JP2016002282A - Electrode unit and tissue stimulation system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an electrode unit and a tissue stimulation system capable of preventing adhesion of thrombi with a higher performance.SOLUTION: The electrode unit comprises: a distal fastener 25 and a proximal fastener 26; a plurality of wire parts 27 of which ends are connected to at least the distal fastener 25 and the proximal fastener 26, respectively, and which are curved such that the intermediate portions of the wire parts in an axial direction along the axis passing through the distal fastener 25 and the proximal fastener 26 are separated from the axis, wherein the intermediate portions are arranged separated from each other about the axis; a pair of stimulating electrodes 28 arranged on a side opposite to the axis of the intermediate part of at least one wire part 27; conductor wires 29 the tips of which are electrically connected to the pair of stimulating electrodes 28 and which extend toward the proximal end along the wire parts 27; and feed pipes 13, 14 which have liquid discharge ports 38, 39 in at least two or more arbitrary positions different from each other and has at least two or more feed channels connected to the liquid discharge ports 38, 39.

Description

  The present invention relates to an electrode unit and a tissue stimulation system.

2. Description of the Related Art Conventionally, stimulation systems for applying electrical stimulation to living tissue are known. For example, Patent Document 1 discloses an electrode unit and a tissue stimulation system including an electrode support assembly in which distal sides of a plurality of splines are bound by a hub and a proximal side of the splines is bound by a base portion.
Since the electrode unit and the tissue stimulation system described in Patent Document 1 do not have large protrusions that are likely to protrude or damage the endocardial tissue, there is a possibility of causing trauma to the tissue. Is low. Moreover, in the electrode unit and the tissue stimulation system described in Patent Document 1, the electrode carried near the hub can be brought into close contact with the endocardial tissue.

Japanese Patent No. 3423719

When an electrode unit or tissue stimulation system is applied in a blood-filled space such as a blood vessel or heart, a material that has excellent blood compatibility and does not easily adhere to platelets or proteins in the blood is used. . However, depending on the shape and surface area of a member that contacts blood in the electrode unit or tissue stimulation system, there are sites where it is difficult to prevent thrombus adhesion.
In the electrode unit and the tissue stimulation system described in Patent Document 1, there is a possibility that platelets, blood proteins, and the like adhere to the hub and the base.

As a means for preventing blood adhesion, it is known to administer a drug solution that inhibits blood coagulation in a timely manner. The drug solution is a drug solution capable of inhibiting coagulation, physiological saline, or the like.
For example, patients who have received stents or stent grafts for vascular interiors generally receive heparin sodium intravenously or warfarin potassium orally continuously for the purpose of suppressing thrombus formation on the wearing part. These drugs suppress blood clot formation in the wearing part by reducing the coagulation ability of the whole blood circulating in the body by keeping the blood concentration at a predetermined concentration.
However, as in the electrode unit and the tissue stimulation system described in Patent Document 1, when the surface area of a structure that is exposed to blood and inhibits blood flow is large, or the structure disposed in the blood vessel is retained in blood In the case of a shape that is likely to cause thrombosis, it is more probable that thrombus formation and adhesion of clots to the surface of the structure will occur if a blood solution or physiological saline that is capable of inhibiting clotting is supplied to the blood in the vicinity of such a structure. Effective suppression is possible.
In addition to supplying a high concentration of drug solution (improves blood properties among Virchow's three elements related to so-called thrombus formation), the liquid actively flows to places where blood retention tends to occur (so-called Virchow's 3 related to thrombus formation) By improving the blood flow retention among the elements, it is possible to prevent blood retention and thrombus formation. Moreover, since liquid can be administered by administration means such as a pump and blood retention can be prevented, it is also effective to administer only physiological saline.
For this purpose, it is conceivable to include a flow path and a pump for administering a drug solution that inhibits blood coagulation to a member that is prone to thrombosis.

  However, when there are multiple sites where thrombosis is likely to occur, if a plurality of flow paths are branched from a single pump, the drug solution can easily flow through the flow path with less pressure loss, and a suitable dose is maintained for each site. Difficult to do. In addition, providing each site with a flow path and a pump for suitably delivering a drug solution to each site requires coordinated operation of multiple pumps in order to precisely control the dose, and inhibits blood coagulation. It is not realistic because it requires a procedure that is very different from the general administration procedure of drugs.

  The present invention has been made in view of the above problems, and an object of the present invention is to provide an electrode unit and a tissue stimulation system that can improve the adhesion prevention performance of thrombus.

In order to solve the above problems, the present invention proposes the following means.
One embodiment of the present invention includes a distal end fastener and a proximal end fastener that are spaced apart from each other, and an end portion that is formed in an axial shape with an elastic material and is connected to at least the distal end fastener and the proximal end fastener, respectively. And an intermediate portion in an axial direction along an axis passing through the distal end fastener and the proximal end fastener is curved so as to be separated from the axis, and the intermediate portions are separated from each other in a circumferential direction centering on the axis. And a pair of stimulation electrodes provided on the opposite side of the axis in the intermediate portion of the at least one wire portion, and a tip portion electrically connected to the pair of stimulation electrodes And at least two or more feed streams connected to the liquid discharge port, each having at least two or more liquid discharge ports at different positions and extending to the base end side along the wire portion A feed tube having an electrode unit, characterized in that it comprises a.

Note that the above electrode unit may include at least two or more channel blocking portions that press the feeding channel from the outside, and a control unit for controlling the channel blocking portion.
Further, in the above electrode unit, each of the flow path blocking portions may be closed at an arbitrary timing.

  The electrode unit further includes a lead body connected to the proximal end fastener, and the liquid discharge port is located in the vicinity of the distal end distal end fastener and in the proximal side near the proximal end fastener. And it may be installed on any two or more of the lead bodies.

  According to another aspect of the present invention, there is provided a single unit for removably connecting an electrode unit and a proximal end of the feed pipe to supply an anticoagulant into a feed flow path of the feed pipe. A tissue stimulation system comprising: an infusion pump.

  ADVANTAGE OF THE INVENTION According to this invention, the electrode unit and tissue stimulation system which can improve the adhesion prevention performance of a thrombus can be provided.

1 is an external view of a tissue stimulation system according to a first embodiment of the present invention. It is a partially broken side view of the electrode unit of 1st Embodiment of this invention. It is the sectional view on the AA line of FIG. It is a partially broken external view around the base end fastener of FIG. It is process explanatory drawing of the front | former stage in the case of indwelling in the blood vessel in the tissue stimulation system. It is process explanatory drawing of the back | latter stage at the time of indwelling in the blood vessel in the tissue stimulation system. It is a partially broken side view of the electrode unit of 2nd Embodiment of this invention. It is the BB sectional view taken on the line of FIG. It is a partially broken external view around the base end fastener of FIG. It is a partially broken side view of the electrode unit of 3rd Embodiment of this invention. It is CC sectional view taken on the line of FIG. It is sectional drawing of the surroundings of the supply pipe | tube in the modification of the electrode unit. It is sectional drawing of the surroundings of the feed pipe in the other modification of the electrode unit. It is a partially broken external view of the electrode unit of 4th Embodiment of this invention. It is a partially broken external view of the electrode unit of 5th Embodiment of this invention. It is a partially broken external view of the electrode unit of 6th Embodiment of this invention. It is a partially broken external view of the electrode unit of 7th Embodiment of this invention.

(First embodiment)
Hereinafter, a first embodiment of an electrode unit and a tissue stimulation system according to the present invention will be described with reference to FIGS. 1 to 6. This tissue stimulation system is for indwelling in a patient's blood vessel for a certain period of time and applying electrical stimulation to surrounding nerve tissue through the vessel wall of the blood vessel.
FIG. 1 is an external view of a tissue stimulation system. As shown in FIG. 1, the tissue stimulation system 1 includes an electrode unit 11, an infusion pump 12, and a flow path blocker 15.

  FIG. 2 is a partially broken side view of the electrode unit 11. In the following description, illustration of the infusion pump 12 is omitted except for FIG. As shown in FIG. 2, the electrode unit 11 of this embodiment includes a pulse generator 24 that can be attached to and detached from the electrode unit 11, a distal end fastener 25 and a proximal end fastener 26 that are spaced apart from each other, and four pieces. The wire portion 27, the pair of stimulation electrodes 28, the conducting wire 29, and the first feeding pipe 13 and the second feeding pipe 14 are provided.

  The pulse generator 24 has an electrical stimulation supply unit (not shown), and can generate electrical stimulation by a constant current method or a constant voltage method by this electrical stimulation supply unit. Here, as the electrical stimulation, a biphasic waveform group which is a constant voltage method and whose phase is switched is generated with a predetermined interval. Specific examples of the biphasic waveform include a waveform whose voltage changes between plus several volts and minus several volts at a frequency of 20 Hz and a pulse width of 50 to 400 μsec. The pulse generator 24 generates such a biphasic waveform for 3 to 10 seconds per minute. The pulse generator 24 can be attached to and detached from the proximal end portion of the conducting wire 29 by the equipped connector 37 and the connector 33 on the conducting wire 29 side. By connecting both the connectors 37 and 33, the pulse generator 24 can apply the above-described biphasic waveform between the pair of stimulation electrodes 28 included in the respective wire portions 27. At that time, one stimulation electrode 28 of the pair of stimulation electrodes 28 acts as a plus side electrode, and the other stimulation electrode 28 acts as a minus side electrode.

  The distal end fastener 25 and the proximal end fastener 26 are formed in a substantially cylindrical shape with a material having biocompatibility such as stainless steel and titanium, for example. The distal end fastener 25 is disposed on the distal side, and the proximal end fastener 26 is disposed on the proximal side.

  The four wire portions 27 are connected at their respective end portions to the distal end fastener 25 and the proximal end fastener 26, and a pair of stimulation electrodes 28 is provided on one of the four wire portions 27. The wire portion 27 is made of an elastic material and is formed in an arc shape having a central angle of, for example, about 180 ° as a whole. The radius of the wire part 27 is set to about 10 to 20 mm, for example, according to the inner diameter of the indwelling blood vessel. The four wire portions 27 are arranged at equal angles around the axis C1, that is, around the axis C1. The wire portion 27 is curved so that an intermediate portion in the direction of the axis C1 is separated from the axis C1, and the intermediate portions are disposed so as to be separated from each other around the axis C1. The four wire portions 27 are disposed on a spherical surface as a whole. The electrode portion 30 is formed by the four wire portions 27 and the fasteners 25 and 26. The outer diameter dimension of the electrode part 30 is about 20-40 mm in a natural state, for example. The outer diameter dimension is set larger than the inner diameter of the blood vessel in which the electrode unit 30 is placed. The wire part 27 is joined to each fastener 25 and 26 by welding, adhesion, or caulking.

  A distal end portion of a tubular lead body 31 is attached to the proximal end fastener 26. The lead body 31 has, for example, a single-hole tube shape, and is formed by extruding a resin material such as polyurethane, polyamide, or polyether polyamide elastomer. The size of the lead body 31 is, for example, 2 to 3 mm in outer diameter, The length is about 500 mm. The lead wire 29 and the feed pipes 13 and 14 are inserted into the covering 32 of the lead body 31. For example, a known IS1 type connector 33 is provided at the base end portion of the lead body 31, and the base end portion of the conducting wire 29 is connected to the connector 33. The connector 33 includes a negative electrode connector pin 34 and a positive electrode connector pin 35, and a pair of rubber rings 36. The rubber ring 36 has a function of insulating the negative electrode connector pin 34 and the positive electrode connector pin 35 from each other and maintaining water tightness when connected to the pulse generator 24. The negative electrode connector pin 34 and the positive electrode connector pin 35 are made of, for example, stainless steel. The rubber ring 36 is made of, for example, silicone rubber having biocompatibility. As the connector 33, besides the IS1 type, a waterproof connector or the like used when the pulse generator 24 is installed outside the body can be used.

  The conducting wire 29 is formed of an alloy conforming to ISO5832-6: 1997, ASTM F562 having Ni, Co, Cr, and Mo as main components and having a name such as MP35N or 35NLT. The conducting wire 29 preferably has a silver core layer at the center, is processed as a stranded wire made of a filament having an appropriate wire diameter, and has an insulating coating such as ETFE formed on the surface.

  The first supply pipe 13 is inserted into the lead body 31 and routed along one of the four wire portions 27, and then the first liquid discharge pipe is disposed near the tip fastener 25 on the distal side. It has an outlet 38. The first liquid discharge port 38 of the first supply pipe 13 has a function of releasing an anticoagulant around the distal end fastener 25 as the infusion pump 12 is driven. Unlike this, the second supply pipe 14 is inserted into the lead body 31 and has a second liquid discharge port 39 in a part of the proximal end fastener 26 on the proximal side. The second liquid discharge port 39 of the second supply pipe 14 has a function of releasing an anticoagulant around the proximal end fastener 26 as the infusion pump 12 is driven.

  FIG. 3 is a cross-sectional view of the lead body 31. As shown in FIG. 3, the lead main body 31 accommodates the first supply pipe 13 and the second supply pipe 14 on the inner peripheral side of the conducting wire 29 in the coating 32. The first supply pipe 13 is formed on one side of a tube body 40 formed in a tube shape, and has a first supply flow path 20. The second supply pipe 14 is formed on the other side of the pipe body 40 independently of the first supply flow path 20 via the partition plate 41, and has a second supply flow path 22. In addition, the tube body 40 can be replaced with the above-described two cavities and three cavities, two of which can be used for liquid feeding, and the conductor 29 can be accommodated in the remaining one. If it does so, the coating | cover 32 can be made unnecessary.

  FIG. 4 is a partially broken external view around the proximal end fastener 26. As shown in FIG. 4, the proximal end fastener 26 isolates the first supply pipe 13 and the second supply pipe 14 via the partition plate 41. Therefore, the first feed flow path 20 of the first feed pipe 13 is connected to the first liquid discharge port 38 in the vicinity of the front end fastener 25 by the partition plate 41, and the second feed pipe 14 has the second feed pipe 14. The supply flow path 22 is connected to the second liquid discharge port 39 at the proximal end fastener 26.

  The infusion pump 12 shown in FIG. 1 is a general-purpose pump installed in a medical facility such as a hospital. The infusion pump 12 is detachably connected to the proximal ends of the first supply pipe 13 and the second supply pipe 14 via the branch connector 16. Since the anticoagulant such as heparin and albatropane is stored in the infusion pump 12, the anticoagulant is driven to drive the anticoagulant to the first supply pipe 13, the second supply pipe 14, Can be supplied to.

  The flow path blocking unit 15 includes a control unit 17 and includes a first solenoid 18 and a second solenoid 19 that are independently driven by the control unit 17. The 1st solenoid 18 has the indenter 21 which presses the 1st feed flow path (refer FIG. 3) 20 which has in the 1st feed pipe 13 by driving from the exterior. The 2nd solenoid 19 has the indenter 23 which presses the 2nd feed flow path (refer FIG. 3) 22 which has in the 2nd feed pipe 14 by driving from the exterior.

  The first solenoid 18 and the second solenoid 19 are energized alternately by the control unit 17. Accordingly, the first supply flow path 20 and the second supply flow path 22 are controlled to be closed so as to alternately reduce the inner diameter dimension (cross-sectional area). Since the supply channels 20 and 22 are alternately closed and controlled, the pressure loss of one of the supply channels 20 and 22 increases, and as a result, the liquid delivered from the infusion pump 12 It flows only in the other of the flow paths 20 and 22. At this time, the ON / OFF timings of the alternating operations of the solenoids 18 and 19 do not have to be equal, and the liquid amount distribution ratio is increased by increasing the ON time on the side that requires more heparin supply. It is adjustable.

Next, a procedure for placing the electrode unit 30 of the electrode unit 11 in the superior vena cava using the tissue stimulation system 1 configured as described above will be described. In the tissue stimulation system 1 of the present embodiment, the position where the electrode unit 30 is placed is not limited to the superior vena cava.
FIG. 5 is a process explanatory diagram of the previous stage when the tissue stimulation system 1 is placed in a blood vessel. FIG. 6 is a process explanatory diagram of the latter stage when placed in a blood vessel in the tissue stimulation system 1.

  When the electrode unit 30 is placed in the superior vena cava, the outer diameter dimension of the electrode unit 30 in a natural state (a state where no external force is applied) is set larger than the inner diameter of the superior vena cava. In the tissue stimulation system 1 described below, the pulse generator 24 and the infusion pump 12 are not attached as an initial state. The tissue stimulation system 1 is suitable for short-term nerve stimulation, unlike the long-term nerve stimulation system in which the entire system is implanted in the body.

  As shown in FIG. 5, first, the operator forms an opening P1 by making a small incision in the skin near the neck of the patient P. A known unillustrated introducer or dilator is attached to the opening P1, and the electrode unit 11 is introduced from the electrode portion 30 side. At this time, it introduce | transduces, confirming the position of the electrode unit 11 by confirming the position of the wire part 27 or the conducting wire 29 under X-ray | X_line.

  As shown in FIG. 6, when the electrode part 30 is introduced into the external jugular vein P2, the wire part 27 is elastically deformed to the axis C1 side by being pushed by the inner wall of the external jugular vein P2, and the electrode part 30 is pressed. Decreases in diameter as a whole and extends in the direction of the axis C1. Thereby, the outer diameter dimension of the electrode part 30 becomes smaller than the outer diameter dimension in a natural state. The operator introduces the electrode unit 11 while confirming the position under the X-ray, and roughly arranges the electrode unit 30 in the superior vena cava P3. Also at this time, since the outer diameter dimension of the electrode part 30 is set as described above, each wire part 27 is pressed against the axis C1 side by the superior vena cava P3, and each stimulation electrode 28 is It arrange | positions so that the inner wall of the vein P3 may be opposed. A vagus nerve (nerve tissue) P6 is running adjacent to the superior vena cava P3.

  Subsequently, the connector 33 of the lead wire 29 and the connector 37 of the pulse generator 24 are connected outside the body of the patient P, and a biphasic waveform group is generated from the pulse generator 24 and applied between the pair of stimulation electrodes 28. . The surgeon operates the lead body 31 to adjust the longitudinal position of the superior vena cava P3 in the electrode section 30, and also an electrocardiograph attached to the patient P while rotating the lead body 31 about the axis C1. To measure heart rate. When the pair of stimulation electrodes 28 are arranged so as to approach and face the vagus nerve P6 and the electrical stimulation transmitted from the pair of stimulation electrodes 28 to the vagus nerve P6 becomes large, the heart rate of the patient P is the lowest To do. The surgeon adjusts the direction of the electrode portion 30 around the axis C1 so that the heart rate is the lowest, that is, the pair of stimulation electrodes 28 are directed toward the vagus nerve P6.

  The electrode unit 11 is placed in the superior vena cava P3 with the position of the electrode portion 30 around the axis C1 positioned. Then, the infusion pump 12 is connected to each of the delivery pipes 13 and 14 outside the body of the patient P, and the infusion pump 12 is driven so that the anticoagulant becomes the first liquid discharge port 38 of the first delivery pipe 13. From the second liquid discharge port 39 of the second feed pipe 14 to the periphery of the proximal end fastener 26. The rate at which the anticoagulant is released is, for example, about 0.05 to 10 ml per hour, and the anticoagulant is continuously released while the electrode unit 30 is placed. In the portion of the superior vena cava P3 where the electrode portion 30 is disposed, blood flows as shown by an arrow A1 in FIG. For this reason, the anticoagulant discharged from the liquid discharge ports 38 and 39 moves together with the blood. Thereby, it is suppressed that blood clots and thrombus is generated. The timing for starting the supply of the anticoagulant is not limited to this, and can be set as appropriate, such as starting the supply of the anticoagulant when the electrode unit 30 is placed in the superior vena cava P3.

  When electrical stimulation is continuously applied to the vagus nerve P6 for a certain period by the pulse generator 24, the pulse generator 24 and the infusion pump 12 are removed from the electrode unit 11. When the electrode unit 11 is pulled back, the outer diameter of the electrode portion 30 changes according to the inner diameter of the blood vessel or introducer, so that it can be removed even from a small wound, and the electrode unit 11 can be easily taken out of the patient P's body. be able to. Therefore, a surgical reoperation is not required for removing the electrode unit 11. Thereafter, an appropriate treatment such as suturing the opening P1 is performed, and a series of procedures is completed.

  As described above, according to the electrode unit 11 of the present embodiment, the anticoagulant is released from the first liquid discharge port 38 of the first supply pipe 13 to the periphery of the distal end fastener 25. Then, the second liquid discharge port 39 of the second supply pipe 14 discharges around the proximal end fastener 26. Thereby, according to the electrode unit 11, compared with the conventional one, the adhesion prevention performance of the thrombus can be improved.

  Further, according to the tissue stimulation system 1 of the present embodiment, the anticoagulant is released from the first liquid discharge port 38 of the first delivery pipe 13 to the periphery of the tip fastener 25 from the single infusion pump 12. At the same time, it is discharged from the second liquid discharge port 39 of the second feed pipe 14 to the periphery of the proximal end fastener 26. Thereby, according to the tissue stimulation system 1, compared with the conventional one, the adhesion preventing performance of thrombus can be improved.

(Second Embodiment)
Next, a second embodiment of the present invention will be described with reference to FIG. 7 to FIG. 9, but the same parts as those in the first embodiment will be denoted by the same reference numerals, and the description thereof will be omitted. Only explained. FIG. 7 is a partially broken side view of the electrode unit 51 of the second embodiment according to the present invention. FIG. 8 is a cross-sectional view of the lead body 31. FIG. 9 is a partially broken external view around the proximal end fastener 26.

  As shown in FIGS. 7 and 8, in the electrode unit 51, a tube-shaped first supply pipe 52 is accommodated in the lead main body 31, and a second is provided between the first supply pipe 52 and the coating 32. A feed pipe 53 is formed.

  As shown in FIG. 9, the first feed flow path 20 of the first feed pipe 52 is connected in communication with the first liquid discharge port 38 in the vicinity of the front end fastener 25, and the second feed pipe 53 has the second feed path 53. The supply flow path 22 is connected to the second liquid discharge port 39 at the proximal end fastener 26.

  According to the electrode unit 51 of the present embodiment, since the lead body 31 has a simple structure, it can be advantageously manufactured in terms of cost.

(Third embodiment)
Next, a third embodiment of the present invention will be described with reference to FIGS. In the present embodiment, the same parts as those in the first embodiment are denoted by the same reference numerals, description thereof is omitted, and only different points will be described. FIG. 10 is a partially broken side view of the electrode unit 61 of the third embodiment according to the present invention. FIG. 11 is a cross-sectional view of the tube body 40. FIG. 12 is a cross-sectional view around the feed pipes 62 and 63 in a modification of the electrode unit 61. FIG. 13 is a cross-sectional view around the feed pipes 62 and 63 in another modification of the electrode unit 61.

  As shown in FIG. 10, in the electrode unit 61, a single flow path blocking portion 64 is installed in the other second supply pipe 63 of the two supply pipes 62 and 63. The flow path blocking portion 64 has an indenter 66 in the solenoid 65.

  As shown in FIG. 11, the tube body 40 includes a first feed channel 20 having a small cross-sectional area and a second feed channel 22 having a large cross-sectional area. In the tubular body 40, when the solenoid 65 is not driven and is not closed, a large amount of liquid flows toward the first supply flow path 20 having a small flow path resistance. On the other hand, when the indenter 66 is pushed down by driving the solenoid 65, the second supply flow path 22 is controlled to be closed or narrowed, so that the granularity resistance is higher than that of the first supply flow path 20. Becomes larger.

  Here, as in a modification shown in FIG. 12, an orifice portion 67 may be provided in at least one location in the first supply flow path 20. Thereby, the granularity resistance of the 1st feed flow path 20 can be adjusted.

  Further, as in another modified example shown in FIG. 13, a flow path blocking portion 70 having a solenoid 69 having a double-headed indenter 68 is installed on two feed pipes 62 and 63 having the same cross-sectional area. Also good. Thereby, one of the feeding flow paths 20 and 22 can be controlled to be closed by one indenter 68 of the double-headed solenoid 69.

  According to the electrode unit 61 of this embodiment, a liquid containing heparin can be intermittently released without continuously releasing a liquid containing heparin. In this embodiment, even if the liquid containing heparin is intermittently released, it has the same anticoagulability as that of the first embodiment.

  Further, according to the electrode unit 61 of the present embodiment, the distribution ratio of the liquid amount can be adjusted by increasing the ON time on the side that requires more heparin supply in each of the solenoids 65 and 69. That is, in this embodiment, the heparin dose is relatively increased for a site where blood coagulation is likely to occur, and the heparin dose is set for a site where blood coagulation can occur but the degree is relatively low. It can be reduced relatively. As a result, adhesion of blood components to the electrode unit 61 can be suitably suppressed while reducing the total dose of heparin.

(Fourth embodiment)
Next, a fourth embodiment of the present invention will be described with reference to FIG. 14, but the same parts as those in the first embodiment will be denoted by the same reference numerals, the description thereof will be omitted, and only different points will be described. . FIG. 14 is a partially broken external view of an electrode unit 71 according to a fourth embodiment of the present invention.

  As shown in FIG. 14, the electrode unit 71 is inserted through the lead body 31 and routed along one of the four wire portions 27, and then on the distal side in the vicinity of the tip fastener 25. A first feed pipe 72 having a first liquid discharge port 38 is provided. The electrode unit 71 includes a second supply pipe 73 having a second liquid discharge port 39 in the middle of the lead body 31. In this case, by setting the flow rate from the first liquid discharge port 38 to be larger than that of the second liquid discharge port 39, a suitable anticoagulation performance can be obtained.

  According to the electrode unit 71 of the present embodiment, heparin is released from the distal tip fastener 25 and heparin is released from the side surface of the lead body 31, so that thrombus adheres particularly to the side surface of the lead body 31. Prevention can be achieved.

(Fifth embodiment)
Next, a fifth embodiment of the present invention will be described with reference to FIG. 15. However, the same parts as those in the first embodiment will be denoted by the same reference numerals, the description thereof will be omitted, and only different points will be described. . FIG. 15 is a partially broken external view of an electrode unit 81 according to a fifth embodiment of the present invention.

  As shown in FIG. 15, the electrode unit 81 includes a first supply pipe 82 that is inserted into the lead body 31 and has a first liquid discharge port 38 in the proximal end fastener 26 that is the proximal side. The electrode unit 81 includes a second supply pipe 83 having a second liquid discharge port 39 in the middle of the lead body 31. In this case, by setting the flow rate from the first liquid discharge port 38 to be larger than that of the second liquid discharge port 39, a suitable anticoagulation performance can be obtained.

  According to the electrode unit 81 of the present embodiment, heparin is released from the proximal end fastener 26 on the proximal side, and heparin is released from the side surface of the lead body 31, in particular, thrombus to the side surface of the lead body 31. It is possible to prevent adhesion.

(Sixth embodiment)
Next, a sixth embodiment of the present invention will be described with reference to FIG. 16, but the same parts as those in the first embodiment are denoted by the same reference numerals, the description thereof will be omitted, and only different points will be described. . FIG. 16 is a partially broken external view of an electrode unit 91 according to a sixth embodiment of the present invention.

  As shown in FIG. 16, the electrode unit 91 includes a first supply pipe 93 that is inserted through the lead main body 31 and has a first liquid discharge port 92 at the distal end fastener 25. Further, the electrode unit 91 includes a second supply pipe 95 having a second liquid discharge port 94 in the proximal end fastener 26 on the proximal side. The electrode unit 91 includes a third supply pipe 97 having a third liquid discharge port 96 in the middle of the lead body 31. The electrode unit 91 includes solenoids 101, 102, and 103 having three indenters 98, 99, and 100 for adjusting the granularity resistance of the feed pipes 93, 95, and 97, respectively.

  According to the electrode unit 91 of the present embodiment, heparin is released on the distal side, heparin is released on the proximal side, and heparin is released on the side surface of the lead body 31, thereby preventing thrombus adhesion. be able to.

(Seventh embodiment)
Next, a seventh embodiment of the present invention will be described with reference to FIG. 17. However, the same parts as those in the first embodiment are denoted by the same reference numerals, the description thereof will be omitted, and only different points will be described. . FIG. 17 is a partially broken external view of the electrode unit 111 according to the seventh embodiment of the present invention.

  As shown in FIG. 17, the electrode unit 111 includes a wire portion 112 having a proximal end portion bound at the proximal end fastener 26 and a distal end portion opened. The electrode unit 111 includes a first supply pipe 113 that is inserted into the lead body 31 and has a first liquid discharge port 38 on the proximal side near the proximal end fastener 26. In addition, the electrode unit 111 includes a second feed pipe 114 having a second liquid discharge port 39 in the middle of the lead body 31.

According to the electrode unit 101 of the present embodiment, it is possible to prevent thrombus adhesion by releasing heparin on the proximal side and releasing heparin on the side surface of the lead body 31.
In the present embodiment, the distal end portion of the wire portion 112 of the electrode unit 101 is a portion where blood flow is hardly inhibited and blood coagulation is relatively difficult to occur. Blood coagulation can be prevented by the heparin released from the supply tube 114 and reaching the distal end of the wire portion 112 along the bloodstream.

As mentioned above, although embodiment of this invention was explained in full detail with reference to drawings, the concrete structure is not restricted to this embodiment, The design change etc. of the range which does not deviate from the summary of this invention are included.
In addition, the constituent elements shown in the above-described embodiments and modifications can be combined as appropriate.

  In the tissue stimulation system, the electrode unit is introduced from the opening in the vicinity of the neck, but the electrode unit may be introduced into the body through an opening formed near the clavicle.

Further, the plurality of liquid discharge ports may be arranged anywhere near the site where the attachment of the thrombus on the device surface is predicted and upstream of the blood flow.
In addition, the design change etc. with respect to the said specific structure are not limited to the said matter.

DESCRIPTION OF SYMBOLS 1 Tissue stimulation system 11, 51, 61, 71, 81, 91, 111 Electrode unit 12 Infusion pump 13, 52, 62, 72, 82, 93, 113 1st feeding pipe 14, 53, 63, 73, 83, 95, 114 Second feed pipe 15, 64 Flow path blocking part 16 Branch connector 17 Control part 18 First solenoid 19 Second solenoid 20 First feed path 21, 23, 66, 68, 98, 99, 100 Indenter 22 Second feed flow path 24 Pulse generator 25 Tip clamp 26 Base clamp 27, 112 Wire portion 28 Stimulation electrode 29 Conductor 30 Electrode portion 31 Lead body 32 Cover 33, 37 Connector 34 Negative electrode connector pin 35 Positive Connector pin for electrode 36 Rubber ring 38, 92 First liquid discharge port 39, 94 Second liquid discharge port 40 Tubing body 41 Separating plate 65, 69, 10 , 102, 103 solenoid 67 orifice portion 96 third liquid outlet 97 third supply pipe C1 axis

Claims (5)

Distal and proximal fasteners spaced apart from each other;
It is formed in an axial shape with an elastic material, and an end portion is connected to at least the distal end fastener and the proximal end fastener, respectively, and an axial intermediate portion along an axis passing through the distal end fastener and the proximal end fastener is the A plurality of wire portions that are curved so as to be separated from an axis, and wherein the intermediate portion is spaced apart from each other in a circumferential direction around the axis;
A pair of stimulation electrodes provided on the opposite side to the axis in the intermediate portion of at least one of the wire portions;
A lead wire electrically connected to the pair of stimulation electrodes and extending to the proximal side along the wire portion;
A feed pipe having at least two or more liquid discharge ports at arbitrary positions different from each other and having at least two or more feed flow paths connected to the liquid discharge ports;
An electrode unit comprising: At least two or more flow path blockers that press the feed flow path from the outside;
A control unit for controlling the flow path blocking unit;
The electrode unit according to claim 1, comprising:   The electrode unit according to claim 2, wherein each of the flow path blocking portions can be closed at an arbitrary timing. A lead body connected to the proximal end fastener;
The liquid discharge port may be installed in any two or more of the vicinity of the distal end distal end fastener, the proximal side proximal end fastener, and the lead body. The electrode unit according to any one of claims 1 to 3. The electrode unit according to any one of claims 1 to 4,
A single infusion pump detachably connected to the proximal end of the delivery tube and for supplying an anticoagulant into the delivery channel of the delivery tube;
A tissue stimulation system comprising:

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