JP2013027593A - Embolus capturing device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an embolus capturing device capable of coping with various situations inside a lumen and more surely capturing an embolus.SOLUTION: The embolus capturing device 10 for capturing and removing the embolus inside the lumen of a living body includes: a long shaft member 11 whose distal end side is sent out into the lumen; a flexible distal end guide part 12 disposed at the distal end of the shaft member 11; and embolus capturing filters 13, 23 provided with filter parts 14, 24 in a basket shape, which are formed of a mesh constituted of wires having elasticity or shape-memory property, contracted inside a catheter for device conveyance and expanded when discharged into the lumen from the catheter, and binding parts 16, 26 for binding the wires constituting the filter parts 14, 24 on the distal end side and the proximal end side, respectively. The two embolus capturing filters 13, 23 are arranged longitudinally on the proximal end side of the distal end guide part 12.

Description

  The present invention relates to an embolus capturing device for capturing an embolus such as a thrombus in a lumen of a living body.

  Cerebral infarction is a disease that occurs when an embolism (a blood clot, a fat embolus, a tumor embolus, etc.) enters a brain artery, constricts the artery, blocks blood flow, and causes cerebral ischemia. When the blood flow to the brain is blocked by embolism, the brain cells are cut off from oxygen and nutrient supply, and in a short time head to necrosis. For this reason, it is important to quickly ensure normal blood flow in the early stage of the onset of cerebral infarction. If normal blood flow is not ensured at an early stage, the brain tissue loses its function due to necrosis, and there is a high risk that the patient's life will be threatened.

  Treatment of cerebral infarction is generally cerebral embolization therapy in which a drug is directly injected into a static artery or a closed artery to dissolve or move the embolus and reopen the blood vessel within 3 to 6 hours after onset. Used. However, this cerebral embolic dissolution therapy may not completely dissolve the embolus. Moreover, the moved embolus may flow to the peripheral side of the lesioned part to block the blood flow again, resulting in serious complications.

  Therefore, in recent years, with the advancement of endovascular treatment, a method for surgically securing blood flow and a method for removing emboli have been implemented. For example, there are a vasodilation method in which a blood vessel is expanded with a microcatheter with a balloon, a stent placement method in which a reticular tube called a stent is placed in a blood vessel, and a vascular wall is supported from the inside to prevent stenosis.

  Furthermore, an embolus capturing device has been developed so far in which a wire (shaft) is directly passed through a stenosis portion of a blood vessel and the embolus is captured by a basket-type filter or the like provided on the wire (see, for example, Patent Document 1).

  FIG. 10 shows an outline of a conventional embolus capturing device. As shown in FIG. 10, the conventional embolus capturing device 300 includes a shaft 301 and an embolus capturing filter 303.

  The shaft 301 is a long wire in which an embolus capturing filter 303 is disposed in the vicinity of the tip thereof. The shaft 301 is made of a thin and flexible wire to advance in the blood vessel 200, and the embolus capturing filter 303 is installed at an arbitrary position in the blood vessel 200 by operating the proximal end of the shaft 301.

  The embolus capturing filter 303 is made of a synthetic resin, a nonwoven fabric or the like, and includes a basket-shaped filter main body 304A that captures the embolus released in the blood vessel 200, and an elastic or shape memory supporting portion 304B that supports the filter main body 304A. The filter main body 304A or the support portion 304B is bound and attached to the shaft 301 so as to be fixed or slidable.

  The embolus capture device 300 is carried to an arbitrary position in the blood vessel 200 in a state of being accommodated in a delivery catheter (not shown), and when released from the delivery catheter, the embolus capture filter 303 is elastic or shape memory property. Is automatically expanded to fit the inner wall of the blood vessel 200. The embolus capture filter 303 can capture the embolus while securing the blood flow in the blood vessel 200 by providing a plurality of small holes 303A in the filter body 304A.

JP 2004-097807 A

  However, the above-described conventional embolus capturing device 300 may not be able to completely fit the inner wall of the embolus capturing filter 303 depending on the state in the applied lumen, and the embolus is passed through the gap generated in such a case. There was a fear.

  In addition, after the embolus is captured, when the embolus capturing filter 303 is accommodated in the delivery catheter, the captured embolus may be dropped.

  Furthermore, there has been a problem that it is difficult to exert the effect when the flow of body fluid in the lumen is not uniform.

  In view of the above situation, an object of the present invention is to provide an embolus capturing device that can capture an embolus more reliably in response to various situations in a lumen.

  To solve the above problems, the present invention provides an embolus capturing device for capturing and removing an embolus in a lumen of a living body, a long shaft member whose distal end is fed into the lumen, and the shaft member It consists of a mesh composed of a flexible tip guide portion arranged at the tip of the wire and a wire having elasticity or shape memory, and contracts within the catheter for device delivery and is released from the catheter into the lumen. Then, an embolus capture filter having a basket-shaped filter portion that expands, and a bundling portion that binds the wires constituting the filter portion on the distal end side and the proximal end side, respectively. An embolus capturing device is provided in which two are arranged in tandem on the proximal end side of the distal end guide portion.

Here, it is preferable that the two embolus capturing filters have different properties as follows.
(1) The openings of the two embolus capture filters are arranged in different directions.
(2) The meshes of the two embolus capture filters are different from each other.
(3) The diameters of the filter portions when the two embolus capture filters are expanded are different from each other.

  An excision coil for destroying and excising the embolus attached to the inner wall of the lumen may be further provided on the upstream side in the lumen of the embolus capturing filter.

  The filter unit is configured by a substantially semi-ellipsoidal filter main body made of a wire mesh having elasticity or shape memory, and a support unit that supports the opening side of the filter main body and is attached to the shaft member. Is preferred. Alternatively, the filter portion is formed of a substantially ellipsoid made of a wire mesh having elasticity or shape memory, and the distal end side binding portion and the proximal end side binding portion are attached to the shaft member during the expansion. You may make it approach along, and the said substantially ellipsoid may be return | folded by the center part and may deform | transform into a substantially semi-ellipsoid.

  In addition, it is preferable that either one of the front end side binding portion and the proximal end side binding portion of the filter portion is provided to be slidable in the axial direction along the shaft member, and the other is fixed to the shaft member. It is. Alternatively, both the distal end side binding portion and the proximal end side binding portion of the filter portion are provided to be slidable in the axial direction along the shaft member, and the distal end side binding portion and the proximal end side binding portion are movable. A stopper member for regulating the range may be fixedly disposed on the shaft member.

  It is preferable that the proximal end side binding portion and the distal end side binding portion are made of a radiopaque metal material.

  Moreover, it is preferable that the said front-end | tip guide part is formed by winding the coil which consists of a radiopaque metal raw material on the said shaft member.

  Further, the wire constituting the filter part may be any of nickel titanium wire, titanium wire, a wire composed of platinum or gold and a composite material wire of nickel titanium alloy, nickel wire plated with gold, or wire of titanium alloy. It is preferable to form from these.

  Further, the embolus capturing device may be provided with a hydrophilic coating.

  According to the embolus trapping device of the present invention, by disposing the embolus trapping filters in a double manner, it is possible to catch even emboli that could not be trapped by the upstream embolus trapping filter or dropped during storage.

  Further, by making the two embolus capture filters have different properties (direction, mesh roughness, size, etc.), it is possible to capture the embolus more reliably in response to various situations in the lumen.

1 is an overall schematic view of an embolus capturing device according to a first embodiment of the present invention. It is a schematic diagram for demonstrating the usage method of the embolus capture device shown in FIG. It is a whole schematic diagram of an embolus capture device concerning a second embodiment of the present invention. It is a whole schematic diagram of an embolus capture device concerning a third embodiment of the present invention. It is a whole schematic diagram of an embolus capture device concerning a 4th embodiment of the present invention. It is the whole embolization capture device schematic diagram concerning a 5th embodiment of the present invention. It is a whole schematic diagram of an embolus capture device concerning a 6th embodiment of the present invention. It is a schematic diagram which shows the detail of the embolus capture filter of the embolus capture device shown in FIG. It is a schematic diagram for demonstrating the modification of a binding part of the embolus capture | acquisition apparatus which concerns on other embodiment of this invention. It is a schematic diagram which shows the outline | summary of the conventional embolus capture apparatus.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. In the present specification, all substances that block the lumen of a living body, such as a blood clot, a fat embolus, a tumor embolus, etc. are collectively referred to as an embolus. In the following, a blood vessel is described as an example of a living body lumen.

[First embodiment]
FIG. 1 is an overall schematic view of an embolus capturing device according to a first embodiment of the present invention. As shown in this figure, an embolus capture device 10 of this embodiment includes a shaft (shaft member) 11, a tip guide portion 12, and two embolus capture filters (a first embolus capture filter and a second embolus capture filter). ) 13 and 23.

  The shaft 11 is a long wire in which a distal end guide portion 12 and an embolus capturing filter 13 and 23 are disposed at the distal end. The shaft 11 is made of a thin and flexible wire to advance in the blood vessel, and the embolus capture filters 13 and 23 are installed at arbitrary positions in the blood vessel by operating the proximal end (not shown) of the shaft 11. . As a material for the shaft 11, a metal such as a nickel titanium alloy or stainless steel is suitable.

  A flexible tip guide portion 12 is disposed at the tip portion of the shaft 11. The distal end guide portion 12 is positioned at the head of the embolus capturing device 10 and is formed flexibly so that the embolus capturing device 10 can be guided without damaging the blood vessel wall or the like when the embolus capturing device 10 is advanced in the blood vessel 200. Preferably, the wire is a coiled wire or a knitted wire. The distal end guide portion 12 is preferably made of a radiopaque metal material (for example, platinum, tungsten, etc.) so that the position and posture can be confirmed under fluoroscopy.

  Two embolus capture filters 13 and 23 are arranged in a column on the proximal end side of the distal end guide portion 12. The embolus capture filters 13 and 23 are attached to the shaft 11 by binding the basket-shaped filter portions 14 and 24 that capture the emboli released in the blood vessel and the wires constituting the filter portions 14 and 24 so as to be fixed or slidable. And ring-shaped bundling portions 16 and 26. Here, both the embolus capture filters 13 and 23 are arranged so that the openings 15 and 25 thereof face the proximal end side of the embolus capture device 10.

  The filter portions 14 and 24 are formed by weaving thin and flexible wires having elasticity or shape memory. Here, the filter parts 14 and 24 are constituted by parachute baskets in which substantially semi-ellipsoidal filter main bodies 14A and 24A are supported by the support parts 14B and 24B.

  The substantially semi-ellipsoidal filter main bodies 14A and 24A that hit the parachute umbrella are made of a braided wire mesh that allows blood flow to pass while the embolus can be reliably captured. The support portions 14B and 24B corresponding to the parachute suspension cable are made of one or a plurality of bundled wires and support the openings 15 and 25 side of the filter main bodies 14A and 24A. The filter portions 14 and 24 are bound at the distal end side of the filter main bodies 14A and 24A by distal end side binding portions 16A and 26A which will be described later, and the proximal end sides of the support portions 14B and 24B are bound by proximal end side binding portions 16B and 26B. And attached to the shaft 11 respectively.

  Since the filter parts 14 and 24 are formed by weaving thin and flexible wires, they can be easily expanded and contracted. Further, as will be described later, the proximal end side binding portions 16B and 26B are fixed to the shaft 11, and the distal end side binding portions 16A and 26A are slidable along the axial direction of the shaft 11. Therefore, the filter portions 14 and 24 are elongated and contracted when the distal end side binding portions 16A and 26A move in the distal direction, and when the distal end side binding portions 16A and 26A move in the proximal direction, the filter portions 14 and 24 expand in a round shape as shown in FIG. The diameter is expanded as follows. The filter parts 14 and 24 made of a wire having elasticity or shape memory property are processed so as to take this expanded state under a natural state or a shape memory recovery temperature.

  The filter main bodies 14A and 24A and the support portions 14B and 24B constituting the filter portions 14 and 24 are preferably knitted from a plurality of wires. Moreover, the wire which comprises the filter parts 14 and 24 is a nickel titanium wire, a titanium wire, the wire which consists of platinum or gold, and the wire of the composite material of a nickel titanium alloy, the nickel wire which gave gold plating, or the wire of a titanium alloy Etc. are suitable.

  The bundling portions 16 and 26 are ring-shaped members that are attached to the shaft 11 by bundling the wires constituting the filter portions 14 and 24 on the distal end side and the proximal end side, respectively. This ring-shaped member can be fixed to the shaft 11 or slidable with respect to the shaft 11. Here, the distal end side binding portions 16 </ b> A and 26 </ b> A are provided so as to be slidable in the axial direction of the shaft 11, and the proximal end side binding portions 16 </ b> B and 26 </ b> B are fixed to the shaft 11. Therefore, as described above, the filter portions 14 and 24 can be stored in the delivery catheter in a state of being elongated and reduced in diameter by moving the distal end side binding portions 16A and 26A in the distal direction. Further, when released from the delivery catheter into the lumen, the distal side bundling portions 16A, 26A move in the proximal direction due to the elasticity or shape memory of the wires constituting the filter portions 14, 24, and the filter portions 14, 24 Expands to fit the inner lumen wall.

  The bundling portions 16 and 26 are made of a radiopaque metal material (for example, platinum, tungsten, etc.) so that the position can be confirmed under fluoroscopy.

  Hereinafter, a method of using the above-described embolus capturing device 10 will be specifically described with reference to FIG.

  First, a guide wire (not shown) is introduced into the blood vessel 200 in which the embolus capturing device 10 is to be installed as a stage before the embolus capturing device 10 is transported. Then, a microcatheter (delivery catheter) 202 is inserted into the blood vessel 200 through the guide wire, and the guide wire is retracted.

  Next, as shown in FIG. 2A, the microcatheter 202 inserted into the blood vessel 200 is moved through the embolus capturing device 10 to the installation site. At this time, in the microcatheter 202, the distal side bundling portions 16A and 26A of the embolus capture filters 13 and 23 are moved in the distal direction, and the embolus capture filters 13 and 23 are elongated and contracted in a reduced diameter state. Move through 202. Thus, since the embolus capture filters 13 and 23 can be expanded and contracted, the embolus capture device 10 can move smoothly in the microcatheter 202.

  Next, as shown in FIG. 2B, the distal end guide portion 12 of the embolus capture device 10 and the distal end side embolus capture filter (first embolus capture filter) 13 are released from the distal end of the microcatheter 202. When the embolus capturing filter 13 is detached from the microcatheter 202, the embolus capturing filter 13 is automatically expanded due to its elasticity or shape memory.

  Further, as shown in FIG. 2 (c), the proximal-side embolus capture filter (second embolus capture filter) 23 is released from the distal end of the microcatheter 202. Similarly to the distal end side embolus capture filter 13, the proximal end side embolus capture filter 23 automatically expands due to its elasticity or shape memory.

  Next, as shown in FIG. 2D, the microcatheter 202 is retracted, and in that state, the embolus 201 is captured while ensuring blood flow.

  When the use is finished, the microcatheter 202 is advanced, and the embolus capturing device 10 is housed in the microcatheter 202 in the reverse manner to the above. At this time, the embolus capturing filters 13 and 23 are housed in the microcatheter 202 in a state where they are elongated and contracted again.

  In this way, by arranging the embolus capturing filters in a double manner, it is possible to reliably capture even emboli that could not be captured by the upstream embolus capturing filter, emboli dropped during storage, and the like.

  Here, an example in which both the embolus capturing filters 13 and 23 are arranged so that the openings 15 and 25 face the proximal end side of the embolus capturing device 10 is shown. You may arrange | position so that 15 and 25 may face the front end side of the embolus capture | acquisition apparatus 10. FIG.

  Further, the openings of the two embolus capture filters may be directed in different directions. Hereinafter, an example in which the openings of the embolus capturing filter are directed in different directions will be described.

[Second Embodiment]
FIG. 3 is an overall schematic view of an embolus capturing device according to a second embodiment of the present invention. In addition, about the part same as embodiment shown in FIG. 1, the same code | symbol is attached | subjected and detailed description is abbreviate | omitted.

  As shown in FIG. 3, the embolus capture device 30 of this embodiment includes a shaft (shaft member) 11, a tip guide portion 12, and two embolus capture filters (a first embolus capture filter and a second embolus capture filter). 33, 43.

  On the proximal end side of the distal end guide portion 12, two embolus capture filters 33 and 43 are arranged in tandem in opposite directions. The embolus capturing filters 33 and 43 are attached to the shaft 11 by binding the basket-shaped filter portions 34 and 44 for capturing the embolus released in the blood vessel and the wires constituting the filter portions 34 and 44 so as to be fixed or slidable. And ring-shaped bundling portions 36 and 46. As shown in FIG. 3, here, the first embolus capture filter 33 is arranged so that the opening 35 faces the distal direction of the apparatus, and the second embolus capture filter 43 is arranged so that the opening 45 faces the proximal direction of the apparatus. Has been.

  The filter portions 34 and 44 are formed by weaving thin and flexible wires having elasticity or shape memory. Here, the filter parts 34 and 44 are constituted by parachute baskets in which substantially semi-elliptical filter main bodies 34A and 44A are supported by the support parts 34B and 44B.

  The substantially semi-ellipsoidal filter bodies 34A and 44A that hit the parachute umbrella are made of a braided wire mesh that allows blood flow to pass while the emboli can be reliably captured. The support portions 34B and 44B that hit the parachute suspension cable are made of one or a plurality of bundled wires, and support the openings 35 and 45 side of the filter bodies 34A and 44A. The filter portion 34 of the first embolus capturing filter 33 is formed by binding the distal end side of the filter main body 34A with the distal end side binding portion 36A and binding the proximal end side of the support portion 34B with the proximal end side binding portion 36B. 11 is attached. On the other hand, the filter portion 44 of the second embolus capturing filter 43 is formed such that the distal end side of the support portion 44B is bound by the distal end side binding portion 46A, and the proximal end side of the filter body 44A is bound by the proximal end side binding portion 46B. It is attached to the shaft 11.

  Since the filter portions 34 and 44 are formed by weaving thin and flexible wires, they can be easily expanded and contracted. Further, as will be described later, the proximal end side binding portions 36B and 46B are fixed to the shaft 11, and the distal end side binding portions 36A and 46A are provided so as to be slidable along the axial direction of the shaft 11. Therefore, the filter portions 34 and 44 are elongated and contracted when the distal end side binding portions 36A and 46A move in the distal direction, and when the distal end side binding portions 36A and 46A move in the proximal direction, the filter portions 34 and 44 swell round and are shown in FIG. The diameter is expanded as follows. The filter portions 34 and 44 made of a wire having elasticity or shape memory properties are processed so as to take this expanded state under a natural state or a shape memory recovery temperature.

  The filter bodies 34A and 44A and the support portions 34B and 44B constituting the filter portions 34 and 44 are preferably formed by knitting from a plurality of wires. The wires constituting the filter portions 34 and 44 are nickel titanium wire, titanium wire, wire made of platinum or gold and a wire of a composite material of nickel titanium alloy, nickel wire plated with gold, or wire of titanium alloy. Etc. are suitable.

  The bundling portions 36 and 46 are ring-shaped members that are attached to the shaft 11 by bundling wires constituting the filter portions 34 and 44 on the distal end side and the proximal end side, respectively. This ring-shaped member can be fixed to the shaft 11 or slidable with respect to the shaft 11. Here, the distal end side binding portions 36 </ b> A and 46 </ b> A are provided to be slidable in the axial direction of the shaft 11, and the proximal end side binding portions 36 </ b> B and 46 </ b> B are fixed to the shaft 11. Therefore, as described above, the filter portions 34 and 44 can be stored in the delivery catheter in a state of being elongated and reduced in diameter by moving the distal end side binding portions 36A and 46A in the distal direction. Further, when released from the delivery catheter into the lumen, the distal end binding portions 36A and 46A move in the proximal direction due to the elasticity or shape memory of the wires constituting the filter portions 34 and 44, and the filter portions 34 and 44 Expand to fit the inner lumen wall. About the usage method, it is the same as that of the embolus capture | acquisition apparatus 10 of 1st Embodiment shown in FIG.

  The binding portions 36 and 46 are made of a radiopaque metal material (for example, platinum, tungsten, etc.) so that the position can be confirmed under fluoroscopy.

  As described above, by setting the openings 35 and 45 of the embolus capturing filters 33 and 43 in different directions, it is possible to capture the embolus even when the flow of the body fluid in the lumen is not uniform.

  In the above description, the openings 35 and 45 of the embolus capturing filters 33 and 43 are disposed so as to face in opposite directions, but conversely, the openings 35 and 45 may be disposed so as to face each other.

[Third embodiment]
Next, examples in which the meshes of the wires constituting the two embolus capturing filters have different roughnesses will be described.

  FIG. 4 is an overall schematic view of an embolus capturing device according to a third embodiment of the present invention. In addition, about the part same as embodiment shown in FIG. 1, the same code | symbol is attached | subjected and detailed description is abbreviate | omitted.

  As shown in FIG. 4, the embolus capture device 50 of the present embodiment includes a shaft (shaft member) 11, a tip guide portion 12, and two embolus capture filters (a first embolus capture filter and a second embolus capture filter). ) 53, 63.

  Two embolus capture filters 53 and 63 are arranged in a column on the proximal end side of the distal end guide portion 12. The embolus capture filters 53 and 63 are attached to the shaft 11 by binding the basket-shaped filter portions 54 and 64 that capture the emboli released in the blood vessel and the wires constituting the filter portions 54 and 64 so as to be fixed or slidable. And ring-shaped binding portions 56 and 66. Note that, here, the embolus capturing filters 53 and 63 both show the example in which the openings 55 and 65 are arranged facing the proximal end side of the embolus capturing device 50, but can be arranged in various directions depending on the application. It is.

  The filter parts 54 and 64 are formed by weaving thin and flexible wires having elasticity or shape memory. Here, the filter parts 54 and 64 are comprised by the parachute-type basket with which the filter bodies 54A and 64A of a substantially semi-elliptical body are supported by the support parts 54B and 64B.

  The substantially semi-ellipsoidal filter bodies 54A and 64A that hit the parachute umbrella are made of a braided wire mesh that allows blood flow to pass while the emboli can be reliably captured. Here, as shown in FIG. 4, the mesh of the filter main body 54A is finer than the mesh of the filter main body 64A. The support portions 54B and 64B that hit the parachute suspension cable are made of one or a plurality of bundled wires, and support the openings 55 and 65 side of the filter main bodies 54A and 64A. The filter portions 54 and 64 are bound at the distal end side of the filter main bodies 54A and 64A by distal end side binding portions 56A and 66A described later, and at the proximal end side of the support portions 54B and 64B by the proximal end side binding portions 56B and 66B. And attached to the shaft 11 respectively.

  Since the filter parts 54 and 64 are formed by weaving thin and flexible wires, they can be easily expanded and contracted. Further, as will be described later, the proximal-side binding portions 56B and 66B are fixed to the shaft 11, and the distal-side binding portions 56A and 66A are provided so as to be slidable along the axial direction of the shaft 11. Therefore, the filter portions 54 and 64 are elongated and contracted when the distal end side binding portions 56A and 66A move in the distal end direction, and when the distal end side binding portions 56A and 66A move in the proximal end direction, the filter portions 54 and 64 bulge round and are shown in FIG. The diameter is expanded as follows. The filter portions 54 and 64 made of a wire having elasticity or shape memory properties are processed so as to take this expanded state under a natural state or a shape memory recovery temperature.

  The filter main bodies 54A and 64A and the support portions 54B and 64B constituting the filter portions 54 and 64 are preferably formed by knitting from a plurality of wires. The wires constituting the filter sections 54 and 64 are nickel titanium wire, titanium wire, wire made of platinum or gold and a wire of a composite material of nickel titanium alloy, nickel wire with gold plating, or wire of titanium alloy. Etc. are suitable.

  The bundling portions 56 and 66 are ring-shaped members that are attached to the shaft 11 by bundling the wires constituting the filter portions 54 and 64 on the distal end side and the proximal end side, respectively. This ring-shaped member can be fixed to the shaft 11 or slidable with respect to the shaft 11. Here, the distal end side binding portions 56 </ b> A and 66 </ b> A are slidably provided in the axial direction of the shaft 11, and the proximal end side binding portions 56 </ b> B and 66 </ b> B are fixed to the shaft 11. Therefore, as described above, the filter portions 54 and 64 can be stored in the delivery catheter in a state of being elongated and reduced in diameter by moving the distal end side binding portions 56A and 66A in the distal direction. Further, when released from the delivery catheter into the lumen, the distal side bundling portions 56A, 66A move in the proximal direction due to the elasticity or shape memory of the wires constituting the filter portions 54, 64, and the filter portions 54, 64 are moved. Expands to fit the inner lumen wall. About the usage method, it is the same as that of the embolus capture | acquisition apparatus 10 of 1st Embodiment shown in FIG.

  The bundling portions 56 and 66 are made of a radiopaque metal material (for example, platinum, tungsten, etc.) so that the position can be confirmed under fluoroscopy.

  Here, an example in which the mesh of the first embolus capture filter 53 is made finer than the mesh of the second embolus capture filter 63 is shown, but conversely, the mesh of the second embolus capture filter 63 is replaced with the first embolus capture filter 63. It may be finer than the mesh of the capture filter 53. The fine mesh filter is preferably located downstream of the lumen than the coarse mesh filter.

  Thus, by making the mesh of one embolus capture filter out of the embolus capture filters 53, 63 finer than the mesh of the other embolus capture filter, the embolus that the other embolus capture filter has caught is also It can be captured with an embolus capture filter.

[Fourth embodiment]
Next, examples in which the sizes of the two embolus capture filters are different will be described.

  FIG. 5 is an overall schematic view of an embolus capturing device according to a fourth embodiment of the present invention. In addition, about the part same as embodiment shown in FIG. 1, the same code | symbol is attached | subjected and detailed description is abbreviate | omitted.

  As shown in FIG. 5, the embolus capturing device 70 of this embodiment includes a shaft (shaft member) 11, a tip guide portion 12, and two embolus capturing filters (a first embolus capturing filter and a second embolus capturing filter). ) 73 and 83.

  Two embolus capture filters 73 and 83 are arranged in tandem on the proximal end side of the distal end guide portion 12. The embolus capturing filters 73 and 83 are attached to the shaft 11 by binding the basket-shaped filter portions 74 and 84 that capture the emboli released in the blood vessel and the wires constituting the filter portions 74 and 84 so as to be fixed or slidable. And ring-shaped binding portions 76 and 86. Here, the embolus capture filters 73 and 83 both show the example in which the openings 75 and 85 are arranged facing the proximal end side of the embolus capture device 70, but can be arranged in various directions depending on the application. It is.

  The filter portions 74 and 84 are formed by weaving thin and flexible wires having elasticity or shape memory. Here, the filter parts 74 and 84 are constituted by parachute baskets in which substantially semi-elliptical filter main bodies 74A and 84A are supported by the support parts 74B and 84B.

  The substantially semi-ellipsoidal filter bodies 74A and 84A that hit the parachute umbrella are made of a braided wire mesh that allows blood flow to pass while the emboli can be reliably captured. The filter portions 74 and 84 are bound at the distal ends of the filter bodies 74A and 84A by distal-end binding portions 76A and 86A, which will be described later, and the proximal ends of the support portions 74B and 84B are bound by the proximal-end binding portions 76B and 86B. And attached to the shaft 11 respectively.

  Here, the filter portion 84 of the second embolus capturing filter 83 is formed in a shape smaller than the filter portion 74 of the first embolus capturing filter 73. Specifically, the diameter when the filter portion 84 is expanded is smaller than that of the filter portion 74.

  Since the filter parts 74 and 84 are formed by weaving thin and flexible wires, they can be easily expanded and contracted. In addition, as will be described later, the proximal side binding portions 76B and 86B are fixed to the shaft 11, and the distal end side binding portions 76A and 86A are provided so as to be slidable along the axial direction of the shaft 11. Therefore, the filter parts 74 and 84 are elongated and contracted in diameter when the distal side binding parts 76A and 86A move in the distal direction, and bulge round when the distal side binding parts 76A and 86A move in the proximal direction, as shown in FIG. The diameter is expanded as follows. The filter portions 74 and 84 made of a wire having elasticity or shape memory properties are processed so as to take this expanded state under a natural state or a shape memory recovery temperature.

  The filter bodies 74A and 84A and the support portions 74B and 84B constituting the filter portions 74 and 84 are preferably formed by knitting from a plurality of wires. The wires constituting the filter portions 74 and 84 are nickel titanium wire, titanium wire, wire made of platinum or gold and a wire made of a composite material of nickel titanium alloy, nickel wire plated with gold, or wire of titanium alloy. Etc. are suitable.

  The bundling portions 76 and 86 are ring-shaped members that are attached to the shaft 11 by bundling the wires constituting the filter portions 74 and 84 on the distal end side and the proximal end side, respectively. This ring-shaped member can be fixed to the shaft 11 or slidable with respect to the shaft 11. Here, the distal end side binding portions 76A and 86A are provided to be slidable in the axial direction of the shaft 11, and the proximal end side binding portions 76B and 86B are fixed to the shaft 11. Therefore, as described above, the filter portions 74 and 84 can be accommodated in the delivery catheter in a state of being elongated and reduced in diameter by moving the distal end side binding portions 76A and 86A in the distal direction. Further, when released from the delivery catheter into the lumen, the distal side binding portions 76A, 86A move in the proximal direction due to the elasticity or shape memory of the wires constituting the filter portions 74, 84, and the filter portions 74, 84 are moved. Expands to fit the inner lumen wall. About the usage method, it is the same as that of the embolus capture | acquisition apparatus 10 of 1st Embodiment shown in FIG.

  The binding portions 76 and 86 are made of a radiopaque metal material (for example, platinum, tungsten, etc.) so that the position can be confirmed under fluoroscopy.

  Here, an example in which the filter portion 84 of the second embolus capture filter 83 is made smaller than the filter portion 74 of the first embolus capture filter 73 is shown. Conversely, the filter portion 74 of the first embolus capture filter 73 is shown. May be smaller than the filter portion 84 of the second embolus capture filter 83. The large filter part is preferably located downstream of the lumen than the small filter part.

  As described above, by making one of the embolus capturing filters 73 and 83 smaller than the other filter, it is possible to apply to various shapes of lumens.

[Fifth embodiment]
Next, a description will be given of an embolus capture device in which an ablation coil is further provided on the proximal end side of the embolus capture filter to destroy and excise the embolus attached to the lumen wall.

  FIG. 6 is an overall schematic view of an embolus capturing device according to a fifth embodiment of the present invention. In addition, about the part same as embodiment shown in FIG. 1, the same code | symbol is attached | subjected and detailed description is abbreviate | omitted.

  As shown in FIG. 6, the embolus capture device 90 of this embodiment includes a shaft (shaft member) 11, a tip guide portion 12, and two embolus capture filters (first embolus capture filter, second embolus capture). Filters 13 and 14 and an ablation coil 91.

  The ablation coil 91 is composed of a wire 92 having elasticity or shape memory, and retains a coil shape as shown in FIG. 6 due to this elasticity or shape memory under a natural state or shape memory recovery temperature. The number of spirals of the ablation coil 91 is preferably 2 to 5. Both ends of the wire 92 are connected to the shaft 11 by coil connecting portions 93A and 93B. Here, the distal end side coil coupling portion 93 </ b> A is slidable along the axial direction of the shaft 11, and the proximal end side coil coupling portion 93 </ b> B is fixed to the shaft 11. Therefore, the ablation coil 91 can extend linearly along the shaft 11 by moving the distal end side coil coupling portion 93A in the distal direction within the delivery catheter. As another embodiment, the distal end side coil coupling portion 93A may be fixed to the shaft 11, and the proximal end side coil coupling portion 93B may be slidable. Alternatively, both the distal end side coil coupling portion 93A and the proximal end side coil coupling portion 93B are slidable with respect to the shaft 11, and are fixed to the shaft 11 between the distal end side coil coupling portion 93A and the proximal end side coil coupling portion 93B. A stopper member (not shown) may be arranged to restrict the sliding range of the coil connecting portions 93A and 93B.

  The wire 92 constituting the ablation coil 91 is composed of a nickel titanium wire, a titanium wire, a wire made of platinum or gold and a wire of a composite material of a nickel titanium alloy, a nickel wire plated with gold, a titanium alloy wire, or the like. . The wire 92 may be further heat treated to have thermosetting properties. The diameter of the wire 92 is preferably about 0.02 to 0.1 mm.

  Here, the ablation coil 91 is provided on the proximal end side of the embolus capture filters 13 and 23, but the ablation coil 91 may be provided upstream of the openings 15 and 25 of the embolus capture filters 13 and 23. May be provided on the distal end side of the embolus capture filters 13 and 23.

  As described above, by further providing the ablation coil 91 for destroying and excising the embolus attached to the lumen wall on the upstream side of the embolus capture filters 13 and 23, the embolus excised by the ablation coil 91 is divided into two. The embolus capture filters 13 and 23 can be reliably captured.

[Sixth embodiment]
In the above-described embodiment, an example in which a parachute-type embolus capturing filter that supports a semi-ellipsoidal filter main body by a support portion has been described. Hereinafter, an example using a parasol-type embolus capturing filter will be described.

  FIG. 7 is an overall schematic view of an embolus capturing device according to a sixth embodiment of the present invention. In addition, about the part same as embodiment shown in FIG. 1, the same code | symbol is attached | subjected and detailed description is abbreviate | omitted.

  As shown in FIG. 7, the embolus capture device 110 of this embodiment includes a shaft (shaft member) 11, a tip guide portion 12, and two embolus capture filters (a first embolus capture filter and a second embolus capture filter). ) 113 and 123.

  Two embolus capture filters 113 and 123 are arranged in tandem on the proximal end side of the distal end guide portion 12. The embolus capture filters 113 and 123 are attached to the shaft 11 by binding the basket-shaped filter portions 114 and 124 that capture the emboli released in the blood vessel and the wires constituting the filter portions 114 and 124 so as to be fixed or slidable. And ring-shaped bundling portions 116 and 126. Note that, here, the embolus capture filters 113 and 123 both show the example in which the openings 115 and 125 are arranged facing the proximal end side of the embolus capture device 110, but can be arranged in various directions depending on the application. It is.

  FIG. 8 shows details of the embolus capturing filters 113 and 123. As shown in FIG. 8, the filter portions 114 and 124 are made of a mesh knitted with a thin, flexible elastic or shape memory so that an embolus can be captured while allowing blood flow to pass. As shown, it is formed in a substantially ellipsoid. However, due to elasticity or shape memory, processing is performed to form a parasol-type basket in which a substantially ellipsoid is folded at a substantially center as shown by a solid line and a broken line in FIG. 8 under a natural state or a shape memory recovery temperature. Has been.

  The wires constituting the filter portions 114 and 124 are attached to the shaft 11 with the distal end side bound by the distal end side binding portions 116A and 126A and the proximal end side by the proximal end side binding portions 116B and 126B. As will be described later, the distal side binding portions 116A and 126A are fixed to the shaft 11, and the proximal end side binding portions 116B and 126B are provided so as to be slidable along the axial direction of the shaft 11. Therefore, the filter portions 114 and 124 are elongated and contracted when the distal side binding portions 116A and 126A move in the distal direction, and are folded back at a substantially central portion when the distal side binding portions 116A and 126A move in the proximal direction. As shown in FIG. 7, the diameter is expanded to a parasol type.

  The filter bodies 114A and 124A and the support portions 114B and 124B constituting the filter portions 114 and 124 are preferably formed by knitting from a plurality of wires. The wires constituting the filter portions 114 and 124 are nickel titanium wire, titanium wire, a wire made of platinum or gold and a composite material wire of nickel titanium alloy, a nickel wire plated with gold, or a wire of titanium alloy. Etc. are suitable.

  The bundling portions 116 and 126 are ring-shaped members that are attached to the shaft 11 by bundling the wires constituting the filter portions 114 and 124 on the distal end side and the proximal end side, respectively. This ring-shaped member can be fixed to the shaft 11 or slidable with respect to the shaft 11. Here, the distal end side binding portions 116 </ b> A and 126 </ b> A are provided so as to be slidable in the axial direction of the shaft 11, and the proximal end side binding portions 116 </ b> B and 126 </ b> B are fixed to the shaft 11. Therefore, as described above, the filter portions 114 and 124 can be stored in the delivery catheter in a state of being elongated and reduced in diameter by moving the distal end side binding portions 116A and 126A in the distal direction. Further, when released from the delivery catheter into the lumen, the distal side bundling portions 116A, 126A move in the proximal direction due to the elasticity or shape memory of the wires constituting the filter portions 114, 124, and the filter portions 114, 124 are moved. Is wrapped and expanded. About the usage method, it is the same as that of the embolus capture | acquisition apparatus 10 of 1st Embodiment shown in FIG.

  The binding portions 116 and 126 are made of a radiopaque metal material (for example, platinum, tungsten, etc.) so that the position can be confirmed under fluoroscopy.

  As described above, by using the folded parasol-type embolus capturing filters 113 and 123, the filter portions 114 and 124 form a double filter, and the embolus can be captured more reliably.

  In the embodiments described so far, as an example, the distal end side binding portion of the embolus capturing device is slidable with respect to the shaft, and the proximal end side binding portion is fixed to the shaft. The binding portion may be fixed and the proximal end side binding portion may be slidable. Moreover, you may make it possible to slide both a base end side binding part and a front end side binding part.

  FIG. 9 shows an example in which the bundling portions on the distal end side and the proximal end side are slidable. Here, the parachute embolus capturing filter 13 shown in FIG. 1 is illustrated as an example. In addition, about the part same as embodiment shown in FIG. 1, the same code | symbol is attached | subjected and detailed description is abbreviate | omitted.

  In this modification, both the distal end side binding portion 16 </ b> C and the proximal end side binding portion 16 </ b> D are provided so as to be slidable with respect to the shaft 11. Then, as shown in FIG. 9A, a stopper member 17 for restricting the movement range of the binding portions 16 </ b> C and 16 </ b> D is fixed to the shaft 11. The stopper member 17 is arranged between the binding portions 16C and 16D, and has an outer diameter larger than the inner diameter of the ring-shaped binding portions 16C and 16D so that the binding portions 16C and 16D cannot get over.

  Since both the binding portions 16C and 16D are slidable, the embolus capturing filter 13 can be freely expanded and contracted, for example, the diameter of the embolus capturing filter 13 is reduced in the delivery catheter and the diameter is increased when released into the lumen. On the other hand, since the stopper member 17 is provided on the shaft 11, the movement range of the binding portions 16C and 16D is restricted to the dotted line range shown in FIG. In addition, although the example which regulates the movement range of the binding parts 16C and 16D with one stopper member 17 is shown here, a plurality of stopper members may be used. Further, the stopper member 17 may be provided inside the filter portion 14 as shown in FIG. 9, but may be provided outside the filter portion 14 or both inside and outside the filter portion 14.

  While various embodiments of the embolus capturing device of the present invention have been described above, the surface of the embolus capturing device may be coated with a drug. For example, if a hydrophilic coating is applied, lubrication will be exhibited when touched with blood, so that the introduction operation into the blood vessel 200 is facilitated.

  The embolus capturing device of the present invention can be applied to various body lumens such as cerebral blood vessels, other blood vessels, and lymphatic vessels.

  According to the embolus trapping device of the present invention, by disposing the embolus trapping filters in a double manner, it is possible to catch even emboli that could not be trapped by the upstream embolus trapping filter or dropped during storage.

  Further, by making the two embolus capture filters have different properties (direction, mesh roughness, size, etc.), it is possible to capture the embolus more reliably in response to various situations in the lumen.

  As mentioned above, although embodiment of this invention was described, this invention is not limited to the said embodiment, Based on the meaning of this invention, various deformation | transformation are possible, These are excluded from the scope of the present invention. is not.

  The present invention relates to an embolus capturing device for capturing an embolus such as a thrombus in a lumen of a living body, and has industrial applicability.

10, 30, 50, 70, 90, 110 Embolus capture device 11 Shaft (shaft member)
12 Tip guide parts 13, 33, 53, 73, 113 First embolus capturing filters 14, 24, 34, 44, 54, 64, 74, 84, 114, 124 Filter parts 14A, 24A, 34A, 44A, 54A, 64A, 74A, 84A Filter body 14B, 24B, 34B, 44B, 54B, 64B, 74B, 84B Support portion 15, 25, 35, 45, 55, 65, 75, 85, 115, 125 Opening 16, 26, 36, 46, 56, 66, 76, 86, 116, 126 Bundling portions 16A, 16C, 26A, 36A, 46A, 56A, 66A, 76A, 86A, 116A, 126A Tip side bundling portions 16B, 16D, 26B, 36B, 46B, 56B, 66B, 76B, 86B, 116B, 126B Base end side bundling portion 17 Stopper member 23, 43, 63, 83, 123 Second embolus capture filter 91 Ablation coil 92 Wire 93A Tip side coil connection part 93B Base end side coil connection part

Claims (13)

In an embolus capture device for capturing and removing an embolus in a lumen of a living body,
A long shaft member whose distal end is fed into the lumen;
A flexible tip guide portion disposed at the tip of the shaft member;
A basket-shaped filter part that is made of a mesh composed of a wire having elasticity or shape memory, contracts in the catheter for conveying the apparatus, and expands when released from the catheter into the lumen, and the filter part A bundling portion for bundling the wire on the distal end side and the proximal end side, respectively,
With
An embolus capture device, wherein two of the embolus capture filters are arranged in tandem on the proximal end side of the distal end guide portion.   The embolus capture device according to claim 1, wherein openings of the two embolus capture filters are arranged in different directions.   The embolus capture device according to claim 1 or 2, wherein the two embolus capture filters have different mesh roughness.   The embolus capture device according to any one of claims 1 to 3, wherein the diameters of the filter portions when the two embolus capture filters are expanded are different from each other.   The cutting coil for destroying and excising the embolus stuck to the inner wall of the lumen is further provided on the upstream side in the lumen of the embolus capturing filter, according to any one of claims 1 to 4. The embolus trapping device as described.   The filter unit is configured by a substantially semi-ellipsoidal filter main body made of a wire mesh having elasticity or shape memory, and a support unit that supports the opening side of the filter main body and is attached to the shaft member. The embolus trapping device according to any one of claims 1 to 5, wherein The filter portion is composed of a substantially ellipsoid made of a wire mesh having the elasticity or shape memory property,
When the expansion is performed, the distal end side binding portion and the proximal end side binding portion approach along the shaft member, and the substantially ellipsoid is folded back at a central portion to be transformed into a substantially semi-ellipsoid. The embolus capture device according to any one of claims 1 to 5.   Any one of the front end side binding portion and the base end side binding portion of the filter portion is provided to be slidable in the axial direction along the shaft member, and the other is fixed to the shaft member. The embolus capture device according to any one of claims 1 to 7.   Both the distal end side binding portion and the proximal end side binding portion of the filter portion are provided to be slidable in the axial direction along the shaft member, and the movable range of the distal end side binding portion and the proximal end side binding portion is increased. The embolus capturing device according to any one of claims 1 to 7, wherein a stopper member to be regulated is fixedly disposed on the shaft member.   The embolus capture device according to any one of claims 1 to 9, wherein the proximal end side binding portion and the distal end side binding portion are made of a radiopaque metal material.   The embolus capture device according to any one of claims 1 to 10, wherein the distal end guide portion is formed by winding a coil made of a radiopaque metal material on the shaft member. .   The wire constituting the filter section is any one of a nickel titanium wire, a titanium wire, a wire made of platinum or gold and a wire of a composite material of a nickel titanium alloy, a nickel-plated nickel wire, or a wire of a titanium alloy The embolus capturing device according to any one of claims 1 to 11, wherein the embolus capturing device is formed.   The embolus capture device according to any one of claims 1 to 12, wherein the embolus capture device is provided with a hydrophilic coating.

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