JP2018075209A - Electrode catheter for lung cancer treatment - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an electrode catheter for lung cancer treatment, for making it possible to vary an outer diameter of an electrode to enable uniform cautery treatment along bronchus's circumferential direction.SOLUTION: An electrode catheter for lung cancer treatment comprises: a catheter shaft 10; an electrode 20 that is fixed at a tip of the catheter shaft 10, is constituted by a metal tube M1 on which a plurality of slits 21 are formed in an axial direction, and expands in a radial direction when compressed to transform into a basket shape; a tip chip 25 fixed to a tip of the electrode 20; an operation handle 30 fixed at a base end of the catheter shaft 10; a lead wire 40 that is connected to the electrode 20 and extends inside the catheter shaft 10; a temperature sensor 50 that includes a temperature measurement section 55 fixed to the electrode 20 and extends inside the catheter shaft 10; and an operation wire 60 that includes a tip section 61 fixed to the tip chip 25, extends movably in the axial direction inside the catheter shaft 10, and includes a base end on which pulling operation can be performed.SELECTED DRAWING: Figure 2

Description

  The present invention relates to an electrode catheter for treating lung cancer, and more particularly to an electrode catheter for treating lung cancer that can cauterize cancer cells by high-frequency energization.

  In recent years, as a method of treating lung cancer as an alternative to surgical therapy, a method of cauterizing cancer cells by high-frequency energization has attracted attention. (See Patent Document 1 below).

  As an application mode of the electrode catheter for lung cancer treatment, the electrode catheter for lung cancer treatment is inserted into the lumen of the guiding sheath that is inserted into the channel of the bronchoscope (endoscope) and extends from the distal end opening of the bronchoscope. The distal electrode of the lung cancer treatment electrode catheter extended from the distal end of the guiding sheath reaches the treatment site, and a high-frequency current is connected between the distal electrode and the counter electrode attached to the patient's body surface. And the lung cancer cells are cauterized.

Japanese Patent Laid-Open No. 8-308853

  In the electrode catheter for lung cancer treatment as described above, the outer diameter of the catheter shaft and the tip electrode is reduced to some extent in order to pass through the channel of the bronchoscope and reach the distal bronchus (bronchiole). There is a need.

  However, a lung cancer treatment electrode catheter equipped with such a small-diameter tip electrode cannot perform sufficient cauterization treatment for cancer cells formed in a thick bronchus. ) Can be cauterized only in the vicinity of the site where the tip electrode is in contact.

The present invention has been made based on the above situation.
A first object of the present invention is an electrode for treating lung cancer, which can change the outer diameter of the electrode according to the thickness of the bronchus at the treatment site and can perform uniform cauterization treatment along the circumferential direction of the bronchus. It is to provide a catheter.
The second object of the present invention is that cancer cells formed in peripheral bronchi (bronchioles) and alveoli can be cauterized, and cancer cells formed around the entire bronchus (the entire circumference) such as the main bronchus. On the other hand, it is providing the electrode catheter for lung cancer treatment which can be cauterized uniformly along the circumferential direction of the said bronchus.

(1) An electrode catheter for treating lung cancer of the present invention comprises a catheter shaft,
It is composed of a metal tube fixed to the distal end of the catheter shaft and formed with a plurality of slits extending in the axial direction. When compressed in the axial direction, the slit opens and expands in the radial direction, and consists of a plurality of spines. An electrode for high-frequency energization that transforms into a basket shape;
A tip which is fixed to the tip of the electrode;
An operation handle fixed to the proximal end of the catheter shaft;
A conductive wire electrically connected to the electrode and extending into the catheter shaft;
An operation wire having a distal end portion fixed to the distal tip, extending in an axial direction inside the catheter shaft, and having a proximal end capable of being pulled. To do.

  According to the electrode catheter having such a configuration, since the electrode is configured by the metal tube in which a plurality of slits extending in the axial direction are formed, the outer diameter of the electrode when the diameter is reduced can be sufficiently reduced. Can reach the peripheral bronchi (bronchioles), and cancer cells formed in bronchioles and alveoli can be cauterized.

  Further, by pulling the operation wire and compressing the electrode (metal tube having a plurality of slits) in the axial direction, the electrode expands in the radial direction and deforms into a basket shape. As a result, the outer diameter (maximum diameter) of the electrode at the time of diameter expansion can be made sufficiently large, and cancer cells formed around the thick bronchus (the entire circumference) such as the main bronchus along the circumferential direction of the bronchus Can be cauterized uniformly.

  In addition, the spine constituting the electrode (basket-like electrode) at the time of expansion is formed by dividing the tube wall of the metal tube in the circumferential direction by opening a slit formed in the metal tube. Even if it is a metal tube, many spines can be formed reliably, and, thereby, uniform cauterization treatment can be performed along the circumferential direction of the bronchus.

(2) In the electrode catheter of the present invention, the metal tube includes an electrode component portion in which the slit extending in the axial direction is formed;
It is composed of a shaft component part that is insulated and coated on the proximal end side of the electrode component part to constitute the catheter shaft,
It is preferable that a spiral slit or groove is formed in the shaft component.

  According to the electrode catheter having such a configuration, the electrode can be securely fixed to the distal end of the catheter shaft, and a helical slit or groove is formed in the shaft component portion of the metal tube. It is possible to sufficiently ensure flexibility and flexibility at the tip portion of the.

(3) In the electrode catheter of the present invention, it is preferable that the catheter shaft has a multi-lumen structure on a proximal end side with respect to the shaft constituent portion of the metal tube. According to the electrode catheter having such a configuration, the operation wire, the conductive wire, and the temperature sensor can be extended inside the catheter shaft without interfering with each other.

(4) In the electrode catheter of the present invention, the outer diameter of the catheter shaft is preferably 2.0 mm or less.
According to the electrode catheter having such a configuration, the catheter shaft can be inserted into the channel of the bronchoscope, and the electrode fixed to the distal end of the catheter shaft can be reliably reached to the peripheral bronchus (bronchiole) Can do.

(5) In the electrode catheter of the present invention, it is preferable that the number of the slits extending in the axial direction formed in the metal tube is 6 or more.
According to the electrode catheter having such a configuration, uniform ablation treatment can be reliably performed along the circumferential direction of the bronchus.

(6) In the electrode catheter of the present invention, the electrode catheter includes a temperature sensor fixed to the electrode, and includes a temperature sensor extending inside the catheter shaft. The temperature sensor of the temperature sensor has a spiral shape It is preferable that the contraction tube in which the slit is formed is fixed at a position corresponding to the maximum diameter portion of the electrode on the inner peripheral side of at least one spine constituting the electrode.

According to the electrode catheter having such a configuration, the temperature of the portion (inner wall of the bronchus) where the electrode (spine) is in contact can be reliably measured.
Further, by using a contraction tube in which a spiral slit is formed, the contraction tube can be wound around the spine even if the slit formed in the axial direction does not reach the end of the metal tube. Therefore, the temperature measuring part of the temperature sensor can be securely fixed to the spine.

(7) In the electrode catheter of the present invention, it is preferable that the electrode includes a front end side conical portion, a cylindrical straight body portion, and a rear end side conical portion.
According to the electrode catheter having such a configuration, by causing the straight body portion of the electrode to contact (surface contact) with the inner wall of the bronchus, uniform ablation treatment can be performed not only in the circumferential direction of the bronchus but also in the axial direction. It becomes possible.

(8) In the electrode catheter of the present invention, the metal tube is sandwiched between the two regions by insulatingly coating the front end side region and the rear end side region in the portion where the slit extending in the axial direction is formed. It is preferable that high-frequency energization is performed only in the intermediate region (this intermediate region serves as an electrode for high-frequency energization).
According to the electrode catheter having such a configuration, high-frequency energization is performed only in the intermediate region of the basket, so that loss of high-frequency energy can be suppressed.

(9) The electrode catheter of the present invention is preferably used by being inserted into a channel of a bronchoscope.

The electrode catheter for lung cancer treatment of the present invention can change the outer diameter (maximum diameter) of the electrode according to the thickness of the bronchus at the treatment site, and can perform uniform cauterization treatment along the circumferential direction of the bronchus. it can.
In addition, cancer cells formed in the peripheral bronchi (bronchioles) and alveoli can be cauterized by the reduced-diameter electrode, and the diameter of the main bronchi can be increased by pulling the operation wire to expand the electrode. A cauterization treatment can be performed uniformly along the circumferential direction of the bronchi on cancer cells formed around such a thick bronchus (the entire circumference).

It is a front view at the time of the electrode diameter reduction of the electrode catheter which concerns on 1st Embodiment. It is a front view at the time of the electrode diameter expansion of the electrode catheter which concerns on 1st Embodiment. It is a front view which shows the principal part at the time of the electrode diameter reduction of the electrode catheter which concerns on 1st Embodiment. It is IV-IV sectional drawing of FIG. It is a front view which shows the principal part at the time of electrode diameter expansion of the electrode catheter which concerns on 1st Embodiment. It is VI-VI sectional drawing of FIG. It is VII-VII sectional drawing of FIG. It is VIIIA-VIIIA sectional drawing of FIG. It is VIIIB-VIIIB sectional drawing of FIG. FIG. 7 is a detailed view of a part IX in FIG. 6. It is XX sectional drawing of FIG. FIG. 11 is a detailed view of an XI unit in FIG. 10. FIG. 7 is a detailed view of a portion XII in FIG. 6. It is a perspective view which shows the state which has fixed the temperature measuring part of the temperature sensor to the spine. It is explanatory drawing which shows the principal part at the time of the electrode diameter reduction of the electrode catheter which concerns on 2nd Embodiment, (a) is a front view, (b) is XIVB-XIVB sectional drawing of (a). It is explanatory drawing which shows the principal part at the time of electrode diameter expansion of the electrode catheter which concerns on 2nd Embodiment, (a) is a front view, (b) is XVB-XVB sectional drawing of (a). It is explanatory drawing which shows the principal part at the time of electrode diameter expansion of the electrode catheter which concerns on 3rd Embodiment, (a) is a front view, (b) is XVIB part detail drawing of (a).

<First Embodiment>
The lung cancer treatment electrode catheter 100 of this embodiment shown in FIGS. 1 to 13 is formed with a catheter shaft 10 and 16 slits 21 that are fixed to the distal end of the catheter shaft 10 and extend in the axial direction when the diameter is reduced. When the metal tube M1 is constituted and is compressed in the axial direction, the slit 21 is opened and expanded (expanded) in the radial direction, and the slit 21 is opened to divide the tube wall of the metal tube M1. Further, the electrode 20 for high-frequency energization deformed into a basket shape composed of 16 spines 23, a tip 25 fixed to the tip of the electrode 20, an operation handle 30 fixed to the proximal end of the catheter shaft 10, and an electrode 20, a conductive wire 40 that is electrically connected to the inside of the catheter shaft 10, and a temperature measuring portion 55 that is fixed to the electrode 20. An operation having an internal temperature sensor 50 and a distal end portion 61 fixed to the distal tip 25, extending in the axial direction inside the catheter shaft 10, and having a proximal end capable of being pulled. Wire 60.

  The catheter shaft 10 constituting the electrode catheter 100 of the present embodiment includes a proximal end portion 11, a distal end portion 12, and a most distal end portion 13.

  As shown in FIGS. 8A and 8B, the proximal end portion 11 and the distal end portion 12 of the catheter shaft 10 are formed by an inner portion 17 and an outer portion 18 that covers the inner portion 17, and the proximal end portion 11 and the distal end portion are formed. A central lumen 15 is formed in the inner portion 17 of the twelve, and sub-lumens 161 to 168 are formed around the central lumen 15.

  An operation wire 60 extends to the central lumen 15, a conductive wire 40 extends to the sub-lumen 161, and a temperature sensor 50 extends to the sub-lumen 165.

  As shown in FIG. 8B, a braid 19 is knitted on the outer portion 18 of the base end portion 11, and the base end portion 11 (blade tube) into which the braid 19 is knitted has flexibility and a certain degree of rigidity. As a result, the electrode catheter 100 has good pushability and torque transmission.

Synthetic resins such as polyolefin, polyamide, polyether polyamide, polyurethane, nylon, polyether block amide (PEBAX) can be used as the constituent material of the base end portion 11 and the tip end portion 12, and among these, PEBAX is Can be used.
Moreover, as a constituent material of the braid 19 knitted in the outer part 18 of the base end part 11, a metal or a resin material which can exhibit a reinforcing effect by being embedded can be mentioned.

The hardness of the resin constituting the base end portion 11 is usually 55D to 80D, preferably 63D to 75D.
The hardness of the resin constituting the tip portion 12 is usually 25D to 55D, preferably 30D to 45D.

As shown in FIGS. 7 and 9, the distal end portion 13 of the catheter shaft 10 is formed by insulatingly covering the proximal end portion of the metal tube M <b> 1 connected to the distal end portion 12 with a resin layer 14.
A spiral slit 131 is formed in the base end portion (shaft constituent portion) of the metal tube M1, and thereby the flexibility (flexibility) of the most distal end portion 13 is ensured.
The pitch of the spiral slits 131 becomes narrower toward the distal end, thereby improving operability.

The length of the catheter shaft 10 is usually 1100 to 2000 mm, and 1200 mm is a preferable example.
Further, the length of the base end portion 11 (blade tube having a multi-lumen structure) is usually 900 to 1970 mm, and 1120 mm if a suitable example is shown.
Moreover, the length of the front-end | tip part 12 (non-blade tube of a multi-lumen structure) shall be 30-200 mm normally, and will be 80 mm if a suitable example is shown.
Moreover, the length of the most advanced part 13 shall be 10-40 mm normally, and will be 25 mm if a suitable example is shown.

The outer diameter of the catheter shaft 10 is preferably 2.0 mm or less, more preferably 1.7 mm or less, and 1.35 mm if a suitable example is shown.
With such a small-diameter catheter shaft 10, it can be inserted into the channel of the bronchoscope (in the case of using a guiding sheath, the lumen of the guiding sheath). The electrode placed at the tip can reach the treatment site in the peripheral bronchus (bronchiole) or alveoli.

  The electrode 20 for high-frequency energization constituting the electrode catheter 100 of the present embodiment is composed of a metal tube M1 in which 16 slits 21 extending in the axial direction when the diameter is reduced are formed at equal angular intervals along the circumferential direction. Has been.

As shown in FIGS. 1, 3, and 4, the shape of the electrode 20 at the time of diameter reduction is a cylindrical shape. Sixteen slits 21 formed in the electrode 20 (electrode constituent portion of the metal tube M1) are formed at equal angular intervals (22.5 ° intervals) along the circumferential direction.
In addition, the 16 slits 21 are formed at the same axial position, and the front and rear ends of the 16 slits 21 do not reach the front and rear ends of the metal tube M1.

When the diameter-reduced electrode 20 is compressed in the axial direction, each of the slits 21 is opened, and the electrode 20 (electrode constituent portion of the metal tube M1) expands in the radial direction.
At this time, each of the slits 21 is opened, so that the tube wall of the metal tube M1 in the electrode constituent portion is divided into 16 in the circumferential direction, whereby 16 spines are formed and the electrode 20 is deformed into a basket shape.

  In the electrode catheter 100 of the present embodiment, the shape of the electrode 20 at the time of expansion is an elliptical sphere as shown in FIGS. 2, 5, and 6 (a spheroid with the tube axis of the metal tube M1 as the rotation axis). Yes, the central position in the axial direction is the maximum diameter portion.

The diameter-reduced electrode 20 is preferably not in a perfect cylindrical state, but is formed in a middle-high shape by slightly bending the center position of the tube wall that becomes the spine 23 when the diameter is expanded.
As a result, when the electrode 20 is compressed, a portion of the tube wall portion that should become the spine 23 is not curved inward, and can be reliably expanded into an elliptical sphere.

The outer diameter of the electrode 20 when the diameter is reduced is substantially the same as the outer diameter of the catheter shaft 10.
The diameter reduction of the electrode 20 at the time of the diameter reduction can be achieved only by configuring the electrode 20 from the metal tube M1.

  The outer diameter of the electrode 20 during expansion (the maximum diameter of the basket-like electrode) is preferably 1.35 mm or more, more preferably 1.5 to 2.0 mm, and 1.6 mm if a suitable example is shown. It is. As a result, the largest diameter portion of the electrode 20 can be brought into contact with the inner wall of a thick bronchus such as the main bronchus, and cancer cells formed around the entire bronchus can be cauterized uniformly. Become.

The wall thickness of the metal tube M1 constituting the electrode 20 (the thickness of the spine 23) is preferably 0.3 mm or less, more preferably 0.02 to 0.2 mm, and a suitable example is shown. 0.05 mm.
If this wall thickness is excessive, the outer diameter of the metal tube at the time of contraction will be excessive, and it will be difficult to make the electrode 20 reach the treatment site in the peripheral bronchus (bronchiole) or alveoli.

As a constituent material of the electrode 20 (metal tube M1), the same material as the tip electrode of a conventionally known ablation catheter can be used.
Specifically, platinum, gold, platinum-iridium alloy and the like having high X-ray contrast properties can be mentioned, and a suitable material is Ni-Ti alloy.

A tip 25 is fixed to the tip of the electrode 20, and the tip of the electrode 20 and the tip 61 of the operation wire 60 are connected via the tip 25.
Examples of the constituent material of the tip 25 include platinum, gold, platinum-iridium alloy, and the like.

As shown in FIGS. 1 and 2, an operation handle 30 is fixed to the proximal end of the catheter shaft 10.
The operation handle 30 constituting the electrode catheter 100 of the present embodiment is an operation unit including a handle main body 31 and a rotating plate 33 having a knob 32.

As shown in FIG. 9, on the inner peripheral surface of the base end portion (shaft constituent portion) of the metal tube M1 constituting the electrode 20, the leading end of the conducting wire 40 is fixed by solder (not shown), thereby the conducting wire 40 and the electrode. 20 is electrically connected.
The conducting wire 40 constituting the electrode catheter 100 of the present embodiment extends inside the catheter shaft 10 (sublumen 161) and is led to the inside of the operation handle 30. The proximal end portion of the conducting wire 40 is connected to a connector mounted inside the operation handle 30.

  As shown in FIGS. 10 to 13, the inner side of one spine 231 out of the 16 spines 23 constituting the electrode 20 at the time of expansion, and the central position (electrode) in the length direction of the spine 231 The temperature measuring portion 55 of the temperature sensor 50 made of a thermocouple is fixed by a shrinkable tube 57 at a position corresponding to the maximum diameter portion of 20.

  Since the temperature measuring unit 55 is arranged at the center position in the length direction of the spine 231 (the position corresponding to the maximum diameter portion of the electrode 20 at the time of expansion), the portion where the electrode 20 (spine 231) is in contact ( The temperature of the inner wall of the bronchus) can be reliably measured.

  The temperature sensor 50 enters the inside of the catheter shaft 10 (the most distal end portion 13) along the inner peripheral side of the spine 231 and extends inside the catheter shaft 10 (sub-lumen 165). It has been passed on as it is. A base end portion of the temperature sensor 50 is connected to a connector mounted inside the operation handle 30.

  As shown in FIG. 13, a spiral slit 59 is formed in the contraction tube 57 for fixing the temperature measuring unit 55 of the temperature sensor 50 to the spine 231.

As described above, the front end and the rear end of the slit 21 defining the spine 231 do not reach the front end and the rear end of the metal tube M1 (the front end or the rear end of the spine 231 is not a free end).
For this reason, although it cannot attach to the spine 231 with a normal shrink tube, if it is the shrink tube 57 in which the spiral slit 59 is formed, it is made into a ribbon screw shape by stretching it, and then the temperature sensor 50 The temperature measuring unit 55 can be held by the spine 231 by being wound around the spine 231 together with the temperature measuring unit 55. Then, by heating the contraction tube 57, the contraction tube 57 contracts in the same manner as a normal contraction tube, thereby fixing the temperature measuring unit 55 of the temperature sensor 50 to the inner peripheral side of the spine 231. it can.

  As shown in FIG. 11, the temperature measuring unit 55 of the temperature sensor 50 is fixed to the inner peripheral side of the spine 231 in a state of being covered with an insulating resin 58. Thereby, when the electrode catheter 100 is used (high-frequency energization), it is possible to prevent electrical conduction between the spine 231 made of metal and the temperature measuring unit 55 (temperature sensor 50). Temperature measurement can be performed.

  In addition, by filling the inside (gap) of the shrinkable tube 57 fixing the temperature measuring unit 55 with an adhesive or applying an adhesive around the shrinkable tube 57, the spine 231 (the electrode 20) can be applied. The fixing force of the temperature measuring unit 55 of the temperature sensor 50 can also be improved.

  As shown in FIG. 6, the operation wire 60 constituting the electrode catheter 100 of the present embodiment has its distal end portion 61 fixed to the distal end tip 25 by solder (not shown) and passes through the inside of the electrode 20 of the catheter shaft 10. The inside of the catheter shaft 10 (the central lumen 15) extends into the inside of the operation handle 30 by entering the inside (the most advanced portion 13).

The proximal end portion of the operation wire 60 is fixed to the rotary plate 33 of the operation handle 30.
Examples of the constituent material of the operation wire 60 include metal materials such as stainless steel and Ni—Ti superelastic alloys, and high strength non-conductive materials.

  By rotating the rotating plate 33 of the operation handle 30 and pulling the proximal end of the operation wire 60, the operation wire 60 moves to the proximal end inside the catheter shaft 10, and the distal end of the operation wire 60 is moved. When the distal tip 25 to which the portion 61 is fixed moves toward the proximal end, the reduced diameter electrode 20 is compressed in the axial direction. Thereby, the electrode component of the metal tube M1 expands in the radial direction, and the electrode 20 is deformed into an elliptical basket shape.

The electrode catheter 100 of the present embodiment is inserted into a channel of a bronchoscope, which is an endoscope, and used under visual observation.
For example, the guiding sheath is inserted into the bronchoscope channel, the electrode catheter 100 of this embodiment is inserted into the lumen of the guiding sheath extended from the distal opening of the bronchoscope, and extended from the distal end of the guiding sheath. The electrode 20 of the electrode catheter 100 is made to reach a target treatment site, and a high frequency current is passed between the electrode 20 and a counter electrode affixed to the body surface of the patient to cauterize lung cancer cells.

  According to the electrode catheter 100 of the present embodiment, the outer diameter of the electrode 20 (the maximum diameter of the basket-like electrode) can be changed according to the thickness of the bronchus serving as a treatment site, and along the circumferential direction of the bronchus Uniform ablation treatment can be performed.

Further, since the electrode 20 is constituted by the metal tube M1 (electrode constituent part) in which 16 slits 21 extending in the axial direction are formed, the outer diameter of the electrode 20 when the diameter is reduced is sufficiently reduced (catheter shaft 10). Of the outer diameter of the outer diameter of the outer diameter).
As a result, the electrode 20 can reach the peripheral bronchus (bronchiole), and ablation treatment can be performed on cancer cells formed in the bronchiole and the alveoli.

Further, by pulling the operating wire 60 and applying a compressive force to the metal tube M1, the electrode 20 expands in the radial direction and deforms into a basket shape, so that the outer diameter (maximum diameter) of the electrode 20 is sufficiently increased. Can be bigger.
Thereby, uniform ablation treatment can be performed along the circumferential direction of the bronchus even for cancer cells formed around the entire bronchus such as the main bronchus.

In addition, each of the 16 spines 23 constituting the basket-like electrode 20 at the time of expansion opens the slit 21 formed in the metal tube M1, so that the tube wall of the metal tube M1 (electrode constituent portion) is surrounded. Since it is formed by being divided in the direction, even if the metal tube M1 has a small diameter, 16 spines 23 can be reliably formed.
In addition, since the basket-like electrode 20 can be formed by forming the axial slit 21 in the metal tube M1, the electrode 20 can be easily manufactured and the productivity as an electrode catheter is excellent.

Here, if each of the spines constituting the basket-like electrode is constituted by, for example, a resin tube having a ring electrode attached to the outer periphery, a lead wire or a core wire is disposed inside the resin tube. The manufacturing operation becomes complicated, and the outer diameter of the spine made of the resin tube becomes considerably thick.
And even if it is going to manufacture the basket-like electrode similar to the electrode 20 which comprises the electrode catheter 100 of this embodiment by such a spine, the bundle-like body of the proximal end part of 16 spines (resin tube) is used as a catheter. It is impossible to insert it into the shaft. Further, when the number of spines is reduced to such an extent that a bundle at the proximal end portion can be inserted into the catheter shaft (the number of the spines that can be inserted into the catheter shaft is about several at most), such a basket shape. Depending on the electrode, uniform ablation treatment cannot be performed along the circumferential direction of the bronchus.

As mentioned above, although one Embodiment of this invention was described, the electrode catheter of this invention is not limited to these, A various change is possible.
For example, the number of spines constituting the basket-like electrode is not limited to 16.
In the electrode catheter of the present invention, the number of spines constituting the electrode (corresponding to the number of slits formed in the metal tube) is preferably 6 or more, more preferably 8 or more, and still more preferably 12 More than a book.

When the number of spines (slits) is too small, it becomes difficult to perform uniform cauterization treatment along the circumferential direction of the bronchi on cancer cells formed around the bronchus (entire circumference).
When the number of spines is small, the arrangement gap of the electrodes in the circumferential direction of the bronchus becomes large, and it becomes difficult to perform uniform cauterization treatment along the circumferential direction of the bronchi.

Further, the number of temperature sensors constituting the electrode catheter of the present invention is not limited to one, and two or three temperature measuring portions are fixed to the electrodes at equal angular intervals along the circumferential direction. More than one temperature sensor may be provided. A sensor other than a thermocouple such as a thermistor thermometer may be used as the temperature sensor.
Further, the electrode catheter of the present invention may be a catheter capable of tip deflection operation provided with a mechanism for bending the tip portion of the catheter shaft.
The electrode catheter of the present invention can also be used for the treatment of benign tumors of the lung.

Second Embodiment
The electrode catheter 200 for treating lung cancer of the present embodiment shown in FIGS. 14 and 15 is different from the electrode catheter of the first embodiment in the configuration of the electrodes (the shape of the basket).
In FIG. 14 and FIG. 15, the part shown with the same code | symbol as FIGS. 3-5 is the structure similar to 1st Embodiment, The description is abbreviate | omitted.

  The electrode 70 constituting the electrode catheter 200 of this embodiment includes a front end side conical portion 701, a straight body portion 702, and a rear end side conical portion 703.

  The electrode 70 is composed of a metal tube M2 fixed to the distal end of the catheter shaft 10 and formed with 16 slits 71 extending in the axial direction in a cylindrical straight body 702, and compressed in the axial direction. Sometimes, while maintaining the straightness in the axial direction of the tube wall constituting the straight body portion 702, the slit 71 opens and expands (expands) in the radial direction. The wall is deformed into a basket composed of 16 spines 73 formed by dividing the wall.

The 16 slits 71 formed in the metal tube M <b> 2 when the diameter is reduced are formed from the front end of the front end side conical portion 701 to the rear end of the rear end side conical portion 703.
Each of the 16 slits 71 extends in the axial direction (the tube axis direction of the metal tube M2) in the straight body portion 702 of the electrode 70, and in the radial direction (the tube diameter of the metal tube M2) in the tip side conical portion 701. Direction) extending in the front end direction while inclining inward, and the rear end side conical portion 703 extends in the rear end direction while inclining radially inward.

  Of the tube walls of the metal tube M2, which is partitioned by the 16 slits 71 and becomes the spine 73 at the time of expansion, the tube wall portion constituting the straight body portion 702 of the electrode 70 compresses the metal tube M2 in the axial direction. Even when expanded in the radial direction, the shape is memorized so that each linearity is maintained. Accordingly, the straight body portion 702 of the expanded electrode 70 also has a cylindrical shape.

  Such an electrode 70 is formed by heating a metal tube (cylindrical metal tube M1 constituting the electrode 20 of the first embodiment) in which 16 slits extending in the axial direction are formed in a mold. Can be manufactured by attaching a bending ridge to the boundary between the straight body portion and the conical portion.

According to the electrode catheter 200 of this embodiment, all the effects exhibited by the first embodiment can be exhibited.
Even in the expanded diameter state, the straight body portion 702 of the electrode 70 can maintain a cylindrical shape. Therefore, by bringing the straight body portion 702 into contact (surface contact) with the inner wall of the bronchus, only the circumferential direction of the bronchus is obtained. In addition, uniform ablation treatment is possible even along the axial direction.

<Third Embodiment>
The electrode catheter 300 for treating lung cancer according to this embodiment shown in FIG. 16 is different from the electrode catheter according to the first embodiment and the electrode catheter according to the second embodiment in the configuration of the electrodes.
In FIG. 16, the parts denoted by the same reference numerals as in FIGS. 14 and 15 have the same configuration as in the second embodiment (first embodiment), and the description thereof is omitted.

The electrode catheter 300 of the present embodiment includes a front-end-side conical portion (a front-end-side region 801 in a portion where a slit extending in the axial direction is formed) and a rear-end-side conical shape of the electrode constituting the electrode catheter of the second embodiment. An insulating coating 85 is applied to the portion (rear end side region 803 in the portion where the slit extending in the axial direction is formed).
As a result, in the electrode catheter 300 of the present embodiment, high-frequency energization is not performed in the distal end side region 801 and the rear end side region 803, and the intermediate region 802 without the insulating coating 85 (the electrode catheter of the second embodiment is used). Only the intermediate region 802 functions as the electrode 80.

According to the electrode catheter 300 of this embodiment, all the effects exhibited by the second embodiment can be exhibited.
Further, high-frequency energization is performed only in the intermediate region 802 (straight trunk portion) that contacts the inner wall of the bronchus, and high-frequency energization is not performed in the front end side region 801 and the rear end region 803 that do not contact the inner wall. Loss can be suppressed.

DESCRIPTION OF SYMBOLS 100 Electrode catheter M1 Metal tube 10 Catheter shaft 11 Base end part 12 Tip part 13 Most advanced part 131 Spiral slit 14 Resin layer 15 Central lumen 161-168 Sublumen 17 Inner part 18 Outer part 19 Braid 20 Electrode 21 Slit 23 Spine Reference numeral 231 Spine 25 Tip 30 Operation handle 31 Handle body 32 Knob 33 Rotating plate 40 Conductor 50 Temperature sensor 55 Temperature measuring portion 57 Shrinkable tube 58 Resin covering the temperature measuring portion of the temperature sensor 60 Operation wire 61 Tip of operation wire 200 Electrode catheter M2 Metal tube 70 Electrode 701 Front side conical part 702 Straight body part 703 Rear end side conical part 71 Slit 73 Spine 300 Electrode catheter 80 Electrode 801 Front end side area 803 Rear end side area 802 Medium Region 85 insulating coating

Claims (9)

A catheter shaft;
It is composed of a metal tube fixed to the distal end of the catheter shaft and formed with a plurality of slits extending in the axial direction. When compressed in the axial direction, the slit opens and expands in the radial direction, and consists of a plurality of spines. An electrode for high-frequency energization that transforms into a basket shape;
A tip which is fixed to the tip of the electrode;
An operation handle fixed to the proximal end of the catheter shaft;
A conductive wire electrically connected to the electrode and extending into the catheter shaft;
An operation wire having a distal end portion fixed to the distal tip, extending in an axial direction inside the catheter shaft, and having a proximal end capable of being pulled. Electrode catheter for lung cancer treatment. The metal tube has an electrode component in which the slit extending in the axial direction is formed;
It is composed of a shaft component part that is insulated and coated on the proximal end side of the electrode component part to constitute the catheter shaft,
The electrode catheter for treating lung cancer according to claim 1, wherein a helical slit or groove is formed in the shaft component.   The electrode catheter for lung cancer treatment according to claim 1 or 2, wherein the catheter shaft has a multi-lumen structure at a proximal end side of the shaft constituent portion of the metal tube.   The outer diameter of the said catheter shaft is 2.0 mm or less, The electrode catheter for lung cancer treatment in any one of Claims 1-3 characterized by the above-mentioned.   The electrode catheter for treating lung cancer according to any one of claims 1 to 4, wherein the number of the slits formed in the metal tube and extending in the axial direction is six or more. A temperature sensor fixed to the electrode; and a temperature sensor extending inside the catheter shaft;
The temperature measuring portion of the temperature sensor is a position corresponding to the innermost diameter side of at least one spine constituting the electrode and corresponding to the maximum diameter portion of the electrode by a contraction tube in which a spiral slit is formed. The electrode catheter for lung cancer treatment according to any one of claims 1 to 5, wherein the electrode catheter is fixed to a lung cancer.   The electrode catheter for lung cancer treatment according to any one of claims 1 to 6, wherein the electrode includes a front-end-side conical portion, a straight body portion, and a rear-end-side conical portion.   In the metal tube, the front end side region and the rear end side region in the portion where the slit extending in the axial direction is coated with insulation, so that only a middle region sandwiched between the two regions is subjected to high frequency energization. The electrode catheter for lung cancer treatment according to any one of claims 1 to 7.   The electrode catheter for treating lung cancer according to any one of claims 1 to 8, wherein the electrode catheter is inserted into a channel of a bronchoscope and used.

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