JP2010213800A - Catheter - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a catheter with a new structure capable of curving an inserting tip along a curving part of blood vessels, etc., when inserted into the curving part of a tubular tissue in a body such as a blood vessel, etc. <P>SOLUTION: The catheter includes a protruding section 32 for changing the direction which is partially protruded on the circumference at the tip of the flexible catheter body 12 by using a contact reaction force to the inner surface of the tubular organ inserted with the catheter body 12 to bend the tip of the catheter body 12, and a control means 28 for controlling the protruded section 32 into the protruded condition and the non-protruded condition. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a catheter that is used by being inserted into a body tubular tissue such as a blood vessel, a digestive tract, or a bronchial tube to observe an insertion site or perform medical treatment.

  2. Description of the Related Art Conventionally, catheters are known as a kind of medical instruments for performing inspections, treatments, and the like on internal tubular tissues such as blood vessels and tubular organs. Specifically, catheters are used in procedures such as PCTA (percutaneous coronary artery angioplasty), PTCR (coronary thrombolysis), PTCD (percutaneous transhepatic biliary drainage), PEIT (Pate), etc. .

  By the way, in medical treatment using such a catheter, it is necessary to insert the catheter into a blood vessel or the like and push the tip of the catheter to a target site in the body tissue. At that time, since the blood vessels and the like are curved in the body, the catheter itself is also made of a flexible material that can be bent in order to insert the catheter along the curvature of the blood vessels and the like.

  However, the catheter itself is required to have a certain degree of strength and hardness in order to insert the catheter into a blood vessel or the like by an external force or to withstand negative pressure applied to the catheter. Therefore, when the curvature of the blood vessel or the like into which the catheter is inserted is large, it is difficult to curve the distal end of the catheter along the curvature, and it may not be possible to reach the target site.

  In order to cope with such a problem, Japanese Patent Application Laid-Open No. 2-1292 (Patent Document 1) forms a tension lumen eccentric on the cross section of the catheter, and a tension wire is attached to the tension lumen. An inserted structure has been proposed. That is, the distal end of the tensile linear body is fixed to the catheter distal end, and by pulling the tensile linear body at the operation portion on the proximal side of the catheter, the tensile force is exerted on the catheter distal end via the tensile linear body, The distal end portion of the catheter is bent.

  However, in the catheter described in Patent Document 1, since the force is exerted on the entire lumen through the tensile linear body, it is difficult to stably curve only the distal end portion of the target lumen to the target shape. was there.

  Moreover, since the tension linear body is located on the inner peripheral side of the curved portion of the catheter, for example, in the case of a suction catheter, the tip of the suction lumen opens to the outer peripheral side, and the tip of the suction lumen is set on the inner peripheral side. Difficult to open toward For this reason, for example, when there is a thrombus or the like in the curved portion of the blood vessel, the tip opening of the suction lumen deviates from the thrombus portion toward the outer peripheral side and faces the outer peripheral wall of the blood vessel, and it is difficult to obtain a sufficient suction effect. It was.

JP-A-2-1292

  The present invention has been made in the background as described above, and the problem to be solved is to stably bend the tip portion into a desired shape along a curved portion such as a blood vessel. An object of the present invention is to provide a catheter having a novel structure.

  In addition, when the present invention is applied to, for example, a suction catheter, the distal end opening of the suction lumen can be directed to the inner peripheral side of the curved portion of the blood vessel and the like, thereby effectively treating the blood vessel in the curved portion. It is also an object of the present invention to provide a catheter that can be performed automatically.

  A feature of the present invention is a catheter that is inserted into a tubular organ in the body, and protrudes partially on the circumference at the distal end portion of the flexible catheter body, and abuts against the inner surface of the tubular organ. A catheter provided with a projecting portion for changing the direction of bending the distal end portion of the catheter body using force and a control means for controlling the projecting portion to a projecting state and a non-projecting state.

  In the catheter constructed according to the present invention, not only the protrusion reaction force of the protrusion, but also the contact reaction force caused by the contact of the protrusion with the inner wall surface of the tubular organ is exerted on the distal end portion of the catheter body. . In particular, since the contact reaction force is exerted on the catheter relatively and directly from the tubular organ, the distal end portion of the catheter is brought into contact with the outer peripheral wall surface of the curved portion of the tubular organ so that the distal end portion of the catheter is brought into contact with the tubular organ. It is possible to direct the bending directly and reliably toward the inner peripheral side of the bending portion.

  In addition, the protrusion reaction force and the contact reaction force of the protrusion are efficiently exerted only on the distal end portion of the catheter from which the protrusion protrudes. Therefore, unlike the prior art described in Patent Document 1, no external force is exerted on the entire catheter, and only the distal end portion of the catheter can be effectively bent.

  Further, in the present invention, an opening is formed in the outer peripheral surface of the distal end portion of the catheter body, and the protruding means protrudes outward from the opening in the protruding state by the control means, while the control means A configuration in which the protruding portion is accommodated inside the catheter main body without protruding from the opening in the non-projecting state is preferably adopted.

  By projecting the protruding portion outward through the opening of the catheter body in this way, it is possible to set a large amount of protrusion of the protruding portion from the catheter body without requiring a large deformation or the like in the catheter body. Become. Moreover, in the non-projecting state, the projecting portion is housed in the catheter body, so that interference of the projecting portion with the inner surface of the tubular organ is avoided.

  By the way, as described above, the projecting portion that is deformed and operated in the projecting state from the opening formed in the catheter body and the housed state is advantageously realized by the following configuration, for example. That is, a control lumen is formed in the catheter body, a control wire is inserted into the control lumen, the tip of the control wire is fixed to the tip of the catheter body, and the control lumen is passed through the opening. The control wire is opened on the outer peripheral surface of the catheter body, and the control means is configured to apply an external force in the feeding direction and the drawing direction to the control lumen with respect to the proximal end side of the control wire by the control means. A configuration that can be controlled to project from the control lumen through the opening and to be housed in the control lumen can be employed in the present invention.

  The control wire protrudes outward from the opening at the distal end portion of the catheter body and abuts against the inner surface of the wall of the tubular tissue into which the catheter body is inserted. Based on this, a bending force can be exerted on the catheter tip, and the catheter tip can be bent and deformed in the direction opposite to the protruding direction of the control wire. In addition, by operating the proximal end side of the control wire in the pulling direction from the catheter body, it is possible to transmit the force directly to the protruding portion, and to securely store the protruding portion in the catheter body. It becomes possible to reliably change the projecting portion between the projecting state and the non-projecting state.

  In the present invention, it is also possible to adopt a balloon instead of the above-described control wire, and to realize the protruding portion with the following configuration, for example. That is, the protruding portion is constituted by a balloon provided at the distal end portion of the catheter body and partially protruding on the circumference, and a control lumen is formed in the catheter body, and the control means is used to control the control body. A configuration in which the pressure fluid is supplied to and discharged from the balloon through the lumen to control the balloon in a bulged protruding state and a contracted non-projecting state can be employed in the present invention.

  By configuring the protruding portion with the balloon, the contact area of the tubular tissue with the inner wall surface can be set large, and the contact pressure (contact force per unit area) of the protruding portion with respect to the tubular tissue can be dispersed. In addition, since the contact area of the tubular tissue with the wall inner surface is set large, the catheter tip can be stably held in the tubular tissue in a state of being bent in a specific direction.

  Further, in the present invention, a treatment lumen is formed in the catheter body, and an opening in the distal end surface of the catheter body of the treatment lumen is formed on the catheter body with respect to the protruding direction of the protrusion. A configuration that is biased to the opposite side in the direction perpendicular to the axis is preferably employed.

  If such a treatment lumen is employed, the treatment lumen can be opened on the inner circumferential side of the distal end surface of the catheter body. Therefore, the treatment of the thrombus or the like in the curved portion of the tubular tissue is effectively performed by directing the opening of the therapeutic lumen that is easy to face the wall surface on the curved outer peripheral side in the curved portion of the tubular tissue to the curved inner peripheral side. It becomes possible.

  Further, when adopting the above-described treatment lumen, a guide lumen is formed in the catheter body by being biased to the opposite side of the treatment lumen in the direction perpendicular to the axis, and a guide wire is inserted into the guide lumen. The possible configuration is preferably employed.

  In this way, by deviating the guide lumen to the same side as the protruding direction of the protruding portion with respect to the therapeutic lumen, it is possible to set a large cross-sectional area while directing the therapeutic lumen toward the curved inner peripheral side. Become. In addition, the curvature of the catheter body in the target direction with the treatment lumen formed on the opposite side in the direction perpendicular to the axis with respect to the protrusion and the guide lumen is not only the action of the protrusion but the guide wire. It can be generated more stably by utilizing the rigidity of.

  Further, in the present invention, the bending stiffness at least at the distal end portion of the catheter body is different between the half-circular portion on the side where the protruding portion protrudes and the half-circular portion on the opposite side, and the protruding portion protrudes. A configuration in which the half-circumferential portion on the side is more difficult to bend than the half-circular portion on the opposite side is suitably employed.

  The half-circumferential portion opposite to the side from which the protruding portion protrudes is the inner peripheral side having a small curvature radius in the intended curved shape of the catheter body. Therefore, by making the inner peripheral side easier to bend, the curved shape in the direction in which the catheter body is intended, that is, the side where the protruding portion protrudes becomes the outer peripheral side and the opposite side becomes the inner peripheral side is more stable. Expressed.

  In the present invention, it is desirable to provide a contrast marker that serves as an index of the protruding direction of the protruding portion. By using this contrast marker, it is possible to accurately grasp the protruding direction of the protruding portion in the tubular tissue during the treatment.

1 is an overall schematic view showing a thrombus aspiration catheter as a first embodiment of the present invention. It is the front-end | tip part longitudinal cross-sectional view of the catheter shown by FIG. 1, Comprising: II-II sectional drawing in FIG. III-III sectional drawing in FIG. The front-end | tip part longitudinal cross-sectional view which shows the protrusion state of the protrusion part in the catheter shown by FIG. Explanatory drawing which shows the bending operation state in the catheter shown by FIG. It is a front-end | tip part longitudinal cross-sectional view which shows the thrombus aspiration catheter as 2nd embodiment of this invention, Comprising: VI-VI sectional drawing in FIG. VII-VII sectional drawing in FIG. The front-end | tip part longitudinal cross-sectional view which shows the thrombus aspiration catheter as 3rd embodiment of this invention. The front-end | tip part longitudinal cross-sectional view which shows the non-projection state of the protrusion part in the catheter shown by FIG. The front-end | tip part longitudinal cross-sectional view which shows the thrombus aspiration catheter as 4th embodiment of this invention. The front-end | tip part longitudinal cross-section which shows the protrusion state of the protrusion part in the catheter shown by FIG.

  Hereinafter, in order to clarify the present invention more specifically, embodiments of the present invention will be described in detail with reference to the drawings.

  FIG. 1 shows an overall outline of a thrombus aspiration catheter 10 as a first embodiment of the present invention. The thrombus aspiration catheter 10 of the present embodiment includes a long catheter body 12, and a hub 14 that also serves as a gripping portion is provided on the proximal end side of the catheter body 12. Then, in the state where the distal end side of the catheter body 12 is inserted into the blood vessel from the wrist or thigh of the human body and reaches the treatment site such as the coronary artery, an operation on the side of the hub 14 exposed from the human body is used to perform thrombus aspiration, etc. Treatment is to be given.

  More specifically, the catheter body 12 has a thickness that can be inserted into a blood vessel to be inserted and a length that reaches a target treatment site. In addition, it is made of a soft material that can be bent along blood vessels. For example, polyamide, polyvinyl chloride, polyurethane, polyimide, polyethylene, polyethylene elastomer, polypropylene, polytetrafluoroethylene, polyetherketone, polyvinylidene fluoride, etc. What was shape | molded by metal materials, such as a resin material, stainless steel, a nickel-titanium alloy, and these combination may be employ | adopted.

  As shown in FIGS. 2 to 4, three lumens 16, 18, and 20 extending in the length direction are formed inside the catheter body 12. Specifically, there are a suction lumen 16 as a treatment lumen, a guide wire lumen 18 as a guide lumen, and a control lumen 20. All the lumens 16, 18, and 20 are continuously formed from the proximal end portion to the distal end portion of the catheter body 12 with a substantially constant cross-sectional shape and a relative cross-sectional positional relationship.

  The suction lumen 16 opens at the distal end surface of the catheter body 12, and is connected to the negative pressure generating means 22 via the hub 14 on the proximal end side of the catheter body 12. Then, by applying a negative pressure exerted from the negative pressure generating means 22 into the blood vessel through the opening on the distal end side of the catheter main body 12, a thrombus or the like in the blood vessel can be sucked and removed.

  The guide wire lumen 18 is open to the distal end surface of the catheter main body 12, and is open to the outside through the hub 14 on the proximal end side of the catheter main body 12. A guide wire 24 is inserted into the guide wire lumen 18 so as to be insertable / removable as shown in FIG. In short, in this embodiment, the guide wire 24 is inserted through the catheter body 12.

  The guide wire 24 has a smaller diameter than the catheter body 12 and is inserted into the blood vessel in advance prior to insertion of the catheter body 12. Thereafter, by inserting the catheter body 12 into the guide wire 24, the catheter body 12 is smoothly inserted into the blood vessel, and the distal end of the catheter body 12 is guided to the vicinity of the target treatment site.

  Further, the control lumen 20 opens at the distal end surface of the catheter body 12, and communicates with a controller 26 as control means via the hub 14 on the proximal end side of the catheter body 12. A control wire 28 is inserted through the control lumen 20.

  The distal end of the control wire 28 is fixed to the opening of the control lumen 20 on the distal end side of the catheter body 12. The other end of the control wire 28 is connected to the controller 26 through the hub 14. The controller 26 applies an axial external force in the feeding direction and the drawing direction to the control lumen 20 to the control wire 28. Specifically, for example, a manually operable pressure piston is provided, and the proximal end side of the control wire 28 is fixed to the pressure piston, or the wire itself is pushed or pulled out by hand without using a means such as a piston. Thus, the controller is realized by braking the control wire.

  On the other hand, an opening 30 is formed in the peripheral wall portion of the control lumen 20 at the distal end portion of the catheter body 12. The control lumen 20 is communicated with the external space of the catheter body 12 through the opening 30. Further, a control wire 28 is inserted through a portion where the opening 30 is formed in the control lumen 20.

  Thus, when the controller 26 provided on the proximal end side of the catheter body 12 is operated to apply an external force in the feeding direction to the control wire 28 inserted through the control lumen 20, the distal end of the control wire 28 The longitudinal compression force is transmitted to the part. As a result, as shown in FIG. 4, the control wire 28 protrudes outward from the opening 30 at a portion opened by the opening 30, and is bent and deformed. In short, the control wire 28 is prevented from being deformed by the peripheral wall in the storage portion in the control lumen 20, and the outward bulging deformation is concentrated only in the portion opened by the opening 30. It is made to protrude.

  In addition, as is clear from this, in this embodiment, the distal end portion of the catheter body 12 partially protrudes on the periphery by the distal end portion of the control wire 28 that protrudes outward from the opening 30 and deforms. A protruding portion 32 is configured. Further, the projecting portion 32 releases the projecting state from the opening portion 30 by operating the controller 26 to apply an axial external force in the pulling direction from the control lumen 20 to the control wire 28, and again It is possible to restore the non-projecting state accommodated in the catheter body 12. As described above, the protruding portion 32 has a protruding state that protrudes outward from the opening 30 when the control wire 28 is operated in the feeding direction and the drawing direction by the controller 26 to exert an external force in the axial direction, and the catheter Switching to the non-projecting state accommodated in the main body 12 is controlled.

  Thus, when the protruding portion 32 protrudes outward at the distal end portion of the catheter body 12 as described above, a bending force is exerted on the distal end portion of the catheter body 12 by the protruding reaction force. That is, with respect to the protruding portion 32 protruding outward from the opening 30 of the catheter body 12, the protruding portion 32 is applied to the distal end portion of the catheter body 12 that exerts a supporting force on both ends as a reaction force of the supporting force. Will bend in the same direction.

  In addition, as illustrated in FIG. 5, the protruding portion 32 protruded at the distal end portion of the catheter body 12 in the curved portion of the blood vessel 34 is brought into contact with the inner wall surface of the blood vessel 34 on the curved outer peripheral side. The contact reaction force of the protruding portion 32 against the blood vessel 34 causes the distal end portion of the catheter body 12 to be further curved and deformed inward in the bending direction.

  Therefore, in the thrombus aspiration catheter 10 of the present embodiment, the contact reaction force of the protruding portion 32 against the blood vessel 34 is efficiently exerted as a bending force only on the distal end portion of the catheter body 12 from which the protruding portion 32 protrudes. It is. Therefore, as compared with the catheter having the conventional structure described in Patent Document 1, only the distal end portion of the catheter body 12 can be reliably bent in the intended blood vessel bending direction, and the distal end portion of the catheter body 12 is bent. It can be easily inserted into the blood vessel 34.

  In the present embodiment, as shown in FIG. 3, in the cross-sectional shape of the catheter main body 12, the suction lumen 16 is formed in a substantially semicircular cross-sectional shape in a region extending substantially half a circumference. The guide wire lumen 18 and the control lumen 20 are each formed in a substantially circular cross section in the other half-circumferential region. In short, the guide wire lumen 18 and the control lumen 20 are both biased to the opposite side in the axis-perpendicular direction with respect to the suction lumen 16 having an opening formed over substantially a half circumference.

  As a result, in the catheter body 12, the guide wire lumen 18 and the control lumen 20 are formed in the upper half in FIG. 3 as compared with the formation portion of the suction lumen 16 in the lower half in FIG. The secondary moment (I) of the cross section with respect to the radial line extending in the left-right direction is increased. 3 together with the rigidity of the guide wire 24 inserted through the guide wire lumen 18 and the control wire 28 inserted through the control lumen 20, the catheter body 12 has an upper portion in FIG. The lower half circumference portion in FIG. 3 which is the opposite side is easier to bend than the half circumference portion.

  Due to the uneven distribution of the ease of bending on the cross section of the catheter body 12, the catheter body 12 itself also has a portion where the suction lumen 16 that is easily bent becomes the inner peripheral side having a large curvature, and the protruding side of the protruding portion 32 that is difficult to bend. It is easy to bend and deform in a direction in which the portion is on the outer peripheral side having a small curvature. Accordingly, the distal end portion of the catheter body 12 is bent in a target direction by the bending force exerted on the catheter body 12 based on the protrusion reaction force of the protrusion 32 and the contact reaction force against the blood vessel 34 described above. Deformation is more stable.

  Further, since the suction lumen 16 and the protrusion 32 are formed on the opposite sides in the direction perpendicular to the axis inside the catheter body 12, the suction lumen 16 is formed on the distal end surface of the catheter body 12 with the protrusion 32. The catheter body 12 opens with a bias toward the opposite side of the catheter body 12 with respect to the protruding direction. Since the suction lumen 16 opens on the inner peripheral side in the bending direction on the distal end surface of the catheter body 12 that is bent and deformed, the opening of the suction lumen 16 extends from the outer peripheral wall surface of the blood vessel 34 in the bending direction. Located away. Thereby, the suction lumen 16 is efficiently opened forward in the curved blood vessel 34, and an effective suction effect on the thrombus 36 and the like in the blood vessel 34 can be obtained. .

  Note that the bending direction of the distal end portion of the catheter body 12 can be controlled by the protruding direction of the control wire 28. At this time, it is desirable to attach a contrast marker so that the operator can accurately grasp the position of the opening 30 in the protruding direction of the control wire 28 and perform a manipulation on the proximal end side of the catheter body 12. Specifically, for example, as shown in FIG. 3, a contrast marker 38 made of a radiopaque platinum tip or the like is secured to a specific position on the circumference of the distal end portion of the catheter body 12. Is done.

  Next, FIGS. 6 to 7 show a distal end portion of a thrombus aspiration catheter 40 as a second embodiment of the present invention. The thrombus aspiration catheter 40 according to the present embodiment employs a balloon 42 instead of the control wire in the thrombus aspiration catheter 10 according to the first embodiment as the protruding portion.

  That is, the suction lumen 16, the guide wire lumen 18, and the control lumen 20 are formed in the catheter body 44 as in the first embodiment, but the control lumen 20 is formed at the distal end portion of the catheter body 44. A balloon 42 communicated with is formed. The balloon 42 may be formed of a hollow body formed separately from the catheter body 44. However, in this embodiment, the outer peripheral wall portion of the catheter body 44 in the control lumen 20 is thinned and elastically expanded. The balloon 42 is integrally formed by the catheter body 44 by being made deformable.

  Although not shown, the internal space of the balloon 42 is communicated with a pressure supply / discharge source as control means connected to the hub 14 through the control lumen 20. Then, the positive pressure generated by the pressure supply / discharge source is supplied to the internal space of the balloon 42 through the control lumen 20 by using an appropriate pressure medium such as air or physiological saline. As shown in the figure, the balloon 42 is partially bulged and deformed outward in the circumferential direction so as to express the protrusion.

  The amount of protrusion of the balloon 42 can be controlled by adjusting the pressure exerted on the internal space of the balloon 42 by the pressure supply / discharge source. Further, the balloon 42 is contracted by removing pressure or sucking the internal space of the balloon 42 so that the projection of the balloon 42 can be released.

  In the thrombus aspiration catheter 40 of this embodiment as well, as the balloon 42 protrudes, the distal end portion of the catheter body 12 has both a reaction force against the inner wall of the blood vessel along with a protrusion reaction force. Acts as a bending force. Therefore, the same effect as the thrombus suction catheter 10 of the first embodiment can be exhibited.

  In addition, it is easy to secure a large contact area with the blood vessel in the protruding portion constituted by the balloon 42 as compared with the protruding portion constituted by the control wire 28 in the first embodiment. Therefore, the distal end portion of the catheter body 44 can be stably held at a predetermined position in the blood vessel based on the contact of the balloon 42 with the inner wall of the blood vessel. In addition, it is possible to reduce the contact force per unit area by dispersing the contact force of the protruding portion from the catheter body 44 to the inner wall of the blood vessel.

  Next, FIGS. 8 to 9 show a distal end portion of a thrombus aspiration catheter 46 as a third embodiment of the present invention. The thrombus suction catheter 46 of this embodiment employs a deformed wire 48 instead of the control wire 28 in the thrombus suction catheter 10 of the first embodiment.

  The deformed wire 48 is inserted in the control lumen 20 of the catheter body 12 so as to be displaceable in the axial direction. Although not shown, the deformed wire 48 is located at the proximal end portion on the hub (14) side with respect to the control lumen 20. Displacement operation can be performed in the feeding direction and the drawing direction. Further, as shown in FIG. 8, a deformed portion 50 having a “<” shape is provided at the distal end portion of the deformed wire 48 in a single initial shape. Further, the deformed wire 48 is formed of an elastic material such as a spring material at least in the deformed portion 50, and the deformed portion 50 can be deformed by an external force and is restored to an initial shape of “<” shape when the external force is removed. It is supposed to be.

  Then, by moving the deformed wire 48 in the feeding direction side to the control lumen 20 and aligning the deformed portion 50 with the opening 30 of the catheter body 12, as shown in FIG. The portion 50 protrudes from the opening 30 onto the outer peripheral surface of the catheter body 12 to form a protruding portion. On the other hand, the deformed wire 48 is moved from the control lumen 20 to the drawing direction side, and the deformed portion 50 is removed from the position of the opening 30 of the catheter body 12 to the proximal end side, as shown in FIG. In addition, the deformed portion 50 is held down by the peripheral wall of the control lumen 20, the protruding state is released, and the deformed portion 50 is deformed into a substantially linear shape and stored in the catheter body 12.

  Also in the thrombus aspiration catheter 46 of this embodiment, by projecting the deformed portion 50 to the outside of the catheter body 12 through the opening 30, the distal end portion of the catheter body 12 has a reaction force to the inner wall of the blood vessel. Any of the contact reaction forces acts as a bending force in a specific direction. Therefore, the same effect as the thrombus suction catheter 10 of the first embodiment can be exhibited.

  Next, the front-end | tip part of the thrombus aspiration catheter 52 as 4th embodiment of this invention is shown by FIGS. The thrombus suction catheter 52 of this embodiment employs a cylindrical elastic body 54 instead of the control wire 28 in the thrombus suction catheter 10 of the first embodiment.

  The cylindrical elastic body 54 is made of an elastically deformable cylindrical body, and is bulged and deformed outward in the direction perpendicular to the axis as it is compressed and deformed in the axial direction. Specifically, for example, a cylindrical rubber-like elastic body or the like can be used as the cylindrical elastic body 54 in addition to a knitted deformable fiber such as metal or synthetic resin.

  The cylindrical elastic body 54 is disposed at the portion where the opening 30 is formed at the distal end portion of the catheter body 12 while being accommodated in the control lumen 20. Further, the proximal end portion in the axial direction of the cylindrical elastic body 54 is supported in a fixed position in the axial direction with respect to the catheter body 12. On the other hand, the distal end portion of the cylindrical elastic body 54 in the axial direction can be displaced in the axial direction of the control lumen 20 in the catheter body 12.

  Further, an external force transmission wire 56 is inserted into the control lumen 20, and the base end side of the control lumen 20 is connected to the controller (26) via a hub (14) (not shown) as in the case of the guide wire 24 of the first embodiment. It is connected. By the operation of the controller (26), the external force transmission wire 56 is driven in the axial direction in the feeding direction and the drawing direction to the control lumen 20.

  Further, the distal end side of the external force transmission wire 56 is inserted into the cylindrical elastic body 54 and is fixed to the axial distal end portion of the cylindrical elastic body 54. Thus, when the external force transmission wire 56 is driven in the pulling direction from the control lumen 20 by the operation of the controller (26), the distal end portion of the cylindrical elastic body 54 is the proximal end portion as shown in FIG. The cylindrical elastic body 54 is compressed and deformed in the axial direction. Accordingly, the cylindrical elastic body 54 bulges and deforms outward, and a protruding portion 58 that protrudes outward from the opening 30 of the catheter body 12 is generated.

  In particular, the cylindrical elastic body 54 is limited in its outward bulging deformation by the peripheral wall portion of the control lumen 20 of the catheter body 12 except for the portion exposed to the outside through the opening 30. Therefore, the bulging deformation toward the outer peripheral side as the cylindrical elastic body 54 is compressed and deformed in the axial direction concentrates on the outward bulging deformation through the opening 30, and the protrusion 58 is efficient. It is made to protrude greatly.

  In addition, by driving the external force transmission wire 56 in the feeding direction to the control lumen 20, the cylindrical elastic body 54 is extended in the axial direction, and accordingly, as shown in FIG. The protrusion 58 disappears, and the cylindrical elastic body 54 is accommodated in the control lumen 20 again.

  Also in the thrombus aspiration catheter 52 of this embodiment, the cylindrical elastic body 54 is compressed and deformed in the axial direction, and the protruding portion 58 protruding outward from the catheter body 12 through the opening 30 is expressed. Both the reaction force against the inner wall of the blood vessel and the protruding reaction force act as a bending force in a specific direction on the distal end portion of the main body 12. Therefore, the same effect as the thrombus suction catheter 10 of the first embodiment can be exhibited.

  As mentioned above, although several embodiment of this invention was described, this invention is not limited by the specific description in these embodiment. For example, in the above-described embodiment, the present invention is applied to a thrombus aspiration catheter. However, the present invention can also be applied to a drug solution injection catheter, an endoscopic catheter, and the like, and various body such as a digestive system and a bronchial system. Application to various catheters used for tubular tissues is also possible.

  In particular, even when the present invention is applied to a medical fluid injection catheter or an endoscopic catheter, the medical fluid injection port provided on the distal end surface of the catheter main body or the endoscope observation surface is formed in a tubular body such as a blood vessel, as in the suction catheter. By avoiding contact with the outer peripheral wall surface at the curved portion of the tissue and being directed inward in the bending direction, it is possible to advantageously perform drug solution administration and endoscopic observation on the target site.

  Further, the specific structure of the catheter differs depending on such various uses, and for example, the guide wire lumen 18 and the guide wire 24 shown in the embodiment are not essential in the present invention.

  Even when the opening 30 is provided to project the protrusions 32 and 58 accommodated in the catheter body 12 to the outside, the catheter body in addition to the opening 30 having a predetermined opening area as in the above embodiment. A slit-shaped opening that is held in a closed state based on the elasticity of 12 may be employed. Such a slit-shaped opening is opened only when the protrusions 32 and 58 protrude.

  Further, the protruding portion does not need to be completely accommodated in the catheter body 12 in the non-projecting state, and the protruding amount is made small enough not to exert a bending force on the catheter body 12 as compared to the protruding state. It ’s fine.

  In addition, by providing the projection 32 with a contrast marker by forming the projection 32 of the control wire 28 with a radiopaque material, the treatment person can confirm the projection direction and the projection amount of the projection 32. May be.

10: thrombus aspiration catheter, 12: catheter body, 14: hub, 16 aspiration lumen, 20: control lumen, 26: controller, 28: control wire, 30: opening, 32: protrusion, 34: blood vessel, 36 : Thrombus, 38: Contrast marker

Claims (8)

A catheter inserted into a tubular organ in the body,
A projecting portion for changing the direction of the distal end portion of the flexible catheter body that partially protrudes on the circumference and curves the distal end portion of the catheter body using a contact reaction force against the inner surface of the tubular organ;
A catheter comprising control means for controlling the protruding portion between a protruding state and a non-projecting state. Forming an opening in the outer peripheral surface of the distal end portion of the catheter body,
The protruding portion protrudes outward from the opening in the protruding state by the control means, while the protruding portion does not protrude from the opening in the non-protruding state by the control means. The catheter according to claim 1, wherein the catheter is housed. Forming a control lumen in the catheter body, inserting a control wire through the control lumen;
While fixing the distal end of the control wire to the distal end of the catheter body, and opening the control lumen to the outer peripheral surface of the catheter body through the opening,
The control means applies an external force in the feeding direction and the drawing direction to the control lumen with respect to the proximal end side of the control wire, so that the control wire is removed from the control lumen through the opening. The catheter according to claim 2, which can be controlled in a protruding state and a storage state in the control lumen. The protrusion is formed by a balloon provided at the distal end portion of the catheter body and partially protruding on the circumference,
A control lumen is formed in the catheter body, and the control means supplies and discharges the pressure fluid to and from the balloon through the control lumen. The catheter according to claim 1 or 2, which is controllable to a state.   A treatment lumen is formed in the catheter body, and an opening in the distal end surface of the catheter body of the treatment lumen is opposite to the direction perpendicular to the axis of the catheter body with respect to the protrusion direction of the protrusion. The catheter according to any one of claims 1 to 4, which is biased.   6. The guide body according to claim 5, wherein a guide lumen is formed in the catheter body so as to be biased to the opposite side in the axis-perpendicular direction with respect to the treatment lumen, and a guide wire can be inserted into the guide lumen. catheter.   The bending rigidity of at least the distal end portion of the catheter body is different between a half-circular portion on the side where the protruding portion protrudes and a half-circular portion on the opposite side, and the half-circular portion on the side where the protruding portion protrudes. The catheter according to any one of claims 1 to 6, wherein the catheter is more difficult to bend than the opposite half-circumferential portion.   The catheter of any one of Claims 1-7 in which the contrast marker used as the parameter | index of the protrusion direction of the said protrusion part is provided.

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