JP2011194068A - Catheter - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a catheter capable of securely turning the distal end of a catheter body in a desired direction within a living lumen.SOLUTION: The catheter 1 includes: the catheter body 2 including an outer tube 21, an inner tube 22 inserted into the outer tube 21 with the distal end 221 projecting from the outer tube 21, and a connection wire 23 which connects the distal end 22 of the inner tube 22 with the distal end 212 of the outer tube 21; and an operating means for selectively performing either first operation of pulling the inner tube 22 to approximate the distal end 221 of the inner tube 22 to the distal end 212 of the outer tube 21, or second operation of pulling the inner tube 22 to approximate the distal end 221 of the inner tube 22 to the distal end 212 of the outer tube 21 and rotate the outer tube 21 around the axis of rotation. The connection wire 23 is bent by the first and second operation to form a projection 233 projecting toward a side of the catheter body 2. The shape of the projection 233 formed by the first operation is different from the shape formed by the second operation.

Description

  The present invention relates to a catheter.

  As a catheter used by being inserted into a living body lumen, a balloon catheter having a long flexible catheter body and a balloon that is provided on the outer periphery of the distal end of the catheter body and can be expanded and contracted is known. (For example, refer to Patent Document 1). The catheter main body of the balloon catheter described in Patent Document 1 has a distal end opening portion whose distal end is opened, and a side hole that is opened at a portion closer to the distal end side than the portion where the balloon is installed at the outer peripheral portion of the distal end. ing. And the balloon catheter of such a structure is used for the removal of the thrombus produced in the blood vessel, for example. In this case, the thrombus can be removed from the blood vessel by sucking the thrombus into the catheter body through the tip opening or the side hole.

  However, in the balloon catheter described in Patent Document 1, when the thrombus is removed, the distal end of the catheter body is centered with respect to the blood vessel when the balloon is expanded and the catheter body is fixed and placed in the blood vessel. The tip opening and the side hole will move away from the thrombus. As a result, there is a problem that it is difficult to suck a thrombus through the tip opening or the side hole.

JP-A-8-38609

  An object of the present invention is to provide a catheter in which a distal end portion of a catheter main body can surely face a desired direction in a living body lumen.

Such an object is achieved by the present inventions (1) to (13) below.
(1) A flexible outer tube, a flexible inner tube that is inserted into the outer tube and has a distal end projecting from the outer tube, and an elastic wire, the inner tube and the A catheter body having a connecting member for connecting the outer tube;
A first operation of relatively moving the inner tube and the outer tube along the axial direction of the catheter body to bring the distal ends of the inner tube and the outer tube closer to each other; The outer tube is moved relatively along the axial direction so that the tip portions of the inner tube and the outer tube are brought close to each other, and the inner tube and the outer tube are rotated relatively around the axis. An operation means for selecting and performing one of the second operations to be performed,
In each of the first operation and the second operation, the connecting member bends to form a protruding portion protruding toward the side of the catheter body, and the shape of the protruding portion is the first operation. A catheter characterized in that the operation differs from the second operation.

  (2) The catheter according to (1), wherein a distal end portion of the connection wire is fixed to a distal end portion of the inner tube, and a proximal end portion is fixed to a distal end portion of the outer tube.

  (3) By performing the first operation, the top portion of the protruding portion is deformed so as to be along the axial direction, and by performing the second operation, the top portion of the protruding portion intersects the axis. The catheter according to (1) or (2), wherein the catheter is deformed so as to be along a direction to be performed.

  (4) When the catheter body is inserted into the living body lumen and the protruding portion comes into contact with the wall portion of the living body lumen, the distal end portion of the catheter body is opposite to the protruding direction of the protruding portion. The catheter according to any one of (1) to (3), which moves in a direction.

  (5) The catheter according to any one of (1) to (4), wherein the operation means has a movement limit restricted in the first operation and a rotation limit restricted in the second operation. .

(6) It further includes a cylindrical hub installed at the base end of the outer tube,
The operating means is formed on the side portion of the hub along the axial direction thereof, and is formed on the side portion of the hub so as to be inclined with respect to the shaft, and communicates with the first groove. A cam groove having a second groove; and a cam follower that supports the inner tube and moves in the cam groove;
When performing the first operation, the cam follower is moved along the first groove, and when performing the second operation, the cam follower is moved along the second groove. The catheter according to any one of (5).

  (7) The catheter according to any one of (1) to (6), wherein the operation means is configured to maintain a shape of the protruding portion.

(8) It further comprises a hub installed at the base end of the outer tube,
The operating means includes an operating piece connected to the inner pipe and a plurality of engaging portions provided on the hub and having different positions, and one of the plurality of engaging portions is engaged. The catheter according to (7), wherein the shape of the protruding portion is maintained by engaging the operation piece with the portion.

  (9) The catheter according to any one of (1) to (8), wherein the operation unit is configured to be able to change a rotation direction in the second operation.

  (10) The catheter according to any one of (1) to (9), wherein the operation unit is configured to be able to select a rotation angle in the second operation from a plurality of angles.

  (11) The catheter according to any one of (1) to (10), wherein the connecting member is made of a superelastic alloy.

  (12) The above-described (1) to (11) further including a hub that is installed at a base end portion of the outer tube and is connectable to a suction mechanism that sucks at least one of the outer tube and the inner tube. The catheter according to any one of the above.

(13) The inner tube includes a window portion having transparency at a tip portion thereof,
The catheter according to any one of (1) to (12), wherein a long medical device including an imaging unit that images a target site through the window is inserted into the inner tube.

  According to the present invention, for example, when the first operation or the second operation is performed by the operation means in a state where the catheter body is inserted into the living body lumen where the lesion portion has occurred, the connecting member bends and the connecting member A protrusion is formed on the surface. And when this protrusion part contact | abuts to the wall part of a biological lumen, the front-end | tip part of a catheter main body can be made to face in a desired direction reliably, ie, it can be made to approach the lesioned part side, thereby treatment for a lesioned part is carried out. And diagnosis can be performed easily and reliably.

  When the top of the protrusion is deformed so as to be along the axial direction of the catheter body by the first operation, and the top of the protrusion is deformed so as to be along the direction intersecting the axis of the catheter body by the second operation. The direction in which the catheter can be displaced relative to the living body lumen and the direction in which the displacement is regulated vary depending on the deformed shape. Thereby, for example, the catheter can be easily operated according to the procedure.

It is the top view (a) and side view (b) which show the initial state of 1st Embodiment of the catheter of this invention. It is the top view (a) and side view (b) which show the state which performed 1st operation with respect to the catheter shown in FIG. It is the top view (a) and side view (b) which show the state which performed 2nd operation with respect to the catheter shown in FIG. It is a longitudinal cross-sectional view which shows the front-end | tip part vicinity of the catheter shown in FIG. It is a longitudinal cross-sectional view which shows the base end part vicinity of the catheter shown in FIG. It is a perspective view which shows the positional relationship of the cam groove and cam follower in the catheter shown in FIG. It is a perspective view which shows the positional relationship of the cam groove and engaging part in the catheter shown in FIG. It is a fragmentary longitudinal cross-section which shows the use condition of the catheter shown in FIG. It is a fragmentary longitudinal cross-section which shows the use condition of the catheter shown in FIG. It is a perspective view which shows the cam groove in the catheter (2nd Embodiment) of this invention. It is a perspective view which shows the cam groove in the catheter (3rd Embodiment) of this invention.

  Hereinafter, the catheter of the present invention will be described in detail based on a preferred embodiment shown in the accompanying drawings.

<First Embodiment>
FIG. 1 is a plan view (a) and a side view (b) showing an initial state of the first embodiment of the catheter of the present invention, and FIG. 2 shows a state where the first operation is performed on the catheter shown in FIG. FIG. 3 is a plan view (a), a side view (b), and FIG. 3 are a plan view (a), a side view (b), and FIG. 4 showing a state where the second operation is performed on the catheter shown in FIG. 1 is a longitudinal sectional view showing the vicinity of the distal end portion of the catheter shown in FIG. 1, FIG. 5 is a longitudinal sectional view showing the vicinity of the proximal end portion of the catheter shown in FIG. 1, and FIG. 6 shows the cam groove and cam follower in the catheter shown in FIG. FIG. 7 is a perspective view showing the positional relationship between the cam groove and the engaging portion in the catheter shown in FIG. 1, and FIG. 8 is a partial longitudinal section showing the use state of the catheter shown in FIG. FIG. 9 and FIG. 9 are partial longitudinal sectional views showing the use state of the catheter shown in FIG. That. In the following, for convenience of explanation, the right side in FIGS. 1 to 5, 8, and 9 is referred to as “base end”, and the left side is referred to as “tip”, and in FIGS. 6 and 7 (FIGS. 10 and 11). The same applies to the above) is called the “base” and the lower left is called the “tip”.

  A catheter 1 shown in FIGS. 1 to 3 includes a long catheter body 2 and a hub 3 disposed on the proximal end side of the catheter body 2. The catheter 1 can be used for both diagnosis in the body lumen and treatment in the body lumen. In addition, although it does not specifically limit as a biological lumen, In this embodiment, it is set as the blood vessel 500 (refer FIG. 8, FIG. 9). In addition, as “diagnosis”, for example, an image of the catheter 1 by an optical signal, in particular, an optical coherence tomography diagnostic apparatus (OCT), or an optical coherence tomography diagnostic apparatus (OFDI) using a wavelength sweep which is an improved version thereof is used. Use, after generating interference light by irradiating a living tissue with near infrared rays emitted from a transmission / reception unit provided at the tip of an imaging unit (not shown) and causing reflected light from the living tissue to interfere with reference light, A cross-sectional image of the blood vessel 500 can be drawn based on the interference light. The “treatment” includes, for example, removing the observed thrombus 501. Before describing the catheter 1, a medical device used in the diagnosis and the treatment will be described.

  When the catheter 1 is used for the diagnosis in the blood vessel 500, as shown in FIG. 4 (the same applies to FIGS. 8 and 9), the catheter 1 is a long medical device provided with an imaging means 201. The shaft 20 can be used by being inserted from the hub 3 side. The drive shaft 20 includes a main body 202 having an elongated shape, a prism 203 installed at the tip of the main body 202, and a housing 204 that houses the prism 203.

  The main body 202 is configured by, for example, an optical fiber covered with a multilayer coil. The main body 202 has a base end connected to a scanner (not shown). The prism 203 is a right-angle prism, and is fixed to the tip of the main body 202 (tip of the optical fiber). The housing 204 is formed of a transparent cylinder, and is a member that houses and protects the prism 203 therein. The housing 204 is also fixed to the tip of the main body 202. In the drive shaft 20, light from the scanner is transmitted to the prism 203 via the main body 202 and emitted from the prism 203. Then, the reflected light reflected from the blood vessel 500 is received by the prism 203 and read by the scanner via the main body 202. With such a configuration, it is possible to image the thrombus 501 that is a target site in the blood vessel 500.

  Further, when the catheter 1 is used for the treatment in the blood vessel 500, the drive shaft 20 is removed from the catheter 1, and instead, the mouth portion of the syringe 30 is inserted into the hub 3 of the catheter 1 as shown in FIG. 301 can be used together. The syringe 30 is a suction mechanism that can suck the inside of the catheter body 2. For example, when a side hole (not shown) is formed in the catheter main body 2 (inner tube 22), if the syringe 30 is operated, the thrombus 501 is sucked into the catheter main body 2 from the side hole, and the blood vessel 500 Can be removed.

  Next, the catheter 1 will be described. As described above, the catheter 1 includes the catheter body 2 and the hub 3.

  As shown in FIG. 4, the catheter body 2 includes an outer tube 21, an inner tube 22, and a connection wire (connection member) 23.

  The outer tube 21 is composed of a flexible tube. The size of the outer tube 21 is not particularly limited and can be, for example, as follows.

  The length of the outer tube 21 is preferably, for example, 50 to 3000 mm, and more preferably 1000 to 1500 mm. For example, the inner diameter of the outer tube 21 is preferably 0.7 to 5.0 mm, and more preferably 1.0 to 3.0 mm. The outer diameter of the outer tube 21 is preferably 0.9 to 6.0 mm, for example, and more preferably 1.1 to 3.5 mm.

  An inner tube 22 is inserted into the outer tube 21. The inner tube 22 is a flexible tube having a closed end. The outer diameter of the inner tube 22 is not particularly limited, and is preferably 70 to 95%, and more preferably 80 to 90%, of the inner diameter of the outer tube 21, for example. Note that the tip of the inner tube 22 is not limited to being closed, and may be open.

  The inner tube 22 has a tip 221 protruding from a tip opening 211 of the outer tube 21. Although it does not specifically limit as this protrusion length, In the initial state shown in FIG. 1, it is preferable that it is 10-60 mm, for example, and it is more preferable that it is 20-40 mm.

  A distal end member 24 having a tubular guide wire insertion portion 241 through which the guide wire 40 is inserted is fixed to the distal end portion 221 of the inner tube 22. The catheter 1 is inserted into the blood vessel 500 with the guide wire 40 inserted through the guide wire insertion portion 241. The catheter 1 is a so-called “rapid exchange type (short monorail type)” catheter that can quickly insert and remove the guide wire 40. The fixing method of the tip member 24 is not particularly limited, and examples thereof include a method using adhesion (adhesion with an adhesive or a solvent), fusion (thermal fusion, high frequency fusion, ultrasonic fusion, etc.), and the like. It is done.

  In addition, as shown in FIGS. 4, 8, and 9, the drive shaft 20 described above can be inserted into the inner tube 22 via the hub 3. In the inner tube 22, at least the distal end portion 221 has transparency, and the thrombus 501 can be imaged by the drive shaft 20 through the distal end portion 221. Thus, the tip 221 functions as a window when imaging the thrombus 501.

  The constituent material of the outer tube 21 and the inner tube 22 is not particularly limited. For example, styrene, polyolefin, polyurethane, polyester, polyamide, polybutadiene, transpolyisoprene, fluororubber, chlorinated polyethylene Examples include various thermoplastic elastomers such as a system, and combinations of one or more of these (polymer alloy, polymer blend, laminate, etc.) can be used.

  The outer tube 21 and the inner tube 22 are single-layered in the configuration shown in FIG. 4, but are not limited to this, and may be configured by a laminated body in which a plurality of layers are stacked, for example. .

  The distal end 221 of the inner tube 22 and the distal end 212 of the outer tube 21 are connected via a connecting wire 23. The connecting wire 23 is linear in a natural state, and a distal end portion 231 thereof is fixed to the distal end portion 221 of the inner tube 22, and a proximal end portion 232 is fixed to the distal end portion 212 of the outer tube 21. As the fixing method, for example, in the configuration shown in FIG. 4, a fixing member 25 configured by a heat shrinkable tube is used. The fixing member 25 may be further fused to the inner tube 22 and the outer tube 21. As another fixing method, for example, a method by adhesion (adhesion with an adhesive or a solvent) can be used. Thereby, the fixing strength with respect to the connecting wire 23 increases.

  The connecting wire 23 has elasticity, and as its material, for example, a superelastic alloy can be used. Since the super elastic alloy is rich in flexibility and has resilience, the connecting wire 23 is made of a super elastic alloy so that the connecting wire 23 includes the tip 221 of the inner tube 22 and the tip 212 of the outer tube 21. Can be easily bent (see FIGS. 2, 3, 8, and 9). Moreover, when the front-end | tip part 221 of the inner tube | pipe 22 and the front-end | tip part 212 of the outer tube | pipe 21 are spaced apart from this bent state, the connection wire 23 will restore | restore reliably linearly. The superelastic alloy is particularly preferably a Ni-Ti alloy such as a Ni-Ti alloy of 49 to 52 atomic% Ni.

  The diameter of the connecting wire 23 is not particularly limited. For example, when the connecting wire 23 is made of a superelastic alloy, the diameter is preferably 0.1 to 0.6 mm, and preferably 0.2 to 0.4 mm. It is more preferable that The length of the connecting wire 23 is not particularly limited. For example, when the connecting wire 23 is made of a superelastic alloy, the length is preferably 10 to 50 mm and more preferably 20 to 40 mm. preferable.

  As shown in FIG. 5, the hub 3 is installed at the proximal end 213 of the outer tube 21 of the catheter body 2. The hub 3 has an outer cylinder 4 and an inner cylinder 5 inserted into the outer cylinder 4.

  The inner cylinder 5 is composed of a cylindrical member. A proximal end portion 213 of the outer tube 21 of the catheter body 2 is fitted to the distal end portion 51 of the inner cylinder 5. Thereby, the inner cylinder 5 and the outer tube | pipe 21 are fixed. As the fixing method, in addition to the method by fitting, a method by adhesion (adhesion with an adhesive or a solvent) or fusion (thermal fusion, high frequency fusion, ultrasonic fusion, etc.) may be combined. Good.

The outer cylinder 4 is comprised by the member which makes | forms a rectangular tube shape.
An inner cylinder installation part 41 in which the inner cylinder 5 is installed is provided in the middle of the longitudinal direction of the outer cylinder 4. The inner diameter of the inner cylinder installation portion 41 is slightly larger than the outer diameter of the inner cylinder 5. Thereby, the outer cylinder 4 and the inner cylinder 5 can be rotated relatively around the axis (see FIG. 7).

  Further, a reduced diameter portion 42 whose inner diameter is smaller than the inner diameter of the inner cylinder installation portion 41 is formed at the proximal end portion of the inner peripheral portion of the outer cylinder 4. A base end portion 222 of the inner tube 22 is inserted into the reduced diameter portion 42 in a liquid-tight manner. As described above, when the catheter 1 is used for the diagnosis in the blood vessel 500, the drive shaft 20 can be inserted from the reduced diameter portion 42 and can be inserted through the inner tube 22 (see FIG. 4). . In addition, when the catheter 1 is used for the treatment in the blood vessel 500, the inside of the inner tube 22 can be sucked by connecting the mouth portion 301 of the syringe 30 to the reduced diameter portion 42 (see FIG. 5). The reduced diameter portion 42 may be provided with a valve body that opens and closes as necessary.

  The constituent materials of the outer cylinder 4 and the inner cylinder 5 are not particularly limited. For example, polyvinyl chloride, polyethylene, polypropylene, polystyrene, poly- (4-methylpentene-1), polycarbonate, acrylic resin, acrylonitrile. -Various resins such as butadiene-styrene copolymer, polyester such as polyethylene terephthalate, butadiene-styrene copolymer, polyamide (for example, nylon 6, nylon 6,6, nylon 6,10, nylon 12), and cyclic polyolefin. Can be mentioned.

  The catheter 1 configured as described above has the operation means 10 for operating the inner tube 22 with respect to the outer tube 21. This will be described below.

  The operation means 10 can select and perform one of the first operation shown in FIG. 2 and the second operation shown in FIG. The first operation is an operation of pulling and moving the inner tube 22 in the proximal direction to bring the distal end portion 221 of the inner tube 22 and the distal end portion 212 of the outer tube 21 closer. In the second operation, the inner tube 22 is pulled and moved in the proximal direction, the distal end portion 221 of the inner tube 22 and the distal end portion 212 of the outer tube 21 are brought close to each other, and the outer tube 21 is rotated about its axis. It is an operation. In each of the first operation and the second operation, the connecting wire 23 bends by the amount that the inner tube 22 is pulled and protrudes in one direction on the side of the catheter body 2. 233 is formed. The shape of the protruding portion 233 at this time is different between the first operation and the second operation. That is, the protruding portion 233 when the first operation is performed is deformed so that the top portion 234 is along the axial direction of the catheter body 2, and the protruding portion 233 when the second operation is performed is The top portion 234 is deformed so as to be along a direction intersecting (orthogonal to) the axis of the catheter body 2.

  The operation means 10 capable of such an operation includes a cam groove 6 formed in the outer peripheral portion (side portion) 52 of the inner cylinder 5 of the hub 3 and a plurality of outer peripheral portions 43 of the outer cylinder 4 of the hub 3. The engagement portion 7, the cam follower 8 that moves in the cam groove 6, and the operation piece 9 that operates the cam follower 8 (see FIGS. 1 to 3 and FIGS. 5 to 7). The outer cylinder 4 is formed with a long opening 44 that opens to the outer periphery 43, and a part of the cam groove 6 is exposed through the opening 44 (see, for example, FIG. 7). .

  As shown in FIG. 6, the cam groove 6 has a first groove 61 and a second groove 62 that penetrate through the outer peripheral portion 52 of the inner cylinder 5 in the thickness direction. The first groove 61 is formed along the axial direction of the inner cylinder 5. The second groove 62 is formed to be inclined with respect to the axis of the inner cylinder 5. Further, the front end 621 of the second groove 62 is connected to the front end 611 of the first groove 61, that is, intersects. As a result, the cam groove 6 is such that the first groove 61 and the second groove 62 communicate with each other. In the initial state, the cam follower 8 is located in the first groove 61, the second groove 62, and the intersecting portion 60.

  The cam follower 8 can move in the cam groove 6. The cam follower 8 is formed of a long member, and passes through the cam groove 6 in the vertical direction in FIG. The cam follower 8 has an upper part 81 projecting from the cam groove 6 toward the side (upper side in FIG. 5) and a lower part 82 located in the inner cylinder 5 (lower side than the cam groove 6 in FIG. 5). And can be divided into The upper portion 81 supports the operation piece 9 so as to be rotatable. The support method is not particularly limited. For example, a method using a shaft and a bearing can be used. The lower part 82 supports and fixes the middle of the inner tube 22 in the longitudinal direction. The fixing method is not particularly limited, but, for example, a method of fitting to the inner tube 22, a method of adhesion (adhesion with an adhesive or a solvent), fusion (heat fusion, high frequency fusion, ultrasonic fusion, etc.) ), A method of sandwiching the inner tube 22, and the like.

  The operation piece 9 is connected to the inner tube 22 via the cam follower 8. The operation piece 9 is composed of a plate piece and is gripped when the first operation or the second operation is performed, that is, the fingertip is attached.

  Specifically, when the first operation is performed, the operation piece 9 is grasped and operated in the direction of arrow A in FIG. 2 (also in FIG. 6). In conjunction with this operation, the cam follower 8 moves along the first groove 61. As a result, as shown in FIG. 2, the inner tube 22 is pulled in the same direction, the connecting wire 23 is bent, and a protruding portion 233 is formed on the connecting wire 23. Further, when the cam follower 8 abuts on the base end 612 of the first groove 61, further movement of the cam follower 8 is restricted. By restricting the movement limit in the first operation in this manner, excessive tension on the inner tube 22 can be reliably prevented.

  When the second operation is performed, the operation piece 9 is grasped and operated in the direction of arrow B in FIG. 2 (also in FIG. 6). In conjunction with this operation, the cam follower 8 moves along the second groove 62. As a result, as shown in FIG. 3, the inner tube 22 is pulled in the same direction, the connecting wire 23 is bent, and a protruding portion 233 is formed on the connecting wire 23. Note that the shape of the protrusion 233 is different from the shape of the protrusion 233 in the first operation. Further, when the cam follower 8 comes into contact with the base end 622 of the second groove 62, further movement of the cam follower 8 is restricted. By restricting the movement limit and the rotation limit in the second operation in this way, excessive tension on the inner tube 22 can be surely prevented, so that the connecting wire 23 is connected to the inner tube 22 and the outer tube 21. It can be surely prevented from being wound around.

  Further, since the cam follower 8 moves in the cam groove 6 when the operation piece 9 is operated, the operation can be easily performed, and the first operation and the second operation can be reliably selected and performed. Can do. In addition, there is an advantage that the catheter 1 (device) can be operated without re-handling.

  As shown in FIG. 5, the operation piece 9 has a distal end portion 91 whose thickness gradually decreases in the distal direction. Further, the operation piece 9 is rotatably supported on the upper portion 81 of the cam follower 8 as described above, and as a result, the tip 91 is engaged with the predetermined engagement portion 7 as shown in FIGS. The state and the state shown in FIG. 1 in which the engagement is released can be taken.

  As shown in FIG. 7, the plurality of engaging portions 7 are each configured by a recess into which the distal end portion 91 of the operation piece 9 enters. These engaging portions 7 are arranged in one row on both sides of the opening 44 of the outer peripheral portion 43 of the outer cylinder 4. The positions of the engaging portions 7 in each row are different from each other along the axial direction of the outer cylinder 4.

  By the way, as described above, the inner cylinder 5 can rotate with respect to the outer cylinder 4. As a result, when the first groove 61 is exposed through the opening 44 of the outer cylinder 4 (see FIG. 2) and the second operation is performed, the second groove 62 passes through the opening 44. Take the exposed state (see FIG. 3). When the first operation is performed, the operation piece 9 can be engaged with one engagement portion 7 in each row at a desired position in the longitudinal direction of the first groove 61. By this engagement, the shape of the protrusion 233 in the first operation is maintained. Further, when the second operation is performed, the operation piece 9 can be engaged with one engagement portion 7 in each row at a desired position in the longitudinal direction of the second groove 62. Thereby, the shape of the protrusion part 233 in 2nd operation is maintained. Such a configuration is effective when it is desired to perform the diagnosis or the treatment while maintaining the shape of the protruding portion 233. In addition, there is an advantage that it also serves as a measure for measuring the inner diameter of the blood vessel 500.

  Next, an example of how to use the catheter 1 will be described with reference to FIGS. 1 to 3, 8, and 9. Here, a case where the thrombus 501 generated in the blood vessel 500 is observed with the drive shaft 20 will be described as an example.

  The catheter body 2 of the initial state catheter 1 shown in FIG. 1 is inserted into the blood vessel 500. This insertion is facilitated by leading the guide wire 40 to a position beyond the thrombus 501 in the blood vessel 500, inserting the guide wire 40 through the guide wire insertion portion 241 of the catheter body 2, and pushing the catheter body 2. Can be done. The drive shaft 20 is preferably inserted in the catheter 1 in advance.

  Then, the catheter 1 is pushed to a position where the thrombus 501 can be imaged by the prism 203 of the drive shaft 20. The confirmation of this position can be performed under fluoroscopy using, for example, a contrast medium.

  Next, a first operation is performed by the operating means 10 to bring the catheter 1 into the state shown in FIG. As a result, the connecting wire 23 is bent and the protruding portion 233 is formed. The catheter 1 is positioned such that the protruding direction of the protruding portion 233 is opposite to the thrombus 501 side with respect to the catheter body 2. As shown in FIG. 8, when the protruding portion 233 comes into contact with the blood vessel wall 502, the distal end portion 221 of the inner tube 22 of the catheter body 2 moves in the direction opposite to the protruding direction of the protruding portion 233, that is, toward the thrombus 501. To do. Thereby, the prism 203 of the drive shaft 20 can be brought close to the thrombus 501, so that the thrombus 501 can be reliably imaged and observed.

  Further, as shown in FIG. 8, the protrusion 233 formed by the first operation has a top portion 234 having a shape along the longitudinal direction of the blood vessel 500. As a result, the catheter 1 can move along the longitudinal direction of the blood vessel 500, but the movement of the blood vessel wall 502 in the circumferential direction (the front side and the back side of the sheet of FIG. 8) is restricted. Therefore, for example, the thrombus 501 can be imaged while gradually moving the catheter 1 in the proximal direction.

  On the other hand, also when the second operation is performed by the operation means 10 and the catheter 1 is brought into the state shown in FIG. As shown in FIG. 9, when the protruding portion 233 comes into contact with the blood vessel wall 502, the distal end portion 221 of the inner tube 22 of the catheter body 2 moves to the thrombus 501 side. Thereby, the prism 203 of the drive shaft 20 can be brought close to the thrombus 501, so that the thrombus 501 can be reliably imaged and observed.

  Further, as shown in FIG. 9, the protrusion 233 formed by the second operation has a top portion 234 that is shaped along the circumferential direction of the blood vessel wall 502. As a result, the catheter 1 can move along the circumferential direction of the blood vessel wall 502 (the front side and the back side in FIG. 9), but the movement of the blood vessel 500 in the longitudinal direction is restricted. Therefore, for example, the thrombus 501 can be imaged while gradually rotating the catheter 1 along the circumferential direction of the blood vessel wall 502.

Second Embodiment
FIG. 10 is a perspective view showing a cam groove in the catheter of the present invention (second embodiment).

  Hereinafter, the second embodiment of the catheter of the present invention will be described with reference to this drawing, but the description will focus on the differences from the above-described embodiment, and the description of the same matters will be omitted.

  The present embodiment is the same as the first embodiment except that the cam groove has a different configuration, that is, the cam groove has two second grooves.

  The cam groove 6A shown in FIG. 10 has a first groove 61 and two second grooves 62 and 62 '. The second groove 62 ′ is formed on the opposite side to the second groove 62 through the first groove 61. The angles of the second grooves 62 and 62 with respect to the axis of the inner cylinder 5 are the same. With such a cam groove 6A, the cam follower 8 can move in any direction of arrows A, B, and B '. Then, when the operation in the arrow B direction is selected and when the operation in the arrow B ′ direction is selected, the rotation direction of the outer tube 21 in the second operation is opposite to each other. Thereby, when performing 2nd operation, the rotation direction of the outer tube | pipe 21 can be changed according to a procedure, Therefore, the catheter 1 becomes more excellent in operativity.

<Third Embodiment>
FIG. 11 is a perspective view showing a cam groove in the catheter (third embodiment) of the present invention.

  Hereinafter, a third embodiment of the catheter of the present invention will be described with reference to this figure, but the description will focus on differences from the above-described embodiment, and the description of the same matters will be omitted.

  The present embodiment is the same as the first embodiment except that the cam groove has a different configuration, that is, the cam groove has two second grooves.

  The cam groove 6B shown in FIG. 11 has a first groove 61 and two second grooves 62, 62 ″. The second groove 62 ″ is formed between the first groove 61 and the second groove 62. The angle of the second groove 62 ″ with respect to the axis of the inner cylinder 5 is smaller than the angle of the second groove 62 with respect to the axis of the inner cylinder 5. Such a cam groove 6B allows the cam follower 8 to move in any of the directions of arrows A, B, and B ″. Then, the rotation angle of the outer tube 21 in the second operation changes depending on whether the operation in the arrow B direction is selected or the operation in the arrow B ″ direction is selected. Thereby, when performing 2nd operation, the rotation angle of the outer tube | pipe 21 can be selected from two angles according to a procedure, Therefore, the catheter 1 becomes the thing excellent in operativity.

  The catheter of the present invention has been described above with respect to the illustrated embodiment. However, the present invention is not limited to this, and each part constituting the catheter can be replaced with an arbitrary structure that can exhibit the same function. can do. Moreover, arbitrary components may be added.

  In addition, the catheter of the present invention may be a combination of any two or more configurations (features) of the above embodiments.

  Further, the catheter of the present invention is configured to be able to suck the inside of the inner tube by the suction mechanism, but is not limited thereto, and may be configured to be able to suck the inside of the outer tube, for example, the outer tube and the inner tube These two pipes may be configured to be able to suck.

  In the catheter of the present invention, the connection wire in the initial state is linear, but is not limited to this, and may be curved, that is, may be bent.

  Further, the catheter of the present invention is configured so that the operating means pulls the inner tube in the proximal direction to bring the distal ends of the inner tube and the outer tube closer to each other. You may be comprised so that the front-end | tip parts of an inner pipe and an outer pipe may be made to approach by pushing to a front-end | tip direction.

  The catheter of the present invention is configured so that the operating means displaces the outer tube of the inner tube and the outer tube. However, the present invention is not limited to this. May be.

  When diagnosing a thrombus, the OFDI catheter can be inserted into a blood vessel along a guide wire inserted through a guide wire insertion portion of the catheter, and the diagnosis can be performed.

  When performing thrombus suction treatment, the suction treatment can be performed by inserting a suction catheter into the blood vessel along the guide wire inserted through the guide wire insertion portion of the catheter.

DESCRIPTION OF SYMBOLS 1 Catheter 2 Catheter main body 21 Outer pipe | tube 211 End opening 212 End part 213 Base end part 22 Inner pipe | tube 221 End part 222 Base end part 23 Connection wire (connection member)
231 Tip portion 232 Base end portion 233 Protruding portion 234 Top portion 24 Tip member 241 Guide wire insertion portion 25 Fixing member 3 Hub 4 Outer cylinder 41 Inner tube installation portion 42 Reduced diameter portion 43 Outer portion 44 Opening portion 5 Inner tube 51 Tip portion 52 Outer part (side)
6, 6A, 6B Cam groove 60 Crossing portion 61 First groove 611 Tip portion 612 Base end 62, 62 ', 62''Second groove 621 Tip portion 622 Base end 7 Engaging portion 8 Cam follower 81 Upper portion 82 Lower portion 9 Operation piece 91 Tip 10 Operation means 20 Drive shaft 201 Imaging means 202 Main body 203 Prism 204 Housing 30 Syringe 301 Mouth 40 Guide wire 500 Blood vessel 501 Thrombus 502 Blood vessel wall

Claims (13)

A flexible outer tube, a flexible inner tube inserted into the outer tube and having a tip projecting from the outer tube, and an elastic wire, the inner tube and the outer tube, A catheter body having a connecting member for connecting
A first operation of relatively moving the inner tube and the outer tube along the axial direction of the catheter body to bring the distal ends of the inner tube and the outer tube closer to each other; The outer tube is moved relatively along the axial direction so that the tip portions of the inner tube and the outer tube are brought close to each other, and the inner tube and the outer tube are rotated relatively around the axis. An operation means for selecting and performing one of the second operations to be performed,
In each of the first operation and the second operation, the connecting member bends to form a protruding portion protruding toward the side of the catheter body, and the shape of the protruding portion is the first operation. A catheter characterized in that the operation differs from the second operation.   The catheter according to claim 1, wherein a distal end portion of the connection wire is fixed to a distal end portion of the inner tube, and a proximal end portion is fixed to a distal end portion of the outer tube.   By performing the first operation, the top of the protrusion is deformed so as to be along the axial direction, and by performing the second operation, the top of the protrusion is in a direction intersecting the axis. The catheter according to claim 1, wherein the catheter is deformed so as to follow.   When the catheter body is inserted into a living body lumen and the protruding portion comes into contact with the wall of the living body lumen, the distal end portion of the catheter body moves in a direction opposite to the protruding direction of the protruding portion. The catheter according to any one of claims 1 to 3.   The catheter according to any one of claims 1 to 4, wherein the operation means is restricted in a movement limit in the first operation and restricted in a rotation limit in the second operation. Further comprising a cylindrical hub installed at the proximal end of the outer tube;
The operating means is formed on the side portion of the hub along the axial direction thereof, and is formed on the side portion of the hub so as to be inclined with respect to the shaft, and communicates with the first groove. A cam groove having a second groove; and a cam follower that supports the inner tube and moves in the cam groove;
6. The cam follower is moved along the first groove when performing the first operation, and the cam follower is moved along the second groove when performing the second operation. The catheter according to any one of the above.   The catheter according to any one of claims 1 to 6, wherein the operating means is configured to maintain the shape of the protruding portion. A hub installed at the proximal end of the outer tube;
The operating means includes an operating piece connected to the inner pipe and a plurality of engaging portions provided on the hub and having different positions, and one of the plurality of engaging portions is engaged. The catheter according to claim 7, wherein the shape of the protruding portion is maintained by engaging the operation piece with the portion.   The catheter according to any one of claims 1 to 8, wherein the operation means is configured to be able to change a rotation direction in the second operation.   The catheter according to any one of claims 1 to 9, wherein the operation means is configured to be able to select a rotation angle in the second operation from a plurality of angles.   The catheter according to claim 1, wherein the connecting member is made of a superelastic alloy.   The catheter according to any one of claims 1 to 11, further comprising a hub that is installed at a proximal end portion of the outer tube and is connectable to a suction mechanism that sucks at least one of the outer tube and the inner tube. . The inner tube includes a window portion having transparency at a tip portion thereof,
The catheter according to any one of claims 1 to 12, wherein a long medical device including an imaging means for imaging a target site through the window is inserted into the inner tube.

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