JP2020116263A - catheter - Google Patents

Abstract

To provide a catheter that allows the catheter introduced into a blood vessel of an arm to be easily guided to a lower limb blood vessel.SOLUTION: A whole length L1 of a tip shaft part 18 of a catheter 10 is longer than a whole length L2 of a base end shaft part 20. A plurality of slits 26 extending in a direction intersecting with an axial direction of the base end shaft part 20 and penetrating to an inner peripheral surface from an outer peripheral surface of the base end shaft part 20 is formed in at least a portion of the base end shaft part 20. In a treatment method using the catheter 10, the base end shaft part 20 is located in at least a portion of a curved region of a blood vessel connecting a blood vessel of an arm and an aorta.SELECTED DRAWING: Figure 1

Description

The present invention relates to catheters.

For example, Patent Document 1 discloses a so-called over-the-wire type catheter in which a lumen through which a guide wire is inserted is formed over the entire length of the catheter. In such a catheter, since the guide wire and the catheter can be arranged coaxially over the entire length of the catheter, the pushability of the guide wire when passing the guide wire through a lesion (stenosis or occlusion) ( Excellent pushability). Further, Patent Document 1 discloses a method of treating the lesioned part of the lower limb artery by introducing it from the radial artery of the arm using the above catheter.

U.S. Patent Application Publication No. 2014/0358123

The present invention has been made in relation to the catheter as described above, and an object of the present invention is to provide a catheter that can easily guide a catheter introduced into a blood vessel of an arm to a blood vessel of a lower leg.

One aspect of the present invention is a catheter in which a lumen through which a guide wire is inserted is formed over the entire length of a shaft and is introduced from a blood vessel of an arm to a blood vessel of a lower limb, wherein the shaft forms a distal end side of the shaft. A distal shaft portion and a proximal shaft portion extending from the proximal end of the distal shaft portion to the proximal end of the shaft, wherein the total length of the distal shaft portion is longer than the overall length of the proximal shaft portion. A plurality of slits extending in a direction intersecting the axial direction of the base end shaft portion and penetrating from the outer peripheral surface to the inner peripheral surface of the base end shaft portion in at least a part of the base end shaft portion. Is formed, and is a catheter.

According to the present invention, since the plurality of slits are formed in the proximal shaft portion, the proximal shaft portion can be easily bent along the curved portion of the blood vessel connecting the blood vessel of the arm and the aorta. Thereby, the catheter introduced into the blood vessel of the arm can be easily guided to the blood vessel of the lower limb.

It is a schematic structure figure of a catheter concerning one embodiment of the present invention. FIG. 2 is a partially omitted vertical sectional view of the shaft of FIG. 1. FIG. 2 is a partially omitted perspective view of a proximal shaft portion of FIG. 1. 4A is a cross-sectional view taken along line IVA-IVA of FIG. 2, and FIG. 4B is a cross-sectional view taken along line IVB-IVB of FIG. It is explanatory drawing of the manufacturing method of a base end shaft part. 3 is a flowchart for explaining a treatment method using the catheter of FIG. 1. It is a schematic explanatory drawing of the said treatment method. It is a 1st explanatory view of the 2nd arrangement|positioning step of the said treatment method. 9A is a second explanatory diagram of the second placement step of the treatment method, and FIG. 9B is an explanatory diagram of the passing step of the treatment method. It is explanatory drawing of exchange of the guide wire in the said treatment method. 11A is a cross-sectional explanatory view showing a slit according to a modification, FIG. 11B is a cross-sectional explanatory view showing a slit according to another modification, and FIG. 11C is a base of a proximal end shaft portion according to the modification. It is sectional explanatory drawing which shows the shape of an edge part.

Hereinafter, preferred embodiments of the catheter according to the present invention will be described and described with reference to the accompanying drawings.

A catheter 10 according to an embodiment of the present invention shown in FIG. 1 has a guide wire GW in a lesion (stenosis or occlusion) generated in a blood vessel in a percutaneous angioplasty (PTA). It is a medical device used for supporting the guide wire GW when it is passed. Specifically, the catheter 10 is used, for example, to improve a lesioned part of the popliteal artery of the lower limb.

As shown in FIG. 1, the catheter 10 is configured as a so-called over-the-wire type catheter. The catheter 10 includes a flexible hollow shaft 12 and a proximal portion 14 provided at the proximal end of the shaft 12. The shaft 12 is long and has a small diameter. The total length of the shaft 12 is not particularly limited, but is set to 600 mm or more and 3000 mm or less. In particular, when the catheter 10 is introduced from the blood vessel of the arm and guided to the blood vessel of the lower extremity to treat the lesion of the blood vessel of the lower extremity, the total length of the shaft 12 is preferably 1500 mm or more and 2500 mm or less, and more preferably 2300 mm.

In FIG. 2, it is preferable that at least a part of the outer peripheral surface of the shaft 12 is provided with a lubricating layer 16 by coating a hydrophilic material (hydrophilic polymer) or the like. The hydrophilic material is not particularly limited, and examples thereof include a copolymer of methyl vinyl ether and maleic anhydride, a copolymer of dimethyl acrylamide and glycidyl methacrylate, and the like. Accordingly, the shaft 12 can be smoothly and easily inserted into the inner hole of another catheter (guiding catheter) or the blood vessel (living body lumen).

The shaft 12 is formed with a lumen 12a extending along the entire length thereof and through which the guide wire GW is inserted. The lumen 12a extends from the front end of the shaft 12 to the base end thereof with a substantially constant diameter. The diameter of the lumen 12a (the inner diameter of the shaft 12) is not particularly limited, but is set to 0.4 mm or more and 1 mm or less.

As shown in FIG. 1, the shaft 12 includes a distal shaft portion 18 that forms the distal side of the shaft 12, and a proximal end that extends from the proximal end portion of the distal shaft portion 18 to the proximal end (hand portion 14) of the shaft 12. And a shaft portion 20.

The total length L1 of the distal shaft portion 18 is longer than the total length L2 of the proximal shaft portion 20. The total length of the shaft 12, which is the effective length of the catheter 10, is the sum of the total length L1 of the distal shaft portion 18 and the total length L2 of the proximal shaft portion 20. Specifically, the total length L1 of the tip shaft portion 18 is 450 mm or more. In particular, when the catheter 10 is introduced from the blood vessel of the arm to the blood vessel of the lower extremity to treat the lesion of the blood vessel of the lower extremity (when the total length of the shaft 12 is 1500 mm or more), the total length L1 of the distal shaft portion 18 is 1350 mm or more. Is preferably set to. When the total length of the shaft 12 is 2300 mm, the total length L1 of the tip shaft portion 18 is preferably 1700 mm.

Examples of the constituent material of the distal shaft portion 18 include polyolefin (for example, polyethylene, polypropylene, polybutene, ethylene-propylene copolymer, ethylene-vinyl acetate copolymer, ionomer, or a mixture of two or more thereof) and poly. Examples thereof include polymeric materials such as vinyl chloride, polyamide, polyamide elastomer, polyurethane, polyurethane elastomer, polyimide, fluororesin and the like, or a mixture thereof, or two or more kinds of the above polymeric materials.

A tapered surface 19 (see FIG. 2) having a diameter reduced toward the tip is formed on the outer peripheral surface of the tip of the tip shaft portion 18. A reinforcing body (not shown) may be embedded in the wall portion of the tip shaft portion 18. The reinforcing body is not particularly limited, but a spiral coil or rod shape made of tungsten, stainless steel, or the like is preferably used. The tip shaft portion 18 may be provided with a contrast marker (not shown) made of a substance that is opaque to X-rays (radios). Further, a lubricating layer such as PTFE may be provided on the inner surface of the tip shaft portion 18.

The proximal shaft portion 20 is formed in a tubular shape. The proximal shaft portion 20 has higher rigidity than the distal shaft portion 18. Specifically, the proximal shaft portion 20 is made of a material that is harder than the distal shaft portion 18, and thus has higher rigidity than the distal shaft portion 18. Here, the rigidity may be the hardness of the material itself, or the load when the shaft 12 is bent for a certain distance by three-point bending, so-called bending rigidity.

Examples of the constituent material of the proximal shaft portion 20 include a metal material such as stainless steel and a Ni—Ti alloy, or a resin material such as PEEK having higher rigidity (higher material hardness) than the distal shaft portion 18. The proximal shaft portion 20 is joined to the proximal end of the distal shaft portion 18 while being arranged coaxially with the distal shaft portion 18.

In FIG. 2, the inner peripheral surface of the proximal shaft portion 20 is preferably provided with a lubricating layer 22 formed by coating a hydrophilic material (hydrophilic polymer) or the like. As the hydrophilic material, the same material as the lubricating layer 16 described above can be used. Alternatively, the lubricating layer 22 may not be provided on the inner peripheral surface of the proximal shaft portion 20.

As shown in FIGS. 1 to 3, the proximal shaft portion 20 is formed with a plurality of first slit portions 24a and a plurality of second slit portions 24b. The first slit portions 24a and the second slit portions 24b are alternately arranged along the axial direction of the proximal shaft portion 20. The first slit portion 24a and the second slit portion 24b are arranged along the proximal shaft portion 20 so as to be separated from each other.

The distance L3 between the first slit portion 24a and the second slit portion 24b adjacent to each other at the base end portion of the base end shaft portion 20 is equal to the second slit portion 24a and the second slit portion 24a adjacent to each other at the tip end portion of the base end shaft portion 20. It is larger than the distance L4 from the slit portion 24b. In other words, the interval between the first slit portion 24a and the second slit portion 24b that are adjacent to each other becomes smaller toward the distal end direction of the proximal shaft portion 20. That is, the rigidity (bending rigidity) of the proximal shaft portion 20 decreases toward the distal end.

The first slit portion 24a includes two first slits 26a that extend in a direction intersecting the axial direction of the proximal shaft portion 20 and penetrate from the outer peripheral surface to the inner peripheral surface of the proximal shaft portion 20. 2 to 4A, the two first slits 26a are arranged so as to face each other with the lumen 12a interposed therebetween. In other words, the two first slits 26a are arranged apart from each other along the extending direction of the first slits 26a. The first slits 26a are separated from each other by the first wall portion 28a of the proximal shaft portion 20. The distance between the two first slits 26a (the length of the first wall portion 28a) is shorter than the entire length of each first slit 26a (see FIG. 4A).

The first slit 26a extends so as to be inclined with respect to the axial direction of the proximal shaft portion 20 and the radial direction (direction orthogonal to the axial direction). The total length of the first slit 26a is less than half the outer peripheral length of the proximal shaft portion 20 along the extending direction of the first slit 26a. Specifically, the total length of the first slit 26a is preferably set within a range of 85% or more and 95% or less of the outer peripheral length of the proximal shaft portion 20 along the extending direction of the first slit 26a.

As shown in FIG. 1, the inclination angle θ1 of the first slit 26a located at the base end portion of the base end shaft portion 20 is larger than the inclination angle θ2 of the first slit 26a located at the tip end portion of the base end shaft portion 20. .. The inclination angles θ1 and θ2 of the first slit 26a refer to the inclination of the first slit 26a with respect to the line segment along the axial direction of the proximal shaft portion 20.

The width dimension of the first slit 26a is set to more than 0% and 50% or less, preferably 10% or more and 40% or less of the thickness dimension of the wall portion of the proximal shaft portion 20. In other words, the width dimension of the first slit 26a is preferably set to 20 μm or more and 30 μm or less. In this case, when priming the lumen 12a of the catheter 10, it is possible to prevent the priming liquid (physiological saline) from leaking from the lumen 12a to the outside through the first slit 26a.

The second slit portion 24b includes two second slits 26b extending in a direction intersecting with the axial direction of the proximal shaft portion 20 and penetrating from the outer peripheral surface to the inner peripheral surface of the proximal shaft portion 20. In FIGS. 2, 3 and 4B, the two second slits 26b are arranged so as to face each other with the lumen 12a interposed therebetween. In other words, the two second slits 26b are arranged apart from each other along the extending direction of the second slits 26b. The second slits 26b are separated from each other by the second wall portion 28b of the proximal shaft portion 20. The spacing between the two second slits 26b (the length of the second wall portion 28b) is shorter than the entire length of each second slit 26b (see FIG. 4B).

The second slit 26b is basically configured similarly to the above-mentioned first slit 26a. Therefore, detailed description of the second slit 26b is omitted. Hereinafter, when the first slit portion 24a and the second slit portion 24b are not distinguished, they are referred to as "slit portions 24", and when the first slit 26a and the second slit 26b are not distinguished, they are referred to as "slits 26". There is.

As shown in FIG. 5, such a proximal shaft portion 20 is manufactured by laser processing the tube member 40, for example. Specifically, while rotating the tube member 40 around its axis and moving the tube member 40 in the direction of arrow A with respect to the laser beam 42, the laser beam 42 is directed from the outside in the radial direction of the tube member 40 to the outer peripheral surface of the tube member 40. Irradiate. Accordingly, the slit 26 can be easily formed on the outer peripheral surface of the tube member 40.

The method of manufacturing the proximal shaft portion 20 is not limited to the example of FIG. In the method of manufacturing the proximal shaft portion 20, the slit 26 may be formed by moving the laser light 42 with respect to the tube member 40. Further, in the method for manufacturing the proximal shaft portion 20, the slit 26 may be formed by machining the wall portion of the tube member 40.

As shown in FIG. 1, the proximal portion 14 is for operating the shaft 12, and has a hollow hub 30 having an inner hole 30a communicating with the lumen 12a. The hub 30 is formed in a size that can be easily operated by human hands. The hub 30 has higher rigidity than the shaft 12. The hub 30 is formed with a groove 32 extending from the base end of the hub 30 toward the distal end and guiding the guide wire GW to the lumen 12a. Alternatively, a hub without the groove 32 may be used.

In such a catheter 10, the rigidity of the proximal shaft portion 20 is higher than the rigidity of the distal shaft portion 18. Therefore, even with the long shaft 12 that is inserted from the blood vessel of the arm to the blood vessel of the lower limb, the torque input to the proximal portion 14 can be reliably transmitted to the distal end portion of the shaft 12. Further, since the plurality of slits 26 are formed in the proximal shaft portion 20, the proximal shaft portion 20 can be easily formed along a curved blood vessel (a blood vessel having a relatively small radius of curvature) between the blood vessel of the arm and the aorta. Can be bent to Therefore, the tip portion of the shaft 12 can be efficiently guided to the lower limb blood vessel.

As shown in FIG. 2, the guide wire GW used together with such a catheter 10 is a linear member having appropriate rigidity and appropriate flexibility, and has an outer diameter slightly smaller than the diameter of the lumen 12a. Have a diameter. The total length of the guide wire GW is longer than the total length of the catheter 10. The distal end portion of the guide wire GW is shaped so as to bend in the axial direction of the guide wire GW. The distal end of the guide wire GW is formed in an R shape (for example, hemispherical shape) in order to prevent damage to the catheter 10 and living tissue. However, the guide wire GW may have an arbitrary shape.

Next, a treatment method using the above catheter 10 will be described. Here, as shown in FIGS. 6 and 7, the catheter 10 introduced into the radial artery 200 from the arm 102 of the patient 100 is guided to the popliteal artery 220 of the leg 104 to treat the lesioned part 300 generated in the popliteal artery 220. I will describe how to do.

As shown in FIG. 6, the treatment method using the catheter 10 includes a first placement step (step S1), a catheter preparation step (step S2), a priming step (step S3), a second placement step (step S4), It includes a passing step (step S5) and a removing step (step S6).

First, in the first placement step (step S1), the operator punctures the radial artery 200 with a sheath introducer (not shown) by the Seldinger method and, as shown in FIG. 7, precedes the guiding wire GW with the guiding catheter. 50 is inserted into the radial artery 200 of the patient 100. The guiding catheter 50 is connected to the radial artery 200, brachial artery 202, subclavian artery 204, brachiocephalic artery 206, aorta (aortic arch 208, thoracic aorta 210, abdominal aorta 212), common iliac artery 214, external iliac The guiding catheter 50 is delivered to the femoral artery 218 via the artery 216.

In addition, in the catheter preparation step (step S2), the operator prepares the catheter 10 described above. Then, in the priming step (step S3), the operator fills the lumen 12a of the catheter 10 with a priming liquid (physiological saline). At this time, since the lubricating layer 22 is provided on the inner peripheral surface of the base end shaft portion 20, bubbles (air bubbles) generated during priming can be efficiently discharged.

Then, in the second placement step (step S4), the operator inserts the catheter 10 into the inner hole 50a of the guiding catheter 50 with the guide wire GW passed through the lumen 12a of the catheter 10, and the distal end portion of the catheter 10 is inserted. The catheter 10 is arranged so that the protrusions protrude from the tip of the guiding catheter 50 (see FIG. 9A).

Specifically, the operator inserts the catheter 10 from the proximal end side of the guide wire GW. That is, the guide wire GW is passed from the distal end side of the catheter 10 through the lumen 12a of the shaft 12 and the inner hole 30a of the hub 30, and the guide wire GW is led out from the proximal end of the catheter 10. As a result, the guide wire GW is inserted through the entire length of the catheter 10. At this time, since the lubricating layer 22 is formed on the inner circumferential surface of the proximal shaft portion 20, the guide wire GW can be smoothly inserted into the catheter 10.

Then, the operator advances the catheter 10 through the inner hole 50a of the guiding catheter 50, and positions the tip of the catheter 10 slightly proximal to the tip of the guide wire GW (see FIG. 9A). At this time, as shown in FIG. 8, the proximal shaft portion 20 is located at a curved portion (a portion having a relatively small radius of curvature) of the blood vessel connecting the blood vessel of the arm and the aorta. Specifically, the proximal shaft portion 20 is located in the radial artery 200, the brachial artery 202, the subclavian artery 204, and the brachiocephalic artery 206 (see FIGS. 7 and 8).

In the second placement step, the proximal shaft portion 20 is preferably located in at least a part of the subclavian artery 204. However, there are individual differences in the length and shape of the blood vessel of the patient 100. Therefore, in the second arranging step, the proximal shaft portion 20 may be located at least at a part of the curved portion of the blood vessel that connects the blood vessel of the arm and the aorta. That is, in the second placement step, the proximal shaft portion 20 may be located in the radial artery 200 and the brachial artery 202, and may not be located in the subclavian artery 204 and the brachiocephalic artery 206.

Then, in the passing step (step S5), the operator holds the proximal end side of the guide wire GW and pushes it in the distal direction while the catheter 10 is projected from the distal end of the guiding catheter 50. The tip of the GW is passed through the lesioned part 300 (see FIG. 9B).

At this time, a reaction force from the lesioned part 300 acts on the guide wire GW, but since the inner surface of the distal end shaft portion 18 longer than the proximal end shaft portion 20 contacts and supports the guide wire GW, the guide wire GW is supported. It is possible to prevent the GW from bending in the direction orthogonal to the axis thereof. Thereby, the pushing force of the operator can be efficiently transmitted to the distal end portion of the guide wire GW. Therefore, the guide wire GW can be easily passed through the lesioned part 300.

Next, in the removal step (step S6), the operator removes the catheter 10 outside the body while keeping the guide wire GW passing through the lesion portion 300.

After that, various treatment catheters such as an atherectomy catheter, a balloon catheter, a stent delivery catheter, a drug-coated balloon catheter, and a drug-coated stent delivery catheter are inserted along the guide wire GW to remove the calcified lesion of the lesion 300, Expansion, drug application, stent placement, etc. are performed. Two or more therapeutic catheters may be used. After the treatment is completed, the operator removes the treatment catheter and the guiding catheter 50 out of the body.

By the way, in the above-mentioned treatment method using the catheter 10, the guide wire GW may be exchanged with the shaft 12 of the catheter 10 left inside the blood vessel (inside the inner hole 50a of the guiding catheter 50). In this case, the guide wire GW is removed with the catheter 10 left inside the blood vessel, and another guide wire GW1 is inserted from the proximal end side of the catheter 10 in the distal direction as shown in FIG. At this time, if the width dimension of the first slit 26a and the second slit 26b exceeds 0% of the radius of curvature of the distal end portion of the guide wire GW1 to be inserted and is set to 20% or less, the distal end of the guide wire GW1. It is possible to prevent the portion from being caught in the slit 26.

The guide wire GW and the catheter 10 may be replaced with one having a different hardness or thickness depending on the hardness of the lesion, the size of the guide wire lumen of the therapeutic catheter, or the meandering of the blood vessel to the lesion. ..

The treatment method using the catheter 10 is not limited to the example described above. INDUSTRIAL APPLICABILITY The present invention is a method for treating a lesioned part formed in the anterior tibial artery 222, the posterior tibial artery 224, the peripheral blood vessel 226, etc. of the leg 104 by using the catheter 10 introduced into the radial artery 200 from the arm 102 of the patient 100. (See FIG. 7). Alternatively, the present invention uses the catheter 10 introduced into the radial artery 200 from the arm 102 of the patient 100 to use the common iliac artery 214, the external iliac artery 216, the internal iliac artery, the common femoral artery, the superficial femoral artery, and the deep femoral artery. It may be a method of treating a lesion part occurring in the femoral artery, these peripheral blood vessels, collateral blood vessels and the like.

In this case, the catheter 10 and the treatment method using the catheter 10 according to the present embodiment have the following effects.

In the catheter 10, the shaft 12 has a distal shaft portion 18 that forms the distal side of the shaft 12, and a proximal shaft portion 20 that extends from the proximal end of the distal shaft portion 18 to the proximal end of the shaft 12. The total length L1 of the distal shaft portion 18 is longer than the total length L2 of the proximal shaft portion 20. At least a part of the proximal shaft portion 20 has a plurality of slits 26 extending in a direction intersecting the axial direction of the proximal shaft portion 20 and penetrating from the outer peripheral surface to the inner peripheral surface of the proximal shaft portion 20. Are formed.

In addition, the treatment method using the catheter 10 includes a first placement step of introducing the guiding catheter 50 from the blood vessel of the arm and placing the tip of the guiding catheter 50 in the blood vessel of the lower limb, and a catheter preparation for preparing the catheter 10. Step and insert the catheter 10 into the inner hole 50a of the guiding catheter 50 with the guide wire GW passing through the lumen 12a of the shaft 12 so that the distal end of the catheter 10 projects from the distal end of the guiding catheter 50. The second placement step of placing 10 and the passing step of passing the guide wire GW through the lesioned part 300 of the lower extremity blood vessel after the second placement step, and the catheter 10 with the guide wire GW passed through the lesioned part 300. And a removal step of removing it outside the body. In the second arranging step, the proximal shaft portion 20 is positioned at least at a part of the curved portion of the blood vessel that connects the blood vessel of the arm and the aorta.

According to the present invention, since the plurality of slits 26 are formed in the proximal shaft portion 20, it is possible to easily bend the proximal shaft portion 20 along the curved portion of the blood vessel that connects the blood vessel of the arm and the aorta. it can. Accordingly, the catheter 10 introduced into the blood vessel of the arm can be easily guided to the blood vessel of the lower limb.

The rigidity of the proximal shaft portion 20 is higher than the rigidity of the distal shaft portion 18.

With such a configuration, the torque input to the proximal end portion of the catheter 10 can be efficiently transmitted to the distal shaft portion 18. Therefore, the catheter 10 introduced into the blood vessel of the arm can be efficiently guided to the blood vessel of the lower limb.

The plurality of slits 26 are arranged apart from each other along the axial direction of the shaft 12.

According to such a configuration, the proximal shaft portion 20 can be more easily bent.

The interval L3 between the slits 26 adjacent to each other in the axial direction of the proximal shaft portion 20 at the proximal end portion of the proximal end shaft portion 20 is defined by the slits 26 adjacent to each other in the axial direction of the proximal end shaft portion 20 at the distal end portion of the proximal end shaft portion 20. Is larger than the interval L4.

It is possible to make the distal end side of the proximal end shaft portion 20 that is easily located at the curved portion of the blood vessel connecting the blood vessel of the arm and the aorta bend more easily than the proximal end side.

The slits 26 that are adjacent to each other along the axial direction of the proximal shaft portion 20 are out of phase with each other in the circumferential direction of the proximal shaft portion 20.

With such a configuration, the proximal shaft portion 20 can be provided with appropriate rigidity.

The plurality of slits 26 are arranged apart from each other along the extending direction of each of the plurality of slits 26.

According to such a configuration, the proximal shaft portion 20 can be more easily bent.

A lubricating layer 22 is provided on the inner peripheral surface of the proximal shaft portion 20.

With such a configuration, it is possible to efficiently remove air bubbles from the inside of the proximal shaft portion 20 when priming the catheter 10.

A proximal portion of the proximal shaft portion 20 is provided with a proximal portion 14 for operating the shaft 12.

With such a configuration, the torque can be efficiently transmitted to the distal end portion of the shaft 12 by operating the hand portion 14.

The proximal portion 14 includes a hollow hub 30 having an inner hole 30a communicating with the lumen 12a.

According to such a configuration, since the hand portion 14 is the hub 30, the configuration can be simplified.

The hub 30 is formed with a groove 32 extending from the base end of the hub 30 toward the distal end and guiding the guide wire GW to the lumen 12a.

With such a configuration, the guide wire GW can be inserted into the lumen 12a of the catheter 10 along the groove 32.

The shape of the slit 26 can be set arbitrarily. The width dimension of the slit 34 shown in FIG. 11A changes in the thickness direction of the wall portion of the proximal shaft portion 20. Specifically, in the slit 34, the width dimension of the central portion of the proximal end shaft portion 20 in the thickness direction is smaller than the width dimension of the proximal end shaft portion 20 on the peripheral surface (inner peripheral surface and outer peripheral surface) side. ing. In other words, the wall surface forming the slit 34 is formed into a convex curved surface.

In this case, the same effect as that of the slit 26 described above is obtained. In addition, it is possible to prevent the priming liquid from leaking from the slit 34 when the catheter 10 is primed. Further, when the guide wire GW is exchanged with the shaft 12 of the catheter 10 left in the blood vessel, the distal end of the guide wire GW1 inserted into the lumen 12a from the proximal end side of the catheter 10 may be caught in the slit 34. It can be effectively suppressed.

The slit 36 shown in FIG. 11B extends linearly from the outer peripheral surface of the proximal shaft portion 20 toward the inner peripheral surface so as to be inclined in the distal direction of the proximal shaft portion 20. In this case, the same effect as that of the slit 26 described above is obtained. Further, when the priming liquid is introduced into the lumen 12a from the proximal end side during the priming of the catheter 10, it is possible to prevent the priming liquid from leaking from the slit 36. Furthermore, when exchanging the guide wire GW with the shaft 12 of the catheter 10 left in the blood vessel, the distal end of the guide wire GW1 inserted into the lumen 12a from the proximal end side of the catheter 10 may be caught in the slit 36. It can be effectively suppressed.

The catheter 10 may not be provided with the hand portion 14. In this case, as shown in FIG. 11C, the inner diameter of the base end portion of the base end shaft portion 20 may be increased toward the base end direction of the base end shaft portion 20. That is, the base end portion of the base end shaft portion 20 may be flared. In this case, the guide wire GW can be easily inserted into the lumen 12a from the proximal end side of the proximal shaft portion 20.

The slit portion 24 may include one slit 26 or three or more slits 26. The slit 26 may extend along the circumferential direction of the proximal shaft portion 20. The intervals between the slit portions 24 adjacent to each other may be the same over the entire length of the proximal shaft portion 20.

The present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the gist of the present invention.

10... Catheter 12... Shaft 12a... Lumen 14... Hand part 16, 22... Lubrication layer 18... Tip shaft part 20... Proximal shaft part 24... Slit part 26, 34, 36... Slit 30... Hub GW... Guide wire

Claims (13)

A catheter in which a lumen through which a guide wire is inserted is formed over the entire length of a shaft and which is introduced from a blood vessel of an arm to a blood vessel of a lower leg,
The shaft is
A tip shaft portion forming the tip side of the shaft,
A proximal end shaft portion extending from the proximal end of the distal shaft portion to the proximal end of the shaft,
The total length of the distal shaft portion is longer than the total length of the proximal shaft portion,
At least a part of the proximal shaft portion has a plurality of slits extending in a direction intersecting the axial direction of the proximal shaft portion and penetrating from the outer peripheral surface to the inner peripheral surface of the proximal shaft portion. A formed catheter. The catheter of claim 1, wherein
The catheter, wherein the rigidity of the proximal shaft portion is higher than the rigidity of the distal shaft portion. The catheter according to claim 1 or 2, wherein
The catheter wherein the plurality of slits are arranged apart from each other along the axial direction of the shaft. The catheter according to claim 3,
The distance between the slits adjacent to each other in the axial direction of the proximal shaft portion at the proximal end portion of the proximal end shaft portion is greater than the distance between the slits adjacent to each other in the axial direction of the proximal end shaft portion at the distal end portion of the proximal end shaft portion. Also large, catheter. The catheter according to claim 3 or 4, wherein
The catheter in which the slits adjacent to each other along the axial direction of the proximal shaft portion are out of phase in the circumferential direction of the proximal shaft portion. The catheter according to any one of claims 1 to 5,
The plurality of slits are spaced apart from each other along the extending direction of each of the plurality of slits. The catheter according to any one of claims 1 to 6,
The plurality of slits extend from the outer peripheral surface of the proximal shaft portion toward the inner peripheral surface so as to be inclined in the distal direction of the shaft. The catheter according to any one of claims 1 to 7,
A catheter in which a lubricating layer is provided on the inner peripheral surface of the proximal shaft portion. The catheter according to any one of claims 1 to 8, wherein:
A catheter, wherein a proximal portion of the proximal shaft portion is provided with a proximal portion for operating the shaft. The catheter according to claim 9,
The catheter comprises a hollow hub having an inner hole communicating with the lumen. The catheter according to claim 10, wherein
The catheter, wherein the hub has a groove portion extending from the proximal end of the hub toward the distal end and guiding the guide wire to the lumen. The catheter according to any one of claims 1 to 8, wherein:
The catheter, wherein the inner diameter of the proximal end portion of the proximal shaft portion is increased in the proximal direction of the proximal shaft portion. A treatment method using a catheter in which a lumen through which a guide wire is inserted is formed over the entire length of a shaft,
The shaft is
A tip shaft portion forming the tip side of the shaft,
A proximal end shaft portion extending from the proximal end of the distal shaft portion to the proximal end of the shaft,
The total length of the distal shaft portion is longer than the total length of the proximal shaft portion,
The proximal shaft portion is formed with a plurality of slits extending in a direction intersecting the axial direction of the proximal shaft portion and penetrating from the outer peripheral surface to the inner peripheral surface of the proximal shaft portion,
A first arranging step of introducing a guiding catheter from a blood vessel of an arm and arranging a tip portion of the guiding catheter in a blood vessel of a lower limb;
A catheter preparation step of preparing the catheter,
The catheter is inserted into the inner hole of the guiding catheter while the guide wire is passed through the lumen of the shaft, and the catheter is arranged so that the distal end of the catheter projects from the distal end of the guiding catheter. A second placement step,
A passing step of passing the guide wire through the lesioned part of the lower extremity blood vessel after the second placement step;
A withdrawal step of withdrawing the catheter outside the body while passing the guide wire through the lesion site,
In the second arranging step, a treatment method using a catheter, wherein the proximal shaft portion is positioned at at least a part of a curved portion of a blood vessel connecting the blood vessel of the arm and the aorta.

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