JP2020156891A - Contrast medium injection catheter - Google Patents

Abstract

To provide a contrast medium injection catheter that is easy to insert into a narrow body cavity and easy to inject a contrast medium.SOLUTION: A contrast medium injection catheter 10 is configured such that a wire insertion port 17 is sealed when an elastic member 18 is compressed by a pressing portion 23 while a guide wire G or a stylet wire S is inserted through the elastic member 18. When a catheter 40 is inserted into an endoscope, it can be smoothly inserted while the stylet wire S is inserted. Thus, the stylet wire S is pulled out, the guide wire G is inserted, and the wire insertion port 17 is sealed, and then the contrast medium can be injected. This means that the inner diameter of the catheter can be made relatively large and that the outer diameter of the catheter can be made relatively small, allowing easy insertion into a narrow body cavity and easy injection of the contrast medium.SELECTED DRAWING: Figure 2

Description

The present invention is a contrast agent injection catheter that is inserted into a body cavity through an endoscope, specifically into the bile duct or pancreatic duct, and used to inject a contrast medium into the bile duct or pancreatic duct (hereinafter, simply, simply, It is also referred to as a "contrast medium injection catheter").

When taking an X-ray photograph of the bile duct or pancreatic duct, a contrast medium injection catheter is inserted from the papilla of Vater into the bile duct or pancreatic duct through an endoscope inserted from the nose or mouth to the duodenum, and the contrast medium is inserted into the bile duct or pancreatic duct. Inject. For example, the following catheters for injecting a contrast medium have been proposed.

Japanese Unexamined Patent Publication No. 2014-11348 Japanese Unexamined Patent Publication No. 2018-015086

Patent Document 1 includes a first lumen into which a guide wire is inserted, and a second lumen for injecting a contrast medium on the outer peripheral side of the first lumen for injection of a contrast medium. The catheter is disclosed.

Patent Document 2 discloses a catheter for injecting a contrast medium, which is on the proximal end side of the catheter and has a check valve at the insertion port of the guide wire so that the contrast medium can be injected without pulling out the guide wire. There is. In Patent Document 2, the term "slilet wire" is used to mean a guide wire in the present specification, but it is different from the stylet wire in the present specification.

By the way, a catheter for injecting a contrast medium, which is inserted into a bile duct or a pancreatic duct, is generally made of a highly flexible material. When such a contrast medium injection catheter is inserted into an endoscope, the catheter bends and is caught inside the endoscope, so that a predetermined strength is given to the catheter so that the catheter can be smoothly inserted into the endoscope. I need to let you. As a method for this, there is a method in which a stylet wire is inserted inside the catheter. The stylet wire is usually pre-inserted into the catheter and is separate from the guide wire. The guide wire can move the inside of the catheter forward and backward, and is inserted into the body cavity so as to extend beyond the catheter and is used to move the catheter forward and backward along the guide wire. It is a thing. Since the guide wire and the stylet wire have different uses, the materials and structures are different.

The contrast medium injection catheters disclosed in Patent Documents 1 and 2 do not include the stylet wire as described above. In this regard, the catheter of Patent Document 1 is provided with a second lumen for injecting a contrast medium on the outer periphery of the first lumen, so that the catheter as a whole is thick and there is no stylet wire. , Can retain the strength to be inserted through the endoscope. However, the catheter has a relatively large diameter and may not be suitable as a catheter to be inserted into a narrow body cavity such as a bile duct or a pancreatic duct.

Since the contrast medium injection catheter of Patent Document 2 does not have a stylet wire, it is necessary to thicken the catheter in order to impart strength for insertion into the endoscope. Then, like the catheter of Patent Document 1, the catheter has a relatively large diameter and may not be suitable as a catheter to be inserted into a narrow body cavity.

Further, since the contrast medium is a liquid having a high viscosity, if the space in the catheter is narrow, the injection resistance of the contrast medium is large, which causes a problem that it is difficult to inject the contrast medium.

Therefore, in view of the above-mentioned problems, an object of the present invention is to provide a contrast medium injection catheter that can be easily inserted into a narrow body cavity and easily inject a contrast medium.

The present invention includes a tubular catheter and
It has a connector attached to the proximal end side of the catheter and having a contrast medium injection port and a wire insertion port communicating with the inside of the catheter.
An elastic member having a hole through which either a guide wire or a stylet wire can be inserted is arranged in the wire insertion port.
A slider member provided so as to be able to move forward and backward with respect to the connector is provided.
The slider member includes a pressing portion that compresses or releases the elastic member from the compressed state.
A contrast medium injection characterized in that the guide wire or stylet wire is inserted through the elastic member, and the wire insertion port is sealed when the elastic member is compressed by the pressing portion. The above-mentioned problem was solved by the catheter.

According to the present invention, an elastic member having a hole through which either a guide wire or a stylet wire can be inserted is provided at the wire insertion port, and a slider member provided so as to be able to move forward and backward with respect to the connector is provided. The slider member includes a pressing portion that compresses or releases the elastic member from the compressed state, and when a guide wire or a stylet wire is inserted through the elastic member and the elastic member is compressed by the pressing portion, a wire insertion port is provided. Is configured to be hermetically sealed so that when inserting the catheter into the endoscope, the stylet wire can be inserted smoothly with the stylet wire inserted, and then the stylet wire is pulled out to guide it. The wire can be inserted, the tip of the catheter can be positioned at a desired location in the body, the wire insertion port can be sealed, and then the contrast agent can be injected. That is, the stylet wire can give the catheter strength for smooth insertion into the endoscope, so that the catheter can be made thinner. In other words, the inner diameter of the catheter can be made relatively large, and the outer diameter of the catheter can be made relatively small. Therefore, it is easy to insert it into a narrow body cavity. Further, when the contrast medium is injected, only the guide wire is inserted into the catheter, and as described above, the inner diameter of the catheter can be made relatively large, so that the contrast medium can be easily injected. It can be a catheter for injection of contrast medium.

Further, the pressing portion of the slider member is movable in the axial direction in the wire insertion port, and the elastic member is compressed by pressing the elastic member toward the tip end side of the connector, and is concentric with the hole of the elastic member. If the configuration is provided with a wire guide path, the guide wire can be easily inserted from the wire guide path into the hole of the elastic member and, by extension, into the inside of the catheter. If the wire guide path is tapered so that the diameter decreases from the base end side to the tip end side, the guide wire can be further easily inserted.

If the surface area of the tip of the pressing portion of the slider member is smaller than the surface area of the surface of the elastic member facing the tip of the pressing portion, the reaction force received by the compressed elastic member can be reduced. Therefore, the airtightness of the wire insertion port can be improved.

Further, if the slider member is fixed at the position where the elastic member is compressed and is provided with a lock member capable of releasing the fixed state, the sealed state of the wire insertion port can be easily maintained. Can be done.

Further, a plate-shaped elastic body having a connector having an engaging portion and a lock member provided on the slider member and extending toward the outer diameter side toward the tip side, and an engaging member provided on the plate-shaped elastic body. If the slider member is fixed at the position where the elastic member is compressed by engaging the engaging portion of the connector and the engaging member of the plate-shaped elastic body, the slider member is securely fixed. be able to.

Further, if the slider member is provided with a hooking member and the connector is provided with a hooking portion for hooking the hooking member with respect to the base end side, it is possible to prevent the slider member from falling off from the connector. , It is possible to prevent an accident due to the slider member falling off.

Further, by making the outer diameter in the range of 15 cm from the tip of the catheter smaller than the outer diameter in the other range of the catheter, it is possible to obtain a contrast medium injection catheter that is easier to insert into a narrow body cavity.

Further, if the catheter is further provided with a nipple incision wire and a nipple incision wire lumen through which the nipple incision wire is inserted, a body cavity having a small diameter that makes it difficult to insert the tip of the catheter is incised as needed. It can be a catheter for injecting a contrasting agent.

The front view of the 1st Embodiment of this invention. A cross-sectional view along an axial direction showing a main part of the first embodiment of the present invention. The figure in the state where the elastic member of FIG. 2 is compressed. A cross-sectional view taken along the axial direction showing a main part of the second embodiment of the present invention. A cross-sectional view taken along the axial direction showing a main part of the catheter according to the third embodiment of the present invention.

Hereinafter, embodiments of the present invention will be described with reference to FIGS. 1 to 5. However, the present invention is not limited to this embodiment.

As shown in FIG. 1, the contrast medium injection catheter 10 has a catheter 40 and a connector 12. The catheter 40 is tubular and has a hollow interior. The connector 12 is attached to the proximal end side of the catheter 40 and has a separate contrast agent injection port 30 and a wire insertion port 17 (see FIG. 2). A slider member 20 is connected to the connector 12. The slider member 20 is provided so as to be able to move forward and backward with respect to the connector 12. The catheter 40, the connector 12, and the slider member 20 may be made of a known resin material such as plastic.

FIG. 2 is a cross-sectional view of a main part of the contrast medium injection catheter 10 along the axial direction. As shown in FIG. 2, a communication hole 15 is formed in the connector 12, and the communication hole 15 communicates with the inside of the catheter 40, that is, the lumen 42 and the contrast medium injection port 30. And communicate with the wire insertion port 17. The contrast medium passage 32 is displayed for convenience of explanation, and is different from the position shown in FIG. Further, the inside of the connector 12 and the catheter 40 are in close contact with each other or sealed so that a liquid such as a contrast medium does not leak out.

An elastic member 18 is arranged in the wire insertion port 17 at a position adjacent to the communication hole 15. The elastic member 18 is made of a material such as silicon rubber. The elastic member 18 is provided with a hole 19 through which either a guide wire or a stylet wire can be inserted. The holes 19 of the elastic member 18 are provided so as to communicate with the communication holes 15.

The slider member 20 includes a pressing portion 23 facing the elastic member 18. Further, the slider member 20 has a hollow inside, and a wire guide path 27 and a wire opening 28 are formed. The wire guide path 27 is provided so as to communicate with the hole 19 of the elastic member 18. Here, the hole 19 of the elastic member 18 and the wire guide path 27 are preferably concentric so that the user of the contrast medium injection catheter 10 can easily insert and remove the guide wire or the stylet wire, and further, the wire guide. As shown in the figure, it is desirable that the road 27 has a tapered shape in which the diameter decreases from the proximal end side toward the distal end side.

As shown in the figure, the contrast medium injection catheter 10 has a predetermined number of contacts from the wire opening 28 of the slider member 20 to the lumen 42 of the catheter 40 before the catheter 40 is inserted into an endoscope (not shown). A stylet wire S having dimensions and strength is inserted in advance and used. The stylet wire S can be pulled out when the catheter 40 passes through the inside of the endoscope and reaches the human body or the like. After that, a guide wire G (see FIG. 3) is inserted into the lumen 42 of the catheter 40 from the wire opening 28, extends from the tip of the catheter 40 and is inserted into the body cavity, and the guide wire G moves the catheter 40 forward and backward. You will be guided.

As described above, the slider member 20 is provided so as to be able to move forward and backward with respect to the connector 12, and the pressing portion 23 of the slider member 20 is movable in the axial direction in the wire insertion port 17. The user of the contrast medium injection catheter 10 can grasp the handle portion 22 of the slider member 20 and move the slider member 20 forward and backward with respect to the connector 12. Here, the slider member 20 includes a hooking member 24, and when the slider member 20 moves forward and backward with respect to the connector 12, the hooking member 24 is inside the notch 14 of the connector 12 (see also FIG. 1). To move. Since the connector 12 includes a hooking portion 14a that hooks the hooking member 24 to the base end side, it is possible to prevent the slider member 20 from falling off from the connector 12, and the slider member 20 falls off. Accidents can be prevented.

FIG. 3 shows a state in which the slider member 20 is moved to the tip end side of the connector 12 and the pressing portion 23 compresses the elastic member 18. In the state shown in FIG. 3, the pressing portion 23 of the slider member 20 compresses the elastic member 18, and the elastic member 18 is in close contact with the tip wall 11 of the wire insertion port 17 of the connector 12 and the guide wire G. There is. As a result, the wire insertion port 17 is sealed, and the contrast medium injected into the contrast medium passage 32 from the contrast medium injection port 30 using a syringe or the like (not shown) does not flow into the wire insertion port 17, and the lumen 42 of the catheter 40 Inflow only against.

As described above, in the contrast medium injection catheter 10, when the catheter 40 is inserted into the endoscope, it can be smoothly inserted with the stylet wire S inserted, and then the stylet wire S is pulled out. Then, the guide wire G can be inserted, the tip of the catheter 40 can be positioned at a desired position in the body, the wire insertion port 17 can be sealed, and then the contrast medium can be injected. Therefore, the stylet wire S can impart strength to the catheter 40 for smooth insertion into the endoscope, so that the catheter 40 can be made thinner. That is, the inner diameter of the catheter 40 can be made relatively large, and the outer diameter of the catheter 40 can be made relatively small. Therefore, it is easy to insert it into a narrow body cavity. Further, when the contrast medium is injected, only the guide wire G is inserted into the catheter 40, and the inner diameter of the catheter 40 can be made relatively large, so that the contrast medium can be easily injected. It is.

A lock member that can fix the slider member 20 at the position of the slider member 20 when the elastic member 18 is compressed by the pressing portion 23 and the wire insertion port 17 is sealed, and can release the fixed state. It is preferable to have a configuration including 21. In the contrast medium injection catheter 10, the lock member 21 is composed of a protrusion-shaped engaging member 26 provided on the slider member 20 and a hole-shaped engaging portion 16 provided on the connector 12. In the contrast medium injection catheter 10, the engaging portion 16 and the engaging member 26 are provided at two locations in the circumferential direction, but may be one or three or more locations. The engaging member 26 may have a different shape such as a claw shape as well as a protrusion shape, and the engaging portion 16 may have a concave shape or a hole shape.

When the slider member 20 is moved to the tip end side of the connector 12 from the state shown in FIG. 2 and the pressing portion 23 compresses the elastic member 18, the engaging member 26 engages with the engaging portion 16 as shown in FIG. Then, the position of the slider member 20 is fixed. On the contrary, when the slider member 20 is moved from the state shown in FIG. 3 to the base end side of the connector 12, the engaging member 26 and the engaging portion 16 are disengaged, and the fixed state of the slider member 20 is released. To. By providing the lock member 21 in this way, the sealed state of the wire insertion port 17 can be easily maintained, so that the catheter for injecting the contrast medium can be easily operated. ..

Further, as shown in FIG. 1, if the outer diameter of the range 44 15 cm from the tip of the catheter 40 is smaller than the outer diameter other than the range A of the catheter 40, the contrast medium can be easily inserted into a narrow body cavity. The agent injection catheter 10 can be used.

FIG. 4 shows the contrast medium injection catheter 10a of the second embodiment of the present invention. Since the contrast medium injection catheter 10a basically has the same configuration as the contrast medium injection catheter 10 shown in FIGS. 1 to 3, different points will be described below.

The slider member 20a of the contrast medium injection catheter 10a has a pressing portion 23a. The surface area of the tip of the pressing portion 23a is smaller than the surface area of the surface of the elastic member 18 facing the tip of the pressing portion 23a. With this configuration, the reaction force received by the compressed elastic member 18 on the pressing portion 23a can be reduced, so that the airtightness of the wire insertion port 17 can be improved. Therefore, it is possible to prevent the contrast medium from leaking from the hole 19 of the elastic member 18.

Further, like the lock member 21a of the contrast medium injection catheter 10a, the engaging member 26a may be provided on the plate-shaped elastic body 29 extending from the slider member 20a toward the tip end side toward the outer diameter side. According to this configuration, the slider member 20a can be reliably fixed at the position where the elastic member 18 is compressed by the pressing portion 23a.

As shown in FIG. 5, the catheter 40a may further include a nipple incision wire W and a nipple incision wire lumen 46 through which the nipple incision wire W is inserted. Since the nipple incision wire is known, detailed description thereof will be omitted, but with this configuration, a contrast medium injection capable of incising a body cavity having a small diameter that makes it difficult to insert the tip of the catheter 40a is possible. The catheter 10b can be used.

As described above, according to the present invention, it is possible to provide a contrast medium injection catheter that can be easily inserted into a narrow body cavity and easily inject a contrast medium.

10, 10a, 10b Catheter for injection of contrast agent 12 Connector 14a Hooking part 16 Engaging part 17 Wire insertion port 18 Elastic member 19 Holes 20, 20a Slider member 21,21a Locking member 23, 23a Pressing part 24 Hooking member 26, 26a Engagement member 27 Wire guide path 29 Plate-shaped elastic body 30 Contrast agent injection port 40, 40a Catheter 46 Wire lumen for papillary incision G guide wire S Stylet wire W Papillary incision wire

Claims (9)

Tubular catheter and
It has a connector attached to the proximal end side of the catheter and having a contrast medium injection port and a wire insertion port communicating with the inside of the catheter.
An elastic member having a hole through which either a guide wire or a stylet wire can be inserted is arranged in the wire insertion port.
A slider member provided so as to be able to move forward and backward with respect to the connector is provided.
The slider member includes a pressing portion that compresses or releases the elastic member from the compressed state.
The guide wire or stylet wire is inserted into the elastic member, and when the elastic member is compressed by the pressing portion, the wire insertion port is sealed.
Contrast injection catheter. The pressing portion is movable in the axial direction in the wire insertion port, and is configured so that the elastic member is compressed by pressing the elastic member toward the tip end side of the connector, and the wire guide concentric with the hole. The contrast medium injection catheter according to claim 1, which comprises a path. The contrast medium injection catheter according to claim 2, wherein the surface area of the tip of the pressing portion is smaller than the surface area of the surface of the elastic member facing the tip of the pressing portion. The contrast medium injection catheter according to claim 2 or 3, further comprising a lock member capable of fixing the slider member at a position where the elastic member is compressed and releasing the fixed state. The connector has an engaging part
The lock member is composed of a plate-shaped elastic body provided on the slider member and extending toward the outer diameter side toward the tip side, and an engaging member provided on the plate-shaped elastic body.
The contrast medium injection catheter according to claim 4, wherein the slider member is fixed at a position where the elastic member is compressed by engaging the engaging portion with the engaging member. The slider member includes a hook member and
The contrast medium injection catheter according to any one of claims 2 to 5, wherein the connector includes a hook portion for hooking the hook member with respect to the proximal end side. The catheter for injecting a contrast medium according to any one of claims 2 to 6, wherein the wire guide path has a tapered shape whose diameter decreases from the proximal end side to the distal end side. The contrast medium injection catheter according to any one of claims 1 to 7, wherein the outer diameter in the range of 15 cm from the tip of the catheter is smaller than the outer diameter of the catheter outside the range. The contrast medium injection catheter according to any one of claims 1 to 8, wherein the catheter further comprises a nipple incision wire and a nipple incision wire lumen through which the nipple incision wire is inserted.

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