JP2003010194A - Method and device for intravascular operation using catheter adopting reverse injection technology of liquid current - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a reverse injection technology of a catheter using a pressure circulating circuit in which a flow region reverse to the flowing direction of a liquid pressurized and supplied into an inner tube of a coaxial double tube is formed between the inner and outer tubes by turning the injection direction of a liquid jet by a nozzle part. SOLUTION: The outer tube of the double catheter tube is used for suction, and the inner tube is used for pressurizing and injecting liquid. The tip of the inner tube is provided with the nozzle part for turning the injection direction backward, and the nozzle part is projected from a suction tube opening to thereby break a lesion part and thrombus, and the nozzle part is drawn into the suction tube to thereby improve the suction and collect work for injected medicinal liquid and broken pieces.

Description

Detailed Description of the Invention

[0001]

TECHNICAL FIELD The present invention relates to a medical catheter, and more particularly to a catheter technique for treating lesions in blood vessels and organs.

[0002]

2. Description of the Related Art A catheter technique with a nozzle for injecting a drug solution has been proposed as a method for removing thrombus in a blood vessel. In order to integrally configure the nozzle portion at the tip of the catheter thin tube, the tip is thinned because it depends on pressure and pressure from the outside, which causes the accident of perforating the curved wall of the blood vessel. There is also a method in which the nozzle portion is made of a different material and is attached to the tip of the injection pipe, but the conventional treatment method using nozzle injection has a problem in its effectiveness, and it is the current situation that it cannot be put to practical use. In other words, the method of destroying intravascular lesions / thrombus by direct injection of the chemical solution in the anterior region is such that the destroyed lesion or thrombus is diffused into the blood vessel in the area prior to the injection together with the drug solution, making it difficult to recover, and this causes blockage of other small blood vessels. As a result, problems such as restriction on the quality and amount of the used drug solution occur, and there is no decisive factor for cleaning up the supplied drug solution, lesion debris, thrombus debris, etc. even though the thrombus can be opened temporarily. Solving the problem is the most important issue in developing thrombus removal methods.

[0003]

DISCLOSURE OF THE INVENTION The present invention relates to a method for destroying / removing a thrombus in a blood vessel, and a lesion piece subdivided by the destruction.
The challenge is to present a method and device for collecting and discharging the thrombus and the drug solution used for destruction to the other area in the shortest time without dissipating to other areas. It is intended for presentation.

[0004]

The present invention uses a catheter tube having a dual structure of an outer tube and an inner tube coaxially with each other, and the outer tube is a suction tube and the inner tube is a jetting tube, and the tubes are movable at intervals. It is a structure having. In the tip region of the inner tube, the nozzle hole direction is directed so as to reverse the flow of the chemical liquid supplied under pressure from the rear part of the inner tube and eject the liquid backward. Therefore, when the injection is performed in the outer pipe, a flow region opposite to the flow of the inner pipe is pressurized in the space between the outer and inner pipes, which performs a suction action, by the backward injection. In other words, the reverse injection in the suction pipe forms a pressurized circulation circuit of the chemical liquid in the inner pipe and the suction pipe. Therefore, even if the suction port is brought close to the thrombus during injection of the drug solution, the drug solution is not supplied into the blood vessel, but the suction port is brought close to the thrombus part, and the injection nozzle part is projected from the suction port to allow the drug solution to enter the thrombus. Is a mechanism that is injected and supplied. In this case, since the suction port is positioned in the flow direction of the thrombus piece or lesion piece that is destroyed or subdivided by the reverse injection,
The debris will be captured and sucked at the suction port together with the drug solution. In this case, if the space between the outer tube portion of the suction port and the inner wall of the blood vessel is temporarily closed by a balun, an ideal collection and elimination action is realized, and the collection purpose is completely achieved. In addition, if an operation is performed in which the tip portion that has been projected and destroyed is pulled into the suction tube, a large negative pressure is generated in the suction port due to the pulling action, and this action also enlarges the volume of the suction portion. Pieces can be collected.

[0005]

BEST MODE FOR CARRYING OUT THE INVENTION An embodiment of the present invention will be described below with reference to the drawings. Inner pipe (1) and outer pipe (2) of FIG.
The inner tube distal end portion (4) of the coaxial double catheter (3) of FIG. (6) is formed in plural. Therefore, if injection is performed inside the outer pipe,
In the space (7) of the outer pipe, a flow field in the direction opposite to the inner pipe inner flow is formed under pressure. The outer tube is connected in advance to the negative pressure chamber (8) so as to perform the role of a suction tube, and all the liquid injected into the outer tube returns to the negative pressure chamber. In this state, as shown in FIG. 2, the suction port (9) is brought close to the atheroma (11) and the thrombus (12) in the blood vessel (10), and the inner tube nozzle is projected into the thrombus to inject the energy. The thrombus, which is the cause of the flow inhibition, is broken down into subdivisions, and is reliably sent out by jet flow in the direction of the suction port (9) without being scattered in the front area (13), with the purpose of suctioning / removing from the suction port in a negative pressure atmosphere. To be achieved. This method not only removes blood clots and the like, but also can supply the drug solution to the vascular lesion without dissipating into the blood vessel, so that a powerful drug solution effective for treatment can be used. Also, as shown in Fig. 3, insert the inner tube into the thrombus.
If the operation of penetrating and then retracting and moving in the direction of the negative pressure chamber rather than the suction port is performed alternately, the negative pressure in the suction port will increase with the withdrawal action, and at the same time the volume of the suction path will also increase, resulting in a large lesion. Can remove and eliminate pieces and thrombus pieces. In this case, if a balloon device (14) is provided in the vicinity of the suction port and the blood flow is temporarily cut off and the operation is performed, complete recovery treatment of the supplied chemical liquid, broken pieces, etc. can be realized.

[0006]

INDUSTRIAL APPLICABILITY The present catheter device has a hemispherical inner tube tip shape, which is convenient for using the inner tube pressurized liquid delivery path as a guide wire use passage, and the outer tube suction port and the inner tube tip are the same. Once inserted, there is no risk of the vessel wall being damaged by the tip. Furthermore, the inner pipe injection pressure is 1-3MP
The high pressure of a and high pressure are not required, and the inflow characteristic of the rearward inverted jet into the outer suction tube reduces the negative pressure load on the outer tube by the supplied reverse flow in the negative pressure atmosphere of the suction tube. This makes it possible to use a flexible catheter by utilizing the pressure balance of the supplied chemical liquid without using a rigid high pressure catheter tube containing a metal mesh that impairs the flexibility required for the catheter. Also, regarding the supply of the injection liquid to the affected area, the necessary injection can be performed in a timely manner by forming and retracting the nozzle by forming a self-circulating circuit of the liquid, and at the same time suction and recovery of the liquid and debris can be performed, so excess chemical liquid The risk of mixing inside is also avoided. In the present embodiment, the method / apparatus was mainly described for removing thrombus in the blood vessel / treatment of the affected area by the jetting energy of the liquid, but the basic principle is to pressurize the inside of the thin tube by defining the jetting direction of the liquid using the reverse jet nozzle. This is a technique for forming a circulation circuit. Therefore, according to the application of the present technology, it is possible to perform an X-ray or endoscopic operation on a lesioned part of an organ without using a large mallet-shaped device having a double tube structure made of a hard material. For example, it becomes possible to partially remove an organ lesion and to intensively administer an anticancer drug or drug. In addition, the adhesion part in the abdominal cavity and washing can be effectively performed. As described above, the present invention is a technology that can greatly contribute to the development of medical science related to life.

[Brief description of drawings]

FIG. 1 is an enlarged cross-sectional view in which a device is brought close to a thrombus portion in a blood vessel.

FIG. 2 is an enlarged cross-sectional view of a case where injection is performed into a thrombus.

FIG. 3 is an enlarged cross-sectional view of a suction path by pulling out an inner tube.

[Explanation of symbols]

1 ... Inner tube 2 ... Outer tube 3 ... Double catheter 4 ... Inner tube tip 5 ... Pressurized liquid feeding pipe 6 ... Nozzle injection hole 7 ... Space 8 ... Negative pressure chamber 9 ... Suction port 10 ... Blood vessels 11 ... Atheromatous part 12 ... Thrombus 13 ... upstream region of blood vessel 14 ... Balun device 15 ... Pressurizing device 16 ... Small lesion pieces destroyed 17 ... Large blood clot ←… Flow injection direction

Claims (7)

[Claims] 1. A dual catheter tube in which a liquid pressure jetting catheter tube is coaxially inserted into a suction catheter tube, and a liquid flow for supplying pressure is supplied to the tip region of the pressure jetting catheter tube. Inverted with respect to the axis, the injection hole is directed so as to inject toward the rear side, and the reverse injection nozzle section is formed.
A catheter treatment method in which a suction tube mouth is brought close to an affected area or a reverse injection nozzle is projected into a thrombus to remove a blood clot or treat a blood vessel by a reverse injection action of a drug solution. 2. A catheter having a dual structure in which a liquid pressure injection catheter is enclosed in a suction catheter,
A structure in which there is a space between the inner diameter of the suction pipe and the outer diameter of the injection pipe, and by injecting into the suction pipe as a backward injection with the injection direction from the tip of the injection pipe, a backward flow circuit by pressurizing the space between the inner and outer pipes. And a catheter device for improving the suction action by the action of extracting the inner tube. 3. A dual catheter tube which is flexible and carries out jetting and suctioning, and has a suction port and a jetting hole which are hardened and reinforced with a material whose only catheter tip region is visible by X-rays. 2. The catheter device according to 2. 4. The thrombus according to claim 1, wherein the injection catheter portion in the suction catheter is configured to be freely insertable and withdrawable, and the suction action and the suction volume portion are expanded with the withdrawal action of the injection catheter portion. Suction removal method. 5. A lesion or thrombus is formed by inserting a suction catheter into the vascular lesion or thrombus from the downstream region of the blood vessel to bring the suction port close to the lesion and causing the medicinal solution injection unit to project or retract. The method for vascular catheterization according to claim 1, characterized in that the lesion piece, the thrombus piece, and the drug solution are aspirated and collected by destroying and destroying the drug solution. 6. The catheter device according to claim 1, further comprising a balun device capable of temporarily stopping blood flow in the outer tube region of the suction tube. 7. The jet nozzle device according to claim 2, wherein a disc-shaped jet pattern is formed laterally or at a rear angle.