JP2013146496A - Embolus scraping device and embolus scraping kit - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an embolus scraping device which can sufficiently scrape off an embolus such as a thrombus.SOLUTION: An embolus scraping device 19 includes: a wire 17, a thrombus scraper 11, and stoppers 15, 15, wherein the thrombus scraper 11 is mounted to move on the wire 17 and has a bag-shaped meshwork structure 12 which has been shaped into a bag by throttling a tube shaped meshwork structure 12 in the vicinity of both the ends; and the stoppers 15, 15 are placed apart from each other within the bag-shaped meshwork structure 12 and come into contact with the throttled parts in the bag-shaped meshwork structure 12, thereby stopping the thrombus scraper 11 from moving on the wire 17.

Description

  The present invention relates to an embolus scraping device and an embolus scraping kit.

  A thromboembolic disease (thromboembolism) such as myocardial infarction, pulmonary embolism, peripheral thrombus, or organ occlusion is a disease that completely or partially clogs a blood vessel lumen or the like. A substance (emboli) that clogs blood vessels or the like is a viscoelastic blood clot containing platelets, fibrinogen, or a coagulation factor, and is called a thrombus.

  As a treatment for such thromboembolism, there is a surgical incision thrombectomy operation, but percutaneous or intravascular catheter-guided interventional therapy that is less invasive than surgery is also employed. As a medical instrument used for such intervention therapy, for example, a thrombus trap described in Patent Document 1 or a filter described in Patent Document 2 can be cited.

  The thrombus capturing device of Patent Document 1 includes a wire equipped with an elastic coil body and a stopper (this wire is used as a thrombus capturing portion), and a catheter into which the thrombus capturing portion is inserted. In detail, the thrombus capturing part is provided with a fixed part at the tip of the elastic coil body, so that the elastic coil body is fixed at the tip side of the wire, while a movable part is provided at the rear end of the elastic coil body, The rear end portion of the elastic coil body is slid on the wire. A stopper is arrange | positioned between the fixed part and movable part in a wire, and stops the movement of the rear-end part of an elastic coil body by contacting a movable part.

  In such a thrombus trap, the thrombus capture part is guided to the vicinity of the thrombus by the catheter, and further, the thrombus capture part is advanced until it penetrates the thrombus (in this progress, the fixed part is arranged at the destination) ) Thereafter, the thrombus capturing part is pulled back to the operator's hand side. In the case of this pullback, the movable part that contacts the thrombus is moved toward the stopper, so that the coil elastic body is compressed and the diameter is expanded. Therefore, the swollen coil elastic body scrapes off the thrombus by this pulling back.

  The filter of Patent Document 2 is a cylindrical filter with both ends narrowed down, and moves on the mandrel by passing a linear mandrel fitted with a stopper through the inside. And this filter moves to the inside of a blood vessel easily by becoming a diameter-reduced state by moving until both ends come into contact with the stopper, and collects the thrombus flowing through the blood flow after being placed at a predetermined position.

JP 2010-188068 A JP 2007-117760 A

  In the thrombus trap of Patent Document 1, the thrombus is scraped only when the thrombus capturing part is pulled back. That is, when the thrombus capturing portion proceeds toward the thrombus fixed to the blood vessel wall, the thrombus is not scraped off. Therefore, this thrombus trap cannot be scraped off by reciprocating (repeatingly moving) the thrombus. For this reason, this thrombus trap cannot sufficiently remove the thrombus firmly adhered to the blood vessel wall.

  In addition, the filter of Patent Document 2 not only reciprocates with respect to the thrombus in the same manner as Patent Document 1, but only collects the thrombus flowing along with the blood flow while stopped in the blood vessel. It does not remove the thrombus that has adhered to the surface. That is, this filter cannot sufficiently remove the thrombus adhering to the blood vessel wall.

  The present invention has been made to solve the above problems. An object of the present invention is to provide an embolus scraping device that can sufficiently scrape an embolus such as a thrombus adhering to a blood vessel wall.

  The embolus scraping device is a bag-type gap structure that is a bag-type gap structure that is mounted so as to move on the wire and squeezes both ends of the cylindrical gap structure. And a stopper which is disposed apart inside the bag-type gap structure and stops movement of the embolus scraping portion on the wire by contacting a portion to be squeezed in the bag-type gap structure. .

  Moreover, it is desirable that the embolus scraping portion has elasticity.

  The gap structure is preferably a mesh or a braided body.

  The shape of the bag-type gap structure is preferably an elliptical sphere.

  It is desirable that the embolus scraping part is provided with a thrombolytic coating.

  An embolus scraping kit including the embolus scraping device as described above and a catheter for inserting the embolus scraping device can be said to be the present invention.

  According to the embolus scraping device of the present invention, the same embolus is scraped off repeatedly several times, so that the embolus is reliably removed.

FIG. 3 is a perspective view showing a catheter and an embolus scraping device. These are explanatory drawings which show the one aspect | mode of the embolus scraping device used. These are explanatory drawings which show the one aspect | mode of the embolus scraping device used. These are explanatory drawings which show the one aspect | mode of the embolus scraping device used. These are explanatory drawings which show the one aspect | mode of the embolus scraping device used. These are explanatory drawings which show the one aspect | mode of the embolus scraping device used. These are explanatory drawings which show the one aspect | mode of the embolus scraping device used. These are explanatory drawings which show the one aspect | mode of the embolus scraping device used. These are explanatory drawings which show the one aspect | mode of the embolus scraping device used.

[Embodiment 1]
The following describes one embodiment with reference to the drawings. For convenience, hatching, member codes, and the like may be omitted, but in such a case, other drawings are referred to. Conversely, for convenience, hatching may be used even if it is not a sectional view. In addition, the dimensions of various members in the drawings are adjusted for easy viewing. The white arrow indicates the moving direction of the embolus scraping device. In the following, the proximal side means the operator's hand side using the catheter or embolus scraping device, and the distal side is the opposite side of the proximal side, that is, the side away from the operator. Means.

  FIG. 1 is a perspective view showing a catheter 29 and an embolus scraping device [medical device] 19 conveyed through the lumen 29L of the catheter 29. FIG. Note that a kit including the catheter 29 and the embolus scraping device 19 is referred to as an embolus scraping kit [medical set] 39.

  The catheter 29 is a tube having a lumen 29L that allows the embolus scraping device 19 to pass therethrough. The distal end 29D of the catheter 29 is close to a lesion (for example, a stenosis that narrows the lumen 41L of the blood vessel 41 with an embolus such as a thrombus 42; see FIG. Further, the embolus scraping device 19 is transported through the lumen 29L so as to exceed the tip of the catheter 29, thereby reaching and treating the lesion. The type of the catheter 29 is not particularly limited as long as the catheter 29 has a lumen 29L that can be passed through the embolus scraping device 19.

  The embolus scraping device 19 includes a wire 17, a thrombus scraping portion [emboli scraping portion] 11, and a stopper 15.

  The wire 17 is linear, and when the thrombus scraping portion 11 is attached, the thrombus scraping portion 11 is operated. It is desirable that the wire 17 has flexibility (movability) in order to move in the blood vessel and has a characteristic (insertability) that can easily proceed in the blood vessel. For example, when a hydrophilic coating is applied to the surface of the wire 17, the lubricity with respect to blood is improved and the wire 17 can be easily inserted into the lumen 41 </ b> L. However, when the wire 17 advances in the blood vessel 41, it is desirable that the tip is rounded so that the blood vessel 41 is not perforated at the tip of the wire 17.

  The structure of the wire 17 is not particularly limited, and may be a one-piece structure (single structure), a hypotube structure, or a torque wire structure. Further, the material of the wire 17 is not particularly limited, and may be a metal or a resin. However, from the viewpoint of preventing plastic deformation, the material of the wire 17 is preferably, for example, stainless steel or a Ni—Ti (Nytinol-Titanium) alloy.

  Also, the outer diameter of the wire 17 is not particularly limited, but in consideration of diverting a medical guide wire, it is preferably 0.25 mm (0.010 inch) to 0.86 mm (0.035 inch), and most preferably 0.36 mm (0.014). inch) to 0.46 mm (0.016 inch). Further, when the medical guide wire is diverted to the wire 17, the wire 17 is also assured of operability in the blood vessel to the same extent as the medical guide wire. Therefore, the wire 17 may be diverted from a medical guide wire, or may have the same length and rigidity (flexibility) as the medical guide wire.

  Further, a protective member may be attached to the tip of the wire 17 in order to prevent blood vessel perforation, for example. For example, a spiral coil made of stainless steel or Ni—Ti alloy is wound around the tip of the wire 17, a helical cut hypotube is inserted into the tip of the wire 17, or a urethane resin or the like is coated on the tip of the wire 17. It doesn't matter.

  Next, the thrombus scraping unit 11 will be described. The clot scraping unit 11 scrapes (entangles) them by contacting (contacting) a lesion that is an embolus such as the thrombus 42. The thrombus scraping portion 11 includes a cylindrical structure 12 made of a member having a gap (pitch) such as a net. The cylindrical gap structure 12 passes the wire 17 into the cylinder. In this state, the both ends in the axial direction are squeezed to form a bag shape. The cylindrical gap structure 12 in the form of a bag (hereinafter also referred to as the bag-type gap structure 12) slides along the wire 17 because the wire 17 is passed through the inside. .

  The bag-type gap structure 12 is squeezed at both ends, so that the outer diameter and inner diameter in the vicinity of both ends become smaller than the outer diameter and inner diameter in the vicinity of the center of the bag-type gap structure 12. Therefore, in the bag-type gap structure 12, the vicinity of both ends is tapered as compared with the vicinity of the center {that is, the vicinity of both ends of the thrombus scraping portion 11 is the axial direction of the wire 17 (in other words, the bag-type gap structure 12 To the axial direction).

  The structure of the bag-type gap structure 12 is not particularly limited, and for example, a braided structure may be adopted. In the case of this structure, a plurality of wires are wound spirally in one direction on a mandrel (braiding core), and another plurality of wires are wound spirally in another direction. Then, a knitted fabric formed of wires wound in two directions on a mandrel is completed, and it functions as a cylindrical network structure (wires wound in the same direction are referred to as a set of wires).

  Moreover, not only a braided structure but also a coil structure or a stitch structure may be used. In these structures, since there is a gap generated between adjacent strands, it is desirable to easily scrape the thrombus 42. For example, in the case of the blood clot scraping part 11 having a braided structure, the pitch of the strands is 0.5 to 2.0 mm, preferably 0.5 to 1.5 mm, and most preferably 0.5 to 0.8 mm.

  Moreover, the cross-sectional shape of the wire forming the bag-shaped gap structure 12 is not particularly limited, and may be a round wire, a deformed wire such as a flat wire or a rectangular wire, or the like. The cross-sectional shape here means a cross-sectional shape perpendicular to the axial direction of the strands, the round line is a circular cross-sectional shape, and the flat line is a rectangular or rectangular cross-sectional shape. Yes, a flat wire is a shape in which the cross-sectional shape is a rectangle or rounded corners of the rectangle.

  Also, the outer diameter of the strand is not particularly limited, but considering the rigidity in the thrombus scraping portion 11 having a braided structure, for example, the outer diameter of the strand is preferably 0.040 to 0.080 mm, and most preferably 0.040 to 0.060 mm. It is. As the material of the wire, metal or resin can be used, but it is desirable that the thrombus scraping portion 11 has a property of being reversibly deformed so as to adhere to the lesion. It may be formed of an elastic alloy or may be subjected to processing such as heat treatment.

  Further, the maximum outer diameter of the bag-type gap structure 12 and by extension, the thrombus scraping portion 11 (the maximum outer peripheral diameter with respect to the axial direction of the bag-type gap structure 12) is not particularly limited, but the embolus scraping device 19 Considering the case where the application site is a cardiovascular, since the inner diameter of the target blood vessel is about 2.0 to 4.0 mm, it is desirable that the maximum outer diameter of the thrombus scraping portion 11 is also about 2.0 to 4.0 mm. This is because, if the maximum outer diameter of the thrombus scraping portion 11 is about the same as the inner diameter of the blood vessel, it is easy to scrape the thrombus, but if it becomes too large, the blood vessel tissue may be damaged.

  The total length of the thrombus scraping portion 11 (the maximum length in the axial direction of the bag-type gap structure 12) is not particularly limited, but is preferably 10 to 20 mm.

  By the way, the portion narrowed down in the cylindrical gap structure 12 is referred to as a throttling portion 13, and the side closer to the distal end side of the wire 17 is the distal throttling portion 13D, and the opposite side to the distal throttling portion 13D. The proximal throttling portion 13P is referred to as the throttling portion 13 (the distal side is the side close to the lesion).

  The narrowed portion 13 is formed of, for example, a resin tube or a metal tube. More specifically, in the case of a resin tube, the vicinity of the end of the cylindrical gap structure 12 is inserted into the lumen of the resin tube, and further, the resin tube is covered with a shrink tube (heat shrinkable tube) and heated. The diameter is reduced, and the throttle part 13 that squeezes the cylindrical gap structure 12 is formed. In the case of a metal tube, the vicinity of the end of the cylindrical gap structure 12 is inserted into the lumen of the metal tube, and further, the diameter of the cylindrical gap structure 12 is reduced by caulking by the caulking device. It becomes the aperture section 13 for aperture.

  In the case of such a diameter reduction of the resin tube by the shrink tube and a diameter reduction of the metal pipe by the caulking device, a mandrel is inserted into the end of the cylindrical gap structure 12. Therefore, if the outer diameter of the mandrel is larger than the outer diameter of the wire 17, the portion where the mandrel is pulled out from the cylindrical gap structure 12, that is, the inner cavity of the throttle portion 13 has an inner diameter that allows the wire 17 to be inserted. As a result, the thrombus scraping part 11 including the throttle part 13 can move on the wire 17.

  Conversely, if the outer diameter of the mandrel is smaller than the outer diameter of the wire 17, post-processing is required to make the portion where the mandrel is pulled out from the cylindrical gap structure 12 larger than the outer diameter of the wire 17. .

  In addition, a part of the cylindrical gap structure 12 may be the throttle portion 13. More specifically, the pitch of the end of the cylindrical gap structure 12 is narrower than the pitch of the other part of the cylindrical gap structure 12 with a laser or the like, so that the cylindrical gap structure is smaller than the outer diameter of the other part. The outer diameter in the vicinity of the end of 12 may be a small diameter to form the throttle portion 13. However, it goes without saying that the inner diameter formed in the vicinity of the end of the cylindrical gap structure 12 is larger than the outer diameter of the wire 17.

  The maximum outer diameter and the total length of the narrowed portion 13 are not particularly limited, but are desirably as small as possible considering the insertability into the blood vessel. Further, the distal end (distal end) of the distal throttling portion 13D and the proximal end (proximal end) of the proximal throttling portion 13P are inserted into the lumen 42L of the thrombus 42. In view of the properties, it is desirable that R processing (chamfering processing) is performed. In addition, the method of this R process is not specifically limited.

  The thrombus scraping part 11 as described above is preferably coated with a thrombolytic agent such as streptokinase or urokinase. The coating site or coating method is not particularly limited. That is, the coating only needs to be applied to at least a part of the thrombus scraping portion 11, and various coating methods may be used.

  Next, the stopper 15 will be described. The stopper 15 is attached to the wire 17 inside the thrombus scraping part 11 and stops movement of the thrombus scraping part 11 on the wire 17 by contacting the throttle part 13.

  The stopper 15 is not particularly limited in shape, material, etc., as long as it is a member that contacts the throttle portion 13. Therefore, the stopper 15 may be, for example, a tubular member in which the wire 17 is inserted into the lumen, or may be a piece of material (for example, an adhesive) raised from the wire 17. The method for attaching the stopper 15 is not particularly limited, and various methods such as adhesion using an adhesive, caulking, or laser welding may be used.

  The stopper 15 may be an X-ray opaque marker. That is, it is desirable that the material of the stopper 15 is stainless steel, tungsten, platinum, iridium, gold, or the like having high radiopacity.

  In the case where the stopper 15 is, for example, a cylindrical shape, the maximum outer diameter of the stopper 15 is not particularly limited, but is preferably 0.2 to 3.0 mm in view of visibility, insertion into a blood vessel, etc. ~ 0.8mm is most desirable. The length of the stopper 15 alone is not particularly limited, but is preferably 0.5 to 3.0 mm, and most preferably 1.0 to 2.0 mm. If the stopper 15 alone is too long, the flexibility of the wire 17 is impaired, and the blood vessel followability of the embolus scraping device 19 is lowered.

  Further, in FIG. 1, an example is given in which two stoppers 15 are attached to the wire 17 in a state of being separated from each other, but the number may be singular or plural other than two (however, In the case of a single stopper 15, the total length of the stopper 15 is shorter than the distance between the two throttle portions 13D and 13P. In the case of a plurality of stoppers 15, the distance between the stoppers 15 at both ends is between the throttle portions 13D and 13P. Shorter than distance).

  In FIG. 1, the stopper 15 near the distal throttling portion 13D is referred to as a distal stopper 15D, and the stopper 15 near the proximal throttling portion 13P is referred to as a proximal stopper 15P.

  Here, an example of how to use the embolus scraping device 19 will be described with reference to FIGS.

  First, as shown in FIG. 2, the catheter 29 is guided to the vicinity of the thrombus 42 attached inside the blood vessel 41. The embolus scraping device 19 is advanced toward the distal end (distal end 29 </ b> D) of the catheter 29 through the lumen 29 </ b> L of the catheter 29.

  Thus, when the embolus scraping device 19 is advanced toward the distal end 29D of the catheter 29, the surface (lumen surface) 29S of the lumen 29L of the catheter 29 moves the thrombus scraping portion 11 to the proximal side. (In short, a pressing force is generated to move the thrombus scraping portion 11 to the proximal side). However, a stopper 15 that contacts the throttle portion 13 is fixed to the wire 17 inside the thrombus scraping portion 11. Therefore, when the thrombus scraping portion 11 moves to the proximal side, the distal throttling portion 13D and the distal stopper 15D come into contact with each other, and the thrombus scraping portion 11 stops. That is, the thrombus scraping portion 11 is advanced toward the distal end 29D of the catheter 29 in a state where the distal side throttling portion 13D and the distal side stopper 15D are in contact with each other.

  Further, when the embolus scraping device 19 fits in the lumen 29L of the catheter 29, the periphery of the thrombus scraping portion 11 (the outer surface of the thrombus scraping portion 11) is compressed by being pressed against the lumen surface 29S of the catheter 29. Yes, in detail, the outer diameter and inner diameter of the thrombus scraping portion 11 are reduced in diameter compared to the initial state (a state where no force is applied to the thrombus scraping portion 11). That is, the compressed thrombus scraper 11 is advanced toward the distal end 29 </ b> D of the catheter 29 while the distal throttling portion 13 </ b> D and the distal stopper 15 </ b> D are in contact with each other.

  Subsequently, as the embolus scraping device 19 advances toward the distal end 29D of the catheter 29, it jumps out of the catheter 29 beyond the distal end 29D, as shown in FIG. When it pops out in this manner, the thrombus scraping portion 11 is not pressed down by the lumen surface 29S of the catheter 29, and thus returns to its original state. That is, the outer diameter / inner diameter of the thrombus scraping portion 11 that has been reduced in diameter by being pressed down by the lumen surface 29S of the catheter 29 is increased in diameter by being not pressed down (note that the distal throttling portion 13D and It often remains in contact with the distal stopper 15D).

  When the embolus scraping device 19 is advanced toward the thrombus 42, as shown in FIG. 4, the thrombus scraping portion 11 reaches the thrombus 42 and comes into contact therewith. Then, the distal side of the thrombus scraping portion 11 (for example, the vicinity of the distal throttling portion 13D) is pushed toward the proximal side by the thrombus 42, so that the thrombus scraping portion 11 is reliably proximal. And then the thrombus scraping portion 11 is stopped by the contact between the distal throttling portion 13D and the distal stopper 15D (that is, the throttling portion in the direction of travel of the embolus scraping device 19). 13 and the stopper 15 come into contact with each other, and the thrombus scraping portion 11 is fixed on the wire 17).

  Subsequently, as shown in FIG. 5, when the embolus scraping device 19 is advanced toward the thrombus 42, the thrombus scraping portion 11 that is not displaced (immobilized) on the wire 17 scrapes the thrombus 42. More specifically, the periphery of the thrombus scraping portion 11 fixed by the wire 17 is compressed by being pressed against the thrombus 42, while being repelled by the force pressed by the thrombus 42, the thrombus scraping portion 11 is Press the thrombus 42. Therefore, the thrombus scraping portion 11 advances while pressing the surface (lumen surface) 42S of the lumen 42L of the thrombus 42, and scrapes off the thrombus 42.

  Then, as the embolus scraping device 19 advances toward the distal end 42D of the thrombus 42 (the end opposite to the first entry side to the thrombus 42), as shown in FIG. It jumps out of the lumen 42L of the thrombus 42 beyond the distal end 42D. When it pops out in this way, the thrombus scraping part 11 to which the thrombus 42 is attached cannot be pressed down by the lumen surface 42S of the thrombus 42, and thus returns to its original state. That is, the outer diameter / inner diameter of the thrombus scraping portion 11 that has been reduced in diameter by being pressed down by the lumen surface 42S of the thrombus 42 is increased in diameter by being not pressed down (in addition, the distal throttling portion 13D and It often remains in contact with the distal stopper 15D).

  Next, as shown in FIG. 7, the embolus scraping device 19 is pulled back to the proximal side (the operator's hand side). When the embolus scraping device 19 is advanced toward the thrombus 42, the thrombus scraping portion 11 reaches the thrombus 42 and comes into contact therewith. Then, the proximal side of the thrombus scraping portion 11 (for example, the vicinity of the proximal throttle portion 13P) is pushed to the distal side by the thrombus 42, so that the thrombus scraping portion 11 moves to the distal side. Then, the thrombus scraping portion 11 is stopped by contact between the proximal throttling portion 13P and the proximal stopper 15P (that is, the throttling portion 13 and the stopper in the advancing direction of the embolus scraping device 19). 15 and the thrombus scraper 11 is fixed on the wire 17).

  Subsequently, as shown in FIG. 8, when the embolus scraping device 19 is advanced toward the thrombus 42, the thrombus scraping portion 11 that is not displaced on the wire 17 enters the lumen 42L of the thrombus 42, The inner wall 42S of the lumen 42L is contacted, and the thrombus 42 is scraped off.

  Then, when the embolus scraping device 19 advances toward the proximal end 42P of the thrombus 42 (the end opposite to the thrombus 42 distal end 42D), as shown in FIG. It jumps out of the lumen 42L of the thrombus 42 beyond 42P. When it pops out in this way, the thrombus scraping part 11 to which the thrombus 42 is attached cannot be pressed down by the lumen surface 42S of the thrombus 42, and thus returns to its original state (note that the proximal side throttling part 13P and the proximal side stopper 13 15P often remains in contact).

  In this way, the embolus scraping device 19 will be described in detail. The bag 17 is a bag shape that is mounted so as to move on the wire 17 and squeezes both ends of the cylindrical gap structure 12. The clot scraping part 11 having the gap structure 12 and the clot scraping part 11 are arranged inside the bag-type gap structure 12 and come into contact with the portion to be squeezed (squeezed part 13) in the bag-type gap structure 12. The embolus scraping device 19 including the stopper 15 that stops the movement of the portion 11 on the wire 17 scrapes the thrombus 42 by advancing from the proximal end 42P of the thrombus 42 toward the distal end 42D. In addition, the thrombus 42 is repeatedly scraped off by advancing from the distal end 42D of the thrombus 42 toward the proximal end 42P.

  That is, the thrombus scraping portion 11 of the embolus scraping device 19 reciprocates with the thrombus 42 as a boundary, whereby the thrombus 42 is scraped by the thrombus scraping portion 11 a plurality of times (note that FIG. FIG. 9 shows an example in which the thrombus scraping part 11 reciprocates once with respect to the thrombus 42, but the number of reciprocations is not particularly limited. Therefore, the embolus scraping device 19 surely scrapes more thrombus 42 than an embolus scraping device that only scrapes the thrombus 42 once.

  Further, in particular, as shown in FIG. 1, the two stoppers 15 are arranged apart from each other inside the thrombus scraping portion 11 (more specifically, the cylindrical gap structure 12). When the movement of the thrombus scraping portion 11 on the wire 17 is stopped by contacting the throttle portion 13, it is preferable to one stopper.

  For example, when one stopper having the same total length as the distance between the two stoppers 15D and 15P is attached to the wire 17 and disposed inside the thrombus scraping portion 11, the flexibility of the wire 17 is reduced. The blood vessel followability of the embolus scraping device 19 is deteriorated (in short, the portion between the plurality of stoppers 15D and 15P can be bent, but the embolus scraping device including only one stopper is The portion between the entire lengths of the stopper cannot be bent, and the blood vessel followability is lowered).

  Further, when one of the two stoppers 15D and 15P is removed and only one stopper is attached to the wire 17 and disposed inside the thrombus scraping portion 11, the embolus scraping device 19 is A relatively long amount of movement is required to move the thrombus scraping portion 11, resulting in a complicated procedure, and consequently positioning of the thrombus scraping portion 11 becomes difficult.

  However, as shown in FIG. 1, if the two stoppers 15 are separated from each other inside the thrombus scraping portion 11, such a situation is unlikely to occur.

  The stopper 15 is installed with the distance L from the tip of the wire 17 as the center C as shown in FIG. 1, and the distance between the adjacent stoppers 15 is set substantially equal (distance from the stopper 15D to the center C). And the distance from the center C to the stopper 15P is the same).

  Then, considering the ease of the procedure or the positioning accuracy of the thrombus scraping portion 11, the center in the full length direction of the normal (undeformed) thrombus scraping portion 11 and the center C coincide with each other. The distance from the throttle portion 13D to the stopper 15D and the distance from the throttle portion 13P to the stopper 15P are preferably 0.5 to 4.0 mm, and most preferably 1.0 to 2.0 mm.

  If the distance is less than 0.5 mm, the thrombus scraping portion 11 does not contract in the axial direction of the wire 17 but only deforms, and the adhesion to the blood vessel wall during movement decreases. On the other hand, if the distance exceeds 4.0 mm, a relatively long movement amount is required to move the thrombus scraping portion 11, so that positioning of the thrombus scraping portion 11 becomes difficult. However, if the distance is 0.5 to 4.0 mm, preferably 1.0 to 2.0 mm, such a situation hardly occurs.

  The embolus scraping device 19 is recovered outside the body through the catheter 29, whereby the thrombus 42 attached to the embolus scraping device 19 is recovered. In addition to this, the thrombus 42 scraped by the embolus scraping device 19 is, for example, sucked by a suction catheter or collected after being collected by a peripheral protection device.

  By the way, it is desirable that the thrombus scraping portion 11 has elasticity. That is, it is desirable that the thrombus scraping portion 11 has a characteristic of returning to its original state (before compression deformation) when the force is lost, even though a force (pressing or the like) is applied by the thrombus 42 or the like. In short, it is desirable that the thrombus scraping portion 11 has a property of reversibly deforming.

  In this case, when the thrombus scraping portion 11 advances while being accommodated in the lumen 42L of the thrombus 42, the thrombus scraping portion 11 is brought into contact with the stopper 15 and the thrombus scraping portion 11 becomes a wire. Stop the movement on 17. Further, when the thrombus scraping portion 11 advances in this stopped state, the thrombus scraping portion 11 is deformed along the shape of the lumen 42L of the thrombus 42, and the inner wall surface 42S of the lumen 42L is appropriately adjusted. And scrape off the thrombus 42 without crushing it. On the other hand, the thrombus scraping portion 11 does not apply excessive force (repulsive force) to the inner wall surface 41S of the blood vessel 41 and does not damage it. That is, the embolus scraping device 19 removes the blood clot 42 without damaging it and without crushing the thrombus 42.

  Specifically, when the thrombus scraping portion 11 advances from the proximal end 42P of the thrombus 42 toward the distal end 42D, the proximal side of the distal side throttling portion 13D and the distal stopper 15D are in contact with each other. The aperture 13P becomes a free end. Further, when the thrombus scraping portion 11 advances from the distal end 42D to the proximal end 42P of the thrombus 42, the distal throttling portion 13P and the proximal stopper 15P are in contact with each other. The part 13D becomes a free end. That is, among the both ends of the proceeding thrombus scraping portion 11, one end of the destination is fixed, but the other end is a free end.

  Thus, when the end that first collides with the thrombus 42 becomes a fixed end and the opposite end of the fixed end becomes a free end, the thrombus scraping portion 11 is fixed when the lumen 42L of the thrombus 42 advances. With reference to the end, a part of the thrombus scraping portion 11 near the free end is easily deformed in accordance with the lumen 42L of the thrombus 42. For this reason, the thrombus scraping portion 11 does not apply excessive force to the inner wall surface 41S of the blood vessel 41 and does not damage the thrombus (wall thrombus) 42 stuck to the inner wall surface 41S of the blood vessel 41. Remove reliably without crushing.

  In the embolus scraping device 19, the thrombus scraping portion 11 includes the bag-type gap structure 12. And this bag type clearance structure 12 is desirable in it being a mesh body or a braided body, for example.

  Although the net-like body and the braided body are deformed, for example, since the net-like body and the braided body have a strong structure as compared with the coil body, it is difficult to plastically deform. Therefore, the thrombus scraping part 11 of such a net or braid is suitable for the embolus scraping device 19 that repeatedly scrapes the thrombus 42. Further, the thrombus scraping portion 11 of the net-like body or the braided body remains deformed when the thrombus 42 is scraped off, and does not cause a situation where it must be replaced. That is, the embolus scraping device 19 simplifies the operator's procedure (in short, the necessity of replacing the embolus scraping device 19 in the procedure is reduced).

  In addition, the shape of the thrombus scraping portion 11 (that is, the bag-type gap structure 12) is preferably an elliptical sphere.

  In this way, in the thrombus scraping portion 11, the vicinity of both ends is tapered compared to the vicinity of the center. Therefore, when the thrombus scraping portion 11 enters the lumen 42L of the thrombus 42, it is easy to enter the opening of the lumen 42L. On the other hand, as the thrombus scraping portion 11 progresses with respect to the thrombus 42, the vicinity of the center of the thrombus scraping portion 11 having a gradually increased outer diameter comes into contact with the thrombus 42. It is scraped off. That is, such a thrombus scraping portion 11 is easy to enter the lumen 42L of the thrombus 42 and reliably scrapes the thrombus 42.

11 Thrombus scraping part [emboli scraping part]
12 cylindrical gap structure, bag-type gap structure 13 throttling portion 13D distal throttling portion 13P proximal throttling portion 15 stopper 15D distal side stopper 15P proximal side stopper 17 wire 19 embolus scraping device 29 catheter 29D Distal end of catheter 39 emboli scraping kit 41 blood vessel 41L lumen of blood vessel 41S lumen surface of blood vessel 42 thrombus 42L lumen of thrombus 42S lumen surface of thrombus 42D distal end of thrombus 42P proximal end of thrombus

Claims (6)

Wire,
An embolus scraping portion that is a bag-type gap structure that is mounted so as to move on the wire and that has become a bag shape by squeezing the vicinity of both ends of the cylindrical gap structure;
A stopper that is disposed apart inside the bag-type gap structure and stops movement of the embolus scraping portion on the wire by contacting a portion to be squeezed in the bag-type gap structure,
Embolus scraping device including.   The embolus scraping device according to claim 1, wherein the embolus scraping unit has elasticity.   The embolus scraping device according to claim 1 or 2, wherein the gap structure is a mesh or a braided body.   The embolus scraping device according to any one of claims 1 to 3, wherein the bag-shaped gap structure has an oval shape.   The embolus scraping device according to any one of claims 1 to 4, wherein a thrombolytic coating is applied to the embolus scraping portion. The embolus scraping device according to any one of claims 1 to 5,
A catheter for inserting the embolus scraping device;
An embolus scraping kit.