JP2013183951A - Medical device for removing foreign matter in blood vessel - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a low-invasion medical device for removing foreign matter in a blood vessel which certainly captures and removes foreign matter in a blood vessel.SOLUTION: A medical device 1 for removing foreign matter in a blood vessel is used so as to remove embolus objects 102 from in a blood vessel 100 by being inserted into the blood vessel 100. The medical device 1 for removing the foreign matter in a blood vessel includes: a device body 2 having a first flow passage 23 through which blood 101 passes toward the proximal end side, a second flow passage 24 through which the blood 101 passes toward the distal end side, and a communication passage 25 for communicating the first flow passage 23 and the second flow passage 24, and through which the blood 101 passes toward the second flow passage 24 from the first flow passage 23; a suction/discharge means 3 sucking the blood 101 into the first flow passage 23 together with the embolus objects 102, and discharging the sucked blood 101 into the blood vessel 100 through the second flow passage 24; and a filter member 4 provided in the communication passage 25, for making the blood 101 pass therethrough, prevent the embolus objects 102 from passing therethrough, and capturing the embolus objects 102 not passing through the filter member 4.

Description

  The present invention relates to a medical instrument for removing intravascular foreign matter.

  According to the Ministry of Health, Labor and Welfare's demographic statistics, the first cause of death in Japan is cancer, the second is heart disease, the third is stroke, and deaths and sequelae are especially urgent. It has become.

  In recent years, thrombolytic therapy using a thrombolytic agent has been developed for treating cerebral infarction in the acute phase in the treatment of stroke, and its therapeutic effect has been raised, but its limitations are also pointed out. In other words, from the experience of doctors, thrombolytic agents require a long time for thrombolysis, smaller thrombi fly further to form new emboli sites, and there are thrombi that do not dissolve with thrombolytic agents. It recognized. In the case of cerebral infarction, if the blood flow can be resumed within 3 hours after the onset of the infarction, not only will the survival rate increase, but it has been proved in the United States and Europe that it can be inserted into the cerebral blood vessels and directly takes a thrombus. There is a strong demand for the development of medical devices that can be used.

  As such a medical device, there is one configured to suck foreign matter (emboli piece) in a blood vessel together with blood and remove it from the blood vessel (see, for example, Patent Document 1). However, the medical instrument described in Patent Document 1 has a problem in that foreign matter is sucked and removed together with blood, so that the blood (normal blood) is also removed in the same manner as the foreign matter. This places a heavy burden (invasion) on the patient.

JP-A-5-31117

  An object of the present invention is to provide a medical device for removing a foreign substance in a blood vessel that is minimally invasive and can reliably capture and remove the foreign substance in the blood vessel.

Such an object is achieved by the present inventions (1) to (7) below.
(1) A medical device for removing a foreign substance in a blood vessel that is used to insert the substance into a blood vessel and remove the foreign substance from the blood vessel,
A long body, at least a distal end portion thereof is inserted into a blood vessel, is formed along the longitudinal direction of the long body, and blood passes through from the distal end side toward the proximal end side. A flow path, a second flow path formed along the longitudinal direction, through which blood passes from the proximal end side toward the distal end side, a proximal end portion of the first flow path, and the second flow path An instrument body having a communication path through which blood passes from the first flow path toward the second flow path.
Suction / discharge means for sucking blood into the first channel together with the foreign matter in the blood vessel and discharging the sucked blood into the blood vessel through the second channel;
A medical device for removing intravascular foreign matter, comprising a filter member that is provided in the communication path and passes blood but does not pass foreign matter and captures foreign matter that does not pass.

  (2) The filter member has a film-like shape, and is disposed in the middle of the communication path. The communication path includes a first space upstream of the filter member, and the filter member. The blood vessel foreign substance removing medical device according to (1), which is partitioned into a second space on the downstream side.

  (3) The suction / discharge means is composed of at least one syringe provided with an outer cylinder having a mouth portion that is formed to protrude from the tip portion, and the mouth portion is liquid-tightly connected in the middle of the communication path. The medical device for removing intravascular foreign matter according to (1) or (2) above.

(4) The filter member has a film-like shape, and is arranged in the middle of the communication path. The communication path includes a first space upstream of the filter member and the filter member. Is divided into a second space on the downstream side,
The suction / discharge means includes two syringes, and the mouth portion of one of the two syringes communicates with the first space, and the mouth portion of the other syringe The medical device for removing a foreign substance in a blood vessel according to (3), wherein is in communication with the second space.

  (5) The intravascular foreign body removal according to any one of (1) to (4), wherein the instrument body is formed in the communication path and has at least one injection port for injecting liquid into the communication path. Medical equipment.

(6) The filter member has a film-like shape, and is arranged in the middle of the communication path. The communication path includes a first space upstream of the filter member, and the filter member. Is divided into a second space on the downstream side,
The instrument body has two inlets, one of the two inlets communicating with the first space, and the other inlet communicating with the second space. The medical device for removing a foreign substance in a blood vessel according to (5) above.

(7) The first flow path has a first opening that opens at a distal end surface of the instrument body,
The second flow path has a second opening that opens at the distal end surface of the instrument body,
The medical instrument for removing intravascular foreign matter according to any one of (1) to (6), wherein the first opening and the second opening are arranged so as to be shifted in the longitudinal direction.

  In the medical device for removing foreign matter in a blood vessel of the present invention, when the first opening and the second opening are viewed from the distal end side, the size of the first opening is the second It is preferable that it is larger than the size of the opening.

  In the medical device for removing intravascular foreign matter according to the present invention, the direction of blood flow is regulated in one direction in the middle of the longitudinal direction of each of the first flow path and the second flow path. A one-way valve is preferably installed.

  In the medical device for removing foreign matter in a blood vessel of the present invention, the device main body is formed in a portion of the second flow path upstream of the one-way valve installed in the second flow path. It is preferable to have a discharge port for discharging a part of blood from the second flow path.

  In the medical device for removing intravascular foreign matter of the present invention, it is preferable that the device body has a guide wire insertion passage formed along the longitudinal direction and through which the guide wire is inserted.

  In the medical device for removing intravascular foreign matter of the present invention, it is preferable that the insertion direction of the medical device for removing intravascular foreign matter into the blood vessel is the same as the blood flow in the blood vessel.

  According to the present invention, blood in a blood vessel can be sucked together with foreign matters, and the sucked foreign matter can be reliably captured by the filter member and reliably removed from the blood vessel. On the other hand, the sucked blood is returned again to the blood vessel. As a result, the burden on the patient can be greatly reduced compared to conventional medical devices for removing foreign matter in blood vessels in which blood is also removed (ischemic) together with the foreign matter, that is, the foreign matter is less invasive. Can be removed. In particular, when removing foreign matter from the blood vessels of the brain or heart, ischemia is a problem that should be avoided as much as possible, and thus medical instruments are preferably used.

  Moreover, when using the medical device for removing a foreign substance in a blood vessel according to the present invention, it is possible to make one insertion point for a blood vessel. This is minimally invasive for the patient.

It is a fragmentary longitudinal cross-sectional view which shows in order the usage method of the medical device (1st Embodiment) for the intravascular foreign material removal of invention. It is a fragmentary longitudinal cross-sectional view which shows in order the usage method of the medical device (1st Embodiment) for the intravascular foreign material removal of invention. It is a fragmentary longitudinal cross-sectional view which shows in order the usage method of the medical device (1st Embodiment) for the intravascular foreign material removal of invention. It is a fragmentary longitudinal cross-sectional view which shows in order the usage method of the medical device (1st Embodiment) for the intravascular foreign material removal of invention. It is the figure (front view) seen from the arrow A direction in FIG. It is a fragmentary longitudinal cross-section which shows 2nd Embodiment of the medical device for intravascular foreign material removal of this invention.

  Hereinafter, the medical device for removing intravascular foreign matter of the present invention will be described in detail based on preferred embodiments shown in the accompanying drawings.

<First Embodiment>
1 to 4 are partial vertical cross-sectional views sequentially showing a method of using the medical device for removing a foreign substance in a blood vessel according to the present invention (first embodiment), and FIG. 5 is viewed from the direction of arrow A in FIG. It is a figure (front view). In the following, for convenience of explanation, the right side in FIGS. 1 to 4 (the same applies to FIG. 6) is referred to as “base end”, and the left side is referred to as “tip”.

  The medical device for removing foreign substances in blood vessels (hereinafter simply referred to as “medical devices”) 1 shown in FIGS. 1 to 4 is inserted into the blood vessel 100 to cause emboli such as blood clots and blood clots. Used to remove a foreign substance (hereinafter referred to as “emboli 102”). The blood vessel 100 into which the medical instrument 1 is inserted may be either an artery or a vein.

  The medical instrument 1 includes an instrument main body 2 constituted by an elongated body, suction / discharge means 3 for discharging the sucked blood 101 and suctioning blood 101, and blood 101 passes through, but the embolus 102 is The filter member 4 which does not pass is provided.

  The instrument main body 2 is configured by a long body whose shape (cross-sectional shape) viewed from the tip side is an ellipse (see FIG. 5). The instrument body 2 can be divided into a flexible portion 21 on the distal end side and a hard portion 22 on the proximal end side in the middle of the longitudinal direction. The flexible part 21 is a part that has flexibility and is inserted into the blood vessel 100. The hard part 22 is a part located on the body surface side in a state where the flexible part 21 is inserted into the blood vessel 100.

  The constituent material of the flexible portion 21 is not particularly limited. For example, polyolefin such as polyethylene and polypropylene, polystyrene, polyamide, polyimide, polyetheretherketone, polyurethane, polyethylene terephthalate, polyester such as polybutylene terephthalate, polytetrafluoro Fluorine-based resins such as ethylene, polyolefin-based, polystyrene-based, polyamide-based, polyurethane-based, polyester-based, fluororubber-based, chlorinated polyethylene-based thermoplastic elastomers, and further combinations of two or more of these (Polymer alloy, polymer blend, etc.). In addition, a member (for example, a ring shape (tubular) made of a material (for example, platinum, gold, tungsten, or the like) having radiopacity (X-ray contrast property) is formed at the distal end portion of the flexible portion 21. A coil-shaped member) may be installed. Thereby, the tip part of the flexible part 21 can be confirmed reliably under X-ray fluoroscopy.

  Moreover, it does not specifically limit as a constituent material of the hard part 22, For example, various metal materials, various plastics, etc. can be used individually or in combination.

  As shown in FIGS. 1 to 4, the instrument body 2 (elongate body) includes a first flow path 23, a second flow path 24, and a guide wire insertion path 26 formed along the longitudinal direction thereof, A communication path 25 that communicates the base end of the first flow path 23 and the base end of the second flow path 24 is provided. In addition, the instrument body 2 includes a first one-way valve (first check valve) 27 a installed in the middle of the first flow path 23 and a middle of the second flow path 24 in the longitudinal direction. And a second one-way valve (second check valve) 27b.

  The first flow path 23 is formed from the flexible portion 21 to the hard portion 22. Further, the first flow path 23 has a first opening 231 that opens to the distal end surface 28 of the instrument body 2. Then, the blood 101 flows into the first flow path 23 through the first opening 231 with the suction force generated by the operation of the suction / discharge means 3, and from the distal end side toward the proximal end side, that is, the continuous flow. It can pass toward the passage 25 (flow down).

  Similarly to the first flow path 23, the second flow path 24 is also formed from the flexible portion 21 to the hard portion 22. Further, the second flow path 24 has a second opening 241 that opens to the distal end surface 28 of the instrument body 2. The blood 101 passes through the second flow path 24 from the proximal end side toward the distal end side, that is, from the communication path 25 side (flows down) by the discharge force generated by the operation of the suction / discharge means 3. And is discharged from the second opening 241.

  The first flow path 23 and the second flow path 24 are in communication with each other via a communication path 25. The communication path 25 is formed in the hard portion 22. The blood 101 can pass through the communication path 25 from the first flow path 23 toward the second flow path 24.

  The first one-way valve 27 a is installed in the middle of the first flow path 23, that is, in the vicinity of the boundary between the flexible portion 21 and the hard portion 22 of the first flow path 23. The first one-way valve 27a regulates the flow direction of the blood 101 flowing down the first flow path 23 in one direction. As a result, even if the discharge force due to the operation of the suction / discharge means 3, that is, the force that causes the blood 101 to flow backward in the first flow path 23, reaches the first flow path 23, the blood 101 flows backward. Can be reliably prevented.

  The second one-way valve 27 b is installed in the middle of the second flow path 24, that is, near the boundary between the flexible portion 21 and the hard portion 22 of the second flow path 24. The second flow path 24 regulates the flow direction of the blood 101 flowing down the first flow path 23 in one direction. As a result, even if the suction force by the operation of the suction / discharge means 3, that is, the force that causes the blood 101 to flow backward in the second flow path 24, reaches the second flow path 24, the blood 101 flows backward. Can be reliably prevented.

  As the first one-way valve 27a and the second one-way valve 27b, for example, a duckbill valve made of an elastic material can be used. In addition, the valve body is composed of a plate-like elastic body, formed on both surfaces thereof, and having slits that intersect with each other inside the elastic body, and is arranged so as to bend toward the downstream side of blood. A valve body can also be used.

  The elastic material is not particularly limited. For example, natural rubber, isoprene rubber, butadiene rubber, styrene-butadiene rubber, nitrile rubber, chloroprene rubber, butyl rubber, acrylic rubber, ethylene-propylene rubber, hydrin rubber, urethane rubber, silicone Various rubber materials (especially those vulcanized) such as rubber and fluoro rubber, styrene, polyolefin, polyvinyl chloride, polyurethane, polyester, polyamide, polybutadiene, trans polyisoprene, fluoro rubber Various thermoplastic elastomers such as chlorinated polyethylene and chlorinated polyethylene can be used, and one or more of these can be used in combination.

  A guide wire insertion passage 26 through which the guide wire 20 is inserted is formed in a portion of the instrument body 2 opposite to the second flow channel 24 via the first flow channel 23. The guide wire insertion path 26 is formed through the flexible portion 21 in the longitudinal direction. Thus, the guide wire insertion passage 26 has a distal end opening 261 that opens to the distal end surface 28 of the instrument body 2 and a proximal end opening 262 that opens to the proximal end face 29 of the instrument body 2. Then, the guide wire 20 can be inserted from the proximal end opening 262 and the distal end 201 of the guide wire 20 can be protruded from the distal opening 261.

  Since the flexible portion 21 in which the guide wire insertion passage 26 is formed has flexibility, the guide wire 20 having higher rigidity is inserted into the blood vessel 100 of the flexible portion 21. Can be easily inserted.

  In addition, it is preferable that the guide wire 20 inserted into the guide wire insertion passage 26 has a distal end portion 201 bent in, for example, a “J” shape in a natural state where no external force is applied (FIGS. 1 to 4). reference).

  The guide wire insertion passage 26 also functions as a supply path for supplying the contrast medium into the blood vessel 100 with the guide wire 20 removed. By supplying the contrast agent into the blood vessel 100, the operation of removing the embolus 102 under fluoroscopy can be easily performed.

  As shown in FIG. 1 (the same applies to FIGS. 2 to 4), the first opening 231 of the first flow path 23, the second opening 241 of the second flow path 24, and the guide wire insertion The distal end side opening 261 of the passage 26 is disposed so as to be shifted in the longitudinal direction. In the illustrated configuration, the distal end side opening 261 is located closest to the distal end, the first opening 231 is located proximal to the distal end side opening 261, and the second opening 241 is the first opening. It is located on the base end side (most base end side) from the portion 231. Further, the first opening 231 is inclined with respect to the longitudinal direction of the first flow path 23.

  Even if the distal end surface 28 of the instrument body 2 abuts on the blood vessel wall 103 due to the synergistic effect of the positional relationship between the openings and the inclination of the first opening 231, the blood 101 It is possible to reliably prevent the first opening 231 functioning as a suction port from being blocked by the blood vessel wall 103. Thereby, the blood 101 can be reliably sucked together with the embolus 102 through the first opening 231. In addition, the blood discharged from the second opening 241 makes it easy to suck blood containing thrombus from the first opening 231.

  As shown in FIG. 5, when the first opening 231 and the second opening 241 are viewed from the distal end side, the size of the first opening 231 is larger than the size of the second opening 241. . In the medical instrument 1, since the suction of the blood 101 is mainly performed than the discharge, such a size relationship between the openings is preferable.

  In the present embodiment, the shapes of the first opening 231, the second opening 241, and the distal end opening 261 when viewed from the distal end side are each elliptical.

  A filter member 4 is provided (arranged) in the middle of the communication path 25. The filter member 4 passes the blood 101 but does not pass the embolus 102, and can capture the embolus 102 that does not pass.

  As shown in FIG. 1 (the same applies to FIGS. 2 to 4), the filter member 4 has a film shape. The edge portion 41 of the filter member 4 is fixed to the wall portion (inner wall) of the hard portion 22 that defines the communication path 25. Thereby, the communication path 25 is upstream of the filter member 4, that is, the first space 251 on the first flow path 23 side, and downstream of the filter member 4, that is, the second flow path 24 side. The second space 252 is partitioned.

  The hard portion 22 has a first connection port 253 that communicates with the first space 251 and a second connection port 254 that communicates with the second space 252 at the proximal end portion thereof. Is formed. A first syringe 31a of a suction / discharge unit 3 (to be described later) is liquid-tightly connected to the first connection port 253, and a second syringe of the suction / discharge unit 3 is connected to the second connection port 254. 31b is liquid-tightly connected.

  Examples of the form of the filter member 4 include a mesh-like (net-like) shape, a woven fabric, a non-woven fabric, or a combination thereof. Among these, a mesh-like (net-like) shape is used. preferable. The thing of such a form can capture | acquire the embolus 102 more reliably, and the blood 101 can pass easily. In the case of the filter member 4 having such a form, the mesh opening is not particularly limited. In general, the size of red blood cells is 7 to 8 μm, and the opening of the filter member 4 is preferably the same as or slightly larger than the size. For example, the aperture of the filter member 4 is preferably 6 to 30 μm, and more preferably 8 to 15 μm. Thereby, it is possible to capture the relatively fine embolus 102 while suppressing an increase in the passage resistance of the blood 101, and the embolization object 102 has high capture efficiency (removability).

  As shown in FIG. 1, the suction / discharge unit 3 includes a first syringe 31a and a second syringe 31b. The first syringe 31 a is a syringe that sucks the blood 101 into the first flow path 23 together with the embolus 102 in the blood vessel 100. The second syringe 31b is a syringe that discharges blood 101 sucked by the first syringe 31a into the blood vessel 100 through the second flow path 24, that is, returns (returns blood). Since the configurations of the first syringe 31a and the second syringe 31b are the same, the first syringe 31a will be representatively described below.

  The first syringe 31 a includes an outer cylinder 32, a gasket 33 that can slide on the outer cylinder 32, and a plunger 34 that is connected to the proximal end side of the gasket 33.

  The outer cylinder 32 is configured by a member having a bottomed cylindrical shape, and has a mouth portion 321 that is formed to protrude from a tip portion (bottom portion) thereof. The mouth portion 321 is liquid-tightly connected to the first connection port 253 of the instrument body 2. Thereby, in the first syringe 31 a, the inner space 35 surrounded by the outer cylinder 32 and the gasket 33 communicates with the first space 251 of the communication path 25.

  Note that the mouth portion 321 of the second syringe 31 b is liquid-tightly connected to the second connection port 254 of the instrument body 2. Thereby, in the second syringe 31 b, the internal space 35 surrounded by the outer cylinder 32 and the gasket 33 communicates with the second space 252 of the communication path 25.

The gasket 33 is made of a disc-shaped elastic body.
The plunger 34 moves the gasket 33 along the axial direction of the outer cylinder 32. By this operation, the internal space 35 can be switched between a reduced pressure state and a pressurized state.

  As described above, the suction / discharge means 3 is configured by the first syringe 31a and the second syringe 31b, so that the first syringe 31a and the second syringe 31b can be independently made at arbitrary timings. Can be operated.

  Next, an example of a method for using the medical instrument 1 will be described with reference to FIGS. This procedure is preferably performed under fluoroscopy.

  [1] First, an unused medical instrument 1 is prepared. In the medical instrument 1, the first syringe 31a and the second syringe 31b are in a state where the plunger 34 is pushed out (see FIG. 1). Further, the guide wire 20 has not yet been inserted into the guide wire insertion passage 26 of the medical device 1 (the device body 2).

  [2] Next, the medical instrument 1 is brought into an assembled state in which the guide wire 20 is inserted into the guide wire insertion passage 26 (see FIG. 1). In the assembled state, the distal end portion 201 of the guide wire 20 protrudes from the distal end side opening 261 of the guide wire insertion passage 26. Then, the assembled medical device 1 is inserted into the blood vessel 100, and the distal end portion of the medical device 1 is guided to the position close to the embolus 102 while the distal end portion 201 of the guide wire 20 is advanced.

  As shown in FIG. 1, the insertion direction of the medical instrument 1 with respect to the blood vessel 100 is the same direction as the flow (blood flow) of the blood 101 in the blood vessel 100 (antegrade). As a result, the medical instrument 1 approaches the embolus 102 from the upstream side thereof, and thus a reduction in suction force at the first opening 231 can be prevented.

  [3] Next, as shown in FIG. 2, the plunger 34 of the first syringe 31a is pulled in the proximal direction. As a result, a suction force is generated in the first flow path 23 and the communication path 25, and the blood 101 is sucked together with the embolus 102 toward the first opening 231. Then, these sucked materials flow down the first flow path 23 toward the communication path 25.

  The suction force also reaches the second flow path 24 (second opening 241), but the second one-way valve 27b is installed in the second flow path 24. The suction of blood 101 into the second flow path 24 is prevented.

  [4] Next, as shown in FIG. 3, the plunger 34 of the second syringe 31 b is pulled in the proximal direction. Thereby, in the communication path 25, a suction force from the first space 251 toward the second space 252 is generated, and the blood 101 passes through the filter member 4. However, since the embolus 102 cannot pass through the filter member 4, it is reliably captured by the filter member 4. Thereby, the embolus 102 is reliably removed from the blood vessel 100.

  Here, similarly to the operation [3], when the plunger 34 of the second syringe 31b is pulled, the suction force due to the tension reaches the second flow path 24 by the second one-way valve 27b. Absent.

  [5] Next, as shown in FIG. 4, the plunger 34 of the second syringe 31 b is pressed toward the distal end. As a result, a discharge force (a force for pushing out blood 101) is generated in the second flow path 24 and the communication path 25, and only the blood 101 flows down the second flow path 24 toward the second opening 241. . Then, the blood 101 that has flowed down is discharged from the second opening 241 and returned to the blood vessel 100.

  Note that the discharge force also reaches the first flow path 23 (first opening 231), but since the first one-way valve 27a is installed in the first opening, Backflow of blood 101 in the first flow path 23 is prevented.

  Moreover, you may perform the press operation of the 1st syringe 31a before and after the said operation of the 2nd syringe 31b, or simultaneously with it.

  By operating the medical instrument 1 as described above, the blood 101 in the blood vessel 100 is sucked together with the embolus material 102, and the embolus material 102 is reliably captured by the filter member 4 and reliably removed from the blood vessel 100. can do. On the other hand, the sucked blood 101 is returned to the blood vessel 100 again. Thus, the burden on the patient can be greatly reduced compared to the conventional medical device for removing foreign matter in blood vessels in which the blood 101 is also removed (ischemic) together with the embolus 102, that is, is less invasive. The embolus 102 can be removed. In particular, when removing the embolus 102 from the blood vessel 100 of the brain or heart, since the ischemia is a problem that should be avoided as much as possible, the medical instrument 1 is preferably used.

  Moreover, in the medical instrument 1, when using it, the insertion location with respect to the blood vessel 100 can be made into one location. This can be said to be a minimally invasive procedure for the patient.

  In the medical instrument 1, the blood 101 circulates. At that time, the blood sucked from the first opening 231 is discharged from the second opening 241 immediately adjacent to the first opening 231. . Thus, even if there is a blood vessel wall 103 that is likely to be sucked into the first opening 231, the blood vessel wall 103 can be pushed back by the blood 101 (discharge force) in the second opening 241. Therefore, it is possible to more reliably prevent the first opening 231 from being blocked by the blood vessel wall 103.

Second Embodiment
FIG. 6 is a partial longitudinal sectional view showing a second embodiment of the medical device for removing foreign matter in a blood vessel of the present invention.

Hereinafter, a second embodiment of the medical device for removing intravascular foreign matter according to the present invention will be described with reference to this figure, but the description will focus on the differences from the above-described embodiment, and the description of the same matters will be omitted. To do.
The present embodiment is the same as the first embodiment except that the configuration of the instrument body is different.

  In the medical device 1 of the present embodiment shown in FIG. 6, the device body 2 includes a first injection port (first injection port) 255, a second injection port (second injection port) 256, and a discharge port. (Discharge port) 242. The first injection port 255, the second injection port 256, and the discharge port 242 are all formed to protrude from the rigid portion 22 of the instrument body 2.

  The first injection port 255 (one injection port) is located in the communication path 25. The first injection port 255 is a port for communicating with the first space 251 of the communication path 25 and injecting liquid into the first space 251.

  The second injection port 256 (the other injection port) is also located in the communication path 25. The second injection port 256 is a port that communicates with the second space 252 of the communication path 25 and injects liquid into the second space 252.

  The discharge port 242 is located at a portion upstream of the second one-way valve 27 b of the second flow path 24. The discharge port 242 is a port for discharging a part of the blood 101 from the second flow path 24. A three-way cock 5 that opens and closes the discharge port 242 is connected to the end of the discharge port 242.

  Thus, in the medical instrument 1, it can be said that the first injection port 255, the second injection port 256, and the discharge port 242 are respectively disposed in the circulation system through which the blood 101 circulates.

  Further, the first injection port 255 is liquid-tightly connected to the first syringe 6a filled with the first liquid 65a, and the second injection port 256 is filled with the second liquid 65b. The second syringe 6b is liquid-tightly connected. Since the configurations of the first syringe 6a and the second syringe 6b are the same, the first syringe 6a will be representatively described below.

  The first syringe 6 a includes an outer cylinder 62, a gasket 63 that can slide on the outer cylinder 62, and a plunger 64 that is connected to the proximal end side of the gasket 63.

  The outer cylinder 62 is configured by a member having a bottomed cylindrical shape, and has a mouth portion 621 that is formed to protrude from a tip portion (bottom portion) thereof. The mouth 621 is liquid-tightly connected to the first injection port 255. Thereby, the first syringe 6 a can inject the first liquid 65 a filled in the space surrounded by the outer cylinder 62 and the gasket 63 into the first space 251.

  Note that the mouth portion 621 of the second syringe 6b is liquid-tightly connected to the second injection port 256. Thereby, the second syringe 6 b can inject the second liquid 65 b filled in the space surrounded by the outer cylinder 62 and the gasket 63 into the second space 252.

The gasket 63 is made of an elastic body having a disk shape.
The plunger 64 moves the gasket 63 along the axial direction of the outer cylinder 62.

  For example, when the first liquid 65a is a thrombolytic agent (for example, urokinase), the embolus 102 attached to the filter member 4 is dissolved by injecting the first liquid 65a into the first space 251. The clogging of the filter member 4 can be prevented. Thereby, even when the medical instrument 1 is continuously used for a predetermined time, the blood 101 can easily pass through the filter member 4, that is, an increase in the passage resistance of the blood 101 in the filter member 4 can be prevented. Can do.

  In addition, when contrast with the contrast agent supplied into the blood vessel 100 from the guide wire insertion passage 26 is completed, the contrast agent may be desired to be diluted (thinned). In this case, the second liquid 65b is preferably physiological saline. Thereby, the second liquid 65 b can be injected into the second space 252 and discharged from the second flow path 24. Then, the contrast agent can be diluted with the discharged second liquid 65b.

  Further, from the discharge port 242, a part of the blood 101 can be discharged while the three-way cock 5 is open. This discharged blood 101 can be used as a blood sample. In addition, the contrast agent used for contrast can be collected from the discharge port 242 together with the blood 101. Thereby, it is prevented or suppressed that the contrast agent is returned into the blood vessel 100.

  The number of injection ports formed for injecting liquid into the communication path 25 is two in the configuration shown in FIG. 6, but is not limited to this. For example, the number of injection ports may be one or three or more. Good.

  Although the illustrated embodiment of the medical device for removing intravascular foreign matter of the present invention has been described above, the present invention is not limited to this, and the respective parts constituting the medical device for removing intravascular foreign matter are the same. It can be replaced with any structure that can perform its function. Moreover, arbitrary components may be added.

  The medical device for removing intravascular foreign matter according to the present invention may be a combination of any two or more configurations (features) of the above embodiments.

  In addition, the suction / discharge means is configured with two syringes in each of the embodiments described above, but is not limited thereto, and may be configured with, for example, a single syringe or an electric pump. It may be a mode in which on / off and / or flow rate and flow rate are changed.

  In addition, the insertion direction of the medical device for removing intravascular foreign matter into the blood vessel is the same direction as the blood flow in each of the above embodiments, but is not limited thereto, and may be the direction opposite to the blood flow (retrograde property). ). In this case, the foreign substance flows toward the medical instrument for removing the foreign substance in the blood vessel (first opening), and the foreign substance capturing property is improved.

1 Medical device for removing foreign substances in blood vessels (medical device)
2 Instrument body 21 Flexible part 22 Hard part 23 1st flow path 231 1st opening part 24 2nd flow path 241 2nd opening part 242 Discharge port (discharge port)
25 communication path 251 first space 252 second space 253 first connection port 254 second connection port 255 first injection port (first injection port)
256 Second inlet port (second inlet)
26 Guide wire insertion passage 261 Tip side opening 262 Base side opening 27a First one-way valve (first check valve)
27b Second one-way valve (second check valve)
28 distal end surface 29 proximal end surface 3 suction / discharge means 31a first syringe 31b second syringe 32 outer cylinder 321 mouth portion 33 gasket 34 plunger 35 inner space 4 filter member 41 edge portion 5 three-way stopcock 6a first syringe 6b first 2 syringe 62 outer cylinder 621 mouth 63 gasket 64 plunger 65a first liquid 65b second liquid 20 guide wire 201 tip 100 blood vessel 101 blood 102 embolus 103 blood vessel wall

Claims (7)

A medical device for removing intravascular foreign matter used to remove foreign matter from the blood vessel inserted into the blood vessel,
A long body, at least a distal end portion thereof is inserted into a blood vessel, is formed along the longitudinal direction of the long body, and blood passes through from the distal end side toward the proximal end side. A flow path, a second flow path formed along the longitudinal direction, through which blood passes from the proximal end side toward the distal end side, a proximal end portion of the first flow path, and the second flow path An instrument body having a communication path through which blood passes from the first flow path toward the second flow path.
Suction / discharge means for sucking blood into the first channel together with the foreign matter in the blood vessel and discharging the sucked blood into the blood vessel through the second channel;
A medical device for removing intravascular foreign matter, comprising a filter member that is provided in the communication path and passes blood but does not pass foreign matter and captures foreign matter that does not pass.   The filter member has a film-like shape, and is arranged in the middle of the communication path. The communication path is formed in a first space upstream of the filter member and downstream of the filter member. The medical device for removing intravascular foreign matter according to claim 1, which is partitioned into a second space.   The suction / discharge means is composed of at least one syringe including an outer cylinder having a mouth portion protruding from a tip portion, and the mouth portion is liquid-tightly connected in the middle of the communication path. The medical device for removing a foreign substance in a blood vessel according to 1 or 2. The filter member has a film-like shape, and is arranged in the middle of the communication path. The communication path is formed in a first space upstream of the filter member and downstream of the filter member. Divided into the second space of
The suction / discharge means includes two syringes, and the mouth portion of one of the two syringes communicates with the first space, and the mouth portion of the other syringe The medical device for removing a foreign substance in a blood vessel according to claim 3, wherein is in communication with the second space.   The medical device for removing intravascular foreign matter according to any one of claims 1 to 4, wherein the device main body is formed in the communication passage and has at least one injection port for injecting a liquid into the communication passage. The filter member has a film-like shape, and is arranged in the middle of the communication path. The communication path is formed in a first space upstream of the filter member and downstream of the filter member. Divided into the second space of
The instrument body has two inlets, one of the two inlets communicating with the first space, and the other inlet communicating with the second space. The medical instrument for removing a foreign substance in a blood vessel according to claim 5. The first flow path has a first opening that opens at the distal end surface of the instrument body,
The second flow path has a second opening that opens at the distal end surface of the instrument body,
The medical instrument for removing intravascular foreign matter according to any one of claims 1 to 6, wherein the first opening and the second opening are arranged so as to be shifted in the longitudinal direction.

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