JP2016202553A - Contrast agent removing device and contrast agent removing method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a compact and easy-to-operate contrast agent removing device for efficiently removing a contrast agent in blood vessels and also to provide a contrast agent removing method.SOLUTION: A contrast agent removing device 10 configured to remove a contrast agent in blood vessels comprises: a shaft part 20 having a distal-side lumen 21 formed in a distal part thereof; a pump 50 mounted inside the distal-side lumen 21 and capable of suctioning an outside fluid through a distal-side opening part 24 of the distal-side lumen 21; a recovery part 30 capable of selectively recovering the contrast agent from the fluid pressurized by the pump 50 within the distal-side lumen 21; and a fluid return part 35 for returning the fluid from which the contrast agent has been removed by the recovery part 30, from the shaft part 20 to the outside.SELECTED DRAWING: Figure 2

Description

  The present invention relates to a contrast medium removing device and a contrast medium removing method for removing a contrast medium from a blood vessel by inserting it into a blood vessel.

  Conventionally, as a treatment method for ischemic heart diseases such as angina pectoris and myocardial infarction, a balloon is inserted into the stenosis or occlusion of the coronary artery and expanded to expand the stenosis or occlusion by expanding the balloon. However, percutaneous coronary angioplasty (PCI) is performed to restore blood flow. PCI is performed while administering a contrast medium to the coronary artery and confirming a stenosis or occlusion under X-ray fluoroscopy.

  By the way, when PCI is performed on a patient with low renal function, contrast agent nephropathy is caused by a side effect of the contrast agent, and dialysis may be necessary in some cases. The cause has not been determined, but the contrast agent flows into the kidney, the renal blood vessels contract, and the renal blood flow and glomerular filtration rate decrease. . Furthermore, it is also known that contrast agents exhibit direct cytotoxicity against tubule cells.

  For this reason, various methods for removing the contrast agent in the blood vessel have been proposed. For example, in Patent Document 1, after a contrast medium is released to the coronary artery for PCI, the contrast medium flowing through the coronary vein to the coronary sinus and the right atrium is extracted outside the body by a device inserted into the right atrium, and filtered. A method is described in which the blood is returned to the body after the contrast agent is removed.

  Contrast agents are also used in lower limb arterial intervention and transcatheter aortic valve implantation (TAVI), and similar toxicity to the kidneys is a problem.

US Pat. No. 7,163,520

  Since the device described in Patent Document 1 requires a large amount of water, it is a large-scale device. Furthermore, it is necessary to take the blood out of the body once and remove the contrast agent, and then return the blood to the body again.

  The present invention has been made to solve the above-described problems, and has a compact configuration, is easy to operate, and can effectively remove a contrast medium from within a blood vessel. The purpose is to provide.

  A contrast agent removing device that achieves the above-described object is a contrast agent removing device for removing a contrast agent from within a blood vessel, wherein the contrast agent removing device is disposed in the lumen, and a shaft portion having a lumen formed at least in a distal portion. A pump capable of sucking an external fluid from the opening of the lumen, a recovery unit capable of selectively recovering the contrast medium from the fluid pressurized by the pump in the lumen, and removing the contrast medium by the recovery unit A contrast medium removing device having a liquid returning part for returning the liquid to the outside from the shaft part.

  The contrast agent removing device configured as described above needs to withdraw the blood from the body once, because the recovery agent can collect the contrast agent while urging the fluid by pressurizing the fluid with a pump arranged in the lumen. Therefore, the operation becomes easy and the contrast medium can be effectively removed from the blood vessel.

  If the pump has a centrifugal pump, and the recovery unit is arranged in the discharge direction of the centrifugal pump, the fluid pressurized by the centrifugal pump efficiently moves to the recovery unit, and the contrast agent is removed. It can be recovered and removed efficiently.

  If the pump further includes an axial flow pump disposed closer to the opening than the centrifugal pump, blood can be efficiently taken into the lumen from the outside.

  If the recovery unit has an adsorbent capable of adsorbing the contrast agent, the contrast agent can be selectively removed from the blood vessel by removing the blood by adsorbing the contrast agent to the adsorbent. It is possible to suppress the occurrence of ischemia.

  If the collection unit has a restriction membrane that allows the contrast medium to pass and restricts the passage of blood, the contrast agent is selectively passed from within the blood vessel by selectively allowing the contrast agent to pass through the restriction membrane. And ischemia due to removal of blood can be suppressed.

  A contrast agent removing method for achieving the above object is a contrast agent removing method for removing a contrast agent from inside a blood vessel, and (i) a contrast agent removing method in which a pump is provided in a lumen formed at a distal portion. An insertion step of inserting the device into the blood vessel; (ii) a pressurizing step of sucking and pressurizing blood and contrast medium into the lumen by rotating the pump; and (iii) pressurized blood and contrast medium A recovery step of selectively recovering the contrast medium from the blood vessel, and (iv) a return step of returning the blood to the blood vessel. The contrast agent removing method configured as described above can pressurize the fluid by a pump arranged in the lumen to facilitate the recovery of the contrast agent, so that it is not necessary to draw blood out of the body once, and a compact configuration. In addition, the operation becomes easy and the contrast agent can be effectively removed from the blood vessel.

  In the collecting step, the contrast agent is adsorbed on the adsorbent and collected by bringing the pressurized blood and the contrast agent into contact with the adsorbent capable of adsorbing the contrast agent. It can be selectively removed and the occurrence of ischemia due to blood discharge can be suppressed.

  In the collecting step, the contrast medium is allowed to pass through and the pressurized blood and the contrast medium are brought into contact with the restriction film that restricts the passage of blood so that the contrast medium passes through the restriction film and is collected. Then, the contrast agent can be selectively removed from the blood, and the occurrence of ischemia due to the discharge of blood can be suppressed.

It is a top view which shows the contrast agent removal device which concerns on 1st Embodiment. It is a longitudinal cross-sectional view which shows the distal part of the contrast agent removal device which concerns on 1st Embodiment. It is the schematic which shows the state which has arrange | positioned the contrast agent removal device which concerns on 1st Embodiment in the right atrium. It is sectional drawing which shows the state at the time of removing a contrast agent from the blood in a right atrium with the contrast agent removal device which concerns on 1st Embodiment. It is a top view which shows the contrast agent removal device which concerns on 2nd Embodiment. It is a longitudinal cross-sectional view which shows the distal part of the contrast agent removal device which concerns on 2nd Embodiment. It is sectional drawing which shows the state at the time of removing a contrast agent from the blood in the right atrium by the contrast agent removal device which concerns on 2nd Embodiment.

Embodiments of the present invention will be described below with reference to the drawings. In addition, the dimension ratio of drawing is exaggerated on account of description, and may differ from an actual ratio.
<First Embodiment>

  The contrast agent removing device 10 according to the first embodiment of the present invention is a device for removing a contrast agent released into a blood vessel during percutaneous coronary angioplasty (PCI) from inside the blood vessel. In this specification, the side of the device to be inserted into the blood vessel is referred to as “distal side”, and the proximal side for operation is referred to as “proximal side”.

  As shown in FIGS. 1 and 2, the contrast agent removal device 10 is rotatably disposed inside the shaft portion 20, the recovery portion 30 disposed outside the distal portion of the shaft portion 20, and the shaft portion 20. A drive shaft 40, a pump 50 that is rotationally driven by the drive shaft 40, and an operation unit 60 that is coupled to the proximal portion of the shaft unit 20.

  The shaft portion 20 is a long tube body, and a lumen is formed therein. The lumen includes a distal lumen 21 having a large inner diameter in which a pump is disposed at a distal portion, and a proximal lumen 22 in which a drive shaft 40 is rotatably disposed closer to the proximal side than the distal lumen 21. It has. In the shaft portion 20, a through hole 23 for supplying a fluid to the recovery portion 30 is formed in the distal lumen 21. A seal member 25 is disposed at the distal portion of the proximal lumen 22 and is disposed to allow the drive shaft 40 to rotate while suppressing the inflow of fluid in the proximal direction.

  The collection unit 30 includes an accommodation tube 31 disposed coaxially with the shaft unit 20 on the outer periphery of the distal portion of the shaft unit 20, and an adsorbent 32 that can adsorb a contrast agent provided inside the accommodation tube 31. ing. The accommodation tube 31 has a distal portion and a proximal portion fixed to the outer peripheral surface of the shaft portion 20, and the adsorbent 32 is placed in the accommodation space 33 that is a gap formed between the accommodation tube 31 and the shaft portion 20. Be placed. The distal portion of the accommodation space 33 communicates with the distal lumen 21 through the through hole 23. A liquid return portion 35 in which a discharge hole 34 penetrating to the outside is formed at the proximal portion of the storage tube 31. Therefore, when the fluid flows from the distal lumen 21 into the distal portion of the accommodation space 33 through the through hole 23, the fluid passes through the gap of the adsorbent 32 and moves to the proximal portion of the accommodation space 33 to be released. It is discharged from the hole 34 to the outside.

  The pump 50 includes an axial flow pump 51 disposed near the distal opening 24 in the distal lumen 21 and a centrifugal disposed closer to the axial flow pump 51 in the distal lumen 21. A pump 52 is provided. The axial flow pump 51 includes an axial flow blade 51A that rotates to suck fluid from the distal opening 24 and push the fluid in the proximal direction. The centrifugal pump 52 includes a plurality of centrifugal impellers 55, and each centrifugal impeller 55 is disposed between two rotating plates 56 that are spaced apart in the rotation axis direction and the rotating plate 56. And a centrifugal blade 57 that pushes the fluid radially outward by rotating. A suction port 58, which is an opening for taking in fluid between the two rotation plates 56, is provided on the center side of the distal rotation plate 56, and a discharge port 59 is provided on the radially outer side of the centrifugal blade 57. A through hole 23 is formed in the discharge direction of the centrifugal impeller 55. Therefore, the fluid flowing in the proximal direction through the axial flow pump 51 can be discharged radially outward by the centrifugal pump 52 and pushed out into the accommodation space 33 through the through hole 23.

  The drive shaft 40 has an axial flow pump 51 and a centrifugal pump 52 fixed to the distal side, and a driven gear 62 fixed to the proximal side. A proximal portion of the drive shaft 40 is rotatable within the operation unit 60.

  The drive shaft 40 is flexible and has a characteristic capable of transmitting the rotational power acting from the proximal side to the distal side. For example, the drive shaft 40 has a multilayer coil shape such as a three-layer coil in which the right and left and the winding directions are alternated. It is composed of the tube body.

  As shown in FIG. 1, the operation unit 60 includes a housing 61 and a drive unit 63 that applies a rotational force to the drive shaft 40.

  The drive unit 63 includes a driven gear 62 that is fixed to the proximal portion of the drive shaft 40, a drive gear 64 that meshes with the driven gear 62, a motor 66 that is a drive source that the drive gear 64 fixes, and power to the motor 66. A battery 67 such as a battery to be supplied and a switch 68 for controlling driving of the motor 66 are provided. By turning on the switch 68 and rotating the rotary shaft 65 of the motor 66, the driven gear 62 that meshes with the drive gear 64 rotates, and the drive shaft 40 rotates.

  The target contrast agent in this embodiment is identified by X-rays and is used for intravascular administration. For example, an ionic or nonionic iodine atom having a molecular weight of about 8000 or less. It is a compound containing. Specific examples include iopromide, iopamidol, iomeprol, amidotrizoic acid, iohexol, iotalamic acid, iodamide, metrizoic acid, metrizamide, ioxirane, and the like, and oxaglic acid, adipiodone, iotroxic acid, iodoxamic acid, iotrolan, etc. However, it is not limited to these.

  The constituent material of the shaft portion 20 and the housing tube 31 is preferably a material having hardness and flexibility, for example, polyolefins such as polyethylene and polypropylene, polyesters such as polyamide and polyethylene terephthalate, and fluorine-based materials such as ETFE. A polymer, PEEK (polyetheretherketone), polyimide and the like are preferably used. It is also possible to add a metal blade or coil to the material to increase the rigidity.

  Although the length (length from the most distal part of the shaft part 20 to the operation part 60) of the contrast agent removal device 10 is not specifically limited, For example, 1000 mm-2000 mm are preferable. Although the outer diameter of the shaft part 20 is not specifically limited, For example, 1.5 mm-4.0 mm are preferable.

  The shaft portion 20 and the accommodating tube 31 may be formed by including an X-ray contrast material in the material. Thereby, the position can be accurately grasped under fluoroscopy, and the procedure becomes easier. As the X-ray contrast material, for example, gold, platinum, platinum-iridium alloy, silver, stainless steel, molybdenum, tungsten, tantalum, palladium, or an alloy thereof is preferable.

  Further, a marker made of an X-ray contrast material may be disposed at any position of the shaft portion 20 and the housing tube 31. The marker is formed by winding a wire formed of an X-ray contrast material around the outer surface of the shaft portion 20 or the housing tube 31 or forming a pipe with the X-ray contrast material and forming an outer surface of the shaft portion 20 or the housing tube 31. It is attached by caulking or gluing.

  Although the constituent material of the housing 61 is not specifically limited, For example, hard resin, such as a polycarbonate, polyethylene, a polypropylene, etc. can be used.

Next, the method of using the contrast medium removing device 10 according to the first embodiment will be described by taking as an example the case where the contrast medium released to the coronary artery during PCI is removed from the right atrium.
explain.

  First, priming of the contrast medium removing device 10 to be used is performed, and the inside of the shaft portion 20 and the housing tube 31 is replaced with physiological saline.

  Next, an introducer sheath (not shown) is inserted into the femoral vein or the jugular vein. Next, a guide wire (not shown) is inserted into the vein through the introducer sheath. The position where the introducer sheath is installed is not limited as long as the contrast agent removing device 10 can access the right atrium R.

  Next, the guiding catheter 70 is inserted into the vein of the guiding catheter 70 along the guide wire so that the guiding catheter 70 reaches the right atrium R. Next, the guide wire is removed, and as shown in FIG. 3, the contrast agent removing device 10 reaches the right atrium R via the guiding catheter 70 (insertion step). Note that the distal portion of the contrast agent removal device 10 may be inserted from the right atrium R into the coronary sinus C.

  Alternatively, the contrast agent removing device 10 may be directly inserted from the sheath and not reach the right atrium R without using a guide wire or a guiding catheter.

  Next, for PCI, the contrast agent is released into the coronary artery by another catheter inserted into the coronary artery. The contrast agent released to the coronary artery reaches the coronary sinus C and the right atrium R through the coronary vein.

  Next, when the switch 66 is operated to rotate the motor 66, the rotational force is transmitted from the drive gear 64 to the driven gear 62, and the drive shaft 40 rotates. When the drive shaft 40 rotates, the axial flow pump 51 sucks and pressurizes blood and contrast medium into the distal lumen 21 (pressurization step). The blood and contrast medium sucked into the distal lumen 21 moves in the proximal direction, is sucked into the suction port 58 of any one of the centrifugal pumps 52 arranged in the axial direction, and is discharged radially outward from the discharge port 59. Is done. The discharged blood and contrast medium move into the accommodation space 33 of the collection unit 30 through the through hole 23.

  When the blood and the contrast agent move into the accommodation space 33, the contrast agent is adsorbed to the adsorbent 32 in the accommodation space 33 (recovery step), and the remaining blood passes through the gap of the adsorbent 32 and enters the accommodation space 33. It moves to the proximal portion and is returned from the discharge hole 34 into the right atrium (returning liquid step).

  After the PCI procedure is completed, the motor 68 is stopped by operating the switch 68. As a result, the rotation of the axial flow pump 51 and the centrifugal pump 52 is stopped, and the suction of blood and contrast medium into the distal lumen 21 is stopped.

  Thereafter, the contrast agent removing device 10 is removed from the introducer sheath, and the guiding catheter 70 and the introducer sheath are removed from the vein V to complete the treatment.

  As described above, the contrast agent removing device 10 according to the first embodiment is disposed in the distal lumen 21 with the shaft portion 20 having the distal lumen 21 (lumen) formed at least in the distal portion. The contrast medium is selected from the pump 50 capable of sucking an external fluid from the distal opening 24 (opening) of the distal lumen 21 and the fluid pressurized by the pump 50 in the distal lumen 21. And a liquid return part 35 for returning the liquid from which the contrast medium has been removed by the recovery part 30 to the outside from the shaft part 20. The contrast medium removing device 10 configured as described above pressurizes and sucks blood and contrast medium by the pump 50 in the distal lumen 21, and prompts the collection section 30 to collect the contrast medium, and the rest Can be returned from the liquid return part 35 into the blood vessel. For this reason, the contrast medium removing device 10 does not need to draw blood out of the body, has a compact configuration, is easy to operate, and can effectively remove the contrast medium from the blood vessel. Since the contrast agent can be effectively removed from the blood vessel, the influence of the contrast agent on a living body such as a kidney can be reduced.

  Moreover, since the pump 50 has the centrifugal pump 57 and the collection | recovery part 30 is arrange | positioned in the discharge direction of the centrifugal pump 57, the fluid pressurized by the centrifugal pump 57 moves to the collection | recovery part 30 efficiently, and is contrasted. The agent can be recovered and removed efficiently.

  In addition, since the pump 50 includes the axial flow pump 51 disposed closer to the distal opening 24 (opening) than the centrifugal pump 57, blood is efficiently taken into the distal lumen 21 from the outside. be able to.

  In addition, since the collection unit 30 has the adsorbent 32 that can adsorb the contrast agent, the contrast agent can be selectively removed from the blood vessel by adsorbing the contrast agent to the adsorbent 32, thereby removing blood. The contrast agent can be effectively removed while suppressing the occurrence of ischemia.

  The present invention also includes a contrast agent removal method for removing the contrast agent from the blood vessel. The contrast agent removing method includes (i) an insertion step of inserting a contrast agent removing device having a pump in a lumen formed in a distal portion into a blood vessel, and (ii) rotating the pump to the lumen. A pressure step for aspirating and pressurizing the blood and contrast medium therein; (iii) a recovery step for selectively recovering the contrast medium from the pressurized blood and contrast medium; and (iv) returning the blood to the blood vessel. A liquid step. The contrast agent removing method configured as described above can pressurize the fluid by a pump arranged in the lumen to facilitate the recovery of the contrast agent, so that it is not necessary to draw blood out of the body once, and a compact configuration. In addition, the operation becomes easy and the contrast agent can be effectively removed from the blood vessel.

In the method for removing a contrast agent, in the recovery step, the pressurized blood and the contrast agent are brought into contact with an adsorbent capable of adsorbing the contrast agent, whereby the contrast agent is adsorbed on the adsorbent and recovered. In this way, by adsorbing the contrast agent to the adsorbent, the contrast agent can be selectively recovered from the blood, and the occurrence of ischemia due to the discharge of blood can be suppressed.
Second Embodiment

  The contrast agent removing device 100 according to the second embodiment is different from the first embodiment in that no adsorbent is provided. In addition, the same code | symbol is attached | subjected to the site | part which has a function similar to 1st Embodiment, and description is abbreviate | omitted.

  As shown in FIGS. 5 and 6, the contrast agent removing device 100 is rotatably disposed within the shaft portion 120, a recovery portion 130 disposed outside the distal portion of the shaft portion 120, and the shaft portion 120. A drive shaft 40, a pump 50 that is rotationally driven by the drive shaft 40, and an operation unit 160 that is coupled to the proximal portion of the shaft unit 20.

  The shaft portion 120 is a long tube body, and a lumen is formed therein. The lumen includes a distal lumen 121 having a large inner diameter in which a pump is disposed at a distal portion, and a proximal lumen 122 in which the drive shaft 40 is rotatably disposed at a position proximal to the distal lumen 121. It has. The shaft portion 120 is formed with a through hole 123 for supplying fluid from the distal lumen 121 to the recovery portion 130. The through hole 123 is formed in the discharge direction of the centrifugal impeller 55. A liquid return portion 125 in which a discharge hole 124 penetrating from the distal lumen 121 to the outer surface is formed at a portion proximal to the through hole 123 of the shaft portion 120. The discharge hole 124 is formed on the proximal side of the centrifugal impeller 55.

  The collection unit 130 includes a storage tube 131 disposed on the outer periphery of the distal portion of the shaft unit 120 so as to surround the shaft unit 120, and a suction extending from the storage tube 131 along the shaft unit 120 to the operation unit 160 in the proximal direction. A tube 132 and a limiting film 135 covering the through hole 123 are provided. A housing space 133, which is a gap formed between the housing tube 131 and the shaft portion 120, communicates with a discharge lumen 134 formed inside the suction tube 132. Therefore, when fluid flows into the accommodation space 133 from the distal lumen 121 via the through hole 123, the fluid is discharged from the discharge port 162 of the operation unit 160 through the discharge lumen 134.

  The restricting film 135 selectively passes the contrast medium out of the pressurized blood and the contrast medium, and restricts the passage of at least a part of the blood. The limiting film 135 is, for example, a film in which a plurality of through holes having a hole diameter of 0.001 to 0.030 mm are formed. The constituent material of the limiting film 135 is not particularly limited, but for example, a nonwoven fabric of polyethylene terephthalate can be suitably used.

  The operation unit 160 includes a housing 161, a discharge port 162 communicating with the discharge lumen 134, and a drive unit 63 that applies a rotational force to the drive shaft 40.

Next, a method of using the contrast medium removing device 100 according to the second embodiment will be described by taking as an example the case where the contrast medium released to the coronary artery during PCI is removed from the right atrium.
explain.

  First, the contrast medium removing device 100 to be used is primed, and the inside is replaced with physiological saline.

  Next, an introducer sheath (not shown) is inserted into the femoral vein or the jugular vein. Next, a guide wire (not shown) is inserted into the vein through the introducer sheath. The position where the introducer sheath is installed is not limited as long as the contrast agent removing device 100 can access the right atrium R.

  Next, the guiding catheter 70 is inserted into the vein along the guide wire so that the guiding catheter 70 reaches the right atrium R. Next, the guide wire is removed, and as shown in FIG. 7, the contrast medium removing device 10 is made to reach the right atrium R via the guiding catheter 70 (insertion step). Note that the distal portion of the contrast agent removing device 100 may be inserted from the right atrium R into the coronary sinus C.

  Alternatively, the contrast agent removing device 10 may be directly inserted from the sheath and not reach the right atrium R without using a guide wire or a guiding catheter.

  Next, for PCI, the contrast agent is released into the coronary artery by another catheter inserted into the coronary artery. The contrast agent released to the coronary artery reaches the coronary sinus C and the right atrium R through the coronary vein.

  Next, when the switch 66 is operated to rotate the motor 66, the rotational force is transmitted from the drive gear 64 to the driven gear 62, and the drive shaft 40 rotates. When the drive shaft 40 rotates, blood and contrast medium are sucked into the distal lumen 121 and pressurized by the axial flow pump 51 (pressurization step). The blood and contrast medium sucked into the distal lumen 121 moves in the proximal direction, is sucked into the suction port 58 of one of the centrifugal pumps 52 arranged in the axial direction, and is discharged radially outward from the discharge port 59. Is done. The discharged blood and contrast medium come into contact with the restriction film 135 disposed in the through hole 123. The restriction film 135 selectively allows the contrast medium to pass through among the pressurized blood and the contrast medium, and restricts the passage of at least a part of the blood. Accordingly, contrast agent passes through the restriction membrane 135 and at least a portion of the blood moves proximally through the distal lumen 121. The contrast agent that has passed through the restriction film 135 and moved into the accommodation space 133 is discharged from the discharge port 162 of the operation unit 160 through the discharge lumen 134 to the outside of the body (collection step). The blood that has moved through the distal lumen 121 in the proximal direction is returned into the right atrium R through the discharge hole 124 (return step).

  After the PCI procedure is completed, the motor 68 is stopped by operating the switch 68. Thereby, the rotation of the axial flow pump 51 and the centrifugal pump 52 is stopped, and the suction of blood and contrast medium into the distal lumen 121 is stopped.

  Thereafter, the contrast agent removing device 100 is removed from the introducer sheath, and the guiding catheter 70 and the introducer sheath are removed from the vein V to complete the treatment.

  As described above, in the contrast medium removing device 100 according to the second embodiment, the collection unit 130 includes the restriction film 135 that allows passage of the contrast medium and restricts the passage of blood. By selectively allowing the contrast medium to pass, the contrast agent can be selectively recovered from within the blood vessel, and the contrast agent can be effectively removed while suppressing the occurrence of ischemia due to blood removal.

  Further, in the method of removing a contrast agent for removing a contrast agent from a blood vessel, the pressurized blood and the contrast agent are brought into contact with a restriction membrane that allows passage of the contrast agent and restricts passage of blood in the recovery step. As a result, the contrast medium is passed through the limiting film and collected. Thus, by selectively allowing the contrast medium to pass through the restriction membrane, the contrast medium can be selectively recovered from within the blood vessel, and the occurrence of ischemia due to blood removal can be suppressed.

  Note that the present invention is not limited to the above-described embodiments, and various modifications can be made by those skilled in the art within the technical idea of the present invention. For example, a guide wire lumen may be formed in the contrast agent removing device according to the first and second embodiments.

  Further, the position where the contrast agent is administered is not limited to the coronary artery. For example, this includes left ventricular angiography and aortography of the heart in transcatheter aortic valve implantation (TAVI).

  In the first and second embodiments, the pump 50 includes the axial flow pump 51 and the centrifugal pump 52, but may have a configuration in which only one of them is provided. Further, the position of the axial flow pump and the centrifugal pump in the distal lumen is not particularly limited.

  In addition, the position at which blood and contrast medium are sucked by the contrast medium removing device according to the first and second embodiments is not particularly limited as long as the contrast medium may flow.

10, 100 contrast agent removal device,
20, 120 shaft part,
21, 121 Distal lumen (lumen),
22 proximal lumen,
23 through holes,
24 Distal opening (opening),
30, 130 collection unit,
32 adsorbent,
35, 125 liquid return part,
40 drive shaft,
50 pumps,
51 axial pump,
52 Centrifugal pump,
55 Centrifugal impeller,
57 Centrifugal blade,
100 contrast agent removal device,
120 shaft part,
121 Distal lumen,
122 proximal lumen,
123 through holes,
134 discharge lumen,
135 restriction membrane,
C coronary sinus,
R Right atrium.

Claims (8)

A contrast agent removal device for removing a contrast agent from inside a blood vessel,
A shaft portion having a lumen formed at least in a distal portion;
A pump disposed in the lumen and capable of sucking an external fluid from an opening of the lumen;
A recovery unit capable of selectively recovering a contrast medium from the fluid pressurized by the pump in the lumen;
A contrast medium removing device, comprising: a liquid return section that returns the liquid from which the contrast medium has been removed by the collection section to the outside from the shaft section. The pump has a centrifugal pump,
The contrast medium removing device according to claim 1, wherein the recovery unit is disposed outside the centrifugal pump.   The contrast medium removing device according to claim 2, wherein the pump further includes an axial flow pump disposed closer to the opening than the centrifugal pump.   The contrast medium removing device according to claim 1, wherein the recovery unit includes an adsorbent capable of adsorbing the contrast medium.   The contrast medium removing device according to any one of claims 1 to 3, wherein the recovery unit includes a limiting film that allows a contrast medium to pass therethrough and restricts the passage of blood. A contrast agent removal method for removing a contrast agent from inside a blood vessel,
(I) an insertion step of inserting a contrast medium removing device provided with a pump in a lumen formed in the distal portion into the blood vessel;
(Ii) a pressurizing step of rotating the pump to suck and pressurize blood and contrast medium into the lumen;
(Iii) a recovery step of selectively recovering the contrast agent from the pressurized blood and contrast agent;
And (iv) a liquid return step for returning the blood to the blood vessel.   The contrast agent removing method according to claim 6, wherein in the recovery step, the contrast agent is adsorbed on the adsorbent and recovered by bringing the pressurized blood and the contrast agent into contact with an adsorbent capable of adsorbing the contrast agent. .   The said collection | recovery step allows a contrast medium to pass through and it collect | recovers by allowing the contrast medium to pass through the restriction | limiting film | membrane by making the pressurized blood and contrast medium contact the restriction | limiting film | membrane which restrict | limits the passage of a blood. 7. The contrast agent removing method according to 6.

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