JP2017099519A - Guide wire insertion aid - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an aid for easily inserting a guide wire into each guide wire lumen of a catheter having a plurality of guide wire lumens.SOLUTION: An aid 10 for inserting a guide wire into a plurality of guide wire lumens of a catheter comprises a jig body 11 provided with slits 21, 23 linearly extending from one end region 12 to the other end region 13. The jig body is configured so that one end region is thick in a height direction, the other end region is thinner than one end region, the formation depth of the slit is deep in one end region, and the formation depth of the slit is shallow in the other end region. The slit in the other end region is an insertion guide groove for inserting a catheter sheath of the catheter along an extension direction of the slit. The catheter sheath is inserted to one end region, and an end part of a guide wire lumen is exposed in a visible state at a slit exit in one end region.SELECTED DRAWING: Figure 1

Description

  The present invention relates to an auxiliary device that can easily insert a guide wire into each guide wire lumen of a catheter having a plurality of guide wire lumens.

Catheter is widely used in the medical field by injecting medicinal solution into a patient's body and discharging waste fluid outside the body.
In the use of such a catheter, a guide wire is often used to introduce the catheter into the patient's body.
Since the guide wire is thinner and more flexible than the catheter, it can enter a blood vessel or the like in the patient's body and follow it more appropriately at a curved or refracted portion in the body cavity. For this reason, by sending the guide wire into the body prior to the catheter, it can be operated more safely and easily to the target position. After the guide wire is placed in the body, the catheter is placed along the guide wire. It is common to send and use.

Thus, when using a guide wire when using a catheter, it is necessary to pass the guide wire through the distal end of the catheter. However, since the catheter is a very thin tube, it is not easy to prepare a treatment through a guide wire through the catheter.
Therefore, the present applicant has previously proposed an auxiliary jig in which the distal end portion of the catheter is fixed and a guide wire is inserted to face the catheter (see Patent Document 1).

Patent No. 3902944

  In this auxiliary jig, a groove having a shape along the outer shape of the distal end of the catheter is formed in a flat jig body, and the distal end of the catheter is fitted into the groove. In addition, a thin guide groove is formed at the tip of the catheter-shaped groove in the jig body, and the guide wire is moved so as to face the fitted catheter distal end, so that the lumen is formed in the lumen at the thin catheter distal end. The guide wire is inserted.

However, recently, for example, a catheter provided with a measuring means using an optical element or an acoustic element is used at the distal end of the catheter. For this reason, the catheter distal end has a predetermined path so as to avoid a scanning path by these elements. The type of which the guide wire lumen | rumen for providing the space | interval of this and the guide wire to pass through was provided in two places etc. is used.
In such a catheter, with a conventional auxiliary jig, it is not possible to guide and insert an extremely thin guide wire into two guide wire lumens.

  The present invention has been made to solve the above-described problems, and can guide a guide wire appropriately to a catheter having a plurality of guide wire lumens, and can easily insert a guide wire into each lumen, and a jig. It is intended to provide an auxiliary tool for inserting a guide wire that can be easily detached from the guide.

  An auxiliary tool for inserting a guide wire into a guide wire lumen of a catheter, comprising a jig body provided with a slit extending linearly from one end region to the other end region, The jig body is configured such that the one end region is thick in the height direction and the other end region is thinner than the one end region, and the slit formation depth is deep in the one end region, In the other end region, the slit is formed with a shallower depth, and the slit in the other end region is an insertion guide groove for inserting the catheter sheath of the catheter along the extending direction of the slit, When the catheter sheath is inserted to the one end and the end of the catheter sheath is positioned at the slit exit at the one end, the slit End of the guide wire lumen opening is characterized by being configured to be exposed in a visible state.

According to the above configuration, when the auxiliary tool is disposed, from the end of the other end region of the jig body of the slit, the catheter sheath side is directed to the slit, and the catheter is inserted along the slit. The catheter can be easily set on the auxiliary tool.
When this catheter is pushed further into the slit, the jig body is thin because it is exposed to the slit outlet opening in a state visible from the end of the guide wire lumen formed in the catheter. The other end region can be grasped together with the catheter partially protruding from the groove.
And, by pointing the one end region of the main end to a position where an operator can easily see the end of the guide wire lumen exposed at the slit outlet opening, by passing the guy wire held with the other hand, Easy to insert into the guidewire lumen.
Subsequently, when the guide wire lumen is inserted deeply as it is, it is guided along the slit, and a guide wire is further inserted into another guide wire lumen, so the operation of inserting the guide wire into a plurality of guide wire lumens It becomes very easy.

Preferably, the inner diameter of the slit of the jig body is configured to be slightly smaller than the outer diameter of the catheter sheath.
According to the above configuration, since the catheter sheath is firmly held in the slit, the operation becomes extremely easy.

Preferably, the one end region of the slit is a holding portion embedded in the inserted catheter sheath so as not to be displaced.
According to the above configuration, since the one end region has a sufficient thickness, the slit there can be formed deeply, so that the entire catheter sheath can be sufficiently embedded and the catheter sheath can be more firmly held during the operation.

Preferably, in the other end region of the slit, a part of the inserted catheter sheath is exposed from the shallow slit, so that an operator can connect the other end region of the jig body and the catheter sheath during the work. It is the structure characterized by being able to hold | grip a part of.
According to the said structure, since a catheter sheath and a jig | tool main body can be firmly hold | gripped with an operator's hand, it is easier to work.

Preferably, a distance in the length direction of the holding portion is at least larger than a separation distance between the plurality of guide wire lumens.
According to the said structure, since the said slit can cover the catheter sheath over the full length of the location where a guide wire lumen is interrupted on the way, a guide wire does not shift | deviate a position during an operation | work.

Preferably, in the holding portion, the bottom portion of the slit is wide and is shaped so as to completely surround the catheter sheath.
According to the above configuration, the groove formed by the slit holds the entire outer periphery of the catheter sheath on the back side (lower part), so that the work can be performed accurately and accurately without being displaced in the axial direction during the work. Easy to do.

Preferably, the slit outlet opening is provided with a visual recognition portion that facilitates visual recognition of the guide wire lumen by gradually expanding the diameter toward the outside.
According to the said structure, the position confirmation of a visual recognition part is easy based on the difference in the shape seen from the outside.

  As described above, according to the present invention, a guide wire can be appropriately guided to a catheter having a plurality of guide wire lumens, and the guide wires can be easily inserted into the lumens and removed from the jig. An auxiliary tool for guidewire insertion that can easily be provided.

The schematic perspective view seen from the other end area | region of the auxiliary tool which concerns on embodiment of this invention. The schematic side view of the auxiliary tool of FIG. The figure which looked at the auxiliary tool of FIG. 1 from A direction. The figure which looked at the auxiliary tool of FIG. 1 from the B direction. The cross-section structure example of the catheter front-end | tip part which is the object which uses the auxiliary tool of FIG. An example of the shape of the front-end | tip part of a guide wire. Explanatory drawing for demonstrating the insertion operation | movement of a guide wire using the auxiliary tool of FIG. Explanatory drawing for demonstrating the insertion operation | movement of a guide wire using the auxiliary tool of FIG. Explanatory drawing for demonstrating the insertion operation | movement of a guide wire using the auxiliary tool of FIG. Explanatory drawing for demonstrating the insertion operation | movement of a guide wire using the auxiliary tool of FIG.

DESCRIPTION OF EXEMPLARY EMBODIMENTS Hereinafter, preferred embodiments of the invention will be described in detail with reference to the accompanying drawings.
The embodiment described below is a preferred specific example of the present invention, and thus various technically preferable limitations are given. However, the scope of the present invention is particularly limited in the following description. Unless otherwise stated, the present invention is not limited to these forms.

FIG. 1 is an example of an auxiliary tool (hereinafter referred to as “auxiliary tool”) for inserting a guide wire according to an embodiment of the present invention.
1 and 2, the auxiliary tool 10 has a jig body (hereinafter referred to as “main body”) 11, one end region 12 of the main body 11, and the other end region 13 of the main end 11. The main body 11 is formed with a slit 21 which is a long groove having an upper portion opened at a substantially central portion in the width direction. The slit 21 as a guide portion is linearly provided from the one end region 12 to the other end region 13.

  The material constituting the main body 11 is preferably a molding made of a hard material with little deformation, and examples thereof include polymer materials such as polypropylene and its olefin-based polymer material, polycarbonate polyester, and polyamide, stainless steel, etc. The metal material can be used.

In the case of FIG. 1, the main body 11 has a substantially rectangular shape, and its length is about 20 to 70 mm, preferably 25 to 60 mm, more preferably about 30 to 50 mm. The width of the main body 11 is about 15 to 35 mm, preferably about 15 to 30 mm, and more preferably about 8 to 25 mm.
The thickness D1 of the one end region 12 shown in FIG. 2 needs to be at least about 3 mm to 5 mm. The thickness D2 of the other end region 13 needs to be at least about 1 mm to 3 mm.
The other end region 13 is a grip portion when the guide wire is inserted, as will be described later.
Preferably, the bottom surface of the main body 11 is not a flat surface. A rough surface is appropriately provided, irregularities are provided, and protrusions of an appropriate size are provided. In the present embodiment, the bottom surface of the main body 11 has a structure like a part of a cylinder. The reason why the bottom surface of the main body 11 is made to have a structure other than a plane is to make it easier for the operator to grasp both ends of the auxiliary tool with the slit (groove) facing upward on a work table or the like.

Further, as is apparent from FIGS. 1 and 2, gentle downward inclined curved surfaces 14 and 14 are preferably formed from one end region 12 to the other end region 13.
Further, the upper opening of the slit 21 as a guide wire insertion guide groove to be described later has a narrow opening 22 (having a narrower dimension than a catheter sheath to be described later) 22 in the one end region 12 and wider than 22 in the other end region 13. An opening 23 (having dimensions that allow a later-described catheter sheath to be exposed) is used.

  Preferably, the reference numeral 23a of the slit 23 of the main body 11 has a substantially tapered opening edge chamfered. That is, it is a guide wire insertion guide port to be described later. On the other hand, the slit outlet opening of the slit 22 located on the opposite side is an enlarged opening, and is exposed so that the end portion of the guide wire lumen to be described later can be seen.

3 is a view of the auxiliary tool of FIG. 1 as viewed from the A direction, and FIG. 4 is a view of the auxiliary tool of FIG. 1 as viewed from the B direction.
3, the slit 21 formed in the one end region 12 has an upper slit 21a and a lower slit 21b, and the width W1 of the upper slit 21a is larger than the width W2 of the slit 23 formed in the other end region of FIG. It is made narrowly.
Therefore, in FIG. 3, the lower slit 21b has a tubular shape with a slightly opened upper portion, the lower slit 21b has a substantially circular cross section, and its inner diameter is slightly smaller than the outer diameter of the catheter sheath of the catheter described later. For this reason, as will be described later, when the catheter sheath is inserted into the lower slit 21b, it can be clamped from the periphery and fixed and held without slipping.

Thus, the lower slit 21b which is the back side of the slit 21 serves as a catheter sheath holding part.
The distance at which the lower slit 21b that exhibits this tightening effect is formed is L2 in FIG. 1, and this distance L2 is preferably the same as or more than the distance L1 between two guide wire lumens in the catheter described later. Longer is preferred.

Furthermore, the width of the slit 21 is gradually expanded toward the end portion at the end portion of the one end region. For this reason, when the surgeon inserts a later-described catheter into the slit 21, the exposed guide wire lumen is easily visible as will be described later. Thus, during work, the part of the code | symbol 21c becomes the visual recognition part 21c.
Reference numeral 15 in FIG. 1 is provided on the surface of the main body 11 with a display using a symbol or shape that indicates the insertion direction along the slit. In this embodiment, for example, it is an insertion mark provided by integrally forming an arrow.
The insertion mark 15 is not limited to an arrow, and may be another shape such as a triangle, a character expression, or the like.

Next, in order to understand the assisting tool 10 of this embodiment more correctly, an example of the catheter in which this assisting tool 10 is used is demonstrated with reference to FIG.
FIG. 5 is a schematic cross-sectional view showing the distal end portion of the catheter.
In the figure, the catheter 50 has a plurality of lumens formed in a very thin catheter sheath (also referred to as “tube”) 60 having a thickness of about 1 mm, for example.
The catheter sheath 60 is guided by the guide wire 51 and inserted into a living body such as a living body cavity for the purpose of treatment or measurement.

FIG. 6 is an enlarged view of the distal end portion of the guide wire.
As shown in FIG. 6, the guide wire 51 is a metal wire much thinner than the catheter. The guide wire 51 is, for example, a wire such as stainless steel or nickel-titanium, and is an ultrafine wire of about 0.018 to 0.036 mm. The vicinity of the tip of the guide wire 51 is convenient for searching for a course in the body cavity. It has a bent portion 51a.

Here, the catheter 50 in FIG. 5 is, for example, an ultrasonic catheter, and a measurement lumen 53 used for measurement is formed in the catheter sheath 60. The measurement lumen is a hollow portion provided in the length direction in the catheter sheath 60. The measurement lumen 53 has, for example, an inspection head 54 as an inspection wave transmission / reception unit incorporating an ultrasonic transducer, and a drive shaft 57 that moves the inspection head 54 within the measurement lumen 53 by a predetermined distance.
An ultrasonic tomographic image can be obtained by receiving ultrasonic waves emitted from the inspection head 54 to the affected area.

In order to insert the guide wire 51 into the catheter 50, the first guide wire lumen 55 disposed on the distal end side of the catheter sheath is separated from the first guide wire lumen 51 in the axial direction by a predetermined distance L1. A second guide wire lumen 56 is formed. The reason why the catheter 50 includes a plurality of, for example, two guide wire lumens is as follows.
That is, in the catheter 50, the guide wire lumen is divided into a first guide wire lumen 51 and a second guide wire lumen 56 in order to avoid the formation of a lumen that obstructs ultrasonic waves from the examination head 54.
However, with such a structure, after the guide wire 51 is first passed through the first guide wire lumen 55, it is led out of the catheter sheath 60, and the guide wire 51 is again returned to the second guide wire. It must be inserted into the lumen 56. Considering the fineness of the guide wire lumen, this task is very difficult.
In particular, as shown in FIG. 6, the distal end portion 51 a of the guide wire 51 is usually curved, so that even if it passes through the first guide wire lumen 55, the bent portion of the guide wire line is superior thereafter. It is extremely difficult to pass through the two guide wire lumens 55 and 56 continuously.

Therefore, a method of inserting a guide wire into a plurality of guide wire lumens using the auxiliary tool 10 of the present embodiment will be sequentially described.
Please refer to FIG.
First, when the main body of the auxiliary tool 10 is arranged as shown in the figure, the insertion guide port 23a shown in FIG. The distal end portion of the catheter 50 is forcibly inserted. As already described, since the lower part of the slit is slightly smaller in diameter than the catheter sheath 60, the slit 23, 21 is inserted while being slightly expanded. Here, the difference from FIG. 5 is that the guide wire has not yet been inserted.
It should be noted that when inserting the catheter 50, the posture shown in FIG. 5, that is, the catheter sheath 60 must be placed downward and inserted into the slit 22. Note that the guide wire cannot be inserted properly if the vertical direction is incorrect.
When the distal end portion of the catheter 50 is inserted in such a direction, the catheter sheath 60 can be appropriately passed through the lower slit 21b described with reference to FIG.

When the catheter 50 is advanced in the insertion direction as it is, as shown in FIG. 8, the end portion of the first guide lumen lumen 55 formed in the catheter sheath becomes the visual recognition portion 21 c at the end portion of the one end region 12 of the main body 11. appear.
Next, the second guide wire lumen 56 exposing the other end region 13 is held with one hand so as to be suppressed from above. Then, the guide wire 51 is inserted into the first guide wire lumen 55 as illustrated.

Here, it should be noted that the guide wire 51 is inserted into the first guide wire lumen 55 with the bent portion 51a facing downward, with the vertical direction shown in FIG. As a result, the bent portion 51a of the guide wire 51 is guided without going upward.
In addition, in the state of FIG. 8, the catheter sheath 60 is clamped and held inside the one end region by the catheter sheath holding portion described with reference to FIG.
Then, the first guide wire lumen 55 and the second guide wire that are linearly arranged as described in FIG. 5 can be obtained by simply inserting the guide wire 51 linearly using the slits 21 and 23 in the state of FIG. The lumen 56 is inserted very easily and sequentially.

  Next, as shown in FIG. 9, the catheter 50 through which the guide wire 51 is inserted is moved in the arrow H direction. At this time, inside the slits 21 and 23, the catheter sheath 60 moves in the direction opposite to that at the time of insertion, and is easily extracted from the auxiliary tool 10.

  Subsequently, as shown in FIG. 10, since only the extremely thin guide wire 51 is left in the auxiliary tool 10, the auxiliary tool 10 is lifted in the direction of the arrow J. Thereby, the thin guide wire 51 can move upward from the slits 21 and 23 without any obstruction and can be easily detached from the auxiliary tool 10.

As described above, according to the present embodiment, the guide wire 51 can be appropriately guided to the catheter 50 including the plurality of guide wire lumens 55 and 56, and the guide wire 51 can be easily guided to the lumens 55 and 56. It is possible to provide an auxiliary tool 10 for inserting a guide wire that can be inserted and removed easily.

Moreover, in the above-described embodiment, the inner diameter of the lower slit 21b of the slit 21 of the jig body 11 is configured to be slightly smaller than the outer diameter of the catheter sheath 60, so that the catheter sheath 60 is firmly held in the slit 21. Therefore, the insertion work of the guide wire 51 becomes very easy.
That is, the portion of the one end region 12 of the slit is a holding portion embedded in the inserted catheter sheath 60 so as not to be displaced.

Further, the other end region portion 13 of the slit has a portion of the inserted catheter sheath 60 exposed from the shallow slit, so that, as described with reference to FIG. 13 and a portion of the catheter sheath 60 can be gripped,
It is easier to work.
Furthermore, since the distance L1 in the length direction of the holding portion is larger than the separation distance L2 between the plurality of guide wire lumens shown in FIG. 5, the catheter is covered over the entire length of the portion where the guide wire lumens 55 and 56 are interrupted. Since the slit can cover the sheath 60, the guide wire is not displaced during the operation.
In addition, in this case, since the holding portion 21b has a wide slit bottom and completely surrounds the catheter sheath 60, the groove formed by the slit is substantially the entire outer periphery of the catheter sheath 60 on the back side (lower portion). By holding for a long time, the work can be performed precisely and easily without being displaced in the direction around the axis during the work.

By the way, the present invention is not limited to the above embodiment.
The external shape of the auxiliary tool is not limited to the rectangle as illustrated in the present embodiment, but may be a square, a long ellipse, an ellipse, or a polygon other than a rectangle.
The catheter in which the auxiliary tool of the present invention is used is not limited to a person having two guide wire lumens, and can be used for one having three or more guide wire lumens. Moreover, it can be used also for the catheter provided with one guide wire lumen with the miniaturization of the catheter.
The individual configurations of the above-described embodiments and modifications may be omitted if necessary, or may be combined with other configurations not described.

  DESCRIPTION OF SYMBOLS 10 ... Auxiliary tool, 11 ... Main body, 12 ... One end region, 13 ... Other end region, 21, 23 ... Slit, 51 ... Guide wire, 60 ... Catheter sheath (tube)

Claims (7)

An auxiliary tool for inserting a guide wire into a guide wire lumen of a catheter,
It has a jig body provided with a slit extending linearly from one end region to the other end region,
The jig body is configured such that the one end region is thick in the height direction, and the other end region is thinner than the one end region,
In the one end region, the formation depth of the slit is deep, and in the other end region, the formation depth of the slit is shallow,
The slit in the other end region is an insertion guide groove for inserting the catheter sheath of the catheter along the extending direction of the slit,
The catheter sheath is inserted to the one end region, and when the end portion of the catheter sheath is positioned at the slit outlet in the one end region, the end portion of the guide wire lumen is exposed to the slit outlet opening in a visible state. Auxiliary tool characterized by having a configuration.   The auxiliary tool according to claim 1, wherein an inner diameter of the slit of the jig body is configured to be slightly smaller than an outer diameter of the catheter sheath.   The assisting device according to claim 2, wherein the one end region of the slit is a holding portion embedded in the inserted catheter sheath so as not to be displaced.   In the other end region of the slit, a part of the inserted catheter sheath is exposed from the shallow slit, so that an operator can have the other end region of the jig body and a part of the catheter sheath in operation. The auxiliary device according to any one of claims 1 to 3, wherein the auxiliary tool is configured to be capable of gripping.   The auxiliary tool according to any one of claims 1 to 4, wherein a distance in a length direction of the holding portion is larger than at least a separation distance between the plurality of guide wire lumens.   The assisting device according to any one of claims 3 to 5, wherein, in the holding portion, a bottom portion of the slit is wide and has a shape that completely surrounds the catheter sheath.   The said slit exit opening is provided with the visual recognition part which makes it easy to visually recognize a guide wire lumen by gradually expanding diameter toward outward. Aids.

Images