JP2013179963A - Bump treatment device and bump treatment method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a bump treatment device and a bump treatment method capable of effectively reducing risk of rupture and reducing influence over the peripheral tissue by miniaturizing a bump.SOLUTION: A bump treatment device includes: a miniaturizing mechanism 14 for miniaturizing a bump 62; an elongated shaft 12 (a feeding part); and a detaching mechanism 16 for detachably connecting the shaft 12 and the miniaturizing mechanism 14. The miniaturizing mechanism 14 includes: a plurality of arms 22; and a plurality of engaging parts 24 respectively provided in the arms 22 and capable of engaging with the inner wall of the bump 62. The bump treatment device is configured to be moved from an expanded state with an extended space between the arms 22 to a contracted state with the narrowed space between the arms 22. The miniaturizing mechanism 14 is inserted into the bump 62 so that the arms 22 of the miniaturizing mechanism 14 are expanded, and the engaging parts 24 are engaged with the inner wall of the bump 62. The bump 62 is miniaturized by displacing the arms 22 inward in that state.

Description

  The present invention relates to an aneurysm treatment device and 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” (Patent Document 1 below).

Special table 2008-510594 gazette

  The present invention was made in connection with a method for treating an aneurysm via a blood vessel (by an intravascular interventional procedure), effectively reducing the risk of rupture by reducing the aneurysm. An object of the present invention is to provide an aneurysm treatment device and an aneurysm treatment method capable of reducing the influence on surrounding tissue.

  In order to achieve the above object, an aneurysm treatment device according to the present invention is capable of being inserted into an aneurysm generated in a living body and reducing the aneurysm, and delivering the reducing mechanism to a target site in the living body. And a release mechanism that releasably connects the delivery part and the reduction mechanism, and the reduction mechanism is provided on each of the arms and provided on each of the arms. A plurality of engaging portions that can be engaged, and is configured to be operable from an expanded state in which the interval between the arms is widened to a contracted state in which the interval between the arms is narrowed.

  According to the above configuration, the aneurysm treatment device is inserted into the catheter to access the aneurysm generated in the blood vessel, and the interval between the arms is expanded to engage the engagement portion with the inner wall of the aneurysm, and the arm interval is maintained in that state. The procedure can be performed in which the knob is reduced by narrowing, and then the reduction mechanism is detached from the shaft. In this case, since the reduction mechanism in which the engagement portion engages with the inner wall of the knob and the interval between the arms is narrowed is placed in the knob, the reduced state of the knob can be stably maintained. Therefore, the risk of rupture of the aneurysm can be effectively reduced. Further, by reducing the aneurysm, the pressure on the surrounding tissue by the aneurysm is suppressed or avoided, and the influence on the surrounding tissue can be reduced.

  In the above-described aneurysm treatment device, the reduction mechanism is inserted in a tubular member that is inserted into a living body lumen, and the diameter of the reduction mechanism is smaller than that in the expanded state by restricting expansion by the tubular member. The forced reduced diameter state may be taken, and when the tube member is pushed out from the tubular member, the expanded state may be obtained by an elastic restoring force.

  According to the above configuration, even when treating an aneurysm having a neck that is narrower than the bag-like internal space, the reduction member is placed in a state in which the distal end opening of the tubular member faces the opening of the aneurysm. The reduction mechanism can be smoothly inserted into the aneurysm by extruding from the tip, and the engagement portion can be reliably engaged with the inner wall of the aneurysm by setting the reduction mechanism in the expansion state within the aneurysm. .

  In the above-mentioned aneurysm treatment device, expansion that can be changed from a first state existing between the arms to increase an interval between the arms against an elastic force to a second state in which the forced expansion to the arms is released A control unit may be further provided.

  According to said structure, when an expansion | extension control part will be in a 2nd state, the space | interval of an arm can be narrowed immediately and, thereby, the inner wall of a lump can be rapidly and reliably pulled inward of a lump. Moreover, since such an expansion control part can be comprised compactly in the front-end | tip part of an aneurysm treatment device, the diameter of an aneurysm treatment device can be reduced and it contributes to the improvement of vascular penetration.

  In the aneurysm treatment device, the expansion control unit includes an interposition member that is detachably sandwiched between the arms, and when the interposition member is separated from between the arms, the arms are elastically restored by the elastic restoring force of the arms. May be displaced inward, and the reduction mechanism may be in the contracted state.

  According to the above configuration, the reduction mechanism can be surely and quickly brought into the contracted state by a simple operation.

  In the aneurysm treatment device, the reduction mechanism has a support portion that is connected to a base end of the arm and can be reduced in diameter by elastic deformation, and the detachment mechanism is detachably fitted to the support portion. A holding portion that holds the support portion in a combined state, the support portion is forcibly expanded in a state of being fitted to the holding portion, and is reduced in diameter by an elastic restoring force when detached from the holding portion. Also good.

  According to the above configuration, the reduction mechanism and the shaft are connected by the fitting structure, so that the reduction mechanism can be easily and quickly detached from the shaft. In addition, since the reduction mechanism is contracted at the same time as the reduction mechanism is released from the shaft, two actions (contraction and release of the reduction mechanism) can be achieved at the same time by a single operation. Contribute to.

  In the above-mentioned aneurysm treatment device, the proximal end portion of the arm may be inclined so as to approach inward in the distal direction in a state where the support portion is detached from the holding portion.

  According to said structure, the space | interval of an arm becomes narrower and a lump can be reduced effectively.

  The aneurysm treatment method of the present invention includes a reduction mechanism having a plurality of arms, a delivery unit for delivering the reduction mechanism to a target site in a living body, and a release mechanism for releasably connecting the reduction mechanism from the delivery unit. An access step for delivering the aneurysm treatment device comprising a catheter through the living body lumen to a position where the aneurysm is located, and an insertion step for inserting the reduction mechanism into the aneurysm after the access step And, after the insertion step, an engagement step for engaging the engagement portion provided on each of the arms with the inner wall of the knob, and the engagement portion engaged with the inner wall of the knob, By reducing the distance between the arms, a reduction step for reducing the aneurysm, and simultaneously with the reduction step or after the reduction step, the reduction mechanism is moved to the delivery unit under the action of the detachment mechanism. Characterized in that it comprises a detachment step of separating, the.

  According to the aneurysm treatment device and the aneurysm treatment method of the present invention, by reducing the aneurysm, the risk of rupture can be effectively reduced and the influence on the surrounding tissue can be reduced.

It is a partially omitted side view of the aneurysm treatment device according to the first embodiment of the present invention. It is a perspective view of the reduction mechanism of the aneurysm treatment device shown in FIG. FIG. 3A is a side sectional view showing a state in which the reduction mechanism of the aneurysm treatment device according to the first embodiment is located in the distal end portion of the outer tube, and FIG. 3B is a reduction mechanism of the aneurysm treatment device according to the first embodiment. FIG. 3C is a side cross-sectional view illustrating a state in which the reduction mechanism of the aneurysm treatment device according to the first embodiment is contracted. FIG. 4A is a configuration diagram of the detachment mechanism according to the first configuration example, FIG. 4B is a configuration diagram of the detachment mechanism according to the second configuration example, and FIG. 4C is a configuration of the detachment mechanism according to the third configuration example. FIG. 4D is a configuration diagram of a separation mechanism according to a fourth configuration example, and FIG. 4E is a configuration diagram of a separation mechanism according to a fifth configuration example. FIG. 5A is a first diagram illustrating a method of using the aneurysm treatment device according to the first embodiment, and FIG. 5B is a second diagram illustrating a method of using the aneurysm treatment device according to the first embodiment. is there. FIG. 6A is a third diagram for explaining how to use the aneurysm treatment device according to the first embodiment, and FIG. 6B is a fourth diagram for explaining how to use the aneurysm treatment device according to the first embodiment. is there. FIG. 7A is a fifth diagram illustrating a method of using the aneurysm treatment device according to the first embodiment, and FIG. 7B is a sixth diagram illustrating a method of using the aneurysm treatment device according to the first embodiment. is there. It is a perspective view which shows the front-end | tip part of the aneurysm treatment device which concerns on 2nd Embodiment of this invention. FIG. 9A is a side sectional view showing a state in which the reduction mechanism of the aneurysm treatment device according to the second embodiment is located in the distal end portion of the catheter, and FIG. 9B shows the reduction mechanism of the aneurysm treatment device according to the second embodiment. FIG. 9C is a side sectional view showing a state where the catheter is pushed out from the distal end, and FIG. 9C is a side sectional view showing a state where the reduction mechanism of the aneurysm treatment device according to the second embodiment is contracted. FIG. 10A is a first diagram for explaining how to use the aneurysm treatment device according to the second embodiment, and FIG. 10B is a second diagram for explaining how to use the aneurysm treatment device according to the second embodiment. is there. FIG. 11A is a third diagram for explaining how to use the aneurysm treatment device according to the second embodiment, and FIG. 11B is a fourth diagram for explaining how to use the aneurysm treatment device according to the second embodiment. is there.

  Preferred embodiments of an aneurysm treatment device and aneurysm treatment method according to the present invention will be described below with reference to the accompanying drawings.

[First Embodiment]
FIG. 1 is a partially omitted side view showing the configuration of an aneurysm treatment device 10 according to the first embodiment of the present invention. This aneurysm treatment device 10 is a device for performing treatment to prevent the rupture of an aneurysm by reducing the aneurysm generated in the living body and maintaining the reduced state, and is a long outer tube that can be inserted into the catheter 11. 13 (tubular member), a long shaft 12 (delivery part) inserted through the outer tube 13, a reduction mechanism 14 connected to the shaft 12, and the reduction mechanism 14 can be detached from the shaft 12. A release mechanism 16.

  As shown in FIG. 1, the outer tube 13 is a hollow tubular member that is long and has a linear shape (wire shape) that has flexibility, and is gripped by an operator at the base end portion. For this purpose, a grip 18 having a diameter larger than that of the shaft 12 is provided. The outer tube 13 is preferably flexible enough to easily follow the curvature of the lumen together with the catheter 11 when inserted into a lumen (blood vessel or the like) in the living body and travels in the lumen.

  Therefore, the outer tube 13 is made of metal or resin. 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 outer tube 13 can be composed of a multilayer tube made of a composite formed from these metals and resins.

  The dimensions of the outer tube 13 are appropriately selected depending on the site to be treated. For example, when used for the treatment of a cerebral aneurysm, the overall length is about 800 to 1500 mm and the outer diameter is about 0.6 to 3 mm. Is set.

  The shaft 12 functions as a delivery unit for delivering the reduction mechanism 14 to a target site in the living body, and is inserted and disposed in the lumen of the outer tube 13 so as to be axially displaceable. An operation knob 29 provided on the grip portion 18 is connected. The shaft 12 can be moved forward and backward with respect to the outer tube 13 by operating the operation knob 29 in the axial direction.

  Similar to the outer tube 13, the shaft 12 is flexible enough to easily follow the curvature of the lumen when it is inserted into a lumen (blood vessel or the like) in a living body and travels in the lumen. It is preferable that the reduction mechanism 14 is pushed out of the tube 13 and has a suitable rigidity so that torque can be transmitted to the reduction mechanism 14. Therefore, the shaft 12 can be configured from the materials exemplified above as the constituent material of the outer tube 13.

  As shown in FIG. 2, the reduction mechanism 14 according to the present embodiment includes a base 20 connected to the shaft 12, at least a plurality of (two in the illustrated example) arms 22 branched from the distal end side of the base 20, and each arm. 22 has an engaging portion 24 provided on the outside of the arm 22 and an expansion control portion 26 disposed between the arms 22, and the arm 22 is moved from an expanded state (see FIG. 3B) in which the distance between the arms 22 is increased. It is possible to operate in a contracted state (see FIG. 3C) with a narrow interval.

  The arm 22 is configured to be insertable into the aneurysm through an opening of the aneurysm generated in the living body (communication port with a blood vessel). The base end portion of the arm 22 is connected to the base portion 20. The arms 22 branch from the base 20 and extend in the distal direction.

  The engaging portion 24 is integrally provided on the outer side of each arm 22. In the present embodiment, the engaging portion 24 is a portion extending from the outer peripheral surface of the arm 22 to the outer tip side, and a sharp pointed portion 24a is formed at the tip. The sharpened portion 24a is formed so sharp that it can be punctured or penetrated into the inner wall of the aneurysm. With such a configuration, as will be described later, the reduction mechanism 14 is inserted into the aneurysm to be in a diameter-expanded state, and the reduction mechanism 14 is placed on the back side of the aneurysm with the engaging portion 24 engaged with the inner wall of the aneurysm. Can be engaged with the inner wall of the knob.

  In the present embodiment, the engaging portion 24 is branched outward from the middle portion of the arm 22 in the longitudinal direction. However, the present invention is not limited to this, and the engaging portion 24 of the configuration shown in FIG. A configuration in which the portion of the arm 22 on the distal end side with respect to the proximal end is eliminated may be used. That is, a configuration in which the engaging portion 24 extends from the tip of the arm 22 may be employed.

  The expansion control unit 26 is configured to be able to change from a first state existing between the arms 22 to widen the distance between the arms 22 against the elastic force to a second state in which the forced expansion of the arms 22 is released. ing. In the present embodiment, specifically, the expansion control unit 26 is configured as an interposed member 26 </ b> A that is held between the arms 22 on the proximal end side of the arms 22.

  The arm 22 is forcibly elastically deformed by the interposition member 26A, and is held in a state where the arm 22 is opened compared to the natural state. That is, in the state where the interposition member 26A is sandwiched between the arms 22, as shown in FIG. 2, the distance between the arms 22 increases toward the distal end side. The two arms 22 form an angle and have a substantially V shape. When the bulging portion 27 is provided on the proximal end side of the arm 22 as shown in the drawing and the interposed member 26A is sandwiched between the bulging portions 27, when the interposed member 26A is detached in the proximal direction, The base portion of the arm 22 (the portion where the arms 22 are connected) does not get in the way, and the interposing member 26A can be smoothly detached.

  An X-ray impermeable marker may be provided on the entire reduction mechanism 14 or the arm 22 so as to be recognized under X-ray fluoroscopy.

  As shown in FIG. 3A, the arm 22 sandwiched with the expansion control unit 26 is in a state where expansion is restricted by the inner peripheral surface of the outer tube 13 (the portion on the tip side is more elastic than the portion where the interposed member 26A is sandwiched). It is housed in the outer tube 13 in a deformed state). Since the arm 22 receives a force in a direction in which it is forcibly expanded by the interposed member 26A sandwiched between the arms 22, as shown in FIG. 3B, when the arm 22 is projected from the tip of the outer tube 13, the arm 22 22, the shape of the portion on the tip side of the contact portion with the interposition member 26A is elastically restored, and thereby the space between the arms 22 is opened (diameter expanded state).

  A wire 31 (drive member) is connected to the interposition member 26A. The wire 31 is inserted into the outer tube 13, and the base end side thereof is connected to an operation knob 30 (release operation portion) provided in the grip portion 18. When the operation knob 30 is operated and the wire 31 is pulled in the proximal direction, the interposition member 26A is detached from between the arms 22 as shown in FIG. 3C. Then, the arms 22 are displaced in directions close to each other by an elastic restoring force. Thereby, the reduction mechanism 14 is in a contracted state (a reduced diameter state) in which the interval between the arms 22 is narrowed.

  The base 20 and the arm 22 (including the engaging portion 24) are made of, for example, a metal material having elasticity or superelasticity such as stainless steel, tantalum, cobalt alloy, titanium alloy, Ni-Ti alloy, polyethylene, polypropylene, It can be formed of various polymers such as polyolefins such as ethylene-vinyl acetate copolymer, polyvinyl chloride, polymethyl methacrylate, polycarbonate, polybutadiene, polyamide, and polyester. Alternatively, the base 20 and the arm 22 (including the engaging portion 24) may be made of a composite material of metal and resin.

  The size of the reduction mechanism 14 in a state where the expansion control unit 26 protrudes from the distal end of the outer tube 13 and is disposed between the arms 22 (the state shown in FIG. 3B) is appropriately selected according to the treatment target site. For example, when used for the treatment of a cerebral aneurysm, the total length is set to 1 to 30 mm, and the width H (see FIG. 3B) between the distal ends of the engaging portions 24 in the expanded state is set to about 1 to 30 mm.

  Next, the separation mechanism 16 shown in FIG. 1 will be described. The detachment mechanism 16 is configured to be able to detach the reduction mechanism 14 from the shaft 12. The detachment mechanism 16 having such a function has a configuration in which two separately configured members are detachably connected by physical engagement (fitting, hooking, etc.), or a certain member is subjected to some physical action (thermal It is possible to adopt a configuration in which the parts are separated so as to be detachable by being separated by a chemical action, a chemical action, or the like. Hereinafter, some configuration examples of the separation mechanism 16 will be described, but it is needless to say that the separation mechanism 16 is not limited to these configuration examples.

  The separation mechanism 16A according to the first configuration example shown in FIG. 4A is configured such that the base portion 20 of the reduction mechanism 14 and the shaft 12 are fitted. The fitting force (bonding force) between the base 20 and the shaft 12 is fitted and maintained in a connected state until the force for detaching both is less than a predetermined value. The fitting force is set such that the reduction mechanism 14 and the shaft 12 are detached by disengaging the fitting. According to the detachment mechanism 16A configured in this way, after the engagement portion 24 is engaged with the inner wall of the knob, the reduction mechanism 14 is automatically detached from the shaft 12 by moving the shaft 12 backward. Can do. In FIG. 4A, the base 20 is inserted into the fitting hole 12a provided in the shaft 12 so that the two fit together. However, the relationship between the fitting male and female is reversed. Also good. That is, a fitting hole may be provided in the base portion 20 of the reduction mechanism 14 and a fitting protrusion that can be fitted into the fitting hole may be provided at the tip of the shaft 12.

  The detachment mechanism 16B according to the second configuration example shown in FIG. 4B is configured such that the base portion 20 of the reduction mechanism 14 and the shaft 12 are screwed together. Specifically, a male screw 35 is formed on the outer peripheral portion of the base portion 20, and a female screw 36 is formed on the inner peripheral portion of the shaft 12. The screwing force (coupling force) between the base 20 and the shaft 12 maintains the screwing until the torque acting between them is less than a predetermined value, but when the torque exceeding the predetermined value is applied, the screwing is released. The reduction mechanism 14 and the shaft 12 can be detached.

  According to the detachment mechanism 16B configured in this way, after the engagement portion 24 is engaged with the inner wall of the knob, the rotation of the shaft 12 causes the torque between the reduction mechanism 14 and the shaft 12 to exceed a predetermined value. Since the screwing is released, the reduction mechanism 14 can be automatically detached from the shaft 12. In FIG. 4B, the male screw 35 provided on the base portion 20 is screwed into the female screw 36 provided on the shaft 12 so that they are connected. The configuration may be reversed. That is, a configuration in which a female screw is provided at the base 20 of the reduction mechanism 14 and a male screw is provided at the tip of the shaft 12 may be employed.

  A detachment mechanism 16C according to the third configuration example illustrated in FIG. 4C includes a connection portion 38 that connects the base portion 20 of the reduction mechanism 14 and the tip of the shaft 12, and a heater 40 that is wound around the outer periphery of the connection portion 38 in a coil shape. And first and second conductive wires 42 and 44 connected to the heater 40. The connecting portion 38 is made of a material (for example, a resin, a low melting point metal, or the like) that can be melted and broken when heated. The first conducting wire 42 is connected to one end of the heater 40, the second conducting wire 44 is connected to the other end of the heater 40, and the first and second conducting wires 42 and 44 are inserted into the shaft 12 and connected to the heater 40. It is connected to the power source at the end opposite to the connected side. The power source may be either DC or AC.

  According to the detachment mechanism 16 </ b> C configured in this manner, after the engaging portion 24 is engaged with the inner wall of the knob, the heater 40 is energized through the first and second conductive wires 42 and 44 to generate heat. Thus, the reduction mechanism 14 can be detached from the shaft 12 by melting and breaking the connecting portion 38.

  The disengagement mechanism 16D according to the fourth configuration example shown in FIG. 4D includes a hook portion 46 provided at the base portion 20 of the reduction mechanism 14 and an engagement portion 48 provided at the distal end of the shaft 12 and engaged with the hook portion 46. Prepare. According to this configuration, the engagement between the hook portion 46 and the engagement portion 48 is released by pushing the shaft 12 slightly forward with the engagement portion 24 engaged with the inner wall of the knob. 14 can be detached from the shaft 12. As another operation, when the shaft 12 is rotated after engaging the engaging portion 24 with the inner wall of the knob, the reduction mechanism 14 and the shaft 12 are disengaged from each other. Can be detached from the shaft 12.

  The separation mechanism 16E according to the fifth configuration example shown in FIG. 4E includes an interposition member 51 having a ball-like portion 50 at the base end, a tension member 52 that pulls the interposition member 51 into the base portion 20 of the reduction mechanism 14, and a shaft. 12 is provided with a holding ring 54 provided at the tip of 12 and a release wire 56 inserted into the shaft 12. For example, the release wire 56 is connected to an operation unit (slide knob or the like) provided in the grip unit 18, and is pulled back in the proximal direction by the operation of the operation unit.

  As shown in FIG. 4E, when the release wire 56 is sandwiched between the holding ring 54 and the ball-shaped portion 50 (the ball-shaped portion 50 and the release wire 56 are fixed), the ball-shaped portion 50 is held. Since the passage through the ring 54 and the movement into the base 20 is prevented, the connection state between the reduction mechanism 14 and the shaft 12 is maintained. On the other hand, when the operation portion is operated and the release wire 56 is pulled in the proximal direction, the release wire 56 is detached from between the holding ring 54 and the ball-shaped portion 50, so that the ball-shaped portion 50 moves inside the holding ring 54. The ball-shaped portion 50 moves into the base portion 20 under the tension action of the tension member 52. Thereby, the reduction mechanism 14 can be detached from the shaft 12.

  Other configurations of the detachment mechanism 16 include a configuration in which the base portion 20 of the reduction mechanism 14 and the tip of the shaft 12 are coupled by a metal coupling portion, and the coupling portion is electrolyzed to be detached from the shaft 12 or connected. A configuration may be adopted in which fluid pressure is applied to the portion, and the base 20 of the reduction mechanism 14 and the connecting portion of the shaft 12 are cut off from the shaft 12 and separated.

  The aneurysm treatment device 10 according to the present embodiment is basically configured as described above. In the following, the aneurysm treatment device 10 is related to the method of using the aneurysm treatment device 10 (aneurysm treatment method). The operation and effect of will be described. The aneurysm treatment method using the aneurysm treatment device 10 includes the following steps.

(1) Access step (first step)
In the access step, the aneurysm treatment device 10 is disposed in the vicinity of the aneurysm 62 through the catheter 11. The aneurysm 62 to be treated is a hollow bag-like tissue generated in a living body lumen (blood vessel or the like). The aneurysm 62 consists of a portion whose outer surface protrudes so that a part thereof swells outward from the luminal tissue. The protruding portion has a space inside, and this space communicates with the inside of the lumen via the opening 63. The protrusion 62 has a bag-like structure in which the protrusion 62 protrudes to the outside, and the inside of the bag-like space is separated from the outside by a film-like tissue formed by a part of the tissue. Some of the lumps 62 have a narrowed opening 63 with a lumen to form a neck 64, or some have a relatively large opening 63 and no neck. Examples of the lumen in which the aneurysm 62 is generated include a blood vessel, a digestive tract, a trachea, a bile duct, a lymphatic vessel, an otonasal cavity, and a lacrimal gland. Examples of blood vessels in which the aneurysm 62 is generated include arteries, veins, and peripheral blood vessels. Examples of the aneurysm 62 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. Hereinafter, the case where the lumen is a blood vessel will be described.

  Specifically, in this access step, first, the catheter 11 having the guide wire inserted therein is run in the blood vessel 60, and the distal end of the catheter 11 reaches the vicinity of the opening 63 of the aneurysm 62 or the inside of the aneurysm 62. Thereafter, the guide wire is removed from the catheter 11. After the guide wire is removed from the catheter 11, the aneurysm treatment device 10 with the reduction mechanism 14 housed in the outer tube 13 is inserted into the catheter 11 (see FIG. 5A). Then, the position of the aneurysm treatment device 10 is adjusted so that the tip of the outer tube 13 is slightly inserted into the opening 63 of the aneurysm 62 or the aneurysm 62 (see FIG. 5B).

(2) Insertion step (second step)
Next, in a state where the positions of the catheter 11 and the outer tube 13 are maintained, the operation knob 29 (see FIG. 1) is operated to advance the shaft 12 toward the distal end with respect to the outer tube 13 as shown in FIG. 6A. Then, the reduction mechanism 14 is pushed out from the outer tube 13, and the reduction mechanism 14 is inserted into the knob 62. At this time, the reduction mechanism 14 that has been forcedly reduced in diameter by the inner peripheral surface of the outer tube 13 is released from the restriction, so that the interval between the arms 22 is widened by the elastic restoring force of the arms 22. Since the expansion control unit 26 is sandwiched between the arms 22 of the reduction mechanism 14, the reduction mechanism 14 is in the expanded state. In this expanded state, the engaging portion 24 of the reduction mechanism 14 contacts the inner wall of the knob 62 and presses the inner wall of the knob 62 outward with a weak force.

(3) Engagement step (third step)
Next, an engaging step for engaging the engaging portion 24 provided on the arm 22 with the inner wall of the knob 62 is performed. In the present embodiment, as shown in FIG. 6B, the shafts 12 are advanced in the distal direction while the positions of the catheter 11 and the outer tube 13 are maintained, whereby each engagement portion 24 of the reduction mechanism 14 is Engage with inner wall. Specifically, the engaging portion 24 in contact with the inner wall of the knob 62 is displaced in the distal direction, whereby the engaging portion 24 is inserted into the inner wall of the knob 62 from the sharpened portion 24a. In this case, the sharpened portion 24a of the engaging portion 24 may be protruded from the outer wall of the knob 62, or the sharpened portion 24a may be positioned in the wall portion of the knob 62.

(4) Reduction step (fourth step)
Next, as shown in FIG. 7A, in a state where the engaging portion 24 is engaged with the inner wall of the knob 62, a reduction step for reducing the knob 62 is performed by reducing the interval between the arms 22. In the present embodiment, the interposing member 26 </ b> A is detached from between the arms 22 by pulling the wire 31 in the proximal direction. Then, the arms 22 are displaced in the direction of narrowing each other by the elastic restoring force (inward), and the engaging portion 24 is also displaced inward as the arms 22 are displaced. At this time, the inner wall of the knob 62 is drawn toward the inner side of the knob by the engaging portions 24 engaged with the inner wall of the knob 62 at a plurality of locations in the circumferential direction of the knob 62, whereby the knob 62 is reduced. As a result, the internal volume of the aneurysm 62 is significantly reduced as compared with that before the treatment (the state of FIG. 5A). In FIG. 7A, the aneurysm 62 before treatment is indicated by a virtual line.

(5) Leave step (fifth step)
Next, as shown in FIG. 7B, under the action of the separation mechanism 16, a separation step for separating the reduction mechanism 14 from the shaft 12 is performed. The operation for detaching the reduction mechanism 14 from the shaft 12 differs depending on the configuration of the detachment mechanism 16.

  In the case of the detachment mechanism 16A shown in FIG. 4A, the fitting force between the distal end of the shaft 12 and the base portion 20 of the reduction mechanism 14 is obtained by rotating the shaft 12 with the engaging portion 24 engaged with the inner wall of the knob 62. When a force exceeding 1 is applied, the fitting is released, so that the reduction mechanism 14 can be detached from the shaft 12. Alternatively, the shaft 12 may be moved backward to disengage the tip of the shaft 12 from the base 20 of the reduction mechanism 14. In the case of the disengaging mechanism 16B shown in FIG. 4B, the shaft 12 is rotated in a state where the engaging portion 24 is engaged with the inner wall of the knob 62, so that the tip end of the shaft 12 and the base portion 20 of the reducing mechanism 14 are screwed together. Is released, the reduction mechanism 14 can be detached from the shaft 12.

  In the case of the separation mechanism 16C shown in FIG. 4C, the reduction mechanism 14 can be detached from the shaft 12 by energizing the heater 40 to melt and break the connecting portion 38. In the case of the disengaging mechanism 16D shown in FIG. 4D, the shaft 12 is slightly pushed back or rotated to the distal end side with the engaging portion 24 engaged with the inner wall of the knob 62, so that it is provided on the base portion 20 of the reducing mechanism 14. Since the engagement between the hook portion 46 and the engagement portion 48 provided at the tip of the shaft 12 is disengaged, the reduction mechanism 14 can be detached from the shaft 12. In the case of the detachment mechanism 16E shown in FIG. 4E, the release wire 56 is pulled out from between the ball-shaped portion 50 and the holding ring 54 by operating the operation portion provided on the grip portion 18 (the release wire 56 is moved to the ball-shaped portion). The reduction mechanism 14 can be detached from the shaft 12 by moving the ball-like part 50 into the base 20 (withdrawing the release wire 56 to the base end side).

  As described above, the reduction mechanism 14 is detached from the shaft 12, so that the reduction mechanism 14 is in a contracted state, and the engagement portion 24 is engaged with the inner wall of the knob 62. To be done. After the reduction mechanism 14 is detached from the shaft 12, the aneurysm treatment device 10 (outer tube 13 and the like) and the catheter other than the reduction mechanism 14 and the catheter are removed from the living body.

  As described above, according to the aneurysm treatment device 10 according to the present embodiment, the aneurysm treatment device 10 is inserted into the catheter 11 to access the aneurysm 62 generated in the blood vessel 60 and the interval between the arms 22 is increased. The joint portion 24 is engaged with the inner wall of the aneurysm 62, and in this state, the space between the arms 22 is narrowed to reduce the aneurysm 62. be able to. Since the coil or the like is removed from the aneurysm 62 without the neck 64, the aneurysm treatment device 10 is advantageous in that it can be treated regardless of the presence or absence of the neck 64.

  In this case, since the reduction mechanism 14 with the engagement portion 24 engaged with the inner wall of the knob 62 and the interval between the arms 22 narrowed is placed in the knob 62, the state in which the knob 62 is reduced can be stably maintained. Can hold. Therefore, the risk of rupture of the knob 62 can be effectively reduced. Moreover, since the internal volume of the aneurysm 62 is reduced, the influence on the surrounding tissue can be reduced. That is, for example, in the case of a cerebral aneurysm, by reducing the size of the cerebral aneurysm, the pressure on the brain tissue around the cerebral aneurysm can be reduced, and the therapeutic effect can be further enhanced.

  In the case of the present embodiment, the reduction mechanism 14 is forcedly reduced in diameter in the outer tube 13 (a tubular member inserted into the living body lumen) that is reduced in diameter from the expanded state by the expansion being restricted by the outer tube 13. When the diametrical state is taken and the tube is pushed out of the outer tube 13, it is in an expanded state by an elastic restoring force. According to this configuration, even when treating the aneurysm 62 having the neck portion 64 with the opening 63 narrower than the bag-like internal space, the distal end opening of the outer tube 13 faces the opening 63 of the aneurysm 62. By pushing out the reduction mechanism 14 from the distal end of the outer tube 13, the reduction mechanism 14 can be smoothly inserted into the aneurysm 62, and the engagement portion 24 is moved into the expanded state by bringing the reduction mechanism 14 into an expanded state. The inner wall of the knob 62 can be reliably engaged.

  In the case of this embodiment, expansion control that can be changed from a first state that exists between the arms 22 to increase the distance between the arms 22 against the elastic force to a second state that releases the forced expansion of the arms 22. Part 26 is provided. Therefore, when the expansion control unit 26 is in the second state, the interval between the arms 22 can be immediately narrowed, whereby the inner wall of the aneurysm 62 can be quickly and reliably pulled toward the inside of the aneurysm. Moreover, since such an expansion control part 26 can be comprised compactly in the front-end | tip part of the aneurysm treatment device 10, the diameter of the aneurysm treatment device 10 can be reduced and it contributes to the improvement of the penetration property of a lumen.

  In particular, in the case of the present embodiment, the expansion control unit 26 includes an interposition member 26A that is detachably held between the arms 22, and when the interposition member 26A is separated from between the arms 22, the elastic restoring force of the arms 22 The arm 22 is configured to be displaced inward, whereby the arm 22 is closed. Accordingly, the inner wall of the knob 62 can be quickly and reliably pulled toward the inner side of the knob 62 with a simple configuration.

  The expansion control unit 26 is not limited to the above-described interposition member 26A, and may be configured by a resin or a low melting point metal that melts and melts when energized as another example. According to such another embodiment, before melting, the arm 22 exists between the arms 22 in order to widen the distance between the arms 22 against the elastic force. . Therefore, also according to the other embodiment, the inner wall of the knob 62 can be quickly and reliably pulled toward the inner side of the knob.

  In the aneurysm treatment device 10 described above, the outer tube 13 in which the shaft 12 is inserted so as to be movable in the axial direction is provided, but the outer tube 13 may not be provided. In this case, the catheter 11, not the outer tube 13, functions as a tubular member that makes the reduction mechanism 14 in a forced reduced diameter state that is smaller than the expanded diameter state. In this case, when the reduction mechanism 14 is pushed out from the distal end of the catheter 11, the reduction mechanism 14 is in an expanded state by an elastic restoring force.

[Second Embodiment]
FIG. 8 is a perspective view showing the distal end portion of the aneurysm treatment device 70 according to the second embodiment of the present invention. In the aneurysm treatment device 70 according to the second embodiment, elements having the same or similar functions and effects as those of the aneurysm treatment device 10 according to the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted. To do.

  The aneurysm treatment device 70 according to the present embodiment is different from the aneurysm treatment device 10 according to the first embodiment in the configuration of the reduction mechanism 72 and the detachment mechanism 74. The aneurysm treatment device 70 is different from the aneurysm treatment device 10 according to the first embodiment in that the outer tube 13 is not provided.

  The reduction mechanism 72 is a mechanism connected to the tip end portion of the shaft 12 via a detachment mechanism 74, and as shown in FIG. 8, a plurality of reduction mechanisms 72 are provided at intervals in the circumferential direction around the axis of the shaft 12. (In the illustrated example) four arms 76, a plurality of engaging portions 78 provided outside each arm 76, and an elastically deformable support portion 80 connected to the base end of the arm 76, The reduction mechanism 72 is operable from an expanded state in which the distance between the arms 76 is increased (in the expanded diameter state, see FIG. 9B) to a contracted state in which the distance between the arms 76 is reduced (in the reduced diameter state, see FIG. 9C).

  The arm 76 is configured to be inserted into the aneurysm through an opening of the aneurysm generated in the living body (communication port with a blood vessel). Specifically, the arm 76 is connected to the support portion 80 at the base end portion 77 and extends from the support portion 80 in the distal direction. In a state where the reduction mechanism 72 is held by the detachment mechanism 74, the base end portion 77 of the arm 76 is substantially parallel to the shaft 12, and a portion of the arm 76 on the front end side of the base end portion 77 is located at the base end portion 77. On the other hand, the diameter is expanded outward.

  The engaging portion 78 is integrally provided on the outer side of each arm 76. In the present embodiment, the engaging portion 78 is a portion extending from the arm 76 to the distal end side, and a sharp pointed portion 78a is formed at the distal end. The sharpened portion 78a is formed so sharp that it can puncture or penetrate the aneurysm. With such a configuration, as will be described later, the reduction mechanism 72 is inserted into the aneurysm so as to be in a diameter-expanded state, and the engagement mechanism 78 is engaged with the inner wall of the aneurysm, and the reduction mechanism 72 is placed on the back side of the aneurysm. Can be engaged with the inner wall of the knob.

  In the present embodiment, the engaging portion 78 is branched outward from the middle portion of the arm 76 in the longitudinal direction. However, the present invention is not limited to this, and the engaging portion 78 in the configuration shown in FIG. A configuration in which the portion of the arm 76 on the distal end side with respect to the proximal end is eliminated may be used. That is, the engaging portion 78 may extend from the tip of the arm 76.

  The support portion 80 is forcibly expanded in a state of being fitted to the outer peripheral portion of the holding portion 75, and is configured to be reduced in diameter by an elastic restoring force when detached from the holding portion 75. In the present embodiment, the support portion 80 has a circular ring shape as a whole, and can be elastically expanded and contracted in the circumferential direction at least at one location in the circumferential direction (in the illustrated example, four locations between the arms 76). An expansion / contraction part 81 is provided. Although the circumferential direction expansion-contraction part 81 of the example of illustration is a structure bent in Z shape, you may be comprised by the zigzag shape or the waveform.

  An X-ray impermeable marker may be provided on the entire reduction mechanism 72 or the arm 76 so as to be recognized under X-ray fluoroscopy. The arm 76 (including the engaging portion 78) and the support portion 80 may be made of one or more materials selected from the materials exemplified as the constituent materials such as the arm 76 of the reduction mechanism 72 described above.

  The detachment mechanism 74 has a holding portion 75 that is detachably fitted to the support portion 80 and holds the support portion 80 in the fitted state. The holding portion 75 is connected (fixed) to the tip portion of the shaft 12. In the present embodiment, the holding portion 75 has a circular fitting portion 75a that protrudes in the tip direction on the tip side. The inner peripheral portion of the support portion 80 described above is fitted to the outer peripheral portion of the fitting portion 75a. The outer diameter of the fitting part 75a is larger than the inner diameter of the support part 80 in a natural state (a state where the diameter is not expanded by elastic deformation). For this reason, in the state in which the support portion 80 is fitted to the fitting portion 75a, the circumferential expansion / contraction portion 81 of the support portion 80 is forcibly elastically extended in the circumferential direction, so that the support portion 80 is expanded in diameter. In this state, it is held by the fitting portion 75a.

  As shown in FIG. 9A, when performing treatment using the aneurysm treatment device 70, the reduction mechanism 72 fitted to the holding portion 75 is in a state in which expansion is restricted on the inner peripheral surface of the catheter 11 (tubular member) (holding). The arm 76 on the distal end side relative to the portion 75 is elastically deformed inward) and is housed in the catheter 11. Since the support portion 80 receives a force in a direction in which it is forcibly expanded by the fitting portion 75a of the holding portion 75, when the reduction mechanism 72 protrudes from the distal end of the catheter 11, as shown in FIG. The arm 76 is restored elastically so that the space between the arms 76 is opened.

  When the reduction mechanism 72 is detached from the holding portion 75, as shown in FIG. 9C, the forcibly expanded support portion 80 is elastically reduced in diameter, and the proximal end portion of the arm 76 is directed toward the distal end. Inclined to inward. As a result, the arms 76 are displaced toward each other, the interval between the arms 76 is reduced, and the entire reducing mechanism 72 is contracted in a reduced diameter.

  The aneurysm treatment method using the aneurysm treatment device 70 configured as described above includes the following steps.

(1) Access step (first step)
In the access step, first, the catheter 11 having the guide wire inserted therein is run in the blood vessel 60, and the distal end of the catheter 11 reaches the vicinity of the opening 63 of the aneurysm 62 or the inside of the aneurysm 62. Thereafter, the guide wire is removed from the catheter 11. After the guide wire is removed from the catheter 11, the aneurysm treatment device 70 is inserted with the reduction mechanism 72 housed in the catheter 11 (see FIG. 10A).

(2) Insertion step (second step)
Next, with the position of the catheter 11 held, the shaft 12 is advanced in the distal direction, thereby pushing out the reduction mechanism 72 from the distal end opening of the catheter 11 and inserting the reduction mechanism 72 into the aneurysm 62 as shown in FIG. 10B. To do. At this time, the reduction mechanism 72 that has been forcedly reduced in diameter by the inner peripheral surface of the catheter 11 is released from the restriction, so that the interval between the arms 76 is widened by the elastic restoring force of the arms 76. Since the support portion 80 of the reduction mechanism 72 is fitted in the fitting portion 75a of the holding portion 75, the reduction mechanism 72 is in the expanded state. In this expanded state, the engaging portion 78 of the reduction mechanism 72 contacts the inner wall of the knob 62 and presses the inner wall of the knob 62 outward with a weak force.

(3) Engagement step (third step)
Next, an engaging step for engaging the engaging portion 78 provided on the arm 76 with the inner wall of the knob 62 is performed. In this embodiment, as shown in FIG. 11A, the shaft 12 is advanced in the distal direction while the position of the catheter 11 is maintained, so that each engagement portion 78 of the reduction mechanism 72 is engaged with the inner wall of the knob 62. Let Specifically, the engaging portion 78 in contact with the inner wall of the knob 62 is displaced in the distal direction, whereby the engaging portion 78 is inserted into the inner wall of the knob 62 from the sharpened portion 78a. In this case, the sharpened portion 78a of the engaging portion 78 may protrude from the outer wall of the knob 62, or the sharpened portion 78a may be positioned in the wall portion of the knob 62.

(4) Reduction step and separation step (fourth step)
Next, as shown in FIG. 11B, a reduction step for reducing the aneurysm 62 by reducing the interval between the arms 76 in a state where the engaging portion 78 is engaged with the inner wall of the aneurysm 62, and reduction under the action of the detachment mechanism 74. A release step for releasing the mechanism 72 from the shaft 12 is performed simultaneously.

  In the present embodiment, the shaft 12 is rotated in a state where the engagement portion 78 of the reduction mechanism 72 is engaged with the inner wall of the knob 62, so that the fitting portion 75 a of the holding portion 75 and the support portion 80 of the reduction mechanism 72 are When a force exceeding the fitting force is applied, the fitting is released, so that the reduction mechanism 72 can be detached from the shaft 12. Alternatively, the shaft 12 may be moved backward to disengage the support portion 80 of the reduction mechanism 72 from the fitting portion 75a of the holding portion 75.

  As described above, as the reduction mechanism 72 is detached from the shaft 12 as described above, the support portion 80 that has been forcibly expanded in diameter is elastically reduced in diameter, and the proximal end portion 77 of the arm 76 is in the distal direction. Inclined to approach inward. As a result, the arms 76 are displaced toward each other, the distance between the arms 76 is reduced, and the engaging portion 78 is also displaced inward with the displacement of the arms 76. At this time, the knob 62 is reduced by the inner wall of the knob 62 being pulled toward the inner side of the knob 62 by the engaging portions 78 engaged with the inner wall of the knob 62 at a plurality of locations in the circumferential direction of the knob 62. As a result, the internal volume of the aneurysm 62 is greatly reduced as compared with that before the treatment (state of FIG. 10A). In FIG. 11B, the aneurysm 62 before treatment is indicated by a virtual line.

  According to the aneurysm treatment device 70 according to the present embodiment, the aneurysm treatment device 70 is inserted into the catheter 11 to access the aneurysm 62 generated in the blood vessel 60, and the interval between the arms 76 is widened so that the engaging portion 78 is connected to the aneurysm 62. It is possible to perform a procedure (aneurysm treatment method) in which the aneurysm 62 is reduced by engaging with the inner wall of the inner wall and the arm 76 is narrowed in that state, and then the reduction mechanism 72 is detached from the shaft 12.

  Therefore, similarly to the aneurysm treatment device 10 according to the first embodiment, since the state in which the aneurysm 62 is reduced can be stably maintained, the risk of the rupture of the aneurysm 62 can be effectively reduced, and the surrounding tissue The influence can be reduced.

  In particular, in the case of the present embodiment, the reduction mechanism 72 and the shaft 12 are connected by the fitting structure, so that the reduction mechanism 72 can be easily and quickly detached from the shaft 12. Further, since the reduction mechanism 72 is contracted at the same time as the reduction mechanism 72 is detached from the shaft 12, two actions (contraction and separation of the reduction mechanism 72) can be achieved simultaneously by a single operation. Contributes to quick procedures.

  Further, in the case of the present embodiment, the base end portion 77 of the arm 76 is inclined so as to approach inward toward the distal end direction in a state where the support portion 80 is detached from the holding portion 75. With this configuration, the distance between the arms 76 when the reduction mechanism 72 is in the contracted state becomes narrower, and the knob 62 can be reduced further.

  In the second embodiment, the configuration in which the outer tube 13 through which the shaft 12 is inserted is not provided has been described. However, as in the first embodiment, the outer tube 13 is provided, and the inside of the outer tube 13 passes through the shaft 12. May be configured to be inserted and arranged in the axial direction. In this case, the outer tube 13, not the catheter 11, functions as a tubular member that causes the reduction mechanism 72 to have a reduced diameter state that is smaller than the expanded diameter state. Further, in this case, when the reduction mechanism 72 is pushed out from the tip of the outer tube 13, the reduction mechanism 72 is in an expanded state by an elastic restoring force.

  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. Yes.

DESCRIPTION OF SYMBOLS 10, 70 ... Aneurysm treatment device 11 ... Catheter 12 ... Shaft 13 ... Outer tube 14, 72 ... Reduction mechanism 16, 16A-16E, 74 ... Detachment mechanism 22, 76 ... Arm 24, 78 ... Engagement part 26 ... Expansion control part 26A ... interposed member 75 ... holding part 80 ... support part

Claims (7)

A reduction mechanism that can be inserted into the aneurysm formed in the living body and reduces the aneurysm;
A delivery unit for delivering the reduction mechanism to a target site in the living body;
A release mechanism that releasably connects the delivery unit and the reduction mechanism;
The reduction mechanism includes a plurality of arms and a plurality of engagement portions provided on each of the arms and engageable with an inner wall of the knob, and the distance between the arms from an expanded state in which the distance between the arms is widened. Configured to be able to operate into a narrowed contraction state,
An aneurysm treatment device characterized by that. The aneurysm treatment device according to claim 1, wherein
The reduction mechanism is in a state where it is inserted and arranged in a tubular member that is inserted into a living body lumen, and takes a forced reduced diameter state that is reduced in diameter than the expanded state by restricting expansion by the tubular member, When pushed out from the tubular member, it becomes the expanded state by elastic restoring force,
An aneurysm treatment device characterized by that. The aneurysm treatment device according to claim 1 or 2,
An expansion control unit capable of changing from a first state existing between the arms to expand an interval between the arms against an elastic force to a second state in which the forced expansion with respect to the arms is released;
An aneurysm treatment device characterized by that. The aneurysm treatment device according to claim 3,
The expansion control unit comprises an interposed member that is detachably held between the arms,
When the interposition member is separated from between the arms, the arm is displaced inward by the elastic restoring force of the arm, and the reduction mechanism is in the contracted state.
An aneurysm treatment device characterized by that. The aneurysm treatment device according to claim 1 or 2,
The reduction mechanism has a support portion connected to the base end of the arm and capable of reducing the diameter by elastic deformation,
The detachment mechanism is detachably fitted to the support part, and has a holding part that holds the support part in a fitted state.
The support portion is forcibly expanded in a state of being fitted to the holding portion, and is reduced in diameter by an elastic restoring force when detached from the holding portion.
An aneurysm treatment device characterized by that. The aneurysm treatment device according to claim 5,
The base end portion of the arm is inclined so as to approach inward toward the distal end in a state where the support portion is detached from the holding portion.
An aneurysm treatment device characterized by that. An aneurysm treatment device comprising: a reduction mechanism having a plurality of arms; a delivery part for delivering the reduction mechanism to a target site in a living body; and a release mechanism for releasably connecting the reduction mechanism from the delivery part. An access step for delivering the aneurysm to a location through a catheter inserted into the body lumen;
An insertion step of inserting the reduction mechanism into the aneurysm after the access step;
After the inserting step, an engaging step for engaging an engaging portion provided on each of the arms with the inner wall of the knob,
In a state where the engaging portion is engaged with the inner wall of the aneurysm, a reduction step for reducing the aneurysm by reducing the interval between the arms;
A detaching step of detaching the reducing mechanism from the delivery unit under the action of the detaching mechanism simultaneously with or after the reducing step;
An aneurysm treatment method characterized by the above.

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