JP2008086729A - Cardiac catheter - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a cardiac catheter capable of correctly determining the bending condition of the distal end of the catheter body by feeling operating fingers at the hand side if a slide resistance adjustment mechanism is worked for changing the operation resistance but the feeling is not changed at the finger applied part on which the operation fingers of a user are applied. <P>SOLUTION: The slide resistance adjustment mechanism 20 can add operation resistance to the relative slide operation of a catheter body holding handle 6 and an operation wire holding handle 7 and adjust the operation resistance, and it is mounted at one of the catheter body holding handle 6 and the operation wire holding handle 7, and an adjustment mechanism operation tube 11 is also mounted to one of the holding handle 7 under the condition of surrounding the slide resistance adjustment mechanism 20, and the positional relation of one of the holding handle 7 and the adjustment mechanism operation tube 11 is not changed regardless of the adjustment condition of the slide resistance adjustment mechanism 20. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to a cardiac catheter.

A cardiac catheter inserted into a heart from a blood vessel needs to guide a tip electrode provided at the tip of a flexible elongated catheter body to a target site in the heart. In view of this, the distal end of the catheter body can be bent by pulling the operation wire inserted into the catheter body with the operation handle on the hand side.
Therefore, the operation handle part of the cardiac catheter is arranged so that the catheter body holding handle connected to the proximal end of the catheter body and the operation wire holding handle connected to the proximal end of the operation wire can be relatively slid. (For example, Patent Document 1).
JP 2003-319915 A

  In the cardiac catheter described in Patent Document 1, the catheter body holding handle and the operation wire holding handle (the handle housing 102 and the thumb control unit 116) that slide relative to each other unexpectedly slide without permission. There is provided a slide resistance adjusting mechanism capable of giving an operating resistance to the relative sliding operation of both holding handles and adjusting the magnitude of the operating resistance from the outside. Specifically, the amount of crushing of the rubber O-ring disposed in a state where the base of the catheter body is tightened in order to impart operating resistance can be adjusted by screwing one holding handle. (Paragraph [0049], FIG. 10, FIG. 11).

  In such a conventional slide resistance adjusting mechanism, when the adjustment for changing the magnitude of the operating resistance is performed, the size of the gap between the holding handles (the handle housing 102 and the thumb control unit 116) changes accordingly. However, the part that spans the gap between the two holding handles is a finger pad where the finger of the hand performing the operation of sliding the two holding handles relatively touches, and the user feels the size of the gap that touches the operating finger. Therefore, it is often the case that the bending state of the distal end side of the catheter body is determined. For this reason, conventionally, when the adjustment for changing the magnitude of the operating resistance is performed by the slide resistance adjusting mechanism, the bending state of the distal end side of the catheter body is correctly corrected at the proximal side due to the change in the size of the gap between the two holding handles. In some cases, it was impossible to judge.

  The present invention has been made to solve such a problem, and even if an adjustment for changing the magnitude of the operation resistance is performed by the slide resistance adjustment mechanism, the finger contact portion that the user's operation finger touches is adjusted. It is an object of the present invention to provide a cardiac catheter that has no change in touch and can always correctly determine the bent state of the distal end side of the catheter body by the touch of an operation finger.

  An operation wire is inserted into a flexible elongated catheter body, and is connected to the catheter body holding handle connected to the proximal end of the catheter body and the proximal end of the operation wire by an operation handle portion provided on the proximal side. The operation wire holding handle is configured to slide relative to the axial direction of the operation wire so that the operation wire slides in the axial direction with respect to the catheter body and the portion near the distal end of the catheter body is bent. In a cardiac catheter, a slide resistance adjustment mechanism capable of adjusting the magnitude of the operation resistance by applying an operation resistance to the relative slide operation between the catheter body holding handle and the operation wire holding handle is operated with the catheter body holding handle. Attach to one of the wire holding handles and slide resistance adjuster An adjustment mechanism operation cylinder for changing the adjustment state of the slide from the outside is attached to one holding handle so as to surround the slide resistance adjustment mechanism, and the one holding handle and adjustment mechanism are operated regardless of the adjustment state of the slide resistance adjustment mechanism. The positional relationship with the cylinder was not changed.

  In addition, the adjustment mechanism operation cylinder may be located at a finger contact portion where a finger of a hand that performs an operation for sliding the catheter body holding handle and the operation wire holding handle relative to each other hits. The adjustment mechanism operation cylinder may be attached to the one holding handle so as to be rotatable around the axis and restricted in movement in the axial direction, and engages with the slide resistance adjustment mechanism. The engaging portion may be formed on the inner surface of the adjustment mechanism operation cylinder.

  According to the cardiac catheter of the present invention, adjustment of the slide resistance adjusting mechanism capable of adjusting the magnitude of the operation resistance by applying the operation resistance to the relative slide operation between the catheter main body holding handle and the operation wire holding handle. Regardless of the state, the positional relationship between the holding handle and the adjustment mechanism operation cylinder does not change, so it can be used even if the adjustment mechanism operation cylinder is adjusted to change the operating resistance of the slide resistance adjustment mechanism. There is no change in the feel of the finger contact portion where the operator's operation finger hits, and the bending state of the distal end side of the catheter body can always be correctly determined by the touch of the operation finger.

Embodiments of the present invention will be specifically described below with reference to the drawings.
FIG. 5 shows the overall configuration of the cardiac catheter. An elongated catheter body 1 having flexibility is passed through a blood vessel, and is formed of a multi-lumen tube made of a synthetic resin material or the like. The bending portion 2 formed in the vicinity of the distal end of the catheter body 1 is formed more flexibly, and the distal electrode portion 3 is connected to the distal end. 4 is an operation wire inserted into the catheter body 1 for bending the bending portion 2, and its distal end is displaced to the periphery of the distal end portion (or a position closer to the distal end thereof) of the bending portion 2. It is linked to the position.

  The operation handle portion 5 provided on the proximal side of the cardiac catheter includes a catheter body holding handle 6 connected to the proximal end of the catheter body 1 and an operation wire holding handle 7 connected to the proximal end of the operation wire 4. The operation wire 4 is disposed so as to be relatively slidable in the axial direction. The operation wire holding handle 7 is formed in a substantially cylindrical shape suitable for the user to grasp with the hand, and the finger rest ring 6A of the catheter body holding handle 6 is the belly of the thumb of the hand holding the operation wire holding handle 7. It is formed in a thick, substantially disk shape so that it can be easily pushed and pulled, and is disposed in a state of protruding forward (downward in FIG. 5) from the vicinity of the tip of the operation wire holding handle 7.

  6B is a slide cylinder part of the catheter main body holding handle 6, which is connected to the finger holding ring 6A so as to advance and retreat integrally with the finger holding ring 6A, and is slidably fitted into the operation wire holding handle 7. Yes. Reference numeral 9 denotes a wire clamp fixed to the proximal end of the operation wire 4, which is disposed near the central axis position of the operation wire holding handle 7 and fixed to the operation wire holding handle 7. Reference numeral 10 denotes a bend-preventing member for preventing the proximal end portion of the catheter body 1 from being bent suddenly in the vicinity of the connection portion with the catheter body holding handle 6, and is tapered by a resilient rubber material or the like. It is formed in a shape and is arranged adjacent to the finger rest ring 6A so as to surround the proximal end portion of the catheter body 1.

  Reference numeral 11 denotes an adjustment mechanism operation cylinder attached to the distal end portion of the operation wire holding handle 7 so as to surround a slide resistance adjusting mechanism 20 which will be described later, so that the distal end region of the operation wire holding handle 7 is entirely covered. Is provided. Between the adjustment mechanism operation cylinder 11 and the finger rest ring 6A of the catheter body holding handle 6, a gap is formed for inserting a finger of a hand for performing an operation of sliding the holding handles 6 and 7 relatively. The adjustment mechanism operation cylinder 11 and the finger contact ring 6A serve as finger contact portions on the rear side and the front side on which fingers (for example, the index finger and the thumb) that perform the slide operation hit.

  FIG. 6 shows a state in which the bending portion 2 is bent by remote operation from the operation handle portion 5, and an operation of pushing the catheter body holding handle 6 forward (downward) with respect to the operation wire holding handle 7 is performed. Thus, the operation wire 4 is pulled backward relative to the catheter body 1 and the bending portion 2 bends. And if operation opposite to it is performed, the bending part 2 will return to the straight state shown by FIG. In this manner, in the operation handle portion 5, the bending portion 2 is bent by an arbitrary angle by relatively sliding the catheter body holding handle 6 and the operation wire holding handle 7 in the axial direction of the operation wire 4. The user can determine the bending state of the bending portion 2 from the feeling of the size of the gap between the adjustment mechanism operation cylinder 11 that touches the operation finger and the finger rest ring 6A.

  FIG. 2 shows the front half of the operation handle portion 5. In addition, each member illustrated as one component in each of the following drawings including FIG. 2 is a function not easily related to the contents of the present invention, for facilitating the manufacture of the component, for easy assembly. In order to achieve the above, etc., each can be divided into a plurality of parts, and even if configured in this way, it does not change within the scope of the present invention.

  The proximal end portion of the catheter main body 1 is passed through an attachment hole 12 formed at the axial position of the slide cylinder portion 6B of the catheter main body holding handle 6 and is firmly fixed thereto by adhesion or the like. The operation wire 4 drawn from the proximal end of the catheter body 1 is drawn to the rear through a wire passage hole 13 formed smaller than the attachment hole 12 in the proximal end portion of the attachment hole 12. 14 is a lead wire that is passed through the catheter body 1 separately from the operation wire 4 and connected to each electrode of the distal electrode portion 3, and extends rearward from the wire passage hole 13 along with the operation wire 4. .

  FIG. 3 is a cross-sectional view taken along the line AA in FIG. 2, and the wire clasp 9 fixed to the base end of the operation wire 4 by soldering or the like is the inner peripheral surface of the operation wire holding handle 7. It is fixed to the flat wire fixing plate 15 fitted and fixed in the groove formed by crimping or soldering. Therefore, the operation wire 4 is fixed so as not to move to the axial position of the operation wire holding handle 7 via the wire fixing plate 15. A linear guide groove 17 through which the wire fixing plate 15 passes loosely is formed in the slide tube portion 6B of the catheter body holding handle 6 which is inscribed in the operation wire holding handle 7 so as to be slidable in the axial direction, and the slide tube portion 6B. Is slid with respect to the operation wire holding handle 7, the wire fixing plate 15 slides in the linear guide groove 17. In FIG. 3, the lead wires 14 and the like are not shown.

  Returning to FIG. 2, the finger rest ring 6A of the catheter body holding handle 6 is screwed and connected to the distal end portion of the slide cylinder portion 6B. B is the threaded portion. The anti-bending member 10 is detachably attached to the foremost protruding portion of the slide cylinder portion 6B protruding further forward than the finger rest ring 6A. Specifically, the inward projection formed on the anti-bending member 10 can be engaged with and disengaged from the groove formed on the slide cylinder portion 6B by elastically deforming the anti-bending member 10. C is the engaging portion.

  Inside the adjustment mechanism operation cylinder 11, a slide resistance capable of adjusting the magnitude of the operation resistance by applying an operation resistance to the relative slide operation of the catheter body holding handle 6 and the operation wire holding handle 7. An adjustment mechanism 20 is arranged. The slide resistance adjusting mechanism 20 of this embodiment includes an O-ring 21 made of an elastic rubber material that is in sliding contact with the outer peripheral surface of the slide tube portion 6B of the catheter main body holding handle 6, and for crushing the O-ring 21. The resistance adjusting cylinder 22 is used. Reference numeral 23 denotes a sliding washer formed of a plastic material having good sliding property. The resistance adjusting cylinder 22 is loosely fitted to the outer peripheral surface of the slide cylinder portion 6B at the inner peripheral surface of the small-diameter portion formed toward the front, and is formed on the outer periphery of the distal end of the operation wire holding handle 7 at the rear portion thereof. Screwed into the threaded portion. D is the threaded portion. Therefore, it can be said that the slide resistance adjusting mechanism 20 is attached to the operation wire holding handle 7.

  The adjusting mechanism operation cylinder 11 is formed in a cylindrical shape (cylindrical shape close to a shade) that completely surrounds the slide resistance adjusting mechanism 20, and a tip portion thereof is an outer periphery of the slide cylindrical portion 6 </ b> B. It fits loosely on the surface, and its rear end portion is engaged with the operation wire holding handle 7 so as to be rotatable about its axis. The adjustment mechanism operation cylinder 11 is formed of a hard plastic material or the like that is elastically deformed when a strong force is applied, and an engagement protrusion 24 is formed to protrude inward at the inner peripheral portion of the rear end thereof. 24 is engaged with an engagement groove 16 formed on the outer peripheral surface of the operation wire holding handle 7 over the entire circumference. Therefore, the adjustment mechanism operation simplified body 11 is rotatable around the axis with respect to the operation wire holding handle 7, but cannot move in the axial direction.

  As shown in FIG. 4 which is a cross-sectional view taken along line E-E, the inner surface of the adjustment mechanism operation cylinder 11 and the outer surface of the resistance adjustment cylinder 22 are key groove-shaped that loosely engage with each other. A straight groove 18 and an engaging protrusion 25 are formed. The straight groove 18 is formed in a direction parallel to the axial direction. Therefore, the resistance adjusting cylinder 22 can be rotated through the engagement between the linear groove 18 and the engaging protrusion 25 by rotating the adjusting mechanism operating cylinder 11 about the axis. At that time, the adjustment mechanism operation cylinder 11 does not move in the axial direction even if it is rotated. However, since the resistance adjustment cylinder 22 is screwed with the operation wire holding handle 7 at the screwing portion D, when the rotation is driven. As a result, the O-ring 21 is moved in the axial direction and the crushing amount of the O-ring 21 changes.

  In the embodiment configured as described above, the adjustment of the operation resistance with respect to the relative sliding movement of the catheter main body holding handle 6 and the operation wire holding handle 7 is performed by rotating the adjusting mechanism operating cylinder 11 around the axis. This can be done by screwing the adjusting cylinder 22 and changing the crushing amount of the O-ring 21. As shown in FIG. 1, when the adjustment mechanism operation cylinder 11 is rotated largely to increase the crushing amount of the O-ring 21, the frictional resistance between the O-ring 21 and the slide cylinder 6B increases, and the catheter body The operating resistance between the holding handle 6 and the operation wire holding handle 7 is increased. And even if the position of the resistance adjustment cylinder 22 moves with such adjustment, the position of the adjustment mechanism operation cylinder 11 surrounding it (positional relationship with the operation wire holding handle 7) does not change. There is no change in the feeling of the size of the gap of the finger contact portion where the operating finger hits, and the bending state of the bending portion 2 can always be correctly determined by the touch of the operating finger.

  FIG. 7 shows a second embodiment of the present invention. In the slide resistance adjusting mechanism 20, a taper ring 121 with a slit 121a as shown in FIG. The resistance adjusting cylinder 22 is also formed in a shape suitable for crushing the taper ring 121. Other configurations are the same as those of the first embodiment.

  The present invention is not limited to the above-described embodiments. For example, the slide resistance adjustment mechanism 20 and the adjustment mechanism operation cylinder 11 are attached to the catheter body holding handle 6 side. There is no problem.

FIG. 3 is a side cross-sectional view of the distal portion of the operation handle portion after adjusting the operation resistance of the cardiac catheter according to the first embodiment of the present invention. FIG. 3 is a side cross-sectional view of the distal portion of the operation handle portion of the cardiac catheter according to the first embodiment of the present invention. Sectional drawing of the state cut | disconnected by the AA in FIG. 2 of the operation handle part of the cardiac catheter which concerns on the 1st Embodiment of this invention. Sectional drawing of the state cut | disconnected by the EE line in FIG. 2 of the operation handle part of the cardiac catheter which concerns on the 1st Embodiment of this invention. 1 is an external view showing the overall configuration of a cardiac catheter according to a first embodiment of the present invention. The external view which shows the whole structure of the state by which operation which bends the bending part of the cardiac catheter of the 1st Embodiment of this invention was performed. The side sectional view of the front part of the operation handle part of the cardiac catheter concerning the 2nd embodiment of the present invention. The single-piece | unit perspective view of the tapering of the cardiac catheter of the 2nd Embodiment of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Catheter main body 2 ... Curved part 4 ... Operation wire 5 ... Operation handle part 6 ... Catheter main body holding handle 6A ... Finger rest ring 6B ... Slide cylinder part 7 ... Operation wire holding handle 11 ... Adjustment mechanism operation cylinder 16 ... Engagement Groove 18 ... Linear groove (engagement part)
DESCRIPTION OF SYMBOLS 20 ... Slide resistance adjustment mechanism 21 ... O-ring 22 ... Resistance adjustment cylinder 23 ... Sliding washer 24 ... Engagement protrusion 25 ... Engagement protrusion 121 ... Taper ring D ... Screwing part

Claims (4)

An operation wire is inserted into a flexible and slender catheter body, and an operation handle portion provided on the proximal side includes a catheter body holding handle connected to the proximal end of the catheter body and a proximal end of the operation wire. By sliding the connected operation wire holding handle relative to the axial direction of the operation wire, the operation wire slides in the axial direction with respect to the catheter body, and the vicinity of the distal end of the catheter body is bent. A cardiac catheter configured to:
A slide resistance adjusting mechanism capable of adjusting the magnitude of the operation resistance by applying an operation resistance to the relative slide operation between the catheter body holding handle and the operation wire holding handle is provided in the catheter body holding handle and the operation. Attaching to one of the wire holding handles, an adjustment mechanism operating cylinder for changing the adjustment state of the slide resistance adjusting mechanism from the outside is attached to the one holding handle so as to surround the slide resistance adjusting mechanism, and the slide resistance A cardiac catheter characterized in that the positional relationship between the one holding handle and the adjustment mechanism operation cylinder does not change regardless of the adjustment state of the adjustment mechanism.   The cardiac catheter according to claim 1, wherein the adjustment mechanism operation tube body is a finger contact portion to which a finger of a hand that performs an operation for relatively sliding the catheter body holding handle and the operation wire holding handle is applied. Cardiac catheter located in the   The cardiac catheter according to claim 1 or 2, wherein the adjustment mechanism operation cylinder is attached to a state in which the adjustment mechanism operation cylinder is rotatable about an axis with respect to the one holding handle and movement in the axial direction is restricted. A cardiac catheter.   The cardiac catheter according to claim 3, wherein an engaging portion that engages with the slide resistance adjusting mechanism is formed on an inner surface of the adjusting mechanism operation cylinder.

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