JP2004130110A - Catheter - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a catheter combining easiness in replacing the catheter which is an advantage of an RX type catheter and the transmitting property of tip push-in force which is an advantage of an OTW (over the wire) type catheter. <P>SOLUTION: A first lumen 7 has a sheath body part 22 inserted in an organism; a first shaft serving as a passage provided in the sheath body part 22 and allowing the insertion of a guide wire for guiding the sheath body part 22 in the organism; a first distal end aperture part 75 provided on the distal end side in the inserting direction in the organism to allow the guide wire to pass through; and a first proximal end aperture part provided on the proximal end side to allow the guide wire to pass through. A second lumen 8 has a sheath distal end 21 provided at the distal end of the sheath body part 22; a second distal end aperture part 83 and a second proximal end aperture part 84 through which the guide wire can be inserted; and a second shaft different from the first shaft. <P>COPYRIGHT: (C)2004,JPO

Description

The present invention relates to a diagnostic catheter used for performing various diagnoses by being inserted into a body cavity or a lumen of a blood vessel, a vessel, a digestive organ, etc. The present invention relates to a rapid exchange type catheter in which is formed.

In a blood vessel insertion catheter represented by a catheter (hereinafter, referred to as a PTCA catheter) used in PTCA (Percutaneous Transluminal Coronary Angioplasty), there is a working lumen used for treatment and diagnosis. In addition, a guidewire lumen for guiding a guidewire is formed over the entire length of the catheter.

The guidewire is inserted into the guidewire lumen prior to inserting the catheter into the blood vessel, and guides the distal end of the catheter to the vicinity of the affected part (vascular stenosis), with the distal end leading in the blood vessel.

カ テ ー テ ル The catheter in which the guide wire lumen is formed over the entire length is called an over-the-wire (OTW) catheter.

In the PTCA operation, various catheters such as a dilatation catheter, a stent delivery catheter, an atherectomy catheter, a drug injection catheter, an ultrasonic diagnostic catheter, and the like are used. Since the type of catheter to be used, the size of the balloon or stent of the dilatation catheter, and the treatment method are selected, it may be necessary to replace the catheter after the blood vessel is inserted. In addition, even when a plurality of stents are installed, the catheter may be pulled out of the blood vessel several times and inserted.

Usually, when such a catheter is replaced, it is preferable to leave the guide wire in the blood vessel in order to reduce the burden on the patient, shorten the operation time and labor, prevent infection, and the like.

However, in the conventional OTW type catheter, as described above, the guide wire lumen is formed over the entire length of the catheter. Can not be replaced while indwelling. If the guide wire does not extend out of the body by the length of the catheter, the guide wire will be interrupted in the catheter, so that the guide wire cannot be operated to insert the catheter into the living body. In this case, there is a problem that the length of the guide wire projecting from the outside of the body is too long, and the guide wire lowers the operability of the catheter.

解決 A solution to this problem is a rapid exchange (RX) type catheter in which a guide wire lumen is formed only at the tip of the catheter. This rapid exchange type catheter has a working lumen provided over the entire length of the catheter, and a guide wire lumen formed at a distal end of the catheter with a length of about several centimeters substantially in parallel with the working lumen. . Therefore, there is no guidewire lumen over the entire length of the catheter, such as an OTW catheter.

Therefore, in the RX type catheter, since the guide wire lumen is shorter than the OTW type catheter, when exchanging the catheter while leaving the guide wire in the living body, the guide wire is extended outside the body over the entire length of the catheter. There is no need, and as a result, the catheter can be replaced without compromising the operability of the catheter.

However, in the above-mentioned conventional RX-type catheter, since the guide wire lumen is short, the pushing force of the catheter by the operator is difficult to be transmitted to the distal end, and it is often difficult for the distal end of the catheter to pass through the stenotic part, which is the affected part. is there. In such a case, the catheter must be replaced with an OTW type catheter to penetrate the stenosis.

In order to increase the pushing force at the tip of the catheter, it is conceivable to lengthen the lumen for the guide wire of the RX-type catheter. However, since the portion where the working lumen and the guide wire lumen are parallel becomes longer, the outside of the catheter is increased. Since the portion where the diameter becomes large also becomes long, it is not preferable to lengthen the wire lumen in consideration of the burden on the living body and the like.

The present invention has been made in view of the above-mentioned problems of the conventional catheter, and has an advantage that the catheter exchange is easy, which is an advantage of the RX type catheter, and that the pushability of the tip pushing force, which is an advantage of the OTW type catheter, is improved. The purpose is to provide a catheter that has both functions.

The above object of the present invention is achieved by the following means.

(1) The catheter of the present invention is a sheath main body inserted into a living body, and a guide wire for guiding the sheath main body in a living body, which is a passage provided in the sheath main body. A first distal opening having a first shaft and a guide wire provided on the distal side in the insertion direction into the living body and a first proximal opening capable of passing a guide wire provided on the proximal side. A first lumen having a portion, a sheath distal end provided at the distal end of the sheath main body, and a passage provided at the sheath distal end different from the first lumen, through which a guide wire can be inserted. A second lumen having a second distal opening and a second proximal opening, and having a second axis different from the first axis, the second proximal end of the second lumen. An opening is provided in the first lumen of the first lumen. Characterized in that it is provided on the distal end side than the position of insertion into a living body proximal direction 60mm from the end opening.

{Circle around (2)} The second proximal opening of the second lumen is formed more distally than a position 5 mm proximal from the first distal opening of the first lumen in the body insertion direction.

(3) The distance between the second proximal opening of the second lumen and the first distal opening of the first lumen is 2.5 mm or more and 10 mm or less.

(4) The first distal end opening of the first lumen opens into a passage of the second lumen.

(5) The first distal end opening of the first lumen is open outside the passage of the second lumen.

(6) Instead of the guide wire, an imaging core capable of observing the inside of a living body and having an ultrasonic transducer at the tip can be inserted into the first lumen.

(7) The imaging core is covered with a protective tube.

In the first aspect of the present invention, since there is provided the first lumen provided in the sheath main body through which the guide wire can be inserted, and the second lumen provided in the sheath distal end through which the guide wire can be inserted. The guide wire can be inserted by selecting one of the first lumen and the second lumen. Further, a guide wire can be inserted into both the first lumen and the second lumen.

In the invention described in claim 2, the second proximal opening of the second lumen is formed more distally than a position 5 mm proximal to the insertion direction into the living body from the first distal opening of the first lumen. Since the first lumen and the second lumen do not coexist at the distal end of the catheter, the outer diameter of the catheter at the distal end can be reduced, and the catheter can be smoothly inserted into a living body.

In the invention according to claim 3, a distance between the second proximal opening of the second lumen and the first distal opening of the first lumen is set in a range from 2.5 mm to 10 mm. Therefore, the strength of the catheter can be kept strong without obstructing the observation inside the living body by the catheter.

According to the fourth aspect of the present invention, since the first distal end opening of the first lumen is opened in the passage of the second lumen, the guide wire passing through the first lumen is connected to the second distal end at the distal end of the sheath body. It is introduced into the lumen and protrudes into the living body from the second lumen. Therefore, the pushing force can be easily transmitted to the distal end of the sheath distal end.

In the invention described in claim 5, since the first distal end opening of the first lumen is opened outside the passage of the second lumen, a guide wire is inserted through the first lumen and the second lumen, respectively. Thus, the catheter can be reinforced by the guide wire inserted through the first lumen and the guide wire inserted through the second lumen, can be easily guided to the affected part, and can be introduced into each of the branched blood vessels.

In the invention according to claim 6, since the first lumen has an ultrasonic transducer at the distal end instead of the guide wire and can insert an imaging core capable of observing the inside of a living body, the imaging core and the first guide can be inserted. Only one passage through which the wire passes is sufficient, and the diameter of the catheter can be reduced. Further, since the living body can be observed by the imaging core using the same sheath main body once inserted, the burden on the living body can be reduced.

In the invention according to claim 7, since the imaging core is covered with the protective tube, the imaging core is not damaged when the imaging core is inserted into the sheath body instead of the first guide wire.

Hereinafter, embodiments of the present invention will be described with reference to the drawings.

(First Embodiment)
FIG. 1 is a diagram showing an ultrasonic catheter to which the present invention is applied, and FIG. 2 is a diagram showing an imaging core and a connector.

超 The ultrasonic catheter 1 shown in FIG. 1 includes a sheath 2 inserted into a body cavity, and an operation unit 3 which is not inserted into the body cavity and is arranged at a hand side for operation by a user.

The sheath 2 has a sheath distal end portion 21 and a sheath main body portion 22. The sheath distal end portion 21 is provided on the side of the distal end portion of the sheath main body portion 22 so as to have a different axis deflected from the central axis of the sheath main body portion. A lumen (a second guidewire lumen) that can be inserted is formed.

シ ー ス The sheath body 22 also has a linear lumen formed inside the entire length thereof, and the guide wire 23 or the imaging core 4 is inserted into the lumen. The lumens formed in the sheath distal end portion 21 and the sheath main body portion 22 are substantially parallel to each other, and the lumen formed in the sheath distal end portion 21 is formed much shorter than the lumen formed in the sheath main body portion 22. ing. The overlapping distance where the sheath distal end portion 21 and the sheath main body portion 22 coexist is formed to be extremely short. In FIG. 1, the description will be made assuming that the imaging core 4 is inserted through the sheath body 22. FIG. 2 shows a state in which the imaging core 4 is pulled out from the sheath body 22.

The imaging core 4 includes an ultrasonic transducer 41, a drive shaft 42, and a rotation stabilizing coil 43, and is connected to the connector 5 as shown in FIG. After inserting the sheath 2 into the living body, the ultrasonic transducer 41 generates an ultrasonic wave toward the inside of the living body, and receives the reflected and returned ultrasonic waves, thereby forming an ultrasonic tomographic image of the affected part. And

The drive shaft 42 is flexible and has the property of transmitting the rotational power generated by the operation unit 3 to the ultrasonic transducer 41. For example, a three-layer coil in which the winding direction is alternated between right-left-right and the like. Of a multi-layered coil. The transmission of the power of rotation by the drive shaft 42 causes the ultrasonic transducer 41 to rotate, so that an affected part in a body cavity such as a blood vessel or a blood vessel can be observed 360 degrees. In the drive shaft 42, a signal line for transmitting a signal detected by the ultrasonic transducer 41 to the operation unit 3 is passed.

The rotation stabilizing coil 43 is attached to the tip of the ultrasonic transducer 41 and serves as a guide for the ultrasonic transducer 41 to rotate stably when the imaging core 4 rotates.

{Circle around (2)} As shown in the enlarged portion of FIG. 2, the imaging core 4 is covered with a protective tube 45. The protection tube 45 is fixed to the connector 5 described later, does not rotate with the drive shaft 42, and ensures the safety of the hand. An opening 46 is provided at the tip of the protection tube 45.

The operation unit 3 includes the connector 5 and the hub 6. The connector 5 is connected to the base of the imaging core 4 and has a protective tube (not shown) and a port 51 for supplying an ultrasonic transmission liquid into the sheath 2. The hub 6 also has a similar port 61.

The ultrasonic transmission liquid supplied from the ports 51 and 61 passes through the protective tube and the sheath body 22 from the proximal end to the distal end of the sheath 2, that is, the proximal end of the sheath 2 in the body insertion direction. From the tip to the tip side. The opening 46 provided at the tip of the protection tube 45 fills and circulates the ultrasonic transmission liquid also in the protection tube 45, so that the ultrasonic transducer 41 can transmit ultrasonic waves.

After the ultrasonic transmission liquid is filled in the sheath 2 and the sheath 2 is inserted into a body cavity or the like, the ultrasonic transmission liquid is disposed between the ultrasonic transducer 41 and the blood vessel wall, and the ultrasonic waves are transmitted by the ultrasonic transmission. It can be transmitted to the affected part via the liquid, reflected from the affected part, and returned. Due to the presence of the ultrasonic transmission liquid, the ultrasonic transducer 41 can acquire a video signal by ultrasonic waves. As the ultrasonic transmission liquid, physiological saline or the like that enables the ultrasonic transducer 41 to transmit and receive ultrasonic waves and that does not affect the human body even when discharged from the distal end of the sheath 2 into the body is used.

The connector 5 holds the drive shaft 42 of the imaging core 4 and connects to a motor (not shown) to transmit the rotational power of the motor to the ultrasonic transducer 41 via the drive shaft 42.

The hub 6 is connected to the proximal end of the sheath body 22 and is independent of the connector 5. The hub 6 is provided with a port 61 in addition to the first base end opening into which the imaging core 4 is inserted in FIG. The port 61 of the hub 6 can be used for injecting a chemical solution. The chemical liquid supplied from the port 61 passes through the inside of the sheath main body 22 similarly to the ultrasonic transmission liquid, and is sent from the proximal end to the distal end of the sheath 2. A side hole is provided in the vicinity of the distal end of the sheath body 22, and the drug solution is discharged into the body from the side hole. By injecting the drug solution, the ultrasonic catheter 1 can be used as a drug injection catheter. Note that the hub 6 may be configured such that a known Y-type connector can be selectively attached to the base end of the sheath 2.

Next, referring to FIG. 3, a description will be given of the structure of the distal end side of the sheath distal end portion 21 and the sheath main body portion 22 which are features of the present invention.

FIG. 3 is a cross-sectional view showing a configuration near the distal end of the sheath 2.

As shown in FIG. 3, the sheath main body 22 extends from the proximal end side of the sheath 2, includes a catheter tube 71 and reinforcing parts 72, and has a first lumen 7 formed therein.

As described above, the first lumen 7 is a lumen having the first axis through which the imaging core 4 can be inserted, and further serves as a guidewire lumen through which a guidewire 23 can be inserted instead of the imaging core 4. Also fulfills. Here, the guide wire inserted into the first lumen 7 is the same as the guide wire 23 described above.

先端 A break prevention coil 73 is provided at the tip of the first lumen 7, that is, at the tip of the catheter tube 71 in the body insertion direction. The break prevention coil 73 plays a role of reinforcing the seam at the seam between the sheath body 22 and the sheath distal end portion 21 in order to prevent the sheath 2 from being broken. A plurality of side holes 74 are provided in the catheter tube 71 in a spiral shape, and a medical solution or the like can be discharged into the living body from the side holes 74.

補強 A reinforcing part 72 is attached to the distal end of the catheter tube 71. The reinforcing part 72 is formed of resin, and the direction of the first lumen 7 is changed so that the direction of the first lumen 7 continuing from the catheter tube 71 merges with the second lumen 8 of the sheath distal end portion 21 described later. Change to the direction toward 2 lumens 8.

補強 The reinforcing parts 72 further reinforce the seam between the sheath body 22 and the sheath distal end 21 to prevent breakage (kinking). Here, the reinforcing part 72 is provided with a bending assist slit 721, which allows the guide wire 23 to be inserted from the first lumen 7 to the second distal end opening 83 to insert the sheath 2 into a living body. In addition, the portion from the sheath 2 to the second distal end opening 83 is easily deformed in a straight line, so that even if a load is applied to the sheath 2, the load can be absorbed without breaking. The reinforcing part 72 has a first tip opening 75 that opens toward the inside of the second lumen 8.

The sheath distal end 21 is attached to the side of the reinforcing part 72, that is, to the lateral side of the distal end of the sheath body 22. The sheath distal end portion 21 includes a distal end tube 81 and an X-ray contrast coil 82. The distal tube 81 has a second lumen 8 (second lumen) having a second axis different from the first lumen 7 as a guidewire lumen through which a guidewire (second guidewire) can be inserted. Is formed.

The second lumen 8 is in communication with the first distal opening 75 of the first lumen 7 of the sheath body 22. The second lumen 8 has a second distal opening 83 that opens 5 mm or more from the first distal opening 75 on the distal side, and a second base that opens on the proximal side within 60 mm from the first distal opening 75. It has an end opening 84. Therefore, the guide wire 23 can pass through from the second distal opening 83 to the second proximal opening 84. Since the second distal opening 83 of the second lumen is opened at the distal end by 5 mm or more from the first distal opening 75 of the first lumen 7, the first lumen 7 and the second lumen 8 are provided at the distal end of the ultrasonic catheter 1. And the outer diameter of the ultrasonic catheter 1 at the distal end portion can be reduced, and the insertion into the living body can be smoothly performed.

理由 The reason why the above numerical values are preferable is as follows.

(1) In order to guide the ultrasonic catheter 1 along the guide wire 23, the length of the second lumen 8 needs to be longer than a certain length. Specifically, it is preferably 10 mm or more.

(2) It is not preferable that the second tip opening 83 and the ultrasonic transducer 41 are too far apart. Specifically, it is preferably within 100 mm.

(3) The interval between the second proximal opening 84 of the second lumen 8 and the first distal opening 75 of the first lumen 7 is, in other words, the overlapping (coexisting) portion of the sheath body 2 and the distal tube 81. During this time, the outer diameter of the ultrasonic catheter 1 increases, and the position of the ultrasonic transducer 41 has to be moved to the proximal end side. Although it is not impossible to set the position of the ultrasonic transducer 41 to the position where the distal tube 81 exists, since the distal tube 81 may hinder image acquisition, it is not preferable that both overlap. Therefore, it is preferable that the overlapping portion between the sheath body 2 and the distal tube 81 is short. Therefore, the length of the overlapping portion between the two is preferably 0 mm to 60 mm. More preferably, it is within 2 to 10 mm, further preferably, within 3 to 5 mm.

In the present embodiment, by inclining the second proximal opening 84 in the distal direction by about 20 to 70 degrees with respect to the axial direction of the ultrasound catheter 1, the sheath main body 2 and the distal tube 81 can be connected to each other. The overlap between the sheath body 2 and the distal end tube 81 is reduced while keeping the joining range the same, thereby solving the problems of strength and outer diameter.

An X-ray contrast coil 82 is wound around the distal end of the distal tube 81, and the position of the sheath distal end 21 is confirmed under X-ray fluoroscopy when the ultrasonic catheter 1 is inserted into a body cavity. I can do it.

The sheath distal end 21 and the sheath main body 22 are tightly fixed by using a catheter tube 71 of the sheath main body 22 in which the sheath distal end 21 is wrapped, and further using an adhesive or heat fusion.

As described above, in the ultrasonic catheter 1 to which the present invention is applied, the first lumen 7 joins in the middle of the second lumen 8. Therefore, the guide wire 23 inserted through the first lumen 7 passes through the first lumen 7, enters the second lumen 8 via the first distal opening 75, and goes out of the sheath 2 through the second distal opening 83. You can get out. In this case, since the guide wire 23 is inserted over the entire length of the sheath main body 22, it can play a role of a conventional OTW catheter.

In addition, since the second lumen 8 is provided in a straight line, the guide wire 23 is inserted from the second distal opening 83 to the second proximal opening 84 of the second lumen 8, so that the conventional RX catheter can be used. Can play a role.

Next, a specific application example of the ultrasonic catheter 1 which can play a role of both the OTW type catheter and the RX type catheter will be described.

FIGS. 4 (1) to 4 (6) are schematic diagrams showing examples of using an ultrasonic catheter. 4 (1) to 4 (6), for easy understanding of the guide wire 23, the portion of the guide wire 23 that passes through the sheath is shown in white, and the other portions are shown in black.

First, as shown in FIG. 4A, an ultrasonic catheter 1 of the present invention is used as an RX catheter, a guide wire 23 is inserted through the second lumen 8, and the ultrasonic catheter 1 is produced by guiding the guide wire 23. Insert into the body. First, the ultrasonic catheter 1 is used as the RX type catheter because the RX type catheter can be replaced more quickly than the OTW type catheter, and the imaging core 4 is inserted in advance. This is because if the use of the RX type alone is sufficient, the burden on the living body is light.

However, when used as an RX-type catheter, since the guide wire 23 passes only through the sheath distal end portion 21, the sheath distal end portion 21 is less likely to be curved than the sheath main body portion 22. Thereby, as shown by the arrow in FIG. 4A, the pushing force for pushing the ultrasonic catheter 1 into the lumen is not transmitted to the sheath distal end portion 21 but is transmitted only to the distal end of the sheath main body portion 22. Therefore, when there is a stenosis in the lumen, the pushing force is weak, and there is a case where the stenosis cannot proceed beyond the stenosis.

In such a case, as shown in FIG. 4 (2), only the guide wire 23 is pulled out from the living body while the ultrasonic catheter 1 itself is kept in the living body.

(4) Then, as shown in FIG. 4 (3), the ultrasonic catheter 1 is used as an OTW type catheter, and the guide wire 23 is inserted through the entire length of the sheath body 22. Here, if the imaging core 4 is inserted through the sheath body 22, the guide wire 23 cannot be inserted through the sheath body 22, so that the imaging core 4 is pulled out from the sheath body 22 with the connector 5 held. After that, the guide wire 23 is inserted through the hub 6.

4) The guide wire 23 inserted from the hub 6 passes through the sheath main body 22 and the sheath distal end portion 21 into the lumen as shown in FIG. Then, the guide wire 23 that has passed through the lumen is operated on the proximal end side of the ultrasonic catheter 1 to advance over the stenosis in the lumen prior to the ultrasonic catheter 1.

Next, as shown in FIG. 4 (5), the ultrasonic catheter 1 is pushed along the guide wire 23 to pass through the stenosis. Here, since the ultrasonic catheter 1 is used as an OTW type catheter, the pushing force can be transmitted to the sheath distal end portion 21 and can easily pass through the stenosis.

Then, the ultrasonic catheter 1 having passed through the stenosis is left as it is, and the guide wire 23 is pulled out from the sheath distal end portion 21 and the sheath main body 22 as shown in FIG. The inserted imaging core 4 is inserted into the sheath body 22. The inserted imaging core 4 is positioned by operation of the connector 5 to a stenosis part which is an affected part, and is used for diagnosis of the affected part.

As described above, in the present invention, the second lumen 8 passing through the sheath distal end portion 21 and the first lumen 7 passing through the sheath main body 22 are provided as lumens for the guide wire 23. Can be selected according to the situation. By appropriately changing the lumen to be inserted, the ultrasonic catheter 1 can be easily inserted into the living body while reducing the burden on the living body.

Further, in the ultrasonic catheter 1, the length of the sheath distal end 21 is limited to be shorter than the length of the sheath main body 22, so that the sheath distal end 21 and the sheath main body 22 exist in parallel. The range in which the length is short and the diameter of the ultrasonic catheter 1 inserted into the living body is large is limited, and the burden on the living body can be reduced.

Further, since the first distal opening 75 of the first lumen 7 is open toward the second lumen 8, the guide wire 23 passing through the first lumen 7 is connected to the second lumen 8 at the distal end of the sheath body 22. It is introduced and protrudes from the second lumen 8 into the living body. Therefore, the pushing force can be easily transmitted to the distal end of the sheath distal end portion 21.

In addition, since the imaging core 4 can be inserted into the sheath body 22 instead of the guide wire 23, only one lumen is required for the imaging core 4 and the guide wire 23 to pass through, and the sheath of the ultrasonic catheter 1 The diameter to be inserted into the body can be reduced. In addition, since the living body can be observed by the imaging core 4 using the same sheath body 22 once inserted, the burden on the living body can be reduced.

In addition, since the imaging core 4 is covered with the protective tube 45, as described above, the imaging core 4 does not break when the imaging core 4 is inserted into or pulled out of the sheath body 22. . Further, since the imaging core 4 is protected by the protective tube 45, even if the drive shaft 42 rotates at a high speed, the imaging core 4 is not damaged, and the inside of the sheath body 22 is not damaged. Further, even when the imaging core 4 penetrates the sheath main body 22 and enters the living body, the imaging core 4 does not directly touch the living body due to the presence of the protective tube 45. Is not damaged.

(Second embodiment)
Next, a description will be given of a modified version of the ultrasonic catheter 1. In the ultrasonic catheter 1 according to the second embodiment, the first lumen 7 provided in the sheath main body 22 does not communicate with the second lumen 8 provided in the sheath distal end portion 21, and the outside of the sheath main body 22 is That is, it differs from the first embodiment in that it is open toward the living body.

FIG. 5 is a cross-sectional view showing the configuration of a sheath distal end portion and a sheath main body according to the second embodiment. Since the ultrasonic catheter 1 according to the second embodiment is almost the same as the ultrasonic catheter 1 according to the first embodiment, the same components are denoted by the same reference numerals as those of the first embodiment. , The description of which will be omitted.

補強 A reinforcing part 76 is attached to the distal end of the catheter tube 71 in the second embodiment. The reinforcing part 76 is formed of resin, and has a first distal opening 77 so that the first lumen 7 that continues from the catheter tube 71 opens toward the inside of the living body. Therefore, unlike the first embodiment, the first lumen 7 does not merge with the second lumen 8. The guide wire 23 inserted into the sheath body 22 passes through the sheath body 22 as it is and protrudes into the living body. Here, it is preferable that the first tip opening 77 is provided slightly inclined in a direction away from the second lumen 8.

As described above, in the second embodiment, unlike the first embodiment, the first lumen 7 and the second lumen 8 do not communicate with each other and are independent.

FIGS. 6 and 7 are diagrams showing examples of using the ultrasonic catheter 1 according to the second embodiment.

(6) As shown in FIG. 6, the entire sheath 2 can be reinforced by inserting the guide wires 23 into the first lumen 7 and the second lumen 8, respectively (see the upper part of FIG. 6). Therefore, even if it is difficult to pass through the stenosis using the ultrasonic catheter 1 as an RX-type catheter, the stenosis can be easily passed through the two guide wires 23 (see the lower part of FIG. 6).

Further, as shown in FIG. 7, for example, when there are a plurality of treatment sites, after treating one site, it is also possible to guide the second guide wire 23 ′ to a branch point that branches to another treatment site. That is, in the treatment (diagnosis) of the upper left branch in FIG. 7, the ultrasonic catheter 1 is guided using the guide wire 23, and after the treatment (diagnosis) is completed, the ultrasonic catheter 1 branches to the next treatment point (the lower left branch). The other guide wire 23 ′ can be guided by using the first lumen 7 of the ultrasonic catheter 1 to the branching point to be performed. Thereby, the guide wire 23 'can be easily guided to the branch point without fear of damaging the living body. Since the first distal end opening 77 is inclined at the branch point, the guide wire 23 'can be easily guided in the branch direction.

As described above, in the second embodiment, since the first distal end opening 77 of the first lumen 7 is open toward the inside of the living body, a guide wire is provided for each of the first lumen 7 and the second lumen 8. The sheath 2 of the ultrasonic catheter 1 is reinforced by the guide wires 23 inserted through the first lumen 7 and the guide wires 23 ′ inserted into the second lumen 8 by inserting the guide wires 23 and 23 ′, and the stenosis is reduced. It can be easily passed. Further, when there are a plurality of treatment sites, it becomes easy to insert the guide wire to the next treatment site.

In the second embodiment, the second proximal end opening 84 of the second lumen 8 can be configured to be located on the distal end side in the body insertion direction with respect to the first distal end opening 77.

In the first and second embodiments, the ultrasonic catheter 1 has been described as an example. However, the present invention is not limited to the ultrasonic catheter 1, but may be a dilatation catheter, a stent delivery catheter, an atherectomy catheter, or a drug injection. It can be applied to various catheters such as catheters for medical use.

It is a figure showing the ultrasonic catheter to which the present invention is applied. FIG. 3 is a diagram illustrating an imaging core and a connector. It is sectional drawing which shows the structure near the front-end | tip of a sheath. It is a schematic diagram showing an example of utilization of an ultrasonic catheter. It is a sectional view showing composition of a sheath tip part and a sheath main part in a 2nd embodiment. It is a figure showing an example of utilization of an ultrasonic catheter in a 2nd embodiment. It is a figure showing an example of utilization of an ultrasonic catheter in a 2nd embodiment.

Explanation of reference numerals

1. Ultrasonic catheter,
2 ... sheath,
3. Operation unit,
4. Imaging core,
5. Connector,
6 ... Hub,
7 ... the first lumen,
8 ... the second lumen,
21 ... sheath tip
22 ... sheath body,
23, 23 '... guide wire,
41 ... Ultrasonic detector,
42 ... drive shaft,
43 ... Rotation stabilizing coil,
45 ... Protective tube,
71 ... catheter tube,
72, 76 ... reinforcement parts,
75, 77 ... first tip opening,
83: second tip opening,
84 second opening at the base end

Claims (7)

A sheath body inserted into the living body,
A passage provided in the sheath body, having a first shaft through which a guide wire for guiding the sheath body in a living body can be inserted, and provided at a distal end side in a body insertion direction. A first lumen having a first distal opening through which the guidewire can pass and a first proximal opening through which the guidewire provided at the proximal end can pass;
A sheath tip provided at the tip of the sheath body,
A passage provided at the distal end of the sheath different from the first lumen, having a second distal opening and a second proximal opening through which a guide wire can be inserted, and different from the first shaft; A second lumen having a second axis;
Has,
The catheter, wherein the second proximal opening of the second lumen is provided on the distal side from a position 60 mm proximal from the first distal opening of the first lumen in the body insertion direction. . 2. The method according to claim 1, wherein the second proximal opening of the second lumen is formed more distally than a position 5 mm from the first distal opening of the first lumen in the insertion direction into the living body from the first distal opening. 3. The catheter as described. The catheter according to claim 1 or 2, wherein an interval between the second proximal opening of the second lumen and the first distal opening of the first lumen is 2.5 mm or more and 10 mm or less. カ テ ー テ ル The catheter according to any one of claims 1 to 3, wherein the first distal opening of the first lumen is open in a passage of the second lumen. カ テ ー テ ル The catheter according to any one of claims 1 to 3, wherein the first distal opening of the first lumen is open to the outside of the passage of the second lumen. The catheter according to any one of claims 1 to 5, wherein, in place of the guide wire, an imaging core capable of observing the inside of a living body can be inserted into the first lumen instead of the guide wire. . The catheter according to claim 1, wherein the imaging core is covered with a protective tube.

Images