectional area of a blood vessel to be provided. It is almost supported. The sheet of the covering material 7 is formed by knitting, for example, a warp extending in the axial direction of the artificial blood vessel A and a weft extending in the circumferential direction of the artificial blood vessel A, and the warp yarn is made of a polyester monofilament (about 15 denier). ) And a multifilament (approximately 50 denier) in which super-fine wires are twisted on the weft. Further, the surface material 7 is provided with a waterproof coating (collagen, albumin, etc.) for preventing blood from leaking as necessary.

The ring-shaped wire portions 10 ₁ , 10 ₂ are divided in the axial direction and are arranged to face each other. The inner diameter of the ring-shaped wire portions 10 ₁ , 10 ₂ substantially corresponds to the inner diameter of the surface material 7, as shown in FIG. Is fixed to one end or the other end of the surface material 7 by sewing or bonding, respectively. An annular molding material 10a, which is a protective member, is disposed around the outer periphery of each of the ring-shaped wire portions 10 ₁ and 10 ₂ , and an appropriate portion thereof is sewn or adhered to the ring-shaped wire portion 10 1. ₁ and 10 ₂ are closely fixed.

As shown in FIGS. 1 and 2, the intermediate ring-shaped wire portion 12 has a structure in which one or two ring-shaped wire members 12a are covered with a protective film 12b such as cloth. 7, both ring-shaped wire portions 10 ₁ ,
It is arranged between 10 ₂ to equal division located in the longitudinal direction and is secured to the mounting member 7 by sewing or adhesion or the like an appropriate point on its circumference. And the above-mentioned ring-shaped wire portions 1 at both ends
0 ₁ and 10 ₂ together with these intermediate ring-shaped wire portions 12
Also imparts a cylindrical shape retention force to the entire surface material 7. In addition, among these intermediate ring-shaped wire portions 12 that are formed by enclosing the ring-shaped wire 12a in a pair,
Needles 12a1 are formed at two locations on the circumference to pierce and implant human organs. Specifically, the wire 12a of these intermediate ring-shaped wire portions 12 is
Titanium-nickel alloy needles and the like are used together with the ring-shaped wires 10 ₁ and 10 ₂ , and this kind of material has a problem that it has excellent elastic restoring force but is difficult to weld. In view of such circumstances, the wire rod 12a is bent in a ring shape to cross the vicinity of both ends, and the crossed part is tied and fixed with a string or the like, and the part from the crossed part to the end is bent. Thus, the needle-shaped body 12a1 is formed. Then, those needles 12a1 are
And the outer surface of the bundle of wires 12a is
After being covered with 2b, the needle-like body 12a1 is exposed to the outside through the protective film 12b.

Here, as shown in FIG. 1, the front ring-shaped wire portion 10 ₁ to be first introduced into the catheter 8.
Is divided into two equal parts, and each point is divided into the dividing points 41 ₁ , 4 ₁ of the present invention.
Together define a 3 ₁ defines the midpoint 42 _1, 44 ₁ of the present invention between the two dividing points 41 _1, 43 _1. Also, rear end wire ring 10 ₂ on the same phase position as well division point corresponding portion 41 _2, 43 ₂ and the midpoint corresponding portions 42 _2, 44
Set _2, further intermediate wire rings 12 on the same phase position in the division point corresponding portion 41 ₃ is also 43 ₃ and the midpoint corresponding portion 42 _3, defining a 44 _3. Then, as shown in FIG. 1, the dividing points 41 ₁ , 43 of the front ring-shaped wire portion 10 _1
A pair of loop-shaped hooks 13 is formed with a thread or the like so that the center is located at ₁ . In addition, between the two ring-shaped wire portions 10 ₁ and 10 ₂ , a regulating cord 14 for preventing the entire artificial blood vessel A from extending more than necessary in the axial direction is cross-linked.

Thus, the artificial blood vessel A having the above configuration
To transfer the artificial blood vessel A along the inside of the catheter 8 to the target organ of the human body (see FIG. 3), and the catheter 8
Artificial blood vessel introducing device C for introducing artificial blood vessel A into the inside
(See FIG. 4). The artificial blood vessel transfer device B includes:
As shown in FIG. 3, a tube 2 made of metal and having deformability and having a guide coil spring 2a connected to the tip thereof, and a side window 1 provided near the front end of the tube 2
And a pair of cords 4 having both ends fixed near the side window 1 and having a loop 4a formed in the middle, and a wire 3 movably inserted into the tube 2.

As shown in FIG. 4, the artificial blood vessel introducing device C includes a mounting portion 5 integrally connected to the insertion end 8a of the catheter 8, and a cartridge 6 detachable from the mounting portion 5. Do it. As shown in FIGS. 4 and 5, the mounting portion 5 has first and second annular members 51 and 52 each having an internal thread formed on an inner periphery thereof, and male screws projecting from both ends into the both internal threads. A third annular member 53 for connecting between the annular members 51 and 52, and a straw member 54 for connecting the inner periphery of the first annular member 51 to the inner periphery of the insertion end 8a of the catheter 8 in a liquid-tight manner. And Second annular member 5
A check valve 55 made of an elastic film that closes the open end is mounted on the inner periphery of 2. Further, the cartridge 6 has substantially the same configuration, and as shown in FIGS.
First and second annular members 61 each having a female screw engraved on an inner periphery thereof,
62, a third annular member 63 projecting from both ends thereof with external threads screwing into the both female threads and connecting between the annular members 61 and 62, and a third annular member 63 projecting from the first annular member 61 in the insertion direction. And a straw member 64 to be provided. A check valve 65 made of an elastic film for closing an open end of the second annular member 62 is mounted on the inner periphery.

As shown in FIG. 4, the distal end 6a of the straw member 64 of the cartridge 6 is detachably fitted from the rear end 5a side to the mounting portion 5 connected to the insertion end 8a of the catheter 8 and connected. To be able to. That is, as shown in FIGS. 4 to 6, the inner diameter d ₁ of the mounting portion 5 side of the straw member 54 is Yes and those slightly large diameter than the inner diameter d ₂ of the straw member 64 of the cartridge 6 side, and the cartridge the length L ₂ of the distal end exposed portion of the straw member 64 of 6 is set at substantially equal to the length L ₁ of the whole mount 5. Further, the inner diameter d ₂ and the inner diameter d ₃ of the insertion end 8a of the catheter 8 of the straw member 64 of the cartridge 6 are substantially equal. When the plugged to the extent that the cartridge 6 to the mounting portion 5, the straw member 64 is inserted into the inner circumference of the straw member 54, smooth the inner diameter d ₂ of the tip 6a to the inside diameter d ₃ of the insertion end 8a of the catheter 8 To be continuous. The check valve 55,
Reference numeral 65 denotes an elastic film, which is formed with a hole (not shown), which is normally closed.

As an aid for bending the artificial blood vessel A, a funnel 18 as a guide cylinder as shown in FIG.
Is prepared. The funnel-shaped tube 18 has a large-diameter inlet 18a at the rear end for inserting a tubular artificial blood vessel A. The diameter is gradually reduced from the large-diameter inlet 18a side, and a small-diameter cylindrical connection is formed at the front end. The portion 18b is formed, and the inner surface forms a tapered surface 18d. Then, the connection portion 18b on the front end side of the funnel-shaped tube 18 can be detachably fitted and connected to the rear end portion 6b of the cartridge 6. In addition, the tapered surface 1 of this funnel-shaped cylinder 18
On a specific generating line 8d (the straight line when the straight line moves to form a cylinder), a projection 18c that can be intermittently elastically deformed from the rear end to the front end is protrudingly provided. When the artificial blood vessel A passes along the tapered surface 18d in the funnel-shaped cylinder 18, the projection 18c is pressed by the artificial blood vessel A and elastically deforms, giving the elastic reaction force to the artificial blood vessel A, and It serves to contract the artificial blood vessel A.

In order to easily form the projection 18c,
As shown in FIG. 4, a pair of holes 18e are drilled in a plurality of locations on the tapered surface 18d of the
f is inserted from one hole 18e and pulled out from the other hole 18e to erect a loop-shaped projection 18c inside the tapered surface 18d, and an appropriate portion of the wire 18f is bound by a string 18g.

Next, the artificial blood vessel A is bent using the artificial blood vessel transferring apparatus B and the artificial blood vessel introducing apparatus C configured as described above, and the target position of the blood vessel 9 which is a part of the organ of the human body (the affected part 26). ) Will be described. First, the artificial blood vessel A is externally fitted to the tube 2 as shown in FIG. 7, and in this state, a pair of strings 4 are passed through the hook 13 of the artificial blood vessel A as shown in FIG. Let it. Next, as shown in FIG. 9, the overlapping portion of the loop 4a is hooked on the wire 3 once taken out of the side window 1, and the wire 3 is pushed again from the side window 1 into the tube 2 as shown in FIG. 2 and the wire 3 hold the artificial blood vessel A via the string 4. Then, the artificial blood vessel A is inserted into the cartridge 6 shown in FIG. Specifically, as shown in FIG. 11, the dividing points 41 ₁ , 4 ₁ of the front ring-shaped wire portion 10 ₁ of the artificial blood vessel A are used.
3 ₁ in the state through a common pre-tensioning string 20 to the hook portion 13 formed in positions the midpoint 42 _1, 44 ₁ on the generatrix of the funnel-shaped tube 18 as described above. At this stage, if necessary, a balloon catheter 23 shown in FIG. 12 is used. This balloon catheter 23 has a pipe portion 23a
And a balloon portion 23b formed at the distal end of the pipe portion 23a, and a supply / discharge port provided at the base end side of the pipe portion 23a for guiding air and the like into and out of the balloon portion 23b through the pipe portion 23a. 23c. Then, the artificial blood vessel transfer device B is placed in the pipe portion 23a.
Tube 2 is loosely fitted. That is, the artificial blood vessel transfer device B has its base end side pulled out from the base end of the balloon catheter 23 to the outside, and its distal end side extends outside through the balloon portion 23b of the balloon catheter 23, The penetration is hermetically sealed.
The fastening between the proximal end of the pipe portion 23a and the tube 2 of the artificial blood vessel transfer device B is made detachable by a fastener 24, and when the fastener 24 is tightened, the balloon catheter 2
3 and the tube 2 of the artificial blood vessel transfer device B are connected so as to be integrally movable in the longitudinal direction, and when the fastening tool 24 is released, the balloon catheter 23 is moved in the longitudinal direction with respect to the tube 2 of the artificial blood vessel transfer device B. Can be relatively moved. Then, the balloon catheter 23 is positioned at a position approximately 2-3 cm away from the rear end of the artificial blood vessel A whose tip is loosely fitted in the tube 2, and in this state, the fastener 24 of the balloon catheter 23 is tightened to tighten the balloon catheter 23. Is set to move integrally with the tube 2.

On the other hand, before and after the above, the funnel-shaped cylinder 18 is mounted on the cartridge 6 as shown in FIG. When the connecting portion 18b of the funnel-shaped cylinder 18 is inserted into the annular member 62 of the cartridge 6 at the time of mounting, the annular member 6
The check valve 65, which is an elastic film provided in the inside of the funnel 2, is pushed open by the connecting portion 18b of the funnel-shaped tube 18, and the connecting portion 18b
Is disposed at a position slightly entering the straw portion 64 of the cartridge 6. Then, the front pulling cord 20 is inserted from the rear end portion 18a of the funnel-shaped tube 18 to be drawn out forward from the straw portion 64 at the front end of the cartridge 6, and the tube 2 is inserted into the funnel-shaped tube 18 to a certain extent. In this state, the front pulling cord 20 is pulled forward, and the artificial blood vessel A is introduced into the funnel 18 through the large-diameter entrance 18a of the funnel 18.

When the front pulling cord 20 is pulled,
As shown in FIG. 14, the front ring-shaped wire portion 10 of the artificial blood vessel A
₁ Division point 41 of₁ , 43₁ Is pulled by the front pull cord 20
And the intermediate point 42₁ , 44₁ Is the mother of the tapered surface 18d
The front ring-shaped line is used to engage with the projection 18c provided on the line.
Lumber 10₁ Is the intermediate point 42 as shown in FIG.₁ , 44 ₁ 
As a scaffold and dividing point 41₁ , 43₁ As they approach each other
Are flattened and their division points 41₁ , 43
₁ Is drawn first, so the intermediate point 42₁ , 44₁ Is the projection 18
c and will be located rearward and
Intermediate point 42 of₁, 44₁ To each other in the elastic reaction force of the projection 18c
Therefore, they are urged in directions approaching each other, and are biased as shown in FIG.
It is crushed flat. That is, the front ring-shaped wire portion 10₁ Is
The state of FIG. 14 is changed to the state of FIG.
The state is changed to the state shown in FIG.
41₁ , 43₁ Is the top of the forward-looking Yamagata, and the middle point 42
₁, 44₁ Is the bottom of the forward-facing valley, and the front ring-shaped line
Lumber 10₁ Are folded into a regular wavy pattern as a whole
Will be. That is, as shown in FIG.
Wire member 10₁ The funnel is gradually folded
18. In addition, tension is applied to the surface material 7
, The front pulling cord 20 is pulled forward.
As shown in FIG.
Point Corresponding Portion 41 of Toothed Wire 12_Three , 43_Three and
Rear ring-shaped wire section 10_Two Division point corresponding part 41_Two , 43_Two 
The pulling force is also transmitted. At this time, the intermediate ring shape
Intermediate point corresponding part 42 of wire rod part 12_Three , 44_Three And after phosphorus
Wire member 10_Two Intermediate point corresponding part 42 of_Two , 44_Two Hayaha
Projecting on the generatrix of the tapered surface 18d
18c, resulting in the middle of these
Ring-shaped wire portion 12 and rear ring-shaped wire portion 10_Two Also,
As shown in FIG.
_Three , 43_Three , 41_Two , 43_Two Becomes the top of Yamagata
Response part 42_Three , 44 _Three , 42_Two , 44_Two Is the bottom of the valley
And the front ring-shaped wire portion 10₁ Bent in the same phase as the wave
It can be done. In the above bending process,
And both ring-shaped wire portions 10₁ , 10_Two Around the outer edge of
Of the molding material 10a that follows
And In addition, the needle-shaped body 12a1 is
When the artificial blood vessel A is bent for the front end side or
It is pushed down toward the rear end side.

The artificial blood vessel A inserted into the connecting portion 18b as described above is further introduced into the straw member 64 of the cartridge 6 by pulling the cord 20 for pulling forward as shown in FIG. In this state, the front pulling cord 20 is pulled out of the hooking portion 13 by removing the knot and pulling one end, and the funnel-shaped tube 18 is pulled out of the rear end portion 6b of the cartridge 6. Thus, the artificial blood vessel A is stored in the straw member 64 of the cartridge 6 as shown in FIG. 21, and the check valve 65 is slightly opened from the rear end 6b of the cartridge 6 to open the balloon 2 having the tube 2 therein. Only the pipe portion 23a of the catheter 23 is brought out to the outside.

On the other hand, as shown in FIG. 22, the catheter 8 is punctured in advance, for example, into the hip artery at the base F of the foot, and its distal end is fed to the affected part 26 of the blood vessel 9 such as an aortic aneurysm as shown in FIG. Leave. In this case, the catheter 8
Is inserted so as to be positioned at a position slightly passing through the affected part 26, which is the target part. Also, the mounting portion 5 connected to the insertion end 8a side of the catheter 8 is kept exposed outside the body as shown in FIG. Next, when the cartridge 6 loaded with the artificial blood vessel A is inserted into the mounting portion 5 by pushing and opening the check valve 55 at the rear end portion 5a, as shown in FIG. Is disposed at a position smoothly continuing to the inner periphery of the insertion end 8 a of the catheter 8. In this state, the operation of feeding the balloon catheter 23 to the catheter 8 is started by grasping the pipe portion 23a of the balloon catheter 23, and is gradually inserted deeper into the catheter 8. Since the tube 2 is connected to the balloon catheter 23 via the fastener 24 and the artificial blood vessel A is held by the tube 2, the artificial blood vessel A gradually moves to a deep position in the body as the balloon catheter 23 moves. Be transported. Then, when the distal end of the tube 2 is finally located at the distal end of the catheter 8 as shown in FIG. 23, the feeding operation of the balloon catheter 23 is stopped. At this time, the artificial blood vessel A is positioned at the diseased part 26 which is the target position. Here, when the catheter 8 is pulled out as shown in FIG. 24 while leaving the balloon catheter 23 and the tube 2 into which the wire 3 is inserted at that position, the artificial blood vessel A folded and inserted into the catheter 8 Is released from the front end into the blood vessel 9 around the affected part 26 in the order of FIG. 24 → FIG. 25 → FIG. The released artificial blood vessel A is restored to a cylindrical shape and pressed against the inner wall of the blood vessel 9. Next, the fastening of the fastener 24 shown in FIG. 12 is released to release the connection between the balloon catheter 23 and the tube 2, and the balloon catheter 23 is moved along the tube 2 while keeping the tube 2 at that position. A into the artificial blood vessel A as shown in FIG.
Proceed to the tip of the Here, air or the like is introduced from the supply / drain port 23 c of the balloon catheter 23 to
b is expanded as shown by the alternate long and short dash line in FIG.
Is completely restored and fixed to the inner wall of the blood vessel 9. At this time,
The needle-shaped body 12a1 pierces the inner wall of the blood vessel 9 and is implanted. When the fixation of the artificial blood vessel A is completed in this manner, air or the like is led out from the supply / drain port 23c to release the balloon catheter 2
The balloon portion 23b of No. 3 is contracted, the pipe portion 23a is retracted, and the balloon portion 23b is withdrawn from the artificial blood vessel A. Then, after confirming that the artificial blood vessel A is fixed to the inner wall of the blood vessel 9, the wire 3 is pulled to the tube 2 so that the distal end of the wire 3 is in the side window portion of the tube 2 as shown in FIG. When the wire 4 is retracted, the loop 4a of the string 4 wound around the wire 3 at the side window portion 1 comes off the wire 3. When the tube 2 is pulled in this state, the string 4 comes off from the front hooking portion 13. Then, the balloon catheter 23 and the tube 2
Are connected again with the fastener 24, and the balloon catheter 23 is pulled out of the body together with the tube 2 while leaving only the artificial blood vessel A at a predetermined position in the blood vessel 9.

As described above, this embodiment uses the artificial blood vessel A
Can be completed, and the artificial blood vessel A is restored after the transplantation, and effectively functions as a means for preventing the blood vessel 9 from being blocked at the affected part 26. As described above, the artificial blood vessel A of the present embodiment has a plurality of bendable elastic ring-shaped wire portions 10 ₁ arranged at intermittent positions,
10 ₂ and 12 are connected by a tubular covering material 7 formed of a flexible and stretched sheet. The covering material 7 is made by knitting a warp extending in the axial direction of the artificial blood vessel A and a weft extending in the circumferential direction of the device. The warp uses a polyester monofilament, and the weft has an ultra-fine wire. And a multifilament made of polyester obtained by twisting them.

For this reason, the rigidity of the warp yarns imparts shape-retaining properties to the surface covering material 7, and the denseness of the weft yarns imparts waterproofness to the surface covering material 7. There is tension in the direction, strong pulling force, self-sustainability as a cylinder, and prevention of blood leakage. Therefore, when folded, it can be made small, and when it is restored, it can be made into an appropriate cylindrical shape, and blood can be prevented from flowing around the affected part.

In particular, since the sheet of the covering material 7 is formed in a bellows shape, the entire artificial blood vessel A can be bent more easily, and can be implanted even when the artificial blood vessel A is implanted into a curved organ. The condition can be better.
In particular, since a polyester monofilament having shape retention properties is used for the warp, if a bellows shape is given to the device along the warp, the bellows shape is effectively maintained for a long period of time. When the artificial blood vessel A is to be restored to the original shape, the return operation of the bellows itself effectively assists this, so that a more appropriate three-dimensional shape can be restored.

Further, since the surface material 7 is provided with a waterproof coating, higher liquid tightness can be obtained. In addition, since the monofilament is about 15 denier, sufficient strength can be secured, and at the same time, it is possible to contribute to thinning the entire artificial blood vessel A. On the other hand, since the multifilament is about 50 denier, a sufficient leakage prevention effect can be expected without accompanying bulkiness.

In addition, with such a device as the artificial blood vessel A, various other conventional inconveniences can be effectively solved. That is, the conventional device has a configuration in which a pair of ring-shaped wire portions are connected via a frame mainly including a connection wire portion, and the rear ring-shaped wire portion of the rear end of the device is pressed to cause a catheter. It is introduced into the body and transported to a target organ of the human body. For this reason, it is necessary to transfer the pressing force applied to the rear ring-shaped wire portion to the front ring-shaped wire portion to transport the entire instrument, and in addition to making the frame an essential component, the material is made of metal. It is essential to use something that is robust. However, when such a frame is used, there is a problem that the ring-shaped wire portion and the frame interfere with each other, so that the bending operation of the ring-shaped wire portion is easily disturbed, and it becomes difficult to bend the wire into a regular wave shape. In addition, if the bending operation of the ring-shaped wire portion is hindered, it becomes difficult to fold the entire device small.

On the other hand, when the ring-shaped wire portion is crushed by a relatively strong force and inserted into the catheter by folding it small,
Since the ring-shaped wire has an elastic limit, if it is bent by force, the ring-shaped wire will exceed its elastic limit and will be plastically deformed. There is. In addition, the strain caused by the plastic deformation may cause snagging when moving in the catheter, which may cause a large sliding resistance, making it difficult or impossible to carry to the target position.

Further, there is a problem that a device using a frame is likely to hinder the transplantation into a human body organ in an appropriate shape. In particular, when disposing an instrument at a bent part of a human body organ, there is a possibility that each part of the frame may interfere and be deformed flat, and even if it is transplanted with great effort, the original function of the instrument may not be exhibited. . In addition, conventional frames
Since the wire of the ring-shaped wire at both ends is used bare, the wire may scratch and hurt the inner wall of the organ, and when used as an artificial blood vessel due to low adhesion to the inner wall of the organ, From the blood easily leaks.

Further, when introducing the bent instrument into the catheter, the tip of the catheter is inserted into a blood vessel of a human body in advance, so that a check valve is provided at the open end of the catheter which is drawn out of the catheter. Even when introducing the device, the check valve must be pushed and opened progressively. Therefore, with more bleeding than such open ends,
Some measures are needed to prevent bleeding.

Therefore, the present invention is to develop a non-frame type instrument such as the above-mentioned artificial blood vessel A, and to solve all the problems described based on this instrument. That is, in the method of bending the implantable device according to the present invention, the device is formed by a pair of ring-shaped wire portions divided from each other and a flexible and tensioned sheet connecting between the ring-shaped wire portions. A cylindrical surface material and an intermediate ring-shaped wire portion which is intermittently arranged between both ring-shaped wire portions and whose outer periphery is fixed to the surface material by sewing or adhesion, etc. While dividing the circumference of the ring-shaped wire portion into a plurality of equal parts and pulling each division point forward, restricting the forward interlocking movement of the intermediate point between each division point along the tapered surface, With this, the front ring-shaped wire portion is bent in a wave shape so that the dividing point is the top of the mountain and the middle point is the bottom of the valley toward the front, and further the dividing point of the front ring-shaped wire portion is directed forward. Towing, Characterized in that bending the intermediate end wire ring and the rear end wire ring by limiting action along the surface in a wave of the front end wire ring and the same phase.

In this case, a loop-shaped hook portion may be formed at the dividing point of the front ring-shaped wire portion, and a front pulling string may be inserted through the hook portion and pulled forward. In particular, it is effective that the dividing points of the front ring-shaped wire portion are attracted to each other by inserting and pulling a common front pulling string through the plurality of hook portions. Also, by using a guide tube having a tapered surface whose inner surface is reduced in diameter toward the front, and by pulling the dividing point of the front ring-shaped wire portion forward while inserting a tool into the guide tube, each ring-shaped wire portion is The dividing points and the intermediate points may be brought closer to each other. In particular, a protrusion that can be elastically deformed is formed on the tapered surface of the guide cylinder, and the intermediate point of each ring-shaped wire portion is engaged with the protrusion, so that the forward linked movement of the intermediate point is limited by the protrusion. It is effective to urge the intermediate points in a direction in which they approach each other. Furthermore, you may arrange | position the protection member which has flexibility along the outer periphery of a ring-shaped wire part.

On the other hand, in the implanting device according to the present invention, a pair of bendable and elastic ring-shaped wire portions are provided at a position divided from each other, and the space between the ring-shaped wire portions is flexible and stretched. In addition to connecting with only the cylindrical outer cover material formed of a sheet having a sheet, an intermediate ring-shaped wire portion is arranged between both ring-shaped wire portions, and an appropriate portion on the circumference of the intermediate ring-shaped wire portion is sewn. It is characterized in that it is fixed to the surface material by bonding or bonding.

As the flexible and stretched sheet, a polyester monofilament having a shape-retaining property is used, in which a warp extending in the axial direction of the device and a weft extending in the circumferential direction of the device are knitted. And those using a polyester multifilament having waterproof property for the weft. The sheet of the facing material may be formed in a bellows shape. In particular, between the ring-shaped wire parts at both ends,
It is effective that the bellows is bridged with a regulating string for preventing the bellows from extending beyond a certain limit. Further, a protection member having flexibility may be arranged around the outer periphery of the ring-shaped wire portion at both ends. Further, a needle-shaped body that is stuck into an organ of a human body and implanted may be protruded from at least a part of the outer periphery of the ring-shaped wire portion. It is effective that the needle-shaped body is formed in a portion from the intersection to the end by bending the wire into a ring shape, intersecting the vicinity of both ends, and fixing the intersection.

Further, the apparatus for introducing the folded implantable device according to the present invention into a catheter comprises a mounting portion formed at an insertion end of the catheter and having an open end closed by a flexible check valve. And a cartridge which is detachable from the mounting portion and has a distal end portion communicating with the catheter at the time of mounting, and an open end of which is closed by a check valve having flexibility. The stop valve is pushed open to house the implanting device in the cartridge, and the tip is pushed open to insert the check valve of the mounting portion into the catheter while the check valve is almost closed. .

In this case, the inner diameter of the catheter mounting portion is made larger than the inner diameter of the insertion end of the catheter, and the inner diameter of the distal end portion of the cartridge passes through the inner diameter of the catheter mounting portion while the cartridge is mounted. Thus, the catheter may be smoothly connected to the inner diameter of the insertion end of the catheter. According to the bending method of the present invention, the bending operation can be easily and appropriately performed. That is, it is difficult to fold the ring-shaped wire portion so that it is small enough to enter the catheter by simply applying a non-directional external force to the front ring-shaped wire portion. However, the plurality of equally divided division points on the circumference of the front ring-shaped wire portion are pulled forward, and at this time, the forward interlocking movement of the intermediate point between each division point is performed along the tapered surface. If limited, the front ring-shaped wire portion can be bent into a waveform such that the dividing point is the top of the mountain and the middle point is the bottom of the valley, using the intermediate point as a scaffold.
Further, after the front ring-shaped wire portion is bent, the split point of the front ring-shaped wire portion is further pulled forward, so that the pulling force is applied to the intermediate ring-shaped wire portion and the rear ring via a tensioned surface material. The intermediate ring-shaped wire portion and the rear ring-shaped wire portion are restricted along the tapered surface at the same time, so that those ring-shaped wire portions are also bent into the same phase as the front ring-shaped wire portion. be able to. For this reason, it becomes possible to fold the entire instrument without difficulty.

At this time, it should be particularly noted that the bending method according to the present invention is such that the ring-shaped wire portions at both ends of the device are connected only by a tubular surface material formed of a flexible and stretched sheet. In this case, the front ring-shaped wire portion is pulled forward. In other words, in the conventional method of pressing the rear end of the device and inserting it into the organ of the human body, the existence of a relatively robust frame mainly composed of the connecting wire is indispensable to transmit the pressing force applied rearward to the front. However, since the present invention is based on the assumption that the front ring-shaped wire portion is pulled forward, even if the frame is omitted, easy insertion can be ensured. And, since the surface material is deformed into an arbitrary shape following the bending operation of the ring-shaped wire portion, it does not interfere with the ring-shaped wire portion and interfere with the bending operation as in the case of using a frame. . Therefore, according to the bending method of the present invention, each ring-shaped wire portion can be bent in a regular wavy shape, and the entire device can be easily folded small.

Such a bending operation can be easily performed by forming a loop-shaped hook portion at a dividing point of the front ring-shaped wire portion, inserting a front pulling string through the hook portion, and pulling forward. it can. In particular, when a common front pulling string is inserted into a plurality of hooks, the dividing points are drawn together, so that the pulling force can be more effectively converted to a folding force.

In the bending operation, if a guide tube whose inner surface is reduced in diameter toward the front is used, as the instrument is gradually inserted deeper into the guide tube, the dividing points and the intermediate points of each ring-shaped wire portion are connected. It narrows down in the approaching direction, so that the whole device can be folded small. At that time, if an elastically deformable projection that engages with the intermediate point is formed on the inner surface of the guide cylinder, the intermediate points are urged positively by elastic reaction force from the projection, Since a gap is formed between the ring-shaped wire portion and the guide tube, it is possible to effectively prevent a situation in which the two are brought into close contact with each other to increase the sliding resistance and prevent the appliance from being pulled out.

Further, in the case where a flexible protective member is arranged around the outer periphery of the ring-shaped wire portion, it is possible to prevent the function of the device from being impaired during the bending operation. That is, if the ring-shaped wire portion is bent beyond the elastic limit, it becomes difficult to restore the original ring shape, and when the catheter is moved in the catheter, the bent portion is caught and cannot be moved. Although it may fall into a situation, if a protection member is provided, even if the division point is strongly pulled locally, the protection member disperses the tension, so that a tensile force acts locally only at the division point. The ring-shaped wire portion is not bent beyond the elastic limit. For this reason, it is possible to prevent the plastic deformation of the front ring-shaped wire portion and to fold the wire into a regular wavy shape with a proper restoration function to the ring shape and a smooth movement in the catheter.

Further, as described above, a device constructed without a frame assures a proper function as an artificial blood vessel or the like even when viewed as a device itself. That is, in the device of the present invention, tension is applied to the surface mounting material itself, and both ends and appropriate locations of the surface mounting material are supported by the ring-shaped wire portion and the intermediate ring-shaped wire portion. Therefore, when the entire device is released from the crushed state and each of the ring-shaped wire portions attempts to elastically restore to the ring shape, the surface material is returned to the original appropriate cylindrical shape following the ring-shaped wire portions. It will be. In addition, the conventional device having a frame may be deformed flat due to interference of various parts when disposed at a bent portion in a human body organ,
Since the device of the present invention without the frame is freely deformable,
It can be reasonably adapted to various shapes of organs of the human body.

If the sheet is made by knitting a warp and a weft, a polyester monofilament is used for the warp, and a polyester multifilament is used for the weft, the whole apparatus becomes flexible,
The warp gives the facing material an axial tension and shape retention, and the weft improves the density of the facing material and enhances the waterproofness.

In particular, if the sheet of the covering material is formed in a bellows shape, the whole instrument bends more easily, so that the implantation state of the instrument into the organ becomes better. In the case where the sheet of the outer covering material is formed in a bellows shape, a situation in which the sheet extends completely and the bellows is flattened can be prevented by bridging between the ring-shaped wire portions with the regulating string. By arranging flexible protective members around the ring-shaped wire portions at both ends of the device, in addition to the effect of preventing the plastic deformation of the ring-shaped wire portion at the time of the bending operation as described above, in addition to the effect of preventing such ring It is also possible to prevent a situation in which the wire member directly contacts the organ of the human body and damages the inner wall. In addition, since this protective member can function as a sealing material for bringing both ends of the implanting device into close contact with the inner wall of the organ of the human body,
Leakage of blood from both ends can be effectively prevented when an artificial blood vessel is transplanted or the like.

Further, if a needle-like body is protruded from the ring-shaped wire portion, the needle-like body is pierced and implanted into the inner wall of the organ, thereby fixing the entire instrument. Therefore, it is possible to effectively prevent a situation in which the device is displaced after the device is implanted in the organ, and is eventually caused to flow downstream in the blood vessel. In the production of the needle-shaped body, if the vicinity of both ends of the wire is crossed and the crossed part is tied with a string or the like, the needle-shaped body can be easily formed even if a material difficult to weld is used for the ring-shaped wire. And its reliability can be secured for a long period of time.

On the other hand, when the device for introducing into a catheter according to the present invention is used, it is possible to smoothly introduce the device into the catheter. That is, the implanting device is inserted into the cartridge while pushing the check valve open, and is advanced to a position where it is almost completely accommodated.At about the same time, the cartridge is mounted on the mounting portion formed at the insertion end of the catheter in advance. In this state, the device is further advanced in that state, and is introduced into the catheter via the mounting portion. In this case, when the valve of the mounting portion is opened, the valve of the cartridge is closed, so that even if blood in a blood vessel flows into the cartridge over time, it is ensured that the blood bleeds out of the body from the cartridge. Is prevented. Moreover, if the device is to be inserted directly into the catheter, smooth insertion is not easy due to the flexibility of the catheter and the device, and the pressing force may cause the catheter to bend, thereby blocking the insertion system or weakening the catheter itself. However, if the device is inserted into the catheter via the mounting portion and the cartridge, such a problem that the catheter is bent by making the mounting portion and the cartridge relatively rigid and easy to grasp. Therefore, the device can be easily and smoothly introduced into the catheter. At this time, if the inner diameter of the catheter mounting portion is made larger than the inner diameter of the catheter, and the inner diameter of the distal end portion of the cartridge is smoothly connected to the inner diameter of the insertion end of the catheter while the cartridge is mounted, transplantation can be performed. It is possible to prevent the occurrence of a situation in which the device is gradually expanded and clogged at the mounting portion, and the device can be introduced directly into the back of the catheter.

The above will be described below with reference to an embodiment based on the accompanying drawings. That is, only added simply force the non-oriented before end wire ring 10 _1, it is difficult to fold the end wire ring 10 ₁ is folded small to the extent that fall within the catheter 8. However, a plurality of equally divided division points 41 on the circumference of the front ring-shaped wire rod portion 10 _1
1, 43 ₁ a pulling forward, since that time limit the midpoint 42 _1, 44 ₁ of the interlocking motion forward between each division point 41 _1, 43 ₁ along the taper surface 18d , the waveform as the midpoint 42 ₁ becomes the midpoint 42 _1, 44 ₁ dividing points 41 ₁ end wire ring 10 ₁ prior to the scaffold, 43 ₁ chevron apex, 44 ₁ is the bottom of the valley shaped Can be deflected. Further, after the previous flexed end wire ring 10 _1, when pulling the dividing points 41 _1, 43 ₁ of the front end wire ring 10 ₁ forward by further pre-tensioning string 20, the pulling force is a tension mounting intermediate wire rings 12 and the rear end wire ring 10 ₂ of the division point corresponding portion 41 ₃ through the timber 7, 43 _3, 41 _2, 43 ₂ transmitted to, simultaneously intermediate wire rings 12 and the rear end wire ring Part 10
Since the _second intermediate point corresponding portion 42 _3, 44 _3, 42 _2, 44 ₂ restricted along the tapered surface 18 d, the even their end wire ring 12, 10 ₂ front end wire ring 10
It can be folded into a wave shape with the same phase as ₁ . Therefore, it becomes possible to fold the entire artificial blood vessel A without difficulty.

At this time, it should be particularly noted that the present embodiment
Is bent at the both ends of the artificial blood vessel A.
0₁ , 10_Two Flexible and tight sea between
Connected only by the tubular surface material 7 formed by
And the front ring-shaped wire portion 10 ₁ To the artificial blood vessel transfer device B
Therefore, the point is that it is towed forward. Sand
In other words, press the rear end of the instrument and insert it into a human organ.
In the conventional method, the pressing force applied to the rear is transmitted to the front
Of a relatively robust frame mainly composed of connecting wires
Although the presence was indispensable, in this embodiment, the front ring-shaped wire portion
10₁ Is to be pulled forward.
Therefore, even if the frame is omitted, easy insertion can be ensured.
Wear. The surface material 7 is provided in each of the ring-shaped wire portions 10.₁ , 1
2,10 _Two Deforms to an arbitrary shape following the bending operation of
Therefore, as in the case of using a frame,
And interfere with their bending operation
I do not. Therefore, the bending method of this embodiment
According to each ring-shaped wire portion 10₁ , 12, 10_Two The rules
It can be bent in the correct wave shape, and the entire artificial blood vessel A
It becomes possible to fold it small easily.

Further, in the present embodiment, the dividing points 41 ₁ such folding operation the front end wire ring 10 _1, 43 ₁
The hook 13 is formed in a loop shape, and the front pull cord 20 is inserted through the hook 13 and pulled forward, so that the operation can be performed extremely easily. In particular, since the pull is inserted a common pre-tensioning string 20 to a pair of hook portions 13, the effect of drawing the dividing points 41 _1, 43 ₁ to each other occurs, to convert the pulling force more effectively the folding force Can be.

Further, in this embodiment, since the funnel-shaped tube 18 whose inner surface is reduced in diameter at the time of the bending operation is used, as the artificial blood vessel A is gradually and deeply inserted through the funnel-shaped tube 18, Refine in a direction coming close before the division point 41 _first end wire ring 10 _1, 43 ₁ and between the midpoint 42 _1, 44 ₁ to each other, as a result, can be folded small overall. In particular, since in this embodiment forms the elastically deformable projections 18c of the tapered surface 18d contact engaging the midpoint 42 _1, 44 ₁ of funnel-shaped tube 18, the midpoint of an elastic reaction force from the protrusions 18c 42 _1, 44 ₁ to each other can be biased in a direction to approach aggressively and a gap is formed between the end wire ring 10 ₁ and the funnel-shaped tube 18, slide both become close contact It is also possible to effectively prevent a situation in which the resistance increases and the artificial blood vessel A does not come and go. Such action is to say exactly the same for the intermediate wire rings 12 and the rear end wire ring 10 _2.

In this embodiment, the ring-shaped wire portion 10
_1, 10 and the molding material 10a having flexibility circling disposed _second outer periphery to prevent the function of the artificial blood vessel A is impaired especially during operation bending before end wire ring 10 ₁ Can be. That is, if the previous end wire ring 10 ₁ is bent beyond the elastic limit event, in addition to restoring to the original ring-shape becomes difficult, the bent portion is caught in or when moving the catheter 8 May not be able to move.
By providing the a, since the dividing points 41 _1, 43 ₁ locally strong pull even the mall material 10a is to distribute the tension, dividing points 41 _1, 43 ₁ only locally tensile force never as bending bending beyond the elastic limit of the end wire ring 10 ₁ acts. Therefore, in particular to prevent the plastic deformation of the front end wire ring 10 _1, it can be folded small in the regular wavy while ensuring the proper restoration function to the ring shape and a smooth movement of the catheter 8 become.

Further, as described above, the artificial blood vessel A constituted by omitting the frame ensures its proper function even when viewed as an instrument itself. That is, the artificial blood vessel A of the present embodiment is configured such that tension is applied to the surface covering material 7 itself, and an appropriate portion of the surface covering material 7 is supported by the intermediate ring-shaped wire portion 12. Therefore, the entire artificial blood vessel A is released from the crushed state, and the respective ring-shaped wire portions 10 ₁ , 10
When the ring members ₂ and 12 are to be elastically restored to the ring shape, the surface material 7 is returned to the original appropriate cylindrical shape following the ring-shaped wire portions 10 ₁ , 10 ₂ and 12. In addition, when the conventional artificial blood vessel having a frame is disposed at a bent portion in an organ of a human body, there is a possibility that each part interferes and deforms flatly. Since the artificial blood vessel A is freely deformable, the artificial blood vessel A can be easily adapted to various shapes of organs of the human body.

Further, since the band between the ring-shaped wire portions 10 ₁ and 10 ₂ is bridged by the regulating cord 14, it is possible to prevent the sheet from being stretched and the bellows from being flattened. Further, in this embodiment, the ring-shaped wire portions 10 at both ends of the artificial blood vessel A are used.
_1, 10 ₂ so that the molding material 10a having flexibility orbiting disposed, in addition to the effect of preventing the end wire ring 10 ₁ of the plastic deformation during operation bent as described above,
It is also possible to prevent a situation in which the wires of both the ring-shaped wire portions 10 ₁ and 10 ₂ come into contact with the organs of the human body in a bare state and damage the inner wall. In addition, since the molding members 10a can also function as sealing materials for adhering both ends of the artificial blood vessel A to the inner wall of the organ of the human body, it is also effective that blood leaks from both ends when the artificial blood vessel A is transplanted. Can be prevented.

Further, since the needle-shaped body 12a1 is protruded from the intermediate ring-shaped wire portion 12, the needle-shaped body 12a1 is formed.
1 is pierced and implanted in the inner wall of the organ, whereby the entire artificial blood vessel A is fixed. Therefore, the artificial blood vessel A
After the transplantation, it is possible to effectively prevent the artificial blood vessel A from being displaced, and eventually flowing downstream in the blood vessel. The needle-shaped body 12a1 is also formed such that the vicinity of both ends of the wire is crossed and the crossed part is tied with a string or the like to form the needle-shaped body 12a1 between the crossed part and the end. The needle-like body 12a1 can be easily manufactured even if a material that is difficult to weld is used for the material 12, and its reliability can be secured for a long period of time.

On the other hand, when the introduction device C into the catheter 8 according to the present embodiment is used, the introduction into the catheter 8 can be performed smoothly. That is, the artificial blood vessel A is inserted into the cartridge 6 while pushing the check valve 55 open, and is advanced to a position where it is almost completely accommodated, and the cartridge 6 is formed at the insertion end 8a of the catheter 8 around the same time. The artificial blood vessel A is further advanced in this state, and is introduced into the catheter 8 via the mounting part 5. In this case, since the check valve 65 of the cartridge 6 is closed when the check valve 55 of the mounting portion 5 is opened, even if blood in a blood vessel flows into the cartridge 6 in a gradual manner, the blood is further removed from the cartridge. Bleeding out of the body from 6 is reliably prevented. Moreover, when the artificial blood vessel A is directly inserted into the catheter 8, smooth insertion is not easy due to the flexibility of the catheter 8 and the artificial blood vessel A, and the catheter 8 is bent by the pressing force, and the insertion system is closed. However, in the present embodiment, the artificial blood vessel A is inserted into the catheter 8 via the mounting portion 5 and the cartridge 6, so that the mounting portion 5 and the The cartridge 6 is made relatively rigid and easy to grasp so that the catheter 8 does not bend and the artificial blood vessel A
Can be smoothly and smoothly introduced into the catheter 8. At this time, the inner diameter d1 of the mounting portion 5 of the catheter 8
Is larger than the inner diameter d3 of the insertion end 8a of the catheter 8, and the inner diameter d2 of the distal end of the cartridge 6 with the cartridge 6 mounted is changed to the insertion end 8 of the catheter 8.
Since the artificial blood vessel A is smoothly connected to the inner diameter d3 of the catheter a, the artificial blood vessel A is prevented from generating a situation in which the artificial blood vessel A is gradually expanded and clogged in the mounting portion 5, and the artificial blood vessel A is directly inserted into the inner part of the catheter 8. Can be introduced.

The present invention is limited only to the above-described embodiment.
It is not something to be done. For example, in the above embodiment, the front ring
Wire 10₁ Is divided into two equal parts, and two division points 41₁ , 43
₁ And two intermediate points 42₁ , 44₁ Was set, but FIG. 28
As shown in FIG.₁ Divided into four equal parts
Four division points 141₁ , 143₁ , 145₁ , 147 ₁ 
And the four intermediate points 142₁ , 144₁ , 146₁ , 148
₁ May be set. Also, as shown in FIG.
Wire part 210₁ Is divided into three equal parts, and three division points 241
₁ 243₁ , 245₁ And three intermediate points 242₁ , 24
4₁ , 246₁Can also be set.

In the above embodiment, the artificial blood vessel transfer device B
Are provided as a pair in a loop 4a, but need not necessarily be provided as a pair. However, by providing a pair, a balanced traction force can be applied to the artificial blood vessel A, which is effective. The entire loop 4a may be twisted. Furthermore, since the balloon catheter 23 is used in the above embodiment, the artificial blood vessel transfer device B is integrated into the balloon catheter 23. However, when the balloon catheter 23 is unnecessary, the tube 2 of the artificial blood vessel transfer device B can be used. What is necessary is just to operate | move directly and introduce | transduce into a catheter.

Further, in the above-mentioned embodiment, it is effective to apply the method for assisting restoration of a transplantation instrument described below. This restoration assisting method is based on the intermediate point corresponding portions 42 ₂ , 4 ₂ of the rear ring-shaped wire portion 102 of the artificial blood vessel A, which is a transplantation instrument.
4 ₂ hook after the loop shape as shown in FIG. 30 13
previously formed the a, it is to allow the pulling backwards through the rear hook portion 13a of the end wire ring 10 ₂ after the artificial blood vessel A which has been released from the catheter 8. That is, in the above-described embodiment, for example, the artificial blood vessel A may be released to a position that has passed through the affected part 26 shown in FIG. 26 due to an erroneous operation or the like. When you Hikimodoso the artificial blood vessel a to the front, only the front end wire ring 10 ₁ is moved to the rear end wire ring 10 ₂ side, a problem arises that the whole artificial blood vessel a is the proper shape shrunk in the axial direction is impaired There are cases. Also, when in that state to release the artificial blood vessel A to the stenosis so as to insert the balloon catheter 23 into the artificial blood vessel A is the balloon catheter 23 is end wire ring 10 ₂ of the rear opening of the artificial blood vessel A It may not be inserted properly and may get caught on the periphery of the opening. At this time, the rear ring-shaped wire portion 10 ₂ is pressed and moves toward the front ring-shaped wire portion 10 ₁ , and the entire artificial blood vessel A shrinks in the axial direction, which may cause a problem that an appropriate shape is damaged. Once such a situation occurs, the artificial blood vessel transfer device B
Since only have ready a function of towing the front end wire ring 10 ₁ toward the front exclusively, the artificial blood vessel A
This is not an effective means for correcting the shrinkage of the stomach or returning it to the proper release position.

[0060] In such a case, it is effective to use a method and apparatus for pulling the end wire ring 10 ₂ after the artificial blood vessel A after the release toward the rear. 30 and 31 exemplify a restoration assisting device D for this purpose, and are constituted by a tube 102 having a side window 101 near the distal end, and a wire 103 inserted into the tube 102. And artificial blood vessel A
Intermediate point corresponding portions 42 ₂ , 44 of the rear ring-shaped wire portion 10 _2
2 , a loop-shaped rear hook portion 13a is formed, and then the loop of the hook portion 13a is directly hooked on the wire 103 once drawn out of the tube 102 from the side window portion 101. Thereafter, the wire 103 is again inserted into the tube 102. , The wire 103 holds the rear hook 13a. In this state, the tube 102 containing the wire 103 is introduced into the catheter 8 together with the artificial blood vessel A. More specifically, an elongated hole 23d as shown in FIG. 32 is formed in the thickness of the pipe portion 23a of the balloon catheter 23 used in the above embodiment from the base end to the vicinity of the balloon portion 23b along the longitudinal direction. ; then, is introduced to a pair of tubes 102 is provided an opening window 23d _1, as shown in FIG. 30 to the base end side of the long hole 23d, their tube 102 to open windows 23d ₂ provided on the distal end side Derived. The tube 102 can be moved in the longitudinal direction integrally with the feeding operation of the balloon catheter 23. However, when only the tube 102 is operated, the tube 102 is relatively moved in the longitudinal direction with respect to the balloon catheter 23. It can also be done. And
At the stage of FIG. 26 where the position of the artificial blood vessel A after release is adjusted,
Alternatively, it is used in the stage of FIG. 26 → FIG. 27 where the balloon catheter 23 is inserted into the artificial blood vessel A. First, when the release position is past over slightly frontward of the affected area 26 shown in FIG. 26, driving the rear end wire ring 10 ₂ rearward to pull the tube 102 containing the wire 103 to the front, the front ring the Jo wire portion 10 ₁ then end wire ring 1
0 so as to follow the _second motion. Further, in the step of inserting the balloon catheter 23 shown in FIG. 26 → 27, advance prohibits forward movement of the rear end wire ring 10 ₂ by pulling on the tube 102 in advance accommodating a wire 103 to the front, the state To push the balloon catheter 23 into the artificial blood vessel A. After use in this manner, the wire 10 housed in the tube 102
When only the wire 3 is pulled toward the front, the wire 1 is positioned when the tip of the wire 103 comes to the side window 101 of the tube 102.
03, the rear hook 13a of the artificial blood vessel A comes off, and the artificial blood vessel A is separated from the restoration assisting device D.
Therefore, it is possible to remove the restoration assisting device D together with the balloon catheter 23 while leaving only the artificial blood vessel A in the affected part 26.

[0061] it is possible to keep such When used with equipment, always proper distance between the front end wire ring 10 ₁ and the rear end wire ring 10 _2. Therefore, it is possible to reliably prevent a situation in which the artificial blood vessel A contracts in the axial direction and the proper shape is damaged, and the insertion of the balloon catheter 23 and the position adjustment of the artificial blood vessel A can be completed quickly and accurately. Become.

Incidentally, as the restoration assisting device for the implanting device, a configuration shown in FIG. 33 can be used. In this device, a pair of strings 104 are attached near the side window 101 of the tube 102 so that the ends form a loop.
04 loop of a pair of posterior pulling portions 13a of the artificial blood vessel A
And then hooked on the wire 103. This tube 102 may be transferred and accommodated in the pipe portion 23a of the balloon catheter 23 similarly to the tube 102.

In the above description, the balloon catheter 23 may not be used.
02 may be connected together with the artificial blood vessel transfer device B so as to be integrally transportable and separable.

[0064]

According to the implanting device of the present invention having the above-described structure, the entire device can be easily folded and made flexible, and at the same time, the warp yarns can be applied to the covering material in the axial direction to maintain the tension. The shape is given, and the waterproofness of the surface material can be enhanced by the weft, so that the device can be folded small when transported through a catheter or the like, and also ensures a proper restoration state when released at the target position. And leakage of blood and the like can be reliably prevented.

In particular, if the sheet of the covering material is formed in a bellows shape, the whole instrument bends more easily, so that the implantation state of the instrument into a curved organ can be improved. In addition, since the polyester monofilament having shape retention properties is used for the warp of the present invention, if a bellows shape is provided to the device along the warp, the bellows shape can be effectively formed over a long period of time. In addition, it can be expected that the bellows itself can be restored when the device is to be restored to the original shape.

The waterproof property can be further enhanced by applying a waterproof coating to the surface material. In particular,
If the monofilament is about 15 denier, it is easy to achieve both the required strength and the overall thickness of the device, and if the multifilament is about 50 denier, the leakage prevention effect will be sufficient without making it thicker than necessary. Can be obtained.

Therefore, according to the present invention, a ring-shaped wire portion is provided between a pair of front and rear ring-shaped wire portions which are disposed in a pair at mutually divided positions and connected therebetween by a surface covering material, and are located between the two ring-shaped wire portions. The present invention can be extremely useful when applied to an implanting device comprising an intermediate ring-shaped wire portion in which an appropriate portion on the circumference is fixed to the surface material by sewing or bonding.

[Brief description of the drawings]

FIG. 1 is a perspective view showing an artificial blood vessel used in one embodiment of the present invention.

FIG. 2 is a partial longitudinal sectional view of the artificial blood vessel of the embodiment.

FIG. 3 is a perspective view showing an artificial blood vessel transfer device used in the embodiment.

FIG. 4 is a perspective view showing an artificial blood vessel introducing device used in the embodiment.

FIG. 5 is a partially enlarged longitudinal sectional view of a mounting section in FIG. 4;

6 is a partially enlarged longitudinal sectional view of the cartridge in FIG.

FIG. 7 is a perspective view showing a state in which the artificial blood vessel is loosely fitted on the outer periphery of the artificial blood vessel transfer device in the embodiment.

FIG. 8 is a perspective view showing a procedure for holding the artificial blood vessel in the artificial blood vessel transfer device in the embodiment.

FIG. 9 is a perspective view showing a procedure for holding the artificial blood vessel in the artificial blood vessel transfer device in the embodiment.

FIG. 10 is a partially enlarged perspective view showing a state in which the artificial blood vessel is held by the artificial blood vessel transfer device in the embodiment.

FIG. 11 is a perspective view showing a procedure for introducing an artificial blood vessel into a catheter in the embodiment.

FIG. 12 is a perspective view showing a procedure for introducing an artificial blood vessel into a catheter in the embodiment.

FIG. 13 is a perspective view showing a procedure for introducing an artificial blood vessel into a catheter using the artificial blood vessel introducing device in the embodiment.

FIG. 14 is an explanatory diagram showing the order in which the front ring-shaped wire portion of the artificial blood vessel is bent in the embodiment.

FIG. 15 is an explanatory view showing the order in which the front ring-shaped wire portion of the artificial blood vessel is bent in the embodiment.

FIG. 16 is an explanatory view showing the order in which the front ring-shaped wire portion of the artificial blood vessel is bent in the embodiment.

FIG. 17 is an explanatory diagram showing a state in which the front ring-shaped wire portion of the artificial blood vessel is bent in the funnel-shaped cylinder in the same embodiment.

FIG. 18 is an explanatory view showing a procedure in which the intermediate ring-shaped wire portion and the rear ring-shaped wire portion of the artificial blood vessel are bent in the embodiment.

FIG. 19 is an explanatory view showing a state in which the artificial blood vessel is bent in the embodiment.

FIG. 20 is an explanatory diagram showing a procedure for inserting the artificial blood vessel into the cartridge in the embodiment.

FIG. 21 is a view showing a state in which the artificial blood vessel is inserted into the cartridge in the embodiment.

FIG. 22 is an explanatory view showing a procedure for transferring the artificial blood vessel from the cartridge to the mounting portion in the embodiment.

FIG. 23 is a cross-sectional view showing a state in which the artificial blood vessel is transferred to the diseased part in the same example.

FIG. 24 is an explanatory view showing a procedure for releasing an artificial blood vessel into a blood vessel at an affected part in the same embodiment.

FIG. 25 is an explanatory diagram showing a procedure for releasing an artificial blood vessel into a blood vessel at an affected part in the same embodiment.

FIG. 26 is a sectional view showing a state in which the artificial blood vessel is released into the blood vessel at the affected part in the same example.

FIG. 27 is an explanatory view showing a procedure for further expanding the artificial blood vessel with a balloon catheter in the embodiment.

FIG. 28 is a principle view showing another embodiment of the present invention.

FIG. 29 is a principle view showing still another embodiment of the present invention.

FIG. 30 is a perspective view corresponding to FIG. 12, showing another embodiment of the present invention.

FIG. 31 is an enlarged perspective view of a main part of the embodiment.

FIG. 32 is an enlarged sectional view taken along line ZZ in FIG. 31;

FIG. 33 is a perspective view corresponding to FIG. 31 and showing a modification of the embodiment.

[Explanation of symbols]

A: Instrument (artificial blood vessel) 7: Surface material 10 ₁ ... Front ring-shaped wire portion 10 ₂ ... Rear ring-shaped wire portion 12 ... Intermediate ring-shaped wire portion

Claims (6)

[Claims] A plurality of bendable elastic ring-shaped wire members arranged at intermittent positions are connected by a tubular cover material formed of a flexible and stretched sheet. But weaving the warp along the axial direction of the device and the weft along the circumferential direction of the device, using a polyester monofilament with shape-retaining properties on the warp, waterproof to the weft An implanting device characterized by using a polyester multifilament having: 2. The implanting device according to claim 1, wherein the sheet of the covering material is formed in a bellows shape. 3. The implantable device according to claim 1, wherein the covering material is coated with a waterproof coating. 4. The implantable device according to claim 1, wherein the monofilament is about 15 denier. 5. The implantable device according to claim 1, wherein the multifilament has a denier of about 50. 6. A ring-shaped wire portion is provided between a pair of front and rear ring-shaped wire portions which are disposed in a pair at divided positions and connected therebetween by a surface mounting material, and is located on a circumference. The implanting device according to claim 1, 2, 3, 4, or 5, comprising an intermediate ring-shaped wire portion in which an appropriate portion is fixed to the surface material by sewing or bonding.