JP2013017693A - Catheter handle - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a catheter handle that configures a catheter having differing curved shapes of the tip portion of a catheter tube without changing the constituent components and also configures a bidirectional catheter that can achieves different curved shapes between the cases in which the tip portion of the catheter tube is bent in one direction and in which it is bent in another direction.SOLUTION: The catheter handle is provided with: a handle body 21 that is mounted to the base end of a catheter tube 10; and a rotating plate 22 that is mounted rotatably to the handle body 21 and to which the base ends of operation wires 31, 32 for bending the tip portion of the tube 10 are fixed. In the rotation plate 22, arced guide rails 231-233, 241-243 for determining the path of the operation wires 31, 32 are formed on concentric circumferences centered on the rotating shaft of the rotating plate 22.

Description

  The present invention relates to a catheter handle, and more particularly to a catheter handle that is mounted on the proximal end side of a catheter tube and constitutes a catheter capable of tip deflection operation.

A medical catheter is usually provided with a handle on the proximal end (proximal end) side of a catheter tube.
Various catheter handles have been proposed depending on the type of catheter. For example, there is a case where the distal end portion (distal end) of the catheter is desired to be bent or stretched by operating the catheter handle. As a mechanism for operating and deflecting the distal end portion of the catheter on the proximal side in this way, the proximal end of the operation wire is connected to a rotating plate rotatably mounted on the handle body, and the rotating plate is rotated. A mechanism for changing (deflecting) the direction of the distal end of the catheter by operating it has been introduced (see Patent Document 1).

FIG. 10A shows an example of the internal structure of a conventional catheter handle.
The catheter handle shown in FIG. 1 is attached to a proximal end side of a catheter tube (not shown), and is rotatably attached to the handle body 1 to bend the distal end portion of the catheter tube. And a rotating plate 3A to which the base ends of the operation wires 2a and 2b are fixed. In the figure, 4 is a rotating shaft of the rotating plate 3A, 5 is a knob of the rotating plate 3A, 6 is an operation tube (insertion tube of the operation wires 2a and 2b), and 7a and 7b are wire fasteners. An annular guide rail 8A is formed on the rotating plate 3A. The guide rail 8A ensures the amount of tension of the operation wires 2a and 2b accompanying the rotation operation of the rotary plate 3A by defining the path of the operation wires 2a and 2b in the rotary plate 3A.

As shown in FIG. 10A, the operation wire 2a extending from the operation tube 6 into the rotary plate 3A is arranged along the outer periphery of the annular guide rail 8A on the right side of the rotary plate 3A. 7a is fixed to the rotating plate 3A.
On the other hand, the operation wire 2b extending from the operation tube 6 into the rotation plate 3A is disposed along the outer periphery of the annular guide rail 8A on the left side of the rotation plate 3A, and the rotation plate 3A by the wire fastener 7b. It is fixed to.

Then, when the rotating plate 3A is rotated in the direction of the arrow 9a from the state shown in FIG. 10A, the operation wire 2a arranged along the outer periphery of the guide rail 8A is pulled, whereby the distal end side of the handle body 1 The distal end portion of the catheter tube attached to the bends (deflects) to the right.
On the other hand, when the rotating plate 3A is rotated in the direction of the arrow 9b, the operation wire 2b arranged along the outer periphery of the guide rail 8A is pulled, so that the catheter tube attached to the distal end side of the handle body 1 is pulled. The tip bends (deflects) to the left.

  In the catheter capable of tip deflection operation having a handle having a structure as shown in FIG. 10A, the curve shape (bend size) of the tip portion of the catheter tube when the rotating plate is rotated by a certain angle is obtained by rotating the rotating plate. When the amount of operation wire pulling (moving) increases, the amount of operation wire pulling usually increases in the route of the operation wire in the rotating plate (after entering the rotating plate and then on the wire fastener). The longer the operation wire length), the longer the wire becomes.

  For this reason, when it is desired to further increase the bending of the tip portion due to the rotation operation, a rotating plate having an annular guide rail having a large outer periphery (diameter) instead of the rotating plate 3A, for example, as shown in FIG. 10B In addition, by attaching the rotating plate 3B formed with the annular guide rail 8B having a larger diameter than the guide rail 8A to the handle body 1, the path of the operation wire accompanying the rotating operation of the rotating plate can be lengthened. .

  On the other hand, when it is desired to reduce the bending of the tip portion due to the rotation operation, instead of the rotating plate 3A, a rotating plate formed with an annular guide rail having a small outer periphery (diameter), for example, as shown in FIG. By attaching the rotating plate 3C formed with the annular guide rail 8C having a smaller diameter than the guide rail 8A to the handle main body 1, the path of the operation wire accompanying the rotating operation of the rotating plate can be shortened.

  As described above, in the conventional catheter handle, different rotating plates (molded articles formed with guide rails of different diameters) are attached to the handle body according to the curve shape (bend size) of the distal end portion of the catheter tube. It was attached to.

JP 2005-230471 A

  However, it is complicated to mold different rotating plates according to the curve shape of the distal end portion of the catheter tube and attach it to the handle body, which is not preferable from the viewpoint of manufacturing cost. For this reason, provision of the catheter handle provided with the rotating plate which can respond to a some curve shape was desired.

On the other hand, in a bi-direction type catheter capable of tip deflection operation, different curve shapes are realized when the tip of the catheter tube is bent in one direction (for example, the right side) and when bent in the other direction (for example, the left side). What can be done is required.
However, depending on the conventional handle provided with the rotating plates (rotating plates 3A to 3C) as described above, it is not possible to configure a tip deflection operable catheter having different left and right curve shapes.

  Further, in a bi-direction type tip deflectable catheter, when one wire is pulled by a rotation operation, the other wire is loosened, and this loosened portion may protrude outside the rotating plate. is there.

The present invention has been made based on the above situation.
A first object of the present invention is to provide a catheter handle that can configure catheters having different curve shapes (bends) at the distal end portion of the catheter tube without changing the components.
A second object of the present invention is to provide a catheter handle that can constitute a bi-direction type catheter that realizes different curved shapes depending on whether the distal end portion of the catheter tube is bent in one direction or the other direction. It is to provide.
A third object of the present invention is to provide a catheter handle in which when one wire is in a tensioned state, the slack portion of the other wire does not protrude outside the rotating plate.

(1) A catheter handle of the present invention includes a handle main body attached to the proximal end side of a catheter tube,
A rotating plate that is rotatably attached to the handle body and to which a proximal end of an operation wire for bending the distal end portion of the catheter tube is fixed;
The rotating plate has a plurality of arc-shaped or annular guide rails for defining a path of the operation wire in the rotating plate on a concentric circle centering on the rotation axis of the rotating plate. It is characterized by being formed.

  According to the catheter handle having such a configuration, one guide rail (single direction type is configured as a guide rail for defining the path of the operation wire from among a plurality of guide rails formed concentrically on the rotating plate. ) Or two (one from each side when configuring the bi-direction type) and winding the guide rail on the guide rail, it is possible to configure a catheter capable of tip deflection operation.

Here, the pulling amount (moving amount) of the operating wire accompanying the rotating operation of the rotating plate usually becomes longer as the path of the operating wire in the rotating plate is longer.
Therefore, when the outermost guide rail is selected as the guide rail that defines the path of the operation wire among the plurality of guide rails formed on the concentric circle, the operation wire accompanying the rotation operation is selected. As a result, the bending amount of the distal end portion of the catheter tube is maximized. Conversely, when the innermost guide rail is selected as the guide rail that defines the path of the operation wire, the pulling amount of the operation wire that accompanies the rotation operation, and hence the distal end portion of the catheter tube, The bend size is minimized.

  In this way, by selecting the guide rail that defines the path of the operation wire from among a plurality of guide rails that are formed concentrically on the rotating plate, the pull amount of the operation wire accompanying the rotation operation is changed. -Since it can be adjusted, it is possible to construct a catheter that can be operated for tip deflection with a different curve shape (bend size) at the tip of the catheter tube without exchanging the rotating plate.

(2) In the catheter handle of the present invention that constitutes a bi-direction deflecting catheter that can be deflected in both directions,
A proximal end of a first operation wire for bending the distal end portion of the catheter tube in the first direction is fixed to one side of the rotation plate, and the first operation wire in the rotation plate is fixed. A plurality of guide rails for defining the path of the above are formed in a concentric arc shape centering on the rotation axis of the rotating plate,
A proximal end of a second operation wire for bending the distal end portion of the catheter tube in the second direction is fixed to the other side of the rotation plate, and the second operation wire in the rotation plate is fixed. It is preferable that a plurality of guide rails for defining the path is formed in a concentric circular arc shape around the rotation axis of the rotating plate.

According to the catheter handle having such a configuration, one guide rail that defines the path of the first operation wire from the plurality of guide rails formed in a concentric arc shape on one side of the rotating plate. By selecting one guide rail that defines the path of the second operation wire from among a plurality of guide rails formed in a concentric arc shape on the other side of the rotating plate, bi-direction A type of tip deflectable maneuverable catheter can be constructed.
Note that “one side” and “the other side” of the rotating plate mean each region divided by a straight line passing through the rotation axis of the rotating plate.

Then, on one side of the rotating plate, the rotation operation is performed by selecting (changing) one guide rail that defines the path of the first operation wire from among a plurality of guide rails formed in a concentric arc shape. Accordingly, the amount of pulling of the first operation wire, that is, the bending of the distal end portion of the catheter tube in the first direction can be adjusted.
Also, on the other side of the rotating plate, rotation can be performed by selecting (changing) one guide rail that defines the path of the second operation wire from among a plurality of guide rails formed in a concentric arc shape. It is possible to adjust the amount of bending of the second operation wire in accordance with the operation, and thus the amount of bending in the second direction of the distal end portion of the catheter tube.

  Further, according to the catheter handle having such a configuration, the tension amount of the first operation wire and the tension amount of the second operation wire can be adjusted separately, so that the distal end portion of the catheter tube is attached to the first portion. A bi-direction type catheter that realizes different curve shapes can be formed by bending in the direction and in the second direction.

(3) In the catheter handle of (2), three guide rails for defining a path of the first operation wire in the rotary plate are provided on one side of the rotary plate. It is formed in a concentric arc shape around the rotation axis of the plate,
On the other side of the rotating plate, three guide rails for defining the path of the second operation wire in the rotating plate are formed in a concentric arc shape centering on the rotating shaft of the rotating plate. It is preferable.

  According to the catheter handle having such a configuration, a bi-direction type catheter that realizes nine patterns (three patterns in each of the first direction and the second direction) without changing the rotating plate is configured. can do.

(4) In the catheter handle of (3), three guide rails are formed concentrically on one side of the rotating plate, and concentric arcs are formed on the other side of the rotating plate. The three guide rails preferably have the same central angle and the corresponding arc radius, and the central angle is 80 to 100 °.

According to the catheter handle having such a configuration, since the central angle of the guide rail formed in a concentric arc shape is 80 ° or more, the pull amount of the operation wire accompanying the rotation operation (when a different guide rail is selected) The difference in the amount of tension) can be sufficiently ensured.
Further, when one of the first operation wire and the second operation wire is in a tensile state as the rotating plate rotates, the other wire is slackened, but the center angle is 100 ° or less. Thus, a non-formation region of the guide rail can be sufficiently secured on the concentric circle including the concentric arc-shaped guide rail, and the slack portion of the other wire can be accommodated in this non-formation region.
Furthermore, since the center angle of the guide rail formed in a concentric arc shape is 100 ° or less, the wire (for example, the first operation wire) pulled along with the rotation operation of the rotating plate is the wire. It is possible to avoid contact with the end of the guide rail on the opposite side (for example, the guide rail that defines the path of the second operation wire).

(5) In the catheter handle of the present invention that constitutes a single-direction type tip deflection operable catheter that deflects only in one direction,
The rotation plate is fixed with a proximal end of an operation wire for deflecting the distal end portion of the catheter tube, and as a guide rail for defining a path of the operation wire in the rotation plate, The annular guide rail and at least one arcuate guide rail located outside the annular guide rail are respectively formed on the circumference of a concentric circle centering on the rotation axis of the rotating plate. preferable.

According to the catheter handle having such a configuration, the guide rail for defining the route of the operation wire is selected from the annular guide rail and the arc guide rail formed on the circumference of the concentric circle on the rotating plate. By selecting, it is possible to configure a single direction type catheter capable of tip deflection operation.
In addition, by selecting (changing) the guide rail that defines the path of the operation wire from the annular guide rail and the arc-shaped guide rail, the pull amount of the operation wire accompanying the rotation operation, and the catheter The amount of bending at the tip of the tube can be adjusted.

(6) In the catheter handle according to (5), a base end of an operation wire for bending the distal end portion of the catheter tube is fixed to the rotation plate, and the operation wire in the rotation plate is used. As guide rails for defining the path of the wire, an annular guide rail, a first arcuate guide rail located outside the annular guide rail, and a second located outside the first arcuate guide rail Each of the arcuate guide rails is preferably formed on the circumference of a concentric circle centering on the rotation axis of the rotating plate.
According to the catheter handle having such a configuration, a single-direction type catheter that realizes three patterns of curve shapes can be configured without exchanging the rotating plate.

(7) In the catheter handle of (6), it is preferable that a central angle of the first arcuate guide rail and the second arcuate guide rail is 150 to 170 °.
According to the catheter handle having such a configuration, when the central angle of the arc-shaped guide rail is 150 ° or more, the amount of tension (guide) associated with the rotation operation of the operation wire whose path is defined by the arc-shaped guide rail. A sufficient difference in the amount of tension between the rails) can be ensured.
Further, when the central angle of the arcuate guide rail is 150 ° or more, the operation wire whose path is defined by the arcuate guide rail (the first arcuate guide rail or the second arcuate guide rail) is It is possible to prevent the operation wire and the annular guide rail from coming into contact with each other when the operation wire is pulled along with the rotation operation.
Further, since the central angle of the arcuate guide rail is 170 ° or less, the operation wire whose path is defined by the annular guide rail and the end of the arcuate guide rail (particularly, the first arcuate guide rail) Can be avoided.

According to the catheter handle of the present invention, it is possible to configure a catheter having a different curve shape (bend size) at the distal end portion of the catheter tube without changing (replacement) the rotating plate. It is possible to share components in the deflectable catheter.
In addition, according to the catheter handle of the present invention including the rotating plate having concentric arc-shaped guide rails formed on both sides, the distal end portion of the catheter tube is bent in the first direction and the second direction. Thus, a bi-direction type catheter that realizes different curve shapes can be configured.
Furthermore, when the central angle of the concentric arc-shaped guide rail formed on both sides of the rotating plate is 80 to 100 °, when one wire is in a tensile state, the slack portion of the other wire is Can be prevented from protruding outside.

It is a front view showing an electrode catheter provided with a handle concerning one embodiment of the present invention. It is explanatory drawing which shows the internal structure of the handle which concerns on one Embodiment of this invention. It is explanatory drawing which shows an internal structure when the rotating plate of the handle | steering-wheel shown in FIG. 2 is rotated a fixed angle clockwise. It is explanatory drawing which shows an internal structure when rotating the rotating plate of the handle | steering-wheel shown in FIG. 2 by the fixed angle counterclockwise. It is a front view which shows an electrode catheter when the rotating plate of a handle | steering_wheel is made into the state shown to FIG. 3A. It is a front view which shows an electrode catheter when the rotating plate of a handle | steering_wheel is made into the state shown to FIG. 3B. It is a front view which shows the electrode catheter provided with the handle which concerns on other embodiment of this invention. It is explanatory drawing which shows the internal structure of the handle which concerns on other embodiment of this invention. It is explanatory drawing which shows the internal structure of the handle which concerns on other embodiment of this invention. It is explanatory drawing which shows the internal structure of the handle which concerns on other embodiment of this invention. It is explanatory drawing which shows an internal structure when rotating the rotating plate of the handle | steering-wheel shown in FIG. 6A to a fixed angle clockwise. It is explanatory drawing which shows an internal structure when the rotating plate of the handle | steering-wheel shown to FIG. 6B is rotated a fixed angle clockwise. It is explanatory drawing which shows an internal structure when the rotating plate of the handle | steering-wheel shown to FIG. 6C is rotated a fixed angle clockwise. It is a front view which shows an electrode catheter when the rotation board of a handle is made into the state shown to FIG. 7A. It is a front view which shows an electrode catheter when the rotating plate of a handle | steering_wheel is made into the state shown to FIG. 7B. It is explanatory drawing which shows the internal structure of the handle which concerns on further another embodiment of this invention. It is explanatory drawing which shows the internal structure of the conventional catheter handle. It is explanatory drawing which shows the internal structure of the conventional catheter handle. It is explanatory drawing which shows the internal structure of the conventional catheter handle.

Hereinafter, the catheter handle of the present invention will be described in detail.
<First Embodiment>
A catheter handle 20 of the present embodiment shown in FIGS. 1 to 4B is a handle constituting an electrode catheter that is a bi-direction type distal deflection operable catheter, and is a handle attached to the proximal end side of the catheter tube 10. A main body 21 and a rotating plate 22 rotatably mounted on the handle main body 21;
On one side (the right side in FIG. 2) of the rotating plate 22, the proximal end of the first operation wire 31 for bending the distal end portion of the catheter tube 10 in the first direction (the direction indicated by the arrow A in FIG. 1). Are fixed by the wire fastener 41, and three guide rails 231, 232, and 233 that can define the path of the first operation wire 31 in the rotating plate 22 are connected to the rotating shaft 220 of the rotating plate 22. It is formed in a concentric arc shape with a center,
On the other side (left side in FIG. 2) of the rotating plate 22, the proximal end of the second operation wire 32 for bending the distal end portion of the catheter tube 10 in the second direction (the direction indicated by the arrow B in FIG. 1). Are fixed by the wire fastener 42, and three guide rails 241, 242, and 243 capable of defining the path of the second operation wire 32 in the rotary plate 22 are connected to the rotary shaft 220 of the rotary plate 22. It is formed in a concentric arc shape with the center.

  The electrode catheter provided with the handle 20 of the present embodiment is used for, for example, diagnosis or treatment of arrhythmia in the heart, and has a catheter tube 10 to which the handle 20 is attached as shown in FIG. .

The catheter tube 10 is constituted by a hollow tube member, and may be constituted by a tube having the same characteristics along the axial direction. Preferably, it has a proximal end portion that is integrally formed in the direction and is relatively stiffer than the distal end portion.
1, 4A, and 4B, the length of the catheter tube 10 is illustrated as being short, but actually, it is several times to several tens of times longer than the axial length of the handle 20.

The catheter tube 10 is made of a synthetic resin such as polyolefin, polyamide, polyether polyamide, or polyurethane.
The outer diameter of the catheter tube 10 is usually about 0.6 to 3 mm, and the inner diameter is about 0.5 to 2.5 mm.

  A distal end electrode 11 and a plurality of ring-shaped electrodes 12 are attached to the distal end portion of the catheter tube 10. The conducting wires connected to the tip electrode 11 and the ring electrode 12 are passed through the axial lumen of the catheter tube 10 in a state where they are insulated from each other.

  The tip electrode 11 and the ring electrode 12 are made of a metal having good electrical conductivity, such as aluminum, copper, stainless steel, gold, or platinum. The outer diameters of the tip electrode 11 and the ring electrode 12 are not particularly limited, but are preferably about the same as the outer diameter of the catheter tube 10 and are usually about 0.5 to 3 mm.

  A swinging member is accommodated inside the distal end portion of the catheter tube 10. The swinging member is not particularly limited, and is constituted by, for example, a leaf spring. A distal end of an operation wire (not shown in FIG. 1) is connected and fixed to the leaf spring as the swinging member.

  The operation wire in the present embodiment includes a first operation wire 31 for bending the distal end portion of the catheter tube 10 in the first direction (the direction indicated by arrow A in FIG. 1), and the distal end portion of the catheter tube 10 as the first portion. It consists of a second operation wire 32 for bending in two directions (the direction indicated by arrow B in FIG. 1).

A handle 20 of this embodiment is attached to the proximal end of the catheter tube 10.
The handle 20 includes a handle body 21 and a rotating plate 22 that is rotatably attached to the handle body 21. From the handle 20, a lead wire (not shown) of a lead wire electrically connected to the tip electrode 11 and the ring electrode 12 is drawn.
As shown in FIG. 2, the first operation wire 31 and the second operation wire 32 respectively extend from the operation tube 13 into the rotary plate 22, and the base ends thereof are wire fasteners 41, 42 is fixed to the rotating plate 22.

The rotating plate 22 constituting the handle 20 is a component for performing a swinging operation (deflection movement operation) of the distal end portion of the catheter tube 10.
As shown in FIG. 1, when the distal end portion of the catheter tube 10 is in a linearly extending state, the rotating plate 22 is in the state (posture) shown in FIG.

As shown in FIG. 2, on the right side of the rotating plate 22, three guide rails including a first small-diameter arc-shaped rail 231, a first intermediate-diameter arc-shaped rail 232, and a first large-diameter arc-shaped rail 233. Is formed in a concentric arc shape centering on the rotation shaft 220 of the rotating plate 22.
On the other hand, on the left side of the rotating plate 22, three guide rails including a second small-diameter arc-shaped rail 241, a second intermediate-diameter arc-shaped rail 242, and a second large-diameter arc-shaped rail 243 are arranged. Are formed in a concentric arc shape with the rotation axis 220 as the center.

  In the state (posture) shown in FIG. 2, three guide rails (a first small-diameter arc-shaped rail 231, a first intermediate-diameter arc-shaped rail 232, a first large-size rail formed on the right side of the rotating plate 22 are formed. Radial arc-shaped rail 233) and three guide rails (second small-diameter arc-shaped rail 241, second intermediate-diameter arc-shaped rail 242, second large-diameter arc-shaped) formed concentrically on the left side of the rotating plate 22. The central angle (α) is the same as that of the rail 243).

In addition, in the three guide rails formed on the right side of the rotating plate 22 and the three guide rails formed on the left side of the rotating plate 22, corresponding guide rails (first small-diameter arc-shaped rail 231 and second small-diameter) are provided. The arc-shaped rail 241, the first intermediate-diameter arc-shaped rail 232, the second intermediate-diameter arc-shaped rail 242, the first large-diameter arc-shaped rail 233, and the second large-diameter arc-shaped rail 243) have the same radius.
That is, the first small-diameter arc-shaped rail 231 and the second small-diameter arc-shaped rail 241 are formed on one (small-diameter) circumference centering on the rotation shaft 220, and the first intermediate-diameter arc-shaped rail 232 and the second The two intermediate-diameter arc-shaped rails 242 are formed on one (intermediate-diameter) circumference around the rotation shaft 220. The first large-diameter arc-shaped rail 233 and the second large-diameter arc-shaped rail 243 are It is formed on one (large diameter) circumference around the rotation shaft 220.

  In the mode shown in FIG. 2, the first operation wire 31 in the rotary plate 22 is arranged along the outer periphery of the first small-diameter arc-shaped rail 231 (that is, the first operation wire 31 is operated by the first small-diameter arc-shaped rail 231. The path of the wire 31 is defined), and the base end thereof is fixed to the rotating plate 22 by the wire fastener 41.

  On the other hand, the second operation wire 32 in the rotating plate 22 is disposed along the outer periphery of the second large-diameter arc-shaped rail 243 (that is, the second large-diameter arc-shaped rail 243 causes the second operation-purpose wire 32 to be A path is defined), and its proximal end is fixed to the rotating plate 22 by a wire fastener 42.

The central angle (α) of the three guide rails formed in a concentric arc shape is preferably 80 to 100 °, and 90 ° if a suitable example is shown.
When the central angle (α) is 80 ° or more, the route of the operation wire in the rotating plate 22 (the length of the operating wire from when entering the rotating plate until being fixed by the wire fastener) It is possible to sufficiently ensure the difference between the pull amount of the operation wire accompanying the rotation operation of the rotating plate 22 and the pull amount when different guide rails are selected.

In addition, when the central angle (α) is 100 ° or less, a guide rail non-formation region can be sufficiently secured on a concentric circle including a concentric arc-shaped guide rail.
For example, as shown in FIG. 2, a guide rail non-formation region is secured on the upper side and the lower side.

Here, the central angle (θ ₁ ) with respect to the upper non-formation region is preferably 100 to 80 °, and 90 ° is a preferable example.
Further, the central angle (θ ₂ ) with respect to the lower non-formation region is preferably 100 to 80 °, and 90 ° is a preferable example.

  In these non-formation regions, the slack portion of the other wire generated by the rotation operation of the rotating plate 22 (the pulling operation of one wire) is accommodated, in other words, in the central direction of the rotating plate 22. Since the slack portion can be released to the inside, it is possible to reliably prevent the slack portion of the wire, which becomes a problem when the annular guide rail is used, from protruding outside the rotating plate 22.

In addition, when the central angle (α) of the concentric arc is 100 ° or less, a constant separation distance (space) can be ensured between the proximal end of the guide rail and the wire fastener. The proximal end of the wire extending from the proximal end of the guide rail can be smoothly guided to the position of the wire fastener (curving inward if necessary), and the proximal end of the wire can be kinked Further, it is possible to prevent the protrusion of the rotating plate 22 from the outside. Here, a straight line connecting the wire fastener (the wire fastener 41 or the wire fastener 42) and the rotary shaft 220 and the base end of the rotary shaft 220 and the guide rail (231, 232, 233 or 241, 242, 243) are connected. The angle (θ ₃ ) formed with the straight line is preferably 30 to 35 °.

  Furthermore, when the central angle (α) of the concentric arc is 100 ° or less, the wire pulled along with the rotation operation of the rotating plate 22 (for example, as shown in FIG. 3A, the first small-diameter arc shape The first operation wire 31) whose path is defined by the rail 231 is in contact (interference) with the end of the guide rail (for example, the second large-diameter arc-shaped rail 243) on the opposite side to the wire. This can be surely prevented, and problems such as a change in tensile amount due to interference with the guide rail, a sense of incongruity in operation, and wire breakage can be avoided.

In the handle 20 of this embodiment, when the rotary plate 22 is rotated in the A1 direction shown in FIGS. 1 and 2 using the knobs 221 on both sides, as shown in FIG. 3A, the first small-diameter arc-shaped rail 231 is obtained. As a result, the first operation wire 31 whose path is defined is pulled, and the second operation wire 32 whose path is defined by the second large-diameter arc-shaped rail 243 is loosened (the rotation angle of the rotating plate 22 at this time is For example, 51 to 52 °).
As a result, the distal end portion of the catheter tube 10 swings in the first direction indicated by the arrow A in FIG. 1 and has a shape as shown in FIG. 4A. Here, the first operation wire 31 that is in a tensile state in accordance with the rotation operation of the rotating plate 22 includes three guide rails formed on one side of the rotating plate 22 (the right side in FIG. 2). Since the path is defined by the first small-diameter arc-shaped rail 231 having the smallest diameter, the amount of tension associated with the rotation operation is relatively small, and as shown in FIG. It is a small one.

  As shown in FIG. 3A, the slack portion generated in the second operation wire 32 is accommodated in the non-formation region of the guide rail and does not protrude outside the rotating plate 22. Further, the first operation wire 31 in the tension state does not come into contact with the end of the second large-diameter arc-shaped rail 243.

On the other hand, when the rotating plate 22 of the handle 20 is rotated in the B1 direction shown in FIGS. 1 and 2, the second operation wire whose path is defined by the second large-diameter arc-shaped rail 243 as shown in FIG. 3B. 32 is pulled, and the first operation wire 31 whose path is defined by the first small-diameter arc-shaped rail 231 is loosened (the rotation angle of the rotating plate 22 at this time is 51 to 52 °, for example).
As a result, the distal end portion of the catheter tube 10 swings in the second direction indicated by the arrow B in FIG. 1 and has a shape as shown in FIG. 4B. Here, the second operation wire 32 that is in a tensile state in accordance with the rotation operation of the rotating plate 22 includes the three guide rails formed on the other side (left side in FIG. 2) of the rotating plate 22. Since the path is defined by the second large-diameter arc-shaped rail 243 having the maximum diameter, the amount of tension associated with the rotation operation is relatively large, and the bending of the distal end portion of the catheter tube 10 is also compared as shown in FIG. 4B. It is a big one.

  As shown in FIG. 3B, the slack portion generated in the first operation wire 31 is accommodated in the non-formation region of the guide rail and does not protrude outside the rotating plate 22. Further, the second operation wire 32 in the tension state and the end portion of the first large-diameter arc-shaped rail 233 do not come into contact with each other.

  The electrode catheter configured as described above, that is, the handle 20 of the present embodiment, the path of the first operation wire 31 in the rotary plate 22 is defined by the first small-diameter arc-shaped rail 231 and the second operation. According to the distal deflection operable catheter that defines the path of the wire 32 by the second large-diameter arc-shaped rail 243, it differs depending on whether the distal end portion of the catheter tube 10 is bent in the first direction or the second direction. A curve shape can be realized.

  A guide that defines the path of the first operation wire 31 from the first small-diameter arc-shaped rail 231, the first intermediate-diameter arc-shaped rail 232, and the first large-diameter arc-shaped rail 233 using the handle 20 of the present embodiment. A rail is selected, the first operation wire 31 is arranged along the outer periphery of the selected guide rail (the first operation wire 31 is wound around the guide rail), and the proximal end of the first operation wire 31 is wire-fastened The tool 41 is fixed to the rotating plate 22 by the tool 41, and the path of the second operation wire 32 is defined from the second small-diameter arc-shaped rail 241, the second intermediate-diameter arc-shaped rail 242 and the second large-diameter arc-shaped rail 243. A guide rail is selected, a second operation wire 32 is arranged along the outer periphery of the selected guide rail (the second operation wire 32 is wound around the guide rail), and the second operation wire is used. By fixed to the rotary plate 22 to the proximal end of the ear 32 by a wire fastener 42, it is possible to constitute a tip deflection steerable catheter by directing type.

  According to the handle 20 of the present embodiment, a bi-direction type catheter in which the distal end portion of the catheter tube 10 has a different curve shape (bend size) is configured without changing (replacement) the rotating plate 22 as a component. Therefore, in the manufacture of a catheter capable of tip deflection operation having a different curve shape, it is possible to make components common.

  Specifically, the following tip (1) to (9) can be configured with the tip deflection operable catheter by the handle 20 of the present embodiment. Among these, the catheters (2) to (4) and (6) to (8) have a curve shape when the distal end portion of the catheter tube 10 is bent in the first direction and a curve shape when the catheter tube 10 is bent in the second direction. This is a different type of asymmetrical catheter.

(1) A catheter in which the path of the first operation wire 31 is defined by the first small-diameter arc-shaped rail 231 and the path of the second operation wire 32 is defined by the second small-diameter arc-shaped rail 241.
(2) A catheter in which the path of the first operation wire 31 is defined by the first small-diameter arc-shaped rail 231 and the path of the second operation wire 32 is defined by the second intermediate-diameter arc-shaped rail 242. (3) A catheter in which the path of the first operation wire 31 is defined by the first small-diameter arc-shaped rail 231 and the path of the second operation wire 32 is defined by the second large-diameter arc-shaped rail 243 (FIGS. 1 to 5) Electrode catheter shown in 4A).
(4) A catheter in which the path of the first operation wire 31 is defined by the second intermediate-diameter arc-shaped rail 232 and the path of the second operation wire 32 is defined by the second small-diameter arc-shaped rail 241. (5) A catheter in which the path of the first operation wire 31 is defined by the second intermediate diameter arc-shaped rail 232 and the path of the second operation wire 32 is defined by the second intermediate diameter arc-shaped rail 242.
(6) A catheter in which the path of the first operation wire 31 is defined by the second intermediate-diameter arc-shaped rail 232 and the path of the second operation wire 32 is defined by the second large-diameter arc-shaped rail 243. (7) A catheter in which the path of the first operation wire 31 is defined by the first large-diameter arc-shaped rail 233 and the path of the second operation wire 32 is defined by the second small-diameter arc-shaped rail 241.
(8) A catheter in which the path of the first operation wire 31 is defined by the first large-diameter arc-shaped rail 233 and the path of the second operation wire 32 is defined by the second intermediate-diameter arc-shaped rail 242. (9) A catheter in which the path of the first operation wire 31 is defined by the first large-diameter arc-shaped rail 233 and the path of the second operation wire 32 is defined by the second large-diameter arc-shaped rail 243.

Second Embodiment
A catheter handle 25 according to this embodiment shown in FIGS. 5 to 8B is a handle constituting a single-direction type distal deflection operable catheter (electrode catheter), which is attached to the proximal end side of the catheter tube 15. A main body 26 and a rotary plate 27 that is rotatably attached to the handle main body 26 are provided. A base end of an operation wire 33 for bending the distal end portion of the catheter tube 15 is fixed to the rotary plate 27. At the same time, as guide rails for defining the path of the operation wire 33 in the rotary plate 27, an annular guide rail 281 and a first arcuate guide rail 282 located outside the guide rail 281 are located outside the guide rail 282. The second arcuate guide rails 283 are respectively concentric circles around the rotation axis 270 of the rotating plate 27. It is formed on the circumference.
5 to 8B showing this embodiment, the same reference numerals are used for the same or corresponding components as those in the first embodiment.

  The electrode catheter provided with the handle 25 of the present embodiment is used, for example, for diagnosis or treatment of arrhythmia in the heart, and has a catheter tube 15 to which the handle 25 is attached as shown in FIG. .

The catheter tube 15 has the same configuration as the catheter tube 10 according to the first embodiment.
A swinging member is accommodated inside the vicinity of the distal end of the catheter tube 15, and the swinging member is not particularly limited, and is configured by, for example, a leaf spring.
The leaf spring as the swinging member has a distal end of an operation wire 33 (not shown in FIG. 5) for bending the distal end portion of the catheter tube 15 in one direction (the direction indicated by the arrow A in FIG. 5). Connection is fixed.

A handle 25 of this embodiment is attached to the proximal end of the catheter tube 15.
The handle 25 includes a handle body 26 and a rotating plate 27 that is rotatably attached to the handle body 25.

The rotating plate 27 constituting the handle 25 is a component for performing a swing operation (deflection movement operation) of the distal end portion of the catheter tube 15.
The operation wire 33 whose distal end is fixed to the swing member extends from the operation tube 13 into the rotary plate 27, and the proximal end of the operation wire 33 is fixed to the rotary plate 27 by the wire fastener 43. Has been.

  As shown in FIG. 5, when the distal end portion of the catheter tube 15 is in a linearly extending state, the rotating plate 27 is in the state shown in FIGS. 6A to 6C (the state where the knob 271 is on the upper side). It has become.

  As shown in FIGS. 6A to 6C, the rotating plate 27 constituting the handle 25 of the present embodiment includes an annular guide rail 281 and two concentric arc-shaped guide rails (first arc-shaped guide rail 282, 2 arcuate guide rails 283) are formed on the circumference of each of the concentric circles around the rotation axis 270 of the rotating plate 27.

  A guide rail that defines the path of the operation wire 33 is selected from these guide rails, and the operation wire 33 is disposed along the outer periphery of the selected guide rail (the operation wire 33 is wound around the guide rail). By fixing the proximal end of the proximal end to the rotating plate 27 with the wire fastener 43, a single direction type catheter can be configured.

For example, as shown in FIG. 6A, an electrode configured by arranging (wrapping) an operation wire 33 extending from the operation tube 13 into the rotary plate 27 along the outer periphery of the first arcuate guide rail 282. In the catheter, when the rotating plate 27 is rotated in the A1 direction shown in FIGS. 5 and 6A, the operation wire 33 whose path is defined by the first arcuate guide rail 282 is pulled, and the state shown in FIG. 7A It becomes.
As a result, the distal end portion of the catheter tube 15 in this electrode catheter swings in the direction shown by the arrow A in FIG. 5 and has a shape as shown in FIG. 8A.

The rotation angle of the rotating plate 27 at this time is, for example, 90 to 94 °.
In FIG. 6A, a straight line (indicated by a one-dot chain line in FIG. 6) that divides the rotating plate 27 into right and left, a rotating shaft 220, and arc-shaped guide rails (first arc-shaped guide rail 282 and second arc-shaped guide rail The angle (θ ₄ ) formed by the straight line connecting the tips of 283) is preferably 35 to 45 °, and 40 ° is a preferable example.

As shown in FIG. 6B, in the electrode catheter configured by arranging (wrapping) the operation wire 33 extending from the operation tube 13 into the rotary plate 27 along the outer periphery of the annular guide rail 281. When the rotating plate 27 is rotated in the A1 direction shown in FIG. 5, the operation wire 33 whose path is defined by the annular guide rail 281 is pulled, and the state shown in FIG. 7B is obtained.
As a result, the distal end portion of the catheter tube 15 in this electrode catheter swings in the direction indicated by the arrow A in FIG. 5 and has a shape as shown in FIG. 8B.
Since the path of the operation wire 33 in this aspect is defined by the annular guide rail 281 having a radius smaller than the radius of the first arcuate guide rail 282, the amount of tension associated with the rotation operation is relatively small. As shown in FIG. 8, the bending of the distal end portion of the catheter tube 15 is also small compared to FIG. 8A.

Further, as shown in FIG. 6C, an electrode configured by arranging (wrapping) an operation wire 33 extending from the operation tube 13 into the rotary plate 27 along the outer periphery of the second arcuate guide rail 283. In the catheter, when the rotating plate 27 is rotated in the A1 direction shown in FIG. 5, the operation wire 33 whose path is defined by the second arcuate guide rail 283 is pulled, and the state shown in FIG. 7C is obtained.
Since the path of the operation wire 33 in this aspect is defined by the second arcuate guide rail 283 having a radius larger than the radius of the first arcuate guide rail 282, the amount of tension accompanying the rotation operation is relatively large. The degree of bending of the distal end portion of the catheter tube 15 is greater than that shown in FIG. 8A.

The central angle (β) of the first arcuate guide rail 282 and the second arcuate guide rail 283 formed on the rotating plate 27 constituting the handle 25 of this embodiment is preferably 150 to 170 °, and Preferably it is 150-160 degrees, and if it shows a suitable example, it is 155 degrees.
When the central angle (β) is 150 ° or more, a sufficient pulling amount of the operation wire 33 whose path is defined by the first arcuate guide rail 282 or the second arcuate guide rail 283 can be secured. .
Further, when the central angle (β) is 150 ° or more, the operation wire 33 whose path is defined by the first arc-shaped guide rail 282 or the second arc-shaped guide rail 283 is used for the rotation operation of the rotating plate 27. It is possible to avoid the operation wire 33 from coming into contact with the annular guide rail 281 when it is pulled together (the state shown in FIG. 7A or 7C).
On the other hand, when the central angle (β) is 170 ° or less, as shown in FIG. 6B, the operation wire 33 whose path is defined by the annular guide rail 281 becomes the end of the first arcuate guide rail 282. Contacting the part can be avoided.

  According to the handle 25 of the present embodiment, a single direction type catheter having a different curve shape (bend size) at the distal end portion of the catheter tube 15 can be configured without changing (replacement) the rotating plate 27 as a component. Therefore, in the manufacture of a catheter capable of tip deflection operation having a different curve shape, it is possible to make components common.

As mentioned above, although embodiment of this invention was described, the handle | steering_wheel for catheter of this invention is not limited to these, A various change is possible.
For example, on the rotating plate, the number of guide rails formed on the circumference of each concentric circle is not limited to three, but as shown in FIG. 9, an annular guide rail 281 and an arcuate guide rail 282 May be a rotating plate (a rotating plate 27 ′ not formed with the second arcuate guide rail 283 formed on the rotating plate 27 according to the second embodiment).

DESCRIPTION OF SYMBOLS 10 Catheter tube 11 Tip electrode 12 Ring-shaped electrode 13 Operation tube 20 Handle 21 Handle body 22 Rotating plate 220 Rotating shaft 221 Knob 231 First small-diameter arc-shaped rail 232 First intermediate-diameter arc-shaped rail 233 First large-diameter arc-shaped rail 241 Second small-diameter arc-shaped rail 242 Second intermediate-diameter arc-shaped rail 243 Second large-diameter arc-shaped rail 31 First operation wire 32 Second operation wire 41 Wire fastener 42 Wire fastener 15 Catheter tube 27 Rotating plate 270 Rotating shaft 271 Knob 25 Handle 26 Handle body 281 Annular guide rail 282 First arc guide rail 283 Second arc guide rail 25 Handle 33 Operation wire 43 Wire fastener

Claims (7)

A handle body mounted on the proximal end side of the catheter tube;
A rotating plate that is rotatably attached to the handle body and to which a proximal end of an operation wire for bending the distal end portion of the catheter tube is fixed;
The rotating plate has a plurality of arc-shaped or annular guide rails for defining a path of the operation wire in the rotating plate on a concentric circle centering on the rotation axis of the rotating plate. A catheter handle characterized in that the handle is formed. The catheter handle according to claim 1, wherein the catheter is a bi-directional type bi-directional type tip deflection operable catheter.
A proximal end of a first operation wire for bending the distal end portion of the catheter tube in the first direction is fixed to one side of the rotation plate, and the first operation wire in the rotation plate is fixed. A plurality of guide rails for defining the path of the above are formed in a concentric arc shape centering on the rotation axis of the rotating plate,
A proximal end of a second operation wire for bending the distal end portion of the catheter tube in the second direction is fixed to the other side of the rotation plate, and the second operation wire in the rotation plate is fixed. A catheter handle, characterized in that a plurality of guide rails for defining the path are formed in a concentric arc shape centering on the rotation axis of the rotating plate. On one side of the rotating plate, three guide rails for defining the path of the first operation wire in the rotating plate are formed in a concentric arc shape centering on the rotating shaft of the rotating plate. ,
On the other side of the rotating plate, three guide rails for defining the path of the second operation wire in the rotating plate are formed in a concentric arc shape centering on the rotating shaft of the rotating plate. The catheter handle according to claim 2, wherein the catheter handle is provided.   The three guide rails formed in a concentric arc shape on one side of the rotating plate and the three guide rails formed in a concentric arc shape on the other side of the rotating plate have a central angle and a corresponding one. The catheter handle according to claim 3, wherein radii of arcs are the same, and the central angle is 80 to 100 degrees. The catheter handle according to claim 1, which constitutes a single-direction type tip deflection operable catheter that deflects only in one direction,
The rotation plate is fixed with a proximal end of an operation wire for deflecting the distal end portion of the catheter tube, and as a guide rail for defining a path of the operation wire in the rotation plate, The annular guide rail and at least one arcuate guide rail located outside the annular guide rail are respectively formed on the circumference of a concentric circle centering on the rotation axis of the rotating plate. Feature catheter handle.   The rotation plate is fixed with a proximal end of an operation wire for deflecting the distal end portion of the catheter tube, and as a guide rail for defining a path of the operation wire in the rotation plate, An annular guide rail, a first arcuate guide rail located outside the annular guide rail, and a second arcuate guide rail located outside the first arcuate guide rail, respectively, The catheter handle according to claim 5, wherein the catheter handle is formed on a circumference of a concentric circle having a rotation axis as a center.   The catheter handle according to claim 6, wherein a central angle of the first arcuate guide rail and the second arcuate guide rail is 150 to 170 °.

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