JP2018134350A - Intravascular foreign matter extraction forceps - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide forceps suitable for extracting an intravascular foreign matter.SOLUTION: Intravascular foreign matter extraction forceps include: an external cylinder; and a slidable internal cylinder arranged on the inner side of the external cylinder. The external cylinder has a pair of blades that are arranged on a tip side and to be opened/closed by a sliding operation of the internal cylinder. One in the pair of blades is a longer blade having a spatula-like shape and being relatively long, and the other is a shorter blade having projections inside and being relatively short.SELECTED DRAWING: Figure 1

Description

  The present invention relates to a forceps used for removing a foreign substance in a blood vessel.

As shown in Patent Documents 1 and 2, surgical forceps having a blade (jaw) that opens and closes at the tip are known.
However, these forceps have the same length of a pair of blades or have a thick blade, and are not suitable for removing intravascular foreign matters such as stents in stent placement and the like.

Japanese Patent Laying-Open No. 2015-80579 Special table 2013-526362

  In view of the problems of the above-described existing forceps, an object of the present invention is to provide a forceps suitable for removing foreign substances in blood vessels.

  The forceps for removing a foreign substance in a blood vessel according to the present invention includes an outer cylinder and an inner cylinder that is slidable inside the outer cylinder, and the outer cylinder has a pair of blades that are opened and closed by a sliding operation of the inner cylinder on a distal end side. One of the pair of blades is a spatula-like relatively long, long blade, and the other is a relatively short, short blade having a projection on the inside.

Thus, the forceps according to the present invention is characterized in that the pair of blades are asymmetric.
The long blade has a plate-like spatula and is easily inserted between a foreign substance existing in the blood vessel and the inner wall of the blood vessel.
On the other hand, the short blade has, for example, a protrusion made of a plurality of teeth on the inner side so that the foreign object can be easily gripped when the pair of blades are closed.
In the present invention, the inner tube is also formed in a hollow tube shape so that a guide wire for inserting a sheath portion into a blood vessel can be inserted.

In the present invention, the long blade has the outer end of the rear end portion pivotally attached to the outer cylinder and has a guide hole on the inner side, and the holding blade has the outer end of the rear end portion pivotally attached to the outer cylinder and has the guide hole on the inner side. The pin part provided in the front-end | tip side of the said inner cylinder is inserted into both said guide holes, and the form which carried out slide connection is mentioned as an example.
In this case, it is preferable that a rear end side of the outer cylinder has a grip, and the inner cylinder is connected to a slide operation knob provided on the grip.

  In this way, the foreign body in the blood vessel can be removed simply by sliding the knob back and forth while holding the grip in hand.

  In the forceps according to the present invention, one of the pair of blades is long in the shape of a spatula and the other has a protrusion on the inside, so when removing foreign matter in the blood vessel, It can be inserted so as to be slid between the foreign matter, and the blade can be closed as it is, so that the foreign matter can be gripped by the projection inside the short blade and the long blade.

  For example, stent placement is performed for the treatment of coronary artery disease and the like, and this stent is suitable for extraction.

(A)-(c) shows the structure of the forceps which concerns on this invention. (A) shows a state in which the blade is closed, and a cross-sectional view thereof is shown in (b). (A) shows a state where the blade is opened, and a cross-sectional view thereof is shown in (b). The state in which the guide wire is inserted is shown in (a) and (b). The perspective view of the blade part of a prototype is shown. The photograph of the forceps which concerns on this invention is shown. The flow of extraction of the stent indicated by → in the porcine coronary artery is shown. A pathological specimen is shown.

  Hereinafter, although the structural example of the forceps which concerns on this invention is demonstrated based on figures, this invention is not limited to this.

FIG. 1A shows an overall view of the forceps.
The sheath 10 is attached to the grip 20 using an attachment 30 such as a screw member.
In FIG. 1A, the length of the sheath 10 is partially cut, and in this embodiment, the length of the sheath is about 1,550 mm, the length of the grip is about 110 mm, and the outer diameter is about 14 mm. It has become.
As shown in enlarged views in FIGS. 2 and 3, a tubular inner cylinder 12 is disposed inside the tubular outer cylinder 11, and the rear end side of the inner cylinder 12 is slidably attached to the grip 20. Are connected to the knob 21.
The outer cylinder 11 is made of resin, such as a polyethylene tube or a Teflon (registered trademark) tube.
The inner cylinder 12 is an example in which polyether ether ketone (PEEK) is used in this embodiment, but a thin stainless steel tube, a thin blade tube in which a stainless steel blade is protected with polyethylene, and the like are also exemplified. .

A stainless steel coupler 11a is fixed to the distal end side of the outer cylinder 11, and the outer shape is about 1.8 to 2.0 mm.
The pair of blades 13 and 14 are also made of stainless steel, and the relatively long long blade 13 has a plate-like spatula structure. A shallow shallow groove 13a is formed on the inner side, and the outer side of the rear end is pinned or the like. And a guide hole 13c having an oblique long hole on the inside.
A relatively short, short blade 14 is formed with a plurality of tooth-like projections 14a on the inside so that it is easy to grasp the foreign matter to be extracted, and the rear end is opposed to the long blade and the outside is a shaft. It is pivotally attached to the connector 11a on the outer cylinder side using the attaching portion 14b.
The short blade 14 also has a long guide hole 14c on the inner side, and the oblique long hole direction is a direction crossing the long blade guide hole 13c.
A stainless steel opening / closing piece 12a is fixed to the distal end side of the inner cylinder 12 having the hollow portion 12c, and the opening / closing piece 12a is a sliding portion provided on the inner peripheral portion of the outer cylinder 11 by a knob operation of the grip 20. Move forward or backward along 11b.
A pin 12b provided on the opening / closing piece 12a is inserted into the guide holes 13c and 14c of the long blade and the short blade.
Thereby, as shown by the arrows in FIGS. 2B and 3B, the pair of blades 13 and 14 are opened and closed by the knob operation.
The guide wire 1 can be inserted into the hollow portion 12c of the inner cylinder of the forceps, and the state is shown in FIG.

FIG. 5 shows a photograph of the appearance of the blade opened.
FIG. 6 shows photographs of the open / close state of the forceps.
Using the forceps thus prototyped, a stent recovery experiment was performed from the porcine coronary artery.
In the photograph of FIG. 7, the portion indicated by the white arrow is the stent.
First, a second photograph from the left side of FIG. 7 shows a state in which a stent is placed in a porcine coronary artery.
Next, the sheath of the forceps according to the present invention is inserted into the coronary artery through the guide wire, the tip of the long blade with the blade opened is slid between the blood vessel wall and the stent, and then the blade is moved by a knob operation. The closed and grasped stent was collected in the guide catheter.
FIG. 8 shows a pathological specimen of a porcine coronary artery used in this experiment.
There was no obvious damage to the coronary arteries associated with the procedure.

DESCRIPTION OF SYMBOLS 1 Guide wire 10 Sheath 11 Outer cylinder 11a Connecting tool 12 Inner cylinder 12a Opening / closing top 12b Pin 12c Hollow part 13 Long blade 13c Guide hole 14 Short blade 20 Grip 21 Knob 30 Fixing tool

Claims (3)

An outer cylinder and an inner cylinder that is slidable inside the outer cylinder;
The outer cylinder has a pair of blades that are opened and closed by sliding the inner cylinder on the distal end side,
One of the pair of blades is a spatula-like, relatively long, long blade, and the other is a relatively short, short blade having a projection on the inside thereof. The long blade is pivotally attached to the outer cylinder on the outer side of the rear end, and has a guide hole on the inner side.
The gripping blade is pivotally attached to the outer cylinder on the outer side of the rear end portion, and has a guide hole on the inner side.
2. The intravascular foreign matter extracting forceps according to claim 1, wherein a pin portion provided on the distal end side of the inner cylinder is inserted into both the guide holes and slidably connected.   The forceps for removing an intravascular foreign body according to claim 2, wherein a grip is provided on a rear end side of the outer cylinder, and the inner cylinder is connected to a slide operation knob provided on the grip. .