JP2001212243A - Medical guide wire - Google Patents

Abstract

PROBLEM TO BE SOLVED: To keep the blood flowing through a narrowed diseased part when the bulging part provided on the head section, in which a coil spring is loosely fit in a core material, of a medical guide wire is inserted into the part and improve the performance of the medical guide wire by facilitating its passage through the narrowed diseased part. SOLUTION: In the medical guide wire 1 the coil spring is continually provided with a leading coil section 5 with a coil external diameter D1, a bulging coil section 6 with a coil external diameter D2 following the leading coil section 5 and a final coil section 7 with a coil external diameter D1 following the bulging coil section 6. The coil spring is structured to meet the inequality of the coil external diameter D2 > the coil external diameter D1. Moreover the bulging coil section 6 is shaped like a spindle and provided with a gap C between the coil wire rods 8. When the medical guide wire is inserted into the diseased part 10, the gap C secures a channel 12 of blood flowing through the diseased part 10 and the rotation of the guide wire increases the advancement of the bulging coil section 6 through the diseased part 10.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical guidewire used as an insertion guide for a catheter to be inserted into a blood vessel when treating a vascular stenosis.

[0002]

2. Description of the Related Art For the purpose of angiography, a catheter having an ultra-fine flexible tube is inserted into a blood vessel, or a balloon catheter is inserted into a blood vessel for treating a stenotic region of a coronary artery. In order to ensure the safe insertion, a medical guidewire made of a flexible wire is used. Japanese Patent Publication No. 4-25024 and Japanese Patent Publication No. 4-2
There is a known example disclosed in Japanese Patent No. 92175.

[0003] Then, this medical guide wire (hereinafter, referred to as a medical guide wire)
The guide wire is simply inserted into the blood vessel / branch blood vessel of a tortuous and complicated path from the distal end, so that it is required to have flexible flexibility and vertical load resistance (buckling resistance) against a load in the traveling direction. Furthermore, since the terminal portion located outside the body is rotated and inserted into the blood vessel and advanced, it has both torsional rigidity corresponding to the rotation and a steering property that can operate the direction of the distal end portion in the blood vessel by operating the terminal portion. Mechanical properties are required, and there is a basic form in which a distal end portion of the basic form is formed by fitting a coil spring to an ultrafine wire core material mainly composed of a wire. In this basic form, the stenotic lesion is expanded by the tip portion inserted into the stenosis lesion portion, and the intent is to make it easier to indwell and set the balloon catheter. A structure having a portion is proposed in Japanese Utility Model Publication No. 5-19078.

[0004]

The above-mentioned known guide wire with a bulging portion has a certain effect of expanding the stenosis lesion by the bulging portion, but the bulging portion has a function of "wire wire". A separate swelling tubular body consisting of a tightly wound cylindrical coil spring or metal pipe is fitted to the guidewire and "brazed and fixed" so that the swelling reaches the stenotic lesion In such a case, it is difficult to secure the blood flow and hinder the treatment. In addition, the bulging portion does not have the effect of expanding the diameter of the stenotic lesion by the bulging portion itself, and is merely a function of temporarily expanding the diameter to make it easier to insert the balloon catheter. Furthermore, since the separate bulging portion is attached and fixed to the distal end portion of the guide wire, the forming process of the guide wire is complicated, troublesome and costly.

[0005] The present invention provides a guidewire which solves the above-mentioned drawbacks of the prior art.

[0006]

According to the present invention, there is provided a medical guidewire comprising a distal end portion in which a coil spring is loosely fitted on a long flexible core material, wherein the coil spring is A series of a leading coil portion having a thin coil outer diameter and a bulging coil portion having a thick coil outer diameter following the leading coil portion, and the bulging coil portion has a substantially weight-proof shape having a clearance between coil wires. A guide wire of the first invention consisting of

[0007] In a medical guidewire comprising a distal end portion in which a coil spring is loosely fitted in a long flexible core material,
The coil spring includes a series of a leading coil portion having a small coil outer diameter and a bulging coil portion having a large coil outer diameter following the leading coil portion, and the bulging coil portion is formed in a substantially weight-proof shape. And a combination of a main coil spring made of a main coil wire and a sub coil spring made of a sub coil wire having a diameter smaller than that of the main coil wire. A guide wire according to the second invention comprising a multi-spring structure having a spiral concave groove formed on the outer periphery thereof based on a wire diameter difference between the main coil wire and the sub coil wire with a sub coil wire interposed therebetween. ing.

That is, when the bulging coil portion provided at the distal end portion of the guide wire of the present invention is in a state of being tightly inserted into the stenotic lesion, the first wire according to the first aspect of the present invention relates to the gap between the wire between the coil spring and the coil. The blood flow passing through the inside of the stenosis lesion is secured by the "blood flow passing through the spiral groove on the outer periphery of the coil spring". By increasing the coil pitch, the "passability of the swelling coil portion through the stenosis lesion by one rotation of the guide wire" is improved, and further, the swelling coil portion is advanced and retracted within the stenosis lesion portion to thereby increase the coil pitch. The structure is characterized in that the outer periphery of the bulging coil portion whose size is increased is made to function as a scraping tool, and the stenosis lesion can be treated with a guide wire for diameter expansion.

[0009] The loose fitting of the coil spring in the present invention means that the core material has a play around the entire circumference and a part of the outer circumference of the core material having a rectangular cross section is joined to the inner circumference of the coil spring. Means what is done. Then, the bulging coil portion of the first invention is formed by a long tapered line gradually increasing in diameter from the front to the rear, or the bulging coil portion of the first second invention is connected in series via a neck portion. Sometimes.

[0010]

According to the guidewire of the present invention having the above-described structure, when the bulging coil portion is inserted into the stenosis lesion, "the blood flow path from the intercoil gap to the coil hollow portion" or "the outer periphery of the bulging coil portion" With the "existing spiral blood flow path", a blood flow path flowing through the stenotic lesion can be secured. Then, when the bulging coil portion in the inserted state is operated forward and backward, the outer periphery of the coil wire of the bulging coil portion joined to the stenotic lesion wall functions as a shaving tool for the morbid portion, and the guide wire itself is used for the stenotic lesion. Enlargement treatment works. And since the bulging coil portion has the above-mentioned substantially weight-proof shape, it can be gradually inserted into the stenotic lesion without difficulty, and a catheter tube is joined or temporarily locked to the rear end to follow and cooperate with the stenosis. Insertion of the treatment method becomes possible.

Further, when the bulging coil portion that has reached the stenotic lesion is advanced forward by rotating the rear end of the guide wire located outside the body, the bulging coil is joined to the inner wall of the stenotic lesion to lead the forward operation. Since the lead pitch of the outer periphery of the coil wire is large, the amount of advance for one rotation of the guide wire is increased as compared with the conventional example, and the operation of advancing and passing the affected part becomes extremely easy. Since the guide wire with the bulging portion of the present invention can be formed by forming a part of the coil spring loosely fitted to the distal end portion into a bulging coil, the conventional separate object is "brazed and retrofitted". It is simpler in structure than the one and can be formed easily and can be formed at low cost.

[0012]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS First, a guide wire according to an embodiment of the first invention will be described with reference to FIG. That is, in the guide wire 1 composed of the distal end portion 2 in which the coil spring is loosely fitted to the core material 3 of the flexible elongated body, the coil spring has a coil outer diameter having a rounded leading plug 4 attached to the distal end. D
1, a leading coil section 5, a bulging coil section 6 having a coil outer diameter D2 following the leading coil section 5, and a succeeding coil section 7 having a coil outer diameter D1 following the bulging coil section 6. The leading coil portion 5, the bulging coil portion 6, and the succeeding coil portion 7 are formed of a single coil wire 8 having a common coil core 11.
And a coil spring having a coil outer diameter D1
D2 has a size relationship of “D1 <D2”.

More specifically, the leading coil section 5 and the succeeding coil section 7 are coil springs in which a coil wire 8 is wound tightly.
The bulging coil portion 6 is a line gap coil spring having a clearance C between the coil wires 8, and gradually increases from the coil outer diameter D1 of the leading coil portion 5 to the coil outer diameter D2 of the bulging coil portion 6. The leading coil part 5 and the succeeding coil part 7 are integrated through the coil diameter gradually changing part 9A and the coil diameter gradually changing part 9B which gradually reduces the coil outer diameter D2 from the coil outer diameter D2 to the coil outer diameter D1 of the succeeding coil part 7, It has a substantially anti-weight shape in which several coils of the coil outer diameter D2 are present.

(See FIG. 1B) Stenosis lesion 10
The swelling coil portion 6 of the guide wire 1 inserted into the blood vessel for treatment of the lesion 1
0 to expand the diameter and insert the guide wire 1 as a guide to insert the balloon catheter into a lesion 1
0, the wall of the swelling part 10 is scraped off by the outer periphery of the coil wire 8 of the bulging coil part 6 by expanding and retracting in the direction of the arrow in the insertion state shown in the drawing, and the diameter of the morbid part 10 is enlarged. The treatment is to be given. The guide wire 1 of the embodiment shown in FIG.
= 0.355 mm, coil outer diameter D2 = about 0.56 mm, length of leading coil section 5 = about 40 mm, bulging coil section 6
Length = approximately 5 mm, the total coil length from the leading end of the leading coil section 5 to the rear end of the succeeding coil section 7 = approximately 300 mm, the diameter of the coil wire 8 = approximately 0.09 mm, and the interline gap C is a thrombus. Is set to such a small amount that does not cause Although not shown, the distal end portion 2 of the guide wire 1 of the embodiment shown in FIG. 1 has a separate bulge near the distal end of a single coil spring having a small outer diameter from the leading coil portion 5 to the succeeding coil portion 7. There is a case where the output coil portion 6 is externally fitted and brazed to form a "coupling form of two coil springs".

The guide wire 1 of the embodiment shown in FIG. 1 has the above-mentioned action, and can secure the blood flow 12 flowing through the lesion 10 through the interline gap C when inserted into the lesion 10. By the above-described reciprocating operation, effective diameter enlargement treatment of the lesion 10 can be performed, and the distal end portion 2 is rotated to change the lesion 1
When passing through zero, the amount of advance of the distal end portion 2 with respect to one rotation of the guide wire 1 is large, so that the lesion 10 can be quickly and easily passed.

Further, the distal end portion 2 of the guide wire 1
Since the bulging coil portion 6 is an interline gap coil, the bending deformation centering around the coil core 11 is particularly easy to bend as compared with the conventional cylindrical bulging portion (the clearance C exists). So that the coil core 11 can be easily bent as a bending neutral surface,
And is bent to a small radius of curvature), the insertion progresses into a blood vessel that bends in a complicated manner, and the insertion passes through “various forms of lesions 10 such as eccentric, irregular, complex, and long-sized”. There is a specific effect that makes it easier.

Next, another embodiment of the bulging coil portion 6 of the first invention will be described with reference to FIG. That is, in FIG. 2A, the coil wire 8 has a wire diameter d1 from the front to the rear.
To d2, a long tapered coil wire 8A having a gradually increasing diameter is used. The bulging coil portion 6 shown in FIG. 2A has a configuration in which the front portion has high flexibility and flexibility to increase the deformation rigidity toward the rear portion. It is safer and smoother with no burden on the resistance.

FIGS. 2 (B) and 2 (C) show another embodiment of the substantially weight-proof shape of the bulging coil portion 6.
(B) shows the maximum coil diameter D2 at the intermediate point.
2C has a stepped portion 15 due to a coil diameter difference between the bulging coil portion 6 and the succeeding coil portion 7. The distal end of the catheter tube 16 is joined to the step 15 and set. In addition, although not shown, a flat wire having a rectangular cross section may be used as the coil wire 8 in another embodiment.

Next, a guide wire according to an embodiment of the second invention will be described with reference to FIG. That is, in the case of the tip portion 2 composed of the “leading coil portion 5, the bulging coil portion 6, and the subsequent coil portion 7” similar to the embodiment of FIG. 1, the bulging coil portion 6 of the FIG. The main coil spring 20 having a diameter of the coil wire 8B and a coil outer diameter D2 "and the auxiliary coil wire 8C having a small diameter and a coil outer diameter D2
The sub-coil spring 21 having a smaller coil outer diameter D6 is combined with the same coil core 11, and integrated into the play space C of the coil wire 8B of the main coil spring 20 with the coil wire 8C of the sub-coil spring 21 interposed. And the spiral concave groove 19 due to the diameter difference between the two types of coil wires 8B and 8C.
Is provided on the outer periphery, and the concave groove 19 forms a spiral coil flow path forming a spiral blood flow path 22 that appears along the outer periphery of the bulging coil portion 6.

The guide wire of FIG. 3A has the following specific action. That is, from a healthy blood vessel to a stenosis lesion 1
The blood flow around the guide wire approaching the stenosis lesion 1
0, the blood flow path is narrowed, and the blood flow speed is increased to enter the spiral blood flow path 22 and flow at a high speed spiral. F and its own rotational force T are generated and applied. Accordingly, the introduction of the guide wire distal end portion 2 into the lesion 10 and the indwelling set are performed by adding the “self-propelling force F and the self-rotating force T” to the manual operation force of the extracorporeal rear end portion. Since the mobility is improved, the operation is further facilitated, and the operation force to be transmitted by the intermediate portion of the guide wire is reduced, so that the strict mechanical properties required for the guide wire can be alleviated slightly. Then, the spiral blood flow path 22 has a “slip agent pool groove” when a slip agent is applied to the distal end portion for the purpose of improving the insertability into a blood vessel.
There is a side effect that can be utilized as well.

The multi-strand coil spring shown in FIG. 3A has a coil wire 8B in which the main coil spring 20 and the sub coil spring 21 are combined (see FIGS. 3B and 3C). A clearance C1 is provided between 8C to further improve the blood flow action, or the main coil spring 20 composed of the large-diameter coil wire 8B and the two sub-wires composed of the small-diameter wire 8C and 8D. Coil springs 21A and 21B "are combined to form a three-row spring configuration, and the three kinds of coil wire rods serve to reduce the flow capacity of the spiral blood flow path 22 of the concave groove 19 appearing on the outer periphery of the bulging coil portion 6. There may be a mode to further improve.

Next, another embodiment of the first and second inventions is shown in FIG.
It will be described based on. That is, in the apparatus having the swelling coil section 6 shown in the embodiment of FIGS. 1 and 3, the swelling coil section 6 is connected in series via the neck section 13 in two units of 6A and 6B or in three units of 6A, 6B and 6C. In the form, the coil outer diameter D2 of the front 6A and the coil outer diameter D3 of the rear 6B and 6C
・ The diameter may be gradually increased to D4. In this embodiment, by setting the outer diameter D2 of the coil 6A at the distal end to an appropriate amount, the insertion resistance to the lesion 10 is reduced as much as possible, and a safer, smoother and faster insertion passage operation and expansion treatment are performed. Can be. In the coil spring of the guide wire according to the present invention, the trailing coil portion 7 may be omitted.

The guide wire 1 of the present invention in each of the above embodiments.
Has a substantially weight-proof bulging coil portion 6 and can be effectively used in the following treatment method. That is, when the known stent placed and set in the lesion 10 subjected to the diameter expansion treatment causes an abnormality such as strain reduction and deformation, and needs to be re-treated, the distal end of the bulging coil portion 6 reinserted into the lesion 10 is used. The abnormally deformed stent is gradually expanded in diameter and returned to a normal shape, and a balloon catheter for maintaining the normal shape can be extremely easily and accurately set inside the stent.

[0024]

As described above, the medical guidewire according to the present invention makes it possible to more quickly and easily insert and guide a guidewire for introducing and setting a catheter into a stenotic lesion, and to further enhance the stenosis lesion. Ensures blood flow through the lesion at the time of insertion into the stenosis, alleviates pain and improves treatment for patients with stenosis lesion treatment, and enables the treatment of the stenosis lesion with the guidewire itself to expand the diameter. Improve the performance. And the above-mentioned useful guide wire with a bulging portion can be mass-produced at low cost. There are the above effects.

[Brief description of the drawings]

FIG. 1 shows a guide wire according to a first embodiment of the first invention,
(A) is a front view of the tip portion, (B) is a front view of the use state.

FIG. 2 shows a bulging coil portion of another embodiment of the first invention,
(A), (B), and (C) are front views thereof.

3A and 3B show a bulging coil portion of a guide wire according to an embodiment of the second invention, wherein FIG. 3A is a front view of one example, and FIGS. 3B and 3C are partial front views of another embodiment.

FIG. 4 is an explanatory view of another embodiment of the bulging coil portion of the guide wire according to the first and second inventions.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Guide wire 2 Tip part 3 Core material 4 Leading plug 5 Leading coil part 6 Swelling coil part 7 Subsequent coil part 8 Coil wire 9A / 9B Diameter gradually changing part 10 Stenosis lesion part 11 Coil core 12 Blood flow path 13 Neck part 15 Step 16 Balloon catheter 19 Spiral concave groove 20 Main coil spring 21 Secondary coil spring 22 Spiral blood flow path D Coil outer diameter d Coil wire diameter

 ──────────────────────────────────────────────────続 き Continuing on the front page (72) Inventor Shoji Momota 3-100 Akatsuki-cho, Seto-shi, Aichi Prefecture Inside Asahi Intec Co., Ltd. (72) Inventor Tomohisa Kato 3- 100 Akatsuki-cho, Seto-shi, Aichi 100 Asahi Intec Inside the corporation

Claims (4)

[Claims] 1. A medical guide wire comprising a distal end portion in which a coil spring is loosely fitted in a long flexible core material,
The coil spring has a series of a leading coil portion having a small coil outer diameter and a bulging coil portion having a large coil outer diameter following the leading coil portion, and the bulging coil portion has a gap between coil wires. A medical guidewire having a structure formed in a substantially weight-proof shape. 2. The medical guidewire according to claim 1, wherein the coil wire of the bulging coil portion is a long taper coil wire whose diameter gradually increases from front to back. 3. A medical guide wire comprising a distal end portion in which a coil spring is loosely fitted in a long flexible core material,
The coil spring includes a series of a leading coil portion having a small coil outer diameter and a bulging coil portion having a large coil outer diameter following the leading coil portion, and the bulging coil portion is formed in a substantially weight-proof shape. And a combination of a main coil spring made of a main coil wire and a sub coil spring made of a sub coil wire having a diameter smaller than that of the main coil wire. A medical guide wire having a multi-spring configuration in which a sub-coil wire is interposed, and a spiral concave groove based on a wire diameter difference between the main coil wire and the sub-coil wire is provided on the outer periphery. 4. The bulging coil portion is connected in series via a neck portion, and the outer diameter of the coil gradually increases from the bulging coil portion at the front of the tandem mounting to the bulging coil portion at the rear. The medical guidewire according to claim 1 or claim 3.