JP2017042236A - Self-expanding type stent delivery system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a self-expanding type stent delivery system that strikes a balance between a simple structure and an easy operability.SOLUTION: The stent delivery system 10 includes a traction operation part 150 for moving an outer pipe 30 relatively to an inner pipe 20. The traction operation part includes: an operation wire 160 for transmitting traction force to the outer pipe 30; and a wind up mechanism 170 allowing an operation for winding up the operation wire.SELECTED DRAWING: Figure 3

Description

  The present invention relates to a self-expanding stent delivery system.

  BACKGROUND ART A stent delivery system is widely known as a medical device used for delivering a self-expanding stent to a desired position such as a biological lumen.

  For example, in Patent Document 1 below, a stent is placed in a gap defined between an outer tube and an inner tube, the stent is delivered to a desired position in the body lumen, and then the outer tube is turned into the inner tube. A stent delivery system is disclosed that is configured to be moved relative to each other to release the stent to the outside. Further, in this stent delivery system, driving means for assisting movement of the outer tube is provided, and the operator moves the outer tube by an amount corresponding to the operation amount by operating a predetermined drive lever. It is possible.

International Publication No. 2007/122901

  In the above stent delivery system, the operability when moving the outer tube is improved, but the structure of the driving unit for assisting the movement of the outer tube is very complicated, so the driving unit is incorporated. The structure of the stent delivery system is also very complicated. For this reason, the increase in the number of components of a structural member, the complexity of a manufacturing process, and the increase in the manufacturing cost resulting from these become a subject.

  The present invention has been made to solve the above-described problems, and an object of the present invention is to provide a self-expanding stent delivery system that achieves both a simple structure and easy operability.

  The self-expanding stent delivery system according to the present invention that achieves the above object includes an inner tube in which a guide wire lumen is inserted, and an outer tube disposed so as to cover the distal end side of the inner tube. And an operation portion for moving the outer tube relative to the inner tube; and a distal end portion of the inner tube and a distal end portion of the outer tube, and accompanying the movement of the outer tube A self-expandable stent that is released from between the inner tube and the outer tube and expands and deforms, and a port that is disposed on the proximal end side of the inner tube and communicates with the guide wire lumen is formed. A handle portion, and the operation portion includes an operation wire for transmitting a traction force to the outer tube and a winding mechanism that enables a winding operation of the operation wire.

  According to the self-expanding stent delivery system configured as described above, since the operation wire and the winding mechanism are employed as the configuration for assisting the movement of the outer tube, a delivery system with a simple structure is realized. be able to. Furthermore, since the stent can be released by moving the outer tube by a simple operation of winding the operation wire, the stent can be placed easily.

It is a figure showing the whole self-expanding stent delivery system composition concerning an embodiment. It is a fragmentary sectional view of the self-expanding stent delivery system concerning an embodiment. It is sectional drawing which shows the inside of the handle | steering-wheel part with which the self-expanding stent delivery system which concerns on embodiment is provided. It is the elements on larger scale which show the example of operation of the self-expanding stent delivery system concerning an embodiment. It is a figure which shows the self-expanding stent with which the self-expanding stent delivery system which concerns on embodiment is mounted | worn.

  Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. In addition, the following description does not limit the technical scope and terms used in the claims. In addition, the dimensional ratios in the drawings are exaggerated for convenience of explanation, and may differ from actual ratios.

  FIG. 1 and FIG. 2 are diagrams showing an overall configuration of a self-expanding stent delivery system (hereinafter referred to as a stent delivery system) according to an embodiment, and FIG. 3 is a diagram showing a handle portion provided in the stent delivery system; FIG. 4 is a diagram illustrating an operation example of a stent delivery system using a handle portion, and FIG. 5 is a diagram illustrating a self-expanding stent (hereinafter referred to as a stent) attached to the stent delivery system.

  As shown in FIG. 1 and FIG. 2, the stent delivery system 10 according to the present embodiment can be summarized as an inner tube 20 having a guide wire lumen 21 into which a guide wire (not shown) is inserted, and an inner tube 20. An outer tube 30 disposed so as to cover the distal end side, a traction operation unit (corresponding to an operation unit) 150 for moving the outer tube 30 relative to the inner tube 20, A stent 200 that is disposed between the distal end portion and the distal end portion of the outer tube 30 and is expanded and deformed by being released from between the inner tube 20 and the outer tube 30 as the outer tube 30 moves, and the base of the inner tube 20 And a handle portion 140 that can be gripped and has a port 143 that is disposed on the end side and communicates with the guide wire lumen 21.

  In this specification, the side to be inserted into the living body is referred to as “distal end” or “distal end side”, and the proximal side where the handle portion 140 is disposed is referred to as “proximal end” or “proximal end side”.

  As shown in FIG. 2, the inner tube 20 is constituted by a long tubular body in which a guide wire lumen 21 extending from the distal end to the proximal end is formed. A guide wire that guides the stent delivery system 10 to a lesion in a living body lumen is inserted into the guide wire lumen 21. As the guide wire to be used, for example, a well-known guide wire made of a metal material such as stainless steel or nitinol can be used.

  In the stent delivery system 10 according to the present embodiment, the guide wire lumen 21 is a so-called over-the-wire (OTW) in which the guide wire lumen 21 continuously communicates from the distal end opening 23a provided at the distal end to the port 143 provided at the proximal end of the handle portion 140. ) Is configured as a type.

  As shown in FIG. 2, a tip member 23 is disposed at the forefront of the stent delivery system 10. The distal end member 23 is fixed to the distal end portion of the inner tube 20 via a predetermined fastener 22.

  The distal end member 23 is formed in a tapered shape that gradually decreases in diameter toward the distal end in consideration of insertability into the living body lumen. A distal end opening 23 a through which the guide wire is inserted is formed at the distal end of the distal end member 23. For example, the tip member 23 can be configured by a member different from the inner tube 20, or can be configured integrally by the same member as the inner tube 20. As a material constituting the tip member 23, a material having flexibility is preferably used, and for example, a known resin material or the like can be used.

  The fastener 22 is embedded in the tip member 23. The fastener 22 has a function of preventing the tip member 23 from being detached. The fastener 22 can be formed of a metal material such as stainless steel, for example.

  As shown in FIG. 3, the proximal end of the inner tube 20 is inserted through a port 143 for taking in and out the guide wire. The proximal end of the inner tube 20 can be fixed to the port 143 with, for example, an adhesive.

  As a material constituting the inner tube 20, it is preferable to use a material having flexibility, for example, polyolefin such as polyethylene and polypropylene, polyester such as polyamide and polyethylene terephthalate, fluorine-based polymer such as ETFE, PEEK, polyimide and the like. Can be used.

  The outer tube 30 is constituted by a long tubular body. As shown in FIG. 2, the outer tube 30 is disposed on the outer surface side of the inner tube 20 so as to be movable relative to the inner tube 20.

  In a state where the inner tube 20 and the outer tube 30 are assembled, the distal end portion of the inner tube 20 is disposed so as to protrude from the distal end portion of the outer tube 30. A gap 40 for accommodating the stent 200 is formed between the distal end portion of the inner tube 20 and the distal end portion of the outer tube 30.

  The gap 40 is configured by a space defined between the distal end marker 60 and the stent stopper 70 disposed in the outer tube 30 and the inner wall of the outer tube 30. The stent 200 is housed in the gap portion 40 in a state compressed inward in the radial direction, as shown in FIG.

  As shown in FIG. 2, the outer tube 30 includes an inner layer 30a and an outer layer 30b that covers the outer surface of the inner layer 30a. For example, a reinforcing body for improving the kink resistance of the outer tube 30 can be disposed between the inner layer 30a and the outer layer 30b.

  As a material constituting the inner layer 30a, for example, a fluorine resin such as polytetrafluoroethylene (PTFE), polyethylene, or the like can be used. Moreover, as a material which comprises the outer layer 30b, polyester resins, such as a polyamide resin and a polyethylene terephthalate (PET), etc. can be used, for example. As a material constituting the reinforcing body, for example, a metal wire braided in a mesh shape can be used.

  The outer diameter of the outer tube 30 can be formed to 0.5 to 4.0 mm, for example, and when applied to a relatively thin lumen such as a peripheral blood vessel of the lower limb, it is formed to 0.8 to 2.0 mm. It is preferable. The inner diameter of the outer tube 30 can be formed to 0.2 to 1.8 mm, for example.

  In a state where the stent 200 is housed in the gap 40, the stent 200 receives a restraining force from the inner surface of the outer tube 30 and is restricted from expanding radially outward. FIG. 5A illustrates a state where the stent 200 is contracted.

  In the stent 200, when the outer tube 30 moves to the proximal end side with respect to the inner tube 20 and the gap 40 is exposed to the outside, the restraint by the inner surface of the outer tube 30 is released, and FIG. As shown in B), it is expanded and deformed radially outward.

  The stent 200 can be formed so that the outer diameter in the expanded state is, for example, 2 to 12 mm. Moreover, the thickness of the stent 200 can be formed to 0.05 to 0.25 mm, for example.

  As the stent 200, a known stent having self-expandability can be appropriately used. For example, it is possible to use a stent made of a superelastic alloy such as a nickel titanium alloy, or a stent made of a polymer material or another metal material. Examples of the polymer material include polyolefins such as polyethylene and polypropylene, polyesters such as polyethylene terephthalate, and fluorine-containing polymers such as polytetrafluoroethylene and tetrafluoroethylene-ethylene copolymers. Examples of the metal material include cobalt-chromium alloy, stainless steel, iron, titanium, aluminum, tin, and zinc-tungsten alloy.

  As shown in FIGS. 5A and 5B, the stent 200 includes a distal-side stent marker 201 and a proximal-side stent marker 202 having X-ray contrast properties.

  The distal-side stent marker 201 and the proximal-side stent marker 202 can be made of a material having X-ray contrast properties, for example. As a material having X-ray contrast properties, for example, a metal such as platinum, gold, silver, iridium, titanium, tungsten, or an alloy thereof can be used.

  As shown in FIG. 2, the tip marker 60 arranged in the outer tube 30 is fixed to the outer surface of the inner tube 20. Since the outer diameter of the tip marker 60 is formed substantially the same as the inner diameter of the outer tube 30, friction is caused between the outer surface of the inner tube 20 and the inner surface of the outer tube 30 via the tip marker 60. Force acts. This frictional force can prevent the outer tube 30 from inadvertently moving with respect to the inner tube 20. The distal marker 60 can be formed of a material having X-ray contrast properties, like the distal stent marker 201 and the proximal stent marker 202.

  The stent stopper 70 is disposed on the proximal end side with respect to the stent 200 accommodated in the gap 40. When performing an operation of moving the outer tube 30 to the proximal end side with respect to the inner tube 20, the proximal end of the stent 200 comes into contact with the stent stopper 70. The movement of the stent 200 to the proximal end side is limited by this contact. Since the outer tube 30 moves further to the proximal side independently of the stent 200, the stent 200 is pushed out from between the inner tube 20 and the outer tube 30 with the proximal end supported by the stent stopper 70. Released to a predetermined indwelling site (lesion).

  As shown in FIG. 1, the stent delivery system 10 has a hand operating unit 100 disposed on the proximal end side of the outer tube 30.

  The hand operating unit 100 includes an outer tube hub 110 to which a proximal end portion of the outer tube 30 is attached, a connector (Y connector) 120 connected to the outer tube hub 110, and the inner tube 20 on the proximal end side of the connector 120. A base shaft 130 to be covered, a handle portion 140 connected to the base shaft 130, and a traction operation unit 150 for operating the movement of the outer tube 30 are provided.

  As shown in FIG. 2, the outer tube hub 110 is liquid-tightly connected to the proximal end portion of the outer tube 30. The outer tube hub 110 can be made of, for example, a known resin material or metal material.

  The connector 120 includes a main body 121 including a lumen 121a through which the inner pipe 20 is inserted, a branch pipe 122 branched from the main body 121, and a valve body 123 configured to freely open and close the lumen 121a of the main body 121. And a lid portion 124 provided at the base end portion of the main body portion 121. The lumen 121a of the main body 121 communicates with the lumen 31 provided in the outer tube 30.

  The main body 121 of the connector 120 is configured to be movable relative to the inner tube 20. For this reason, when the main body 121 of the connector 120 is moved to the proximal side, the outer tube 30 connected to the main body 121 via the outer tube hub 110 is also moved to the proximal side.

  For example, a known fluid supply source such as a syringe is connected to the branch pipe 122 via a tube or the like. For example, a fluid such as physiological saline, contrast medium, Ringer's solution, etc. can be supplied to the lumen 31 of the outer tube 30 via the tube and the branch tube 122.

  The valve body 123 is disposed so as to surround the outer periphery of the base shaft 130. When the opening / closing operation is performed, the valve body 123 fills or widens a gap formed between the valve body 123 and the base shaft 130. The opening / closing operation of the valve body 123 can be performed by the lid portion 124. The valve body 123 can be made of a known elastic material such as natural rubber, synthetic rubber, or silicone rubber.

  The lid portion 124 includes a female screw portion 124 b that is screwed into a male screw portion 124 a formed on the outer surface of the base end portion of the main body portion 121. When the lid portion 124 is rotated in a state where the female screw portion 124b is screwed into the male screw portion 124a, the valve body 123 disposed on the distal end side of the lid portion 124 is pressed and compressed radially inward. The When the tightening by the lid portion 124 is loosened, the compressed state of the valve body 123 is released.

  When the valve body 123 is in the open state, the connector 120 can move relative to the base shaft 130. That is, the outer tube 30 connected to the connector 120 can move relative to the inner tube 20 inserted through the base shaft 130.

  When the valve body 123 is closed, the valve body 123 is pressed against the outer peripheral surface of the base shaft 130. As a result, the liquid tightness is maintained at the tip side of the valve body 123. Moreover, since the movement of the connector 120 with respect to the base shaft 130 is restricted by the pressure contact force applied by the valve body 123, the movement of the outer tube 30 with respect to the inner tube 20 is also restricted.

  By bringing the valve body 123 into pressure contact with the outer peripheral surface of the base shaft 130, a liquid such as physiological saline can be supplied to the lumen 31 of the outer tube 30 via the branch tube 122. Further, when the stent delivery system 10 is inserted into the living body lumen, the relative positions of the outer tube 30 and the inner tube 20 can be prevented from shifting, so that the operability can be improved.

  Each part (the main body part 121, the branch pipe 122, the lid part 124) of the connector 120 can be configured by, for example, a known resin material or metal material.

  The base shaft 130 has a hollow pipe shape through which the inner tube 20 can be inserted. The base shaft 130 can be made of, for example, stainless steel, nitinol, or the like.

  For example, as shown in FIG. 3, the base end of the base shaft 130 is fixed to a handle portion 140 included in the hand operation unit 100. The inner tube 20 is inserted into the handle portion 140 together with the base shaft 130. The inner tube 20 is connected to a port 143 provided at the proximal end of the handle portion 140 so as to penetrate the handle portion 140. The port 143 is formed with a communication hole (not shown) that communicates with the guide wire lumen 21 provided in the inner tube 20. When performing a procedure using the stent delivery system 10, a guide wire can be introduced from the proximal end of the port 143, and the guide wire can be protruded from the distal end opening 23a of the distal end member 23 disposed at the distal end.

  Next, the handle part 140 and the traction operation part 150 will be described.

  The traction operation unit 150 is used when performing an operation of moving the outer tube 30 relative to the inner tube 20, specifically, a traction operation of moving the outer tube 30 to the proximal end side. The traction operation unit 150 includes an operation wire 160 for transmitting a traction force to the outer tube 30 and a winding mechanism 170 that enables the operation wire 160 to be wound.

  The handle portion 140 is a portion that the operator grips when performing a procedure using the stent delivery system 10. The handle unit 140 includes a case 141 that houses a winding mechanism 170 provided in the traction operation unit 150.

  As shown in FIG. 2, the distal end portion of the operation wire 160 is led out from the handle portion 140 and disposed outside the handle portion 140. The distal end portion of the operation wire 160 is connected to the main body portion 121 of the connector 120 provided on the proximal end side of the outer tube 30. A concave groove 125 for fixing and holding the operation wire 160 is provided on the outer surface of the main body 121. In the illustrated example, the operation wire 160 is simply connected to the main body 121 by hooking the annular portion formed on the operation wire 160 to the groove portion 125. For example, an adhesive, welding, adhesive tape, or the like is used. It is also possible to fix by using.

  The material of the operation wire 160 is not particularly limited as long as the operation force for moving the outer tube 30 to the proximal end side can be transmitted. For example, the operation wire 160 can be formed of a known metal material or resin material. For example, metal materials such as SUS wire, copper wire, titanium wire, and nitinol wire, resin materials such as nylon and PET, and fiber materials such as silk yarn, cotton yarn, and cellulose fiber can be used.

  In addition, as the operation wire 160, for example, a wire whose tensile strength of the operation wire 160 is less than the yield point of the outer tube 30 can be used. The advantages of using the operation wire 160 configured as described above are as follows.

  When performing a procedure using the stent delivery system 10, for example, the outer tube 30 may be caught on a lesioned portion (stenosis) or the like, and a high load may be applied to the outer tube 30. Further, while the operation of moving the outer tube 30 to the proximal end side is continued in such a state, the load applied to the outer tube 30 is suddenly released, so that the outer tube 30 is suddenly released. If the stent 200 is released at an unintended timing after moving to the proximal end side, the stent 200 is discharged in a shape different from the desired outer shape, or is left in a state where it does not expand to the desired outer diameter. There is a possibility that it will be. For such a problem, if the operation wire 160 is configured to be broken when pulled to a certain stage, a phenomenon occurs in which the outer tube 30 suddenly moves to the proximal end side. Can be prevented in advance. In particular, when a tensile force is applied to the outer tube 30 until the yield point is reached, the physical properties of the outer tube 30 are greatly changed, and there is a risk that unintended movement or operation of the outer tube 30 is likely to occur due to this. Therefore, by making the operation wire 160 breakable below the yield point of the outer tube 30, it is possible to suitably prevent the stent 200 from being released in an unintended state.

  In the stent delivery system 10, the outer tube 30 is configured to be relatively movable with respect to the inner tube 20, and each part (outer side) located on the proximal end side of the outer tube 30 by a hand operation. Since the outer tube 30 can be moved by moving the tube hub 110, the connector 120, and the like, the stent 200 can be released even after the operation wire 160 is broken.

  In order to make the tensile strength of the operation wire 160 less than the yield point of the outer tube 30, for example, a weak portion (cut, thin-walled portion, etc.) formed with a lower strength than other portions is provided in a part of the operation wire 160. It is possible. Further, the material itself of the operation wire 160 may be appropriately selected, and the tensile strength of the operation wire 160 may be adjusted to be less than the yield point of the outer tube 30.

  As shown in FIG. 2, an opening 145 for leading the operation wire 160 to the outside is formed in the case 141 provided in the handle portion 140. The operation wire 160 is connected to the connector 120 whose distal end portion led out from the opening 145 is located on the proximal end side of the outer tube 30. The proximal end portion of the operation wire 160 is connected to the rotating roller 171 of the winding mechanism 170 housed in the handle portion 140.

  As illustrated in FIG. 3, the winding mechanism 170 includes a rotating roller 171 that winds the operation wire 160 and a restricting portion 173 that restricts the reverse rotation of the rotating roller 171.

  The case 141 that accommodates the winding mechanism 170 has a base end side and a central portion that are bent and rounded. An opening 146 is formed on the upper surface side of the case 141 so that a part of the rotating roller 171 protrudes to the outside.

  The rotating roller 171 includes a disk-shaped roller main body portion 171a having uneven teeth, a rotating shaft 171b, a winding shaft portion 171c that rotates by the rotation of the rotating shaft 171b, and a gear 171d. By rotating a part of the rotating roller 171 protruding from the opening 146 in the arrow R1 direction (direction in which the operation wire 160 is wound), the rotating shaft 171b rotates in the arrow R1 direction. At this time, when the winding shaft portion 171c rotates, the operation wire 160 is wound around the outer surface of the winding shaft portion 171c.

  The restricting portion 173 that restricts the reverse rotation of the rotating roller 171 has an engaging portion 173a that can be engaged with the gear 171d. When the rotating roller 171 is rotated in the direction of the arrow F1, which is the direction opposite to the direction in which the operation wire 160 is wound, the engaging portion 173a of the restricting portion 173 engages with the gear 171d to prevent the rotation. Thus, the rotation of the rotating roller 171 in the direction opposite to the winding direction of the operation wire 160 is restricted.

  Next, an operation example using the towing operation unit 150 will be described with reference to FIG.

  The surgeon performs an operation of moving the outer tube 30 to the proximal side with respect to the inner tube 20 when the stent 200 is placed in the lesion using the stent delivery system 10. At this time, the operator performs an operation of rotating the roller main body portion 171a protruding from the case 141 in the direction of the arrow R1, as shown in FIG. 4A, while holding the handle portion 140 with one hand. By performing this operation, the operation wire 160 connected to the roller main body portion 171a is wound up, and the main body portion of the connector 120 connected to the operation wire 160 as shown by an arrow R2 in FIG. 121 is pulled to the proximal side. Then, the outer tube 30 connected to the connector 120 also moves to the proximal end side with respect to the inner tube 20, and the stent 200 accommodated between the inner tube 20 and the outer tube 30 is released to the outside and expands. The stent 200 is indwelled in the lesioned state.

  As shown in FIG. 4B, when the main body 121 of the connector 120 hits the tip of the handle 140, the subsequent winding of the operation wire 160 is restricted. The operator can easily confirm that the outer tube 30 has moved appropriately without being caught in the living organ by visually confirming the amount of movement of the connector 120.

  As described above, according to the stent delivery system 10 according to the present embodiment, since the operation wire 160 and the winding mechanism 170 are employed as a configuration for assisting the movement of the outer tube 30, delivery with a simple structure is possible. A system can be realized. Furthermore, since the outer tube 30 can be moved and the stent 200 can be released by a simple operation that only winds the operation wire 160, the placement operation of the stent 200 can be easily performed.

  The winding mechanism 170 is provided on the handle portion 140. The distal end portion of the operation wire 160 is disposed outside the handle portion 140 and connected to the proximal end portion side of the outer tube 30. For this reason, since the operation wire 160 can be easily routed compared to the case where the operation wire 160 is disposed inside the inner tube 20 or the outer tube 30, the apparatus configuration can be further simplified. Furthermore, since the operation wire 160 is not disposed inside the inner tube 20 or the outer tube 30 or the like, a binding force is applied from the outside (for example, a lesioned portion) to the distal end portion of the inner tube 20 or the distal end portion of the outer tube 30. Even when the operation wire 160 is pulled in a state where the outer tube 30 is loaded, the outer tube 30 can be moved smoothly because the traction force can be applied directly to the outer tube 30, and the release of the stent 200. Can be performed smoothly.

  Further, by making the tensile strength of the operation wire 160 less than the yield point of the outer tube 30, the stent 200 is released in an unintended state even in a state where a high load is applied to the outer tube 30. It can prevent suitably.

  As described above, the self-expanding stent delivery system according to the present invention has been described through the embodiments. However, the present invention is not limited to the configuration described in the embodiments, and may be appropriately changed based on the description of the claims. It is possible.

  For example, the configuration of the winding mechanism is not limited to the structure shown in the embodiment as long as the operation wire can be wound. The operation wire may be connected to any position as long as it is located on the proximal end side of the outer tube and connected to the outer tube. For example, the operation wire may be connected to an outer tube hub or the like. Is possible.

  In addition, the self-expanding stent delivery system according to the present invention can include an operation wire and a winding mechanism, and can have a structure capable of moving the outer tube relative to the inner tube using the operation wire. As long as the structure of each part, the arrangement of members, and the like can be appropriately changed. Moreover, omission of use of the additional member demonstrated by illustration, use of another additional member, etc. can be performed suitably.

10 Stent delivery system (self-expanding stent delivery system),
20 inner pipe,
21 Guidewire lumen,
30 outer pipe,
100 Hand control unit,
110 outer pipe hub,
120 connector,
130 base shaft,
143 ports,
150 Towing operation unit (operation unit),
160 operation wires,
170 winding mechanism,
200 stent (self-expanding stent).

Claims (3)

An inner tube formed with a guide wire lumen through which the guide wire is inserted;
An outer tube arranged to cover the distal end side of the inner tube;
An operation unit for moving the outer tube relative to the inner tube;
A self-expanding stent disposed between the distal end portion of the inner tube and the distal end portion of the outer tube, and being expanded and deformed by being released from between the inner tube and the outer tube as the outer tube moves. ,
A handle portion that is disposed on the proximal end side of the inner tube and that has a handle that is formed with a port that communicates with the guide wire lumen;
The operation unit is
An operation wire for transmitting traction force to the outer tube;
A self-expanding stent delivery system comprising a winding mechanism that enables a winding operation of the operation wire. The winding mechanism is provided in the handle portion,
2. The self-expanding stent delivery system according to claim 1, wherein a distal end portion of the operation wire is disposed outside the handle portion and connected to a proximal end portion side of the outer tube.   The self-expanding stent delivery system according to claim 1 or 2, wherein a tensile strength of the operation wire is less than a yield point of the outer tube.