JP2008237304A - Cardiovascular system simulation model - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a cardiovascular system simulation model three-dimensionally and truly reproducing the cardiovascular system, corresponding to every blood vessel structure different for every patient and being applied to an evaluation of a catheter procedure and a catheter device. <P>SOLUTION: This simulation model three-dimensionally reproducing the cardiovascular system includes an aorta pathway 7 simulating the aorta, a coronary artery pathway 9 simulating the coronary artery branched from the aorta 7, and a connector 13 interposed between the aorta pathway 7 and the coronary artery pathway 9, wherein the connector 13 has a double tube structure formed by joining an inner tube section having flexibility with a hard outer tube section and has a male connection portion 13a projecting from the outer tube section using one end of the inner tube section as a connecting insertion portion 13c, and a female connection portion 13b for inserting the connection insertion portion 13c and formed of the hard tube section. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to a simulation model in which the cardiovascular system is reproduced three-dimensionally and faithfully, and more particularly to a cardiovascular system simulation model that can be applied to catheter device evaluation from catheter procedures.

  In the treatment of cardiovascular arteriosclerotic diseases, percutaneous coronary angioplasty (PCI) and percutaneous angioplasty (PTA) have become a key point of treatment today, and the training of doctors with catheter procedures This is an important issue. However, the fact is that PTCA training is actually performed on patients, and because the blood vessel structure and diseased site are different for each patient, it is difficult to learn the technique.

  Therefore, various devices for training catheter procedures have been proposed, and training using computer simulators has been attempted in Europe and the United States.

  However, in the simulation using a computer, for example, in order to change the blood vessel structure, a program must be prepared for each blood vessel structure, and the feeling of actual catheter operation cannot be confirmed.

  In addition, the PTCA trainer shown in FIG. 6 can obtain a feeling similar to that when the catheter passes through the coronary artery during an actual procedure. A flat plate 50 having a groove, a transparent plate 51 covering the surface of the flat plate 50, and a plurality of ports 52 for inserting a catheter into the concave groove.

The width of the concave groove is set in various ways. For example, the concave groove 53a that looks like a pseudo-aorta is formed wide, and the concave groove 53b that looks like a coronary artery is narrow. Furthermore, a beginner area 53c that is wide with a relatively simple route, an advanced area 53d that is narrow with a complicated route, and the like are prepared for training (for example, see Patent Document 1).
JP 2001-343891 A

  However, since the above-described conventional PTCA trainer is merely a concave groove imitating the vascular system formed on the flat plate 50, it cannot be said that the vascular system of the patient is reproduced three-dimensionally and faithfully. There is a problem that the effect is low.

  In actual catheter operation, when inserting a catheter through the coronary ostium, operations such as supporting a part of the catheter on the inner wall of the aorta or rotating the catheter around the tube axis to change the direction of the catheter tip are performed. However, the planar PTCA trainer is configured by the flat transparent plate 51 whose upper surface does not simulate a blood vessel, so that it is not possible to train such a catheter operation according to the actual situation.

  Furthermore, since the concave groove pattern cannot be changed, there is a disadvantage that it is not possible to train a catheter operation assuming a different blood vessel structure for each patient.

  The present invention has been made in consideration of the problems in the conventional PTCA trainer as described above. The cardiovascular system is reproduced three-dimensionally and faithfully, and the catheter technique is adapted to the vascular structure that is different for each patient. A cardiovascular simulation model that can be applied to the evaluation of catheter devices is provided.

The present invention is a simulation model that three-dimensionally reproduces the cardiovascular system,
An arterial route simulating an artery, a vascular route simulating a blood vessel branched from the artery, and a connector interposed between the arterial route and the vascular route,
The above connector
A male tube in which a flexible inner tube portion and a hard outer tube portion are joined to form a double tube structure, and one end portion of the inner tube portion is projected from the outer tube portion as a connection insertion portion. It is a cardiovascular system simulation model which has a type | mold connection part and the female type | mold connection part which consists of a rigid tube part in which the said insertion part for a connection is inserted.

  As a specific example of the vascular route, a coronary artery route simulating a coronary artery is shown.

  In the present invention, if the first flange is provided at the connection side end of the outer pipe part and the second flange is provided at the connection side end of the hard pipe part, the male connection part and the female connection part The internal passage can be accurately connected without bending.

  In the present invention, if an annular magnet is attached to the first and second flanges, the male connection portion and the female connection portion can be easily connected by the attractive force of both magnets.

  The annular magnet can be mounted on the opposite side of the first and second flanges.

  In the present invention, a plurality of fluid introduction parts communicating with the coronary artery path are formed on the trunk wall in the vicinity of the connector in the coronary artery path, and introduced from the fluid introduction part to the peripheral part of the coronary artery path. If a fluid discharge part is provided, the actual coronary angiography can be reproduced faithfully.

  In the present invention, if each of the fluid introduction portions is arranged in an inclined posture that is opened at a predetermined angle from the central axis of the female connection portion, directionality can be given to the fluid flowing through the coronary artery path.

  In the present invention, a discharge pump that discharges fluid may be connected to the fluid introduction part, and the fluid sent from the discharge part may be returned to the tank of the discharge pump.

  According to the cardiovascular simulation model of the present invention, a cardiovascular simulation model that can reproduce the vascular system three-dimensionally and faithfully and can be applied to the evaluation of a catheter device from a catheter procedure corresponding to a different vascular structure for each patient. Can be provided.

  Hereinafter, the present invention will be described in detail based on the embodiments shown in the drawings.

1. Overall Configuration of Cardiovascular System Simulation Model FIG. 1 is a perspective view showing an embodiment of a cardiovascular system simulation model (hereinafter abbreviated as a simulation model) according to the present invention.

  In the figure, a simulation model 1 is assembled in a case 2 having a length of 90.5 cm and a width of 48.5 cm, and an arterial route and a vascular route simulating a cardiovascular system are formed.

  Specifically, the femoral artery path 3 as an arterial path, the abdominal aorta path 4, the thoracic aorta path 5, the aortic arch path 6, the ascending aorta path 7, the brachial aorta path 8, the radial artery path 8 ', and the right as a vascular path The coronary artery path 9 and the left coronary artery path 10 are transparent and three-dimensionally formed.

  Each of the arterial routes is tubular using a silicon resin-based material so that a device such as a catheter can pass smoothly and the same feeling as when passing through an actual blood vessel can be obtained. It is molded into.

  Each arterial path is supported by a plurality of transparent support members 11 in a state of being slightly lifted from the base 2a of the case 2 so that the simulation model 1 can be observed from a plane and a side. In the figure, reference numeral 12 denotes a transparent cover that three-dimensionally simulates a part of the waist, and is provided so as to cover the upper part from the femoral artery path 3 to the abdominal aorta path 4.

2. Main Configuration of Simulation Model FIG. 2 is an enlarged view of the simulation model 1 of FIG.

  In FIG. 2, a connector 13 is interposed between the ascending aorta path 7 and the left coronary artery path 10, and a connector 13 is also interposed between the ascending aorta path 7 and the right coronary artery path 9.

  FIG. 3 is an enlarged view showing a state in which the connector 13 is removed, and the configuration of the connector 13 in the right coronary artery path 9 will be described as a representative.

  The connector 13 includes a male connection portion 13a disposed on the ascending aorta route 7 side and a female connection portion 13b disposed on the right coronary artery route 9 side. The connector 13 is provided on the male connection portion 13a. The ascending aorta route 7 and the right coronary artery route 9 are connected and integrated by inserting the connecting insertion portion 13c into the cylindrical hole 13d of the female connection portion 13b.

  4 (a) and 4 (b) show a left side view and a front view of a male connecting part mounted on the male connecting portion 13a, and FIGS. 4 (c) and 4 (d) show the female connecting portion 13b. The front view and right view of the female type | mold connection components with which it is mounted | worn are shown.

2-1. Male connection component The male connection component 13e includes a rigid outer tube portion 13f formed into a tubular shape, and a flexible tube (inner tube portion) that is inserted into the outer tube portion 13f in a nested manner. ) 13g.

  The outer tube portion 13f is made of an acrylic resin molded product, while the tube 13g is made of vinyl chloride resin, and both are fixed by a solvent-type adhesive to form a double tube structure.

  The end surface of the outer tube portion 13f and the tube 13g on the side opposite to the connection direction is formed with a tapered surface 13h that is inclined toward the connection direction so that the device is smoothly guided into the tube 13g.

  The tube axis length L1 of the tube 13g is formed longer than the cylinder axis length L2 of the outer tube portion 13f, and the portion protruding from the outer tube portion 13f constitutes the connecting insertion portion 13c. It has become.

  An annular magnet 13i is fixed to the connection side end of the outer tube portion 13f, and an annular first flange 13j made of an acrylic resin functioning as a packing is formed on the connection side surface of the magnet 13i. It is installed.

The physical properties of the magnet 13i are as follows.
Type: Neodymium magnet Magnetization direction: Thickness direction Surface treatment: Ni plating Surface magnetic flux density: 2,600 gauss Adsorption force: 1.6 kg

  In this embodiment, the tube 13g has an inner diameter of 6 mm and a thickness of 2 mm, the outer tube portion 13f has an inner diameter of 8 mm and a thickness of 2 mm, and the magnet 13i has an inner diameter of 10 mm, an outer diameter of 16 mm, and a thickness of 1.8 mm.

2-2. Female Connection Part On the other hand, the female connection part 13k is formed on the connection side of the hard tube part 13l and the hard pipe part 13l formed in a tubular shape with the same diameter as the outer pipe part 13f. It has the 2nd flange 13m which functions as packing, and the annular | circular shaped magnet 13n with which the surface on the opposite side of this 2nd flange 13m is mounted | worn.

  The hard tube portion 13l and the second flange 13m are made of an integrally molded acrylic resin molded product, and the magnet 13n has the same configuration as the magnet 13i.

  Note that a tapered surface 13p for smooth insertion of the connecting insertion portion 13c is formed on the connection-side end surface of the hard tube portion 13l.

  Thus, since the connecting insertion portion 13c is formed of a flexible member and the tapered surface 13p is formed on the end surface of the female connecting component 13k, the connecting inserting portion 13c of the male connecting component 13e is extremely different. It can be smoothly inserted into the female connecting part 13k.

  In addition, after insertion, the magnets 13i and 13n exhibit a high attractive force with the first flange 13j and the second flange 13m having high dimensional stability in between, so that the male connection part 13e and the female connection part 13k Are accurately connected in a positioned state, whereby the male connecting portion 13a and the female connecting portion 13b are securely connected.

  Further, when the male connecting part 13e and the female connecting part 13k are connected, the inner diameter of the passage extending from the tube 13g to the hard pipe part 13l is expanded.

  Thereby, even if the ascending aorta route 7 and the right coronary artery route 9 are configured as separate parts, the device is inserted from the connection insertion part 13c of the male connection part 13e into the rigid tube part 13l of the female connection part 13k. In doing so, since there are no catches or joints that resist device insertion, training can be performed in the same way as a series of arterial routes.

  Returning to FIG.

  In order to retain the shape of the right coronary artery path 9 along the right ventricle, each peripheral portion thereof is supported by the shape retaining material 14 and also retains the shape of the left coronary artery path 10 along the left ventricle. Therefore, each peripheral portion thereof is supported by the shape retaining material 15.

  The shape-retaining support members 14 and 15 are made of a transparent epoxy resin so as not to obstruct the device inserted into the right coronary artery passage 9 or the left coronary artery passage 10.

  Further, as described above, the right coronary artery path 9 and the left coronary artery path 10 are configured to be detachably connected by the connector 13 as described above, and therefore, the coronary artery paths 9 and 10 can be replaced. It can be.

  Therefore, assuming a different blood vessel structure for each patient, if a plurality of types of right coronary artery path parts 9 (or left coronary artery path 10) are prepared and exchanged, the catheter operation corresponding to each patient can be trained. Is possible.

2-3. Parts for stenosis part Further, for example, the left coronary artery path 10 and the ascending aorta path 7 can be easily separated at the connector 13 portion, so that the stenosis part 16 is embedded in the left coronary artery path 10. However, it is possible to train an expansion operation for a stenosis.

  It is preferable to prepare a plurality of narrowed part parts 16 having different narrowed shapes. For example, a soft resin cylindrical part shaped like a normal stenosis and a cylindrical part like a calcified lesion can be prepared as options.

  In order to attach the stenosis part 16, first, silicon spray is sprayed into the left coronary artery passage 10, and the stenosis part 16 (or calcified lesion part) is pushed into a desired position with a stenosis part insertion tool. A stenosis can be provided in the arterial pathway 10.

  In order to remove the stenosis part 16 from the left coronary artery path 10, first, silicon spray is sprayed into the left coronary artery path 10 so that the rear side of the stenosis part in the left coronary artery path 10 is picked. If the stenosis part 16 moves to the entrance of the left coronary artery path 10 by extruding 16, it can be removed by pulling it out.

  Further, if the stenosis part 16 simulating the calcified lesion is inserted into the left coronary artery path 10 (or the right coronary artery path 9), it becomes possible to train high-speed rotation coronary artery decapitation. . Moreover, if a thrombus-like part is inserted, it becomes possible to train the operation of a thrombus aspiration catheter or the like.

3. Training Method Next, an example of a catheter operation training method using the simulation model of the present invention will be described.

  In the description, a case where a catheter is inserted into the left coronary artery path 10 will be described as an example.

  A catheter introducer (not shown) is punctured into the femoral artery path 3 (see FIG. 1).

  With the guide wire inserted into the lumen of the catheter, the catheter is inserted through the catheter introducer.

  The catheter is inserted in the order of the abdominal aorta route 4 → the thoracic aorta route 5 → the aortic arch route 6 → the ascending aorta route 7 while leading the guide wire.

  When the distal end of the catheter reaches near the upper entrance of the left coronary artery passage 10, the guide wire is pulled out, and the distal end shape of the catheter is returned to the curved state.

  Next, when the catheter is slowly advanced, the tip 20a of the catheter 20 moves along the inner wall of the ascending aorta path 7 and enters the left coronary path 10 from the entrance of the left coronary path as shown in FIG. Inserted.

  Since the connector 13 provided at the left coronary artery opening is configured so that the device can be smoothly inserted as described above, the catheter operation can be simulated with substantially the same feeling as in the actual artery.

  When the distal end 20a of the catheter 20 is not directed to the entrance of the left coronary artery passage 10, the catheter 20 is rotated around the axis so that the distal end portion 20a faces the entrance of the left coronary artery passage 10.

  If the catheter 20 is further inserted to advance the distal end 20 a of the catheter 20 into the left coronary artery path 10, the catheter 20 may bend in the ascending aorta path 7.

  In such a case, a part 20b of the catheter 20 is caused to lean against the inner wall of the ascending aorta path 7, and the distal end portion 20a is advanced into the left coronary artery path 10 with the inner wall of the artery as a support.

  The catheter operation performed in the treatment of such actual ischemic heart disease can also be reproduced by the simulation model of the present invention.

  In the simulation model of the present invention, it is possible to train not only when the catheter introducer punctures the femoral artery path 3, but also when the radial artery 8 'is punctured.

4. Simulation Model for Contrast Injection The majority of catheter examinations currently performed are coronary angiography, and the simulation model of the present invention can reproduce such coronary angiography. .

  In the simulation model for contrast medium injection shown in FIG. 5, four fluid introduction portions 17 a to 17 d are connected to the female connection portion 13 b of the coronary artery passage 9.

  These fluid introducing portions 17a to 17d are formed in a cylindrical shape that can communicate with the internal passage of the female connecting portion 13b, and are arranged substantially evenly on the circumference of the body wall of the female connecting portion 13b.

  Furthermore, each fluid introducing | transducing part 17a-17d is arrange | positioned with the inclination attitude | position which opened predetermined angle (theta) (15-60 degree) from the central axis C of the female type connection part 13b, and gives directionality to the flow of the fluid. ing.

  The mouth portions 17e and 17g of the fluid introduction portions 17a and 17c are connected to branch hoses 19a and 19b branched from the fluid supply hose 19 from the discharge pump 18. The mouth portions 17f and 17h are connected to other branch hoses 19c and 19d that are also branched from the fluid supply hose 19.

  A fluid discharge part 9 a is provided at the distal part of the coronary artery passage 9, and the fluid sent from the fluid outlet 9 a returns to the tank T of the discharge pump 18.

  The discharge pump 18 may be a fixed capacity type or a variable capacity type, but a small pump capable of discharging a flow rate corresponding to the blood volume from the heart is sufficient. In addition, what added glycerin to water or alcohol can be used as said fluid.

  In the figure, M is a motor for driving the discharge pump 18.

4-1. Operation of Contrast Medium Injection Simulation Model When the motor M rotates, the discharge pump 18 is driven to suck up the fluid from the tank T and send it to the fluid supply hose 19 in a pressurized state.

  The flow of the delivered fluid is distributed to the branch hoses 19a and 19b, and the fluid that has flowed to the branch hose 19a side is introduced into the internal passage of the female connection portion 13b from the fluid introduction portions 17a and 17c.

  On the other hand, the flow of the fluid that has flowed to the branch hose 19b side is introduced from the fluid introduction portions 17b and 17d into the internal passage in the female connection portion 13b.

  In this way, the fluids introduced in a state directed by the fluid introduction parts 17 a to 17 d merge in the female connection part 13 b and flow in the coronary artery path 9.

  In an empty cardiovascular simulation model that does not involve a flow, even if a contrast agent is injected, the contrast agent partially adheres to the inner wall of the cardiovascular simulation model, so the injection state of the contrast agent cannot be simulated.

  On the other hand, in the simulation model for injecting contrast medium according to the present invention, since the fluid flow in the direction of the arrow is formed in the female connection portion 13b, the contrast medium can be injected under the same conditions as the coronary artery of the living body. it can. This makes it possible to accurately reproduce the injection state of the contrast agent.

  Further, in the present invention, since the fluid is flowed only through the coronary artery path having a small volume, the discharge pump 18 can be reduced in size, and the simulation model can be made extremely compact with excellent portability. There is an advantage that you can.

  In the above embodiment, the cardiovascular system simulation model of the present invention has been described by taking the coronary artery route simulating the coronary artery as an example, but the carotid artery, the head and neck artery route simulating the cerebral artery, and the lower limb artery are simulated. It can also be replaced with the lower limb arterial pathway.

  In addition, the simulation model of the present invention can be applied to the evaluation of a catheter device because it can constitute a model according to various pathological conditions of an experimental system.

1 is an overall perspective view of a cardiovascular simulation model according to the present invention. It is an A direction arrow enlarged view of FIG. It is explanatory drawing which shows the state which isolate | separated the connector. (a) And (b) is the left view and front view of a male connection component, (c) And (d) is the front view and right view of a female connection component. It is a principle diagram of a simulation model for contrast medium injection. It is a general view which shows the structure of the conventional PTCA trainer.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Simulation model 2 Case 3 Femoral artery route 4 Abdominal aorta route 5 Thoracic aorta route 6 Aortic arch route 7 Ascending aorta route 8 Brachial aorta route 8 'Radial artery route 9 Right coronary artery route 10 Left coronary artery route 10 Transparent support material 12 Transparent Cover 13 Connector 13a Male connection part 13b Female connection part 13c Connection insertion part 13d Tube hole 13e Male connection part 13f Outer pipe part 13g Tube 13h Tapered surface 13i Magnet 13j Packing 13k Female connection part 13l Hard pipe part 13m Flange 13n Magnets 14 and 15 Shape-retaining support material 16 Stenosis parts 17a to 17d Fluid introduction part 18 Discharge pump 19 Fluid supply hose 20 Catheter

Claims (8)

In a simulation model that three-dimensionally reproduces the cardiovascular system,
An arterial route simulating an artery, a vascular route simulating a blood vessel branched from the artery, and a connector interposed between the arterial route and the vascular route,
The above connector
A male tube in which a flexible inner tube portion and a hard outer tube portion are joined to form a double tube structure, and one end portion of the inner tube portion is projected from the outer tube portion as a connection insertion portion. Mold connection,
A female connection part comprising a rigid tube part into which the connection insertion part is inserted;
A cardiovascular simulation model characterized by comprising:   The cardiovascular system simulation model according to claim 1, wherein the vascular route has a coronary artery route simulating a coronary artery.   The cardiovascular system simulation model according to claim 1 or 2, wherein a first flange is provided at a connection side end portion of the outer tube portion, and a second flange is provided at a connection side end portion of the hard tube portion.   The cardiovascular system simulation model according to claim 3, wherein annular magnets are attached to the first and second flanges.   The cardiovascular system simulation model according to claim 4, wherein the annular magnet is mounted on the opposite side of the first and second flanges.   A plurality of fluid introduction parts communicating with the coronary artery path are formed on the trunk wall near the connector in the coronary artery path, and the fluid introduced from the fluid introduction part is discharged to the peripheral part of the coronary artery path. The cardiovascular system simulation model according to claim 2, wherein a section is provided.   The cardiovascular system simulation model according to claim 6, wherein each of the fluid introduction portions is arranged in an inclined posture that is opened at a predetermined angle from a central axis of the female connection portion.   The cardiovascular system simulation model according to claim 6 or 7, wherein a discharge pump that discharges fluid is connected to the fluid introduction section, and the fluid that is sent out from the discharge section is returned to the tank of the discharge pump.