JP2011062411A - Guide wire insertion catheter - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a guide wire insertion catheter for efficiently inserting a guide wire in a stenosis. <P>SOLUTION: The guide wire insertion catheter 10 has: a pipe body 12 forming an inner cavity 17; an insertion shaft 20 which is rotatably placed in the pipe body 12 and in which a rumen 21 for inserting the guide wire 11 is formed; a hand operation part 30 which is placed at a proximal end part 23 of the insertion shaft 20 and operates rotation of the insertion shaft 20; a communication member 50 which is fixed at the distal end part 18 of the pipe body 12 and is joined to the insertion shaft 20; and a pair of rotation members 40a, 40b which are placed in the communication member 50 and are rotatable on both sides of the guide wire 11. Rotation of the insertion shaft 20 causes the pair of rotation members 40a, 40b to rotate, and is converted into advance/retraction movement of the guide wire 11. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to a guide wire insertion catheter.

  There is a wide range of catheter insertion methods in which a flexible metallic guide wire is inserted through the lumen of the body in advance, and a therapeutic catheter such as a balloon catheter is guided to the target site along the guide wire. It is known (see Patent Document 1).

  When the guide wire is inserted into the lumen, it is difficult to insert the guide wire if the lumen is blocked by a stenosis. In such a case, generally, the practitioner operates the guide wire at hand, pushes the guide wire into the lumen, and pushes the distal end of the guide wire against the stenosis to penetrate into the lumen. It is inserted.

JP 2002-301161 A

  However, since the guide wire has flexibility, it is not possible to sufficiently transmit the pressing force to the distal end portion of the guide wire by pushing from the hand of the practitioner, and the stenosis can be efficiently penetrated. May not be possible. As a result, the time required for inserting the guide wire is lengthened. In some cases, the medical operation may be abandoned and replaced with a more invasive surgical operation, but this will increase the operating cost and increase the burden on the patient's body.

  The present invention has been made to solve the above-described problems, and an object of the present invention is to provide a catheter capable of efficiently penetrating a guide wire through a stenosis.

  The guide wire insertion catheter of the present invention that achieves the above object includes a tubular body in which a lumen is formed, a shaft that is rotatably arranged in the tubular body and in which a lumen through which the guide wire is inserted is formed, A proximal operation portion that is disposed at a proximal end portion and operates to rotate the shaft; a transmission member that is fixed to a distal end portion of the tubular body and coupled to the shaft; and a transmission member that is disposed on the transmission member, A pair of rotatable rotating members sandwiched between the pair of rotating members, and rotating the shaft causes the pair of rotating members to rotate and convert the guide wire to advance and retract.

  The guide wire insertion catheter of the present invention configured as described above is a drive in which the rotating member rotates in conjunction with the rotation of the shaft rotated by the hand operation unit, and the guide wire is advanced at a position closer to the distal end portion of the guide wire. Generate power. For this reason, a pressing force can be effectively applied to the stenosis from the distal end portion of the guide wire, and the stenosis can be efficiently penetrated by the guide wire.

  Since the distal end portion of the shaft is connected to a transmission member having a gear mechanism, the rotation of the shaft driven by the operator at hand is smoothly transmitted to the rotating member disposed on the distal end side. be able to.

  The pair of rotating members have an elliptical shape and are configured to sandwich the guide wire between the extended lines of the respective long axes. Therefore, when inserting the catheter, Clearance can be formed, and smooth insertion can be achieved.

It is sectional drawing which simplifies and shows the guide wire penetration catheter which concerns on embodiment. It is a perspective view which expands and shows a transmission member. It is sectional drawing which follows the 3A-3A line | wire of FIG. FIG. 4 is an exploded view of the transmission member, FIG. 4A is a view showing the inside of the transmission member, and FIGS. 4B to 4D are views showing gears. 5A and 5B are diagrams schematically showing the operation of the rotating member, FIG. 5A is a diagram showing the advancement operation of the guide wire by the rotating member, and FIG. 5B is the retreat of the guide wire by the rotating member. It is a figure which shows operation | movement. 6A and 6B are cross-sectional views for explaining the operation of the guide wire insertion catheter according to the embodiment. 7A and 7B are cross-sectional views for explaining the operation of the guide wire insertion catheter according to the embodiment. It is a perspective view which expands and shows the transmission member which concerns on a modification.

  Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. In the description of the drawings, the same elements are denoted by the same reference numerals, and redundant description is omitted. In addition, the dimensional ratios in the drawings are exaggerated for convenience of explanation, and may be different from the actual ratios.

  With reference to FIG. 6 and FIG. 7, in the embodiment, when the guide wire 11 is inserted into the lumen 5 of the living body 1, the guide wire 11 is inserted into the stenosis 8 generated in the lumen 5. In order to enable penetration, the guide wire insertion catheter according to the present invention is applied. The lumen 5 is, for example, a blood vessel of a limb of a patient suffering from atherosclerosis, and the stenosis 8 is, for example, an atheroma in which neutral fat is accumulated in the intima layer and further calcification is generated. Layers, and blood clots. The guide wire 11 is, for example, a conventionally known one made of a metallic material having flexibility, and is a lumen prior to treatment in order to guide a treatment catheter such as a balloon catheter to a target site. 5 is inserted.

  Referring to FIGS. 1, 6, and 7, an outline of a catheter 10 (corresponding to a guide wire insertion catheter) according to the embodiment will be described. A tubular body 12 having a lumen 17 formed therein, An insertion shaft 20 (corresponding to a shaft) formed with a lumen 21 that is rotatably arranged and through which the guide wire 11 is inserted, and a proximal end portion 23 of the insertion shaft 20 that operates the rotation of the insertion shaft 20. An operation unit 30, a transmission member 50 fixed to the distal end portion 18 of the tubular body 12 and connected to the insertion shaft 20, and a pair of rotatable rotation members 40 a and 40 b disposed on the transmission member 50 and sandwiching the guide wire 11. When the insertion shaft 20 is rotated, the pair of rotating members 40 a and 40 b are rotated to convert the guide wire 11 to advance and retract.

  Hereinafter, embodiments will be described in detail.

  Referring to FIG. 1, a catheter 10 has a tubular body 12 in which a hollow lumen 17 is formed. The tubular body 12 has an insertion portion 13 that is inserted into the lumen 5 in the body for a predetermined length, and a non-insertion portion 15 in which the hand operating portion 30 and the like are disposed.

  In the tubular body 12, a part of the drive shaft 31 constituting the hand operation unit 30 and the insertion shaft 20 are accommodated. Since the tubular body 12 covers the outer peripheral surface of the insertion shaft 20, it is possible to prevent the insertion shaft 20 from being damaged during transportation. Clearances are provided between the tubular body 12 and the insertion shaft 20 and between the tubular body 12 and the drive shaft 31 to allow the insertion shaft 20 and the drive shaft 31 to rotate.

  Although the external shape of the tubular body 12 is not particularly limited, it is desirable that the tubular body 12 is formed in a cylindrical shape as illustrated in consideration of the insertion property into the lumen 5, for example.

  Examples of the material of the tubular body 12 include polyolefin, olefin elastomer, polyester, soft polyvinyl chloride, polyurethane, urethane elastomer, polyamide, amide elastomer, polytetrafluoroethylene, fluorine elastomer, polyimide, and ethylene-vinyl acetate. Polymers, polymer materials such as silicon rubber, and the like can be applied. The polyolefin is, for example, polypropylene or polyethylene. The olefin elastomer is, for example, a polyethylene elastomer or a polypropylene elastomer. The amide elastomer is, for example, a polyamide elastomer.

  When the tubular body 12 is formed from a polymer material, for example, it is possible to improve the rigidity by using a superelastic alloy pipe, an embedded coil made of metal, or an embedded mesh.

  The distal end portion 18 of the tubular body 12 preferably has a function as an X-ray contrast marker, and can be formed using, for example, a resin containing an X-ray contrast material. The X-ray contrast material is, for example, a powder of tantalum, tungsten carbide, bismuth oxide, barium sulfate, platinum or an alloy thereof, a cobalt alloy, or the like.

  The insertion shaft 20 has a cylindrical outer shape in which a lumen 21 extending inside is formed so that the guide wire 11 can be inserted.

  During the treatment, when the tubular body 12 is inserted into the lumen 5, the portion located on the distal end portion 25 side of the insertion shaft 20 is inserted into the lumen 5 by a predetermined length together with the insertion portion 13 of the tubular body 12. Become. Therefore, the catheter 10 can be inserted into the lumen 5 along the guide wire 11 by feeding the insertion shaft 20 so as to cover the periphery of the guide wire 11 previously inserted into the lumen 5. (See FIG. 6A). The proximal end portion 23 of the insertion shaft 20 to which the drive shaft 31 is connected is located outside the living body together with the non-insertion portion 15 of the tubular body 12.

The hand operating unit 30 that operates the rotation of the insertion shaft 20 includes a drive shaft 31 that is rotatably provided around an axis, and a drive source 33 that drives the rotation of the drive shaft 31.
The drive shaft 31 is connected to the insertion shaft 20.

  Similar to the insertion shaft 20, the drive shaft 31 has a cylindrical outer shape in which a lumen 32 extending inside is formed so that the guide wire 11 can be inserted. In consideration of the insertion property of the guide wire 11 into the lumen 32 of the drive shaft 31, the central axis of the insertion shaft 20 and the central axis of the drive shaft 31 are formed on the same axis.

  As the drive source 33, a servo motor generally used as a power source is used. The type of the motor is not particularly limited, and a known motor used as a power source can be appropriately used.

  When a driving force is applied to the drive shaft 31 by operating the drive source 33, the drive shaft 31 rotates about its axis. The drive shaft 31 rotates the insertion shaft 20 connected to the drive shaft 31 around its axis in conjunction with its rotation. The rotated insertion shaft 20 drives the rotation of the rotation members 40a and 40b via the transmission member 50 connected to the insertion shaft 20 (see FIGS. 2 and 3).

  The material of the insertion shaft 20 and the drive shaft 31 is determined in consideration of the strength and rigidity required for transmitting the driving force from the drive source 33. For example, a metal, a relatively high-rigidity polymer material, or these materials are used. An appropriate combination or the like can be applied.

  Next, the transmission member 50 and the rotating members 40a and 40b will be described in detail.

  2 to 4, the transmission member 50 includes a first gear 60 connected to the distal end portion 25 of the insertion shaft 20, second gears 70 a and 70 b meshed with the first gear 60, and a second gear. A gear mechanism 55 having third gears 80a and 80b meshed with each of 70a and 70b, and an outer case 90 to which the gear mechanism 55 is attached.

  The exterior case 90 is for attaching the opening 91 facing the front end direction, the through hole 93 to which the first gear 60 is attached, the attachment hole 95a for attaching each of the second gears 70a and 70b, and the shaft-like member 97. The base 90 of the case 90 is fixed to the distal end of the insertion portion 13 of the tubular body 12.

  The guide wire 11 inserted through the lumen 5 in advance is inserted through the opening 91 of the outer case 90 and through the through hole 93 and the cylindrical portion 65 of the first gear 60 connected to the through hole 93. To do. The guide wire 11 inserted through the cylindrical portion 65 of the first gear 60 is inserted through the lumen 21 of the insertion shaft 20 connected to the first gear 60 (see FIG. 4A). In this way, the proximal end portion of the guide wire 11 can be introduced into the lumen 21 of the insertion shaft 20.

  Although the stainless steel is used as the material constituting the outer case 90, it is not limited to this. For example, a polymer material or the like can be selected as appropriate. Further, the outer shape is not limited to the illustrated shape, and can be appropriately changed according to the shape of the lumen.

  The first gear 60 includes a first tooth-like portion 63 that transmits rotation to the second gears 70 a and 70 b, a cylindrical portion 65 to which the distal end portion 25 of the insertion shaft 20 is fitted and connected, and an exterior case 90. And a recessed groove 67 for attaching to (see FIG. 4C).

  The first gear 60 can be attached by hooking the concave groove 67 on the edge of the through hole 93 formed in the exterior case 90. By fitting the distal end portion 25 of the insertion shaft 20 into the cylindrical portion 65 of the first gear 60, the first gear 60 and the insertion shaft 20 can be connected.

  The second gears 70a and 70b are meshed with one second toothed portion 73 meshed with the first toothed portion 63 of the first gear 60 and the third toothed portion 83 of the third gears 80a and 80b. It has the other 2nd tooth-like part 75 and the cylindrical part 77 for performing attachment with respect to the exterior case 90 (refer FIG.4 (D)).

  Each of the second gears 70 a and 70 b is a pair of two gears having the same configuration so as to be opposed to the vertical position of the outer case 90. The second gears 70 a and 70 b can be attached by fitting a cylindrical portion 77 into an attachment hole 95 a formed in advance in the vertical position of the exterior case 90.

  The third gears 80a and 80b have third tooth portions 83 that mesh with the second tooth portions 73 and 75 of the second gears 70a and 70b, respectively (see FIG. 4B).

  The third gears 80a and 80b are disposed on the gear 80a where the third tooth-like portion 83 is positioned so as to rotate in conjunction with the rotation of the second gear 70a disposed on the upper portion of the outer case 90, and on the lower portion of the outer case 90. A gear 80b on which the third tooth-like portion 83 is positioned is paired so as to rotate in conjunction with the rotation of the second gear 70b. The two third gears 80a and 80b are arranged such that the position of the third tooth-like portion 83 is different in the vertical direction according to the arrangement of the second gears 70a and 70b. It has a configuration. The third gears 80 a and 80 b are attached to the outer case 90 together with the rotating members 40 a and 40 b via the shaft-like member 97.

  When the practitioner operates the hand operation unit 30 to rotate the insertion shaft 20, the first gear 60 connected to the insertion shaft 20 rotates. When the first gear 60 rotates, the pair of second gears 70a and 70b rotate. Since each of the pair of second gears 70a and 70b is arranged so that the tooth-like portions 73 and 75 face each other, the pair of second gears 70a and 70b rotate in directions opposite to each other. When the pair of second gears 70a and 70b rotate, the pair of third gears 80a and 80b rotate in conjunction with the rotation of the second gears 70a and 70b. When the pair of second gears 70 a and 70 b rotate in the opposite directions, the pair of third gears 80 a and 80 b also rotate in the opposite directions around the shaft member 97. When the pair of third gears 80a and 80b rotate, the pair of rotating members 40a and 40b attached to the shaft-shaped member 97 together with the third gears 80a and 80b rotate. The pair of rotating members 40a and 40b rotate in opposite directions around the shaft-shaped member 97, like the third gears 80a and 80b. 3 indicates the rotation direction of the first to third gears 60, 70, 80 and the rotation member 40a when the insertion shaft 20 is rotated counterclockwise around the axis. An arrow c ′ in the middle indicates the rotation direction of the first to third gears 60, 70, 80 and the rotation member 40a when the insertion shaft 20 is rotated clockwise around the axis.

  Thus, since the distal end portion 25 of the insertion shaft 20 is connected to the transmission member 50 including the gear mechanism 55, the rotation of the insertion shaft 20 driven by the operator's operation is performed on the distal end of the insertion shaft 20. Smooth transmission to the rotating members 40a and 40b arranged on the side of the portion 25 is possible.

  The first to third gears 60, 70, 80 and the shaft-shaped member 97 are made of stainless steel as in the case of the exterior case 90, but are not limited thereto. For example, a polymer material or the like can be selected as appropriate.

  The pair of rotating members 40a and 40b has an elliptical shape, and is attached to the outer case 90 via a shaft-like member 97 (see FIG. 5).

  Referring to FIG. 5A, when the practitioner operates the hand operation unit 30 to rotate the insertion shaft 20 counterclockwise around the axis, the pair of rotating members 40 a and 40 b are connected via the transmission member 50. It rotates in the order shown in (a) to (e). As described above, the pair of rotating members 40 a and 40 b rotate in opposite directions around the axis of the shaft-shaped member 97.

  When the guide wire 11 is disposed between the rotating members 40a and 40b, the guide wire 11 is sandwiched between the rotating members 40a and 40b as shown in FIG. When the rotating members 40a and 40b are further rotated with the guide wire 11 being sandwiched, the portion sandwiched by the rotating members 40a and 40b is discharged and advanced in the direction of arrow f as shown in FIG. By this advance, it becomes possible to apply a pressing force to the stenosis 8 located in front of the guide wire 11 (left side in the figure) (see also FIG. 6B).

  Referring to FIG. 5B, when the insertion shaft 20 is rotated in the clockwise direction, as shown in FIGS. 5A to 5E, the pair of rotating members 40a and 40b are respectively connected via the transmission member 50. It rotates in the direction opposite to the rotation direction. When the rotating members 40a and 40b are further rotated in a state where the guide wire 11 is sandwiched between the rotating members 40a and 40b as shown in (c), the guide wire 11 starts from the portion sandwiched by the rotating members 40a and 40b. Is retracted and retracts in the direction of arrow b (see also FIG. 7A).

  Thus, by rotating the pair of rotating members 40 a and 40 b that sandwich the guide wire 11 in conjunction with the rotation of the insertion shaft 20, it is possible to convert the rotation of the insertion shaft 20 into the forward and backward movement of the guide wire 11. ing.

  The guide wire 11 sandwiched between the rotating members 40a and 40b can be moved forward and backward using the discharge and the pull-in. By setting the clearance between the rotating members 40a and 40b to be small, the guide wire 11 having a smaller diameter is moved forward and backward, or by setting the clearance between the rotating members 40a and 40b to be large, the guide wire 11 having a larger diameter is set. Can be moved forward and backward. By adjusting the clearance between the rotating members 40a and 40b, the apparatus can be shared for the guide wires 11 having different outer diameters.

  A pair of rotating members 40a and 40b formed in an elliptical shape is configured to sandwich the guide wire 11 between the extended lines of the respective long axes 41 (see FIG. 5).

  When the catheter 10 is used, the tubular body 12 is pushed into the lumen 5 while the guide wire 11 is inserted into the lumen 21 of the insertion shaft 20. When the guide wire 11 is inserted into the lumen 21 of the insertion shaft 20, if there is no clearance between the pair of rotation members 40a and 40b disposed on the distal end portion 25 side of the insertion shaft 20, the rotation members 40a and 40b There is a possibility that interference with the guide wire 11 makes it difficult to smoothly insert the catheter 10. Therefore, the rotating members 40a and 40b formed in an elliptical shape are used, and a clearance is formed between the rotating members 40a and 40b when the catheter 10 is inserted (see FIG. 6A). Although it does not prevent the use of the rotating members 40a and 40b other than the elliptical shape, the catheter 10 can be inserted while the guide wire 11 can be moved forward and backward by the pair of rotating members 40a and 40b. It becomes possible to facilitate the work.

  On the outer peripheral surfaces of the rotating members 40a and 40b, tooth-like portions 43 for increasing the frictional resistance with the guide wire 11 are formed. The tooth-like portion 43 makes it possible to more reliably discharge and retract the pinched guide wire 11. The shape and number of the tooth-like portions 43 are not particularly limited, and can be changed as appropriate. Further, it is possible to omit the formation of the tooth-like portion 43 in order to prevent the pinched guide wire 11 from being worn or scratched.

  The rotating members 40a and 40b are made of stainless steel as in the case of the outer case 90, but are not limited thereto. For example, plastic or rubber can be selected as appropriate.

  Next, the operation of the catheter 10 will be described.

  With reference to FIG. 6 (A), when the stenosis 8 exists in the lumen 5 during the treatment, the forward movement of the guide wire 11 attempted to be inserted into the lumen 5 is prevented. In such a case, in order to insert the guide wire 11 to a predetermined position, it is necessary to penetrate the constriction 8.

  The catheter 10 is inserted into the lumen 5 with the distal end portion of the guide wire 11 positioned in the vicinity of the stenosis 8. The guide wire 11 is inserted into the lumen 21 of the insertion shaft 20 while pushing the insertion portion 13 of the tubular body 12 into the lumen 5. The pair of rotating members 40 a and 40 b disposed on the distal end portion 25 side of the insertion shaft 20 are advanced to the periphery of the distal end portion of the guide wire 11.

  The insertion shaft 20 is inserted in a state where a clearance is formed between the pair of rotating members 40a and 40b. This prevents interference between the guide wire 11 and the rotating members 40a and 40b, and allows the catheter 10 to be inserted into the lumen 5 smoothly.

  With reference to FIG. 6 (B), after inserting the insertion shaft 20 to a predetermined position, the hand operating part 30 is operated and the insertion shaft 20 is rotated.

  The transmission member 50 provided with the gear mechanism 55 smoothly transmits the rotation of the insertion shaft 20 driven by the hand operation unit 30 to the rotation members 40a and 40b.

  The rotating members 40a and 40b sandwich the guide wire 11 between the extended lines of the respective long axes 41 as they rotate. The rotating members 40a and 40b are further rotated with the guide wire 11 sandwiched therebetween. The part pinched by the rotating members 40a and 40b is discharged and the guide wire 11 advances (arrow f in the figure), and a pressing force is applied to the constriction 8 located in front of the guide wire 11.

  As described above, the rotation of the insertion shaft 20 driven by the hand operation unit 30 drives the rotation of the rotating members 40 a and 40 b positioned around the distal end portion of the guide wire 11, and at a position closer to the distal end portion of the guide wire 11. A driving force for advancing the guide wire 11 is generated.

  Here, as a general technique, a method is known in which a practitioner operates a guide wire at hand and pushes the guide wire into the lumen to press the distal end portion of the guide wire against the stenosis and perform penetration. Yes.

  When the practitioner pushes in from the hand, a sufficient pressing force cannot be transmitted to the distal end portion of the flexible guide wire, and the stenosis cannot be efficiently penetrated by the guide wire. As a result, the time required for inserting the guide wire is lengthened. In some cases, the medical operation may be abandoned and replaced with a more invasive surgical operation, but this will increase the operating cost and increase the burden on the patient's body.

  In addition, in order to efficiently perform the penetration, it has been proposed to use a sharp-shaped drilling guide wire having a relatively hard tip, and when such a guide wire is used, blood vessel drilling is performed. May cause complications such as

  On the other hand, in the catheter 10 according to the present embodiment, the rotating members 40 a and 40 b rotate in conjunction with the rotation of the insertion shaft 20 rotated by the hand operation unit 30, and the tip of the guide wire 11 rotates. A driving force for advancing the guide wire 11 is generated at a close position. For this reason, a pressing force can be effectively applied from the distal end portion of the guide wire 11 to the stenosis 8, and the stenosis 8 can be efficiently penetrated by the guide wire 11. Accordingly, it is possible to prevent the time required for insertion of the guide wire 11 from being prolonged, and to prevent an increase in operation cost and an increase in burden on the patient's body. In addition, it is possible to prevent complications such as blood vessel perforation that can occur with the use of a guide wire for perforation.

  Referring to FIG. 7A, when the guide wire 11 does not penetrate by one push, the guide wire 11 is once retracted by the rotating members 40a and 40b (arrow b in the figure) and moved forward again. And try to penetrate. It is also possible to attempt to penetrate the guide wire 11 by rotating the rotating members 40a and 40b a plurality of times in the direction in which the guide wire 11 moves forward so that the guide wire 11 is engaged.

  By repeating the forward and backward movement a plurality of times, the guide wire 11 can be more reliably penetrated. Since the practitioner can move the guide wire 11 forward and backward by a simple operation of driving the rotation of the insertion shaft 20 by the hand operating unit 30, even when the penetrating operation is repeated several times, the guide wire 11 It is possible to prevent the time required for the insertion of a long time.

  With reference to FIG. 7B, the guide wire 11 can be penetrated through the constriction 8 by performing the above operation. After the catheter 10 is removed from the lumen 5, a therapeutic balloon catheter or the like is sent along the guide wire 11 to the target site. In this way, the guide wire 11 and the treatment catheter can be inserted into the lumen 5.

<Modification>
FIG. 8 shows a modification of the above-described embodiment. The same members as those in the embodiment described above are denoted by the same reference numerals, and a part of the description is omitted.

  The modification is different from the above-described embodiment in that the outer case 90 of the transmission member 50 is formed in a smooth curved surface. By using the exterior case 90 having the shape shown in the figure, it is possible to further reduce the burden on the body when inserted into the lumen 5 in the living body 1.

  The present invention is not limited to the embodiments described above, and various modifications can be made within the scope of the claims.

  For example, the shapes of the rotating members 40a and 40b are not limited to the elliptical shape shown in the embodiment, and can be modified as long as the sandwiched guide wire 11 can be moved forward and backward by a rotating operation. Therefore, it is also possible to employ a circular rotating member, or to employ one having a different shape between the rotating member and the other rotating member.

  Further, for example, it is also possible to use a configuration in which the stenosis object 8 is scraped by pressing the rotation members 40a and 40b against the stenosis 8 using the tooth-like portions 43 formed on the outer peripheral surfaces of the rotation members 40a and 40b. In such a case, a suction system such as a pump is provided so that the foreign matter can be crushed between the rotating members and the foreign matter can be transported out of the lumen using the lumen of the insertion shaft. It is desirable to provide a discharge system or the like for injecting a chemical solution such as physiological saline around the periphery.

  Further, for example, the number and shape of the gears provided in the gear mechanism, the rotation direction and the rotation speed of the gears interlocking with the rotation of the transmission member are not particularly limited, and the guide in which the rotation member sandwiches the rotation operation of the insertion shaft. It can be modified as long as it can be converted into a forward / backward movement of the wire.

  In addition, for example, the insertion shaft 20 is rotated by applying a driving force to the driving shaft 31 by the driving source 33. However, the practitioner may directly rotate the driving shaft and the insertion shaft manually. Is possible.

  Further, for example, the lumen in a living body is not limited to a blood vessel, and can be applied to a biliary tract that secretes bile into the intestinal tract. In this case, the constriction of the biliary tract is, for example, a gallstone (stone) made of cholesterol stone (pure cholesterol stone, composite stone, cholesterol pigment limestone or mixed stone).

1 living body,
5 lumens,
8 Stenosis,
10 catheter (guide wire insertion catheter),
11 Guide wire,
12 tubular body,
13 Insertion part,
15 Non-insertion part,
17 the lumen of the tubular body,
18 The tip of the tubular body,
20 Insert shaft (shaft),
21 lumens,
23, proximal end of the insertion shaft,
25 The tip of the insertion shaft,
30 Hand control unit,
31 drive shaft,
32 lumens,
33 drive source,
40a, 40b Rotating members (a pair of rotating members),
41 long axis,
50 transmission members,
55 gear mechanism,
60 first gear,
63 first tooth,
70a, 70b second gear,
73 one second tooth,
75 Other second teeth,
80a, 80b third gear,
83 third tooth,
90 exterior case,
91 opening,
97 Shaft-shaped member.

Claims (3)

A tubular body with a lumen formed therein;
A shaft rotatably disposed in the tubular body and having a lumen formed through the guide wire;
A proximal operation portion that is disposed at a proximal end portion of the shaft and operates to rotate the shaft;
A transmission member fixed to the distal end of the tubular body and connected to the shaft;
A catheter having a pair of rotatable rotation members disposed on the transmission member and sandwiching the guide wire,
By rotating the shaft, the pair of rotating members rotate and convert the guide wire into a forward / backward movement.   The guide wire insertion catheter according to claim 1, wherein the transmission member includes a gear mechanism that transmits rotation of the shaft to the pair of rotation members.   The guide wire insertion catheter according to claim 1 or 2, wherein the pair of rotating members have an elliptical shape, and the guide wire is sandwiched between the extended lines of the respective long axes.

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