JP2018175312A - Medical appliance and method for detecting hemodynamics - Google Patents

Medical appliance and method for detecting hemodynamics Download PDF

Info

Publication number
JP2018175312A
JP2018175312A JP2017078519A JP2017078519A JP2018175312A JP 2018175312 A JP2018175312 A JP 2018175312A JP 2017078519 A JP2017078519 A JP 2017078519A JP 2017078519 A JP2017078519 A JP 2017078519A JP 2018175312 A JP2018175312 A JP 2018175312A
Authority
JP
Japan
Prior art keywords
blood vessel
sensor
blood
detecting
physical property
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
JP2017078519A
Other languages
Japanese (ja)
Inventor
洋一 樋口
Yoichi Higuchi
洋一 樋口
杏梨 藤井
Anri Fujii
杏梨 藤井
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Terumo Corp
Original Assignee
Terumo Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Terumo Corp filed Critical Terumo Corp
Priority to JP2017078519A priority Critical patent/JP2018175312A/en
Publication of JP2018175312A publication Critical patent/JP2018175312A/en
Pending legal-status Critical Current

Links

Images

Landscapes

  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
  • Measurement Of The Respiration, Hearing Ability, Form, And Blood Characteristics Of Living Organisms (AREA)
  • Surgical Instruments (AREA)

Abstract

PROBLEM TO BE SOLVED: To provide a medical appliance that enables an embolus state of a blood vessel near target tissue to be determined from the upstream side of the blood vessel with respect to a site of embolization, and a method for detecting hemodynamics.SOLUTION: A medical appliance comprises a linear member capable of being inserted through a blood vessel, and a sensor that is attached to the linear member so as to detect a predetermined physical property value enabling the determination of the embolus state on the downstream side of the blood vessel.SELECTED DRAWING: Figure 2

Description

本開示は医療器具及び血行動態を検出するための方法に関する。   The present disclosure relates to medical devices and methods for detecting hemodynamics.

従来から、免疫を高めて癌を治療する癌免疫療法が知られている。癌免疫療法の中には、患者の免疫細胞の機能を高めて癌を治療する免疫細胞療法がある。この免疫細胞療法は、患者の免疫細胞を体外に取り出し、培養・活性化した上で患者の体内に戻すことで、癌細胞に対する免疫を高め、癌を治療するものである。特許文献１には、癌免疫療法の一例が記載されている。   BACKGROUND ART Conventionally, cancer immunotherapies for improving immunity and treating cancer are known. Among cancer immunotherapies, there are immune cell therapies that enhance the function of patient's immune cells to treat cancer. In this immune cell therapy, the patient's immune cells are taken out of the body, cultured and activated, and returned to the patient's body, thereby enhancing immunity to cancer cells and treating cancer. Patent Document 1 describes an example of cancer immunotherapy.

特表２０１７−５０３４７２号公報JP-A-2017-503472

ところで、免疫細胞などの所定の細胞を、経血管的に標的組織に向けて局所的に投与する医療器具や細胞投与方法は確立されていない。所定の細胞を、経血管的に標的組織に向けて局所的に投与するには、投与された所定の細胞を標的組織の近傍に停滞させるべく、標的組織につながる末梢動脈等の、標的組織近傍の血管の血流を止めることが求められる。   By the way, a medical device or a cell administration method for locally administering a predetermined cell such as an immune cell to a target tissue transvascularly has not been established. In order to locally administer predetermined cells transvascularly to a target tissue, the target tissue may be adjacent to the target tissue, such as a peripheral artery connected to the target tissue in order to cause the administered predetermined cells to stagnate in the vicinity of the target tissue. It is required to stop the blood flow of blood vessels.

本開示は、標的組織の近傍の血管の塞栓状態を、塞栓部位よりも血管の上流側から判別可能とする医療器具及び血行動態を検出するための方法を提供することを目的とする。   An object of the present disclosure is to provide a medical instrument and a method for detecting hemodynamics that make it possible to determine the embolization state of a blood vessel in the vicinity of a target tissue from the upstream side of the blood vessel rather than the embolization site.

本発明の第１の態様としての医療器具は、血管内を挿通可能な線状部材と、前記線状部材に取り付けられ、前記血管の下流側の塞栓状態を判別可能な所定の物性値を検出するセンサと、を備える。   A medical device according to a first aspect of the present invention detects a predetermined physical property value that is attached to a linear member that can be inserted into a blood vessel and the linear member and that can determine the embolization state on the downstream side of the blood vessel And a sensor to

本発明に１つの実施形態としての医療器具は、前記センサが検出した前記所定の物性値に基づき、前記センサよりも前記血管の下流側の塞栓の有無を判別する判別装置を備える。   The medical device as one embodiment of the present invention includes a determination device that determines the presence or absence of an embolism downstream of the blood vessel with respect to the sensor based on the predetermined physical property value detected by the sensor.

本発明に１つの実施形態として、前記判別装置は、前記センサが検出した前記所定の物性値の単位時間当たりの変化量に基づき、前記センサよりも前記血管の下流側の塞栓の有無を判別する。   As one embodiment of the present invention, the determination device determines the presence or absence of an embolism on the downstream side of the blood vessel with respect to the sensor based on the amount of change per unit time of the predetermined physical property value detected by the sensor. .

本発明に１つの実施形態として、前記判別装置は、前記変化量が所定値以上の場合に、塞栓が発生したと判別する。   As one embodiment of the present invention, the determination device determines that an embolism has occurred when the amount of change is equal to or greater than a predetermined value.

本発明に１つの実施形態として、前記センサは、前記所定の物性値として、前記血管内の単位時間当たりの血流量を検出可能な血流センサである。   As one embodiment of the present invention, the sensor is a blood flow sensor capable of detecting a blood flow volume per unit time in the blood vessel as the predetermined physical property value.

本発明に１つの実施形態として、前記センサは、前記所定の物性値として、前記血管内の圧力を検出可能な圧力センサである。   As one embodiment of the present invention, the sensor is a pressure sensor capable of detecting the pressure in the blood vessel as the predetermined physical property value.

本発明に１つの実施形態として、前記センサは、前記所定の物性値として、前記血管内の液体の所定成分の成分量を検出可能な成分量センサである。   As one embodiment of the present invention, the sensor is a component amount sensor capable of detecting the component amount of a predetermined component of the liquid in the blood vessel as the predetermined physical property value.

本発明の第２の態様としての方法は、腫瘍の塞栓治療において血行動態を検出するための方法であって、複数の分岐血管に対して経血管的に塞栓部材を配置するステップと、前記塞栓部材による前記複数の分岐血管の血流の制限、又は、前記複数の分岐血管の血流の停滞、を前記塞栓部材よりも血管の上流側において検出することにより、前記複数の分岐血管の塞栓状態を判別するステップと、を含む。   A method according to a second aspect of the present invention is a method for detecting hemodynamics in embolic treatment of a tumor, comprising translocating an embolic member to a plurality of branched blood vessels, and The embolic state of the plurality of branched blood vessels by detecting the restriction of the blood flow of the plurality of branched blood vessels by the member or the stagnation of the blood flow of the plurality of branched blood vessels on the upstream side of the blood vessel with respect to the embolic member. And determining.

本開示によれば、標的組織の近傍の血管の塞栓状態を、塞栓部位よりも血管の上流側から判別可能とする医療器具及び血行動態を検出するための方法を提供することができる。   According to the present disclosure, it is possible to provide a medical instrument and a method for detecting hemodynamics that make it possible to determine the embolization state of a blood vessel in the vicinity of a target tissue from the upstream side of the blood vessel rather than the embolization site.

癌免疫療法の一例の概要を示す図である。It is a figure which shows the outline | summary of an example of a cancer immunotherapy. 本発明の一実施形態としての医療器具が血管内に留置されている状態を示す図である。It is a figure which shows the state in which the medical device as one Embodiment of this invention is detained in the blood vessel. 本発明の一実施形態としての血行動態を検出するための方法を示すフローチャートである。5 is a flow chart illustrating a method for detecting hemodynamics according to one embodiment of the present invention.

以下、本発明に係る医療器具及び血行動態を検出するための方法の実施形態について、図１〜図３を参照して説明する。各図において共通する部材・部位には同一の符号を付している。   Hereinafter, embodiments of a medical device and a method for detecting hemodynamic status according to the present invention will be described with reference to FIGS. 1 to 3. The same code | symbol is attached | subjected to the member and site | part which are common in each figure.

図１は、癌免疫療法の一例の概要を示す図である。図１に示す癌免疫療法では、患者Ｐの血液から免疫細胞Ｘを取り出し、活性化・培養し、再び患者Ｐの血液に戻す。これにより、患者Ｐの免疫力が高められ、癌細胞の排除と、癌細胞の発生の抑制と、を実現することができる。   FIG. 1 shows an outline of an example of cancer immunotherapy. In the cancer immunotherapy shown in FIG. 1, immune cells X are removed from the blood of patient P, activated and cultured, and returned to the blood of patient P again. As a result, the immunity of the patient P is enhanced, and elimination of cancer cells and suppression of the generation of cancer cells can be realized.

図２は、図１に示す癌免疫療法に利用可能な、本実施形態としての医療器具１を示す図である。図２では、医療器具１が血管ＢＶ内に留置されている状態を示している。より具体的に、図２では、医療器具１が、癌治療の対象となる標的組織Ｔに対して、血管ＢＶの上流側の近傍の位置に留置されている状態を示している。   FIG. 2 is a view showing a medical device 1 according to the present embodiment which can be used for cancer immunotherapy shown in FIG. FIG. 2 shows a state in which the medical device 1 is indwelled in the blood vessel BV. More specifically, FIG. 2 shows a state where the medical instrument 1 is indwelled in the vicinity of the upstream side of the blood vessel BV with respect to the target tissue T to be subjected to cancer treatment.

図２に示すように、医療器具１は、線状部材２と、センサ３と、判別装置４と、を備えている。   As shown in FIG. 2, the medical instrument 1 includes a linear member 2, a sensor 3, and a discrimination device 4.

線状部材２は、血管ＢＶ内を挿通可能である。線状部材２は、例えば、高密度ポリエチレン、ポリプロピレンのようなポリオレフィン；ナイロン６６のようなポリアミド；ポリウレタン；ポリエチレンテレフタレート、ポリブチレンテレフタレート、ポリシクロヘキサンテレフタレートのようなポリエステル；ポリテトラフルオロエチレン、エチレン−テトラフルオロエチレン共重合体等のようなフッ素系樹脂；からなる群より選択される少なくとも１種を主とするものとすることができる。   The linear member 2 can be inserted into the blood vessel BV. The linear member 2 is, for example, a high-density polyethylene, a polyolefin such as polypropylene; a polyamide such as nylon 66; a polyurethane; a polyester such as polyethylene terephthalate, polybutylene terephthalate or polycyclohexane terephthalate; polytetrafluoroethylene, ethylene-tetra It may be mainly composed of at least one selected from the group consisting of a fluorine-based resin such as a fluoroethylene copolymer and the like;

センサ３は、線状部材２の先端部に取り付けられている。また、センサ３は、血管ＢＶの下流側の塞栓状態を判別可能な所定の物性値を検出可能である。   The sensor 3 is attached to the tip of the linear member 2. Further, the sensor 3 can detect predetermined physical property values capable of determining the embolization state on the downstream side of the blood vessel BV.

センサ３により検出可能な所定の物性値としては、例えば、血管ＢＶ内の単位時間当たりの血流量、血管ＢＶ内の圧力、血管ＢＶ内の液体の所定成分の成分量、等が挙げられる。この所定の物性値の詳細は後述する。   Examples of predetermined physical property values that can be detected by the sensor 3 include the blood flow volume per unit time in the blood vessel BV, the pressure in the blood vessel BV, the component amount of the predetermined component of the liquid in the blood vessel BV, and the like. Details of the predetermined physical property values will be described later.

判別装置４は、センサ３が検出した所定の物性値に基づき、センサ３よりも血管ＢＶの下流側の塞栓の有無を判別する。具体的に、本実施形態の判別装置４は、センサ３が検出した所定の物性値の単位時間当たりの変化量に基づき、センサ３よりも血管ＢＶの下流側の塞栓の有無を判別する。より具体的に、本実施形態の判別装置４は、センサ３が検出した所定の物性値の単位時間当たりの変化量が所定値以上の場合に、センサ３よりも血管ＢＶの下流側で塞栓が発生したと判別する。   The determination device 4 determines the presence or absence of an embolism on the downstream side of the blood vessel BV with respect to the sensor 3 based on the predetermined physical property value detected by the sensor 3. Specifically, based on the amount of change per unit time of the predetermined physical property value detected by the sensor 3, the determination device 4 of the present embodiment determines the presence or absence of an embolism on the downstream side of the blood vessel BV than the sensor 3. More specifically, when the amount of change per unit time of the predetermined physical property value detected by the sensor 3 is equal to or larger than the predetermined value, the discrimination device 4 of the present embodiment has an embolism downstream of the blood vessel BV than the sensor 3. Determine that it has occurred.

判別装置４は、ＭＰＵやＣＰＵなどのプロセッサにより構成するこができる。判別装置４は、演算装置や、センサ３により検出される所定の物性値の閾値情報や各種プログラムなどを記憶する記憶装置などから構成されている。   The determination device 4 can be configured by a processor such as an MPU or a CPU. The determination device 4 is configured of an arithmetic device, a storage device that stores threshold information of predetermined physical property values detected by the sensor 3, various programs, and the like.

なお、図２に示すように、本実施形態の判別装置４は、センサ３と共に血管ＢＶ内に位置しているが、判別装置４を体外に配置し、センサ３と有線又は無線により通信可能な構成としてもよい。   As shown in FIG. 2, the discrimination device 4 of the present embodiment is located in the blood vessel BV together with the sensor 3, but the discrimination device 4 can be disposed outside the body and can communicate with the sensor 3 by wire or wirelessly. It is good also as composition.

また、医療器具１が、上述した線状部材２、センサ３及び判別装置４に加えて、例えば、判別装置４の判別結果を表示する表示装置などを備える構成としてもよい。   Moreover, in addition to the linear member 2 mentioned above, the sensor 3, and the discrimination | determination apparatus 4, it is good also as a structure provided with the display apparatus etc. which display the discrimination result of the discrimination | determination apparatus 4, for example.

以下、医療器具１を用いて血管ＢＶの塞栓状態を検出する塞栓検出方法について詳細に説明する。   Hereinafter, an embolus detection method for detecting the embolus state of the blood vessel BV using the medical device 1 will be described in detail.

まず、免疫細胞Ｘなどの所定の細胞を、経血管的に標的組織Ｔに向けて局所的に投与するため、図２に示すように、標的組織Ｔ近傍の血管ＢＶを塞栓する。具体的に、図２では、標的組織Ｔ近傍の血管ＢＶとしての、標的組織Ｔにつながる末梢動脈ＰＡを塞栓している。また、図２では、標的組織Ｔ近傍の血管ＢＶとしての、標的組織Ｔ内に位置する複数の毛細血管ＢＣを塞栓している。このように、図２に示す例では、標的組織Ｔ近傍の血管ＢＶが、末梢動脈ＰＡの位置、又は、毛細血管ＢＣの位置、で塞栓されている。なお、図２で示す複数の末梢動脈は、その上流側の１つの本幹から分岐する分岐血管である。また、図２で示す毛細血管ＢＣも、その上流側の末梢動脈から分岐する分岐血管である。末梢動脈ＰＡ及び毛細血管ＢＣの塞栓は、塞栓部材５を用いて行うことができる。塞栓部材５は、例えば、血管ＢＶ内で血液と触れることで膨潤して血栓を生成する血栓生成物質を保持するステントにより構成することができる。血液と触れて膨潤する血栓生成物質としては、例えば、ハイドロゲルが挙げられる。図２では、ステントを構成する線材と、膨潤した血栓生成物質と、により栓子が生成されることで、血管ＢＶとしての末梢動脈ＰＡ及び毛細血管ＢＣが塞栓されている。なお、塞栓部材５の血栓生成物質としては、血管ＢＶ内で血液を凝固させる作用を持つ物質としてもよい。また、塞栓部材５としてビーズ乃至ゼラチンスポンジを用いてもよい。   First, in order to locally administer a predetermined cell such as an immune cell X toward the target tissue T transvascularly, as shown in FIG. 2, the blood vessel BV in the vicinity of the target tissue T is embolized. Specifically, in FIG. 2, the peripheral artery PA connected to the target tissue T is embolized as a blood vessel BV in the vicinity of the target tissue T. Further, in FIG. 2, a plurality of capillaries BC located in the target tissue T as blood vessels BV in the vicinity of the target tissue T are embolized. Thus, in the example shown in FIG. 2, the blood vessel BV in the vicinity of the target tissue T is embolized at the position of the peripheral artery PA or at the position of the capillary blood vessel BC. The plurality of peripheral arteries shown in FIG. 2 are bifurcated blood vessels branched from one main trunk on the upstream side. The capillary blood vessel BC shown in FIG. 2 is also a branched blood vessel branched from the upstream peripheral artery. The embolization of the peripheral artery PA and the capillary BC can be performed using the embolic member 5. The embolic member 5 can be configured of, for example, a stent that holds a thrombogenic substance that swells by contacting blood in the blood vessel BV to generate a thrombus. Examples of thrombus forming substances that swell in contact with blood include hydrogels. In FIG. 2, the thrombus is generated by the wire forming the stent and the swollen thrombus forming material, and thereby the peripheral artery PA and the capillary blood vessel BC as the blood vessel BV are embolized. The thrombus-generating substance of the embolic member 5 may be a substance having the function of coagulating the blood in the blood vessel BV. Alternatively, beads or gelatin sponges may be used as the embolic member 5.

医療器具１は、上述の末梢動脈ＰＡや毛細血管ＢＣの塞栓工程を実行する間、複数の末梢動脈ＰＡの上流側でつながる血管ＢＶの本幹内に留置されている。医療器具１のセンサ３は、センサ３が先端部に取り付けられている線状部材２を、血管ＢＶ内に留置されている管状部材６を通じて進行させることで、血管ＢＶ内の所定位置に留置させることができる。そして、医療器具１を用いて末梢動脈ＰＡ、又は、末梢動脈ＰＡよりも下流側の毛細血管ＢＣ、が塞栓されたか否かをモニタリングすることで、塞栓状態を検出し、上述の標的組織Ｔ近傍の血管ＢＶの塞栓工程の完了を確認することができる。   The medical device 1 is indwelled in the main trunk of the blood vessel BV connected on the upstream side of the plurality of peripheral arteries PA while performing the above-described embolization process of the peripheral artery PA and the capillary blood vessel BC. The sensor 3 of the medical instrument 1 causes the linear member 2 to which the sensor 3 is attached to the tip to advance through the tubular member 6 indwelled in the blood vessel BV, thereby indwelling at a predetermined position in the blood vessel BV. be able to. Then, the embolization state is detected by monitoring whether or not the peripheral artery PA or the capillary BC downstream of the peripheral artery PA is embolized using the medical device 1, and the vicinity of the target tissue T described above is detected. The completion of the embolization process of blood vessel BV can be confirmed.

医療器具１のセンサ３の一例として、血管ＢＶ内の単位時間当たりの血流量を検出可能な血流センサを用いる場合、上述の塞栓工程の間、単位時間当たりの血流量の変化量をモニタリングする。末梢動脈ＰＡや毛細血管ＢＣが塞栓されると、血液の滞留が発生し始めるため、血管ＢＶの本幹における血流量は塞栓により減少する。したがって、医療器具１の判定装置４は、単位時間当たりの血流量の変化量が所定値（所定の閾値）以上となった場合に、塞栓が完了したと判別することができる。このような血流センサの測定系は、例えば、血管ＢＶ内の温度、超音波、光などを利用して構成することができる。また、血流センサとしては、冠血流予備量比（ＦＦＲ）のような相対的血流量を測定するものであってもよく、赤血球量等による絶対的血流量を測定するものであってもよい。   When a blood flow sensor capable of detecting a blood flow volume per unit time in a blood vessel BV is used as an example of the sensor 3 of the medical instrument 1, the change amount of the blood flow volume per unit time is monitored during the above-described embolic process. . When the peripheral artery PA or capillary BC is embolized, blood retention starts to occur, so the blood flow in the main stem of the blood vessel BV is reduced by the embolization. Therefore, the determination device 4 of the medical device 1 can determine that the embolism is completed when the change amount of the blood flow volume per unit time becomes equal to or more than a predetermined value (predetermined threshold value). The measurement system of such a blood flow sensor can be configured, for example, using the temperature in the blood vessel BV, ultrasonic waves, light and the like. The blood flow sensor may measure relative blood flow such as coronary flow reserve ratio (FFR), or may measure absolute blood flow by the amount of red blood cells etc. Good.

医療器具１のセンサ３の別の例として、血管ＢＶ内の圧力を検出可能な圧力センサを用いる場合、上述の塞栓工程の間、圧力をモニタリングする。そして、末梢動脈ＰＡや毛細血管ＢＣが塞栓されると、血液の滞留が発生し始めるため、血管ＢＶの本幹における圧力が大きくなる。したがって、医療器具１の判定装置４は、血管ＢＶ内の圧力の変化量が所定値（所定の閾値）以上となった場合に、塞栓が完了したと判別することができる。   As another example of the sensor 3 of the medical device 1, when using a pressure sensor capable of detecting the pressure in the blood vessel BV, the pressure is monitored during the above-described embolic process. Then, when the peripheral artery PA and the capillary blood vessel BC are embolized, blood retention starts to occur, so the pressure at the main trunk of the blood vessel BV becomes large. Therefore, the determination device 4 of the medical instrument 1 can determine that the embolism is completed when the amount of change in pressure in the blood vessel BV becomes equal to or more than a predetermined value (predetermined threshold).

なお、センサ３としては、血管ＢＶの下流側の塞栓状態を判別可能な所定の物性値を検出するものであればよく、上述の血流センサや圧力センサに限られるものではない。   The sensor 3 may be any sensor that detects a predetermined physical property value that can determine the embolization state on the downstream side of the blood vessel BV, and is not limited to the above-described blood flow sensor or pressure sensor.

また、血管ＢＶの塞栓状態を、塞栓工程後であって、血管ＢＶ内に造影剤や、免疫細胞Ｘなどの所定の細胞を投与した後に確認してもよい。   In addition, the embolization state of the blood vessel BV may be confirmed after the embolization step and after administration of a contrast medium and predetermined cells such as immune cells X into the blood vessel BV.

このような医療器具１のセンサ３の一例としては、血管ＢＶ内の液体の所定成分の成分量を検出可能な成分量センサを挙げることができる。例えば、血管ＢＶの本幹から抹消動脈にかけて、造影剤や、癌治療のための所定の細胞を投与した場合、これら投与物質が停滞することで、その位置での赤血球などの血液中の所定成分の成分量の比率が少なくなる。そのため、例えばセンサ３として、赤血球の成分量として赤血球の粒子数を検出可能な成分量センサを用いる場合、医療器具１の判定装置４は、赤血球の変化量としての粒子数の減少量が所定値（所定の閾値）以上となった場合に、塞栓が完了していることを判別することができる。なお、成分量センサとしては、赤血球の粒子数に限らず、血液中の他の成分の成分量や、造影剤や細胞などの投与物質の所定成分の成分量を検出可能なものとしてもよい。また、成分量センサの測定系は、例えば、血管内の温度や、超音波、光などを利用して構成することができる。   As an example of the sensor 3 of such a medical instrument 1, the component amount sensor which can detect the component amount of the predetermined component of the liquid in the blood vessel BV can be mentioned. For example, when a contrast agent or predetermined cells for cancer treatment are administered from the main stem of blood vessel BV to the peripheral artery, these administered substances stagnate, and thus predetermined components of blood such as red blood cells at that position The ratio of the component amounts of Therefore, for example, when a component amount sensor capable of detecting the number of red blood cell particles as the amount of red blood cell component is used as the sensor 3, the determination device 4 of the medical device 1 determines that the reduction amount of the number of particles as the red blood cell change amount is a predetermined value When (predetermined threshold value) or more is reached, it can be determined that the embolism is completed. The component amount sensor is not limited to the number of red blood cell particles, and may be capable of detecting the component amounts of other components in blood, or the component amounts of predetermined components of the administered substance such as contrast medium and cells. Further, the measurement system of the component amount sensor can be configured, for example, using the temperature in the blood vessel, ultrasonic waves, light and the like.

以上のように、医療器具１によれば、標的組織Ｔの近傍の血管ＢＶとしての末梢動脈ＰＡや毛細血管ＢＣを確実に塞栓したことを確認することができる。   As described above, according to the medical device 1, it can be confirmed that the peripheral artery PA or capillary BC as the blood vessel BV in the vicinity of the target tissue T is reliably embolized.

そして、標的組織Ｔの近傍の末梢動脈ＰＡや毛細血管ＢＣが塞栓されていることで、この末梢動脈ＰＡや毛細血管ＢＣの位置で投与される、免疫細胞Ｘなどの所定の細胞を、標的組織Ｔの近傍に停滞させることができる。すなわち、免疫細胞Ｘなどの所定の細胞を、経血管的に標的組織Ｔに向けて局所的に投与することが実現できる。   Then, by embolizing the peripheral artery PA or capillary BC in the vicinity of the target tissue T, a predetermined cell such as an immune cell X to be administered at the position of the peripheral artery PA or capillary BC can be targeted It can stagnate in the vicinity of T. That is, local administration of predetermined cells such as immune cells X toward the target tissue T transvascularly can be realized.

換言すれば、医療器具１により、腫瘍の塞栓治療において血行動態を検出することができる。図３は、医療器具１により実現される、腫瘍の塞栓治療において血行動態を検出するための方法を示すフローチャートである。図３に示す方法は、複数の分岐血管としての末梢動脈ＰＡ又は毛細血管ＢＣに対して経血管的に塞栓部材５を配置するステップＳ１（図３では「塞栓工程」と記載）と、塞栓部材５による複数の分岐血管の血流の制限、又は、複数の分岐血管の血流の停滞、を塞栓部材５よりも血管の上流側において検出することにより、複数の分岐血管の塞栓状態を判別するステップＳ２（図３では「判別工程」と記載）と、を含む。ステップＳ２では、医療器具１のセンサ３が、塞栓部材５による複数の分岐血管の血流の制限、又は、複数の分岐血管の血流の停滞、を塞栓部材５よりも血管の上流側において検出する。また、ステップＳ２では、医療器具１の判別装置４が、複数の分岐血管の塞栓状態を判別する。   In other words, the medical device 1 can detect hemodynamics in tumor embolization treatment. FIG. 3 is a flow chart showing a method for detecting hemodynamics in tumor embolization treatment realized by the medical device 1. The method shown in FIG. 3 includes a step S1 of disposing the embolic member 5 transvascularly with respect to peripheral arteries PA or capillaries BC as a plurality of branched blood vessels (denoted as “embolic process” in FIG. 3), and the embolic member The embolization state of the plurality of branched blood vessels is determined by detecting the restriction of the blood flow of the plurality of branched blood vessels by 5 or the stagnation of the blood flow of the plurality of branched blood vessels on the upstream side of the blood vessel from the embolic member 5 Step S2 (described as “determination step” in FIG. 3). In step S2, the sensor 3 of the medical device 1 detects the restriction of the blood flow of the plurality of branched blood vessels by the embolic member 5 or the stagnation of the blood flow of the plurality of branched blood vessels on the upstream side of the blood vessel from the embolic member 5 Do. Further, in step S2, the discrimination device 4 of the medical instrument 1 discriminates the embolization state of a plurality of branched blood vessels.

なお、局所的に投与する所定の細胞は、標的組織Ｔやその目的に応じて適宜設定される。したがって、局所的に投与する所定の細胞としては、免疫細胞Ｘである血液細胞（例えば、リンパ球（Ｔ細胞、Ｂ細胞、ＮＫ細胞）、赤血球、顆粒球、単球、血小板）に限らず、例えば、造血幹細胞、筋芽細胞、心筋細胞、線維芽細胞、間葉系幹細胞、滑膜細胞、胚性幹細胞、上皮細胞、内皮細胞などであってもよい。また、上述の所定の細胞は、同種異系ドナー細胞、異種ドナー細胞、同系ドナー細胞、遺伝子操作された細胞、株化された細胞系、患者由来の細胞、などを含むものである。   The predetermined cells to be administered locally are appropriately set according to the target tissue T and the purpose thereof. Therefore, predetermined cells to be administered locally are not limited to blood cells that are immune cells X (eg, lymphocytes (T cells, B cells, NK cells), red blood cells, granulocytes, monocytes, platelets), For example, hematopoietic stem cells, myoblasts, cardiomyocytes, fibroblasts, mesenchymal stem cells, synovial cells, embryonic stem cells, epithelial cells, endothelial cells, etc. may be used. In addition, the predetermined cells described above include allogeneic donor cells, xenogeneic donor cells, syngeneic donor cells, genetically engineered cells, established cell lines, cells derived from patients, and the like.

本開示に係る医療器具及び血行動態を検出するための方法は、上述した実施形態に記載した事項に限られるものではなく、特許請求の範囲の記載を逸脱しない限り、種々の変更・変形が可能である。   The medical device and the method for detecting hemodynamics according to the present disclosure are not limited to the items described in the above-described embodiment, and various changes and modifications can be made without departing from the scope of the claims. It is.

本開示は医療器具及び血行動態を検出するための方法に関する。   The present disclosure relates to medical devices and methods for detecting hemodynamics.

１：医療器具
２：線状部材
３：センサ
４：判別装置
５：塞栓部材
６：管状部材
ＢＣ：毛細血管
ＢＶ：血管
ＰＡ：末梢動脈
Ｐ：患者
Ｔ：標的組織
Ｘ：免疫細胞 1: medical device 2: linear member 3: sensor 4: discrimination device 5: embolic member 6: tubular member BC: capillary BV: blood vessel PA: peripheral artery P: patient T: target tissue X: immune cell

Claims (8)

血管内を挿通可能な線状部材と、
前記線状部材に取り付けられ、前記血管の下流側の塞栓状態を判別可能な所定の物性値を検出するセンサと、を備える医療器具。 A linear member which can pass through the inside of a blood vessel,
A sensor attached to the linear member and detecting a predetermined physical property value capable of determining an embolic state on the downstream side of the blood vessel. 前記センサが検出した前記所定の物性値に基づき、前記センサよりも前記血管の下流側の塞栓の有無を判別する判別装置を備える、請求項１に記載の医療器具。   The medical instrument according to claim 1, further comprising a determination device that determines the presence or absence of an embolism downstream of the blood vessel based on the predetermined physical property value detected by the sensor. 前記判別装置は、前記センサが検出した前記所定の物性値の単位時間当たりの変化量に基づき、前記センサよりも前記血管の下流側の塞栓の有無を判別する、請求項２に記載の医療器具。   The medical device according to claim 2, wherein the discrimination device discriminates the presence or absence of an embolism on the downstream side of the blood vessel with respect to the sensor based on the amount of change per unit time of the predetermined physical property value detected by the sensor. . 前記判別装置は、前記変化量が所定値以上の場合に、塞栓が発生したと判別する、請求項３に記載の医療器具。   The medical instrument according to claim 3, wherein the discrimination device discriminates that an embolism has occurred when the amount of change is equal to or more than a predetermined value. 前記センサは、前記所定の物性値として、前記血管内の単位時間当たりの血流量を検出可能な血流センサである、請求項１乃至４のいずれか１つに記載の医療器具。   The medical instrument according to any one of claims 1 to 4, wherein the sensor is a blood flow sensor capable of detecting a blood flow volume per unit time in the blood vessel as the predetermined physical property value. 前記センサは、前記所定の物性値として、前記血管内の圧力を検出可能な圧力センサである、請求項１乃至４のいずれか１つに記載の医療器具。   The medical instrument according to any one of claims 1 to 4, wherein the sensor is a pressure sensor capable of detecting a pressure in the blood vessel as the predetermined physical property value. 前記センサは、前記所定の物性値として、前記血管内の液体の所定成分の成分量を検出可能な成分量センサである、請求項１乃至４のいずれか１つに記載の医療器具。   The medical device according to any one of claims 1 to 4, wherein the sensor is a component amount sensor capable of detecting the component amount of a predetermined component of the liquid in the blood vessel as the predetermined physical property value. 腫瘍の塞栓治療において血行動態を検出するための方法であって、複数の分岐血管に対して経血管的に塞栓部材を配置するステップと、
前記塞栓部材による前記複数の分岐血管の血流の制限、又は、前記複数の分岐血管の血流の停滞、を前記塞栓部材よりも血管の上流側において検出することにより、前記複数の分岐血管の塞栓状態を判別するステップと、を含む方法。 A method for detecting hemodynamics in tumor embolization treatment, comprising transvascularly placing an embolic member on a plurality of bifurcated blood vessels,
The restriction of the blood flow of the plurality of branch blood vessels by the embolic member or the stagnation of the blood flow of the plurality of branch blood vessels is detected on the upstream side of the blood vessel with respect to the embolic member. Determining an embolism condition.
JP2017078519A 2017-04-11 2017-04-11 Medical appliance and method for detecting hemodynamics Pending JP2018175312A (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
JP2017078519A JP2018175312A (en) 2017-04-11 2017-04-11 Medical appliance and method for detecting hemodynamics

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
JP2017078519A JP2018175312A (en) 2017-04-11 2017-04-11 Medical appliance and method for detecting hemodynamics

Publications (1)

Publication Number Publication Date
JP2018175312A true JP2018175312A (en) 2018-11-15

Family

ID=64279946

Family Applications (1)

Application Number Title Priority Date Filing Date
JP2017078519A Pending JP2018175312A (en) 2017-04-11 2017-04-11 Medical appliance and method for detecting hemodynamics

Country Status (1)

Country Link
JP (1) JP2018175312A (en)

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2003525913A (en) * 2000-03-07 2003-09-02 ザ、ボード、オブ、トラスティーズ、オブ、ザ、リーランド、スタンフォード、ジュニア、ユニバーシティ Methods and kits for locally administering an active agent to a host interstitial space
JP2008522646A (en) * 2004-11-26 2008-07-03 ザ リージェンツ オブ ザ ユニバーシティ オブ カリフォルニア Apparatus, system and method for regulating local blood pressure
JP2009506838A (en) * 2005-09-01 2009-02-19 プロテウス バイオメディカル インコーポレイテッド Implantable wireless communication system
JP2016116605A (en) * 2014-12-19 2016-06-30 学校法人 関西大学 Diagnosis support device, diagnosis support method, and computer program

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2003525913A (en) * 2000-03-07 2003-09-02 ザ、ボード、オブ、トラスティーズ、オブ、ザ、リーランド、スタンフォード、ジュニア、ユニバーシティ Methods and kits for locally administering an active agent to a host interstitial space
JP2008522646A (en) * 2004-11-26 2008-07-03 ザ リージェンツ オブ ザ ユニバーシティ オブ カリフォルニア Apparatus, system and method for regulating local blood pressure
JP2009506838A (en) * 2005-09-01 2009-02-19 プロテウス バイオメディカル インコーポレイテッド Implantable wireless communication system
JP2016116605A (en) * 2014-12-19 2016-06-30 学校法人 関西大学 Diagnosis support device, diagnosis support method, and computer program

Similar Documents

Publication Publication Date Title
Bose et al. A novel, self-expanding, nitinol stent in medically refractory intracranial atherosclerotic stenoses: the Wingspan study
Puffer et al. Patency of the ophthalmic artery after flow diversion treatment of paraclinoid aneurysms
Gester et al. In vitro evaluation of intra-aneurysmal, flow-diverter-induced thrombus formation: a feasibility study
Gao et al. Stent-assisted coiling of intracranial bifurcation aneurysms leads to immediate and delayed intracranial vascular angle remodeling
Koppara et al. Thrombogenicity and early vascular healing response in metallic biodegradable polymer-based and fully bioabsorbable drug-eluting stents
Serruys et al. Evaluation of the second generation of a bioresorbable everolimus drug-eluting vascular scaffold for treatment of de novo coronary artery stenosis: six-month clinical and imaging outcomes
Hwang et al. Delayed ischemic stroke after stent-assisted coil placement in cerebral aneurysm: characteristics and optimal duration of preventative dual antiplatelet therapy
Nikoubashman et al. Necessary catheter diameters for mechanical thrombectomy with ADAPT
US20160051806A1 (en) Ductus side-entry jackets and prosthetic disorder response systems
US11992596B2 (en) Medical device dislodgment detection
Allon et al. Hemodialysis vascular access monitoring: current concepts
Roessler et al. The platelet-rich plasma clot: a standardized in-vitro clot formation protocol for investigations of sonothrombolysis under physiological flows
Saito et al. Modified jailed balloon technique for bifurcation lesions
Mattea et al. Low rate of access site complications after transradial coronary catheterization: A prospective ultrasound study
US11480559B2 (en) Blood collection tube, reagent, and method for analyzing blood characteristics using same
Wang et al. The physiological and computational approaches for atherosclerosis treatment
DePietro et al. Choosing the right treatment for the right lesion, part I: a narrative review of the role of plain balloon angioplasty in dialysis access maintenance
JP2018175312A (en) Medical appliance and method for detecting hemodynamics
Bae et al. Mechanical and physio-biological properties of peptide-coated stent for re-endothelialization
Mendes et al. Carbon dioxide contrast medium for endovascular treatment of ilio-femoral occlusive disease
Arbab-Zadeh et al. Hemodialysis access assessment with intravascular ultrasound
Meyermann et al. Treatment of abdominal aortic pathology
Kilic et al. Coronary subclavian steal syndrome
Lucas et al. Numerical simulation of blood fluid in hemodialysis catheters and its thrombogenic potential
Yamada et al. Comparison between blood coagulability in the intra-atrial and peripheral regions during the acute phase after rapid atrial pacing

Legal Events

Date Code Title Description
A621 Written request for application examination

Free format text: JAPANESE INTERMEDIATE CODE: A621

Effective date: 20191108

A977 Report on retrieval

Free format text: JAPANESE INTERMEDIATE CODE: A971007

Effective date: 20200819

A131 Notification of reasons for refusal

Free format text: JAPANESE INTERMEDIATE CODE: A131

Effective date: 20200825

A521 Request for written amendment filed

Free format text: JAPANESE INTERMEDIATE CODE: A523

Effective date: 20201005

A02 Decision of refusal

Free format text: JAPANESE INTERMEDIATE CODE: A02

Effective date: 20201201