JP2017209501A - Catheter with sensor - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a catheter with a sensor in which detection by the sensor can be stable and fitting workability is high when an optical fiber sensor is passed through the inside of a balloon or in adjacent to the balloon.SOLUTION: A catheter comprises: an inner tube 3; an outer tube; a balloon provided between a distal end of the outer tube and a distal end of the inner tube; an optical fiber 8 which is bonded on an outer peripheral surface of the inner tube along a longitudinal direction; a sensor 12 which has a nearly equal diameter and is provided at a distal end of the optical fiber; a distal end tip 15 fitted and arranged on the outer peripheral surface of the distal end of the inner tube and having a pore of distal and rear end openings in an axial direction; and a metal pipe 21 of distal and rear end openings inserted into the pore in the distal end tip. In the distal end of the optical fiber with the sensor within the metal pipe, the sensor faces the distal end opening of the pore via the distal end opening of the metal pipe, and is inserted while being covered with the metal pipe without shock absorption. The thickness of the peripheral wall of the metal pipe is the radius of the optical fiber or less.SELECTED DRAWING: Figure 3

Description

  The present invention relates to a catheter with a sensor, and more particularly to a catheter-related technique in which an optical fiber having a protective case is installed in a balloon lumen of a coaxial tube and a tip is provided at the distal end of the catheter.

  A general cardiac surgery perfusion catheter is provided with a monitor lumen for measuring perfusion pressure in order to prevent ischemia due to a perfusion circuit kink, blood vessel damage due to hyperperfusion, and the like. The monitor lumen opens at the distal end of the catheter, and is constructed to measure the pressure with a pressure transducer (blood pressure measuring device) that draws blood from the catheter and connects it to the catheter terminal. Is in a safe range.

  However, in this structure, if the inner diameter of the pressure monitor lumen is reduced, the pressure measurement response is reduced, and accurate pressure measurement cannot be performed. Therefore, it has been functionally difficult to provide a pressure monitor lumen in a small diameter catheter.

  Recently, IABP catheters and PTA catheters in which an electric signal conversion type sensor (optical fiber sensor) is inserted into a thin monitor lumen have been devised.

  The IABP balloon catheter that supports the pulsation of patients who cannot send blood to the whole body with reduced cardiac function and the PTA balloon catheter that expands the stenosis is important for the expansion function of the balloon, and the guide lumen passes through the main lumen. The perfusion catheter is designed to flow blood for the purpose of preventing organ ischemia, but the size of the perfusion lumen is an important issue. In order to obtain a large flow rate, a small diameter perfusion catheter uses a coaxial tube with a double tube structure that applies microcatheter technology. The main lumen of the inner tube is a perfusion lumen through which blood flows. The gap between the tubes is a balloon lumen.

  By the way, Japanese Patent Application Laid-Open No. 9-84879 (Patent Document 1) is a patent document which is considered to be a reference by providing a sensor with a balloon catheter related to the coaxial tube as described above.

  In the above-mentioned Patent Document 1, a balloon is provided at the distal end, and a hot balloon catheter provided with a heater that also serves as a temperature sensor inside or adjacent to the balloon, and a heater for the hot balloon catheter are added. An energizing means for supplying a temperature current, a temperature detecting means for receiving a temperature detection signal from the heater, and a switching means for automatically switching between supplying a heating current to the heater and receiving a temperature detection signal from the heater And a vasodilator comprising temperature control means for controlling the current supplied to the heater based on the temperature detection signal received by the temperature detection means (Claims 1 and 1 of the claims). According to this apparatus, there is an effect that the heating temperature of the heater can be accurately measured and controlled (paragraph 0013).

  However, in the case of Patent Document 1, although the above-described operation effect is recognized for the heater, the sensor is not recognized without any description of the operation effect, and the heater is disposed on the outer periphery of the inner tube. It is connected to the heater temperature control unit via the wound lead wire, and the measurement accuracy is lower than that of the heater arranged at the tip of the inner tube, and it takes time to install it at the time of installation. There is no disclosure about the point that the labor is required and the workability is poor, the sensor can be installed very easily and the workability is high, which is a problem of the present invention.

Japanese Patent Laid-Open No. 9-84879

  Therefore, in view of the conventional problems as described above, the present invention makes it possible to install a sensor very easily when passing an optical fiber sensor inside or adjacent to the balloon, and the detection by the sensor is also stable. It is an object of the present invention to provide a sensor-equipped catheter that can be attached and has high workability.

  In order to solve the above-mentioned problems, an invention according to claim 1 is directed to an inner tube having a distal end opened and an axially inner portion formed in a main lumen, and a distal end opened and an axially inner portion being a main lumen of an inner tube. An outer tube having a larger diameter lumen and an annular balloon lumen formed between the lumen and the inner tube, and a balloon provided between the distal end of the outer tube and the distal end of the inner tube An optical fiber disposed along the longitudinal direction on the outer peripheral surface of the inner tube in the balloon lumen, a sensor of the same diameter as the fiber provided at the tip of the optical fiber, and the tip of the inner tube A front end tip that is fitted to the outer peripheral surface of the front end tip and provided with a hole in the front and rear end opening in the axial direction; A metal pipe having a front and rear end opening inserted into a hole portion of the tip chip, and a tip portion of an optical fiber having the sensor at the tip in the metal pipe, and the sensor through the tip opening of the metal pipe. The metal pipe is covered and inserted without being buffered by a metal pipe, and the thickness of the peripheral wall of the metal pipe is formed to be thinner than the radius of the optical fiber.

  According to a second aspect of the present invention, in the first aspect, the metal pipe has a front end opening located near the front end opening of the hole of the front end tip, and a rear end opening located near the rear end opening of the hole. It is arranged over a predetermined length.

  The invention according to claim 3 is the invention according to claim 1 or 2, wherein a protection tube having a front and rear end opening is inserted into the metal pipe, and the tip of the optical fiber having a sensor at the tip of the protection tube is other than the sensor. Is covered with a protective tube and inserted.

  The invention described in claim 4 is characterized in that, in claim 3, the protective tube is made of a polyimide tube, and the thickness of the peripheral wall thereof is formed to be substantially the same as that of the metal pipe.

  The present invention is as described above. According to the first aspect of the present invention, the tip is open, the inner tube in the axial direction is formed in the main lumen, the tip is open, and the inner portion in the axial direction is An outer tube having a larger diameter than the main lumen of the inner tube and an annular balloon lumen formed between the lumen and the inner tube, and between the outer tube tip and the inner tube tip A balloon provided over the optical fiber disposed along the longitudinal direction on the outer peripheral surface of the inner tube in the balloon lumen, a sensor having substantially the same diameter as the fiber provided at the tip of the optical fiber, A tip that is fitted to the outer peripheral surface of the tip of the inner tube and is provided with a hole in the front and rear end opening in the axial direction. A tip and a metal pipe having a front and rear end opening inserted into the hole of the tip, and the tip of the optical fiber having the sensor at the tip in the metal pipe, the sensor has a tip opening of the metal pipe. Since the front end opening of the hole portion is faced and covered and inserted without being buffered by the metal pipe, the thickness of the peripheral wall of the metal pipe is formed to be thinner than the radius of the optical fiber. When the optical fiber sensor is passed inside or adjacent to the balloon, the optical fiber is arranged in advance along the longitudinal direction on the outer peripheral surface of the inner tube, so that the sensor can be installed very easily. Moreover, detection by the sensor can be performed stably. In addition, a large-diameter perfusion lumen can be secured without adding a new monitor lumen by passing an optical fiber sensor through the balloon lumen, and the mounting workability is higher than that of the conventional one. The sensor has the same diameter as the optical fiber, and the thickness of the peripheral wall of the metal pipe is less than the radius of the optical fiber, so the metal pipe can be made as small as possible to match it. Thus, there is an excellent effect that the tip can be made thin and the diameter of the catheter itself can be reduced.

  According to invention of Claim 2, it becomes possible to support more stably the front-end | tip part of the optical fiber with a sensor inserted. Moreover, since the tip opening of the metal pipe is located near the tip opening of the hole of the tip and does not protrude from the tip opening, the appearance is good. According to the third aspect of the present invention, the protective tube is interposed between the tip of the optical fiber with sensor and the metal pipe so that both of them are buffered, and the support of only the metal pipe is supported with respect to the tip of the optical fiber with sensor. Furthermore, stable support can be achieved. According to the fourth aspect of the present invention, since the peripheral wall of the protective tube is thin as well as the metal pipe, it is possible to reduce the diameter together with the metal pipe.

BRIEF DESCRIPTION OF THE DRAWINGS It is the whole schematic explanatory drawing which abbreviate | omitted some catheters with a sensor concerning one embodiment of this invention. It is an expansion front sectional view of a tip part with a balloon same as the above. It is the fragmentary sectional view which expanded the A section of FIG. It is a fragmentary sectional view which shows the other example of FIG. It is an expanded side sectional view which follows the BB line of FIG. It is a figure which shows the adhesion | attachment process of an outer tube and a balloon in manufacture of the front-end | tip part with a balloon same as the above. It is a figure which shows the adhesion process of an inner tube and a front-end | tip tip in manufacture of a front-end | tip part with a balloon same as the above. It is a figure which shows the process of inserting the front-end | tip part of an optical fiber in the hole part of a front-end | tip tip in manufacture of a front-end | tip part with a balloon same as the above. In the manufacture of the tip portion with the balloon as described above, after inserting the tip portion of the inner tube from the rear end opening side of the lumen of the outer tube, in the step of bonding one end side of the balloon to the outer peripheral surface of the inner tube, FIG. It is drawing which shows the adhesion state after insertion among the adhesion processes same as the above.

  Hereinafter, a catheter with a sensor according to an embodiment of the present invention will be described with reference to the drawings.

  1 to 5, reference numeral 1 denotes a sensor-equipped catheter (perfusion balloon catheter) made of a material suitable for a living body, such as silicone rubber, and having an outer diameter of 1.5 mm or less. The inner tube 3 is formed in the main lumen 2, the tip is open, and the inner part in the axial direction is formed in the lumen 4 having a larger diameter than the main lumen 2 of the inner tube 3, and between the lumen and the inner tube 3. An outer tube 6 having an annular balloon lumen 5 formed therein, and a balloon 7 provided between the distal end portion of the outer tube 6 and the distal end portion of the inner tube 3. That is, the distal end of the outer tube 6 is disposed at a rear end (terminal) side of a predetermined length from the distal end of the inner tube 3, and the balloon 7 is interposed between the distal end portion of the outer tube 6 and the distal end portion of the inner tube 3. Is provided by bonding. Adhesive portions 7a and 7b having a predetermined length are provided at one end portion of the balloon 7 on the distal end side of the inner tube 3 and the other end portion on the distal end side of the outer tube 6, respectively. It is longer (wider) than the bonding allowance of the bonding portion 7b at the end. In the drawing, the balloon 7 is shown in an inflated state for easy understanding.

  An optical fiber 8 is disposed on the outer peripheral surface of the inner tube 3 including the inside of the balloon lumen 4 so as to adhere in a substantially straight line along the longitudinal direction. As shown in detail in FIG. 3, the outer peripheral surface of the tip end of the optical fiber 8 is covered with a polyimide tube 10 having a front and rear end opening. A pressure measurement sensor 12 for measuring blood pressure, protective fluid pressure, and the like is provided at the tip of the optical fiber 8 protruding from the tip opening of the polyimide tube 10. Although not shown in detail, the sensor 12 has a diaphragm structure, and utilizes the fact that the amount of deflection of the diaphragm changes according to the change in pressure, so that the amount of deflection of the diaphragm is regarded as a change in the spectrum of light intensity. Is to be detected. That is, the pressure around the optical fiber 8 transmitted through the optical fiber 8 is detected, for example, in the case of blood pressure measurement, the blood pressure in the blood vessel is detected and measured by a detection system (not shown) connected to the optical fiber terminal. It is like that. Note that the sensor 12 may be covered with an elastomer 13 filled in a metal pipe, which will be described later, as shown in FIG.

  The tip of the optical fiber 8 covered with the polyimide tube 10 is inserted into the hole 16 of the front and rear end opening of the tip 15 bonded to the outer peripheral surface of the inner tube 3 so that the sensor 12 faces the tip opening. Yes. The polyimide tube 10 is supported by a metal pipe 21 in the hole 16 of the tip 15. The polyimide tube 10 has elasticity and can absorb the load applied to the optical fiber 8, and also serves as a buffering agent for preventing the sensor 12 and the metal pipe 21 from contacting each other. Further, the metal pipe 21 plays a role of reducing the load from the inflating balloon 7 and the load applied when the distal end of the catheter comes into contact with the tissue and the like, and preventing the detection ability of the sensor 12 from being lowered.

  The distal tip 15 is formed in a curved surface whose outer peripheral surface gradually becomes smaller in diameter toward the front, so that the catheter 1 can be easily inserted. The tip 15 may be made of a relatively rigid material as an option, or may be formed by applying a polymer.

  With the above-described configuration, the tip 12 is not deformed because the sensor 12 is supported by the metal pipe 21. Further, since the sensor 12 is disposed so as to face the distal end opening in the hole portion 16 and has an independent form that does not come into direct contact with the catheter 1, it is possible to measure only the blood flow pressure to send blood. Noise is not picked up by sensing when touching directly or indirectly. Therefore, blood pressure can be measured accurately.

  In this embodiment, only one hole 16 is formed. However, the number of holes 16 is not limited to one, but a plurality of holes 16 are formed in the circumferential direction, and any one of them is selected. You may do it. The polyimide tube 10 is an example of a protective case, and is not limited to this as long as it has the same material and shape.

  As described above, in the balloon 7 provided so as to straddle between the distal end portion of the outer tube 6 and the distal end portion of the inner tube 3, the distal end of the bonding portion 7 a on the inner tube 3 side is more than the distal end of the inner tube 3. A predetermined length is provided biased toward the outer tube 6 side. Thereby, the front-end | tip part of the optical fiber 8 can protrude so that it may be located in the front-end | tip part side of the inner tube 3 from the inside of the balloon 7 for the length of this adhesion part 7a.

  In FIG. 1, 17 is a connector provided in connection with the rear end opening connected to the main lumen 2 of the inner tube 3, and 18 is connected to the rear end opening connected to the lumen 4 (balloon lumen 5) of the outer tube 6. It is a connector provided. The connector 17 is connected to a supply means (not shown) for sending a chemical solution or the like to the main lumen 2, and the connector 18 is connected to another supply means (not shown) for sending physiological saline or the like to the balloon lumen 5 in order to inflate the balloon 7. It has become so. An optical fiber 8 disposed on the outer peripheral surface of the inner tube 3 is disposed on the connector 18 so that it can be pulled out via the balloon lumen 5.

  Next, a method for manufacturing the sensor-equipped catheter 1 will be described with reference to FIGS.

  In manufacturing, first, the other end side of the balloon 7 is bonded to the outer peripheral surface of the distal end portion of the outer tube 6 as shown in FIG. That is, the bonding portion 7b at the other end of the balloon 7 is bonded to the outer peripheral surface of the distal end portion of the outer tube 6 as illustrated. Next, as shown in FIG. 7, the distal end tip 15 provided with the hole 16 is fitted on the outer peripheral surface of the distal end of the inner tube 3 and is inserted and bonded.

  Next, as shown in FIG. 8, the tip of the optical fiber 8 with the sensor 12 is inserted into the hole 16 of the tip 15 from the rear end opening. The tube 10 and the metal pipe 21 are arranged such that the polyimide tube 10 covers the tip of the optical fiber 8 from the vicinity of the sensor 12 to the rear end face of the tip chip 15, and the tip of the metal pipe 21 is positioned near the tip opening of the hole 16. Cover the sensor 12. By doing so, the sensor 12 is placed in the metal pipe 21 so as to face the opening of the tip of the hole 16. Thereafter, a silicone adhesive 22 is injected into the annular gap formed between the polyimide tube 10 covering the outer peripheral surface of the tip end of the optical fiber 8 and the hole 16 from the terminal side, that is, from the rear end opening of the hole 16.

  Next, as shown in FIG. 9, the inner tube 3 in which the tip tip 15 and the optical fiber 8 with sensor are bonded is inserted into the lumen 4 of the outer tube 6 from the rear end opening side of the outer tube 6, and the tip portion of the inner tube 3 is a balloon. 7 into the bonding portion 7a and further protrudes from one end opening of the bonding portion 7a as shown in the figure.

  After docking by inserting the inner tube 3 and the outer tube 6 is completed in this way, the bonding portion 7a of the balloon 7 is bonded to the outer peripheral surface of the inner tube 3 as shown in FIG. By this adhesion, the optical fiber 8 is held in a state where the tip portion is firmly held by the polyimide tube 10 and is also held by the adhesive force from the inner peripheral surface of the bonding portion 7a. Therefore, the physiological saline or the like in the balloon 7 supplied when the balloon 7 is inflated does not leak from the bonding portion 7a.

  After the attachment of the balloon 7 is completed, connectors 17 and 18 are bonded to the rear ends of the inner tube 3 and the outer tube 6 as shown in FIG. If the optical fiber 8 disposed in the position is positioned on the connector 18 side, the manufacture of the catheter 1 as described above is completed.

  Next, the use of the catheter 1 manufactured as described above will be described. In order to use the catheter 1, first, the catheter 1 is inserted into the blood vessel from the distal end side while the balloon 7 is deflated, and the insertion is guided to the vicinity of the target affected area. When the distal end portion of the catheter 1 is located in the vicinity of the affected part, physiological saline or the like is sent from the supply means connected to the connector 18 to inflate the balloon 7, and the catheter 1 is fixedly placed at that position.

  At this time, the sensor 12 provided on the distal tip 15 of the catheter 1 is positioned so as to face the distal opening in the hole 16 of the distal tip 15. Since the sensor 12 is provided further to the distal end side than the part where the balloon 7 is provided, the pressure can be measured accurately and quickly. Therefore, there is no need for troublesome work such as the conventional perfusion balloon catheter to check the circuit internal pressure and predict the perfusion flow and internal pressure in the blood vessel. There is. Further, the sensor lumen for passing the sensor 12 through the balloon lumen 5 is not required, and the perfusion lumen can be enlarged. Therefore, a sufficient perfusion rate can be ensured.

  Thus, in the catheter 1, since the sensor 12 is provided in the hole 16 of the distal tip 15 which is the distal end of the catheter 1 as described above, there is no fear that the measurement accuracy is lowered as in the conventional case. Further, the sensor 12 can be attached smoothly in a short time, and the workability is improved.

  Note that the above embodiment is merely a preferred example, and the design and the like of the present invention can be arbitrarily changed and modified within the scope of the claims. Moreover, although the sensor 12 for pressure measurement was shown as a sensor in embodiment, if it is a sensor, a use will not be ask | required.

DESCRIPTION OF SYMBOLS 1 Catheter with sensor 2 Main lumen 3 Inner tube 4 Large diameter lumen 5 Balloon lumen 6 Outer tube 7 Balloon 8 Optical fiber 10 Polyimide tube (protection tube)
12 Pressure Sensor 13 Elastomer 15 Tip 16 Hole 17, 18 Connector 21 Metal Pipe 22 Silicone Adhesive

In order to solve the above-mentioned problems, an invention according to claim 1 is directed to an inner tube having a distal end opened and an axially inner portion formed in a main lumen; and a distal end opened and an axially inner portion being a main lumen of an inner tube An outer tube having a larger diameter lumen and an annular balloon lumen formed between the lumen and the inner tube, and a balloon provided between the distal end of the outer tube and the distal end of the inner tube An optical fiber disposed along the longitudinal direction on the outer peripheral surface of the inner tube in the balloon lumen, a sensor of the same diameter as the fiber provided at the tip of the optical fiber, and the tip of the inner tube A front end tip that is fitted to the outer peripheral surface of the front end tip and provided with a hole in the front and rear end opening in the axial direction; A serial distal tip of the hole portion above the rear end opening of the metal pipe which is inserted in, is inserted into the metal pipe, comprising a protective tube covering the other sensor at the tip of the optical fiber with the sensor on the tip, The sensor is located behind the tip opening of the metal pipe and in front of the tip opening of the protective tube, faces the tip opening of the hole portion of the tip tip from the tip opening of the metal pipe, and is buffered by the metal pipe. is covered without the wall thickness of the metal pipe, characterized in that it is formed thinner in the radial or less of the optical fiber.

The present invention is as described above. According to the first aspect of the present invention, the tip is open, the inner tube in the axial direction is formed in the main lumen, the tip is open, and the inner portion in the axial direction is An outer tube having a larger diameter than the main lumen of the inner tube and an annular balloon lumen formed between the lumen and the inner tube, and between the outer tube tip and the inner tube tip A balloon provided over the optical fiber disposed along the longitudinal direction on the outer peripheral surface of the inner tube in the balloon lumen, a sensor having substantially the same diameter as the fiber provided at the tip of the optical fiber, A tip that is fitted to the outer peripheral surface of the tip of the inner tube and is provided with a hole in the front and rear end opening in the axial direction. The chip, the previous rear end opening of the metal pipe which is inserted into the hole portion of the distal tip, is inserted into the metal pipe, and a protective tube covering the other sensor at the tip of the optical fiber with the sensor on the tip, The sensor is located behind the tip opening of the metal pipe and in front of the tip opening of the protective tube, facing the tip opening of the hole of the tip tip from the tip opening of the metal pipe, and the metal pipe Since the thickness of the peripheral wall of the metal pipe is made thinner than the radius of the optical fiber, that is, when the optical fiber sensor is passed through the inside of the balloon or adjacent to the balloon. In addition, since the optical fiber is pre-adhered to the outer peripheral surface of the inner tube along the longitudinal direction, the sensor can be installed very easily. Moreover, detection by the sensor can be performed stably. In addition, a large-diameter perfusion lumen can be secured without adding a new monitor lumen by passing an optical fiber sensor through the balloon lumen, and the mounting workability is higher than that of the conventional one. The sensor has the same diameter as the optical fiber, and the thickness of the peripheral wall of the metal pipe is less than the radius of the optical fiber, so the metal pipe can be made as small as possible to match it. Thus, there is an excellent effect that the tip can be made thin and the diameter of the catheter itself can be reduced.

Claims (4)

  An inner tube having a distal end opened and an axially inner portion formed in a main lumen; and a distal end opened and an axially inner portion formed in a lumen having a larger diameter than the main lumen of the inner tube; the lumen and the inner tube; An outer tube having an annular balloon lumen formed between the outer tube, a balloon provided between the distal end portion of the outer tube and the distal end portion of the inner tube, and an outer peripheral surface of the inner tube in the balloon lumen along the longitudinal direction. An optical fiber arranged in a glued manner, a sensor having the same diameter as that of the optical fiber provided at the tip of the optical fiber, and fitted to the outer peripheral surface of the tip of the inner tube. And a metal pad having a front and rear end opening inserted into the hole of the tip. The tip of the optical fiber having the sensor at the tip in the metal pipe is covered with the sensor facing the tip opening of the hole through the tip opening of the metal pipe and without being buffered by the metal pipe. The sensor-attached catheter is characterized in that the thickness of the peripheral wall of the metal pipe is formed to be thinner than the radius of the optical fiber.   2. The metal pipe is disposed over a predetermined length such that a front end opening thereof is positioned near a front end opening of a hole portion of a front end tip and a rear end opening thereof is positioned near a rear end opening of the hole portion. The catheter with a sensor as described.   A protective tube having a front and rear end opening is inserted into the metal pipe, and a tip portion of an optical fiber having a sensor at the tip is inserted into the protective tube while being covered with a protective tube except for the sensor. 3. A catheter with a sensor according to 2.   The catheter with a sensor according to claim 3, wherein the protective tube is made of a polyimide tube, and the thickness of the peripheral wall thereof is substantially the same as that of the metal pipe.

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