JP2013176488A - Guide wire - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a guide wire which can avoid situations where a tip of the guide wire is captured by a narrowed part and stacked, which has high passability into the narrowed part, and which is preprovided with a bent part.SOLUTION: A guide wire 10 includes: a long core shaft 14; an outside coil body 60 around which at least one wire 69 is wound and which surrounds a tip part of the core shaft 14; a chip 15 which joins a tip of the outside coil body 60 to a tip of the core shaft 14; an inside coil body 50 which is arranged inside the outside coil body 60, around which at least one wire 51 is wound, and which surrounds a tip part of the core shaft 14; an inside tip joint 53 which is arranged in the rear of the chip 15 and which joins a tip of the inside coil body 50 to the core shaft 14; and a bent part 70 which is configured by bending the core shaft 14 in the state of preventing mutual contact between the wires 69 forming the outside coil body 60, between the chip 15 and inside tip joint 53.

Description

  The present invention relates to a medical guide wire.

  Conventionally, various guide wires have been proposed for guiding tubular organs such as blood vessels, gastrointestinal tracts, and ureters, and catheters that are used by being inserted into body tissues for treatment and examination. For example, there are those in which the coil body is provided double at the tip of the core shaft (for example, see Patent Documents 1 and 2 below), those having a stranded wire consisting of a plurality of strands in the coil (for example, See Patent Document 3 below).

  In addition, the guide wire is operated by a surgeon such as a doctor who shapes the tip of the guide wire at an angle according to the condition of the blood vessel or the like when the guide wire is inserted into the patient's body. For convenience, there is a guide wire that is pre-shaped, that is, pre-shaped when the product is shipped (see, for example, Patent Document 4 below).

JP-T 6-501179 JP 2006-511304 Gazette US Patent Application Publication No. 2007/0185415 JP 2010-279881 A

  When the stenosis of the blood vessel represented by chronic total occlusion (CTO) is relatively severe, in order to pass the guide wire through a slight gap existing in the advanced stenosis, It has been found that it is preferable to perform shaping within a very short range of about 1.0 mm from the tip of the guide wire. However, such a short range of shaping is difficult even for a skilled technician. Further, even if pre-shaped like the guide wire shown in the above document 4, the bending is provided over the entire length of the coil, so that the bending must be corrected. If the shape is not properly formed or the pre-shape is not properly corrected, the leading end of the guide wire may be trapped in the stenosis and become so-called stuck state that it becomes difficult to move. Such a situation deteriorates the passage of the guide wire through the constriction.

  The present invention has been made in view of such circumstances, can avoid the situation where the tip of the guide wire is trapped and stuck in the stenosis, and is provided with a pre-bent portion that is highly permeable to the stenosis. It is an object to provide a guide wire.

  The inventor of the present invention has a situation in which the tip portion of the guide wire bent by shaping is bent in the stenosis, and as a result, the gap of the spiral constituting the coil body is disturbed and bent. Caused by a part where the spacing of the wound wire is greatly spread locally on the outside of the coil body, and a part of the calcified lesion constituting the narrowed portion enters the gap of the spread wire I found out that there is. In addition, due to the shape of the guide wire, adjacent wires contact and interfere with each other on the inner side where the guide wire bends. I found out that there is.

  In the present invention, the above problems are solved by the means listed below.

<1> A long core shaft, at least one strand wound, an outer coil body surrounding the tip of the core shaft, and a tip of the outer coil body at the tip of the core shaft A chip to be joined, an inner coil body that is disposed inside the outer coil body, wound with at least one strand, and surrounds the tip portion of the core shaft, and is disposed behind the chip. In the state where the strands forming the outer coil body are not in contact with each other between the inner tip joining portion for joining the tip of the inner coil body to the core shaft, and the tip and the inner tip joining portion, A guide wire having a bent portion obtained by bending the core shaft.

<2> The guide wire according to aspect 1, wherein the outer coil has a smaller diameter of the strand inside the bent portion.

<3> The guide wire according to aspect 1 or 2, wherein the bent portion is formed on the tip side between the tip and the inner tip joint portion.

<4> The guide wire according to any one of aspects 1 to 3, wherein the inner coil body is a tubular stranded coil body formed by twisting a plurality of strands.

<1> The guide wire of the present invention has a bent portion formed by bending the core shaft in a state where the strands forming the outer coil body do not contact each other between the tip and the inner tip joint portion. . For this reason, even if the tip of the guide wire is likely to be captured in a constricted portion or the like, the tip of the guide wire can be swung by the gap between the strands provided in the bent portion, so that without stacking, It can pass through a stenosis. Moreover, since the adjacent strands are not in contact with each other in advance in the bent portion, it is possible to prevent the spacing between the strands from being locally large. Therefore, it is possible to prevent a fragment of a calcified lesion such as a stenosis from entering the gap between the strands and hindering the movement of the distal end portion of the guide wire inside the stenosis or the like. Therefore, the passability of the guide wire can be improved.

  In the present invention, since the inner coil body is provided inside the outer coil body, a space is formed between the core shaft and the outer coil body between the tip and the inner tip joint portion depending on the thickness of the inner coil body. It can be secured. At this time, since the rigidity is ensured by the inner coil body, sufficient rigidity can be obtained even if the core shaft is thinned. For this reason, a bending part provided with the state which does not contact an adjacent strand can be easily formed by having a clearance gap between the strands which comprise an outer side coil body.

<2> In the aspect 2 of the present invention, the diameter of the wire is reduced inside the bent portion. For this reason, a large gap between the strands provided in the bent portion can be ensured, so that the region where the tip of the guide wire swings can be enlarged. Therefore, it is possible to further prevent the tip of the guide wire from being caught and stuck in the narrowed portion or the like.

<3> In the aspect 3 of the present invention, the bent part is formed on the chip side between the chip and the inner tip joint part. For this reason, since it becomes a position away from the front-end | tip of an inner side coil body, a bending part is easy to form. In addition, since the distal end side is shortened from the bent portion, the entrance of a small hole formed in a relatively severe narrowed portion called a microchannel is searched at the distal end of the guide wire, and it is easy to enter and engage. Become. In addition, it is possible to prevent the resistance from increasing when passing through a blood vessel or the like, and to reduce the resistance received when contacting the inner wall or the like of the bending blood vessel. Therefore, the passability of the guide wire can be further improved.

<4> In aspect 4 of the present invention, the inner coil body is formed of a cylindrical stranded wire coil body in which a plurality of strands are twisted together. The stranded wire coil body is highly effective in improving rigidity while maintaining flexibility. For this reason, the diameter of the tip of the core shaft can be further reduced. Therefore, since a sufficient space between the core shaft and the outer coil body can be secured between the tip and the inner tip joint portion, the adjacent wires of the outer coil body are not in contact with each other at the bent portion. It becomes easier.

FIG. 1 is an overall view of a guide wire according to the present embodiment. FIG. 2 is a partially enlarged view of FIG. FIG. 3 is an enlarged view of the bent portion. FIG. 4 is a view showing a guide wire according to another embodiment.

The guide wire of this Embodiment is demonstrated referring FIGS. 1-3. 1 to 3, the right side in the figure is the distal end side (distal side) to be inserted into the body, and the left side is the rear end side (hand side, proximal end side) operated by the operator.
1 and 2 show a straight state before the guide wire is pre-shaped. FIG. 3 is an enlarged view of the most distal portion of the guide wire when pre-shaped. The pre-shape means that a bent portion is provided at the tip of the guide wire in advance when the product is shipped.

  The guide wire has a length of about 1500 mm to about 3000 mm. The guide wire 10 of the present embodiment is mainly used for treatment of blood vessels in the heart and has a length of about 1900 mm. Accordingly, FIGS. 1 and 2 illustrate the guide wire 10 in a state in which the longitudinal direction is smaller than the direction orthogonal to the longitudinal direction in order to make the entire image of the guide wire 10 easy to understand. 1 and 2, the wire 51 of the inner coil body 50, the wire 69 of the outer coil body 60, the chip 15 and the like, which will be described later, are compared with the dimensions of the core shaft 14 for easy understanding. It is exaggerated.

  The guide wire 10 mainly includes a core shaft 14, an inner coil body 50, and an outer coil body 60. The core shaft 14 is roughly divided into a main body portion 20 and a tip portion 30. A hydrophilic coating is applied to the outer surface from the tip of the guide wire 10 through the outer surface of the outer coil body 60 to a predetermined range of the main body 20.

The tip portion 30 is a portion where the core shaft 14 is reduced in diameter, and in the case of the present embodiment, it is about 200 mm to about 600 mm. The main body portion 20 is a cylindrical portion having a constant diameter and occupies a portion other than the tip portion 30. In the case of the present embodiment, the diameter of the main body 20 is set to about 0.25 mm to about 0.45 mm.
The material of the core shaft 14 is not particularly limited, but in the present embodiment, stainless steel (SUS304) is used. As other materials, a super elastic alloy such as a Ni-Ti alloy, a piano wire, or the like is used.

  The tip portion 30 includes a first taper portion 31, a first small diameter portion 32, a second taper portion 33, a second small diameter portion 34, a third taper portion 35, in order from the main body portion 20 toward the tip of the guide wire 10. It has the most advanced part 40.

  In the case of the present embodiment, the first tapered portion 31 has a length of about 30 mm to about 60 mm in the axial direction. The 1st taper part 31 is a taper-shaped part with a circular cross section, and a diameter reduces toward a front-end | tip direction.

  The first small diameter portion 32 is a cylindrical portion having a circular cross section and a constant diameter. In the present embodiment, the diameter is set to about 0.2 mm to about 0.3 mm.

  In the case of the present embodiment, the second taper portion 33 has a length of about 20 mm to about 40 mm in the axial direction. The 2nd taper part 33 is a taper-shaped part with a circular cross section, and a diameter decreases toward a front-end | tip direction.

  The second small diameter portion 34 is a cylindrical portion having a circular cross section and a constant diameter. In the present embodiment, the diameter is set to about 0.14 mm to about 0.25 mm.

  In the case of the present embodiment, the third tapered portion 35 has a length of about 100 mm to about 150 mm in the axial direction. The third tapered portion 35 is a tapered portion having a circular cross section, and has a diameter that decreases in the distal direction. In the case of the present embodiment, the diameter on the tip side of the third tapered portion 35 is set to about 0.045 mm to about 0.15 mm.

  As shown in FIG. 2, the forefront portion 40 includes a first taper flexible portion 41, a first columnar flexible portion 42, a second taper flexible portion 43, in order from the third taper portion 35 side toward the tip of the guide wire 10. And a second columnar flexible portion 44. The tip of the second columnar flexible portion 44 reaches the tip of the chip 15 described later. In the present embodiment, the length in the axial direction of the most distal portion 40 excluding the length of the chip 15 is set to about 5 mm to about 30 mm.

The first taper flexible portion 41 is a tapered portion having a circular cross section. The first columnar flexible portion 42 is a cylindrical portion having a circular cross section and a constant diameter.
The first tapered flexible portion 41 is configured such that the diameter decreases from the distal end of the third tapered portion 35 toward the first columnar flexible portion 42. In the case of the present embodiment, the diameter of the first columnar flexible portion 42 is set to about 0.04 mm to about 0.1 mm.

  The second tapered flexible portion 43 and the second columnar flexible portion 44 are portions that are flattened with a substantially rectangular cross section by pressing a portion on the tip side from the first columnar flexible portion 42. The second taper flexible portion 43 is a portion having a flat surface inclined such that the height direction becomes shorter toward the tip of the core shaft 14. The 2nd columnar flexible part 44 is a part which has a substantially parallel plane. In the present embodiment, the height (thickness) of the second columnar flexible portion 44 is set to about 0.02 mm to about 0.8 mm by pressing.

The inner coil body 50 is attached to the core shaft 14 so as to surround about half of the first columnar flexible portion 42 from the distal portion of the third tapered portion 35 at the tip portion 30 of the core shaft 14. After the inner coil body 50 is tightly twisted so that a plurality of metal strands 51 are in contact with the core metal, the residual stress when twisted is removed by a known heat treatment method, and the core metal is removed. It is the cylindrical twisted-wire coil body manufactured by extracting. In the present embodiment, the outer diameter of the inner coil body 50 is set to about 0.1 mm to about 0.2 mm.
In the case of the present embodiment, eight strands 51 are used for the inner coil body 50. The diameter of the strand 51 is set to about 0.015 mm to about 0.04 mm.

  Although the material of the strand 51 is not specifically limited, In the case of this Embodiment, stainless steel is used. As other materials, a super elastic alloy such as a Ni-Ti alloy is used. It is also possible to combine strands of different materials. The number of the strands 51 is not particularly limited.

  The tip of the inner coil body 50 is joined to the first columnar flexible portion 42 of the most distal portion 40 coaxially with the core shaft 14 by brazing. The brazing portion forms an inner tip joint portion 53 by a brazing member.

  The rear end of the inner coil body 50 is joined to the distal portion of the third tapered portion 35 by brazing. The brazed portion forms an inner rear end joined portion 52 by a brazing member.

  The inside of the outer coil body 60 surrounds a position from about half of the second small diameter portion 34 to the tip of the most distal end portion 40 at the tip portion 30 of the core shaft 14. The outer coil body 60 is formed by winding a single metal wire 69 and has a coil body portion 61, a taper coil portion 62, and a tip straight coil portion 63 in order from the rear end side. .

  The coil main body 61 is a portion around which the wire 69 is wound so as to have a constant outer diameter. In the case of the present embodiment, the outer diameter of the coil body 61 is set to about 0.25 mm to about 0.45 mm. The length of the coil body 61 in the axial direction is set to about 50 mm to about 150 mm. In the coil main body 61, the strands 69 are wound closely so that adjacent strands 69 forming a spiral come into contact with each other.

  The taper coil portion 62 is a portion around which the wire 69 is wound so that the outer diameter decreases in the distal direction. In the present embodiment, the length of the taper coil portion 62 in the axial direction is set to about 10 mm to about 50 mm. In the taper coil portion 62, the strands 69 are wound closely so that adjacent strands 69 forming a spiral come into contact with each other.

  The tip straight coil portion 63 is a portion wound so that the strand 69 has a constant outer diameter. In the case of the present embodiment, the outer diameter of the distal straight coil portion 63 is set to about 0.2 mm to about 0.3 mm, and the axial length is set to about 30 mm or less. The distal straight coil portion 63 has a densely wound portion 63a wound closely so that adjacent strands 69 forming a spiral on the rear end side come into contact with each other, and between the adjacent strands 69 adjacent to the distal end side. Has a sparsely wound portion 63b in which the wire 69 is sparsely wound so that there is a gap. The loosely wound portion 63b increases the flexibility of the distal end portion of the outer coil body 60 and forms a bent portion 70 which will be described later.

The strand 69 of the outer coil body 60 is made of a radiopaque metal wire such as a platinum alloy. The diameter of the strand 69 is set to about 0.05 mm to about 0.1 mm in the present embodiment.
The element wire 69 of the outer coil body 60 is composed of one element wire in which a radiopaque metal wire such as platinum alloy and a radiolucent metal wire made of stainless steel or the like are joined. The range of about 30 mm on the front end side of the body 60 may be a coil body wound with a radiopaque strand, and the remaining rear end side may be a coil body wound with a radiolucent strand.

The distal end of the outer coil body 60 is joined to the distal end of the core shaft 14 by brazing so as to be coaxial with the core shaft 14. The brazing portion forms a chip 15 with a brazing member.
In the present embodiment, the length of the tip 15 in the axial direction is about 0.5 mm to 0.7 mm. The tip 15 has a base portion 15a, an inclined portion 15b, and a tip arc portion 15c in order from the rear end side.

  The base portion 15a is a portion that fixes the tip of the outer coil body 60 to the tip of the core shaft 14, and occupies a length corresponding to 1 to 4 pitches of the outer coil body 60 (see FIG. 3). For this reason, the outer diameter of the base portion 15 a substantially matches the outer diameter of the tip straight coil portion 63 of the outer coil body 60.

The inclined portion 15b is a portion in which the outer diameter of the chip 15 is reduced toward the tip.
The tip arc portion 15c is a portion formed in an arc shape so that the tip of the tip 15 is not excessively sharp. The tip of the core shaft 14 reaches the tip of the tip arc portion 15c, and is formed into an arc shape together with the tip arc portion 15c.

  The rear end of the outer coil body 60 is joined to the second small diameter portion 34 by brazing. The brazing portion forms an outer rear end joint portion 66 by a brazing member.

  The outer coil body 60 is joined to the third tapered portion 35 of the core shaft 14 by brazing on the rear end side of the tapered coil portion 62. The brazing portion forms an outer intermediate joint portion 65 by a brazing member.

A tip gap 54 is formed between the inner tip joint portion 53 and the chip 15 inside the loosely wound portion 63 b of the outer coil body 60. That is, the inner coil body 50 is not arranged up to the tip 15 that is the tip of the core shaft 14, and is located on the rear end side of the tip 15 with the tip gap 54 interposed. As a result, a sufficient gap is formed between the outer peripheral surface of the most distal portion 40 of the core shaft 14 and the outer coil body 60, so that a bent portion 70 described later can be easily formed.
In the present embodiment, the distance from the tip of the chip 15 to the inner tip joint portion 53 is set to about 2 mm to about 15 mm.

  As shown in FIG. 3, a bent portion 70 is formed by bending the guide wire 10 in advance in a certain direction between the tip 15 and the inner tip joint portion 53. In the case of the present embodiment, the bent portion 70 is formed in the second columnar flexible portion 44 of the most distal portion 40. For this reason, the direction in which the bent portion 70 is bent is bent in a direction perpendicular to the long side of the substantially rectangular cross section of the second columnar flexible portion 44 where the flat second columnar flexible portion 44 is easily bent.

  As described above, the bent portion 70 is positioned between the tip 15 and the inner tip joint portion 53 where a sufficient gap is formed between the outer peripheral surface of the most distal portion 40 of the core shaft 15 and the outer coil body 60. Is formed. In order to allow the guide wire 10 to enter a relatively severe constricted portion, the bent portion 70 is preferably formed at a position closer to the tip of the guide wire 10. For this reason, the bent part 70 is located on the chip 15 side between the chip 15 and the inner tip joint part 53. Further, since this arrangement is a position away from the tip of the inner coil 50, there is an advantage that the bent portion 70 can be easily formed.

  More specifically, in FIG. 3, when the axis of the guide wire 10 in the natural state is C1 and the axis of the distal end portion from the bent portion 70 is C2, the position of the bent portion 70 is the tip 15. Is represented by a bending distance L from the tip of the axis to the intersection CX of the axis C1 and the axis C2. In the present embodiment, the bending distance L is set to a range of about 0.8 mm to about 1.2 mm, and is about 1.0 mm. If the bending distance L exceeds about 1.2 mm, the resistance tends to increase when the tip of the guide wire 10 passes through a blood vessel or the like. Further, the resistance received when the tip of the guide wire 10 comes into contact with the inner wall of the blood vessel or the like tends to increase. On the other hand, when the bending distance L is less than about 0.8 mm, as described above, the tip 15, which is the tip of the guide wire 10, is engaged with a minute hole called a microchannel that exists in a highly narrowed portion. The approach to enter tends to be difficult. In addition to this, it tends to be difficult to form the gap 70a between the adjacent strands 69 wound spirally of the outer coil body 60 inside the bent portion 70 described later.

  In the present embodiment, the bending angle α, which is the angle at which the bending portion 70 bends, is indicated by the angle at which the axis C2 intersects the axis C1 is set in the range of about 30 ° to about 60 °. More preferably, it is set in the range of about 35 ° to about 55 °. In this embodiment, the angle is about 45 °. When the bending angle α exceeds about 60 °, the resistance tends to increase when the distal end of the guide wire 10 passes through a blood vessel or the like, as in the case where the bending distance L is large. Further, the resistance received when the tip of the guide wire 10 comes into contact with the inner wall of the blood vessel or the like tends to increase. On the other hand, when the bending angle α is less than about 30 °, it is difficult to make the tip 15 that is the tip of the guide wire 10 engage and enter a minute hole called a microchannel that exists in a highly narrowed portion. Tend to be. In addition, if the bending angle α is set in the above range, an operator such as a doctor can finely adjust the difference depending on the lesion of the patient, so the above range is preferable.

  The bent portion 70 plastically deforms and bends the second columnar flexible portion 44 of the core shaft 14. At this time, the bent portion 70 is adjacent to the loosely wound portion 63 b of the outer coil body 60 surrounding the second columnar flexible portion 44. The gap between the strands 69 to be left is left even after the bent portion 70 is formed. That is, adjacent spirals formed by the strands 69 wound at the bent portion 70 have a gap in the circumferential direction. Therefore, the gap between the adjacent strands 69 inside the bent portion 70 is smaller than the gap between the adjacent strands 69 of the loosely wound portion 63b of the outer coil body 60 where the bent portion 70 is not formed. The gaps 70a are substantially uniform. Similarly, the gap between the adjacent strands 69 outside the bent portion 70 is slightly larger than the gap between the strands 69 of the loosely wound portion 63b of the outer coil body 60 where the bent portion 70 is not formed. The gaps 70b are substantially uniform.

  Such a configuration can be formed relatively easily because the tip gap 54 is secured between the inner tip joint portion 53 and the chip 15 inside the loosely wound portion 63 b of the outer coil body 60. it can. In particular, the rigidity of the most distal end portion 40 of the core shaft 14 is reinforced by the inner coil body 50 described above, so that the outer diameter of the most distal end portion 40 of the core shaft 14 can be reduced. It can be done.

  Accordingly, the gaps 70a and 70b between the adjacent strands 69 of the outer coil body 60 in the bent portion 70 are formed substantially equally, and the adjacent strands 69 are in contact with each other or adjacent strands. A large gap is not generated locally between 69. By having such substantially uniform gaps 70a and 70b in the outer coil body 60, adjacent strands 69 do not interfere with each other and the movement of the bent portion 70 is not hindered. As described above, the portion on the distal end side of the bent portion 70 abuts on the narrowed portion or the like and can flexibly swing inward or outward even when an external force is applied. Further, since there is no gap between the large strands 69 locally outside the bent portion 70, debris of a calcified lesion such as a stenosis or the like enters the large gap and guides inside the stenosis or the like. It is possible to prevent the movement of the distal end portion of the wire 10 from being hindered.

  Based on the above structure, the case where the guide wire 10 of this Embodiment treats the constriction part formed in the coronary artery of the heart is demonstrated.

  Usually, before the guide wire is inserted into the blood vessel, the operator performs an operation called shaping to provide a constant angle at the tip, but in the case of the guide wire 10 of the present embodiment, an appropriate bending angle is provided in advance. Since the α bent portion 70 is provided, there is no need to perform shaping again. Even in the case of a skilled operator, it is sufficient to finely adjust the bending angle α of the bending portion 70 in accordance with the lesion of the patient. This frees the operator from troublesome work and reduces the time for the procedure.

  The guide wire 10 is passed through the aortic arch by being inserted into the artery from the thigh or the like, and is advanced toward a stenosis portion formed in the coronary artery, which is a therapeutic purpose. At this time, the inner coil body 50 improves the axial push-in force of the guide wire 10 provided by an operator such as a doctor and the torque transferability in the rotational direction. In other words, the push-in characteristic and the rotational torque transmission property are enhanced compared to a normal guide wire having only an outer coil body.

  Even when the guide wire 10 passes through a complicatedly bent blood vessel, a bent portion 70 is formed at the distal end of the guide wire 10, so that the operator rotates the proximal side of the guide wire 10. By doing so, the direction of the tip of the guide wire 10 can be changed in the direction in which the blood vessel bends, and the guide wire 10 can be inserted into the blood vessel that is easily bent. In particular, in the case of the present embodiment, between the strands 69 of the outer coil body 60, there are substantially uniform gaps 70 a and 70 b on both the inside and the outside of the bent portion 70. As a result, the distal end of the guide wire 10 can be flexibly swung, so that the guide wire 10 can be advanced along the bending blood vessel.

When the tip of the guide wire 10 reaches the entrance of the stenosis part which is the target site, the tip 15 which is the tip of the guide wire 10 is provided with the inclined part 15b so as to be tapered, so that the stenosis part is relatively easy. Can enter.
Further, even when the tip 15 that is the tip of the guide wire 10 is engaged with a minute hole called a microchannel that exists in the narrowed portion and the approach is performed, the bent portion 70 is provided in the guide wire 10. Since the gaps 70a and 70b are provided between the adjacent wires 69 of the outer coil body 60 in the bent portion 70, the tip of the guide wire 10 can swing flexibly. As a result, the chip 15 captures and engages the microchannel, and the guide wire 10 can be advanced from the microchannel to the narrowed portion.

  When the distal end of the guide wire 10 enters the stenosis, the operator further pushes the guide wire 10 to pass the stenosis. At this time, when the distal end of the guide wire 10 comes into contact with a relatively hard calcified portion in the narrowed portion, the bent portion 70 is provided in the guide wire 10 as described above. Since the gap 70a is provided between the adjacent strands 69, the distal end of the guide wire 10 can flexibly swing inward, and the direction of the distal end of the guide wire 10 can be changed. As a result, the guide wire 10 can pass around the relatively hard calcified portion.

  At this time, since the gaps 70a between the adjacent strands 69 inside the bent portion 70 are provided substantially uniformly, even if the distal end portion of the guide wire 10 is bent, the bent portion 70 is surrounded. It is possible to prevent the gap between the strands 69 of the outer coil body 60, particularly the outer gap 70b, from being greatly opened locally, and calcified lesions and the like enter between the strands of the bent portion 70. Can be prevented. Therefore, it can be avoided that the tip of the guide wire 10 is trapped by a calcified lesion and becomes stuck, that is, is stuck. Therefore, the passability of the guide wire 10 with respect to the narrowed portion can be improved.

  As described above, the guide wire 10 according to the present embodiment is provided with the bent portion 70 in the guide wire 10, and the wire 69 around which the outer coil body 60 is wound in the bent portion 70 is substantially even. Since the gaps 70a and 70b are provided, it is possible to improve the permeability to the bent blood vessel and the narrowed portion.

  After the bent portion 70 of the guide wire 10 enters the stenosis portion, a push force is further applied by the operator, and the guide wire 10 enters the stenosis portion. At this time, the guide wire 10 according to the present embodiment has the tapered coil portion 62 whose outer diameter decreases in the distal direction on the outer coil body 60, so that the distal end of the guide wire 10 gradually enters the narrow constricted portion and is then gradually moved by the tapered coil portion 62. It is possible to continue to enter the stenosis while expanding the stenosis. Therefore, the taper coil portion 62 further improves the passability to the narrow constriction portion.

  As described above, when the distal end portion of the guide wire 10 passes through the stenosis portion, a treatment catheter such as a balloon catheter (not shown) is inserted along the guide wire 10 and treatment for expanding the stenosis portion is performed. Done.

  In the embodiment described above, the diameter of the wire 69 of the outer coil 60 is constant including the bent portion 70, but like the bent portion 170 shown in FIG. The diameter of the wire 69 may be smaller than the diameter of other strands. With such a configuration, a large gap 170a between the adjacent strands 69 inside the bent portion 170 can be secured, so that the region where the tip of the guide wire swings can be further expanded. Therefore, it is possible to further prevent the tip of the guide wire from being caught and stuck in the narrowed portion or the like.

  The configuration of the bent portion 170 shown in FIG. 4 can be formed by polishing only a portion of the wire 69 corresponding to the inside of the bent portion 170 in the outer coil 60 using electrolytic polishing or the like.

  In the embodiment described above, the tip 15 is composed of the base portion 15a, the inclined portion 15b, and the tip arc portion 15c in order from the rear end side, and has a tapered shape toward the tip. However, like a chip 115 shown in FIG. 4, it may be composed of a base portion 115a joined to a coil and a hemispherical tip arc portion 115c, like a normal guide wire.

In the embodiment described above, the tip of the core shaft 14 reaches the tip of the tip 15, but as shown in FIG. 4, the tip of the core wire 114 needs to reach the tip of the tip 115. No.
In FIG. 4, the same components as those in FIG. 3 are denoted by the same reference numerals.

  In the embodiment described above, the inner coil body 50 is constituted by a stranded coil body including a plurality of strands 51. The stranded coil body is highly effective in improving rigidity and torque transmission. However, in forming the gap between the strands of the bent portion 70, a single wire coil body made of one strand may be used.

  Further, in the embodiment described above, the outer coil body 60 is composed of the three parts of the coil main body part 61, the taper coil part 62, and the tip linear coil part 63, but the cylindrical shape without the taper coil part 62. It is good also as a structure provided with a taper-shaped coil part to a front-end | tip, without having the front-end | tip linear coil part 63 in the front-end | tip side of this coil or the taper coil part 62.

  In the embodiment described above, the most distal portion 40 includes the first tapered flexible portion 41, the first columnar flexible portion 42, the second tapered flexible portion 43, and the second columnar flexible portion 44, and the second tapered portion. The flexible part 43 and the second columnar flexible part 44 are pressed. However, the shape of the forefront portion 40 is not limited to this, and one or a plurality of cross-sectional shapes may be configured by circular columnar portions.

  In the embodiment described above, the single bent portion 70 is provided. However, if necessary, a second bent portion is provided on the base end side of the bent portion 70 and a plurality of bent portions are provided. Also good. In this case, not only the most distal end portion 40 of the core shaft 14 but also a proximal end portion such as the third tapered portion 35 can be bent.

  Further, the guide wire of the present embodiment is not limited to the heart, but can be used for the brain, the lower limbs, and other organs.

DESCRIPTION OF SYMBOLS 10 Guide wire 14 Core shaft 15 Tip 30 Tip part 50 Inner coil body 51 Strand 53 Inner tip junction part 60 Outer coil body 69 Strand 70 Bending part

Claims (4)

A long core shaft,
An outer coil body formed by winding at least one element wire and surrounding a tip portion of the core shaft;
A tip for joining the tip of the outer coil body to the tip of the core shaft;
An inner coil body disposed inside the outer coil body, wound with at least one strand, and surrounding the tip portion of the core shaft;
An inner tip joint that is disposed behind the chip and joins the tip of the inner coil body to the core shaft;
A guide wire comprising: a bent portion formed by bending the core shaft in a state where the strands forming the outer coil body do not contact each other between the tip and the inner tip joint portion. 2. The guide wire according to claim 1, wherein the outer coil has a smaller diameter of the strand inside the bent portion. The guide wire according to claim 1, wherein the bent portion is formed on the tip side between the tip and the inner tip joint portion. The guide wire according to any one of claims 1 to 3, wherein the inner coil body is a tubular stranded coil body formed by twisting a plurality of strands.

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