JP2017003637A - Blood vessel model device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a blood vessel model device that can simulate such a technique as one for self-expanding stent placement with a blood vessel model in a similar condition to that of a blood vessel of a patient.SOLUTION: A cover plate 30 is rotatably fitted to a flat plate-like model body 20 having a base part 21 and a replacement component 22 which in turn is detachably attached to the base part 21. The model body 20 further has a groove-like simulated vessel part, opening in the upper surface. The simulated blood vessel part has a first blood vessel part 24 provided on the base part 21 and a second blood vessel part 25 provided on the replacement component 22. The first blood vessel part 24 includes a first approach part 24A, a second approach part 24B, and a third approach part 24C, and each approach part includes a first opening part 24X, a second opening part 24Y, and a third opening part 24Z, opening in a right-side surface 21C of the base part 21.SELECTED DRAWING: Figure 2

Description

  The present invention relates to a blood vessel model device used for simulation of procedures such as catheter operation.

  As a minimally invasive endovascular treatment method, surgery using a catheter, for example, self-expanding stent placement, is known. When performing self-expanding stent placement, the surgeon selects the optimal stent to be placed in the blood vessel based on the patient's examination data, and places the stent in a predetermined position in the blood vessel through preoperative simulation. It is desirable to confirm that this is possible.

  Patent Document 1 discloses a thin blood vessel model used for simulation of catheter operation. This blood vessel model is provided with a plurality of pseudo blood vessel channels, and simulation of catheter operation or the like is performed using any of the pseudo blood vessels. Patent Document 2 discloses a blood vessel model in which the cardiovascular system is reproduced three-dimensionally and faithfully.

JP 2014-92683 A JP 2008-237304 A

  The surgeon can perform the actual operation quickly and accurately by performing the simulation in the same environment as the actual operation. However, when the simulation environment is significantly different from the actual procedure environment, the simulation may be performed in a state that is significantly different from the state of the blood vessel in the actual patient.

  The blood vessel model described in Patent Document 1 is provided with a plurality of pseudo blood vessel channels. However, in the blood vessel model described in Patent Document 1, the shape of the pseudo blood vessel channel and the like cannot be easily changed. Moreover, the blood vessel model described in Patent Document 2 is relatively large and is not suitable for transportation or carrying.

  The present invention has been made in view of the above-described circumstances, and an object of the present invention is to provide a blood vessel model device capable of changing a simulation such as a catheter operation into a variation in accordance with a blood vessel of a patient.

  (1) A blood vessel model device according to the present invention includes a flat plate-shaped model main body having a groove-like pseudo blood vessel portion that opens on the upper surface and side surfaces, a state in which the upper surface of the model main body is covered, and a state in which the upper surface is exposed. The model body is detachable from the base and a base having a first blood vessel that is a part of the pseudo blood vessel. A replacement part having a second blood vessel part which is a part of the pseudo blood vessel part and is continuous with the first blood vessel part.

  The blood vessel model device can change the pseudo blood vessel portion of the model main body into a mode in which the shape of the second blood vessel portion is different by exchanging replacement parts. Therefore, it is possible to simulate a procedure such as a catheter operation in a state according to the state of the blood vessel of the patient. Further, since the pseudo blood vessel part is provided in the flat model body, the blood vessel model device is miniaturized.

  (2) Preferably, it further has a heating part for heating the replacement part.

  In a stent placement simulation using a blood vessel model device, a self-expanding stent having a shape recovery temperature (Af point) near the body temperature often does not completely expand at a room temperature of about 20 ° C. Therefore, by placing components that can heat the blood vessel model to near body temperature, stent placement can be simulated in a more realistic environment.

  (3) Preferably, it further has a temperature display part for displaying the temperature of the replacement part. The temperature display part may be attached to the base part or may be provided outside the model body.

  In the simulation using the blood vessel model device, the heating state of the second blood vessel portion by the heating portion can be easily confirmed by the temperature display portion.

  (4) Preferably, the first blood vessel portion simulates a blood vessel shape including at least a portion extending from a blood vessel of a human upper body to the carotid artery, and the second blood vessel portion is at least one of the human carotid artery. This simulates the blood vessel shape including the part.

  When simulating carotid artery stenting using a blood vessel model device, simulation in a state close to an actual temperature environment is possible.

  According to the present invention, it is possible to easily perform a simulation such as a catheter operation in a state close to a patient's blood vessel without using a three-dimensional complicated and large blood vessel model.

1A is a plan view of the blood vessel model device 10 according to the first embodiment of the present invention, FIG. 1B is a front view thereof, and FIG. 1C is a side view thereof. FIG. 2 is a perspective view showing a state where the cover plate 30 of the blood vessel model device 10 is rotated upward and the replacement part 22 is removed from the base 21. FIG. 3 is a plan view of another replacement part 22 used in the blood vessel model device 10. FIG. 4 is a plan view of a blood vessel model device 10 according to a modification. FIG. 5 is a plan view of a blood vessel model device 10 according to another modification. 6A is a perspective view of the pseudo blood vessel component 26, and FIG. 6B is a plan view thereof.

  Hereinafter, preferred embodiments of the present invention will be described. In addition, this embodiment is only one embodiment of this invention, and it cannot be overemphasized that an embodiment can be changed in the range which does not change the summary of this invention.

  As shown in FIGS. 1A to 1C and FIG. 2, the blood vessel model device 10 is configured in a rectangular parallelepiped shape (flat plate shape). As shown in FIG. 2, the blood vessel model device 10 covers a model main body 20 having a pseudo blood vessel portion that simulates an actual blood vessel shape of a human at the top, and an upper surface of the model main body 20 as shown in FIG. 2. A transparent cover plate 30 (an example of a cover member). The model main body 20 is formed of, for example, polyacetal (POM) so that the length along the longitudinal direction is about 300 mm, the length along the direction orthogonal to the longitudinal direction is about 200 mm, and the thickness is about 17 mm.

  In the following description, in the state where the thickness direction of the blood vessel model device 10 is along the vertical direction 7, the direction along the longitudinal direction of the blood vessel model device 10 is “left-right direction 9”, and is orthogonal to the left-right direction 9. The direction to perform is “front-rear direction 8”. In the blood vessel model device 10, the front side in the front-rear direction 8 is “front side”, the rear side is “rear side”, and “left side” and “right side” in the left-right direction 9 are defined from the front side toward the rear side. .

  Each length of the cover plate 30 along the front-rear direction 8 and the left-right direction 9 is the same as that of the model main body 20 and has a thickness of about 5 mm. The cover board 30 is comprised by the acrylic resin which has translucency, for example.

  As shown in FIG. 1A, the cover plate 30 is placed on the base 21 of the model main body 20 and is aligned with the upper surface of the base 21. In such a state, the upper surface of the model main body 20 can be visually observed through the transparent cover plate 30. In FIG. 1A, the configuration of the model main body 20 that can be viewed through the transparent cover plate 30 is indicated by a solid line and denoted by a reference numeral.

  The rear surface portion of the cover plate 30 is connected to the rear surface portion of the base portion 21 by a pair of hinges 31. Each hinge 31 is attached in the vicinity of both ends in the left-right direction 9 on the rear surface of the cover plate 30 and the model body 20.

  The cover plate 30 is placed on the upper surface of the base portion 21, and a portion located on the front surface side is rotatable upward. When the cover plate 30 is rotated upward, the upper surface of the model body 20 is exposed. When the cover plate 30 is placed on the upper surface of the base portion 21, the two front corner portions of the cover plate 30 can be fixed to the base portion 21 of the model main body 20 with screws 32. When the cover plate 30 is fixed to the base portion 21 with screws 32, the cover plate 30 cannot be rotated with respect to the model main body 20.

  The model main body 20 includes a base 21 and a replacement part 22 that is detachably fitted to the base 21. The base 21 is provided with a recess 23 into which the replacement part 22 is fitted. The concave portion 23 is provided on the rear surface side of the left side portion of the base portion 21.

  As shown in FIG. 2, the recess 23 has a bottom surface 23A. The recess 23 is formed in a rectangular shape in plan view, and the length along the left-right direction 9 is about 1/3 of the length along the left-right direction 9 in the model main body 20. The recess 23 is open to the left side surface 21 </ b> B located on the left side of the base 21. The opening of the recessed part 23 is formed over the length of about 100-105 mm ahead from the position about 20 mm apart from the side edge of the rear surface side of the base 21.

  A step 23B is formed along the front-rear direction 8 at the right end of the bottom surface 23A. Further, a notch 23C is provided in the middle in the front-rear direction on the left side of the bottom surface 23A. The cutout portion 23C is formed at a certain depth. A thin plate-like heater 41 (heating unit) is detachably provided on the bottom surface 23A. The heater 41 is configured in a rectangular shape that is slightly smaller than the bottom surface 23A by, for example, a planar heating element. On the lower surface of the heater 41, a protrusion 41A (see FIG. 1C) that can be fitted into the notch 23C is provided. The heater 41 is positioned in the recess 23 by fitting the protrusion 23C into the notch 23C.

  As shown in FIG. 2, the replacement part 22 is configured in a block shape that fits in an inner space of a recess 23 provided in the base 21 in an aligned state. The replacement part 22 is fitted into the recess 23 of the base 21, so that the flat model body 20 is obtained.

  At the right end of the bottom surface of the replacement part 22, a protrusion 22 </ b> D is provided along the front-rear direction 8 to be fitted in a stepped portion 23 </ b> B formed on the bottom surface 23 </ b> A of the recess 23. When the protrusion 22 </ b> D of the replacement part 22 is fitted in the stepped part 23 </ b> B, the replacement part 22 is fixed in a state where it does not move in the recess 23. In this state, the upper surface of the replacement part 22 and the upper surface of the base portion 21 are located in the same plane. The heater 41 heats the replacement part 22 mounted in the recess 23.

  The pseudo blood vessel portion provided in the model body 20 includes a first blood vessel portion 24 provided on the upper portion of the base portion 21 and a second blood vessel portion 25 provided on the upper portion of the replacement part 22. The second blood vessel portion 25 of the replacement component 22 is in a state of being continuous with the first blood vessel portion 24 of the base portion 21 when the replacement component 22 is mounted in the concave portion 23 of the base portion 21.

  The second blood vessel portion 25 provided in the replacement part 22 is configured in a groove shape opened on the upper surface of the replacement part 22. In the present embodiment, the first blood vessel portion 24 and the second blood vessel portion 25 are configured so as to be suitable for simulation of the carotid artery stenting in which the self-expanding stent is placed in the carotid artery.

  The first blood vessel portion 24 provided on the upper portion of the base portion 21 has a groove shape opened on the upper surface of the base portion 21, and the first blood vessel portion 24 simulates the shape of the blood vessel portion continuous to the carotid artery in the upper body of the human. It is configured in the shape.

  The second blood vessel portion 25 of the replacement part 22 includes a first trunk portion 25A having a shape simulating a part of the common carotid artery in the carotid artery, a first branch portion 25B having a shape simulating the shape of the external carotid artery, A second branch portion 25C having a shape simulating the shape of the carotid artery.

  The first main line portion 25 </ b> A is formed in a straight line shape along the left-right direction 9 of the base portion 21. The right end portion of the first main line portion 25 </ b> A is open to the right side surface 22 </ b> B located on the right side of the replacement part 22. The left end of the first main line portion 25 </ b> A is located approximately in the middle in the left-right direction 9 of the replacement part 22.

  The first branch portion 25B extends in an inclined state from the left end portion of the first main line portion 25A toward the left side on the rear surface side. 25 C of 2nd branch parts are extended in the inclined state toward the left direction of the front side from the left end part of 25 A of 1st trunk line parts. The left end portions of the first branch portion 25 </ b> B and the second branch portion 25 </ b> C are open to the left side surface 22 </ b> A of the replacement part 22.

  The heater 41 attached to the bottom surface 23 </ b> A of the recess 23 in the base 21 is located below the left side portion of the second branch portion 25 </ b> C of the replacement part 22. The heater 41 heats the replacement part 22 mounted in the recess 23.

  The first blood vessel portion 24 provided in the base portion 21 has one second main line portion 24D that extends linearly from the concave portion 23 in the right direction. The second main line portion 24 </ b> D is continuous with the first main line portion 25 </ b> A of the replacement part 22 fitted in the recess 23. Further, the first approach portion 24A, the second approach portion 24B, and the third approach portion 24C branch off from the right end portion of the second main line portion 24D.

  The second trunk portion 24D has a shape simulating a part of the common carotid artery, and extends straight from the recess 23 to the right. The right end portion of the second main line portion 24D is a connection portion 24E that is curved toward the front of the base portion 21. The connecting portion 24E is located on the right side of the middle portion of the base portion 21 in the left-right direction 9.

  24 A of 1st approach parts have the inclination part 24G extended in the inclination state toward the front right side in the base 21 from the connection part 24E of 2nd trunk line part 24D. A first introduction portion 24H that extends linearly in the right direction is continuously provided at the front end portion of the base portion 21 in the inclined portion 24G. The right end portion of the first introduction portion 24H is a first opening portion 24X that opens to the right side surface 21C of the base portion 21. The first opening 24 </ b> X of the first introduction portion 24 </ b> H is located on the front side of the intermediate position in the front-rear direction 8 on the right side surface 21 </ b> C of the base portion 21.

  The second approach portion 24B has a curved portion 24J extending from the connection portion 24E of the second main line portion 24D toward the front left side. The curved portion 24J is curved so as to protrude in the left direction, and is in a larger curved state than the first approach portion 24A. The bending portion 24J is continuously provided with a second introduction portion 24K extending linearly in the right direction. The right end portion of the second introduction portion 24K is a second opening portion 24Y that opens to the right side surface 21C of the base portion 21. The second opening 24Y of the second introduction part 24K is located on the front side of the first opening 24X of the first introduction part 24H in the first approach part 24A.

  The third approach portion 24C includes a distal guide portion 24M that extends linearly from the connection portion 24E of the second trunk portion 24D toward the left side on the front surface side of the base portion 21. The distal guide portion 24M is continuously provided with a curved portion 24N that is curved so as to protrude leftward. The bending portion 24N is continuously provided with a proximal guide portion 24P that extends linearly toward the right direction on the front side of the base portion 21. The proximal guide portion 24P is continuously provided with a third introduction portion 24Q extending linearly in the right direction. The right end portion of the third introduction portion 24Q is a third opening portion 24Z that opens to the right side surface 21C of the base portion 21. The third opening 24Z of the third introduction part 24Q is located on the front side of the second opening 24Y of the second introduction part 24K in the second approach part 24B.

  A plurality of replacement parts 22 that can be attached to and detached from the base 21 are prepared in advance. The shape of the second blood vessel portion 25 in each replacement part 22 is different. In the simulation of the catheter operation, the replacement part 22 having the second blood vessel portion 25 having a shape similar to the shape of the blood vessel of the patient into which the catheter is inserted is attached to the base portion 21.

  As schematically shown in FIG. 1A, a temperature sensor 42 for detecting the temperature of the replacement part 22 heated by the heater 41 is provided on the base 21 of the model body 20 on the front side of the recess 23. Yes. In addition, a control unit 44 is provided inside the base portion 21 on the front side of the temperature sensor 42. The control unit 44 has a temperature display unit 43. The temperature display unit 43 is disposed on the front side of the control unit 44, and the display surface is exposed on the upper surface of the base 21. The control unit 44 controls the heater 41 based on the temperature of the replacement part 22 detected by the temperature sensor 42, and displays the detected temperature on the temperature display unit 43.

  Electric power is supplied to each of the heater 41, the temperature sensor 42, and the control unit 44 from the power source. As the power source, an AC-DC converter that converts household AC current into DC current, a battery, and the like are used.

<Usage example of blood vessel model device 10>
The blood vessel model device 10 is used, for example, for simulation of a carotid artery stenting in which a self-expanding stent formed of a shape memory alloy is placed in the carotid artery. An overview of carotid stenting is determined based on patient information obtained by examination. When executing the simulation, the replacement part 22 having the second blood vessel portion 25 having a shape similar to the shape of the carotid artery of the patient (human) is selected. A catheter equipped with a stent suitable for the carotid artery of the patient is prepared, and simulation is performed using the catheter.

  When the selected replacement part 22 is mounted on the base portion 21 of the model main body 20, the screws 32 for fixing the two front corner portions of the cover plate 30 to the base portion 21 of the model main body 20 are removed. Next, the front side portion of the cover plate 30 is lifted upward. Thereby, as shown in FIG. 2, the upper surface of the model main body 20 is opened upward. In such a state, when the replacement part 22 is mounted on the base 21, the replacement part 22 is removed. Thereafter, the selected predetermined replacement part 22 is mounted in the recess 23. In this case, the replacement part 22 described above, that is, the replacement part 22 having the second blood vessel part 25 simulating a part of the carotid artery is attached to the base part 21.

  Next, the cover plate 30 is rotated downward, so that the upper surfaces of the base 21 and the replacement part 22 are covered with the cover plate 30 as shown in FIG. Thereafter, each of the two front corners of the cover plate 30 is fixed to the base 21 of the model main body 20 with screws 32.

  In such a state, any of the first approach portion 24A, the second approach portion 24B, and the third approach portion 24C in the first blood vessel portion 24 is determined based on the route of the blood vessel into which the catheter is inserted in the actual stent placement. A simulation of stent placement is performed.

  In this case, since the stent used for stent placement is a self-expanding type made of a shape memory alloy, the replacement part 22 is heated to about 37 ° C. by the heater 41. The temperature of the replacement part 22 is displayed on the temperature display unit 43. When the replacement part 22 is heated to about 37 ° C., a stent placement simulation is started.

  The first approach portion 24A is selected for simulation when a catheter is inserted from the femoral artery into the carotid artery in stent placement. For this purpose, the operator (operator) of the catheter inserts the distal end portion of the catheter from, for example, the first opening 24X that opens to the right side surface 21C of the base portion 21. The operator moves the catheter so that the distal end of the catheter reaches the second blood vessel portion 25 from the first introduction portion 24H, the inclined portion 24G, the connection portion 24E of the second trunk portion 24D, and further from the second trunk portion 24D. Manipulate.

  In this case, the distal end position of the catheter can be confirmed visually through the transparent cover plate 30.

  Thereafter, the stent is positioned at, for example, the second branch portion 25C in the second blood vessel portion 25 by operating the catheter. When the model main body 20 is at a predetermined temperature, the stent positioned in the second branch portion 25C changes from the contracted state to the expanded state.

  When it is confirmed that the stent is in the expanded state, the operator inserts the catheter into the second branch portion 25C in the second blood vessel portion 25, the second trunk portion 24D of the first blood vessel portion 24, and the first approach portion 24A. Pull out sequentially. This completes the simulation of stent placement for the carotid artery. After the simulation is completed, the cover plate 30 is rotated to open the upper surface of the model main body 20, whereby the stent placed in the second branch portion 25C is easily removed.

  In addition, it is also possible to perform a simulation using the second approach unit 24B and the third approach unit 24C of the blood vessel model device 10.

<Effects of Embodiment>
In the blood vessel model device 10 of the present embodiment, since the replacement part 22 can be attached to and detached from the base 21 of the model main body 20, the catheter operation can be performed in an environment simulating a patient's blood vessel in an actual carotid artery stenting operation or the like. Etc. can be simulated.

  Since the base 21 has the heater 41 that heats the replacement part 22, it can be confirmed that the stent changes to an expanded state at a predetermined temperature when the stent is a self-expanding type formed of a shape memory alloy.

  By providing the temperature display unit 43 that displays the temperature of the replacement part 22 heated by the heater 41, the heating state of the replacement part 22 can be easily confirmed.

  The first blood vessel portion 24 provided in the flat plate-shaped model main body 20 simulates a blood vessel shape including at least a portion from the blood vessel of the upper body of the human to the carotid artery, and the second blood vessel portion 25 of the replacement part 22 is Simulating a blood vessel shape including at least a part of a human carotid artery. Thereby, the simulation of the catheter operation when inserting the catheter into the carotid artery can be performed. In this case, since the first blood vessel portion 24 and the second blood vessel portion 25 have shapes that simulate the minimum blood vessel portion required for the simulation, the blood vessel model device can be reduced in size. As a result, the blood vessel model device can be easily transported and carried, and the procedure can be simply simulated.

  The replacement part 22 is not limited to the one having the second blood vessel portion 25 simulating a part of the carotid artery as described above, and for example, a blood vessel portion curved in a wave shape as shown in FIG. Those having the second blood vessel portion 25 are prepared in advance.

[Modification]
The control unit 44 having the temperature display unit 43 is not limited to the configuration provided in the base 21, and may be a configuration provided outside the base 21 as schematically shown in FIG. 4.

  Further, in the blood vessel model device 10 shown in FIG. 4, for example, a U-shaped synthetic resin simulated blood vessel part 26 is replaced with a replacement part 22 in order to simulate a stenosis of a blood vessel, as shown in FIG. 5. It may be attached to a part of the second blood vessel part 25 (for example, the second branch part 25C). The simulated blood vessel component 26 can be easily attached and detached with the cover plate 30 being rotated and the upper surface of the model body 20 being open.

  As shown in FIGS. 6A and 6B, the simulated blood vessel component 26 has a groove shape with an open top and is formed so as to be fitted in the second blood vessel portion 25. When the simulated blood vessel part 26 is fitted into the second blood vessel portion 25, the outer peripheral surface is brought into close contact with the inner peripheral surface of the second blood vessel portion 25, and does not protrude upward from the second blood vessel portion 25. . In the inside of the second blood vessel portion 25, each side portion located on both sides in the width direction is raised toward the inside so as to correspond to a stenosis site in a diseased blood vessel. Thereby, the interval between the side portions located on both sides in the width direction of the simulated blood vessel component 26 is shorter than that of the second blood vessel portion 25. Each side part located on both sides in the width direction of the simulated blood vessel component 26 may be smoothly raised inward as shown in FIGS. 6A and 6B, for example, but the surface has an uneven shape. It may be. Further, the simulated blood vessel component 26 does not need to be raised at the side portions located on both sides in the width direction, and only one of them may be raised. By using such a simulated blood vessel component 26, it is possible to simulate the behavior of the stent in placing the stent in the vascular stenosis.

  Furthermore, in the above-described embodiment, the first blood vessel portion 24 of the pseudo blood vessel portion in the model body 20 includes a part of the blood vessel shape including a part of the human carotid artery and a part from the blood vessel of the upper body of the human to the carotid artery. Although it has a configuration having a simulated shape, it is not limited to such a configuration. For example, you may comprise in the shape which simulated the shape of the whole femoral artery used as the path | route in which a catheter is inserted.

  Further, the pseudo blood vessel portion may be configured in a shape simulating a blood vessel shape other than a human carotid artery, for example, a blood vessel shape such as a coronary artery or a hepatic artery. Accordingly, the shape, size, etc. of the model main body 20 may be different from the above embodiment. The simulation using the blood vessel model is not limited to stent placement, and may be a simulation of other catheter operations.

  The cover plate 30 is not limited to a configuration that can be pivoted in the vertical direction with respect to the model main body 20 as described above, and a configuration that is slidable with respect to the model main body 20 or that is detachable is adopted. May be.

DESCRIPTION OF SYMBOLS 10 ... Blood vessel model apparatus 20 ... Model main body 21 ... Base 22 ... Replacement part 23 ... Recess 24 ... First blood vessel 24A ... First approach Part 24B ... second approach part 24C ... third approach part 24X ... first opening 24Y ... second opening 24Z ... third opening 25 ...... second blood vessel part 30 ... Cover plate 41 ... Heater 42 ... Temperature sensor 43 ... Temperature display

Claims (4)

A flat plate-shaped model main body having a groove-like pseudo blood vessel portion opening on the upper surface and side surfaces;
A state of covering the upper surface of the model body, and a cover member having translucency capable of changing the state to a state in which the upper surface is exposed,
The model body is
A base portion having a first blood vessel portion that is a part of the pseudo blood vessel portion;
A blood vessel model device comprising: a replacement part having a second blood vessel portion that is detachable from the base portion and is part of the pseudo blood vessel portion and is continuous with the first blood vessel portion.   The blood vessel model device according to claim 1, further comprising a heating unit that heats the replacement part.   The blood vessel model device according to claim 2, further comprising a temperature display unit that displays a temperature of the replacement part. The first blood vessel part simulates a blood vessel shape including at least a part from a blood vessel of a human upper body to a carotid artery,
The blood vessel model device according to any one of claims 1 to 3, wherein the second blood vessel portion simulates a blood vessel shape including at least a part of a human carotid artery.

Images