JP2004105378A - Catheter for diagnosis and treatment, and fixing mechanism of medical implement - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To keep the inserted length of a catheter body 11 for diagnosis and treatment into a human body by preventing the catheter body 11 from slipping out to the outside of the human body after inserting the catheter body 11 into the human body and positioning it to a specific region. <P>SOLUTION: The catheter 1 consists of: the catheter body 11 consisting of a flexible tube; and a keeping tube 3 for keeping the inserted length in a state where the catheter body 11 is inserted into the human body. The tube 3 is slidable with respect to the catheter body 11, can be positioned by a projection part 2 formed on the catheter body 11, and can be fixed to the outside of the human body with a fixing lip 4 attached to the tube 3 in the state of being rotatable with respect to the catheter body 11. Thus, the catheter body 11 is prevented from slipping out to the outside of the human body and the inserted length into the inside of the human body is preserved. <P>COPYRIGHT: (C)2004,JPO

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to a catheter for diagnosis and treatment and a fixing mechanism for a medical device, a catheter for diagnosis and treatment capable of maintaining a length of insertion into a human body, and easily performing operations such as rotation, and a medical device. The present invention relates to a container fixing mechanism.
[0002]
[Prior art]
Diagnosis and treatment of human tubular organs such as blood vessels, gastrointestinal tracts, and ureters are performed by inserting a tubular catheter into the tubular organ, leading to the target site, and inserting various agents such as a contrast agent, guide wire, balloon catheter, and stent into the tube. This is done by injecting or inserting a device.
[0003]
Conventionally, as such a catheter for diagnosis and treatment, in order to safely and accurately reach a target site without damaging a blood vessel wall or the like, a catheter distal end portion has a substantially L-shape (for example, see Patent Document 1). A device equipped with a fixing device for attaching a locking wire to a mandolin inserted into a tube and locking the wire to a locking portion provided at the rear end of the catheter (for example, see Patent Document 2), or an organ of a human body There is a method in which a biopolymer is immobilized by a covalent bond on the outer surface of a catheter directly in contact with the catheter (for example, see Patent Document 3).
[0004]
[Patent Document 1]
JP-A-2002-85570 (No. 3-4 tribute, FIG. 1)
[Patent Document 2]
Japanese Utility Model Publication No. Sho 62-84441 (FIG. 1)
[Patent Document 3]
JP 2001-129074 A (No. 4-9, FIG. 2)
[0005]
[Problems to be solved by the invention]
When the catheter is inserted into the human body or reaches a specific site, the repulsive force due to friction with the organ walls, steric obstacles, etc. is large, and the force that constantly pushes the catheter out of the human body is applied to the catheter. Works. For this reason, as described above, the conventional catheter focuses on insertion into a human body, improvement in operability in reaching a specific site, and prevention of damage to organ walls.
[0006]
However, the repulsive force as described above continues to act even after the distal end portion of the catheter reaches the target portion, so that the position of the catheter becomes unstable, and the catheter slides out of the human body and is displaced. On the other hand, in diagnostic treatment, it is necessary to hold the catheter at a desired position in the human body for a certain period of time for inserting various devices. For this reason, it is necessary to prevent the catheter from slipping out of the human body and to maintain the insertion length in the human body.
[0007]
[Object of the invention]
An object of the present invention is to provide a diagnostic treatment capable of preventing insertion of a catheter main body into a human body and positioning the catheter main body at a specific site, and then preventing the catheter main body from sliding out of the human body, thereby maintaining the length of insertion into the human body. To provide a catheter for medical use.
[0008]
[Means for Solving the Problems]
Claim 1 is a diagnostic / treatment catheter comprising a catheter body made of a flexible tube and a holder for holding the insertion length in a state where the catheter body is inserted into a human body, The holder is slidable with respect to the catheter main body and attached so as to be positionable in the axial direction, and can be fixed to the outside of the human body while being rotatable with respect to the catheter main body.
[0009]
According to a second aspect of the present invention, there is provided the catheter for diagnosis and treatment according to the first aspect, wherein the retainer can be positioned in the axial direction of the catheter by engaging with a protrusion provided on the catheter body. And
[0010]
According to claim 3, the diagnostic treatment catheter according to claim 1, further comprising a protrusion that can be moved to an arbitrary position on the catheter body, and the holding tool engaging with the protrusion, It can be positioned in the axial direction of the catheter body.
[0011]
According to a fourth aspect of the present invention, there is provided the catheter for diagnosis and treatment according to the first or second aspect, wherein the holder is a tubular member, and the catheter body is inserted into the tubular member. The present invention is characterized in that the member is slid and engaged with the protruding portion to position the tubular member.
[0012]
According to a fifth aspect of the present invention, there is provided the diagnostic / treatment catheter according to any one of the first to fourth aspects, wherein the holding tool includes a lip portion protruding toward the distal end of the catheter body, and the lip portion allows the outside of the human body. It is characterized by being fixed to.
[0013]
According to a sixth aspect of the present invention, there is provided the diagnostic treatment catheter according to any one of the first to fifth aspects, wherein a lubricant is applied to the catheter body.
[0014]
According to a seventh aspect of the present invention, there is provided the catheter for diagnosis and treatment according to the sixth aspect, wherein the catheter main body includes a portion to which the lubricant is not applied and a portion for operating the catheter. I do.
[0015]
According to claim 8, a medical device fixing mechanism including a medical device main body formed of a flexible tube inserted into a human body and a holding device for holding the insertion length of the tube into the human body, wherein the holding device is A part of the medical device main body that is not inserted into the human body can be slid, can be positioned in the axial direction of the tube, and can be fixed outside the human body in a rotatable state. I do.
[0016]
Function and Effect of the Invention
According to the first aspect of the present invention, it is possible to prevent the catheter body from slipping out of the human body by the holder for holding the insertion length of the catheter body into the human body. In addition, since the holder can slide on the catheter body and can be positioned in the axial direction, it can be positioned at a position on the catheter body that is located outside the human body, and does not adversely affect the human body. Further, since the holder is rotatable with respect to the catheter main body, diagnosis and treatment can be performed while preventing the catheter main body from sliding out of the human body.
[0017]
According to the second aspect of the present invention, since the positioning can be performed by engaging the holder with the protrusion provided on the catheter body, the positioning of the holder can be performed with a very simple mechanism. Further, in the positioning mechanism of the present invention, the catheter body can be moved in the direction of entering the human body, so that the operation is easy in diagnostic treatment.
[0018]
According to the invention of claim 3, since the projecting portion can be moved to an arbitrary position on the catheter main body, the holding tool on the catheter main body depends on the size of the person or the position where the holding tool is fixed outside the human body. Can be determined.
[0019]
According to the fourth aspect of the present invention, the holding member is a cylindrical member, and the catheter body is inserted into the cylindrical member, so that the holding member can slide on the catheter body very easily.
[0020]
According to the fifth aspect of the present invention, the lip portion of the holder can be fixed to the outside of the human body using forceps, tape, or the like, so that the catheter can be easily fixed.
[0021]
According to the invention of claim 6, diagnostic treatment can be performed while preventing the catheter body from slipping out of the human body by the holding tool, and the sliding property between the outer surface of the catheter body and the organ wall is reduced. The improvement can solve problems such as insertion into a human body, improvement in operability in reaching a specific site, and prevention of damage to organ walls.
[0022]
According to the seventh aspect of the present invention, since the operation can be performed at the portion where the lubricant is not applied during the diagnosis and treatment, hand slip during operation can be prevented, and erroneous operation can be prevented.
[0023]
According to the invention of claim 8, it is a medical device main body made of a widely flexible tube regardless of the catheter, and needs to be inserted into a human body and to maintain the insertion length into the human body. Can be provided.
[0024]
BEST MODE FOR CARRYING OUT THE INVENTION
An embodiment of the present invention will be described with reference to FIGS.
In the embodiment, a guiding catheter for the coronary artery of the heart will be described. The guiding catheter for the coronary artery is inserted into the radial artery A from the patient's wrist and positioned by locking the distal end of the catheter at the opening at the entrance of the coronary artery B of the heart as shown in FIG. It is.
[0025]
A first embodiment of the present invention will be described with reference to FIGS. The catheter 1 used in the first embodiment has a catheter main body 11 formed of a flexible tube and a bent distal end provided on the distal end side of the catheter main body 11 and having a distal end locked to the coronary artery B. And a connector 13 provided on the distal side of the catheter body 11 for injecting various devices.
[0026]
A projecting portion 2 made of resin is fixed to the catheter body 11 and is locked by a holding tube 3 described later. The protruding portion 2 is fixed to a portion that is not inserted into the human body from the viewpoint of preventing damage to the organ wall, but is preferably within 50 cm from the end of the catheter body 11 in consideration of operability in diagnostic treatment.
[0027]
Between the protruding portion 2 and the connector 13, there is a cylindrical resin holding tube 3. The catheter body 11 is inserted into the holding tube 3, and the holding tube 3 is slidable and rotatable relative to the catheter body 11. The inner diameter of the holding tube 3 is set to be substantially smaller than that of the projection 2, and the sliding of the holding tube 3 is regulated by the projection 2.
[0028]
A fixing lip 4 is attached to the holding tube 3 in a direction toward the bent distal end portion 12. As shown in FIG. 1 or FIG. 2, the fixing lip 4 is fixed to the outside of the human body with a tape, an arm band, forceps, or the like, such as a patient's body surface, a sterilized sheet covering the patient, and a fixing aid on which the patient is placed. Is done.
[0029]
As shown in FIGS. 1 and 5 (a), the holding tube 3 and the fixing lip 4 may be made of metal, instead of resin. The fixing lip 4 can be made of not only a material having high rigidity such as resin but also an elastic body such as rubber.
The cross-sectional shape of the holding tube 3 does not need to be circular but may be polygonal such as square or hexagonal as long as the protrusion 2 can be locked as described later.
[0030]
On the other hand, in the catheter body 11, the outer surface of the portion from the protruding portion 2 to the bent tip portion 12 is made of a hydrophilic material to improve operability in insertion into a human body, reach a specific site, and prevent damage to organ walls. The polymer has been applied. As the hydrophilic polymer, for example, polyvinylpyrrolidone, hyaluronic acid or the like is used, and in addition to the hydrophilic polymer, silicon or the like is also used as a lubricant.
As shown in FIG. 1, an operation unit 14 operated by a doctor is provided at a position very slightly closer to the bent end portion 12 than the protruding portion 2, and the operation unit 14 has malfunction due to hand slippage or the like. No lubricant is applied to prevent The operation unit 14 is formed of, for example, a resin.
[0031]
When the catheter 1 having the above configuration is used, it is possible to prevent the catheter 1 from slipping out of the human body after the bent distal end portion 12 is positioned at the opening of the entrance of the coronary artery B of the heart.
That is, since the holding tube 3 is fixed outside the human body by the fixing lip 4, when the catheter body 11 tries to slide out of the human body, the protruding portion 2 is locked by the holding tube 3 to prevent the catheter 1 from slipping out. be able to.
On the other hand, since the holding tube 3 is rotatable with respect to the catheter main body 11, the catheter main body 11 can be rotated in the human body even after the protrusion 2 is locked by the holding tube 3.
[0032]
Further, the catheter main body 11 does not retreat outside the human body due to the engagement of the protrusion 2 with the holding tube 3, but can be inserted into the human body. For this reason, when it is desired to make fine adjustment in the insertion direction, the catheter body 11 can be easily advanced. At this time, if it is desired to maintain a new insertion length, the tape connecting the fixing lip 4 and the outside of the human body is removed, and if the connection is made to a new place outside the human body, the catheter can be prevented from slipping out again. .
[0033]
Furthermore, the protrusion 2, the holding tube 3, and the fixing lip 4 that constitute the fixing mechanism in the catheter 1 are provided on the distal side of the catheter 1, and are not inserted into the human body. For this reason, it is not necessary to apply extra deformation to the portion of the catheter body 11 to be inserted into the human body or the bent distal end portion 12, and there is no adverse effect on the human body.
[0034]
Further, in the catheter body 11, as described above, the outer surface of the portion from the protruding portion 2 to the bent distal end portion 12 is used for insertion into a human body, improvement in operability in reaching a specific site, and prevention of damage to organ walls. , A hydrophilic polymer is applied.
In particular, in the case of a guiding catheter that is inserted from the radial artery and locked in the coronary artery, the radial artery is thin, so that there is a problem that vasospasm is likely to occur in the blood vessel while the catheter is being inserted. In order to reduce this adverse effect, it is effective to impart lubricity by applying a hydrophilic polymer or the like.
[0035]
Therefore, the locked state of the bent distal end portion 12 with respect to the coronary artery B becomes more and more unstable due to the lubricity of the outer surface of the catheter body 11. However, if the catheter 1 as in this embodiment is used, the insertion length of the catheter main body 11 in the human body can be maintained by the engagement between the protrusion 2 and the holding tube 3, so that the bent distal end portion 12 with respect to the coronary artery B The locked state can be stabilized.
[0036]
Next, a second embodiment of the present invention will be described with reference to FIG. In the present embodiment, the protrusion 2 is movable with respect to the catheter body 11 and can be fixed at an arbitrary position on the catheter body 11. That is, in the present embodiment, the protruding portion 2 is composed of the bolt portion 21 and the nut portion 22, the catheter body 11 is inserted through the bolt portion 21, and the bolt portion 21 can freely move on the catheter body 11.
[0037]
When the bolt 21 is tightened by the nut 22, the inner cylinder of the bolt 21 is pressed against the outer surface of the catheter body 11. For this reason, the protrusion 2 can be fixed to an arbitrary position on the catheter body 11 according to the length of insertion into the human body, and the protrusion 2 is locked to the holding tube 3, so that the catheter body 11 can be prevented from slipping out of the human body.
The method of fixing the protrusion 2 is not limited to a screw mechanism using a bolt / nut, and the protrusion 2 may be fixed on the catheter body 11 with a tape or the like.
[0038]
Next, a third embodiment of the present invention will be described with reference to FIG. In this embodiment, the protrusion 2 is formed integrally with the catheter body 11. Therefore, the projecting portion 2 and the catheter body 11 have a step, and the step is locked by the holding tube 3, so that the catheter body 11 can be prevented from slipping out of the human body.
[0039]
(Modification)
The fixing lip 4 attached to the holding tube 3 in the first embodiment is not an essential component as shown in the second and third embodiments. That is, the holding tube 3 itself can be directly fixed to the outside with a tape or the like. Further, as shown in FIGS. 5B to 5D, the holding tube 3 may be attached to both sides or a plurality of attachment tubes. Further, the shape of the fixing lip 4 is not limited to the shape of the first embodiment, and may be a flat plate as shown in FIG. In this case, the attachment to the outside is more stabilized by the flat plate. Alternatively, an adhesive may be applied to the lip portion in advance so as to have an adhesive function, so that the lip portion can be easily fixed to the outside of the human body.
[0040]
Further, the application of a lubricant to the catheter body 11 is not essential, and the invention can be applied to a catheter to which no lubricant is applied. When there is no influence such as slippage due to the application of the lubricant, the operation unit 14 is not essential, and the catheter body 11 may be directly operated. The projection 2 can be operated as the operation unit 14 even if there is an influence of slippage. Further, the operation unit 14 can be formed integrally with the protrusion 2.
[0041]
Although the present embodiment relates to a guiding catheter for the heart, it may be another catheter, for example, a microcatheter or a catheter for contrast, and may be a human body organ other than the heart. .
In the above-described embodiment, the fixing mechanism is used for the catheter. However, the fixing mechanism can be used for a sheath introducer for inserting the catheter.
[Brief description of the drawings]
FIG. 1 is a view showing a diagnostic treatment catheter according to a first embodiment.
FIG. 2 is a diagram showing the application of the diagnostic treatment catheter to the heart in the first embodiment.
FIG. 3 is a diagram showing a diagnostic treatment catheter according to a second embodiment.
FIG. 4 is a view showing a catheter for diagnosis and treatment in a third embodiment.
FIG. 5 is a view showing a modified example of the holding tube.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Catheter 11 Catheter main body 12 Bending tip part 13 Connector 14 Operation part 2 Projection part 3 Holding tube (holding tool)
4 Fixed lip (lip part)
A Radial artery B Coronary artery

Claims (8)

A diagnostic treatment / catheter comprising a catheter body made of a flexible tube and a holder for holding the insertion length in a state where the catheter body is inserted into a human body, wherein the holder is a catheter A diagnostic treatment / treatment catheter, wherein the catheter is slidably attached to the main body so as to be positionable in the axial direction, and can be fixed to the outside of the human body in a rotatable state with respect to the catheter main body. The catheter for diagnosis and treatment according to claim 1, wherein the retainer can be positioned in the axial direction of the catheter by engaging with a protrusion provided on the catheter body. Diagnostic treatment catheter. The diagnostic / treatment catheter according to claim 1, further comprising a protrusion that can be moved to an arbitrary position on the catheter body, wherein the retainer engages with the protrusion, so that the catheter body. A catheter for diagnosis and treatment, which can be positioned in the axial direction of the patient. The catheter for diagnosis and treatment according to claim 1, wherein the holding tool is a tubular member, the catheter body is inserted into a tube of the tubular member, and the tubular member is placed on the catheter body. A catheter for diagnosis and treatment, wherein the catheter is slid to engage with the protruding portion to position the tubular member. The catheter for diagnosis and treatment according to any one of claims 1 to 4, wherein the holding tool includes a lip protruding toward a distal end of the catheter body, and the lip is fixed outside the human body by the lip. A catheter for diagnosis and treatment, characterized in that: The diagnostic treatment catheter according to any one of claims 1 to 5, wherein a lubricant is applied to the catheter body. The diagnostic catheter according to claim 6, wherein the catheter body includes a portion to which a lubricant is not applied and a portion for operating the catheter. catheter. A medical device fixing mechanism comprising: a medical device main body made of a flexible tube inserted into a human body; and a holding device for holding a length of insertion of the tube into the human body, wherein the holding device includes the medical device. A portion of the container body that is not inserted into the human body can be slid, can be positioned in the axial direction of the tube, and can be fixed outside the human body in a rotatable state. Medical device fixing mechanism.

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