JP2005253513A - Long object inserting device - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a long object inserting device easily inserting a medical long object having a curved distal end and appropriately correcting the curved distal end. <P>SOLUTION: A guide wire inserter 1 comprises a tubular member 2 having a lumen 22 insertable of a guide wire 6 in its inside, and its distal end 25 is connected to a sheath or the like to be used and has a function of correcting the shape of the distal end curved part 61 of the guide wire 6. The tubular member 2 is provided with a slit 3 formed by penetrating the tubular wall in its whole length. The proximal end of the tubular member 2 has a clearance part 4 formed by gradually expanding the groove width of the slit 3 toward the proximal end direction. The distal end of the tubular member 2 is formed with a projection part 5 formed by projecting a circumferential one part of the tubular member 2 toward the distal end direction. The slit 3 passes through the top of a crest of the projection part 5. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to a long article introduction device (inserter) for introducing a long article such as a guide wire or a catheter.

  Conventionally, when inserting a catheter guide wire into an introduction needle, a catheter or a sheath, a guide wire inserter has been used as a guide wire (long object) introduction device.

  This guide wire inserter is used to correct the distal end portion of a guide wire having a curved distal end portion. The guide wire inserter is generally formed of a cylindrical body having a guide wire outlet port provided at a distal end portion, a guide wire introduction port provided at a proximal end portion, and a guide wire passage communicating the both. . Then, with the guide wire outlet opening in contact with the proximal end of the introduction needle, catheter or sheath, the guide wire is inserted from the guide wire introduction opening, and the introduction needle is inserted through the guide wire passage and the guide wire outlet opening, Used by inserting into a catheter or sheath.

  However, with such a guide wire inserter, it has been difficult to insert a guide wire having a curved tip portion into the inserter. The curved shape of the distal end portion of the guide wire is formed so that the distal end portion has a shape of a predetermined blood vessel site, and in particular, the guide wire having a curved distal end portion such as a J type, a double angle type, or an angle type, It was difficult to insert into the inserter while correcting the curved portions.

  Therefore, a guide wire inserter has been proposed in which a notch for introducing a guide wire is provided at the base end portion of the guide wire inserter (near the guide wire introduction port) (see, for example, Patent Document 1). This notch has a shape in which the groove width of the notch is constant in the longitudinal direction of the guide wire inserter and changes in the thickness direction of the outer wall (a shape that forms a V shape in a cross-sectional view).

  In recent years, however, the J-shaped guide wire having a distal end curved shape has started to be used with an extremely small radius of curvature. When such a guide wire is used, a notch portion is formed at the proximal end portion. Even if an attempt was made to insert the guide wire inserter using the guide wire inserter, the J-shaped tip could not be corrected well, and it was difficult to easily insert the guide wire inserter into the guide wire inserter.

  If it is difficult to insert the guide wire from the proximal opening of the guide wire inserter, insert the distal opening of the guide wire inserter (guide wire outlet) into the proximal end of the guide wire, and insert the guide wire inserter into the distal end of the guide wire. Although it is possible to move the guide wire inserter from the proximal end portion to the distal end portion of the guide wire having a length of 150 cm or more, it takes time and effort.

  Also in angiographic catheters, a catheter inserter is used to insert a tip into a living body while correcting the distal end curved in a desired shape. However, there is a problem similar to that described above.

JP-A-7-155382

  An object of the present invention is to provide a long article introducing device capable of easily inserting a medical long object having a curved tip portion and the like and appropriately correcting the curved tip portion and the like. It is in.

  Such an object is achieved by the present inventions (1) to (3) below. Moreover, it is preferable that it is following (4)-(8).

(1) A long object introduction device having a slit formed of a tubular member having a lumen into which a medical long object can be inserted, and penetrating the tube wall of the tubular member over the entire length of the tubular member. Because
A long article introduction device, wherein a tip of the tubular member has a protrusion partly protruding in the circumferential direction, and the slit is formed on the protrusion.

  (2) The long object introduction device according to (1), wherein the protrusion has a substantially chevron shape having a top portion and a side portion in a plan view, and the slit passes through the top portion or the side portion.

  (3) The long object introducing device according to (1) or (2) above, wherein the proximal end portion of the tubular member has a gap portion formed by expanding the groove width of the slit toward the proximal end direction. .

  (4) The long object introducing device according to any one of (1) to (3), wherein a protrusion length of the protrusion is 1 mm or more, particularly 1 to 3 mm.

  (5) The long object introducing device according to any one of (1) to (4), wherein the gap portion is substantially V-shaped.

  (6) Any of the above (1) to (5), wherein d / Dmax is 0.2 to 2.0, where Dmax is the maximum separation distance of the gap and d is the outer diameter of the long object to be used The long object introducing device according to crab.

  (7) The long object introducing device according to any one of (1) to (6), wherein at least a part of the slit in the thickness direction of the tube wall of the tubular member is in close contact with the slit.

  (8) The long object introducing device according to any one of (1) to (7), wherein the tubular member has a tapered portion in which an outer diameter gradually decreases from a proximal end side toward a distal end side.

  According to the present invention, it is possible to easily insert a long medical object such as a guide wire or a catheter having a curved tip portion, etc., and correct (surely) the curved tip portion or the like properly or This corrected state can be maintained. Therefore, it is possible to easily and reliably insert a long medical object having a curved tip or the like into a lumen such as an introduction needle, a catheter, or a sheath.

  In particular, even when a guide wire composed of a curved portion such as a J-shape having a small curvature radius is inserted, the curved portion can be made appropriate without being caught in the slit.

  Moreover, although the long article introduction instrument of this invention may be removed from a medical long article as needed, the operation of removal can be performed easily and rapidly at this time.

  Hereinafter, the long object introducing device of the present invention will be described in detail based on preferred embodiments shown in the accompanying drawings.

  FIG. 1 is a plan view showing an embodiment in which the elongated object introducing device of the present invention is applied to a guide wire inserter, and FIGS. 2 and 3 are a side view and a side cross section of the guide wire inserter shown in FIG. 1, respectively. 4 is a cross-sectional view taken along the line AA in FIG. 2, and FIG. 5 is a cross-sectional view taken along the line BB in FIG.

  As shown in FIGS. 1-5, the guide wire inserter 1 is comprised by the tubular member 2 which has the lumen | bore (guide wire channel | path) 22 which can insert the guide wire 6 which is a medical elongate member inside. .

  The tubular member 2 has a portion having a substantially constant outer diameter on the proximal end side, and has a tapered portion 21 having a tapered shape in which the outer diameter gradually decreases toward the distal end side from this portion. By having such a taper part 21, the guide wire inserter 1 can be inserted easily and smoothly.

  The taper angle of the taper portion 21 may be constant over the entire length of the taper portion 21 or may change in the middle (see FIGS. 1 and 2).

  The distal end portion 25 of the tubular member 2 is preferably tapered (tapered) toward the distal end. The distal end portion 25 is a portion that is inserted into and connected to (connected to) an introduction needle, a catheter or a catheter hub, various connectors, a sheath, etc. (not shown), and a curved distal end portion of the guide wire 6 (curved distal end). It is also a part that bears the function of correcting (stretching) the part 61). Since the distal end portion 25 has a tapered shape, insertion and connection to a sheath or the like can be performed easily and reliably.

  Both ends of the lumen 22 open to the proximal end and the distal end of the tubular member 2, respectively. The proximal end opening of the tubular member 2 forms an introduction port 23 of the guide wire 6, and the distal end opening of the tubular member 2 forms an outlet port 24 of the guide wire 6. In this case, the shapes of the inlet 23 and the outlet 24 are each circular, but may be other than circular, for example, an ellipse or a polygon.

  The inner diameter of the lumen 22 may be substantially constant over the entire length of the tubular member 2 or may have a portion that changes in the middle. In the configuration shown in the drawing, a portion on the proximal end side of the tubular member 2 has a portion in which the inner diameter of the lumen 22 is expanded (gradually increased) in the proximal direction.

  The inner diameter of the lumen 22 only needs to be such that the guide wire 6 can be sufficiently inserted. Specifically, the minimum inner diameter of the lumen 22 is preferably about 0.3 to 1.5 mm. In the case of an inserter for inserting a catheter such as angiographic catheter 8 to be described later, it is preferably about 0.3 to 2.5 mm, and more preferably about 0.4 to 2.2 mm. More preferred.

  As a constituent material of the tubular member 2, for example, a material having a certain degree of elasticity while being rigid is preferable, and examples thereof include polyolefins such as polyethylene and polypropylene, polyamides, and polycarbonates.

  Such a tubular member 2 has a slit 3 formed therein. The slit 3 is formed through the tube wall of the tubular member 2 along the entire length of the tubular member 2. The slit 3 is formed in a straight line in a plan view (FIG. 1).

  By providing such a slit 3, when the guide wire 6 is inserted into the lumen 22 of the tubular member 2, the slit 3 is opened and can be easily inserted through the opened slit 3.

  As shown in FIG. 4, it is preferable that the slit 3 has a substantially I-shaped cross section, that is, substantially adheres from the lumen 22 side to the outer peripheral surface side of the tube wall of the tubular member 2. In addition, for example, a Y-shaped or V-shaped configuration in which the lumen 22 side is in close contact may be used.

  Since the slit 3 is in close contact with the tube wall in the thickness direction, the guide wire 6 once inserted into the lumen 22 is prevented from unintentionally jumping out to the outside through the slit 3. The

  As shown in FIGS. 1 and 5, the base end portion of the tubular member 2 has a gap portion 4 formed by gradually increasing the groove width of the slit 3 toward the base end direction. The gap 4 has a substantially V shape (wedge shape) in plan view. By having such a gap portion 4, the gap portion 4 can serve as a trigger (starting point) for inserting the guide wire 6 into the lumen 22, and the guide wire 6 can be easily inserted into the lumen 22. it can. That is, first, the guide wire 6 is inserted (addressed) into the gap portion 4, and subsequently, the guide wire 6 is pushed toward the inner cavity 22 to be inserted into the slit 3, and the slit 3 is sequentially directed toward the distal end. The guide wire 6 can be sequentially inserted into the lumen 22 by opening.

  In the configuration shown in the drawing, the gap 4 is maximally spaced at the proximal end (most proximal end) of the tubular member 2. The maximum separation distance Dmax of the gap 4 is not particularly limited, but when the outer diameter of the guide wire 6 to be used is d (see FIG. 4), d / Dmax is about 0.2 to 2.0. Is preferable, and about 0.5 to 0.9 is more preferable. By setting it as such a range, the operation which makes the guide wire 6 interrupt in the slit 3 from the clearance gap part 4 can be performed more easily and reliably.

  The length of the gap 4 in the axial direction (longitudinal direction of the tubular member 2) is not particularly limited, but is preferably about 0.1 to 2.5 mm, and about 0.1 to 3.0 mm. Is more preferable.

  At the distal end of the tubular member 2, a protrusion 5 is formed in which a part of the tubular member 2 in the circumferential direction (the upper portion in FIG. 2) projects in the distal direction. The protrusion 5 has a substantially chevron shape having a top portion and a side portion in a plan view (FIG. 1). The slit 3 passes through the top of the peak of the protrusion 5. That is, the protrusion 5 has a symmetrical shape via the slit 3. The slit 3 may be configured to pass through the side of the mountain.

  By providing such a protrusion 5, the strength is increased moderately, and when the distal end bending portion 61 of the guide wire 6 is corrected at the distal end portion 25, the tip bending portion 61 is prevented from being caught in the slit 3. Can do. Therefore, the distal end bending portion 61 of the guide wire 6 can be corrected easily and properly (reliably), and the guide wire 6 can be easily and reliably introduced into the introduction needle, catheter, sheath, and the like.

  The length L of the protrusion 5 protruding in the distal direction is not particularly limited, but is preferably 1 mm or more, and more preferably about 1 to 3 mm.

  Next, an example of a method for using the guide wire inserter of the present invention will be described with reference to FIGS. 6 to 9 are cross-sectional side views each showing an example of a method of using the guide wire inserter of the present invention.

  As shown in FIG. 6, first, the guide wire 6 is inserted into the gap portion 4 in a state where the distal end bending portion 61 of the guide wire 6 is positioned on the distal end side with respect to the protrusion 5 at the distal end of the guide wire inserter 1. .

  Next, a portion in the gap 4 of the guide wire 6 is pushed toward the inner cavity 22, and the guide wire 6 is inserted into the slit 3. As a result, the slit 3 is sequentially opened toward the distal end, and the guide wire 6 is sequentially inserted into the lumen 22 along with this (see FIG. 7).

  When the above operation is performed up to the distal end of the tubular member 2, the guide wire 6 is inserted into the lumen 22 as shown in FIG. 8. That is, the guide wire 6 passes through the introduction port 23, passes through the lumen 22, and protrudes from the outlet port 24 in the distal direction. At this time, the distal end bending portion 61 of the guide wire 6 is in a state of protruding from the outlet port 24 to the distal end while maintaining the curved shape.

  Next, as shown in FIG. 9, when the guide wire 6 is pulled in the proximal direction, the distal curved portion 61 is accommodated in the lumen 22 and is corrected to a substantially straight shape. At this time, since the protrusion 5 is formed at the tip of the tubular member 2, the tip bending portion 61 is prevented from being caught in the slit 3. Thereby, the correction | amendment of the front-end | tip bending part 61 of the guide wire 6 can be performed easily and reliably (proper).

  In the state shown in FIG. 9, the distal end portion 25 of the guide wire inserter 1 is inserted and connected (connected) to the proximal end portion of the sheath, for example. When the guide wire 6 is sent out in the distal direction, the guide wire 6 is inserted into the sheath.

  As described above, since the distal end bending portion 61 of the guide wire 6 is properly corrected, the operation of connecting the distal end portion 25 to the sheath or the like and the operation of feeding the guide wire 6 into the sheath are performed easily and reliably. be able to.

  FIG. 10 is a cross-sectional side view showing an embodiment when the elongated object introducing device of the present invention is applied to a catheter inserter, and FIG. 11 is an example of a method for using the catheter inserter of the present invention (the distal bending portion 81 of the catheter 8). FIG. 12 is a cross-sectional side view showing an example of a method of using the catheter inserter of the present invention (state where the catheter inserter 7 is removed from the catheter 8). FIG. Hereinafter, the catheter inserter will be described with reference to these drawings, but the description of the same matters as those of the above-described guide wire inserter will be omitted, and differences will be mainly described.

  The catheter inserter 7 is composed of the same tubular member 2 as described above having a lumen (guide wire passage) 22 into which the catheter 8 which is a long medical member can be inserted. The tubular member 2 is formed with the same slit 3, gap 4 and protrusion 5 as described above.

  In the illustrated example, the catheter 8 inserted into the lumen 22 is an angiographic catheter, and is a pigtail type catheter in which a distal end bending portion 81 is formed in a loop shape. A hub 83 is installed at the proximal end of the catheter 8.

Next, an example of a method for using the catheter inserter of the present invention will be described.
First, the catheter 8 is inserted into the gap 4 in a state where the distal end bending portion 81 of the catheter 8 is positioned on the distal end side with respect to the protrusion 5 at the distal end of the catheter inserter 7.

  Next, a portion in the gap portion 4 of the catheter 8 is pushed toward the lumen 22, and the catheter 8 is interrupted into the slit 3. As a result, the slit 3 is sequentially opened toward the distal end, and the catheter 8 is sequentially inserted into the lumen 22 along with this.

  When the above operation is performed up to the distal end of the tubular member 2, the catheter 8 is inserted into the lumen 22 (see FIG. 10). That is, the catheter 8 passes through the introduction port 23, passes through the lumen 22, and protrudes from the outlet port 24 in the distal direction. At this time, the distal end bending portion 81 of the catheter 8 is in a state of protruding from the outlet port 24 to the distal end while maintaining the curved shape.

  Next, when the catheter 8 is pulled in the proximal direction, the distal bending portion 81 is accommodated in the lumen 22 and is corrected to a substantially straight shape (see FIG. 11). At this time, since the protrusion 5 is formed at the tip of the tubular member 2, the tip bending portion 81 is prevented from being caught in the slit 3. Thereby, the correction | amendment of the front-end | tip bending part 81 of the catheter 8 can be performed easily and reliably (proper).

  It should be noted that the same action and effect can be obtained even if the shape of the distal end bending portion 81 of the catheter 8 is other than the pigtail type shown in the figure, for example, a Judkins type or Amplats type catheter. That is, the above-described effects can be obtained regardless of the shape of the distal end bending portion 81 of the catheter 8.

  The distal end portion 25 of the catheter inserter 7 is inserted and connected (connected) to the proximal end portion of the sheath, for example. When the catheter 8 is sent out in the distal direction, the catheter 8 is inserted into the sheath. Since the distal end bending portion 81 of the catheter 8 is properly corrected, the operation of connecting the distal end portion 25 to the sheath and the like and the operation of feeding the catheter 8 into the sheath can be performed easily and reliably. Note that the distal end portion 25 of the catheter inserter 7 may be inserted into the proximal end of a guide wire securing a blood vessel without using a sheath, and in this case as well, the catheter 8 is fed into the blood vessel. Can be carried out easily, reliably and safely.

  The catheter inserter 7 may be removed from the catheter 8 as necessary while the catheter 8 is inserted into the lumen 22 of the catheter inserter 7. Since the catheter 8 has the hub 83 at the proximal end, this detaching operation is performed as follows.

  As shown in FIG. 12, first, the catheter 8 is inserted into the gap 4, and the catheter 8 is inserted into the slit 3 so as to be pulled out from the lumen 22. As a result, the slits 3 are sequentially opened in the distal direction, and the catheter 8 is sequentially taken out from the lumen 22 (indicated by a dotted line in FIG. 12).

  In the catheter inserter 7 of the present embodiment, the slit 3 is formed so as to penetrate the tube wall of the tubular member 2 along the entire length of the tubular member 2, so that the removal operation as described above (separation of the catheter inserter 7 and the catheter 8 is performed). Work) can be performed easily and quickly.

  The catheter inserted into the catheter inserter 7 is not limited to the above-described angiographic catheter, and may be any type of catheter.

  The present invention has been described based on the illustrated embodiments. However, the present invention is not limited to these embodiments, and the configuration of each part can be replaced with any configuration that can exhibit the same function. In addition, an arbitrary configuration may be added.

  For example, in the illustrated embodiment, the slit is linear in a plan view (FIG. 1), but is not limited to this, for example, a mode in which all or part of the slit is curved or bent or a spiral shape. It may be of a form extending to

  In addition, the long object introducing device of the present invention is not limited to a guide wire inserter or a catheter inserter, and may be a device for guiding a medical long object other than a guide wire and a catheter.

It is a top view which shows embodiment at the time of applying the elongate article introduction instrument of this invention to a guide wire inserter. It is a side view which shows embodiment of the guide wire inserter of this invention. It is a cross-sectional side view which shows embodiment of the guide wire inserter of this invention. It is the sectional view on the AA line in FIG. It is the BB sectional view taken on the line in FIG. It is a cross-sectional side view which shows an example of the usage method of the guide wire inserter of this invention. It is a cross-sectional side view which shows an example of the usage method of the guide wire inserter of this invention. It is a cross-sectional side view which shows an example of the usage method of the guide wire inserter of this invention. It is a cross-sectional side view which shows an example of the usage method of the guide wire inserter of this invention. It is a cross-sectional side view which shows embodiment at the time of applying the elongate article introduction instrument of this invention to a catheter inserter. It is a cross-sectional side view which shows an example of the usage method of the catheter inserter of this invention. It is a cross-sectional side view which shows an example of the usage method of the catheter inserter of this invention.

Explanation of symbols

1 Guide wire inserter (Long material introducing device)
DESCRIPTION OF SYMBOLS 2 Tubular member 21 Tapered part 22 Lumen 23 Introduction port 24 Outlet port 25 Tip part 3 Slit 4 Crevice part 5 Projection part 6 Guide wire 61 Tip curve part 7 Catheter inserter (elongate article introduction instrument)
8 Catheter 81 Tip curve part 83 Hub

Claims (3)

A long article introduction device comprising a tubular member having a lumen through which a medical long article can be inserted, and having a slit formed through the tube wall of the tubular member over the entire length of the tubular member. ,
A long article introduction device, wherein a tip of the tubular member has a protrusion partly protruding in the circumferential direction, and the slit is formed on the protrusion.   The long object introducing device according to claim 1, wherein the protrusion has a substantially chevron shape having a top and a side in a plan view, and the slit passes through the top or the side.   The long object introducing device according to claim 1 or 2, wherein a gap portion is formed at a proximal end portion of the tubular member so that a groove width of the slit is enlarged toward a proximal end direction.

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