JP2005160951A - Wire and medical instrument for removing foreign body in blood vessel - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a wire and a medical instrument for removing a foreign body in a blood vessel having a simple constitution and surely catching and removing the foreign body in the blood vessel. <P>SOLUTION: This wire 1 for removing the foreign body in the blood vessel is provided with a long wire body 2 having flexibility, a foreign body catching section 4 provided in the wire body 2 and catching the foreign body in the blood vessel, and a pushing member 5 provided at a more distal end side of the wire body 2 than the foreign body catching section 4 and pushing the foreign body catching section 4. The wire body 2 can be relatively moved to the pushing member 5 along the longitudinal direction of the wire body 2. The foreign body catching section 4 is provided with a plurality of branch wires 41, the branch wires formed into an umbrella rib shape opened in a natural state and closed by receiving an external force, when the pushing member 5 moves towards the foreign body catching section 4, and the pushing member 5 pushes the branch wires 41 from the distal end side of the wire body 2 to close the foreign body catching section 4 in the opened state. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to an intravascular foreign matter removing wire and a medical instrument for removing an embolus in a blood vessel.

  According to the Ministry of Health, Labor and Welfare's demographic statistics, the first cause of death in Japan is cancer, the second is heart disease, the third is stroke, and deaths and sequelae are particularly urgent. It has become.

  In recent years, thrombolytic therapy using a thrombolytic agent has been developed for treating cerebral infarction in the acute phase in the treatment of stroke, and its therapeutic effect has been raised, but its limitations are also pointed out. In other words, from the experience of doctors, thrombolytic agents require a long time for thrombolysis, smaller thrombi fly further to form new emboli sites, and there are thrombi that do not dissolve with thrombolytic agents. It recognized.

  In the case of cerebral infarction, if the blood flow can be resumed within 3 hours after the onset of the infarction, not only will the survival rate increase, but it has been proved in the United States and Europe that it can be inserted into the cerebral blood vessels and directly takes a thrombus. There is a strong demand for the development of medical devices that can be used.

  As such a medical instrument, an intravascular foreign matter removing wire having a filter portion (foreign matter catching portion) provided on the distal end side of the wire body and a frame capable of opening and closing the filter portion is disclosed (for example, , See Patent Document 1).

  However, in such a blood vessel foreign matter removing wire, the frame is provided closer to the proximal end of the wire body than the filter portion, and when the filter portion captures foreign matter in the blood vessel (blood), the frame captures this. There was a problem that foreign matter could not be sufficiently captured.

  In addition, when the filter portion is configured to open and close from the proximal end side like this intravascular foreign matter removing wire, the number of components constituting the frame may increase, so the flexibility of the wire body can be increased. There was a problem of blocking.

Special Table 2002-505151

  An object of the present invention is to provide an intravascular foreign matter removing wire and a medical instrument that have a simple structure and can reliably capture and remove foreign matters in blood vessels.

Such an object is achieved by the present inventions (1) to (12) below.
(1) an elongated wire body having flexibility;
A foreign matter catching portion for catching foreign matter in a blood vessel provided in the wire body;
Provided on the distal end side of the wire main body with respect to the foreign matter capturing part, and a pressing member that presses the foreign matter capturing part,
The wire body is movable relative to the pressing member along a longitudinal direction of the wire body;
The foreign matter capturing part has a plurality of branch wires, they open in a natural state, and form an umbrella bone shape that is closed by applying an external force,
When the pressing member moves toward the foreign object capturing part, the pressing member presses the branch wire from the distal end side of the wire body, and the open foreign object capturing part is closed. A wire for removing foreign matter in blood vessels characterized by the above.

  (2) The intravascular foreign matter removing wire according to (1), wherein the pressing member has a through hole penetrating the pressing member, and the wire body is inserted into the through hole.

  (3) The base end side of the pressing member is provided with an operation member that moves the pressing member in the longitudinal direction of the wire body, and a connecting member that connects the operation member and the pressing member. The intravascular foreign matter removing wire according to (1) or (2).

  (4) The intravascular foreign matter removing wire according to any one of the above (1) to (3), having a film-like member provided so as to close a gap between the branch wires.

  (5) The intravascular foreign matter removing wire according to any one of (1) to (4), wherein a top portion of the foreign matter catching portion is located on a distal end side of the wire body.

  (6) The intravascular foreign matter removal device according to any one of (1) to (5), further including an open state maintaining unit that prevents the foreign matter catching portion from closing when the foreign matter catching portion is in the open state. Wire.

  (7) The intravascular foreign matter removing wire according to any one of (1) to (6), further including a restricting means for restricting an opening angle of each branch wire when the foreign matter catching portion is in the open state.

  (8) The intravascular foreign matter removing wire according to any one of (1) to (7), further including a closed state maintaining means for maintaining the closed state when the foreign matter capturing section is closed.

  (9) The intravascular foreign matter removing wire according to any one of (1) to (8), wherein the vicinity of the end of the branch wire has a rounded shape.

  (10) The intravascular foreign matter removing wire according to any one of (1) to (9), wherein the foreign matter catching portion is made of a radiopaque material.

  (11) The intravascular foreign matter removing wire according to any one of (1) to (10), wherein at least a part of the foreign matter trapping portion is made of an alloy exhibiting superelasticity in a living body.

  (12) A medical device comprising the intravascular foreign matter removing wire according to any one of (1) to (11) and a catheter having a lumen capable of storing the intravascular foreign matter removing wire. Instruments.

  According to the present invention, since the pressing member is located on the distal end side of the wire main body with respect to the foreign matter capturing portion, when the foreign matter is captured, the pressing member does not become an obstacle to the capturing, and the foreign matter is reliably captured and removed. can do.

  Further, since the structure of the intravascular foreign matter removal wire is simple, the number of components constituting the intravascular foreign matter removal wire can be reduced, and thus the intravascular foreign matter removal wire has flexibility. Can do.

  In addition, since the intravascular foreign matter removing wire is provided with flexibility, the intravascular foreign matter removing wire can sufficiently reach the details in the blood vessel.

  In addition, when the foreign matter trapping part is made of a radiopaque material, the trapping status of the foreign matter can be easily confirmed under fluoroscopy such as X-rays. Can be captured and removed.

  DETAILED DESCRIPTION OF THE INVENTION Hereinafter, the intravascular foreign matter removing wire and medical device of the present invention will be described in detail based on preferred embodiments shown in the accompanying drawings.

<First Embodiment>
FIG. 1 is a partial longitudinal sectional view showing a first embodiment (opened state) of an intravascular foreign matter removing wire according to the present invention, and FIG. 2 shows a foreign matter catching portion provided in the intravascular foreign matter removing wire shown in FIG. 3 is a partial longitudinal sectional view showing a closed state, FIG. 3 is a sectional view taken along line AA in FIG. 1, and FIG. 4 is a plan view showing an example of a closed state maintaining means provided in the intravascular foreign matter removing wire shown in FIG. FIGS. 5 and 9 are diagrams for explaining step by step how to use the intravascular foreign matter removing wire shown in FIG. 1 (capturing foreign matter fixed in the blood vessel), and FIGS. FIGS. 12A and 12B are diagrams for explaining step by step how to use the intravascular foreign matter removing wire shown in FIG. 1 (capturing foreign matter floating in the blood vessel).

  In the following description, the left side in FIGS. 1 and 2 is referred to as the “base end”, the right side is referred to as the “tip”, and the right side in FIGS. 5 to 9 (the same applies to FIGS. 10 to 12). "The left side is called the" tip ".

  The intravascular foreign matter removing wire 1 shown in FIG. 1 clamps (captures) and removes foreign matter (hereinafter referred to as “emboli 200”) that causes embolization such as blood clots and blood clots in the blood vessel 100. It is.

  The intravascular foreign matter removing wire 1 includes a long wire body 2, a foreign matter catching portion 4 for catching an embolus 200 in the blood vessel 100, a pressing member 5 for pressing the foreign matter catching portion 4, and an open state maintaining means. 54, a regulating means 7, and a closed state maintaining means 6.

  In this intravascular foreign matter removing wire 1, the foreign matter catching portion 4 provided on the wire body 2 can be opened and closed. Hereinafter, the state in which the foreign matter catching portion 4 is opened is referred to as “open state”, and the closed state. Is called “closed state”.

Hereinafter, the configuration of each unit will be described.
A wire body 2 shown in FIG. 1 (also in FIG. 2) is provided with a tubular body 26, a coil 266 provided (fixed) on the distal end side of the tubular body 26, and a distal end side of the coil 266 ( It is composed of a linear body 25 (fixed) and has appropriate rigidity and elasticity (flexibility) over the entire length.

  A coil 266 is provided (connected) at the tip of the tube body 26. By this coil 266, the distal end portion of the tube body 26 (including the coil 266) can be more elastic (flexible).

  The wire body 25 is fixed (fixed) in the same direction as the longitudinal direction of the tubular body 26 so that the linear body 25 protrudes from the distal end opening 263 of the coil 266 at the distal end portion of the inner peripheral surface 262 that defines the lumen 261 of the coil 266. )

  The method for fixing the linear body 25 to the coil 266 (tube body 26) is not particularly limited, but can be fixed by, for example, welding such as brazing, adhesion with an adhesive, or the like.

  The constituent material of the part (member) constituting such a wire body 2 is not particularly limited, and various metal materials, various plastics, and the like can be used alone or in combination.

  Further, the preferred length of the wire body 2 (the total of the tube body 26 (including the linear body 25) and the coil 266) varies depending on cases such as the position and thickness of the blood vessel 100 to be applied. 500 to 4000 mm is preferable, and about 1500 to 2200 mm is more preferable.

  Further, the outer diameter (thickness) of the wire body 2 (tube body 26, coil 266) varies depending on cases such as the position and thickness of the blood vessel 100 to be applied, but the average outer diameter is usually 0. 0.1 to 2.0 mm is preferable, and 0.25 to 0.9 mm is more preferable.

  Further, the wire body 2 is located on the proximal end side, the first part that is relatively hard, the third part that is located on the distal end side and is relatively flexible, the first part, and the third part. And a second portion where the flexibility changes. In other words, the wire body 2 is preferably such that the rigidity (bending rigidity, torsional rigidity, etc.) gradually decreases from the proximal end toward the distal end. Thereby, the operation at hand is reliably transmitted to the distal end portion 24 of the wire body 2, and the running property in the blood vessel 100 and the operability at the bent portion are excellent, and the flexibility of the distal end portion 24 is improved. 100 damage can be prevented. That is, it is possible to ensure higher safety while maintaining the torque transmission performance, pushability (pushability), and kink resistance (bending resistance) of the wire body 2.

  The outer surface (surface) of the wire body 2 may be provided with a coating layer that reduces frictional resistance with the inner surface of the catheter 8 described later. Thereby, insertion / extraction with respect to the catheter 8 can be performed more smoothly. Examples of the coating layer include a coating layer of fluororesin such as polytetrafluoroethylene (Teflon coat (“Teflon” is a registered trademark)), a hydrophilic polymer coat having lubricity when wet.

  As shown in FIG. 1 (the same applies to FIGS. 2 and 3), the foreign matter catching section 4 is branched from the linear body 25 of the wire body 2 and is radially arranged in a plurality (six in this embodiment). A branch wire 41 is used.

  These branch wires 41 (foreign matter catching section 4) have an umbrella shape that opens (becomes open) in a natural state (a state in which no external force is applied) and closes (becomes closed) by applying an external force. In other words, these branch wires 41 have an umbrella-shaped shape that rotates (stands up and down) with the top 42 of the foreign substance capturing unit 4 as the center of rotation. Further, for example, pin joining (pivot structure), winding (twisting) fixing, brazing, or the like can be used for joining the branch wire 41 to the linear body 25 at the center of rotation.

  Such a foreign matter catching portion 4 is provided such that the top portion 42 is located on the distal end side of the wire body 2 and the skirt portion 43 is located on the proximal end side.

  Thereby, the foreign substance capturing space 45 formed by the branch wire 41 and capturing the embolus 200 (in the foreign substance capturing unit 4) can face the embolus 200 in the blood vessel 100 (see, for example, FIGS. 7 and 11). Therefore, the embolus 200 can be captured more reliably.

  Further, as shown in FIG. 1, the vicinity of the end of the branch wire 41 (the skirt portion 43) has a rounded shape.

  Thereby, the danger that the end of the branch wire 41 punctures the inner wall 100a of the blood vessel 100 can be prevented, and thus the intravascular foreign matter removing wire 1 can be operated safely.

  In addition, in the foreign substance capturing unit 4 in the open state, the diameter (the length indicated by D in FIG. 3) centering on the linear body 25 is not particularly limited, but for example, an embolus 200 (thrombus) in the cerebral blood vessel ) Is preferably about 1 to 10 mm, and more preferably about 2 to 4 mm.

  Further, the outer diameter (thickness) of the branch wire 41 (foreign substance capturing unit 4) is not particularly limited. For example, when capturing the embolus 200 (thrombus) in the cerebral blood vessel, it is usually 0.02. About 0.20 mm is preferable, and about 0.04 to 0.12 mm is more preferable.

  Further, the number of branch wires 41 is not limited to six. For example, when capturing an embolus 200 (thrombus) in a cerebral blood vessel, it is preferably about 3 to 16, More preferably, the number is about 6 to 10.

  Further, the constituent material of the foreign matter capturing part 4 is preferably a radiopaque material. The radiopaque material is not particularly limited, and for example, gold, platinum (platinum), platinum-iridium alloy, tungsten, tantalum, palladium, lead, silver, or an alloy or compound containing at least one of these. Etc.

  By using such a radiopaque material, it is possible to easily confirm the capturing state of the embolus 200 in the foreign material capturing unit 4 under fluoroscopy such as X-rays.

  Moreover, as a constituent material of the foreign material capturing part 4, an alloy (including an alloy exhibiting superelasticity (hereinafter referred to as “superelastic alloy”) exhibiting pseudoelasticity in a living body (at least a living body temperature (around 37 ° C.)) is included. Is preferred.

  Alloys exhibiting pseudoelasticity (hereinafter referred to as “pseudoelastic alloys”) include any shape of a stress-strain curve caused by tension, and those in which transformation points such as As, Af, Ms, and Mf can be remarkably measured. Included are all those that cannot be deformed, greatly deformed (strained) due to stress, and that almost return to their original shape upon removal of stress.

  Pseudoelastic alloys include superelastic alloys. Preferred compositions of this superelastic alloy include Ni-Ti alloys such as 49-52 atomic% Ni-Ti alloys, 38.5-41.5 wt% Cu-Zn alloys, 1-10 wt% Cu-Zn-X alloy of X (X is at least 1 type in Be, Si, Sn, Al, Ga), Ni-Al alloy of 36-38 atomic% Al, etc. are mentioned. Of these, the Ni-Ti alloy is particularly preferable.

  By using such a pseudoelastic alloy, the foreign matter trapping portion 4 can obtain sufficient flexibility and bendability, and even if the foreign matter catching portion 4 is repeatedly deformed, it has a bend due to excellent resilience. Can be prevented.

  As shown in FIG. 1, the pressing member 5 is composed of a tubular body 51, and is located (provided) on the distal end side of the wire main body 2 with respect to the foreign matter capturing part 4.

  The tubular body 51 (pressing member 5) is inserted into the through-hole 511 formed in the tubular body 51, and the linear body 25 (wire body 2) is inserted into the wire body 2 along the longitudinal direction of the wire body 2. It is provided so as to be relatively movable.

  Thereby, when the tube body 51 moves along the longitudinal direction of the wire body 2, the linear body 25 guides the tube body 51 along the longitudinal direction of the wire body 2, so that the tube body 51 is It can move reliably along the direction.

  An operation member 52 that moves (operates) the tube body 51 in the longitudinal direction of the wire body 2 is provided on the proximal end side of the tube body 51 (pressing member 5).

  The operation member 52 is connected to the tube body 51 (pressing member 5) via two connecting members (wires) 53 that are inserted through the lumen 261 of the wire body 2 (tube body 26).

  The tube body 51 can be easily operated by such an operation member 52 (connection member 53).

  In addition, a tapered or rounded guide surface 513 is formed in the proximal end opening 512 of the tubular body 51 so that the diameter of the through hole 511 gradually increases in the proximal direction.

  Thereby, when the foreign material capture | acquisition part 4 changes from an open state to a closed state, the branch wire 41 is controlled by the guide surface 513, and can be laid down smoothly and gently (slowly). In addition, since the branch wire 41 falls down in this manner, it is possible to more reliably prevent the embolus 200 from being broken due to the foreign matter capturing portion 4 being suddenly closed.

  Moreover, although the length (length shown by L in FIG. 1) of the pipe body 51 is not specifically limited, For example, about 1-50 mm is preferable and about 5-20 mm is more preferable.

  Further, the outer surface of the connecting member 53 may be provided with a coating layer that reduces the frictional resistance with the inner peripheral surface 262 of the tubular body 26, similarly to the outer surface of the wire body 2. Thereby, the effect similar to the above can be acquired.

  In the intravascular foreign matter removing wire 1 having such a configuration, the foreign matter catching section 4 changes from the open state to the closed state through the following state (operation).

  When the operating member 52 moves in the proximal direction (the direction of arrow B in FIG. 1), the tube body 51 (pressing member 5) is directed toward the foreign material capturing part 4 (in the direction of arrow B in FIG. 1). Go to). At this time, the guide surface 513 (pressing member 5) of the tubular body 51 presses the standing branch wire 41 from the distal end side of the wire body 2 and tilts it. That is, the foreign matter catching section 4 changes from the open state (see FIG. 1) to the closed state (see FIG. 2).

  With the above configuration, the pressing member 5 is positioned (provided) on the side opposite to the foreign matter capturing space 45 side of the foreign matter catching portion 4. In addition, the embolus 200 can be reliably captured and removed.

  Further, in the present invention, the foreign matter capturing part 4 and the pressing member 5 have a relatively simple structure as described above. That is, the number of components constituting these parts can be reduced, and thus the flexibility of the intravascular foreign matter removing wire 1 can be provided.

  Further, since the intravascular foreign matter removing wire 1 has flexibility as described above, the intravascular foreign matter removing wire 1 can sufficiently reach the details in the blood vessel 100.

  As shown in FIG. 1, the open state maintaining means 54 prevents the opened foreign matter catching section 4 from being closed (becomes closed).

  As the open state maintaining means 54, a projection 267 having an outer peripheral surface 264 projecting in the radial direction of the tube body 26 is formed in the vicinity of the base end opening 265 of the tube body 26, and an open portion is formed near the distal end of the operation member 52. A claw portion 521 that engages with the protruding portion 267 in the state is formed. That is, the open state maintaining means 54 is configured by the protrusion 267 and the claw 521.

  Further, when the claw portion 521 is removed from the projection portion 267, the claw portion 521 is configured to be elastically deformed and detached from the projection portion 267.

  With the open state maintaining means 54 having such a configuration, when the foreign matter catching section 4 is in the open state, the operating member 52 moves in the proximal direction, and the pressing member 5 (tubular body 51) unintentionally moves the foreign matter catching section 4. Can be prevented from being pressed. That is, it is possible to prevent the foreign matter capturing unit 4 from being inadvertently closed.

  As shown in FIG. 1, the regulating means 7 regulates the opening angle (angle indicated by θ in FIG. 1) of each branch wire 41 in the open state.

  As shown in FIG. 3, the regulating means 7 is composed of, for example, six flexible linear bodies 71, and each linear body 71 is provided between the skirt portions 43 of the adjacent branch wires 41. ing.

  When the foreign matter catching part 4 is in the open state, the branch wire 41 is opened (raised) by the restriction means 7 having such a configuration, whereby the linear body 71 is pulled in the longitudinal direction, and each branch wire 41 is It can prevent opening too much. That is, each branch wire 41 can be opened at a predetermined angle (opening angle).

  As shown in FIG. 2, the closed state maintaining unit 6 maintains the closed state when the foreign matter capturing unit 4 is closed (closed state).

The closed state maintaining means 6 includes a clip 61 as shown in FIG.
As shown in FIG. 2, in the closed state, the clip 61 is attached to the connecting member 53 from the notch 611 while the side surface 612 on the distal end side of the clip 61 is brought into contact with the proximal end of the tubular body 26 ( It is fixed in the direction of the arrow in FIG.

  With the clip 61 (closed state maintaining means 6) having such a configuration, when the foreign matter capturing unit 4 is in the closed state, the pressing member 5 moves in the distal direction, and the foreign matter capturing unit 4 is unintentionally opened. Can be prevented.

  In addition, it does not specifically limit as a constituent material of such a clip 61, Various metal materials, various plastics, etc. can be used individually or in combination.

  Moreover, you may give the process which increases friction, such as a rough surface process, in the location where the clip 61 in the connection member 53 is mounted | worn. Thereby, the effect similar to the above can be acquired.

  Moreover, the medical instrument 9 of the present invention has such an intravascular foreign matter removing wire 1 and a catheter 8 in which a lumen 82 is formed.

  Next, an example of a method of using the intravascular foreign matter removing wire 1 when capturing the embolus 200 adhered to the inner wall 100a of the blood vessel 100 will be described in detail.

  [1] FIG. 5 shows a state where an embolus 200 such as a thrombus is clogged in the blood vessel 100 and the blood flow is inhibited. The embolus 200 is pressed against the inner wall 100a of the blood vessel 100 by blood pressure and is not easily moved. Further, it is assumed that the presence of the embolus 200 is confirmed on contrast.

  A catheter (microcatheter) 8 and a guide wire 10 inserted through the lumen 82 are inserted into the blood vessel 100, and the distal end portion 101 of the guide wire 10 protruding from the distal end opening 81 of the catheter 8 is embolized. Insert from 200 to the back (peripheral side). In other words, the distal end portion 101 of the guide wire 10 passes through the gap between the embolus 200 and the inner wall 100a of the blood vessel 100 and exceeds the embolus 200. This operation can be performed more easily by using, for example, a micro guide wire having excellent lubricity as the guide wire 10.

  [2] When the distal end portion 101 of the guide wire 10 exceeds the embolus 200, the catheter 8 is advanced with respect to the guide wire 10, and the distal end portion of the catheter 8 is moved to the inner wall of the embolus 200 and the blood vessel 100 as shown in FIG. Enter the gap with 100a. At this time, since the distal end portion of the catheter 8 smoothly enters the gap along the guide wire 10, this operation can be easily performed.

  As a conventional treatment, a thrombolytic agent is flowed retrogradely through the catheter 8 in this state to speed up the thrombolysis. Long hours are often experienced by physicians. The present invention is also useful in such a case.

  [3] From the state shown in FIG. 6, the guide wire 10 is removed, and the intravascular foreign matter removing wire 1 is inserted (accommodated) into the lumen 82 of the catheter 8.

  [4] As shown in FIG. 7, the foreign matter capturing part 4 in the open state is protruded (opened) from the distal end opening 81 of the catheter 8. At this time, the foreign substance capturing part 4 is located at the back (peripheral side) from the embolus 200, and the foreign object capturing space 45 faces the embolus 200 side.

  [5] The catheter 8 is slightly moved in the proximal direction from the state shown in FIG. 7 while maintaining the position of the foreign substance capturing unit 4 as described above. At this time, it is confirmed by angiography, for example, that the embolus 200 is located between the foreign substance capturing part 4 and the catheter 8 in the blood vessel 100 (see FIG. 8).

  [6] When the intravascular foreign matter removing wire 1 is moved in the proximal direction from the state shown in FIG. 8, the embolus 200 is scraped off by the foreign matter catching section 4. Furthermore, when the intravascular foreign matter removing wire 1 is moved in the proximal direction, the embolus 200 is captured by the foreign matter capturing section 4.

  [7] When the operation member 52 is operated from such a state to move the pressing member 5 in the proximal direction, the foreign material capturing unit 4 is pressed by the pressing member 5 to be in a closed state (see FIG. 9). ). Thereby, the embolus 200 is clamped by the foreign material capture | acquisition part 4, Therefore, the embolus 200 can be capture | acquired reliably.

  [8] The intravascular foreign matter removing wire 1 is removed together with the catheter 8 while maintaining the state shown in FIG. As a result, the embolus 200 is recovered (removed) in the parent guiding catheter or sheath introducer (not shown).

  When the embolus 200 is captured in this way, a contrast medium is administered from the proximal end side of the catheter 8 and the intravascular foreign matter removing wire 1 and the catheter 8 are operated while confirming the capture. preferable.

  Next, an example of a method for using the intravascular foreign matter removing wire 1 when capturing the embolus 200 floating (scattering) in the blood vessel 100 will be described in detail.

  [1] For example, when a treatment using a stent (stent treatment) is performed on a stenosis portion (not shown) of the carotid artery, the distal end of the catheter 8 is located behind the stenosis portion (peripheral side) as described above. Insert until

  [2] From this state, in the same manner as described above, the guide wire 10 is removed, the intravascular foreign matter removing wire 1 is inserted into the lumen 82 of the catheter 8, and the foreign matter capturing part 4 in the open state is opened at the distal end of the catheter 8. It protrudes (opens) from the part 81 (refer FIG. 10).

  [3] Further, a stent (not shown) is placed in the stenosis, and the stenosis is expanded. At this time, the embolus 200 scattered on the bloodstream is captured by the foreign matter capturing unit 4 in the open state (see FIG. 11). In addition, expansion of a stenosis part is not limited to performing using a stent, You may perform using the balloon catheter for PTCA.

  [4] From the state shown in FIG. 11, the operating member 52 is operated to move the pressing member 5 in the proximal direction, thereby closing the foreign matter catching section 4 in the open state (see FIG. 12). Thereby, the effect similar to the above can be acquired.

  [5] The intravascular foreign matter removing wire 1 is removed together with the catheter 8 while maintaining the state shown in FIG. As a result, the embolus 200 is recovered (removed) in the parent guiding catheter or sheath introducer (not shown).

Second Embodiment
FIG. 13 is a partial longitudinal sectional view showing a second embodiment (opened state) of the intravascular foreign matter removing wire of the present invention. In FIG. 13, parts around the foreign substance capturing part are omitted.

  Hereinafter, the second embodiment of the intravascular foreign matter removing wire of the present invention will be described with reference to this figure, but the description will focus on the differences from the above-described embodiment, and the description of the same matters will be omitted. .

The present embodiment is the same as the first embodiment except that the configuration of the foreign substance capturing unit is different.
As shown in FIG. 13, a flexible film-like member 46 is provided in the foreign matter capturing part 4 </ b> A so as to close a gap between the branch wires 41.

  Thereby, it is possible to prevent the embolus 200 once captured from being detached from between the branch wires 41. Moreover, the contact area of the foreign matter capturing part 4A with respect to the embolus 200 is increased, so that the embolus 200 can be captured and removed more reliably.

  The membrane member 46 preferably has liquid permeability. Thereby, blood can permeate (pass) through the membranous member 46, and thus blood flow can be secured. Moreover, by having this liquid permeability, resistance due to blood when moving the foreign matter catching portion 4A in the open state to the proximal end side can be reduced, and thus the foreign matter catching portion 4A is inverted (inverted). ) Can be prevented.

  Examples of the film-like member 46 having such liquid permeability include a cloth shape and a net shape.

  Moreover, it does not specifically limit as a constituent material which comprises the film-like member 46, For example, fibers, such as nylon, various metal materials, various plastics, etc. can be used individually or in combination.

  Further, in the intravascular foreign matter removing wire 1 of this embodiment, since the film-like member 46 itself also has the function of the restricting means 7, it is opened without providing the restricting means 7 as in the first embodiment described above. The opening angle of each branch wire 41 in the state can be regulated.

  The fixing method for fixing the membrane member 46 to the branch wire 41 is not particularly limited, but can be fixed by, for example, welding such as brazing, adhesion with an adhesive, or the like.

Moreover, the film-like member 46 is not limited to a film-like shape, and may be a bag-like shape.
As described above, the illustrated embodiment of the intravascular foreign matter removing wire and medical instrument of the present invention has been described. However, the present invention is not limited to this, and each part constituting the intravascular foreign matter removing wire and medical instrument is described. Can be replaced with any structure capable of performing the same function. Moreover, arbitrary components may be added.

  Moreover, when the foreign material capturing part is made of a pseudoelastic alloy, the foreign material capturing part may be made entirely of a pseudoelastic alloy or may be made partially.

  Further, anti-slip means may be provided on the surface of the foreign material capturing part on the foreign material capturing space side. Thereby, the captured embolus can be held more reliably. As the anti-slip means, an elastic material such as rubber having a relatively high friction coefficient can be coated, or minute irregularities (including a rough surface) can be formed by, for example, sandblasting.

It is a fragmentary longitudinal cross-section which shows 1st Embodiment (open state) of the wire for intravascular foreign material removal of this invention. It is a fragmentary longitudinal cross-section which shows the state which the foreign material capture part with which the wire for intravascular foreign material removal shown in FIG. 1 is provided closed. It is the sectional view on the AA line in FIG. It is the top view and side view which show an example of the closed state maintenance means with which the wire for intravascular foreign matter removal shown in FIG. It is a figure for explaining step by step how to use the intravascular foreign matter removing wire shown in FIG. 1 (capturing foreign matter fixed in the blood vessel). It is a figure for explaining step by step how to use the intravascular foreign matter removing wire shown in FIG. 1 (capturing foreign matter fixed in the blood vessel). It is a figure for explaining step by step how to use the intravascular foreign matter removing wire shown in FIG. 1 (capturing foreign matter fixed in the blood vessel). It is a figure for explaining step by step how to use the intravascular foreign matter removing wire shown in FIG. 1 (capturing foreign matter fixed in the blood vessel). It is a figure for explaining step by step how to use the intravascular foreign matter removing wire shown in FIG. 1 (capturing foreign matter fixed in the blood vessel). It is a figure for explaining step by step how to use the intravascular foreign matter removing wire shown in FIG. 1 (capturing foreign matter floating in the blood vessel). It is a figure for explaining step by step how to use the intravascular foreign matter removing wire shown in FIG. 1 (capturing foreign matter floating in the blood vessel). It is a figure for explaining step by step how to use the intravascular foreign matter removing wire shown in FIG. 1 (capturing foreign matter floating in the blood vessel). It is a fragmentary longitudinal cross-section which shows 2nd Embodiment (open state) of the wire for a foreign-body removal in blood vessel of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Wire for removing foreign body 2 Wire body 24 Tip portion 25 Linear body 26 Tubular body 261 Lumen 262 Inner peripheral surface 263 Tip opening 264 Outer peripheral surface 265 Base end opening 266 Coil 267 Projection portion 4, 4A Wire 42 Top portion 43 Bottom portion 45 Foreign matter capturing space 46 Film-like member 5 Press member 51 Tube 511 Through hole 512 Base end opening 513 Guide surface 52 Operation member 521 Claw portion 53 Connecting member 54 Open state maintaining means 6 Closed state maintaining means 61 Clip 611 Notch 612 Side 7 Restriction means 71 Linear body 8 Catheter 81 Tip opening 82 Lumen 9 Medical instrument 10 Guide wire 101 Tip 100 Blood vessel 100a Inner wall 200 Embolus

Claims (12)

A long wire body having flexibility;
A foreign matter catching portion for catching foreign matter in a blood vessel provided in the wire body;
Provided on the distal end side of the wire main body with respect to the foreign matter capturing part, and a pressing member that presses the foreign matter capturing part,
The wire body is movable relative to the pressing member along the longitudinal direction of the wire body,
The foreign matter capturing part has a plurality of branch wires, they open in a natural state, and form an umbrella bone shape that is closed by applying an external force,
When the pressing member moves toward the foreign object capturing part, the pressing member presses the branch wire from the distal end side of the wire body, and the open foreign object capturing part is closed. A wire for removing foreign matter in blood vessels characterized by the above.   The intravascular foreign matter removing wire according to claim 1, wherein the pressing member has a through-hole penetrating the pressing member, and the wire main body is inserted into the through-hole.   The operation member that moves the pressing member in the longitudinal direction of the wire body and the connecting member that connects the operating member and the pressing member are provided on the proximal end side of the pressing member. 3. A wire for removing foreign matter in blood vessels according to 2.   The intravascular foreign matter removing wire according to any one of claims 1 to 3, further comprising a film-like member provided so as to close a gap between the branch wires.   The intravascular foreign matter removing wire according to any one of claims 1 to 4, wherein a top portion of the foreign matter catching portion is located on a distal end side of the wire body.   The intravascular foreign matter removing wire according to any one of claims 1 to 5, further comprising an open state maintaining means for preventing the foreign matter catching portion from closing when the foreign matter catching portion is in the open state.   The intravascular foreign matter removing wire according to any one of claims 1 to 6, further comprising restricting means for restricting an opening angle of each branch wire when the foreign matter catching portion is in the open state.   The intravascular foreign matter removing wire according to any one of claims 1 to 7, further comprising a closed state maintaining means for maintaining the closed state when the foreign matter capturing section is closed.   The intravascular foreign matter removing wire according to any one of claims 1 to 8, wherein a vicinity of an end of the branch wire has a rounded shape.   The intravascular foreign matter removing wire according to any one of claims 1 to 9, wherein the foreign matter catching portion is made of a radiopaque material.   The intravascular foreign matter removing wire according to any one of claims 1 to 10, wherein at least a part of the foreign matter trapping portion is made of an alloy exhibiting superelasticity in a living body.   A medical device comprising: the intravascular foreign matter removing wire according to any one of claims 1 to 11; and a catheter having a lumen capable of storing the intravascular foreign matter removing wire.

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