JP2007020885A - Medical treatment instrument - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical treatment instrument capable of highly accurately measuring a lesion length on a radioscopic image, for accurately and easily selecting and judging an optimum stent. <P>SOLUTION: The medical treatment instrument is provided with a catheter 2 and a guide wire 3, and the catheter 2 and the guide wire 3 respectively have radiopaque three markers M1-M3 and five markers m1-m5 for measuring the length of a stenosing lesion part P. An operator makes liquid flow to the balloon 22 of the catheter 2 to expand the balloon 22, moves the guide wire 3 while looking at perspective images when expanding the balloon 22 or after completing the expansion, and superimposes a shadow image by the marker m2 and the shadow image by the marker M1. A scale S is constituted of a measurement reference shadow image O which is a superimposed shadow image and the other shadow image. Thus, the intervals Z1-Z6 of the scale S are reduced and the lesion length is highly accurately measured while maintaining the flexibility of the guide wire 3 at the center part of a blood vessel diameter direction. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention is used for the treatment of stenotic lesions such as cardiac blood vessels (for example, percutaneous coronary angioplasty), which enables highly accurate measurement of lesion length and the comparison between lesion length and various stent lengths. The present invention relates to a treatment tool.

  For the treatment of stenotic lesions such as cardiac blood vessels, insert a guide wire into the blood vessel, set the tip of the guide wire to exceed the stenosis lesion, and move the balloon catheter along the guide wire to the stenosis lesion There is a treatment method that guides and expands the balloon of the balloon catheter to place the expanded stent in the stenotic lesion and expand the stenotic lesion.

  At this time, it is necessary to select and use a stent having a length corresponding to the length in the blood vessel axis direction of the stenotic lesion (hereinafter referred to as lesion length). Therefore, before the stent placement, the lesion length is measured, and a stent (optimum stent) having an appropriate length with respect to the lesion length is selected from a plurality of stents having various lengths. Therefore, it is desired that highly accurate measurement of the lesion length and easy selection of the optimal stent can be performed.

In addition, various lengths are prepared for the stent products so that an appropriate length can be selected for the lesion length.
For example, a product name cipher, which is a drug-eluting stent manufactured by Johnson & Johnson, is available in five lengths, each having a length of 8 mm, 13 mm, 18 mm, 23 mm, and 33 mm. The brand name Taxus, which is a drug-eluting stent from Boston, is available in seven lengths from 8 mm to 32 mm in increments of 4 mm.

Conventionally, as a method for measuring a lesion length, there is a method of visually confirming an insertion state in a blood vessel on a radioscopic image using a guide wire having a radiopaque marker.
In addition, there is a guide wire having a plurality of radiopaque markers on the distal end side, and the distance between them is a fixed relationship (see Patent Document 1). However, when this guide wire is used, the surgeon must remember the dimensions of this fixed relationship, and in the case of a lesion length that does not match the fixed relationship, the operator's visual measurement will be performed. .

  Moreover, the outer diameter of the guide wire in Patent Document 1 is about 1/10 of the inner diameter of the blood vessel. For this reason, for example, when measuring by inserting a guide wire into an S-shaped blood vessel having two bent portions bent inside by about 90 degrees and further bent outward by about 90 degrees, the guide wire is It is not positioned at the center of the blood vessel in the radial direction, and it is inserted so that it passes through the side with a large radius of curvature at the two bends (largely), or conversely, the radius of curvature at the two bends is small It may be inserted so as to pass through the side (small turn), resulting in a measurement difference. In fact, the blood vessels in the vicinity of the lesion have a plurality of bent shapes such as an S-shape, and thus there is a problem in that highly accurate lesion length measurement cannot be performed.

  In general, the marker of the guide wire is fixed to a brazing material of radiopaque material on the outer surface of the core material and the inner surface of the coil body, or a small coil of radiopaque material is placed in the coil body. Since both ends of the small coil are fixed to the core surface with a brazing material, the smaller the distance between the markers, the shorter the fixing distance due to the brazing material and the higher the bending rigidity. In addition, it becomes difficult to insert a deep part into a fine blood vessel in a meandering manner. Therefore, when the markers are arranged while maintaining the flexibility of insertion into the deep part, the distance between the markers has a limit that cannot be further reduced. Therefore, if the distance between the markers is reduced in order to perform high-accuracy measurement, the flexibility required for the guide wire is lost.

  In addition, there is a catheter in which a plurality of radiopaque markers are provided at equal intervals (see Patent Document 2). However, even with the measurement using only this catheter, the above-described problems occur, so that it is difficult to perform high-precision measurement at a lesion position by deep insertion into a bent blood vessel.

  In addition, there is a balloon catheter provided with a radiopaque marker and a graduation line. The marker and the graduation line are used for position confirmation and are not for measuring a lesion length (Patent Literature). 3).

In addition, there is a method using IVUS (ultrasonic endoscope) as a method for measuring the lesion length. Even in this method, the outer diameter of IVUS (1 to 1.2 mm) is about 1/3 of the inner diameter of the blood vessel. Therefore, there is a problem that the lesion length cannot be measured at the central portion in the radial direction of the blood vessel, and the lesion length cannot be measured with high accuracy. The measurement with IVUS is performed by setting a certain reference point and then pulling it back to the hand after IVUS is advanced to the stenotic lesion. For this reason, since the difference in the axial direction of the reference point setting caused by the reversal operation and the wavy passage route in the uneven state of the vascular inner wall of the lesioned part will cause an error compared to the case of the straight path, High-precision measurement is difficult.
Japanese translation of PCT publication No. 2004-516049 Utility Model Registration No. 3100671 JP 2001-37882 A

  The present invention has been made to solve the above-described problems, and can accurately measure the length of a lesion on a radioscopic image and accurately and easily determine the selection of an optimal stent. An object of the present invention is to provide a medical treatment tool.

[Means of Claim 1]
The medical treatment tool according to claim 1 includes an elongated flexible shaft, a catheter that is disposed so as to surround a part of the shaft and expands the stenotic lesion, and the expansion body to the stenosis lesion. Each of the catheter and the guide wire has a plurality of radiopaque markers for measuring the length of the stenotic lesion, and at least one of the plurality of markers included in the catheter. Is attached to a part of the shaft surrounded by the expansion body, and applies radiation to the marker of the catheter and the marker of the guide wire to project a plurality of images in a row on the fluoroscopic image, and 1 of the images obtained from the catheter marker And one of the images obtained from the marker on the guide wire are overlapped to form a measurement reference image, and the measurement reference image and another image form a scale to measure. Measuring the length of the stenotic lesion by viewing the distance between the quasi-imaging and other imaging.

Both the catheter and the guide wire have a marker, and one of the images obtained from the catheter marker and one of the images obtained from the guide wire marker are superimposed to form a measurement reference image, and this measurement reference image and another image By constructing a scale with the scale, the interval between the images on the fluoroscopic image can be reduced, so there is no need to reduce the interval between the markers, while maintaining the flexibility of the guide wire, Highly accurate lesion length measurement can be performed.
In addition, at least one of the plurality of markers included in the catheter is attached to a part of the shaft surrounded by the expansion body, so that the expansion body is expanded around the inner wall of the blood vessel by expanding the expansion body of the catheter. In contact, the marker of the catheter and the guide wire is always located at the center in the radial direction of the blood vessel, so that highly accurate lesion length measurement can be performed.
Since highly accurate lesion length measurement can be performed on a fluoroscopic image, the optimum stent can be selected accurately and quickly.
Furthermore, by accurately selecting a stent having an appropriate length (optimal stent) with respect to the lesion length, it is possible to contribute to the reduction of the burden on the patient and safety.

[Means of claim 2]
In the medical treatment tool according to claim 2, at least a part of the scale forms an equally-spaced portion in which the intervals between adjacent image images are equal.
Thereby, on the fluoroscopic image, it becomes a scale of equal intervals for measuring the lesion length, and it is easy to visually confirm and easily measure the lesion length.

[Means of claim 3]
In the medical treatment tool according to claim 3, the interval between at least one of the front end portion and the rear end portion of the scale is different from the interval between the equally spaced portions.
As a result, many types of commercially available stent lengths can be displayed at intervals of the scale, and not only the length of the lesion can be measured, but also the comparison between the lesion length and the commercially available stent length can be confirmed, and the optimum stent is selected. Is extremely easy.

[Means of claim 4]
In the medical treatment tool according to the fourth aspect, the plurality of images have at least two different modes, and at least a part of the scale forms an image different portion in which the modes of the adjacent images are different.
As a result, compared to the case where each shadow image has the same form on the fluoroscopic image, the image recognition is performed in regular repeating units based on the shape difference, the lightness difference, and a combination thereof. Easy to measure and easy to measure. In addition, since visual recognition and recognition are facilitated, the possibility that an operator mistakes the scale and selects an inappropriate stent is reduced.

[Means of claim 5]
In the medical treatment tool according to claim 5, the image different part has at least three different forms of images, and at least a part of the image different parts, the images of the three different forms appear sequentially. Medical treatment tool.
This further facilitates visual recognition and recognition, and further reduces the possibility that the surgeon mistakes the scale and selects an inappropriate stent.

[Means of claim 6]
In the medical treatment instrument according to claim 6, the plurality of markers of the catheter are arranged at equal intervals, and the plurality of markers of the guide wire are arranged such that the front end side marker and the rear end side marker are symmetrically arranged with reference to one marker. .
Thereby, the measurement can be performed by switching from the front end side or the rear end side, and in particular, the measurement of the lesion length of a long lesion extending from the expansion body to the front rear end side becomes extremely easy.

[Means of Claim 7]
In the medical treatment tool according to claim 7, the image of a different aspect included in the image different portion is formed by disposing a radiopaque material only on the outer surface on the core side of the guide wire. Guidewire marker, radiopaque material, guidewire marker, radiopaque material formed by placing the outer surface of the guidewire core material and the inner surface of the coiled body of the guidewire. The permeable material is obtained from a marker selected from among the catheter markers formed by placing it on the catheter.
As a result, images of different modes can be obtained, and the interval between the images can be made smaller while maintaining a certain degree of flexibility. Conversely, if the intervals between the images are constant, more flexibility can be obtained. Can be secured.

[Means of Claim 8]
In the medical treatment tool according to claim 8, the axial width of the guide wire marker is 0.3 to 1.5 mm.
If the marker has a width within this range, the boundary between the stenotic lesion and the normal site can be pinpointed and visually recognized on the fluoroscopic image.

[Means of Claim 9]
In the medical treatment instrument according to the ninth aspect, all the guide wire markers are provided at a position in the range of 50 to 125 mm from the distal end of the guide wire.
This is because, within this range, many stenotic lesions that occur frequently in the blood vessel bifurcation of the right or left coronary artery are applicable.

[Means of Claim 10]
In the medical treatment tool according to claim 10, the catheter has three markers.
This facilitates measurement for a relatively long lesion length.

[Means of Claim 11]
In the medical treatment tool according to claim 11, the catheter has two markers.
Thereby, the passage property in a bending meander part can be improved.

[Means of Claim 12]
In the medical treatment tool according to claim 12, the catheter is a balloon catheter.
Thereby, the marker of a balloon catheter and the marker of a guide wire can always be stably maintained in the center part of the radial direction of the blood vessel.

  The medical treatment instrument of the best mode 1 includes an elongated flexible shaft, a catheter that is disposed so as to surround a part of the shaft and expands the stenotic lesion, and guides the expansion to the stenosis lesion. Each of the catheter and the guide wire has a plurality of radiopaque markers for measuring the length of the stenotic lesion, and at least one of the plurality of markers included in the catheter One of the images obtained from the catheter marker, which is attached to a part of the shaft surrounded by the expansion body and projects a plurality of images in a row on the fluoroscopic image by applying radiation to the marker of the catheter and the marker of the guide wire. And one of the images obtained from the marker on the guide wire are superposed to form a measurement reference image, and the measurement reference image and another image form a scale, and the measurement is performed. Measuring the length of the stenotic lesion by viewing the distance between the reference shadow image and the other imaging.

  At least a part of the scale forms an equally spaced portion in which the intervals between adjacent images are equal. The plurality of images have at least two different forms, and at least a part of the scale forms an image different part in which the forms of adjacent images are different. The image of a different aspect included in the image different portion is a guidewire marker formed by arranging a radiopaque material only on the outer surface on the core side of the guidewire, a radiopaque material, Formed by placing guidewire markers and radiopaque material on the catheter, which are formed by bridging the outer surface of the guidewire core and the inner surface of the guidewire coil. Obtained from a marker selected from among catheter markers.

  Further, the guide wire marker has an axial width of 0.3 to 1.5 mm, and all the guide wire markers are mounted at a position in the range of 50 to 125 mm from the tip of the guide wire. The catheter has three markers. The catheter is a balloon catheter.

  In the medical treatment tool of the best mode 2, at least one interval between the front end portion and the rear end portion of the scale is different from the interval between the equally spaced portions.

  In the medical treatment tool of the best mode 3, the catheter has two markers.

  In the medical treatment tool of the best mode 4, the plurality of markers of the catheter are arranged at equal intervals, and the plurality of markers of the guide wire are arranged such that the front end side marker and the rear end side marker are symmetrically arranged with reference to one marker.

In the medical treatment tool of the best form 5, the image different portion has at least three different forms of images, and at least a part of the image different portions, three different forms of images appear in sequence.
The image of the different mode included in the different image portion is a guidewire marker formed by placing the radiopaque material only on the outer surface of the guidewire core side, the radiopaque material, and the guidewire core. Guide wire marker formed by placing the outer surface of the material and the inner surface of the coil body of the guide wire in a cross-linked manner, and the marker of the catheter formed by placing the radiopaque material on the catheter Obtained from a marker selected from among them.

[Configuration of Example 1]
The structure of the medical treatment tool 1 of Example 1 is demonstrated using FIG. 1 and FIG.
As shown in FIGS. 1 and 2, the medical treatment instrument 1 includes a catheter 2 and a guide wire 3, and performs medical treatment by expanding a stenotic lesion P of a blood vessel, for example. Note that an indwelling device called a stent is usually placed in the stenotic lesion P subjected to the expansion treatment in order to maintain the expanded state so that stenosis does not occur again.

The catheter 2 is disposed so as to surround a part of the inner shaft 21, the inner shaft 21, and connected to the rear end side of the balloon 22 and a balloon (expansion body) 22 for expanding the stenotic lesion P. An outer shaft 23 that forms a flow path for flowing a liquid for expansion together with the inner shaft 21 is provided.
The catheter 2 is used for pre-expansion to expand the stenotic lesion P in advance before placing the stent, and the effective length in the axial direction of the balloon 22 is relatively short (15 to 15). About 20 mm).

  The guide wire 3 guides the balloon 22 of the catheter 2 to the stenotic lesion P, and includes a core material 31 and a coil body 32 provided on the outer periphery thereof.

  The catheter 2 and the guide wire 3 have three radiopaque markers M1 to M3 and five markers m1 to m5 for measuring the length of the stenotic lesion P, respectively.

As shown to Fig.2 (a), the markers M1-M3 of the catheter 2 are located in order from the front end side. The markers M1 and M2 are provided on the outer periphery of the inner shaft 21 surrounded by the balloon 22 described above. The marker M3 is provided on the outer periphery of the inner shaft 21 on the rear end side from the balloon 22.
The markers M1 and M2 are provided at a distance X1, and the markers M2 and M3 are provided at a distance X2.
In this embodiment, the distance X1 and the distance X2 are equal.

The markers M1 to M3 are formed by forming a radiopaque material (gold, platinum, tungsten, etc.) in a cylindrical shape. The markers M1 to M3 may be formed in a coil shape to have flexibility. Further, the marker M3 may be provided not on the outer periphery of the inner shaft 21 but on the outer periphery of the outer shaft 23.
In this embodiment, the markers M1 to M3 have an axial width of 1 mm, an outer diameter of 0.64 mm, and a thickness of 0.04 mm.

As shown in FIG.2 (b), the markers m1-m5 are located in a line from the front end side. The markers m1 and m2 are provided at a distance Y1, the markers m2 and m3 are provided at a distance Y2, the markers m3 and m4 are provided at a distance Y3, and the markers m4 and m5 are provided at a distance Y4.
In this embodiment, the distance Y1 and the distance Y2 are equal to 1/2 of the distance X1. The distance Y3 and the distance Y4 are equal to the distance X1.

The markers m1 to m5 are provided so as to crosslink the outer surface of the core material 31 of the guide wire 3 and the inner surface of the coil body 32 of the guide wire 3 using a brazing material of a radiopaque material. ing. Since the inner shaft 21 travels in the blood vessel so as to surround the outer periphery of the guide wire 3 (see FIG. 1), the outer diameters of the markers m1 to m5 are smaller than the inner diameter of the inner shaft 21. Therefore, the outer diameters of the markers m1 to m5 are smaller than the outer diameters of the markers M1 to M3.
In this embodiment, the markers m1 to m5 have an axial width of 1 mm, an outer diameter of the core material is 0.15 mm, an inner diameter of the coil body is 0.21 mm, and an outer diameter is 0.35 mm. The markers m1 to m5 are all provided at positions in the range of 50 to 125 mm from the tip of the guide wire 3.

[Scale formation method of Example 1]
The scale formation method of Example 1 is demonstrated using FIG. 1 and FIG.
First, the body is irradiated with radiation, the blood vessel and the stenotic lesion P are projected on the fluoroscopic image, the guide wire 3 is protruded from the distal end portion of the balloon 22 by about 50 mm, and the catheter 2 and the guide wire 3 are inserted into the blood vessel. Next, the guide wire 3 is inserted into and passed through the stenotic lesion P at the position of the stenotic lesion P. Thereafter, the balloon 22 is guided to the stenotic lesion P along the guide wire 3, and a liquid such as physiological saline is passed through the balloon 22 of the catheter 2 to expand the balloon 22.

When the balloon 22 is expanded or after the expansion is completed, the guide wire 3 is moved while viewing the fluoroscopic image, and the image formed by the marker m2 and the image formed by the marker M1 are superimposed. Then, as shown in FIG. 2C, the superimposed image is set as a measurement reference image O.
Thereafter, the position of the guide wire 3 held by the operator's finger is held, or the connector (not shown) connected to the rear ends of the catheter 2 and the guide wire 3 and used for the operator's hand operation is not stopped. The position of the measurement reference image O is stabilized by preventing the mutual displacement of the catheter 2 and the guide wire 3 by tightening the screw lock portion or the like.
As described above, the scale S is composed of the measurement reference image O and the other images on the fluoroscopic image.

  Here, the other images constituting the scale S are the scale image F1 on the front side of the measurement reference image O and the scale images F2 to F6 on the rear side of the measurement reference image O. As shown in FIG. 2, the scale image F1 to F6 are images formed by the markers m1, m3, M2, m4, M3, and m5, respectively.

[Features of Scale S of Example 1]
Below, the characteristic of the scale S of a present Example is described.
Here, an interval between the scale image F1 and the measurement reference image O is defined as an interval Z1. Similarly, as shown in FIG. 2C, intervals Z2 to Z6 are defined in order from the front end side.

  First, the entire scale S of the present embodiment forms an equally spaced portion SE in which the intervals Z1 to Z6 between adjacent image images are equal to each other. The reason why the intervals Z1 to Z6 are equal to each other will be described below.

  In the present embodiment, since the distance Y2 is 1/2 of the distance X1, the interval Z3 is 1/2 of the distance X1. Since the distance Z3 is 1/2 of the distance X1 and the distance Y3 is equal to the distance X1, the distance Z4 equal to the difference between the distance Y3 and the distance Z3 is equal to 1/2 of the distance X1. Similarly, the intervals Z5 and Z6 are each equal to 1/2 of the distance X1.

As described above, the entire scale S of the present embodiment forms an equally spaced portion SE in which the intervals Z1 to Z6 between adjacent images are each equal to 1/2 of the distance X1.
For example, when the distances X1, X2, Y3, and Y4 are 10 mm and the distances Y1 and Y2 are 5 mm, the intervals Z1, Z2, Z3, Z4, Z5, and Z6 are each 5 mm. Thereby, the scale S in increments of 5 mm can be configured.

  Next, the whole scale S of the present embodiment forms an image different portion FD in which the mode of adjacent image is different. Hereinafter, the reason why the entire scale S forms the image different portion FD will be described.

  In the scale S of the present embodiment, the scale image F1 is an image by the marker m1, and the measurement reference image O adjacent to the rear end side of the scale image F1 is an image obtained by superimposing the image by the marker m2 and the image by the marker M1. is there. Therefore, the scale image F1 and the measurement reference image O are different from each other because they reflect the marker m1, the marker m2, and the marker M1 having different shapes. For example, the scale image F1 and the measurement reference image O have different shape differences due to differences in the size of the fluoroscopic image in the height direction or the brightness on the fluoroscopic image, as shown in FIG. In this manner, a brightness difference is generated.

  In the same manner, the measurement reference image O and the scale image F2 to F6 are different from each other. For example, the shape difference and brightness difference between a small image and a large image in the height direction are regularly repeated.

  As described above, in the present embodiment, adjacent images and mutually different images appear alternately on the entire scale S. That is, the entire scale S forms an image different portion FD in which the forms of adjacent images are different.

[Effect of Example 1]
The catheter 2 has markers M1 to M3, the guidewire 3 has markers m1 to m5, and the image of the catheter 2 by the marker M1 and the image of the guidewire 3 by the marker m2 are superimposed to form a measurement reference image O, By forming the scale S with the measurement reference image O and the other scale image F1 to F6, the intervals S3 to Z6 of the scale S could be reduced.
According to the present embodiment, even if the distances Y3 and Y4 are not reduced, the markers m1 to m5 of the guide wire 3 and the markers M1 to M3 of the catheter 2 are used in combination. Can do. Conventionally, since the markers m1 to m5 of the guide wire 3 and the markers M1 to M3 of the catheter 2 are not used in combination, a scale is formed on either side. Although there was a limit due to the rise, according to this example, the flexibility of the guide wire 3 was kept constant by using the markers m1 to m5 of the guide wire 3 and the markers M1 to M3 of the catheter 2 together. In other words, the deep portion can be inserted into the bent thin blood vessel, and the measurement can be performed with high accuracy by making the scale interval small.

  Of the markers M1 to M3 included in the catheter 2, the marker M1 and the marker M2 are attached to a part of the inner shaft 21 surrounded by the balloon 22, so that the balloon 22 is expanded to the inner wall of the blood vessel. The balloon 22 is circumscribed, and the markers M1 to M3 of the catheter 2 and the markers m1 to m4 of the guide wire 3 are always positioned and stably maintained at the central portion in the radial direction of the blood vessel, and highly accurate lesion length measurement can be performed. it can.

In the present embodiment, all of the scales S form the equally spaced portions SE. On the fluoroscopic image, the scale S is in steps of equal intervals, and the measurement is possible at equal intervals, so that the length of the lesion can be easily measured.
In addition, since it is possible to perform highly accurate lesion length measurement on a fluoroscopic image, it is possible to accurately select a stent optimal for the lesion length from a plurality of stents having various lengths.

Then, by speeding up the comparison between the lesion length and the commercially available stent length, it is possible to reduce the burden on the patient and contribute to safety.
For example, in recent years, drug-eluting stents are commercially available due to the high degree of restenosis after placement of a stenotic lesion site stent (30%). For example, this type of stent has a first layer of a hydrophilic coating containing a therapeutic agent and a hard, hydrophobic second layer outside the first layer, and the second layer cracks during stent expansion. Thus, the therapeutic substance in the first layer is released. In such a case, when the stent is placed, if it rubs against the wall of the calcified lesion or the like during the introduction, the outer surface of the stent is damaged, and the drug is eluted even at a normal site as the placement time becomes longer. Sexual side effects may occur. Accordingly, rapid placement is desired. Furthermore, as described above, the situation of the stenotic lesion P is grasped from the tomographic image using IVUS, but the variation is caused by the thickness of IVUS, the blood vessel diameter, the path through the lesion, etc. I can't hope.
Under such circumstances, by using the medical treatment tool 1 of the present invention, it is possible to accurately measure the lesion length, and at the same time, to confirm the comparison with a commercially available stent length, and to quickly determine whether or not the stent length is appropriate. And special effects that contribute to safety and the like.

  Further, the entire scale S is the image different portion FD. Thereby, on the fluoroscopic image, each of the measurement reference image O and the scale image F1 to F6 constituting the scale S is a fluoroscopic image in which a shape difference and a brightness difference are generated as compared with the case where they are the same mode. Therefore, it is easy to identify and recognize visually, and measurement can be performed with a sense of length measurement. Therefore, even if there are a large number of images, measurement becomes extremely easy.

Note that the marker m2 positioned between the markers m1 and m3 is provided so as to crosslink the outer surface of the core material 31 of the guide wire 3 and the inner surface of the coil body 32 of the guide wire 3. Instead, using a known sputtering apparatus, vapor deposition apparatus, etc., a radiopaque material is formed on the outer surface of the core material 31 with a predetermined film thickness (preferably 0.02 to 0.04 mm). It may be done. Further, a radiopaque wire may be wound around and fixed to the core 31.
When the film is formed on the outer surface of the core material 31 or the wire material is wound and fixed to the core material 31, the outer surface of the core material 31 and the inner surface of the coil body 32 of the guide wire 3 are bridged. The bending rigidity can be kept low as compared with the case where it is fixedly provided. In addition to the above effect, according to this, even if the distances Y1 and Y2 are ½ of the other distances Y3 and Y4, the portion of the marker m2 is as flexible as the other portions of the guide wire 3 Can be maintained. Further, since the marker m2 of the guide wire 3 serving as the measurement reference image O has a shape difference and a brightness difference as compared with the adjacent markers m1 and m3, it is easy to perform an overlapping operation.

  The stent placement treatment is performed after the scale S is constructed using the guide wire 3 and the catheter 2, the lesion length is measured, and the stent length optimal for the lesion length is confirmed and selected. Thus, the reason for using the catheter 2 for pre-expansion before stent placement is that the stenotic lesion P is expanded in advance to improve the passage of the balloon catheter with a stent, and the optimal stent length. This is for confirming the selection and accurate stent placement position before placement.

The configuration of the medical treatment tool 1 according to the second embodiment will be described with reference to FIG. 3 with a focus on differences from the first embodiment.
In the present embodiment, as shown in FIG. 3, the distance Y1 is longer than the distance Y2. That is, the distance X1 is longer than ½ of the distance X1, and the interval Z1 is longer than ½ of the distance X1.

According to this, in the scale S of the present embodiment, the portion from the measurement reference image O to the scale image F6 forms an equally spaced portion SE. That is, among the intervals Z1 to Z6 between adjacent images, the intervals Z2 to Z6 are equal to each other. Further, the interval Z1 that is the tip of the scale S is longer than the intervals Z2 to Z6 of the equally spaced portion SE.
For example, if the distances X1, X2, Y3, and Y4 are 10 mm, the distance Y2 is 5 mm, and the distance Y1 is 8 mm, the interval Z1 is 8 mm and the intervals Z2 to Z6 are 5 mm, respectively.

Thereby, for example, 5 of the trade name Cipher (manufactured by Johnson & Johnson), which is a commercially available drug-eluting stent with five lengths of 8 mm, 13 mm, 18 mm, 23 mm, and 33 mm. The selection of the optimum stent can be made quickly and easily from the length of the kind. That is, when the scale image F1 of the fluoroscopic image is matched with the front end of the stenosis lesion part P and each image point is compared with the rear end of the stenosis lesion part P, the measurement reference image O, the scale image F2, F3 from the scale image F1. , F4, and F6 are 8 mm, 13 mm, 18 mm, 23 mm, and 33 mm, respectively, and all five types of stent lengths and lesion lengths can be checked for comparison.
In addition, since the part from the measurement reference | standard image O to the scale image F6 is the equidistant part SE, the measurement by a length measurement major space | interval is enabled.

The configuration of the medical treatment tool 1 according to the third embodiment will be described with reference to FIG. 4 with a focus on differences from the first embodiment.
In the present embodiment, as shown in FIG. 4, the distance Y1 is shorter than the distance Y2. That is, it is shorter than 1/2 of the distance X1. The distance Y4 is 3/2 of the distance X1.
As a result, the interval Z1 is shorter than ½ of the distance X1, and the interval Z5 is ½ of the distance X1, so the interval Z6 is equal to the distance X1.

According to this, in the scale S of the present embodiment, the portion from the measurement reference image O to the scale image F5 forms an equally spaced portion SE. That is, among the intervals Z1 to Z6 between adjacent images, the intervals Z2 to Z5 are equal to each other. Further, the interval Z1 between the front ends of the scale S is shorter than the intervals Z2 to Z5 of the equally spaced portions SE, and the interval Z6 between the rear ends of the scale S is equal to twice the intervals Z2 to Z5 of the equally spaced portions SE. Become.
For example, if the distances X1, X2, and Y3 are 10 mm, the distance Y2 is 5 mm, the distance Y1 is 3 mm, and the distance Y4 is 15 mm, the interval Z1 is 3 mm, the intervals Z2 to Z5 are 5 mm, and the interval Z6 is 10 mm.

Thus, as in Example 2, the selection of the optimal stent can be made quickly and easily from the five lengths of the trade name Cipher (manufactured by Johnson & Johnson), which is a commercially available drug-eluting stent. Can be. That is, the distances from the scaled image F1 of the fluoroscopic image to the scaled images F2, F3, F4, F5, and F6 are 8 mm, 13 mm, 18 mm, 23 mm, and 33 mm.
In addition, since the part from the measurement reference | standard image O to the scale image F5 is the equally-spaced part SE, the measurement by a length measurement major space | interval is enabled.

The configuration of the medical treatment tool 1 according to the fourth embodiment will be described with reference to FIG. 5 with a focus on differences from the first embodiment.
In this embodiment, as shown in FIG. 5B, the guide wire 3 has four markers m1 to m4. The distance X1 is longer than the distance X2, the distance Y1 is shorter than the distance X1, and is equal to a value obtained by subtracting ½ of the distance X2 from the distance X1. The distance Y2 is equal to the distance X2, and the distance Y3 is longer than the distance X2.

In this embodiment, the image formed by the marker m1 and the image formed by the marker M1 are overlapped, and the overlapped image as shown in FIG.
The other images constituting the scale S are the scale images F1 to F5 on the rear end side with respect to the measurement reference image O. As shown in FIG. 5, the scale image F1 to F5 are images formed by the markers m2, M2, m3, M3, and m4, respectively.

Below, the characteristic of the scale S of a present Example is described.
Here, an interval between the measurement reference image O and the scale image F1 is defined as an interval Z1. Similarly, as shown in FIG. 5C, intervals Z2 to Z5 are defined in order from the front end side.

  First, in the scale S of the present embodiment, the portion from the scale image F1 to the scale image F4 forms an equally spaced portion SE. That is, among the intervals Z1 to Z5 between adjacent images, the intervals Z2 to Z4 are equal to each other. Further, the interval Z1 between the front end portions of the scale S is longer than the intervals Z2 to Z4 of the equally spaced portion SE, and the interval Z5 between the rear end portions of the scale S is longer than the intervals Z2 to Z4 of the equally spaced portion SE. This reason can be explained in the same manner as in the first embodiment.

  For example, if the distance X1 is 13 mm, the distance X2 is 10 mm, the distance Y1 is 8 mm, the distance Y2 is 10 mm, and the distance Y3 is 15 mm, the interval Z1 is 8 mm, the intervals Z2 to Z4 are 5 mm, and the interval Z5 is 10 mm.

  Next, the entire scale S of the present embodiment forms image different portions FD in which the modes of the adjacent images are different by alternately displaying the images of the different modes. The reason why the entire scale S of the present embodiment forms the image different portion FD can be explained in the same manner as in the first embodiment.

According to the present embodiment, it is possible to measure the lesion length by making the measurement reference image O coincide with the tip of the stenotic lesion P.
Thus, as in Example 2, the selection of the optimum stent can be made quickly from the five lengths of the trade name Cypher (manufactured by Johnson & Johnson), which is a commercially available drug-eluting stent, and Easy to do. That is, the distances from the measurement reference image O of the fluoroscopic image to the scale images F1, F2, F3, F4, and F5 are 8 mm, 13 mm, 18 mm, 23 mm, and 33 mm, respectively.
In addition, since the part from the scale image F1 to the scale image F4 is the equally-spaced part SE, it is possible to measure at a length measurement major interval.

The configuration of the medical treatment tool 1 according to the fifth embodiment will be described with reference to FIG. 6 with a focus on differences from the first embodiment.
In the present embodiment, as shown in FIG. 6B, the guide wire 3 has four markers m1 to m4. The distance X1 is shorter than the distance X2 and longer than ½ of the distance X2. The distance Y1 is longer than the distance X1, and is equal to a value obtained by adding the distance X1 and 1/2 of the distance X2. Further, the distance Y2 and the distance Y3 are equal to the distance X2.

In this embodiment, the image formed by the marker m1 and the image formed by the marker M1 are overlapped, and the overlapped image as shown in FIG.
The other images constituting the scale S are the scale images F1 to F5 on the rear end side with respect to the measurement reference image O. As shown in FIG. 6, the scale image F1 to F5 are images formed by the markers M2, m2, M3, m3, and m4, respectively.

Below, the characteristic of the scale S of a present Example is described.
Here, an interval between the measurement reference image O and the scale image F1 is defined as an interval Z1. Similarly, as shown in FIG. 6C, intervals Z2 to Z5 are defined in order from the front end side.

First, in the scale S of the present embodiment, the portion from the scale image F1 to the scale image F4 forms an equally spaced portion SE. That is, among the intervals Z1 to Z5 between adjacent images, the intervals Z2 to Z4 are equal to each other. Further, the interval Z1 between the tips of the scale S is longer than the intervals Z2 to Z4 of the equally spaced portions SE, and the interval Z5 between the rear ends of the scale S is equal to twice the intervals Z2 to Z4 of the equally spaced portions SE. Become.
This reason can be explained in the same manner as in the first embodiment.

  For example, if the distance X1 is 8 mm, the distances X2, Y2, and Y3 are 10 mm and the distance Y1 is 13 mm, the interval Z1 is 8 mm, the intervals Z2 to Z4 are 5 mm, and the interval Z5 is 10 mm.

  Next, in the scale S of the present embodiment, the portion from the measurement reference image O to the scale image F4 forms an image different portion FD in which the form of the adjacent image is different. The reason why the portion of the scale S of the present embodiment from the measurement reference image O to the scale image F4 is different in the form of the adjacent image can be explained in the same manner as in the first embodiment.

According to the present embodiment, it is possible to measure the lesion length by making the measurement reference image O coincide with the tip of the stenotic lesion P. Further, since the measurement reference image O and the scale image F1 have the same size in the height direction, the position of the measurement reference image O is easily recognized on the fluoroscopic image. Furthermore, since the distance X1 between the markers M1 and M2 provided on the outer periphery of the inner shaft 21 surrounded by the balloon 22 is short, the effective length of the balloon 22 in the axial direction can be reduced, and the inside of the bent vasculature can be reduced. It becomes easy to insert the deep part.
Thus, as in Example 2, the selection of the optimum stent can be made quickly from the five lengths of the trade name Cypher (manufactured by Johnson & Johnson), which is a commercially available drug-eluting stent, and Easy to do. That is, the distances from the measurement reference image O of the fluoroscopic image to the scale images F1, F2, F3, F4, and F5 are 8 mm, 13 mm, 18 mm, 23 mm, and 33 mm, respectively.
In addition, since the part from the scale image F1 to the scale image F4 is the equally-spaced part SE, it is possible to measure at a length measurement major interval.

The configuration of the medical treatment tool 1 according to the sixth embodiment will be described with reference to FIG. 7 with a focus on differences from the first embodiment.
In the present embodiment, as shown in FIG. 7A, the catheter 2 has two markers M1 and M2. The distance Y1 is longer than ½ of the distance X1, and the distance Y2 is equal to ½ of the distance X1. The distance Y3 and the distance Y4 are equal to the distance X1.

In this embodiment, the image formed by the marker m2 and the image formed by the marker M1 are overlapped, and the overlapped image is set as the measurement reference image O as shown in FIG.
The other images constituting the scale S are the scale image F1 on the front side of the measurement reference image O and the scale images F2 to F5 on the rear side of the measurement reference image O. In addition, as shown in FIG. 7, the scale image F1-F5 is an image by the markers m1, m3, M2, m4, and m5, respectively.

Below, the characteristic of the scale S of a present Example is described.
Here, an interval between the scale image F1 and the measurement reference image O is defined as an interval Z1. Similarly, as shown in FIG. 7C, intervals Z2 to Z5 are defined in order from the tip side.

  First, in the scale S of the present embodiment, the portion from the measurement reference image O to the scale image F4 forms an equally spaced portion SE. That is, among the intervals Z1 to Z5 between adjacent images, the intervals Z2 to Z4 are equal to each other. Further, the interval Z1 between the tips of the scale S is longer than the intervals Z2 to Z4 of the equally spaced portions SE, and the interval Z5 between the rear ends of the scale S is equal to twice the intervals Z2 to Z4 of the equally spaced portions SE. Become. This reason can be explained in the same manner as in the first embodiment.

  For example, if the distances X1, Y3, and Y4 are 10 mm, the distance Y1 is 8 mm, and the distance Y2 is 5 mm, the interval Z1 is 8 mm, the intervals Z2 to Z4 are 5 mm, and the interval Z5 is 10 mm.

  Next, in the scale S of the present embodiment, the portion from the scaled image F1 to the scaled image F4 forms an image different portion FD in which the form of the adjacent image is different. Note that the reason why the portions of the scale image F1 to the scale image F4 in the scale S of the present embodiment are different from each other in the form of the adjacent image can be explained in the same manner as in the first embodiment.

In the present embodiment, since the number of markers of the catheter 2 is changed from three to two, the flexibility of the inner shaft 21 can be increased, and the passability of the catheter 2 at the bent meandering portion can be improved, and insertion into the blood vessel is possible. Becomes easier. Then, it is possible to measure the lesion length with the measurement reference image O coincident with the tip of the stenotic lesion P.
Thus, as in Example 2, the selection of the optimum stent can be made quickly from the five lengths of the trade name Cypher (manufactured by Johnson & Johnson), which is a commercially available drug-eluting stent, and Easy to do. That is, the distances from the scale image F1 of the fluoroscopic image to the measurement reference image O and the scale image F2, F3, F4, and F5 are 8 mm, 13 mm, 18 mm, 23 mm, and 33 mm.
In addition, since the part from the measurement reference | standard image O to the scale image F4 is the equidistant part SE, the measurement by a length measurement major space | interval is enabled.

The configuration of the medical treatment tool 1 according to the seventh embodiment will be described with reference to FIG. 8 with a focus on differences from the first embodiment.
In the present embodiment, as shown in FIG. 8A, the catheter 2 has two markers M1 and M2. The distance Y2 is shorter than the distance X1, and the distance Y1 is equal to the difference between the distance X1 and 1/2 of the distance Y2. The distance Y3 is equal to 1/2 of the distance Y2, and the distance Y4 is equal to the distance Y2.

In this embodiment, the image formed by the marker m1 and the image formed by the marker M1 are overlapped, and the overlapped image as shown in FIG.
The other images constituting the scale S are the scale images F1 to F5 on the rear end side with respect to the measurement reference image O. In addition, as shown in FIG. 8, the scale image F1-F5 is an image by the markers m2, M2, m3, m4, and m5, respectively.

Below, the characteristic of the scale S of a present Example is described.
Here, an interval between the measurement reference image O and the scale image F1 is defined as an interval Z1. Similarly, as shown in FIG. 8C, intervals Z2 to Z5 are defined in order from the front end side.

First, in the scale S of the present embodiment, the portion from the scale image F1 to the scale image F4 forms an equally spaced portion SE. That is, among the intervals Z1 to Z5 between adjacent images, the intervals Z2 to Z4 are equal to each other. Further, the interval Z1 between the tips of the scale S is longer than the intervals Z2 to Z4 of the equally spaced portions SE, and the interval Z5 between the rear ends of the scale S is equal to twice the intervals Z2 to Z4 of the equally spaced portions SE. .
This reason can be explained in the same manner as in the first embodiment.

  For example, if the distance X1 is 13 mm, the distances Y2 and Y4 are 10 mm, the distance Y1 is 8 mm, and the distance Y3 is 5 mm, the interval Z1 is 8 mm, the intervals Z2 to Z4 are 5 mm, and the interval Z5 is 10 mm.

  Next, in the scale S of this embodiment, the portion from the measurement reference image O to the scale image F3 forms an image different portion FD in which the form of the adjacent image is different. The reason why the portion of the scale S of the present embodiment from the measurement reference image O to the scale image F3 is different in the form of the adjacent image can be explained in the same manner as in the first embodiment.

In the present embodiment, the number of markers of the catheter 2 is changed from three to two, and the distance between the markers M1 and M2 is increased with respect to the sixth embodiment. Therefore, the flexibility of the balloon 22 is increased, and the balloon 22 at the bent meander portion is increased. Can be further improved, and insertion into the stenotic lesion P is facilitated.
Thus, as in Example 2, the selection of the optimum stent can be made quickly from the five lengths of the trade name Cypher (manufactured by Johnson & Johnson), which is a commercially available drug-eluting stent, and Easy to do. That is, the distances from the measurement reference image O of the fluoroscopic image to the scale image F1, the scale image F2, F3, F4, and F5 are 8 mm, 13 mm, 18 mm, 23 mm, and 33 mm.
In addition, since the part from the scale image F1-F4 is the equally-spaced part SE, the measurement by a length measurement major space | interval is enabled.

[Configuration of Example 8]
The configuration of the medical treatment tool 1 according to the eighth embodiment will be described with reference to FIGS. 9 and 10 with a focus on differences from the first embodiment.
In the present embodiment, the guide wire 3 has seven markers m1 to m7. The marker m6 is provided at a distance Y5 from the marker m5, and the marker m7 is provided at a distance Y6 from the marker m6. Centering on the marker m4, the markers m1, m2, and m3 on the front end side of the marker m4 and the markers m5, m6, and m7 on the rear end side of the marker m4 are arranged symmetrically.

  In this embodiment, the distance X1 and the distance X2 are equal, and the distances Y1, Y2, Y5, and Y6 are equal to ½ of the distance X1. The distance Y3 and the distance Y4 are equal to the distance X1.

[First Scale Formation Method of Example 8]
In this embodiment, the image formed by the marker m2 and the image formed by the marker M1 are overlapped, and the overlapped image as shown in FIG. 9C is used as the measurement reference image O, and the measurement reference image O and the other images are displayed. The scale S is configured with

  When the image formed by the marker m2 and the image formed by the marker M1 are overlapped and the overlapped image is used as the measurement reference image O as shown in FIG. 9C, the other image forming the scale S is the measurement reference image. These are the scale image F1 on the front end side from O and the scale image F2 to F8 on the rear end side from the measurement reference image O. As shown in FIG. 9, the scale images F1 to F8 are images formed by markers m1, m3, M2, m4, M3, m5, m6, and m7, respectively.

[Features of Scale S of Example 8]
Below, the characteristic of the scale S of a present Example is described. Here, an interval between the scale image F1 and the measurement reference image O is defined as an interval Z1. Similarly, as shown in FIG. 9C, intervals Z2 to Z8 are defined in order from the front end side.

First, the entire scale S of the present embodiment forms an equally spaced portion SE in which the intervals Z1 to Z8 between adjacent image images are equal to each other.
The reason why the intervals Z1 to Z8 between adjacent images are equal to each other can be explained in the same manner as in the first embodiment.

  For example, if the distances X1, X2, Y3, and Y4 are 8 mm, and the distances Y1, Y2, Y5, and Y6 are 4 mm, the intervals Z1 to Z8 are each 4 mm.

  Next, in the scale S of the present embodiment, the portion from the scaled image F1 to the scaled image F6 forms an image different portion FD in which the form of the adjacent image is different. The reason why the portions of the scale image F1 to the scale image F6 in the scale S of the present embodiment are different in the form of the adjacent image can be explained in the same manner as in the first embodiment.

[Second Scale Formation Method of Example 8]
The guide wire 3 is moved 8 mm from the position where the scale S is formed to the front end side so that the image formed by the marker m6 and the image formed by the marker M3 are superimposed, and the superimposed image is measured as shown in FIG. The scale S ′ can be configured by the reference image O, the measurement reference image O, and other images.

  When the image formed by the marker m6 and the image formed by the marker M3 are overlapped and the overlapped image as shown in FIG. 10C is used as the measurement reference image O, the other image forming the scale S ′ is the measurement reference. The scale images F1 to F7 are located on the front side of the shadow image O, and the scale image F8 is located on the back side of the measurement reference image O. As shown in FIG. 10, the scale images F1 to F8 are images formed by the markers m1, m2, m3, M1, m4, M2, m5, and m7, respectively.

[Features of Scale S ′ of Example 8]
The characteristics of the scale S ′ of this embodiment will be described below.
Here, an interval between the scale image F1 and the scale image F2 is defined as an interval Z1. Similarly, as shown in FIG. 10C, intervals Z2 to Z8 are defined in order from the front end side.

  The scale S ′ shown in FIG. 10C is equal to the scale S shown in FIG. 9C obtained by inverting the front end side and the rear end side around the measurement reference image O, and the interval Z1 of the scale S ′. Corresponds to the interval Z8 of the scale S shown in FIG. 9C. Similarly, the intervals Z2 to Z8 of the scale S ′ correspond to the intervals Z8 to Z2 of the scale S, respectively. Therefore, in the present embodiment, the entire scale S ′ forms an equally spaced portion SE in which the intervals Z1 to Z8 between adjacent images are equal to each other.

  Further, in the scale S ′ of the present embodiment, the portion from the scale image F3 to the scale image F8 forms a different image portion FD in which the mode of the adjacent image is different.

[Effect of Example 8]
According to the present example, an optimal stent from the trade name Taxus (made by Boston), which is a commercially available drug-eluting stent with lengths ranging from 8 mm to 4 mm in increments of up to 32 mm, is available. Selection can be made quickly and easily. That is, on the scale S, the scale image F1 of the fluoroscopic image is made to coincide with the front end of the stenotic lesion P, and the scale images F2 to F8 are compared with the rear end of the stenosis lesion P, so that the measurement standard is obtained from the scale image F1. The distance between each of the image O and the scale images F2 to F8 is 32 mm in increments of 4 mm from 8 mm, and the comparison of all seven types of stent length and lesion length can be confirmed. The comparison can be similarly performed using the scale S ′. Further, the flexibility of the guide wire 3 can be maintained constant, that is, the deep portion can be inserted into the bent thin blood vessel, and the distances Z1 to Z8 can be reduced.
In addition, as a supplement, the markers m2 and m6 are preferably configured such that a radiopaque material is disposed only on the outer surface of the core material 31 without fixing the core material 31 and the coil body 32 to each other.

  According to the present embodiment, the markers M1 to M3 of the catheter 2 are arranged at equal intervals, and the markers m1 to m7 of the guide wire 3 are based on the marker m4, and the markers m1, m2, tip side markers m4, The measurement reference image O is formed on the distal end side of the catheter 2 by arranging m3 and the rear end side markers m5, m6, and m7 symmetrically with respect to the marker m4, and the scale S includes the measurement reference image O and other images. And the scale S ′ can be configured with the measurement reference image O and other images on the rear end side.

Thereby, it is possible to select one of the scale S and the scale S ′ that can easily measure the lesion length.
For example, when the stenotic lesion P exists on the rear end side with respect to the marker M1 of the catheter 2, the measurement reference image is formed by the measurement reference image O and other images. Since the scale image F2 to F8 are arranged on the rear end side from O, the scale image lesion length can be easily measured. On the other hand, when the stenotic lesion P is present on the distal end side of the marker M3 of the catheter 2, the measurement reference image is composed of the measurement reference image O and other images. Since scale images F1 to F7 are arranged on the tip side of O, the lesion length can be easily measured.

  In particular, when the lesion length is long (25 mm or more) as in the case of a chronic lesion, the stenotic lesion P extends and exists at two positions on the distal end side of the marker M1 and the rear end side of the marker M3. In such a case, it is possible to perform measurement by switching from the scale S to the scale S ′ by moving the guide wire 3 back and forth slightly (8 mm in this embodiment) without changing the position of the catheter 2. .

  The markers m2 and m6 are not provided so as to bridge the outer surface of the core 31 of the guide wire 3 and the inner surface of the coil body 32 of the guide wire 3, but are known sputtering devices. Alternatively, a radiopaque material may be formed on the outer surface of the core 31 with a predetermined film thickness using a vapor deposition apparatus or the like. According to this, the flexibility of the guide wire 3 can be further maintained. Further, since the markers m2 and m6 of the guide wire 3 serving as the measurement reference image O have different shapes and lightness differences as compared to the adjacent markers m1, m3, m5, and m7, the overlapping work is performed. It becomes easier to do.

[Configuration of Example 9]
The configuration of the medical treatment tool 1 according to the ninth embodiment will be described with reference to FIG. 11 with a focus on differences from the first embodiment.
In this embodiment, the markers m2 and m4 are provided by depositing a radiopaque material on the outer surface of the core material 31 with a predetermined film thickness using a known sputtering device, vapor deposition device, or the like. The markers m1, m3, and m5 are fixed so as to bridge the outer surface of the core material 31 of the guide wire 3 and the inner surface of the coil body 32 of the guide wire 3 by using a brazing material of a radiopaque material. Is provided.

According to this, as shown in FIG. 11 (b), a marker m 1 that is provided so as to bridge the outer surface of the core material 31 of the guide wire 3 and the inner surface of the coil body 32 of the guide wire 3, The outer diameters of m3 and m5 are larger than the outer diameters of the markers m2 and m4 provided by forming a film on the outer surface of the core material 31. On the other hand, as shown in FIGS. 11A and 11B, the outer diameters of the markers m1, m3, and m5 are smaller than the outer diameters of the markers M1 to M3.
In this embodiment, the distances Y1, Y2, Y4 and the distance Y5 are equal to 1/3 of the distance X1, and the distance Y3 is equal to 2/3 of the distance X1.

[Scale formation method of Example 9]
In this embodiment, the image formed by the marker m1 and the image formed by the marker M1 are overlapped, and the overlapped image is set as the measurement reference image O as shown in FIG.
The other images constituting the scale S are the scale images F1 to F5 on the rear end side with respect to the measurement reference image O. As shown in FIG. 11, the scale images F1 to F6 are images formed by the markers m2, m3, M2, m4, m5, and M3, respectively.

[Features of Scale S of Example 9]
Below, the characteristic of the scale S of a present Example is described.
Here, an interval between the measurement reference image O and the scale image F1 is defined as an interval Z1. Similarly, as shown in FIG. 11C, intervals Z2 to Z6 are defined in order from the tip.

First, the entire scale S of the present embodiment forms an equally spaced portion SE in which the intervals Z1 to Z6 between adjacent image images are equal to each other.
The reason why the intervals Z1 to Z6 between adjacent images are equal to each other can be explained in the same manner as in the first embodiment.

  For example, if the distances X1 and X2 are 15 mm, the distances Y1, Y2, Y4, and Y5 are 5 mm, and the distance Y3 is 10 mm, the intervals Z1 to Z6 are each 5 mm.

  Next, the whole scale S of the present embodiment forms an image different portion FD in which the mode of adjacent image is different. The reason why the entire scale S forms the image different portion FD can be explained in the same manner as in the first embodiment.

  Further, in the present embodiment, three different modes appear sequentially in the scale image F1 to F3, and three modes appear in the same order in the scale image F4 to F6.

In the present embodiment, the markers M1 to M3 of the catheter 2 and markers m1 and m3 provided so as to bridge the outer surface of the core 31 of the guide wire 3 and the inner surface of the coil body 32 of the guide wire 3 are provided. In addition to m5, the markers m2 and m4 provided on the outer surface of the core material 31 are used in combination, so that while maintaining a certain degree of flexibility, unlike the above-described embodiments, further on the perspective image With a small interval, high-precision measurement is possible.
The present embodiment is particularly suitable for measurement of the lesion length of a peripheral meandering portion of a peripheral blood vessel that requires more flexibility, as well as a long lesion length (25 mm or more) and a chronic lesion portion.
The three different forms of images that cause the difference in shape and brightness appear regularly in sequence, so that even if there are a large number of images, visual identification and recognition are easy, and measurement is extremely easy. . Therefore, the possibility that the surgeon mistakes the scale and selects an inappropriate stent is further reduced.

[Modification]
In Example 1 to Example 9, the catheter 2 has the balloon 22 as the expansion body, but the catheter 2 has the basket body 25 that expands in a basket shape as the expansion body (FIG. 12 ( a), and a braided body 26 formed by braiding metal wires (see FIG. 12B).

  In Example 1, the markers m1 to m5 are fixed so as to bridge the outer surface of the core 31 and the inner surface of the coil body 32, but are positioned at a narrow interval between the markers m1 and m3. Only the marker m2 may be formed on the outer surface of the core material 31 with a radiopaque material. Thereby, the flexibility in the vicinity of the measurement reference image O can be secured. These fixing methods may be used in combination with the markers m1 to m5.

  Moreover, you may adjust the brightness on a fluoroscopic image by changing the density of the radiopaque material of the markers M1-M3 and the markers m1-m5.

  Moreover, in Example 5, as shown in FIG. 6, the scale image F4 and the scale image F5 are in the same mode, but the marker m4 is made of a low-radiopaque material and the core material 31 of the guide wire 3 is made. By providing the outer surface and the inner surface of the coil body 32 of the guide wire 3 so as to be bridged, the scale image F4 and the scale image F5 are different from each other, and the entire scale S is the image different part FD. You may make it become.

It is a block diagram of a medical treatment tool (Example 1). (a) is a block diagram of a catheter, (b) is a block diagram of a guide wire, and (c) is a scale on a fluoroscopic image (Example 1). (a) is a block diagram of a catheter, (b) is a block diagram of a guide wire, and (c) is a scale on a fluoroscopic image (Example 2). (a) is a block diagram of a catheter, (b) is a block diagram of a guide wire, and (c) is a scale on a fluoroscopic image (Example 3). (a) is a block diagram of a catheter, (b) is a block diagram of a guide wire, and (c) is a scale on a fluoroscopic image (Example 4). (a) is a block diagram of a catheter, (b) is a block diagram of a guide wire, and (c) is a scale on a fluoroscopic image (Example 5). (a) is a block diagram of a catheter, (b) is a block diagram of a guide wire, and (c) is a scale on a fluoroscopic image (Example 6). (a) is a block diagram of a catheter, (b) is a block diagram of a guide wire, and (c) is a scale on a fluoroscopic image (Example 7). (a) is a block diagram of a catheter, (b) is a block diagram of a guide wire, and (c) is a scale on a fluoroscopic image (Example 8). (a) is a block diagram of a catheter, (b) is a block diagram of a guide wire, and (c) is a scale on a fluoroscopic image (Example 8). (a) is a block diagram of a catheter, (b) is a block diagram of a guide wire, and (c) is a scale on a fluoroscopic image (Example 9). (A) The block diagram of the catheter which has a basket body, (b) The block diagram of the catheter which has a braided body (modification).

Explanation of symbols

1 medical treatment tool 2 catheter 21 inner shaft (shaft)
22 Balloon (expanded body)
25 Basket body (expanded body)
26 Braided body (expanded body)
3 Guide wire 31 Core material 32 Coil body P Stenosis lesion M1-M3 Marker m1-m7 Marker O Measurement standard image F1-F8 Scale image S, S 'Scale Z1-Z8 Interval

Claims (12)

A catheter having an elongated flexible shaft and an expander disposed to surround a portion of the shaft and dilate the stenotic lesion;
A guide wire for guiding the expansion body to the stenotic lesion,
The catheter and the guide wire each have a plurality of radiopaque markers for measuring the length of the stenotic lesion,
At least one of a plurality of markers included in the catheter is attached to a part of the shaft surrounded by the expansion body,
Radiation is applied to the catheter marker and the guide wire marker to project a plurality of images on the fluoroscopic image in a row, and one of the images obtained from the catheter marker and one of the images obtained from the guide wire marker A measurement reference image is formed by superimposing the two, and a scale is formed by the measurement reference image and another image, and the length of the stenotic lesion is determined by visually recognizing the distance between the measurement reference image and the other image. A medical treatment instrument characterized by measuring. The medical treatment tool according to claim 1, wherein
At least a part of the scale forms an equidistant portion where the intervals between adjacent images are equal. The medical treatment tool according to claim 2,
The medical treatment instrument, wherein an interval between at least one of a front end portion and a rear end portion of the scale is different from an interval between the equal interval portions. The medical treatment tool according to any one of claims 1 to 3,
The plurality of images have at least two different aspects;
A medical treatment instrument, wherein at least a part of the scale forms an image different portion in which the form of adjacent images is different. The medical treatment instrument according to claim 4,
The image different part has at least three different forms of images, and at least a part of the image different parts, three different forms of images appear sequentially. The medical treatment instrument according to any one of claims 1 to 5,
The plurality of markers of the catheter are arranged at equal intervals,
The plurality of markers of the guide wire are characterized in that a front end marker and a rear end marker are arranged symmetrically with respect to one marker. The medical treatment tool according to claim 4 or 5,
The images of different aspects included in the image different parts are:
A marker of the guide wire formed by disposing a radiopaque material only on the outer surface of the guide wire on the core side;
A marker of the guide wire formed by arranging a radiopaque material so as to bridge the outer surface of the core material of the guide wire and the inner surface of the coil body of the guide wire;
A marker for the catheter formed by placing a radiopaque material on the catheter;
A medical treatment instrument obtained from a marker selected from the above. The medical treatment instrument according to any one of claims 1 to 7,
A medical treatment instrument, wherein the guide wire marker has an axial width of 0.3 to 1.5 mm. The medical treatment instrument according to any one of claims 1 to 8,
All of the markers of the guide wire are provided at a position in the range of 50 to 125 mm from the tip of the guide wire. The medical treatment instrument according to any one of claims 1 to 9,
The catheter has three markers, and is a medical treatment instrument. The medical treatment instrument according to any one of claims 1 to 10,
The catheter has two markers, and is a medical treatment instrument. The medical treatment tool according to any one of claims 1 to 11,
The medical treatment instrument, wherein the catheter is a balloon catheter.

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