JP2013154087A - Device assembly for aneurysm treatment and aneurysm treatment method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To effectively suppress the enlargement of an aneurysm, and to deter biotissue from being pressed by the aneurysm after treatment.SOLUTION: A device assembly 10 for aneurysm treatment includes a tip indwelling part 32 which has a predetermined elastic force, and a shaft 12 which can support the tip indwelling part 32. The tip indwelling part 32 assumes a shape which is elongated toward a tip direction from base end parts 34a and 36a to a curved part 42, curved in an approximately arc shape in the curved part 42 and elongated toward a base end direction from the curved part 42 to tip parts 34b and 36b, in a natural state. Additionally, when inserted into an aneurysm 102 formed in a blood vessel 100, the tip indwelling part 32 pinches the aneurysm 102 from the inside in such a manner as to press it against an outer surface of the blood vessel 100, and is indwelled in the aneurysm 102.

Description

  The present invention relates to an aneurysm treatment device assembly and an aneurysm treatment method for treating an aneurysm generated in a living organ.

  A portion where a part of a blood vessel is swollen and weakened is called an aneurysm, and particularly, a portion occurring in a cerebral artery is called a cerebral aneurysm. Subarachnoid hemorrhage occurs when a cerebral aneurysm ruptures. There are several methods for treating such rupture. One is a “neck clip technique” in which a neurosurgical craniotomy is performed, and a clip is attached between the cerebral aneurysm and the parent artery (the root portion of the aneurysm) with a clip. In another treatment method, treatment is performed without craniotomy. A catheter is inserted into the cerebral aneurysm through the blood vessel, and a flexible coil made of a metal such as platinum is implanted into the cerebral aneurysm through the catheter. This is a method called “embolization”.

  In recent years, as disclosed in Patent Document 1, a treatment method for performing a neck clip technique with a catheter has also been proposed. The aneurysm treatment device (instrument) disclosed in Patent Document 1 is configured to deliver two wires formed in advance in a predetermined shape by a catheter. And by arranging two wires on the outside of the neck of the aneurysm, the neck of the aneurysm is closed by the two wires.

JP 2008-532575 A

  The present invention has been made in view of the above circumstances, and when treating an aneurysm occurring in a living body lumen, the enlargement of the aneurysm is effectively suppressed by bringing the aneurysm into close contact with the living body lumen. In addition, an object of the present invention is to provide an aneurysm treatment device assembly and an aneurysm treatment method capable of suppressing the compression of living tissue due to the aneurysm after treatment.

  In order to achieve the above object, the present invention comprises a linear indwelling portion having a predetermined elastic force, and a long shaft that supports the indwelling portion, wherein the indwelling portion is in a natural state, A living body lumen extending in the distal direction from the proximal end portion to the curved portion, curved in a substantially arc shape in the curved portion, and extending in the proximal direction from the curved portion to the distal end portion; When inserted into the aneurysm formed on the body, the aneurysm is sandwiched from the inside so as to press against the outer surface of the living body lumen, and can be detached from the shaft in a state where the aneurysm is sandwiched. And

  According to the above, by inserting the indwelling portion having the base end portion, the curved portion, and the distal end portion in the natural state into the aneurysm, the indwelling portion acts to restore the natural state in the aneurysm. For this reason, it becomes possible to sandwich the aneurysm from the inside so as to be pressed against the outer surface of the living body lumen by the indwelling portion, extend the aneurysm along the circumferential direction of the living body lumen, and closely contact the outer surface of the living body lumen. A state in which the aneurysm is caused to protrude from the living body lumen can be achieved. After the treatment with the aneurysm treatment device assembly, since the indwelling portion is placed in the aneurysm, the state in which the aneurysm is in close contact with the living body lumen is maintained, thereby reliably suppressing the compression of the living tissue due to the aneurysm. can do.

  The shaft includes a lumen extending in an axial direction and an opening through which the lumen communicates, and the indwelling portion extends from a distal end of an insertion portion disposed in the lumen. It is preferable that the insertion portion is configured to move forward relative to the shaft when the insertion portion is advanced.

  In this way, the indwelling portion moves forward relative to the shaft based on the advance operation of the insertion portion, so that the distal end portion of the indwelling portion can be easily pushed into the back side of the aneurysm, and the aneurysm is pinched by the indwelling portion. Can be done easily.

  In the case of a configuration having an insertion portion, the shaft or the indwelling portion may be provided with a separation mechanism that separates the insertion portion and allows the separated distal-end insertion portion to be detached from the shaft.

  Thus, by providing the separation mechanism, the indwelling portion can be easily detached and placed in the aneurysm by separating the insertion portion on the distal end side.

  Here, the indwelling portion can be configured by a single linear arm portion in which the base end portion, the bending portion, and the distal end portion are continuous.

  Thus, the indwelling part can be easily delivered to the site to be treated by configuring the indwelling part with one arm part. In addition, the indwelling portion composed of one arm portion can sandwich the knob corresponding to the knobs having various shapes.

  In addition, the indwelling portion is configured by a pair of linear arm portions in which the base end portion, the bending portion, and the tip end portion are continuous, and the base end portions are connected to each other. It can also be set as the structure extended so that the said curved part and the said front-end | tip part may adjoin in the width direction.

  In this way, by configuring the indwelling portion with the pair of arm portions, the knobs can be spread in the width direction and stably sandwiched by the pair of arm portions.

  In this case, it is preferable that a bundling portion capable of holding the pair of arm portions so as to be close to each other is provided at a tip portion of the shaft.

  By holding the pair of arm portions so as to be close to each other by the binding portion, the indwelling portion can be thinned as a whole, and the indwelling portion can be easily inserted into the aneurysm.

  Furthermore, a cushioning member that is more flexible than the distal end portion may be provided at the distal end portion of the indwelling portion.

  As a result, when the indwelling portion is inserted into the aneurysm, even if the distal end abuts on the inside of the aneurysm, the aneurysm is smoothly sandwiched without damaging the aneurysm by the cushioning member, and the aneurysm is aligned along the outer surface of the living body lumen. Can be close.

  In order to achieve the above object, the present invention has a predetermined elastic force and extends in a natural state from the proximal end portion to the bending portion in the distal direction, and is substantially arc-shaped in the bending portion. An aneurysm treatment device assembly comprising: a linear indwelling portion that has a shape that extends in a proximal direction from the bending portion to the distal end portion; and a long shaft that supports the indwelling portion. A delivery step of housing the catheter in the housing lumen and positioning the opening of the housing lumen in the opening of the aneurysm formed in the body lumen; and after the delivery step, the indwelling portion moves forward from the opening of the housing lumen And inserting the indwelling portion into the aneurysm, thereby inserting the aneurysm from the inside so as to press against the outer surface of the living body lumen, and inserting the indwelling portion into the aneurysm after the delivering step. In the state It characterized by having a a withdrawal step of leaving the indwelling unit from the shaft.

  According to the above, the indwelling portion is inserted into the aneurysm through the opening of the accommodation lumen by the delivery step, and the indwelling portion is detached and indwelled in the aneurysm by the detachment step, whereby the aneurysm is inserted into the living body lumen by the indwelling portion. It can be inserted from the inside so as to press against the outer surface of the. Thus, the aneurysm can be extended along the circumferential direction of the living body lumen, and the aneurysm can be brought into close contact with the outer surface of the living body lumen, that is, the aneurysm can be prevented from protruding from the living body lumen. Then, after the treatment with the aneurysm treatment device assembly, the indwelling portion is indwelled, so that the state in which the aneurysm is in close contact with the living body lumen is maintained, so that it is possible to reliably suppress the compression of the living tissue due to the aneurysm it can.

  According to the present invention, when treating an aneurysm generated in a living body lumen, the enlargement of the aneurysm is effectively suppressed by bringing the aneurysm into close contact with the living body lumen, and the living tissue caused by the treated aneurysm The pressure can be deterred.

It is a schematic perspective view which shows the whole structure of the aneurysm treatment device assembly which concerns on this Embodiment. 2A is a main part enlarged plan view showing the tip indwelling part of FIG. 1, FIG. 2B is a main part enlarged plan view showing the shape of the tip indwelling part in FIG. 1 in a natural state, and FIG. It is a principal part enlarged plan view which shows the state which accommodated the 1st indwelling part in the catheter. 3A is a main part enlarged side view showing the shape of the distal end indwelling part in FIG. 1 in a natural state, and FIG. 3B is an enlarged side view of the main part showing a state in which the distal end indwelling part in FIG. . 4A is a first diagram illustrating the functions of the main part and the bundling part of the detachment mechanism, and FIG. 4B is a second diagram illustrating the functions of the main part and the bundling part of the detachment mechanism. These are the 3rd figures explaining the function of the principal part of a separation mechanism, and a binding part, and Drawing 4D is the 4th figure explaining the function of the principal part of a separation mechanism, and a binding part. FIG. 5A is a configuration diagram of the detachment mechanism according to the first configuration example, FIG. 5B is a configuration diagram of the detachment mechanism according to the second configuration example, and FIG. 5C is a configuration of the detachment mechanism according to the third configuration example. FIG. 5D is a configuration diagram of a detachment mechanism according to a fourth configuration example, and FIG. 5E is a configuration diagram of a detachment mechanism according to a fifth configuration example. FIG. 6A is a first perspective view illustrating a method of using the aneurysm treatment device assembly, and FIG. 6B is a cross-sectional view of the aneurysm formation portion of FIG. 6A. FIG. 7A is a second perspective view for explaining a method of using the aneurysm treatment device assembly, and FIG. 7B is a cross-sectional view of a portion where the aneurysm is formed in FIG. 7A. FIG. 8A is a third perspective view for explaining a method of using the aneurysm treatment device assembly, and FIG. 8B is a cross-sectional view of a portion where the aneurysm is formed in FIG. 8A. FIG. 9A is a fourth perspective view for explaining a method of using the aneurysm treatment device assembly, and FIG. 9B is a cross-sectional view of a part where the aneurysm is formed in FIG. 9A. FIG. 10A is a fifth perspective view for explaining a method of using the aneurysm treatment device assembly, and FIG. 10B is a cross-sectional view of a part where the aneurysm is formed in FIG. 10A. FIG. 11A is a sixth perspective view for explaining a method of using the aneurysm treatment device assembly, and FIG. 11B is a cross-sectional view of a portion where the aneurysm is formed in FIG. 11A. FIG. 12 is a schematic perspective view showing an overall configuration of an aneurysm treatment device assembly according to a modification of the present invention.

  Hereinafter, preferred embodiments of an aneurysm treatment device assembly according to the present invention will be described in detail in relation to an aneurysm treatment method with reference to the accompanying drawings.

  The aneurysm treatment device assembly 10 treats an aneurysm 102 (see FIG. 6A) generated in a blood vessel 100 (biological lumen) by an intravascular interventional technique (a technique of delivering a device to an abnormal site through the blood vessel 100). Device. Examples of blood vessels in which the aneurysm 102 is generated include arteries, veins, and peripheral blood vessels. For example, an aneurysm 102 (aneurysm) generated in an artery is constituted by a reservoir portion 104 into which blood flows and a neck portion 106 that communicates the reservoir portion 104 with the blood vessel 100. An opening 108 that communicates with is formed. The aneurysm treatment device assembly 10 can provide suitable treatment for such an aneurysm 102.

  FIG. 1 is a schematic perspective view showing the overall configuration of an aneurysm treatment device assembly 10 according to the present embodiment. An aneurysm treatment device assembly 10 according to the present exemplary embodiment includes a shaft 12 extending in the axial direction and a long body 14 supported by the shaft 12. Further, the long body 14 includes an insertion part 24 extending in the axial direction and a tip placement part 32 extending from the tip of the insertion part 24.

  The surgeon (user of the aneurysm treatment device assembly 10) delivers and positions the distal opening 48a of the catheter 16 (see FIG. 6A) to the opening 108 of the aneurysm 102, and then advances and moves the shaft 12 to move the catheter 16 The long body 14 (the tip indwelling portion 32) is exposed from the inside. Thereby, the distal end indwelling portion 32 is inserted into the aneurysm 102, and the aneurysm 102 is deformed along the outer surface of the blood vessel 100 in the vicinity where the aneurysm 102 is generated. The tip placement unit 32 is placed inside the knob 102 so that the knob 102 is pressed against the outer surface of the blood vessel 100, whereby the knob 102 is in a contracted state (closed to the blood vessel 100). Hereinafter, each configuration of the aneurysm treatment device assembly 10 will be specifically described.

  As shown in FIG. 1, the shaft 12 of the aneurysm treatment device assembly 10 is a long and flexible tubular member (tubular body), a hub 18 is connected to the proximal end side, and a bundling is performed on the distal end side. A part 20 is provided. An insertion lumen 22 is formed inside the aneurysm treatment device assembly 10 so as to penetrate the shaft 12 and the hub 18 in the axial direction.

  The insertion lumen 22 is formed to have an inner diameter that can accommodate an insertion portion 24 of the long body 14 described later. The long body 14 is supported by the shaft 12 at the distal end portion (the distal indwelling portion 32) by accommodating the insertion portion 24 in the insertion lumen 22. The aneurysm treatment device assembly 10 also integrally operates the elongated body 14 (insertion portion 24) accommodated in the insertion lumen 22 according to the advance / retreat operation, rotation operation, bending operation, and the like of the shaft 12.

  The bundling portion 20 is connected and fixed to the distal end surface 12 a of the shaft 12. The distal end opening 26 of the shaft 12 communicating with the insertion lumen 22 is communicated with the proximal end opening 30b of the binding portion 20 (see FIG. 4A).

  The shaft 12 has flexibility (flexibility) that can easily follow the curve of the catheter 16 inserted into the meandering blood vessel 100, and can support the long body 14 and push out the distal end indwelling portion 32. It is preferable to have rigidity. In this case, examples of the material constituting the shaft 12 include metals and resins. Examples of the metal include pseudo-elastic alloys (including superelastic alloys) such as Ni-Ti alloys, shape memory alloys, stainless steel (for example, SUS304, SUS303, SUS316, SUS316L, SUS316J1, SUS316J1L, SUS405, SUS430, SUS434, SUS444, SUS429, SUS430F, SUS302, etc.), cobalt-based alloys, noble metals such as gold and platinum, tungsten-based alloys, carbon-based materials (including piano wires), and the like. Examples of the resin include polyolefin (for example, polyethylene, polypropylene, polybutene, ethylene-propylene copolymer, ethylene-vinyl acetate copolymer, ionomer, or a mixture of two or more thereof), polyvinyl chloride, polyamide, polyamide. Examples thereof include polymer materials such as elastomers, polyesters, polyester elastomers, polyurethanes, polyurethane elastomers, polyimides, fluororesins, mixtures thereof, and the above two or more polymer materials. The shaft 12 can be a multilayer tube made of a composite formed from these metals and resins. An X-ray impermeable marker may be provided near the tip of the shaft 12 so as to be recognized under X-ray fluoroscopy.

  The dimension of the shaft 12 is appropriately selected according to the site to be treated (aneurysm 102). For example, when the aneurysm treatment device assembly 10 is used for the treatment of a cerebral aneurysm, the overall length is about 800 to 1500 mm. The diameter is set to about 0.6 to 3 mm.

  The hub 18 connected to the proximal end side of the shaft 12 is formed to have a larger diameter than the shaft 12 so that the operator can easily grasp it. A proximal end opening 28 communicating with the insertion lumen 22 is formed on the proximal end surface of the hub 18. The operator can insert the distal end indwelling portion 32 supported on the distal end side of the shaft 12 into the aneurysm 102 by holding the hub 18 and performing a predetermined operation (advancement / retraction operation or rotation operation). it can.

  The bundling portion 20 provided at the tip of the shaft 12 is formed in a substantially rectangular parallelepiped shape having long sides in the width direction with respect to the outer diameter of the shaft 12. The bundling portion 20 has a function of supporting the arm portions (first and second arm portions 34 and 36) provided on the distal end side (the distal indwelling portion 32) of the long body 14. Specifically, an accommodation support space 30 (see also FIGS. 4A to 4D) in which the elongated body 14 can be partially accommodated is provided inside the binding unit 20.

  The long body 14 supported by the shaft 12 (bundling portion 20) is formed by molding an elastic material (wire material) having shape restoring properties into a predetermined shape. As described above, the long body 14 includes the insertion portion 24 and the tip placement portion 32. Hereinafter, the elongated body 14 will be specifically described.

  2A is a main part enlarged plan view showing the tip indwelling part 32 in FIG. 1, FIG. 2B is a main part enlarged plan view showing the shape of the tip indwelling part 32 in FIG. 1 in a natural state, and FIG. FIG. 2 is an enlarged plan view of a main part showing a state where the distal end indwelling portion 32 of FIG. 3A is a main part enlarged side view showing the distal end indwelling part 32 of FIG. 1, and FIG. 3B is an enlarged side view of the main part showing a state in which the distal end indwelling part 32 of FIG. .

  The distal end indwelling portion 32 of the elongated body 14 forms a three-dimensional solid shape in a state exposed to the outside of the catheter 16 (natural state). As shown in FIGS. 2A, 2B, and 3A, the distal end indwelling portion 32 has a pair of linear arm portions (first arm portion 34, second arm portion 36) connected to each other, and a connecting portion (base end). A side connecting part 38) is continuous with the insertion part 24. The distal end portion of the long body 14 (including the distal end placement portion 32 and the distal end side of the insertion portion 24) is formed in a substantially Y shape in plan view, and is formed in a substantially C shape in a side view. Yes. The first and second arm portions 34 and 36 branch from the base end side connecting portion 38 where the base end portions 34a and 36a and the insertion portion 24 are connected to the left and right, and are separated from each other by a predetermined width. .

  Further, the first and second arm portions 34 and 36 are formed symmetrically about the axis of the insertion portion 24 as the axis of symmetry. In the following description, the configuration (shape) of the first arm portion 34 will be representatively described, and the description of the second arm portion 36 will be omitted unless otherwise specified.

  The first arm part 34 is connected to the base end part 34 a (base end side connecting part 38) and extends in the tip end direction (distal direction with respect to the shaft 12), and the base end extension part 40. 3B, and a distal end extending portion 44 that extends in the proximal direction (proximal to the shaft 12). For this reason, the front-end | tip part 34b of the 1st arm part 34 is arrange | positioned in the position comparatively near the base end part 34a in a natural state.

  The base end extension portion 40 extends in an oblique direction from the base end portion 34a toward the front end side in the oblique direction in a plan view (see FIGS. 2A and 2B), and is almost straight from the middle position in the front end direction. To extend. The first and second arm portions 34 and 36 are thus separated from each other when the portions close to the base end portions 34a and 36a (base end side connecting portions 38) extend in an obliquely outward direction. (Contact) It is a structure that does not fit each other. Further, the base end extending portion 40 is temporarily extended upward in the vicinity of the base end portion 34a in a side view (see FIG. 3A) to form a small curved portion (hereinafter referred to as a curved engaging portion 46). From the engaging part 46, it becomes a shape which draws a circular arc shape gently in the front end direction.

  The curved portion 42 connected to the proximal end extending portion 40 constitutes a substantially C-shaped intermediate portion of the distal end indwelling portion 32. The curved shape of the curved portion 42 in a side view is set to a curvature larger than the curvature in the circumferential direction of the outer surface of the blood vessel 100 where the aneurysm 102 is formed (see FIG. 3A). Therefore, when the elongated body 14 is engaged with the aneurysm 102 along the outer surface of the blood vessel 100, the curved portion 42 is elastically deformed by the blood vessel 100 so that the elongated body 14 causes the blood vessel 100 to expand. It will press inward.

  The distal end extending portion 44 connected to the curved portion 42 extends substantially straight from the curved portion 42 toward the proximal end in a plan view (see FIGS. 2A and 2B), and obliquely inward from the middle position. Extend. For this reason, the front-end | tip parts 34b and 36b of the 1st and 2nd arm parts 34 and 36 are arrange | positioned in the position which mutually adjoined compared with the other part. Further, the tip extension portion 44 has a shape that draws a gentle arc shape so as to be continuous with the bending portion 42 in a side view (see FIG. 3A).

  When the distal end placement part 32 is supported by the shaft 12, the insertion part 24 is inserted from the distal end surface of the bundling part 20, and the proximal end parts 34 a and 36 a (proximal end side) of the distal placement part 32 are accommodated by the accommodation support space 30 of the binding part 20. The connecting part 38) is held. As shown in FIG. 2A, in a state where the proximal end side connecting portion 38 of the distal end indwelling portion 32 is held by the binding portion 20, the first arm portion 34 and the second arm portion 36 are elastically deformed so as to approach each other.

  The insertion portion 24 of the elongated body 14 is connected to the distal end placement portion 32 and is inserted through the insertion lumen 22 of the shaft 12 via the binding portion 20, and the proximal end side thereof extends from the proximal end opening 28 of the hub 18. (See also FIG. 1). The surgeon can push the extended insertion portion 24 in the advance direction to move the distal end indwelling portion 32 from the binding portion 20. When the insertion portion 24 is pushed out relative to the bundling portion 20, the long body 14 is separated from the bundling portion 20 at the distal end placement portion 32 as shown in FIG. 2B, and the first arm portion 34 and the second arm 14. The arm portion 36 is restored so as to be separated at a predetermined interval.

  In addition, although the 1st arm part 34 and the 2nd arm part 36 which concern on this Embodiment do not mutually connect the front-end | tip parts 34b and 36b, the 1st arm part 34 and the 2nd arm part 36 are not connected. In the configuration that protrudes toward the distal end and returns to the proximal end, the distal ends 34b and 36b of the first arm portion 34 and the second arm portion 36 may be connected to each other. Thus, if the front end portions 34b and 36b of the first arm portion 34 and the second arm portion 36 are connected to each other, a larger load can be supported by the entire structure of the front end indwelling portion 32.

  When the elongated body 14 is accommodated in the catheter 16, as shown in FIGS. 2C and 3B, the first and second arms are formed by the wall portion (inner wall) of the catheter 16 constituting the accommodation lumen 48. The parts 34 and 36 are accommodated and held in a state of being elastically deformed in a substantially linear shape. Thus, in the aneurysm treatment device assembly 10, the first and second arm portions 34 and 36 are accommodated in the catheter 16 in a substantially linear shape, so that the deliverability in the blood vessel 100 is improved.

  Although the material (elastic material) which comprises the elongate body 14 is not specifically limited, For example, pseudoelastic alloys (including a superelastic alloy) like a Ni-Ti system alloy, a shape memory alloy, stainless steel (For example, SUS304, SUS303, SUS316, SUS316L, SUS316J1, SUS316J1L, SUS405, SUS430, SUS434, SUS444, SUS429, SUS430F, SUS302, etc.) Alloys, carbon-based materials (including piano wires) and the like can be mentioned. In particular, since the superelastic alloy is rich in flexibility and is difficult to bend, it is possible to obtain a high followability to the blood vessel 100 or the like that is curved and bent in a complicated manner by configuring the long body 14 with the superelastic alloy. Excellent restoration performance can be obtained when the catheter 16 is delivered. The preferred composition of the superelastic alloy is Ni-Ti alloy such as Ni-Ti alloy of 49-52 atomic% Ni, Cu-Zn alloy of 38.5-41.5 wt% Zn, 1-10 wt% X Cu-Zn-X alloy (X is at least one of Be, Si, Sn, Al, and Ga), 36-38 atomic% Al-Ni-Al alloy, and the like. Of these, the Ni-Ti alloy is particularly preferable.

  In this case, the long body 14 is deformed based on the transformation temperature of the material at the time of casting to obtain an elastic force for the first and second arm portions 34 and 36 to return from a substantially straight shape to a natural state. It is preferable that the tip indwelling portion 32 (and the insertion portion 24) is formed by applying strain. Of course, it is not limited to such a manufacturing method, For example, you may shape | mold the elongate body 14 from a linear strand by plastic deformation.

  Or the elongate body 14 employ | adopts the raw material (for example, Ni-Ti type alloy) by which the shape of the front-end | tip indwelling part 32 is memorize | stored thermomechanically, and predetermined | prescribed heat is given, The front-end | tip indwelling part 32 You may comprise so that a restoration may be accelerated | stimulated.

  In the long body 14 according to the present embodiment, the cross-sectional shape of the wire constituting the first and second arm portions 34 and 36 is circular. Thereby, the slidability of the 1st and 2nd arm parts 34 and 36 with respect to the catheter 16 can be improved. It is needless to say that the cross-sectional shape of the wire is not limited to a circle, and for example, it may be formed in a square shape (including a polygonal shape, a flat plate shape, etc.). By being formed into a square shape in this way, the planar portion of the long body 14 can be brought into surface contact with the wall portion of the aneurysm 102 to improve adhesion, and the long body 14 can be placed more favorably. It can be carried out.

  Further, the tip end portions 34 b and 36 b of the first and second arm portions 34 and 36 are provided with buffer members 45 made of a material that is more flexible than the long body 14. The buffer member 45 serves to relieve stress when the first and second arm portions 34 and 36 abut against the knob 102, thereby preventing the knob 102 from bursting.

  4A is a first diagram for explaining the main part of the separation mechanism 50 and the function of the bundling part 20, and FIG. 4B is a second diagram for explaining the main part of the separation mechanism 50 and the function of the bundling part 20. FIG. FIG. 4C is a third diagram for explaining the functions of the main part of the separation mechanism 50 and the bundling part 20, and FIG. 4D is a fourth diagram for explaining the main parts of the separation mechanism 50 and the function of the bundling part 20. FIG.

  The long body 14 is accommodated in the catheter 16 together with the shaft 12 while being supported by the bundling portion 20 at the distal end of the shaft 12, and is delivered to a treatment target site (aneurysm 102) in the blood vessel 100. As shown in FIGS. 4A to 4D, a rectangular accommodation support space 30 is formed along the outer shape (substantially rectangular parallelepiped shape) inside the binding portion 20 that supports the long body 14. The accommodation support space 30 communicates with a distal end opening 30 a formed on the distal end surface of the binding unit 20. Further, a passage 31 narrower than the accommodation support space 30 is communicated with the proximal end side of the accommodation support space 30, and a proximal end opening 30 b of the passage 31 is formed on the proximal end surface of the bundling portion 20. Yes. The width of the accommodation support space 30 is shorter than the width between the base end extension portions 40 of the first and second arm portions 34, 36. As described above, the first and second arm portions 34, 36 can be held close to each other.

  Further, a detachment mechanism 50 is provided in the insertion lumen 22 near the distal end of the shaft 12 on the proximal end side with respect to the binding portion 20. The detachment mechanism 50 has a function of cutting the insertion portion 24 of the long body 14 based on the operation of the operator. The detachment mechanism 50 includes an operating element 52 (see FIG. 1) operated by an operator, a driving mechanism 56 connected to the operating element 52 via an operating line 54, and an insertion portion 24 under the action of the driving mechanism 56. And a cutting blade 58 for cutting.

  The operation element 52 is provided so as to be exposed on the side peripheral surface of the hub 18 and is movable in the distal direction, and one end of the operation line 54 is connected thereto. The surgeon moves the operation element 52 in the distal direction at a desired timing. As a result, the operating force of the operator 52 is transmitted to the drive mechanism 56.

  The drive mechanism 56 is disposed on a wall portion that constitutes the insertion lumen 22, and a cutting blade 58 that can move in the insertion lumen 22 in the radial direction is accommodated therein. The drive mechanism 56 mechanically converts the operation force of the operation element 52 received via the operation line 54 to operate the cutting blade 58. The drive mechanism 56 is configured to return the cutting blade 58 to the original position based on the operation cancellation of the operation element 52.

  The drive mechanism 56 is not limited to such a configuration, and may adopt other mechanical mechanisms or electrical mechanisms. For example, a motor (not shown) may be provided inside the drive mechanism 56 as an electrical mechanism, and the cutting blade 58 may be driven by supplying electric power to the motor. In this case, the operation element 52 may be a switch for switching on / off the power supply.

  The cutting blade 58 is provided in the drive mechanism 56 so as to be able to advance and retract within the insertion lumen 22 under the drive action of the drive mechanism 56. When the operation element 52 is not operated normally, as shown in FIGS. 4A and 4B, the cutting blade 58 exists in the drive mechanism 56, and the movement (sending) of the long body 14 in the axial direction is ensured. Yes. When cutting the long body 14, the operator 52 is operated, so that the cutting blade 58 moves forward with respect to the long body 14 and cuts the insertion portion 24 as shown in FIG. 4C. As a result, the distal placement portion 32 and the distal insertion portion 24 are separated (detached) from the proximal insertion portion 24 (see FIG. 4D).

  The separation mechanism 50 may employ various configurations other than the above configuration. For example, the long body 14 is composed of two members, and these are physically (fitted, hooked, etc.) engaged and detachably connected, or the long body 14 is subjected to some physical action (thermal action, chemical action). It is possible to adopt a configuration in which the parts are detachably connected by being separated by a manual action or the like. Hereinafter, some configuration examples of other separation mechanisms will be described.

  In the detachment mechanism 50A according to the first configuration example shown in FIG. 5A, the insertion portion 24 of the elongated body 14 includes two members (a first insertion portion 24a and a second insertion portion 24b), and the base portion of the first insertion portion 24a. 60 and the tip of the second insertion portion 24b having the hollow portion 62 are fitted. The fitting force (coupling force) between the base portion 60 and the second insertion portion 24b is fitted and maintained in a connected state until the force for detaching both is less than a predetermined value, but when a force exceeding a predetermined value is applied. Is set to such a fitting force that the first insertion part 24a and the second insertion part 24b are detached by disengagement. According to the detachment mechanism 50A configured as described above, the first insertion portion 24a is moved from the second insertion portion 24b by winding the first insertion portion 24a around the knob 102 and then moving the second insertion portion 24b backward. It can be automatically detached. In FIG. 5A, the base 60 is inserted into the hollow portion 62 and the two are fitted together. However, a configuration in which the relationship between the fitting male and female is reversed may be used.

  The detachment mechanism 50B according to the second configuration example illustrated in FIG. 5B is configured such that the base 60 of the first insertion portion 24a and the tip of the second insertion portion 24b are screwed together. Specifically, a male screw 64 is formed on the outer peripheral portion of the base portion 60, and a female screw 66 is formed on the inner peripheral portion of the second insertion portion 24b. The male screw 64 and the female screw 66 are formed so as to be disengaged by rotating the second insertion portion 24b when performing a procedure for treating the aneurysm 102. According to the detachment mechanism 50B configured as described above, after the first insertion portion 24a is wound around the knob 102, the second insertion portion 24b is rotated to automatically remove the first insertion portion 24a from the second insertion portion 24b. Can be removed. In FIG. 5B, the male screw 64 provided in the base portion 60 is configured to be screwed into the female screw 66 provided in the second insertion portion 24b, so that both are connected. The structure which reversed the relationship of male and female may be sufficient.

  The detachment mechanism 50C according to the third configuration example shown in FIG. 5C is wound in a coil shape around the outer periphery of the connecting portion 68, which connects the base portion 60 of the first insertion portion 24a and the distal end of the second insertion portion 24b. Heater 70 and first and second conducting wires 72 and 74 connected to the heater 70. The connecting portion 68 is made of a material (for example, resin, low melting point metal, or the like) that can be melted and broken when heated. The first conducting wire 72 is connected to one end of the heater 70, the second conducting wire 74 is connected to the other end of the heater 70, and the first and second conducting wires 72, 74 are inside the hollow portion 62 of the second insertion portion 24b. Is connected to the power source at the end opposite to the side connected to the heater 70. The power source may be either direct current or alternating current. According to the separation mechanism 50C configured in this way, after the first insertion portion 24a is wound around the knob 102, the heater 70 is energized through the first and second conductive wires 72 and 74 to generate heat. By melting and breaking the connecting portion 68, the first insertion portion 24a can be detached from the second insertion portion 24b.

  The disengagement mechanism 50D according to the fourth configuration example shown in FIG. 5D includes a hook portion 76 provided at the base portion 60 of the first insertion portion 24a and a hook provided at the tip of the second insertion portion 24b and engaged with the hook portion 76. And a joint portion 78. The engagement force (coupling force) between the hook portion 76 and the engagement portion 78 is related to the hook portion 76 by pushing the second insertion portion 24b slightly toward the distal end side with the distal end indwelling portion 32 disposed inside the knob 102. Since the engagement with the joint portion 78 is released, the first insertion portion 24a can be detached from the second insertion portion 24b. According to the detachment mechanism 50D configured as described above, when the second insertion portion 24b is rotated, the first insertion portion 24a and the second insertion portion 24b are disengaged from each other. It can be made to detach | leave from 2 insertion part 24b.

  A separation mechanism 50E according to the fifth configuration example shown in FIG. 5E includes an interposed member 82 having a ball-shaped portion 80, a tension member 84 that pulls the interposed member 82 into the base portion 60 of the first insertion portion 24a, and a second member The holding ring 86 provided in the front-end | tip part of the insertion part 24b, and the release wire 88 penetrated by the 2nd insertion part 24b are provided. For example, the release wire 88 is connected to the operation element 52 provided in the hub 18, and is pulled back in the proximal direction by the operation of the operation element 52. In a state where the release wire 88 is sandwiched between the retaining ring 86 and the ball-shaped portion 80 (a state where the ball-shaped portion 80 and the release wire 88 are fixed), the ball-shaped portion 80 passes through the retaining ring 86. Since the movement into the base portion 60 is prevented, the connected state of the first insertion portion 24a and the second insertion portion 24b is maintained. On the other hand, when the operating element 52 is operated and the release wire 88 is pulled in the proximal direction, the release wire 88 is detached from between the holding ring 86 and the ball-shaped portion 80, so that the ball-shaped portion 80 moves inside the holding ring 86. The ball-shaped part 80 moves into the base part 60 under the tension action of the tension member 84. Thereby, the 1st penetration part 24a can be detached from the 2nd penetration part 24b.

  Other configurations of the detachment mechanism 50 include a configuration in which the long body 14 is separated by electrolysis, or a fluid pressure is applied to the long body 14 to cut the base portion of the long body 14 and the connecting portion of the shaft 12. A configuration for detaching may be employed.

  The aneurysm treatment device assembly 10 according to the present embodiment is basically configured as described above, and the operation and effect thereof will be described below. 6A is a first perspective view illustrating a method of using the aneurysm treatment device assembly 10, FIG. 6B is a cross-sectional view of a formation portion of the aneurysm 102 in FIG. 6A, and FIG. 7A is an aneurysm treatment device set. FIG. 7B is a cross-sectional view of a portion where the aneurysm 102 is formed in FIG. 7A, and FIG. 8A is an explanatory view illustrating a method of using the aneurysm treatment device assembly 10. FIG. 8B is a cross-sectional view of a portion where the aneurysm 102 of FIG. 8A is formed, and FIG. 9A is a fourth perspective view illustrating how to use the aneurysm treatment device assembly 10. 9B is a cross-sectional view of the formation site of the aneurysm 102 in FIG. 9A, FIG. 10A is a fifth perspective view illustrating how to use the aneurysm treatment device assembly 10, and FIG. 10B is an aneurysm in FIG. 10A. FIG. 11A is a cross-sectional view of the formation location of 102, and FIG. 10 is a sixth perspective view of illustrating how to use, FIG. 11B is a sectional view of the area where the aneurysm 102 in FIG 11A.

  As described above, the aneurysm treatment device assembly 10 according to the present exemplary embodiment is used for the treatment of the aneurysm 102 including the reservoir 104 into which blood flows and the neck 106 communicating with the reservoir 104 and the blood vessel 100. Preferably used. Of course, the aneurysm treatment device assembly 10 may be used to treat an aneurysm 102 that does not have a neck 106. The aneurysm 102 is formed, for example, by weakening the wall portion (blood vessel wall) of the blood vessel 100 (artery) due to arteriosclerosis or the like, and the portion is pushed by the blood flow and gradually expands. Normally, the aneurysm 102 is formed in a bag shape by the enlarged reservoir 104, and blood flows into the bag through the opening 108 communicating with the blood vessel 100. Examples of blood vessels in which the aneurysm 102 is generated include arteries, veins, and peripheral blood vessels. Examples of the aneurysm 102 include a cerebral aneurysm, an abdominal aneurysm, a thoracic aneurysm, a coronary aneurysm, a popliteal aneurysm, a femoral aneurysm, a carotid aneurysm, and a varicose vein.

  Here, the aneurysm treatment method using the aneurysm treatment device assembly 10 will be schematically described. In the aneurysm treatment method, the aneurysm treatment device assembly 10 in which the distal end indwelling portion 32 is supported by the shaft 12 is replaced with an accommodation lumen of the catheter 16. 48, the catheter 16 is delivered, and the distal end opening 48a of the receiving lumen 48 is positioned in the opening 108 of the knob 102. The shaft 12 and the elongated body 14 are moved forward together. Then, the long body 14 is delivered from the distal end opening 48a, and the distal end indwelling portion 32 is inserted into the aneurysm 102, so that the aneurysm 102 is pressed from the inside so as to be pressed against the outer surface of the blood vessel 100 (disengagement step). A third step (detachment step) in which the distal end placement portion 32 is detached from the shaft 12 by the mechanism 50 and placed in the aneurysm 102, the shaft 2 and the fourth step of retracting the catheter 16 from within the vessel 100 (backward step) are carried out sequentially. As a result, the aneurysm 102 can be brought into close contact with the blood vessel 100. Hereinafter, each step will be described in detail.

[Delivery step]
In the delivery step, a guiding catheter (not shown) is inserted into the blood vessel 100 percutaneously from a predetermined position (for example, a thigh), and the guide wire is inserted into the blood vessel 100 in advance. (Not shown) is moved to a position close to the location where the bump 102 is generated. After the guide wire is removed, the catheter 16 configured as a microcatheter is inserted through the lumen of the guiding catheter, and the catheter 16 is delivered to the site where the aneurysm 102 is generated.

  For example, the distal end portion of the catheter 16 has a gently curved shape (for example, the right shape of Judkins) with respect to the axial direction of the blood vessel 100, or the shape of the catheter 16 is brazed so as to be bent approximately 90 °. When the distal end portion is delivered from the opening of the guiding catheter, as shown in FIG. 6A, the curved portion 90 bends 90 ° from the linear shape on the proximal end side so that the distal end opening 48a faces the wall portion of the blood vessel 100. Transformed into Note that the distal end portion of the catheter 16 may be configured to bend with a wire or the like, for example.

  Moreover, the catheter 16 shown to FIG. 6A-FIG. 11B becomes a suitable shape when treating the aneurysm 102 formed in the side peripheral surface of the blood vessel 100 extended linearly. However, the present invention is not limited to this, and it is preferable that the aneurysm treatment device assembly 10 is selected from the catheter 16 having an appropriate shape in accordance with the treatment site (where the aneurysm 102 occurs). For example, when the aneurysm 102 is formed at a site where the blood vessel 100 branches in a substantially Y-shape, the distal end opening 48 a is formed at the opening 108 of the aneurysm 102 using a straight catheter without the curved portion 90. What is necessary is just to oppose.

  As shown in FIG. 6B, the catheter 16 is guided in the blood vessel 100 based on the operation of the operator, and is disposed at an opposing position where the distal end opening 48 a overlaps the opening 108 of the aneurysm 102. At the time of delivery of the catheter 16, the aneurysm treatment device assembly 10 (the long body 14 and the shaft 12) may be arranged in advance at the distal end position of the accommodation lumen 48.

[Transmission step]
After the delivery step, the delivery step is performed as shown in FIGS. 7A-10B. In the delivery step, the shaft 12 and the elongated body 14 are moved forward by moving the hub 18 of the shaft 12 with the distal end opening 48a of the catheter 16 positioned and fixed to the opening 108 of the aneurysm 102. In this case, the base body side connecting portion 38 of the long body 14 is accommodated and supported by the bundling portion 20, so that the long body 14 is integrally advanced as the shaft 12 is advanced.

  As shown in FIG. 7A, along with this advancement movement, the long body 14 (the tip indwelling portion 32) is guided along the accommodation lumen 48, and the tip portions 34b, 36b (the first and second arm portions 34, 36) ( The buffer member 45) is exposed from the tip opening 48a. As a result, the distal end indwelling portion 32 is inserted into the knob 102. As described above, the distal end indwelling portion 32 is brazed so as to have a substantially C shape in a natural state, and is deformed from a substantially linear accommodation state to a substantially C shape with exposure from the distal end opening 48a. The resilience to work. For this reason, as shown to FIG. 7B, the front-end | tip parts 34b and 36b operate | move so that it may contact | abut to the wall part 102a of this knob 102 in the knob 102 positively.

  Further, in the first and second arm portions 34 and 36, the distal end extending portion 44 is curved inward in a plan view, and the distal end portions 34b and 36b are disposed at relatively close positions. Furthermore, the first and second arm portions 34 and 36 are closer to each other because the base end portions 34 a and 36 a are accommodated in the narrow portion by the binding portion 20. For this reason, for example, even when the opening 108 of the knob 102 is narrow, the tip portions 34 b and 36 b can be easily inserted into the knob 102.

  And since the buffer member 45 is provided in the front-end | tip parts 34b and 36b, this buffer member 45 positively contacts the wall part 102a of the knob 102. FIG. Thereby, the stress (restoring force) of the tip indwelling portion 32 can be applied to the wall portion 102a without damaging the knob 102.

  As shown in FIGS. 8A and 8B, when the shaft 12 is further moved forward, the distal indwelling portion 32 is sent out from the catheter 16, and the distal indwelling portion 32 moves forward in the aneurysm 102 so as to involve the aneurysm 102. That is, due to the restoring force of the distal end indwelling portion 32, the distal end portions 34b and 36b of the first and second arm portions 34 and 36 are given elastic force so as to be directed in the opposing direction of the proximal end portions 34a and 36a. As a result, the distal indwelling portion 32 closely contacts the aneurysm 102 along the outer surface on one side of the blood vessel 100 (the left side in FIG. 8B).

  Further, in the delivery step, when the distal end indwelling portion 32 enters the aneurysm 102 to some extent, the advance operation of the shaft 12 is temporarily stopped and only the long body 14 is moved forward. Specifically, the surgeon pushes the insertion portion 24 extending from the proximal end opening 28 of the hub 18 to further advance the distal placement portion 32. Thereby, the tip indwelling part 32 is detached from the binding part 20.

  As shown in FIGS. 9A and 9B, the tip placement part 32 operates so that the first arm part 34 and the second arm part 36 that are close to each other are separated by being detached from the binding part 20. For this reason, the aneurysm 102 into which the first arm portion 34 and the second arm portion 36 are inserted spreads along the axial direction of the blood vessel 100, and the aneurysm 102 extends in a wide range along the axial direction of the blood vessel 100. Get close.

  Further, in the delivery step, the shaft 12 (hub 18) and the elongated body 14 (insertion portion 24) are moved forward while the first arm portion 34 and the second arm portion 36 are separated from each other. As a result, the entire distal indwelling portion 32 is delivered from the distal end opening 48a of the catheter 16 as shown in FIGS. 10A and 10B. In this case, the distal end indwelling portion 32 has the distal end portions 34b and 36b advanced to the vicinity of the top portion (back portion) of the reservoir portion 104 of the knob 102, and the first and second arm portions 34 and 36 (proximal end extension). The outer surface of the blood vessel 100 can be sandwiched via the aneurysm 102 by the portion 40, the curved portion 42, and the distal end extending portion 44). Thereby, the state in which the aneurysm 102 extends along the circumferential direction of one side surface (the left side surface in FIG. 10B) of the blood vessel 100 and the aneurysm 102 is in close contact with the outer surface of the blood vessel 100 is formed.

[Leaving step]
After the sending step, the leaving step is performed as shown in FIG. 10B. In the detachment step, the detachment mechanism 50 is operated in a state where the aneurysm 102 is brought into close contact with the outer surface of the blood vessel 100 by the elongated body 14. That is, by operating the operation element 52 of the hub 18, the cutting blade 58 of the detachment mechanism 50 is moved forward into the insertion lumen 22, and the insertion portion 24 is cut (see also FIG. 4C). As a result, the distal end side of the elongated body 14 (the distal end placement portion 32 and the distal end portion of the insertion portion 24) is detached from the shaft 12 and the insertion portion 24 (see also FIG. 4D). In this way, by removing the elongated body 14 by the detaching mechanism 50, the distal end indwelling portion 32 can be placed with the aneurysm 102 in close contact with the outer surface of the blood vessel 100.

[Backward step]
After the separation step, a backward step is performed as shown in FIGS. 11A and 11B. In the retreating step, the aneurysm treatment device assembly 10 is accommodated in the catheter 16 by retreating the hub 18, and then the aneurysm treatment device assembly 10 and the catheter 16 are moved backward together so as to move from within the blood vessel 100. Remove. Thereby, the tip indwelling part 32 is locked in the knob 102. In this locked state, the aneurysm 102 can be sandwiched from the inside so as to be pressed against the outer surface of the blood vessel 100 by the distal end indwelling portion 32. At this time, the bending engagement portion 46 of the distal end placement portion 32 is brought into contact with a part of the opening portion 108, and the insertion portion 24 connected to the bending engagement portion 46 is connected to the other portion of the opening portion 108 (with the bending engagement portion 46. The tip indwelling portion 32 is hooked on the knob 102 and can be locked more reliably.

  As described above, according to the aneurysm treatment device assembly 10 and the aneurysm treatment method using the aneurysm treatment device assembly 10 according to the present embodiment, the long body 14 is delivered from the distal end opening 48 a of the housing lumen 48. By inserting the distal end indwelling part 32 into the aneurysm 102 and detaching the distal end indwelling part 32, the distal end indwelling part 32 can sandwich the aneurysm 102 from the inside so as to press against the outer surface of the blood vessel 100. As a result, the aneurysm 102 extends along the circumferential direction of the blood vessel 100, and the aneurysm 102 is brought into close contact with the outer surface of the blood vessel 100, that is, the aneurysm 102 does not protrude from the blood vessel 100. After the treatment with the aneurysm treatment device assembly 10, since the distal indwelling portion 32 is indwelled, the state in which the aneurysm 102 is in close contact with the blood vessel 100 is maintained, so that the biological tissue is surely compressed by the aneurysm 102. Can be deterred.

  In addition, the opening 108 of the aneurysm 102 is closed by making the aneurysm 102 come into close contact with the blood vessel 100 easily and reliably. When the opening 108 is closed in this way, blood does not flow into the aneurysm 102, and the blood in the aneurysm 102 coagulates as time elapses, thereby preventing the rupture of the aneurysm 102.

  Further, in the aneurysm treatment device assembly 10, when the curved portion 42 is formed with a larger curvature than the curvature in the circumferential direction of the blood vessel 100, the aneurysm 102 is sandwiched along the outer surface of the blood vessel 100 by the distal placement portion 32. In addition, an appropriate pressing force can be applied to the blood vessel 100 and the aneurysm 102, and the blood vessel 100 and the aneurysm 102 can be sandwiched more firmly.

  Still further, the long body 14 moves forward relative to the shaft 12 based on the advance operation of the insertion portion 24, so that the distal end indwelling portion 32 can be easily pushed into the back side of the knob 102, and the distal end indwelling is performed. It is possible to easily sandwich the knob 102 by the portion 32. At this time, the distal end portions 34 b and 36 b slide smoothly without damaging the knob 102 by the buffer member 45, and can be easily brought into close contact with the outer surface of the blood vessel 100.

  Further, by forming the tip placement part 32 with the first and second arm parts 34 and 36, the knob 102 can be spread in the width direction and stably sandwiched by the first and second arm parts 34 and 36. .

  In the above description, the present invention has been described with reference to preferred embodiments. However, the present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the scope of the present invention. Needless to say. For example, in the above-described embodiment, the configuration of the long body 14 in which the insertion portion 24 and the tip placement portion 32 are integrally formed has been described. However, the configuration is not limited thereto, and the tip placement portion 32 without the insertion portion 24 being provided. It is good also as a structure which makes only the tip of the shaft 12 support, and the advancement movement and detachment | leave of the tip placement part 32 are performed by operation of the shaft 12.

[Modification]
FIG. 12 is a schematic perspective view showing an overall configuration of an aneurysm treatment device assembly 10A according to a modification of the present invention. An aneurysm treatment device assembly 10 </ b> A according to the modification is different from the aneurysm treatment device assembly 10 according to the present embodiment in that one arm portion 92 extends from the distal end portion of the shaft 12.

  In this case, the arm portion 92 is formed in the same shape as the first and second arm portions 34 and 36 of the aneurysm treatment device assembly 10, that is, in a substantially C shape from the base end portion 92a to the tip end portion 92b. It can be made into the shape which has the edge extension part 40, the curved part 42, and the front-end | tip extension part 44. FIG. Thus, even if the distal indwelling portion 32A is constituted by one arm portion 92 (elongate body 14A), the aneurysm 102 can be brought into close contact with the outer surface of the blood vessel 100, and the aneurysm treatment device according to the present embodiment. An effect similar to that of the assembly 10 can be obtained.

  Further, the distal end indwelling portion 32A is configured by one arm portion 92, whereby the shaft 12 can be made thin, and the distal end indwelling portion 32A can be easily delivered to the treatment target site (the aneurysm 102) and the inside of the aneurysm 102 The arm portion 92 can be easily inserted into. Further, the tip placement portion 32A configured by one arm portion 92 can sandwich the knob 102 having various shapes.

DESCRIPTION OF SYMBOLS 10, 10A ... Aneurysm treatment device assembly 12 ... Shaft 14, 14A ... Long body 18 ... Hub 20 ... Bundling part 22 ... Insertion lumen 24 ... Insertion part 30 ... Accommodating support space 32, 32A ... Tip placement part 34 ... First Arm part 36 ... second arm part 40 ... proximal end extension part 42 ... bending part 44 ... distal end extension part 45 ... buffer member 46 ... bending engagement part 50, 50A to 50E ... detachment mechanism 92 ... arm part 100 ... blood vessel 102 ... Lumbar 108 ... Opening

Claims (8)

A linear indwelling portion having a predetermined elastic force;
A long shaft that supports the indwelling part,
The indwelling portion extends in the distal direction from the proximal end portion to the curved portion in a natural state, curves in a substantially arc shape at the curved portion, and extends in the proximal direction from the curved portion to the distal end portion. In a state where the existing aneurysm is inserted into the aneurysm formed in the living body lumen so as to press the aneurysm against the outer surface of the living body lumen, and the aneurysm is inserted, An aneurysm treatment device assembly which is detachable from a shaft. The aneurysm treatment device assembly according to claim 1.
The shaft has an axially extending lumen and an opening through which the lumen communicates,
The indwelling portion is provided so as to extend from a distal end of an insertion portion disposed in the lumen, and moves forward relative to the shaft by the advancement operation of the insertion portion. Aneurysm device assembly. The aneurysm treatment device assembly according to claim 2.
An aneurysm treatment device assembly, wherein the shaft or the indwelling part is provided with a detachment mechanism that separates the insertion part and enables the separated insertion part on the distal end side to be detached from the shaft. The aneurysm treatment device assembly according to any one of claims 1 to 3,
The indwelling portion is constituted by a single linear arm portion in which the proximal end portion, the bending portion, and the distal end portion are continuous. An aneurysm treatment device assembly. The aneurysm treatment device assembly according to any one of claims 1 to 3,
The indwelling portion is constituted by a pair of linear arm portions in which the base end portion, the bending portion, and the distal end portion are continuous,
An aneurysm treatment device assembly, wherein the pair of arm portions are connected so that the base end portions are connected to each other, and the bending portion and the distal end portion are adjacent to each other in the width direction. An aneurysm treatment device assembly according to claim 5,
An aneurysm treatment device assembly, wherein a bundling portion capable of holding the pair of arm portions so as to be close to each other is provided at a distal end portion of the shaft. The aneurysm treatment device assembly according to any one of claims 1 to 6,
An aneurysm treatment device assembly characterized in that a cushioning member that is more flexible than the distal end portion is provided at the distal end portion of the indwelling portion. It has a predetermined elastic force and extends in the distal direction from the proximal end portion to the curved portion in a natural state, bends in a substantially arc shape at the curved portion, and proximally from the curved portion to the distal end portion An aneurysm treatment device assembly comprising a linear indwelling portion having a shape extending toward the inward shape and a long shaft that supports the indwelling portion is accommodated in an accommodation lumen of a catheter, and is formed in a living body lumen A delivery step of positioning the opening of the receiving lumen in the opening of the aneurysm;
After the delivery step, the indwelling portion is advanced from the opening of the receiving lumen, and the indwelling portion is inserted into the aneurysm so that the aneurysm is sandwiched from the inside so as to press against the outer surface of the biological lumen. Steps,
An aneurysm treatment method comprising: a step of detaching the indwelling portion from the shaft in a state where the indwelling portion is inserted into the aneurysm after the delivering step.

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