JP2010017211A - Suction catheter - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a suction catheter for accurately grasping not only a position of a suction port but also an orientation of the suction port when the suction catheter is introduced into a blood vessel. <P>SOLUTION: The suction catheter has a suction lumen 11 disposed in the axial direction in a tubular catheter body 1. A part of a peripheral surface in a distal end portion of the body 1 is formed to be slanted relative to the axis, and the distal end portion of the body 1 is tapered axially forward. "The suction port 15, which is elongated in the axial direction, is opened axially forward and radially outward, and communicates with the suction lumen 11", is formed in the slanted part. A plurality of contrast markers 2-4 showing the position and the orientation of the suction port 15 under radioscopy are provided in the peripheral part of the suction port 15 in the body 1. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to an aspiration catheter that is introduced into the body percutaneously and sucks and removes from the body by negative pressure applied from the proximal end to a debris (foreign matter) such as a thrombus generated in the blood vessel or an atheroma released in the blood vessel. About.

  In thrombotic occlusion lesions such as coronary arteries, an atheroma (atheroma) is formed inside the blood vessel, resulting in the formation of a thrombus and occlusion of the blood vessel. In this case, a suction catheter is introduced into the body through the skin, and debris such as thrombus generated in the blood vessel or atheromatous released in the blood vessel is applied to the outside by negative pressure applied from the proximal end of the suction catheter. Suction removal is performed. In a suction catheter, a suction lumen is disposed in an axial direction in a tubular catheter body, and a suction port communicating with the suction lumen is formed at a distal end portion of the catheter body. From the suction port, a debris such as a thrombus is formed. Is sucked.

  In this suction catheter, in recent years, (1) while being able to satisfactorily suck debris such as a thrombus around the tip of the catheter body, (2) increasing the flexibility of the tip of the catheter body 21, In order to improve the blood vessel followability, as shown in FIGS. 14 and 15, the distal end portion of the catheter body 21 is cut in an inclined manner with respect to the axial center, and a part of the outer peripheral surface at the distal end portion becomes the axial center. On the other hand, it is inclined. Accordingly, the distal end portion of the catheter body 21 is tapered forward in the axial direction, and a suction port 23 communicating with the suction lumen 22 is formed in the inclined portion. It is elongated in the axial direction and opens forward in the axial direction and outward in the radial direction.

  By the way, when the suction catheter is introduced into the blood vessel, if the position of the suction port 23 cannot be grasped, debris such as a thrombus cannot be satisfactorily sucked at the lesion. Therefore, a contrast marker 25 that indicates the position of the suction port 23 under fluoroscopy is disposed at the distal end of the catheter body 21 (see, for example, Patent Document 1).

JP 2004-222946 A

  However, in the prior art, the contrast marker 25 is single, and as described above, only the position of the suction port 23 is shown under fluoroscopy. Therefore, when the suction catheter is introduced into the blood vessel, the position of the suction port 23 can be grasped, but the direction of the suction port 23 cannot be grasped, and thus debris such as a thrombus around the distal end portion of the catheter body 21 can be obtained. The fact is that there was a case where it was not possible to suck the water well in a short time.

  An object of the present invention is to accurately grasp not only the position of the suction port but also the direction of the suction port when the suction catheter is introduced into the blood vessel, and quickly remove debris such as thrombus around the distal end of the catheter body. It is an object of the present invention to provide an aspiration catheter that can be aspirated well.

In order to achieve the above object, the present invention is characterized in that a suction lumen is disposed in the axial direction in a tubular catheter body, and a part of the outer peripheral surface at the distal end portion of the catheter body is disposed in the axial center. The tip of the catheter body is tapered toward the front in the axial direction, and is slanted in the axial direction at the inclined portion, and the front and diameter in the axial direction. In the suction catheter having a suction port that opens outward in the direction and communicates with the suction lumen, a plurality of suction catheter positions and orientations are shown in X-ray fluoroscopy at the periphery of the suction port in the catheter body. The contrast marker is provided at a point.
The number of contrast markers is three consisting of a distal contrast marker, a central contrast marker, and a proximal contrast marker, and the catheter body is located at a substantially central portion in the axial direction of the suction port with respect to the axial direction. And, with respect to the width direction of the suction port, a central contrast marker is disposed at a position located on one side of the suction port, and at the distal end side of the central contrast marker in the catheter body, A distal-side contrast marker is disposed on the catheter body on the side closer to the proximal end than the central contrast marker, and on the side opposite to the central contrast marker placement side with respect to the width direction of the suction port A proximal-side contrast marker may be disposed at the position.
The contrast marker may be made of gold, platinum, iridium, or an alloy thereof.
Furthermore, the contrast marker may be formed by blending a radiopaque inorganic material with a thermoplastic resin.
Further, the radiopaque inorganic material may be bismuth oxide, bismuth subcarbonate, tungsten, or barium sulfate.
Furthermore, the thermoplastic resin used for the catheter body may be the same as the thermoplastic resin used for the contrast marker.
Further, a metal braid knitted in a cylindrical shape of the mesh may be concentrically embedded in the catheter body over the entire portion of the catheter body extending from the proximal end portion to the vicinity of the suction port.

According to the present invention, when the catheter body is introduced into the blood vessel, not only the position of the suction port but also the direction thereof can be accurately grasped, and debris such as thrombus around the distal end portion of the catheter body can be quickly removed. Suction is good.
According to the second aspect of the present invention, since the proximal contrast marker is disposed on the side opposite to the center contrast marker in the width direction of the suction port, the catheter body is extremely thin. In addition, the direction of the suction port can be grasped more accurately.
According to the invention described in claim 6, the adhesion between the contrast marker and the catheter body can be improved, and the contrast marker can be firmly provided on the catheter body.
According to the seventh aspect of the present invention, when a rotational torque is applied to the proximal end portion of the catheter body, the catheter body can be prevented from being twisted, whereby the applied rotational torque is applied to the distal end portion of the catheter body. It can be transmitted well, and the operability of the suction catheter can be improved.

  Hereinafter, a first example of an embodiment of the present invention will be described with reference to the drawings of FIGS. 1 to 9. As shown in FIGS. 1 to 5, the suction catheter is a tubular body, the catheter body 1, and the distal end side. A central portion / base end side contrast marker 2, 3, 4 and a hub (connector) (not shown) connected to the base end of the catheter body 1.

  The catheter body 1 is formed of a thermoplastic resin such as polyethylene, polyamide elastomer, polyester elastomer, polyurethane, etc. In particular, a polyamide elastomer (for example, “Vebucks manufactured by Arkema Co., Ltd.) that can be selected from various hardnesses while being the same material. "(Trademark) etc.) is desirable. The maximum outer diameter of the catheter body 1 is, for example, 1.30 to 2.00 mm, and its effective length is, for example, 1350 to 1400 mm. The catheter body 1 is a tubular body, and is configured by connecting a large-diameter portion 6, a tapered portion 7, and a small-diameter portion 8 in the axial direction from the proximal end toward the distal end. The large-diameter portion 6 constitutes a portion excluding the distal end portion of the catheter body 1, and the outer diameter thereof is constant with respect to the axial direction. As shown in FIG. 3, the large-diameter portion 6 is knitted in a cylindrical shape of the mesh over the entire length in the axial center direction (note that the distal end portion and / or the proximal end portion in the large-diameter portion 6 may be removed). A rare metal braid 9 is embedded concentrically with respect to the catheter body 1. The metal braid 9 prevents twisting of the catheter body when a rotational torque is applied to the proximal end portion of the catheter body 1 and transmits the applied rotational torque to the distal end portion of the catheter body 1 in a good manner. The operability of the suction catheter is improved. The taper portion 7 constitutes the tip portion excluding the tip in the catheter body 1, and a part of the circumferential wall portion (side wall portion) in the circumferential direction is cut in an inclined manner with respect to the axial center, whereby the tip A part of the outer peripheral surface of the portion is formed to be inclined with respect to the axial center, and is tapered toward the front in the axial direction. The outer diameter of the base end is the same as the outer diameter of the large-diameter portion 6. It is said that. The “cut” is used for easy understanding of the shape, and may be formed in the above-described tapered shape without being “cut”, that is, simply formed of resin. The small diameter portion 8 constitutes the distal end of the catheter body 1, and the outer diameter thereof is constant in the axial direction, and the outer diameter thereof is the same as the outer diameter of the distal end of the tapered portion 7. Inside the catheter body 1, a guide wire lumen 10 and a suction lumen 11 are disposed in the axial direction.

  The guide wire lumen 10 is disposed in the circumferential direction of the large-diameter portion 6 and the tapered portion 7 of the catheter body 1 and inside the small-diameter portion 8 in the axial direction. While opening to the outside, the front end of the small diameter portion 8 is opened forward in the axial direction. A guide wire 13 is inserted into the guide wire lumen 10 so as to be relatively movable (slidable) in the axial direction.

  The suction lumen 11 is disposed in the axial direction in substantially the whole inside the large diameter portion 6 and the taper portion 7 of the catheter body 1 except for the guide wire lumen 10, and is connected to the hub at the proximal end. The inner diameter is, for example, 0.90 to 1.10 mm. Then, as described above, a part of the outer peripheral surface at the tip is formed to be inclined with respect to the shaft center, so that the portion that is inclined (cut) has a front and a diameter in the axial direction. A suction port 15 that opens outward in the direction and communicates with the suction lumen 11 is formed. The suction port 15 has an elliptical shape that is elongated in the axial direction.

  The distal-side / central-portion / base-end side contrast markers 2, 3, and 4 indicate the position and orientation of the suction port 15 under fluoroscopy, and are disposed in the peripheral portion of the suction port 15 in the catheter body 1. For example, it is embedded. In some cases, the distal-side / central-portion / base-end side contrast markers 2, 3, 4 may be attached to the outer surface of the catheter body 1 without being embedded. As shown in FIG. 5, the distal-side contrast marker 2 is formed in a ring shape and is embedded in the outer peripheral surface of the catheter body 1 at a position closer to the distal end than the suction port 15. As shown in FIG. 4, the central contrast marker 3 is a location located in the (substantially) central portion of the suction port 15 with respect to the axial direction in the catheter body 1 and the width direction of the suction port 15 ( With respect to the short-diameter direction of the suction port 15 and the radial direction of the catheter body 1), a location located on one side of the suction port 15 (a location on the outer side of one of the suction ports 15, in FIG. (Side place). As shown in FIG. 3, the proximal contrast marker 4 is a portion of the catheter body 1 that is located on the proximal side of the suction port 15 and the one side with respect to the width direction D of the suction port 15. It is arrange | positioned in the location located in the opposite side to the direction (the side by which the center part contrast marker 3 was arrange | positioned). Further, as shown in FIG. 3, the proximal contrast marker 4 is inclined with respect to the central contrast marker 3 with respect to the radial direction E perpendicular to the width direction D of the suction port 15 when viewed from the axial direction. Accordingly, the proximal contrast marker 4 protrudes more toward the suction port 15 with respect to the radial direction E than the central contrast marker 3. It should be noted that the distal-side contrast marker 2 may be located on the distal end side of the central contrast marker 3 rather than the distal end side of the suction port 15 in the catheter body 1. Further, the proximal contrast marker 4 may be located on the proximal side of the central contrast marker 3 rather than the suction port 15 in the catheter body 1. The contrast markers 2, 3 and 4 are (1) preliminarily disposed at a predetermined position of a molding die for molding the catheter body 1 when the catheter body 1 is molded, and the catheter body is formed by pouring a thermoplastic resin into the molding die. At the time of integral formation of 1, it is embedded in the catheter body 1 or bonded to the catheter body 1 after the catheter body 1 is molded. Contrast markers 2, 3 and 4 can be made of any material as long as they have contrast properties under fluoroscopy. For example, (1) Are they made of gold, platinum, iridium, or alloys thereof? Alternatively, it is formed by blending a radiopaque inorganic material with a thermoplastic resin. In the latter case, the thermoplastic resin used for the contrast markers 2, 3, 4 is the same resin as the thermoplastic resin used for the catheter body 1. Thus, if the same resin is used, the contrast markers 2, 3 and 4 and the catheter body 1 are easy to become familiar with, and the adhesiveness between them can be improved, so that the contrast markers 2, 3 and 4 are firmly provided on the catheter body 1. Can do. Examples of the radiopaque inorganic material used for the contrast markers 2, 3, and 4 include bismuth oxide, bismuth subcarbonate, tungsten, or barium sulfate.

  The hub is made of polycarbonate, injection molded, connected to the proximal end portion of the catheter body 1, connected to the suction lumen 11, and connected to a suction pump.

  According to the above configuration example, when performing thrombus aspiration therapy in which thrombus in the coronary artery or debris such as atheroma released in the blood vessel is aspirated and removed by the aspiration catheter, the guide inserted through the guide wire lumen 10 of the catheter body 1 While being guided by the wire 13, the suction catheter is inserted into the blood vessel from the leg or arm and passed through the bent portion of the blood vessel to reach the lesion in the coronary artery.

  When the suction port 15 of the catheter body 1 reaches the lesion in the coronary artery, the suction pump is driven to suck debris such as thrombus or atheroma released into the blood vessel from the suction port 15, and the suction lumen. 11 and collected in a thrombus collection bottle (not shown). In some cases, suction is performed with a syringe instead of the suction pump.

  At this time, when the suction catheter is seen through with X-rays, the contrast markers 2, 3 and 4 and the guide wire 13 can be seen through with any posture shown in FIGS. 6 to 9 or a posture similar to the above posture. As a result, the position of the suction port 15 can be easily grasped, and it can be confirmed in advance which side of the suction port 15 the central contrast marker 3 is positioned in the width direction D of the suction port 15. The direction of the suction port 15 can also be accurately grasped, and debris such as a thrombus around the distal end portion of the catheter body 1 can be sucked well in a short time.

  Theoretically, the proximal contrast marker 4 is positioned on the same side as the side where the central contrast marker 3 is disposed with respect to the width direction D of the suction port 15 or the center position of the suction port 15 with respect to the width direction D. It is possible to grasp the direction of the suction port 15 even if it is disposed. However, the maximum outer diameter of the catheter main body 1 is, for example, 1.30 to 2.00 mm, and the catheter main body 1 is extremely thin. Therefore, when the proximal contrast marker 4 is disposed as described above, FIG. 8 is slightly difficult to discriminate between the posture shown in FIG. 8 and the posture shown in FIG. 7 and the posture shown in FIG. 9, and the direction of the suction port 15 is slightly difficult to grasp. However, when the proximal contrast marker 4 is disposed on the side opposite to the disposed side of the central contrast marker 3 in the width direction D of the suction port 15 as in the above configuration example, the posture shown in FIG. The posture shown in FIG. 8 and the posture shown in FIG. 7 and the posture shown in FIG. 9 can be clearly distinguished, and the orientation of the suction port 15 can be accurately grasped.

  10 and 11 show a second example of the embodiment of the present invention. The central contrast marker 3 and the proximal contrast marker 4 are different from the first example in the width direction D of the suction port 15. , Disposed on the opposite side. That is, in the first example, in FIG. 2 which is a bottom view, the central contrast marker 3 is on the lower side of the paper and the proximal contrast marker 4 is on the upper side of the paper. In the example, in FIG. 11 which is a bottom view, the central contrast marker 3 is on the upper side of the paper, and the proximal contrast marker 4 is on the lower side of the paper.

  FIGS. 12 and 13 show a third example of the embodiment of the present invention. In the first and second examples, the guide wire lumen 10 is disposed inside the suction lumen 11. On the other hand, in the third example, the guide wire lumen 10 is disposed outside the suction lumen 11. The portions shown in FIGS. 12 and 13 in this example correspond to the portions shown in FIGS. 3 and 4 in the first example.

It is a side view which shows the 1st example of embodiment of this invention. It is a bottom view of FIG. FIG. 3 is a cross-sectional view taken along line AA in FIG. 2. FIG. 3 is a cross-sectional view taken along line BB in FIG. 2. FIG. 3 is a cross-sectional view taken along the line CC in FIG. 2. It is explanatory drawing which shows the posture under X-ray fluoroscopy in the 1st example of embodiment of this invention. It is explanatory drawing which shows the posture under X-ray fluoroscopy in the 1st example of embodiment of this invention. It is explanatory drawing which shows the posture under X-ray fluoroscopy in the 1st example of embodiment of this invention. It is explanatory drawing which shows the posture under X-ray fluoroscopy in the 1st example of embodiment of this invention. It is a side view which shows the 2nd example of embodiment of this invention. It is a bottom view of FIG. It is a cross-sectional view which shows the 3rd example of embodiment of this invention. It is a cross-sectional view of a different part from FIG. It is a side view which shows an example conventionally. It is a bottom view of FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Catheter main body 2-4 Front end side, center part, proximal end side contrast marker 9 Metal braiding 11 Suction lumen 15 Suction port D Width direction

Claims (7)

A suction lumen is disposed in the axial direction in the tubular catheter body,
A part of the outer peripheral surface of the distal end portion of the catheter body is formed to be inclined with respect to the axis,
The tip of the catheter body is tapered forward in the axial direction,
In the inclined part,
A suction catheter that is elongated in the axial direction, opens forward in the axial direction and radially outward, and has a suction port communicating with the suction lumen.
A suction catheter in which a plurality of contrast markers that indicate the position and orientation of the suction port under fluoroscopy are disposed around the suction port in the catheter body. The contrast markers are three consisting of a distal contrast marker, a central contrast marker, and a proximal contrast marker,
The central part of the catheter body is located in the central portion of the suction port with respect to the axial direction, and is located at one side of the suction port with respect to the width direction of the suction port. Markers are arranged,
In the catheter body, the tip side contrast marker is disposed at a position on the tip side of the center contrast marker,
In the catheter body, the proximal side contrast is located at a location closer to the proximal end than the central contrast marker and located on the opposite side of the suction port width direction from the central contrast marker placement side. The suction catheter according to claim 1, wherein a marker is disposed.   The suction catheter according to claim 1 or 2, wherein the contrast marker is made of gold, platinum, iridium, or an alloy thereof.   The aspiration catheter according to claim 1 or 2, wherein the contrast marker is a thermoplastic resin blended with a radiopaque inorganic material.   The suction catheter according to claim 4, wherein the radiopaque inorganic material is bismuth oxide, bismuth subcarbonate, tungsten, or barium sulfate.   The suction catheter according to claim 4 or 5, wherein the thermoplastic resin used for the catheter body is the same as the thermoplastic resin used for the contrast marker.   A metal braid knitted in a cylindrical shape of a mesh is embedded concentrically with respect to the catheter body over the entire portion of the catheter body extending from the proximal end to the vicinity of the suction port. The aspiration catheter as described.

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