JP2010213801A - Thrombectomy catheter - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a thrombectomy catheter of novel structure capable of exhibiting effective excision function for a thrombus. <P>SOLUTION: The thrombectomy catheter inserted into a blood vessel to be used for thrombus treatment is constituted to form a lumen 20 for excision in a catheter body 12, to form an opening portion 30 in a distal end part of the catheter body 12, to project an excision wire 28 inserted into the lumen 20 for excision on an outer circumferential surface of the catheter body 12, through the opening portion 30, so as to form a projecting portion 32, and to form further an excision blade 33 in the projecting portion 32, and the thrombus is excised by the projecting portion 32. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a thrombectomy catheter that is used by being inserted into a blood vessel to cut and remove an embolus (hereinafter referred to as a thrombus) in the blood vessel.

  Conventionally, when a thrombus caused by coagulated blood or atheroma is found on the inner surface of a blood vessel, a treatment for avoiding or eliminating blood flow obstruction caused by the thrombus has been performed. As a treatment method thereof, for example, as described in JP-A-57-501167 (Patent Document 1), a method of expanding the diameter of a blood vessel by inserting a balloon into a blood vessel constricted with a thrombus and inflating it. Has also been proposed, but there is a risk of restenosis. Therefore, a treatment for removing blood clots in blood vessels has been proposed and attracted attention.

  By the way, in the treatment for removing the thrombus by cutting, a special treatment tool is required for cutting and removing the thrombus in the blood vessel. Such a treatment tool is proposed in US Pat. No. 4,996,067 (Patent Document 2). In other words, these treatment tools described in Patent Document 2 have a rotary cutter inside the catheter, and the thrombus is cut and removed with the rotary cutter attached to the distal end of the catheter while the catheter is inserted into the blood vessel. It is supposed to be.

  However, any thrombectomy catheter having such a conventional structure forms an opening window on the distal end surface or the outer peripheral surface of the distal end of the catheter, and the thrombus that has entered the inside of the catheter from the opening window is removed by a rotating cutter in the catheter. It was supposed to be excised. Therefore, if the clot does not enter the catheter through the opening window of the catheter due to the shape or properties of the thrombus, the rotary cutter cannot even touch the thrombus and it is extremely difficult to remove the thrombus. there were. For example, in the case of a hard thrombus made of calcium or the like stuck to the inner peripheral surface of the blood vessel, the excision function by the rotary cutter could hardly function.

  In addition, the thrombectomy catheter having the conventional structure as described above has a problem that the distal end portion of the catheter is difficult to bend and lacks flexibility because a rotary cutter is prepared inside the distal end of the catheter. Therefore, it is difficult to insert a catheter into a blood vessel curved with a large curvature, and there is a possibility that the targeted thrombectomy cannot be performed.

Japanese Patent Publication No.57-501167 US Pat. No. 4,994,067

  The present invention has been made in the background as described above, and the problem to be solved is to provide a thrombectomy catheter having a novel structure capable of exhibiting an excellent cutting and removing function against thrombus. There is.

  The present invention is characterized in that, in a catheter that is inserted into a blood vessel and used for treatment of a thrombus, a resecting lumen is formed in the catheter body, and the resecting lumen is disposed at the distal end portion of the catheter body. While forming an opening to be opened on the surface, a resection wire is inserted into the resection lumen, and a protrusion that protrudes on the outer peripheral surface of the catheter body through the opening is provided on the resection wire. The thrombectomy catheter has a cutting blade formed in the part.

  In the thrombectomy catheter having a structure according to the present invention, a protruding portion having a cutting blade that exhibits a cutting and removing function for the thrombus is protruded on the outer peripheral surface of the catheter body. Therefore, it is possible to remove the thrombus existing outside the catheter body by directly acting on the cutting blade without the need to allow the thrombus to enter the catheter body.

  In addition, the protruding portion protruding on the outer peripheral surface of the catheter main body has a large contact with the inner peripheral surface of the thrombus to be cut using the reaction force against the blood vessel on the opposite side of the catheter main body in the direction perpendicular to the axis. It can be pressed by contact pressure. Therefore, by utilizing this contact pressure, the cutting removal function for the thrombus by the cutting blade of the protruding portion is more effectively exhibited.

  Furthermore, in the thrombectomy catheter of the present invention, it is easy to ensure the flexibility of the distal end portion of the catheter as compared with the one described in Patent Document 2 in which a rotary cutter is prepared inside the catheter. In addition, it is possible to exert a bending deformation force on the catheter tip portion by utilizing the contact reaction force of the protruding portion protruding on the outer peripheral surface at the catheter tip portion to the blood vessel inner wall. Therefore, by bringing the protruding portion into contact with the outer peripheral wall surface of the curved portion of the blood vessel, the distal end portion of the catheter can be directed directly and reliably toward the inner peripheral side of the curved portion of the blood vessel. The catheter can be easily inserted into a curved blood vessel.

  Further, in the present invention, on the proximal end side of the ablation wire, a control means for exerting an external force in the feeding direction and the withdrawal direction to the ablation lumen is provided, and is provided at the distal end portion of the catheter body. A configuration in which the projecting state and the non-projecting state of the projecting portion from the opening can be controlled is preferably employed.

  By adopting such control means and adjusting the amount of protrusion of the protrusion from the catheter body, the pressing force of the protrusion against the thrombus is adjusted according to the state of the thrombus, etc., and the thrombectomy efficiency is further improved Can be planned.

  In the present invention, a configuration in which the protruding portion can be accommodated in the resection lumen of the catheter body is preferably employed.

  Thus, by allowing the protruding portion to be housed in the catheter body in a non-projecting state, for example, when the catheter is inserted into the blood vessel, the protruding portion is accommodated in the catheter body, and the protrusion portion interferes with the inner surface of the blood vessel. Can be avoided.

  By the way, the protrusion part which can be protruded from the opening part formed in the catheter main body as mentioned above is implement | achieved by the following structures, for example. That is, the distal end of the ablation wire is fixed at the distal end portion of the catheter body, and the opening is formed in a peripheral wall near the distal end of the ablation lumen accommodated near the distal end of the ablation wire. A configuration in which an external force in the feeding direction to the resecting lumen is exerted on the proximal end side of the resecting lumen to form a projecting portion projecting through the opening near the distal end of the resecting wire can be employed in the present invention. It is.

  According to such a configuration, the vicinity of the distal end of the resection wire constituting the protruding portion protrudes in a substantially arc shape through the opening of the catheter body. Since this protrusion does not include the tip of the excision wire, troubles such as inadvertent puncture of the blood vessel wall at the tip of the excision wire are avoided. In addition, by forming a cutting edge portion on the substantially entire length of the resection wire that protrudes in a substantially arc shape to constitute the protrusion portion, the catheter body is reciprocated in the length direction so that a saw or scissors is against the thrombus. Such a cutting and removing action can be efficiently exhibited.

  Further, in the present invention, instead of the above-described substantially arc-shaped projecting portion, for example, a projecting portion having the following configuration can be adopted. That is, a configuration in which the distal end of the resection wire is the protruding portion that protrudes on the outer peripheral surface of the catheter body through the opening can be employed in the present invention.

  According to such a configuration, for example, a cutting edge portion is provided at a predetermined length of the distal end portion of the protruding cutting wire so as to exert a cutting removal action such as a saw or a scissors against the thrombus, It is also possible to provide a key-like scraping portion at the tip to exert a cutting and removing action such as a scraper or ear scraping on the thrombus. In addition, by adjusting the amount of protrusion of the excision wire from the opening, for example, the tip of the excision wire can be projected further forward than the tip of the catheter body. However, the cutting removal function can be exhibited.

  Further, in the present invention, a plurality of the resecting lumens through which the resection wire is inserted are formed in the circumferential direction of the catheter body, so that the protruding portions are located at different positions on the outer circumferential surface of the catheter body. You may employ | adopt the structure in which each is protruded.

  By providing protrusions at a plurality of locations on the outer peripheral surface of the catheter body in this way, for example, a thrombus present at a plurality of locations on the circumference in the blood vessel can be excised without rotating the catheter body in a plurality of directions. Is possible. Further, by projecting the projecting portions in a plurality of directions at the same time, it becomes possible to more efficiently carry out the cutting removal treatment of the thrombus existing on the outer periphery of the catheter body in the blood vessel.

  In the present invention, a configuration in which a suction lumen is formed in the catheter body may be employed.

  If such a suction lumen is employed, the thrombus cut and removed by the protruding portion can be quickly taken out from the blood vessel through the suction lumen. The suction lumen is preferably opened at the distal end surface of the catheter body.

1 is an overall schematic diagram showing a thrombus aspiration catheter as a first embodiment of the present invention. It is a front-end | tip part longitudinal cross-sectional view of the thrombus aspiration catheter shown by FIG. 1, Comprising: The II-II cross-section equivalent view in FIG. III-III cross-sectional enlarged view in FIG. The front-end | tip part longitudinal cross-sectional view which shows the protrusion state of the protrusion part in the thrombus aspiration catheter shown by FIG. FIG. 3 is an enlarged side explanatory view of an ablation wire constituting a protrusion in the thrombus aspiration catheter shown in FIG. 2. The longitudinal cross-sectional explanatory drawing for demonstrating the excretion operation of the thrombus by the thrombus aspiration catheter shown by FIG. Explanatory drawing which shows the bending operation state in the thrombus aspiration catheter shown by FIG. The front-end | tip part longitudinal cross-sectional view which shows the thrombus aspiration catheter as 2nd embodiment of this invention. FIG. 9 is an enlarged perspective explanatory view of a distal end portion of an excision wire constituting a protruding portion in the thrombus aspiration catheter shown in FIG. 8. The front view longitudinal cross-sectional view which shows the non-protrusion state of the protrusion part in the thrombus aspiration catheter shown by FIG. The front-end | tip part side view which shows the thrombus aspiration catheter as 3rd embodiment of this invention. XII-XII cross-sectional enlarged view in 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 thrombectomy catheter 10 as a first embodiment of the present invention. The thrombectomy catheter 10 of this 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, with the distal end side of the catheter body 12 inserted into the blood vessel from the wrist or thigh of the human body and reaching the treatment site such as the coronary artery, the thrombus is removed by an operation on the hub 14 side exposed from the human body. And extracorporeal suction treatment.

  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 the blood vessel, such as polyamide, polyvinyl chloride, polyurethane, polyimide, polyethylene, polyester elastomer, polypropylene, polytetrafluoroethylene, polyether ether ketone, polyvinylidene fluoride, etc. What was shape | molded by metal materials, such as a synthetic resin material, stainless steel, 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, the suction lumen 16, the guide wire lumen 18, and the resection 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 substantially constant 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 the negative pressure exerted from the negative pressure generating means 22 to the inside of the blood vessel through the opening on the distal end side of the catheter body 12, the cut thrombus and the like can be sucked in the blood vessel and removed from the body. ing.

  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 resecting lumen 20 is open to 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 cutting wire 28 is inserted through the cutting lumen 20.

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

  On the other hand, an opening 30 is formed in the peripheral wall portion of the resection lumen 20 at the distal end portion of the catheter body 12. The resecting lumen 20 is communicated with the external space of the catheter body 12 through the opening 30. In addition, a portion near the tip of the resection wire 28 is inserted into a portion where the opening 30 is formed in the resection lumen 20.

  Accordingly, 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 resection wire 28 inserted through the resection lumen 20, the distal end of the resection wire 28 The longitudinal compression force is transmitted to the part. As a result, as shown in FIG. 4, the cutting wire 28 protrudes outward from the opening 30 at a portion opened by the opening 30 and is bent and deformed. In short, the cutting wire 28 is prevented from being deformed by the peripheral wall in the portion stored in the cutting lumen 20, and the outward bulging deformation is concentrated only in the portion opened by the opening 30. It is made to protrude.

  Further, as is clear from this, in the present embodiment, the distal end portion of the ablation wire 28 that protrudes outward from the opening 30 and is curved and deformed partially projects on the circumference at the distal end portion of the catheter body 12. A protruding portion 32 is configured.

  Further, as shown in FIG. 5, the cutting wire 28 has a non-smooth outer peripheral surface shape in which the cutting blade 33 is formed at least at the tip portion constituting the protruding portion 32. The cutting blade 33 can be formed with an appropriate projection, rough surface, or the like according to the expected properties of the thrombus so as to exhibit a cutting or removing function such as a saw or a scissors with respect to the thrombus. Specifically, for example, the surface of the cutting wire is roughened, or the cutting wire is formed by punching the strands on which the protrusions are formed with an appropriate feeling, or the surface of the single wire is pressed. It is possible to form the cutting blade 33 by providing irregularities by cutting or cutting.

  When performing thrombectomy using the thrombectomy catheter 10 having such a structure, first, an external force in the pulling direction is applied to the excision wire 28 to excise the protrusion 32 as shown in FIG. The state is stored in the use lumen 20. Then, the catheter main body 12 is inserted into the blood vessel using the guide wire 24, and the distal end portion of the catheter main body 12 reaches the treatment target portion where the thrombus exists. Thereafter, the controller 26 is operated to apply an external force in the feeding direction to the ablation wire 28, thereby causing the protrusion 32 to protrude on the outer peripheral surface of the catheter body 12 within the blood vessel. In this manner, the protrusion 32 is accommodated in the catheter body 12 by the controller 26 exerting an external force in the feeding direction and the drawing direction on the resection wire 28 and protruding outward from the opening 30. Switching to the non-projecting state is performed.

  As a result, as shown in FIG. 6, the protruding portion 32 protruding on the outer peripheral surface of the catheter body 12 can be pressed against the thrombus 36 attached to the inner surface of the blood vessel 34. In particular, when the protruding portion 32 is pressed against the thrombus 36 by the protruding output from the catheter body 12, the opposite side of the catheter body 12 in the direction perpendicular to the axis is pressed against the opposing inner surface of the blood vessel 34. Therefore, the protrusion 32 is strongly pressed against the thrombus 36 based on the pressing reaction force of the catheter body 12 against the blood vessel 34.

  With the protrusion 32 strongly pressed against the thrombus 36 in this manner, the hub 14 is operated to reciprocate the entire catheter body 12 including the resection wire 28 in the axial direction with respect to the blood vessel. Thereby, the protrusion 32 provided with the cutting blade 33 is reciprocally displaced relative to the thrombus 36. As a result, a cutting and removing action such as a saw or a scissors is exerted on the thrombus 36, so that the thrombus 36 can be removed.

  The catheter body 12 can be rotated around the central axis by operating the hub 14 or the like. Therefore, in the blood vessel 34, the protruding direction of the protruding portion 32 can be appropriately changed and adjusted according to the position of the thrombus 36, the progress of cutting removal by the protruding portion 32, and the like.

  Furthermore, the amount of protrusion of the protrusion 32 from the catheter body 12 can be adjusted by the operation of the controller 26. Therefore, in the blood vessel 34, the protrusion amount of the protrusion 32 is appropriately adjusted in accordance with the shape, size, and properties of the thrombus 36 and the progress of cutting and removal by the protrusion 32, etc. It is possible to change and adjust the pressing force and the contact length of the portion 32.

  In the excision treatment of the thrombus 36, a contrast marker is attached so that the operator can accurately grasp the position of the opening 30 in the projecting direction of the projecting portion 32 and perform a manipulation on the proximal end side of the catheter body 12. It is desirable. 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. Alternatively, an X-ray opaque contrast marker may be attached to the protrusion 32.

  Furthermore, since the thrombectomy catheter 10 of the present embodiment includes the suction lumen 16 that opens at the distal end surface of the catheter body 12, the thrombus 36 cut by the protruding portion 32 as described above is simultaneously cut. Alternatively, it can be removed from the body through the suction lumen 16 immediately after cutting.

  Further, in the thrombectomy catheter 10 of the present embodiment, the distal end portion of the resection wire 28 that forms the protrusion 32 is completely accommodated in the resection lumen 20 in a non-projection state. When the main body 12 is inserted into the blood vessel 34, problems caused by the protrusion 32 contacting the blood vessel 34 can also be avoided.

  On the other hand, it is also possible to control the direction of the distal end portion of the catheter body 12 within the blood vessel 34 by using the protruding portion 32. That is, as illustrated in FIG. 7, in the curved portion of the blood vessel 34, the protruding portion 32 that is protruded at the distal end portion of the catheter body 12 is brought into contact with the inner wall surface on the curved outer peripheral side of the blood vessel 34. Thereby, the contact reaction force of the protruding portion 32 against the blood vessel 34 can bend and deform the distal end portion of the catheter body 12 inward in the bending direction. In this way, by controlling the bending of the distal end portion of the catheter body 12 using the contact reaction force of the protruding portion 32 against the blood vessel 34, the distal end portion of the catheter body 12 can be easily inserted into the curved blood vessel 34. It becomes possible.

  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. A guide wire lumen 18 and a resection 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 excision lumen 20 are both formed to be biased to the opposite side in the direction perpendicular to the axis with respect to the suction lumen 16 having an opening formed substantially over the entire circumference. As a result, the suction lumen 16 opens on the inner peripheral side in the bending direction at the distal end surface of the catheter body 12 that is bent and deformed as shown in FIG. Therefore, by projecting the projecting portion 32, the opening of the suction lumen 16 can be brought closer to the wall portion of the blood vessel 34 that is opposite to the abutting wall portion of the projecting portion 32 in the direction perpendicular to the axis. . Therefore, an effective suction effect can be obtained for the thrombus 36 adhering to the inner surface of the wall of the blood vessel 34 by causing the protrusion 32 to protrude while appropriately adjusting the rotational position of the catheter body 12 around the central axis. Is possible.

  Next, FIGS. 8 to 10 show a distal end portion of a thrombectomy catheter 40 as a second embodiment of the present invention. The thrombectomy catheter 40 of this embodiment is different from the thrombectomy catheter 10 of the first embodiment in the structure of the protruding portion.

  That is, the suction lumen 16, the guide wire lumen 18, and the resection lumen 20 are formed in the catheter body 41 as in the first embodiment, but the resection lumen 20 is formed at the distal end portion of the catheter body 41. Is the dead end. An opening 42 that opens to the outer peripheral surface of the catheter body 41 is formed at the dead end of the resection lumen 20. Further, the dead end surface of the resecting lumen 20 is a guide surface 43 inclined toward the opening 42.

  The cutting wire 44 inserted into the cutting lumen 20 has a free end at its distal end. Then, when the cutting wire 44 is fed into the catheter body 12, the distal end portion of the cutting wire 44 extends from the opening 42 to the outer peripheral surface of the catheter body 41 over a predetermined length as shown in FIG. Thus, it protrudes toward the front in the oblique axis direction. On the other hand, the excision wire 44 is completely accommodated in the excision lumen 20 of the catheter body 12 including the distal end portion thereof as shown in FIG. 10 by being displaced in the pulling direction from the catheter body 12. The non-protruding state is made.

  Further, the projecting portion 45 formed of the distal end portion of the cutting wire 44 has a substantially sickle neck shape as shown in an enlarged perspective view in FIG. Preferably, the entire surface has no corners and is rounded, for example, an ear-pick-shaped tip.

  Also in the thrombectomy catheter 40 of this embodiment, the thrombus adhering to the inner wall of the blood vessel can be removed by cutting using the protruding portion 45 expressed by protruding the distal end portion of the resection wire 44. Therefore, the same thrombectomy effect as that of the thrombectomy catheter 10 of the first embodiment can be obtained.

  In particular, by adjusting the length and angle of protrusion of the distal end portion of the resection wire 44 from the opening 42, the protrusion 45 can be extended further forward than the distal end of the catheter body 41, for example. Therefore, it is also possible to perform cutting and removal by the protruding portion 45 even for a thrombus or the like existing in a slit where the catheter body 41 does not reach.

  Next, FIGS. 11 to 12 show a distal end portion of a thrombectomy catheter 46 as a third embodiment of the present invention. The thrombectomy catheter 46 of the present embodiment shows another example of the arrangement of the excision wire 28 in the thrombectomy catheter 10 of the first embodiment.

  That is, in this embodiment, a suction lumen 50 is formed in the central portion of the catheter body 48, and a plurality of (three in this embodiment) are spaced apart from each other in the circumferential direction around the suction lumen 50. A resecting lumen 52 is formed. In each of the resecting lumens 52, a resecting wire 54 is accommodated and disposed in the same manner as the resecting lumen 20 of the first embodiment.

  Each ablation wire 54 is the same as the ablation wire 28 of the first embodiment. As shown in FIGS. 11 and 12, an external force in the feeding direction is applied from the proximal end side of the catheter body 12. The protruding portion 58 is formed by protruding from the opening 56 formed on the outer peripheral surface of the distal end portion of the catheter body 12. Thereby, the protrusion part 58 protrudes in the position which differs in the circumferential direction on the outer peripheral surface of the catheter main body 12, respectively. In addition, the external force in the pull-out direction is exerted on the proximal end side of the catheter body 12, but the ablation wires 54 are completely accommodated in the ablation lumen 20, although not illustrated.

  Also in the thrombectomy catheter 46 of this embodiment, the same effect as that of the thrombectomy catheter 10 of the first embodiment is exhibited by projecting only the projecting portion 58 of any one resection wire 28. obtain. In addition, by projecting the projections 58 of two or more ablation wires 28 simultaneously, a plurality of projections 58 are simultaneously developed at the distal end portion of the catheter body 48, so that a plurality of directions around the central axis of the blood vessel. A more efficient cutting and removing action can be exerted on the thrombus present in the.

  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, the suction lumen and the guide wire lumen in the above embodiment are not necessarily required, and a chemical solution injection lumen, an endoscope lumen, or the like may be provided instead of or in addition to those lumens. The present invention can be used not only to excise and remove thrombus in blood vessels but also to excise and remove polyps such as intestinal tract and tumors.

  Even when the openings 30, 42, 56 are provided to project the protrusions 32, 45, 58 accommodated in the catheter body 12 to the outside, the openings having a predetermined opening area as in the above embodiment. In addition, a slit-shaped opening that is held in a closed state based on the elasticity of the catheter body 12 may be employed. Such a slit-shaped opening is opened only when the protrusions 32, 45, 58 protrude.

  Further, the protruding portion does not need to be completely accommodated in the catheter body 12 in the non-projecting state, and does not affect operations such as insertion of the catheter body 12 into the blood vessel as compared to the protruding state. What is necessary is just to make protrusion amount small.

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

Claims (7)

In a catheter that is inserted into a blood vessel and used to treat a thrombus,
An ablation lumen is formed in the catheter body, and an opening for opening the ablation lumen to the outer peripheral surface of the catheter body is formed at the distal end portion of the catheter body, while an ablation wire is inserted into the ablation lumen. The thrombectomy catheter is characterized in that a protrusion projecting on the outer peripheral surface of the catheter body through the opening is provided on the resection wire, and a resection blade is formed on the protrusion.   Control means for exerting external force on the proximal side of the ablation wire in the feeding direction and the withdrawal direction to the ablation lumen is provided, and the opening from the opening provided at the distal end portion of the catheter body is provided. The thrombectomy catheter according to claim 1, wherein the protruding state and the non-projecting state of the protruding portion can be controlled.   The thrombectomy catheter according to claim 1 or 2, wherein the protruding portion can be accommodated in the resection lumen of the catheter body. Fixing the distal end of the ablation wire at the distal end portion of the catheter body, and forming the opening in a peripheral wall near the distal end of the ablation lumen accommodated near the distal end of the ablation wire;
4. A projecting portion that projects near the distal end of the ablation wire through the opening by applying an external force in a feeding direction to the ablation lumen to the proximal end side of the ablation wire. The thrombectomy catheter according to any one of the above.   The thrombectomy catheter according to any one of claims 1 to 3, wherein a distal end of the resection wire is the projecting portion that projects on the outer peripheral surface of the catheter body through the opening.   By forming a plurality of resection lumens through which the resection wire is inserted in the circumferential direction of the catheter main body, the protrusions protrude at different positions on the outer peripheral surface of the catheter main body in the circumferential direction. The thrombectomy catheter according to any one of claims 1 to 4.   The thrombectomy catheter according to any one of claims 1 to 5, wherein a suction lumen is formed in the catheter body.

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