JP2010264129A - Catheter - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To facilitate selection of branched blood vessels for advancing a guide wire or the like in the vicinity of a branch position within the coronary vein. <P>SOLUTION: A catheter 1 is provided which comprises an elongated and flexible insertion section 2 inserted into the blood vessel of a patient, a blood receiving section 3 arranged on the distal end of the insertion section 2 and subjected to the force of blood flow directing the blood receiving section to one of branched blood vessels when positioned to face the blood flow in the vicinity of a branch position within the blood vessel, and a connection section 4 for swingably connecting the blood receiving section 3 to the insertion section 2. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to a catheter.

  Conventionally, a coronary sinus catheter having a balloon for stably supporting a flexible catheter in a coronary vein is known (see, for example, Patent Document 1).

JP-A-6-63148

  However, in a catheter procedure for a coronary vein or the like, it is necessary to advance a guide wire or catheter to a selected branch against the blood flow. Since blood vessel travel is configured with an angle or arrangement structure that allows blood flow to flow uniformly into the tissue, when selecting a blood vessel branch that goes backwards and inserts a guide wire, the angle becomes acute and proceeds forward Selection is difficult compared to In such a coronary vein, there is an inconvenience that it is difficult to select blood vessels even if the technique of Patent Document 1 is used.

  The present invention has been made in view of the above-described circumstances, and an object thereof is to provide a catheter capable of facilitating selection of a blood vessel branch for advancing a guide wire or the like in the vicinity of a branch position in a coronary vein. It is said.

In order to achieve the above object, the present invention provides the following means.
The present invention provides an elongated and flexible insertion portion that is inserted into a blood vessel of a patient, and is disposed at the distal end of the insertion portion and disposed near the branch position in the blood vessel so as to face the blood flow. A catheter is provided that includes a blood receiving part that receives a force directed from the bloodstream in the direction of a blood vessel branch, and a connecting part that connects the blood receiving part to the insertion part so as to be swingable.

  According to the present invention, when the insertion portion with the blood receiving portion disposed at the tip is inserted into the coronary vein against the blood flow, and the blood receiving portion is disposed near the branch position, the blood receiving portion facing the blood flow is A force directed to the direction of any of the blood vessel branches is applied from the bloodstream. Since the blood receiving part is swingably connected to the insertion part by the connecting part, the connecting part is actuated by the force received from the blood flow to be directed in the direction of one of the blood vessel branches.

  For example, by providing a blood receiving portion that is always directed to the side with a high blood flow, a blood vessel branch on the side with a high blood flow can be easily selected. In addition, by providing a blood receiving part that escapes from the blood flow, a blood vessel branch on the side with less blood flow can be easily selected. Furthermore, regardless of the amount of blood flow, by providing a blood receiving part that is directed in the first tilted direction, any blood vessel branch can be selected by swinging the blood receiving part, A clear selection is made that the other unselected vessel branch was not selected.

In the said invention, the said insertion part may have at least 1 through-hole penetrated in the longitudinal direction.
By doing in this way, after selecting the blood vessel branch by directing the blood receiving portion to the direction of any blood vessel branch by the blood flow, the guide wire inserted from the proximal end side of the insertion portion through the through hole Etc. can be easily guided to selected or unselected vascular branches without being obstructed by the blood flow.

Moreover, in the said invention, at least 1 of the said through-hole may penetrate the said connection part and the said blood receiving part, and may open at the front-end | tip of the said blood receiving part.
By doing this, the tip of the guide wire can be easily placed in the blood vessel branch on the side selected by the blood receiving portion by causing the guide wire or the like inserted through the through hole to protrude from the opening at the tip of the blood receiving portion. Can lead to.

Moreover, in the said invention, at least 1 of the said through-holes may be opened in the side surface of this insertion part in the tip vicinity of the said insertion part.
In this way, the tip of the guide wire is inserted into the blood vessel branch on the side not selected by the blood receiving portion by causing the guide wire or the like inserted through the through hole to protrude from the opening near the tip of the insertion portion. It can be easily guided.

Moreover, in the said invention, it is preferable to provide the outer cylinder member which accommodates the said insertion part, the said blood receiving part, and the said connection part so that it can protrude / project from a front-end | tip opening.
By doing so, the distal end of the catheter is guided to the vicinity of the branching position of the blood vessel in a state in which the insertion portion, the blood receiving portion, and the connecting portion are accommodated in the outer cylindrical member, and at that position, the blood receiving portion is By projecting from the distal end opening, the selection operation by the blood receiving part can be performed.

Moreover, in the said invention, it is preferable that the said blood receiving part is foldable.
By doing in this way, a blood-receiving part can be folded and accommodated in an outer cylinder member as a compact form, and the outer diameter dimension of an outer cylinder member can be comprised thinly. Thereby, insertion into a blood vessel can be performed easily.

Moreover, in the said invention, the said blood receiving part may be formed in flat form.
By doing in this way, the blood receiving part can be easily directed to the blood vessel branch on the side with less blood flow by the balance of blood flow on the front and back surfaces of the flat blood receiving part.

Moreover, in the said invention, the said blood receiving part may be formed in the propeller shape turned around the axis line along a blood-flow direction.
By doing in this way, the blood-receiving part can be easily directed to the blood vessel branch on the side where there is much blood flow by turning the propeller-shaped blood-receiving part around the axis along the blood flow direction by the blood flow. .

In the above invention, the blood receiving part may be a balloon that is inflated to a size smaller than the inner diameter of the blood vessel.
By doing in this way, the balloon inflated in the blood vessel can be floated in the blood flow, and can be easily directed to one of the blood vessel branches by the balance of the blood flow.

  According to the present invention, it is possible to easily select a blood vessel branch for advancing a guide wire or the like in the vicinity of a branch position in a coronary vein.

It is a partial perspective view which shows the catheter which concerns on one Embodiment of this invention, (a) The state in which the blood receiving part was accommodated in the outer cylinder member, (b) The blood receiving part protrudes from the front-end | tip opening of an outer cylinder member Each state is shown. It is explanatory drawing explaining the insertion operation | work to the coronary vein of the catheter of FIG. 1, (a) The state in which the blood receiving part was accommodated in the outer cylinder member, (b) The blood receiving part is from the front-end | tip opening of an outer cylinder member. Each of the projected states is shown. It is a modification of the blood receiving part of the catheter of FIG. 1, Comprising: It is a perspective view which respectively shows (a) propeller shape and (b) balloon shape. It is a longitudinal cross-sectional view which shows the modification of the connection part of the catheter of FIG. FIG. 6 is a longitudinal sectional view showing a modification of the catheter of FIG. 1 and having a plurality of through holes for guiding a guide wire.

A catheter 1 according to an embodiment of the present invention will be described below with reference to the drawings.
In this embodiment, a case where a guide wire is inserted into the coronary vein A will be described as an example.

  As shown in FIG. 1 (b), the catheter 1 according to the present embodiment has a tubular hand portion (insertion portion) made of an elongated and flexible material, and a flat plate-like receiving portion attached to the distal end of the hand portion 2. A blood part 3, a connecting part 4 that connects the blood receiving part 3 to the hand part 2, and an outer cylinder member 5 that accommodates the hand part 2, the blood receiving part 3, and the connecting part 4 are provided.

  As shown in FIG. 1 (b), the blood receiving part 3 includes two flat plate parts 3b extending outward in the radial direction outside the cylindrical body 3a. The flat plate portion 3b is made of a flexible material. When the flat plate portion 3b is housed in the outer cylinder member 5, as shown in FIG. When it is reduced and protruded to the outside of the outer cylindrical member 5, as shown in FIG. 1 (b), it extends in a flat plate shape and increases the amount of protrusion in the radial direction.

The connecting portion 4 is made of a material that is more flexible than the hand portion 2, and is formed in a tubular shape that extends the hand portion 2. By bending the connecting portion 4 by its flexibility, the blood receiving portion 3 attached to the tip can be freely swung.
The outer cylinder member 5 is formed in an elongated and flexible tubular shape, and has an inner diameter dimension capable of accommodating the blood receiving part 3 in a state of being rounded into a cylindrical shape. Moreover, the outer cylinder member 5 has the front-end | tip opening 5a, and the blood receiving part 3, the connection part 4, and the hand part 2 can be made to protrude and retract from the front-end | tip opening 5a.

  The hand portion 2, the connecting portion 4, and the blood receiving portion 3 are provided with a through-hole 6 that continues from the proximal end side of the hand portion 2 to the distal end of the blood receiving portion 3. The through-hole 6 has an inner diameter dimension in which a guide wire (not shown) can be inserted so as to be movable in the longitudinal direction.

The operation of the catheter 1 according to this embodiment configured as described above will be described below.
In order to select the vascular branches B and C in the coronary vein A using the catheter 1 according to this embodiment and introduce a guide wire (not shown) into the desired vascular branches B and C, FIG. As shown, the blood receiving part 3, the connecting part 4, and the hand part 2 are inserted into the coronary vein A while being housed in the outer cylinder member 5.

  In this state, the blood receiving part 3 is maintained in a form rounded into a cylindrical shape by the inner surface of the outer cylinder member 5, and the connecting part 4 is a cylinder of the blood receiving part 3 with respect to the hand part 2. 3a is arranged in a substantially straight line. In this state, the catheter 1 is advanced against the blood flow D in the coronary vein A. And when the front-end | tip of the catheter 1 is arrange | positioned in the branch position vicinity, it operates on the base end side, and as shown in FIG.2 (b), the outer cylinder member 5 is retracted with respect to the blood receiving part 3. .

Thereby, the blood receiving part 3 and the connection part 4 are protruded from the front-end | tip opening 5a of the outer cylinder member 5. FIG.
The blood receiving part 3 is released from the state of being rounded into a cylindrical shape by being protruded from the distal end opening 5a of the outer cylindrical member 5, and two flat plate parts 3b on both sides in the radial direction outside the cylindrical body 3a. Is restored to a flat plate shape as a whole (see FIG. 1B).

Further, since the blood receiving part 3 is protruded from the distal end opening 5a of the outer cylinder member 5, the inner surface of the outer cylinder member 5 supporting the blood receiving part 3 is detached from the blood receiving part 3, so that the connecting part 4 is optional. It is possible to bend in the direction.
Since the force due to the blood flow D acts on the front and back surfaces of the blood receiving part 3 projected from the distal end opening 5a of the outer cylinder member 5, a force that causes the blood receiving part 3 to fall in either direction depending on the balance of the force. Is granted. That is, since the blood flow D on the side with the larger blood flow receives a greater force than the side with the smaller blood flow, the blood receiving part 3 receives a force that causes the blood flow to fall to the side with the smaller blood flow (the blood vessel branch C side in FIG. 2). .

  As a result, the connecting portion 4 is easily bent by the force, the blood receiving portion 3 falls in the direction of the blood vessel branch C, and the blood vessel branch C in the direction in which the tip of the through-hole 6 of the cylindrical body 3a falls. Selected. The blood receiving unit 3 falls down until it hits the inner wall of the coronary vein A, and is maintained in a state of being hit by the blood flow D.

  Thereafter, the guide wire introduced from the proximal end side through the through-hole 6 of the proximal portion 2 of the catheter 1 is advanced, so that the connection portion 4 and the blood receiving portion 3 are inserted through the through-hole 6 in the cylindrical body 3a. Thus, the tip of the guide wire can be easily guided in the direction of the selected blood vessel branch C. At this time, since the blood receiving unit 3 is maintained in the collapsed state by the blood flow D, there is an advantage that the guide wire can be stably guided regardless of the blood flow D.

In addition, in the catheter 1 which concerns on this embodiment, the following modifications can be employ | adopted.
First, the blood receiving part 3 is formed in a flat plate shape, but instead of this, as shown in FIG. 3 (a), a propeller-like one or a balloon 7 as shown in FIG. 3 (b) is used. You may employ | adopt what consists of.

  The propeller-shaped blood receiving part 3 can be accommodated by being rolled up in the outer cylinder member 5 and spreads in a state of being released from the outer cylinder member 5 as shown in FIG. What is supported so that turning is freely possible can be employ | adopted. Since it is swung by the blood flow D, it is oriented so that its tip is directed toward the blood vessel branch B on the side where the blood flow D is large like a weathercock. Therefore, it is possible to easily select the blood vessel branch B on the side where the blood flow D is large.

  Moreover, the blood receiving part 3 which consists of the balloon 7 is a flow path for supplying pressurized air in the blood receiving part 3 other than the through-hole 6 opened to a front-end | tip, as FIG.3 (b) shows. 8 is provided in parallel with the through hole 6. The blood receiving part 3 composed of the balloon 7 can be accommodated in the outer cylinder member 5 in a contracted state, and is inflated while being released from the outer cylinder member 5 as shown in FIG.

  The blood receiving part 3 comprising the balloon 7 is inflated until the outer diameter is sufficiently smaller than the inner diameter of the coronary vein A, and the coronary vein A is not occluded even in the inflated state. In the coronary vein A, it can float in the blood flow D. Therefore, since the balance of the force received by the blood receiving part 3 varies depending on the state of the blood flow D, it moves in the direction in which the force is small, and the tip opening of the through-hole 6 is placed in one of the blood vessel branches B and C. can do.

  Next, the connecting portion 4 is formed in a tubular shape made of a flexible material, but instead of this, as shown in FIG. 4, it may be a hinge shaft 9 or a spherical bearing. . In the case of the hinge shaft 9, the degree of freedom of swinging of the blood receiving part 3 is limited to one dimension, but in the case of a spherical bearing, it can be swung in three dimensions.

  Moreover, about the hand part 2, although the case where it had the single through-hole 6 penetrated to the front end side of the blood receiving part 3 was demonstrated, it may replace with this and may have the several through-holes 6 and 10 Good. For example, as shown in FIG. 5, in addition to the through hole 6 that penetrates to the tip of the blood receiving part 3, a through hole 10 that opens to the side surface in the vicinity of the tip of the hand part 2 may be provided. In this way, the guide wire can be guided to protrude from the distal end opening (in the direction of arrow E) to the blood vessel branch B selected by the blood receiving unit 3, and the blood vessel branch C not selected The guide wire can be guided so as to protrude from the side opening (in the direction of arrow F). Thereby, even if any blood vessel branch B, C is selected by the blood receiving part 3, both blood vessel branches B, C can be freely selected to guide the guide wire.

  Moreover, in this embodiment, although what has the through-hole 6 extended from the hand part 2 to the front-end | tip of the blood receiving part 3 was illustrated, it is not limited to this, What does not have the through-hole 6 is employ | adopted. May be. When one of the blood vessel branches (for example, blood vessel branch B) is selected by the blood receiving unit 3, the flow path toward the blood vessel branch is narrowed by the blood receiving unit 3, so that the other blood vessel branch (for example, blood vessel) is selected. Insertion of the guide wire into the branch C) is facilitated.

A Coronary vein (blood vessel)
B, C Blood vessel branch D Blood flow 1 Catheter 2 Hand part (insertion part)
3 Blood receiving part 4 Connecting part 5 Outer cylinder member 6,10 Through hole 7 Balloon

Claims (9)

An elongated and flexible insert that is inserted into the patient's blood vessel;
A blood receiving portion that is disposed at the distal end of the insertion portion and receives a force directed from the blood flow when directed to the direction of any blood vessel branch when disposed near the branch position in the blood vessel;
A catheter comprising: a connecting portion that connects the blood receiving portion to the insertion portion in a swingable manner.   The catheter according to claim 1, wherein the insertion portion has at least one through-hole penetrating in the longitudinal direction thereof.   The catheter according to claim 2, wherein at least one of the through holes penetrates the connecting portion and the blood receiving portion and opens at a distal end of the blood receiving portion.   The catheter according to claim 2, wherein at least one of the through holes is open to a side surface of the insertion portion in the vicinity of the distal end of the insertion portion.   The catheter of Claim 1 provided with the outer cylinder member which accommodates the said insertion part, the said blood receiving part, and the said connection part so that it can protrude and retract from a front-end | tip opening.   The catheter according to claim 5, wherein the blood receiving part is foldable.   The catheter according to any one of claims 1 to 6, wherein the blood receiving part is formed in a flat plate shape.   The catheter according to any one of claims 1 to 6, wherein the blood receiving part is formed in a propeller shape that is swung around an axis along a blood flow direction.   The catheter according to any one of claims 1 to 6, wherein the blood receiving portion is a balloon that is inflated to a size smaller than a blood vessel inner diameter.

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