JP2022068383A - Deployment delivery system - Google Patents

Abstract

To provide a deployment delivery system which is capable of carrying out priming effectively while suppressing reduction in strength.SOLUTION: A deployment delivery system 10 has: an outer pipe 30 that receives a stent 20 and slides to the base end side relative to the stent 20 to open the stent, expanding it to the outside in radial direction; an inner pipe 40 that is disposed inside the outer pipe and the stent, is provided with a through-hole penetrating from the inner surface to the outer surface, and including an engaging part to regulate the movement of the stent to the base end side; a cover tube that covers the through-hole of the inner pipe; and a long reinforcement with its tip side coupled to the inner pipe. The cover tube is fixed to the inner pipe at a position closer to the tip than the through-hole of the inner pipe. Between the inner surface of the cover tube and the outer surface of the inner pipe, a passage is formed that communicates from the through-hole to the space between the inner pipe and the outer pipe.SELECTED DRAWING: Figure 2

Description

The present invention relates to a deployable delivery system for placing a medical deployant such as a stent in a living lumen.

In recent years, for example, in the treatment of myocardial infarction and angina, a method of placing a stent in a lesion (stenosis) of a coronary artery to secure a space in the coronary artery has been performed, and other blood vessels, bile ducts, trachea, etc. Similar methods may be used to improve esophagus, urinary tract, and other strictures that occur in the living lumen. Stents are classified into balloon-expandable stents and self-expandable stents according to their function and placement method.

The balloon-expandable stent does not have a dilating function in the stent itself, and after reaching the target site, it is expanded by the balloon and fixed in close contact with the lumen. On the other hand, in the self-expandable stent, the stent itself has an expansion function and is housed in the catheter in a state of being reduced in diameter in advance. After reaching the target site, the self-expandable stent is released from the catheter, expands by its own diastolic force, and is firmly fixed in the lumen. For example, Patent Document 1 describes an RX-type (Rapid exchange type) stent delivery system that transports a self-expandable stent to a target site in a lumen and firmly fixes the self-expandable stent in the lumen. There is. An distal tube on which a guidewire lumen is formed penetrates the distal end of the stent delivery system described in Patent Document 1. The distal tube is arranged with a locking portion that limits the movement of the stent in order to release the stent from the stent delivery system. When priming this stent delivery system, the priming liquid is supplied to the inside of the stent delivery system through a priming slit formed in the distal tube.

International Publication No. 2011/016386

However, in the stent delivery system as described above, the starting point is the site where the priming slit of the distal tube is formed when passing through a curved portion or when a compression load is applied to the distal tube to open the stent. As a result, it may buckle, deform, or break. As a result, it can cause the stent delivery system to buckle, deform, or break.

Further, in order to reliably prime the inside of the pipe surrounding the inner pipe on the distal end side of the proximal end side opening of the guide wire lumen, it is preferable that the position of the priming slit is close to the proximal end side opening. However, in general, the vicinity of the proximal opening of the guidewire lumen is less strong than the rest. For this reason, bringing the position of the priming slit closer to the proximal opening of the guidewire lumen further reduces the strength in the vicinity of the proximal opening and near the proximal opening of the stent delivery system. Can cause damage.

The present invention has been made to solve the above-mentioned problems, and an object of the present invention is to provide a developed product delivery system capable of effectively priming while suppressing a decrease in strength.

The developed product delivery system that achieves the above object is a developed product delivery system for expanding the developed product in the living body by inserting the distal end side into the living body and operating the proximal end side at hand. An outer tube that can be accommodated and at least partly slid toward the proximal end with respect to the unfolded object to open the unfolded object and expand radially outward, and the outer tube and the unfolded object. An inner tube arranged inside and penetrating from the inner surface to the outer surface is formed, and an inner tube having a locking portion for restricting the movement of the developed object to the proximal end side and the through hole of the inner tube are formed. The covering tube covering the portion, the operation portion located on the proximal end side of the inner pipe and the outer pipe, and the proximal end side were connected to the operation portion, and at least a part of the distal end side was connected to the inner pipe. With a long reinforcing body, the coated tube is fixed to the inner tube on the distal end side and / or the proximal end side of the through hole of the inner tube, and the inner surface of the coated tube and the inner tube. It is characterized in that a passage is formed from the through hole to the inner surface between the inner pipe and the outer pipe.

The deployable delivery system configured as described above can supply the priming fluid from the lumen of the inner tube through the perforations and passages to the internal space, as well as to pass through the bend and to open the stent. When a compression load is applied to the distal tube, buckling, deformation, or breakage at the site where the through hole is formed can be suppressed by the coated tube. Further, since the position where the priming liquid flowing from the through hole of the inner pipe to the passage flows into the internal space can be adjusted by the covering tube, priming can be effectively performed. Further, since the developed product delivery system can adjust the position of the through hole of the inner pipe, it is possible to suppress the decrease in strength of the developed product delivery system due to the through hole. Further, in the developed product delivery system, the strength of the developed product delivery system can be further suppressed by the coated tube covering the through hole.

At least a part of the distal end side of the reinforcing body may be sandwiched between the inner surface of the coated tube and the outer surface of the inner tube. As a result, the area between the inside of the covering tube and the outside of the inner tube and the reinforcing body can be used as a passage, and the passage can be easily formed.

The passage may be formed between the inner surface of the coated tube and the outer surface of the inner tube from the through hole toward the proximal end side. As a result, the priming liquid can easily reach the proximal end side region of the internal space on the proximal end side than the position where the through hole of the inner pipe is formed. Therefore, the developed product delivery system can effectively spread the priming liquid in the internal space.

The inner tube has a tip inner tube and a proximal inner tube located on the proximal end side of the distal inner tube, and the gap between the distal inner tube and the proximal inner tube has the through hole. It may be formed. Thereby, a through hole can be easily and surely formed between the divided tip inner tube and the proximal end inner tube. Since the through hole is formed in the entire circumferential direction (360 degrees) of the inner pipe, it can reliably communicate with the passage.

The deployable delivery system may further include a tow wire whose tip end side is connected to the outer tube, and the proximal end side of the tow wire may be connected to a moving portion operably provided in the operating portion. As a result, the operator moves the moving portion to move the tow wire to the proximal end side, so that the outer tube can be easily moved to the proximal end side by the tow wire.

The outer tube has a proximal outer tube and a distal outer tube that is at least partially located on the distal end side of the proximal outer tube and is movable toward the proximal side with respect to the proximal outer tube. The tip outer tube accommodates the deployable object, is connected to the tow wire, and moves toward the proximal end side with respect to the proximal outer tube to open the deployable object and expand it radially outward. May be possible. As a result, the developed product delivery system can expand the deployed product by opening it from the distal end outer pipe by moving the distal end outer pipe toward the proximal end side by a tow wire without moving the proximal outer pipe. can. Therefore, in the developed product delivery system, it is not necessary to move the base end outer pipe when opening the developed product, so that the resistance for moving the outer pipe is reduced and the operability is improved.

The reinforcing body may be formed by a tow wire whose tip end side is connected to the outer pipe, and the base end side of the tow wire may be connected to a moving portion operably provided in the operating portion. As a result, the tow wire for moving the outer pipe also functions as a reinforcing body. Therefore, the number of parts constituting the developed product delivery system is smaller than that in the case where the tow wire and the reinforcing body are separately provided, and it is possible to reduce the diameter and the manufacturing cost.

It is a top view which shows the development product delivery system which concerns on embodiment. It is sectional drawing which shows the tip side of the deployable material delivery system, (A) shows the state before deployment of a stent, (B) shows the state during deployment of a stent. It is sectional drawing which shows the developed material delivery system, (A) shows the part on the proximal end side with respect to the tip, (B) shows the proximal end side. FIG. 3 is an enlarged cross-sectional view showing a portion on the base end side of the tip end of the developed product delivery system. It is a figure which shows the part on the base end side with respect to the tip of the developed material delivery system, (A) is the sectional view along the line AA of FIG. Is. It is sectional drawing which shows the modified example of a developed object delivery system, (A) is a 1st modified example, (B) is a 2nd modified example, (C) is a 3rd modified example, (D) is a 4th modified example. show. It is sectional drawing which shows the state before deployment of the stent of the 5th modification of the deployable material delivery system, (A) shows the part on the distal end side, (B) shows the site on the proximal end side with respect to the distal end. It is sectional drawing which shows the state during deployment of the stent of the 5th modification of the deployable material delivery system, (A) shows the part on the distal end side, (B) shows the site on the proximal end side with respect to the distal end.

Hereinafter, embodiments of the present invention will be described with reference to the drawings. The dimensions of the drawings may be exaggerated and differ from the actual dimensions for convenience of explanation. Further, in the present specification and the drawings, components having substantially the same function are designated by the same reference numerals, so that duplicate description will be omitted. In the present specification, the side to be inserted into the lumen is referred to as the "tip side", and the hand side to be operated is referred to as the "base end side".

In the deployable delivery system 10 according to the present embodiment, a stent 20 which is a medical deployant is placed in a stenosis or an obstruction formed in a blood vessel, bile duct, trachea, esophagus, urethra, or other living lumen. The purpose is to maintain the patentable state of the living lumen. The stent delivery system 10 is an RX type (Rapid exchange type) in which the guide wire 200 is inserted only on the distal end side.

As shown in FIGS. 1 to 3, the deployable delivery system 10 includes a stent 20, an outer tube 30 accommodating the stent 20, an inner tube 40 arranged inside the outer tube 30, and a base end of the outer tube 30. It includes a proximal shaft 70 arranged on the side, and a connecting tube 60 connecting the outer tube 30 and the proximal shaft 70. The deployable delivery system 10 further includes a tow wire 80 for pulling the outer tube 30, a coated tube 90 that covers a part of the inner tube 40, and a reinforcing body 100 that imparts strength to the deployable delivery system 10. It is provided with an operation unit 110 arranged at the base end portion of the deployed object delivery system 10.

The outer tube 30 includes a distal outer tube 31 for accommodating the stent 20, and a proximal outer tube 32 located on the proximal side of the distal outer tube 31. An inner tube 40 is arranged inside the tip outer tube 31 and the proximal outer tube 32. The tip outer tube 31 is movable toward the proximal end with respect to the proximal outer tube 32. The tip outer tube 31 includes a first tip outer tube 33 and a second tip outer tube 34 located on the proximal end side of the first tip outer tube 33. A reduced diameter stent 20 is placed inside the first tip outer tube 33. The inner surface of the first tip outer tube 33 is covered with a tip-side low friction layer 35 made of a low friction material. As a result, the stent 20 housed inside the first distal end outer tube 33 can easily slide on the distal end side low friction layer 35 on the inner surface of the first distal end outer tube 33. The base end side of the first tip outer tube 33 is formed to have a smaller outer diameter and inner diameter than the tip side, and is arranged inside the tip side of the second tip outer tube 34. The inner surface of the first tip outer tube 33 may not be covered with the tip side low friction layer 35.

The tip end side of the second tip outer tube 34 is located outside the proximal end side of the first tip outer tube 33. A connecting portion 36 made of an adhesive or the like is formed between the tip end side of the second tip outer tube 34 and the base end side of the first tip outer tube 33. The tip end side of the tow wire 80 is embedded in the connecting portion 36. As a result, the tip outer pipe 31 is fixed to the tip side of the tow wire 80. A sliding portion 37 having an outer diameter smaller than the outer diameter on the distal end side of the first distal end outer pipe 33 is formed on the outer surface on the proximal end side of the connecting portion 36 of the second distal end outer pipe 34. The outer diameter of the sliding portion 37 is smaller than the inner diameter of the base end outer pipe 32. The proximal end side of the sliding portion 37 is located inside the proximal end outer pipe 32. As the tip outer pipe 31 moves toward the base with respect to the base outer pipe 32, the sliding portion 37 slides on the inner surface of the base outer pipe 32 and enters the inside of the base outer pipe 32. be able to.

The base end outer pipe 32 is a pipe body that can receive the sliding portion 37 of the second tip outer pipe 34 that moves toward the base end side inside. The base end side low friction layer 38 made of a low friction material is coated on the inner surface of at least the region where the sliding portion 37 enters on the tip end side of the base end outer pipe 32. As a result, the base end outer pipe 32 can smoothly receive the sliding portion 37 of the second tip outer pipe 34 inside the base end outer pipe 32. The inner surface of the base end outer pipe 32 may not be covered with the base end side low friction layer 38.

The outer diameter of the outer tube 30 is not particularly limited, but is, for example, 0.5 to 10.0 mm, preferably 1.0 to 5.0 mm. The outer diameter of the outer pipe 30 is, as a specific example, 1.43 mm. The inner diameter of the outer tube 30 is not particularly limited, but is, for example, 0.4 to 9.0 mm, preferably 0.8 to 4.5 mm. The inner diameter of the outer tube 30 is, as a specific example, 1.27 mm. The axial length of the outer tube 30 is not particularly limited, but is, for example, 10 to 200 mm, preferably 20 to 100 mm. The axial length of the outer tube 30 is, as a specific example, 35 mm.

The constituent materials of the first tip outer tube 33 and the proximal outer tube 32 are not particularly limited, but are preferably hard and flexible materials, and for example, nylon, polyester, fluororesin and the like are preferably used. Can be used. When the low friction layer is not coated on the first tip outer tube 33 and the proximal outer tube 32, the constituent materials of the first distal outer tube 33 and the proximal outer tube 32 are preferably low friction materials, for example, nylon. , Fluororesin and the like can be preferably used.

Fluorine-based resin is preferable as the constituent material of the low friction layer 35 on the distal end side and the low friction layer 38 on the proximal end side. Examples of the fluororesin include polytetrafluoroethylene (PTFE), tetrafluoroethylene / perfluoroalkyl vinyl ether copolymer (PFA), tetrafluoroethylene / hexafluoropropylene copolymer (FEP) and the like. A braided reinforcing wire may be arranged between the first tip outer pipe 33 and the tip side low friction layer 35, and between the proximal end outer pipe 32 and the proximal end side low friction layer 38.

The constituent material of the second tip outer tube 34 is not particularly limited, but is preferably a material having hardness and flexibility, and for example, polyetheretherketone (PEEK), nylon, polyimide, or the like is preferably used. can. A braided reinforcing wire may be arranged in the material of the second tip outer pipe 34.

The connection tube 60 is a tube that connects the proximal outer tube 32 and the proximal shaft 70. As shown in FIGS. 1 and 3, the connection tube 60 includes a tip connection portion 61 connected to the proximal side of the proximal outer tube 32 and a proximal connection portion 62 connected to the distal end side of the proximal shaft 70. , An intermediate portion 63 located between the tip connection portion 61 and the proximal end connection portion 62. The connection tube 60 is connected to the proximal outer tube 32 and the proximal shaft 70 by heat fusion or adhesion. In FIG. 3, the tip connection portion 61 is connected to the outer surface of the proximal outer tube 32, but may be connected to the inner surface of the proximal outer tube 32. Further, although the proximal end connecting portion 62 is connected to the outer surface of the proximal end shaft 70, it may be connected to the inner surface of the proximal end shaft 70. An internal space 39 is formed on the tip side of the intermediate portion 63. The intermediate portion 63 of the connecting tube 60 has a proximal opening 64 in which the proximal side of the inner tube 40 is connected and communicates with the guide wire lumen 41 of the inner tube 40, and a through hole 65 through which the reinforcing body 100 and the tow wire 80 penetrate. Is formed. The connecting tube 60 may be integrally formed with the proximal outer tube 32 and / or the proximal shaft 70. The through hole 65 communicates the lumen of the tip connection portion 61 and the lumen of the proximal end connection portion 62.

The outer diameter of the connecting tube 60 is not particularly limited, but is, for example, 0.4 to 8.0 mm, preferably 0.8 to 4.0 mm. As a specific example, the outer diameter of the connecting tube 60 is 1.1 mm. The inner diameter of the connecting tube 60 is not particularly limited, but is, for example, 0.3 to 7.0 mm, preferably 0.6 to 3.5 mm. As a specific example, the inner diameter of the connecting tube 60 is 1.0 mm. The axial length of the connecting tube 60 is not particularly limited, but is, for example, 2.5 to 100 mm, preferably 5 to 50 mm. The axial length of the connecting tube 60 is, as a specific example, 10 mm.

The constituent material of the connecting tube 60 is not particularly limited, but for example, nylon, polyester and the like can be preferably used.

As shown in FIGS. 2 to 5, the inner tube 40 is a tube body on which the guide wire lumen 41 is formed on the distal end side of the deployable delivery system 10. The inner tube 40 includes a tip inner tube 42, a proximal inner tube 43 located on the proximal end side of the distal inner tube 42, a tip tip 44 fixed to the distal end side of the distal inner tube 42, and a tip marker 45. It is provided with a base end marker 46 (locking portion). The tip tip 44, the tip inner tube 42, and the base end inner tube 43 are aligned in an axial direction to form a common guide wire lumen 41.

The tip inner tube 42 is at least partially located inside the outer tube 30 and penetrates the inside of the stent 20 arranged inside the outer tube 30. The tip of the tip inner tube 42 is located closer to the tip than the outer tube 30, and the base end of the tip inner tube 42 is located inside the outer tube 30. The tip tip 44 is fixed to the tip side of the tip inner tube 42.

The outer diameter of the tip inner tube 42 is not particularly limited, but is, for example, 0.15 to 3.0 mm, preferably 0.3 to 1.5 mm. The outer diameter of the connecting tube 60 is, as a specific example, 0.6 mm. The inner diameter of the tip inner tube 42 is not particularly limited, but is, for example, 0.1 to 2.0 mm, preferably 0.2 to 1.0 mm. The inner diameter of the tip inner tube 42 is, as a specific example, 0.43 mm. The axial length of the tip inner tube 42 is not particularly limited, but is, for example, 50 to 2000 mm, preferably 100 to 1000 mm. The axial length of the tip inner tube 42 is, as a specific example, 600 mm.

The constituent material of the tip inner tube 42 is not particularly limited, but for example, polyetheretherketone (PEEK), nylon, polyimide, or the like can be preferably used.

The tip tip 44 constitutes the tip of the inner tube 40. The guide wire lumen 41 is opened at the tip opening 47 formed at the tip of the tip tip 44. The tip tip 44 may be integrally formed with the tip inner tube 42. The proximal surface of the distal tip 44 is in contact with or in close proximity to the distal surface of the first distal outer tube 33 that houses the stent 20. The tip tip 44 includes a tapered portion 48 whose outer diameter is tapered toward the tip, and a constant portion 49 whose outer diameter is constant along the axial direction. The outer diameter of the fixed portion 49 substantially coincides with the outer diameter on the tip side of the first tip outer tube 33. Therefore, no step is formed between the outer surface of the tip tip 44 and the outer surface of the first tip outer tube 33, and it is possible to suppress catching in the living body. By providing the tapered portion 48, the tip tip 44 can be easily inserted into the narrowed portion.

As the constituent material of the tip tip 44, it is preferable to use a material having flexibility, and for example, nylon elastomer, polyester elastomer, urethane elastomer and the like can be preferably used. The constituent material of the tip 44 may include a contrast agent.

The proximal inner tube 43 is located on the proximal end side of the distal inner tube 42 and is aligned coaxially with the distal inner tube 42. The distal end surface of the proximal inner tube 43 is in contact with the proximal end surface of the distal inner tube 42. The inner diameter and outer diameter of the base end inner pipe 43 are preferably the same as the inner diameter and outer diameter of the tip inner pipe 42, but they do not have to be the same. The axial length of the portion where the base end inner tube 43 and the connecting tube 60 are in contact with each other is not particularly limited, but is, for example, about 5 mm.

The proximal end side of the proximal end inner tube 43 is connected to the intermediate portion 63 of the connecting tube 60. The guide wire lumen 41 of the proximal end inner tube 43 communicates with the proximal end opening 64 provided in the connecting tube 60. Between the proximal end surface of the distal end inner tube 42 and the distal end surface of the proximal end inner tube 43, a through hole 50, which is a gap penetrating from the inner surface to the outer surface, is formed over 360 degrees. The proximal end surface of the distal end inner tube 42 and the distal end surface of the proximal end inner tube 43 are in contact with each other, but are not fixed. Therefore, the fluid can flow through the through hole 50 between the tip inner pipe 42 and the base end inner pipe 43. In order to secure a wide through hole 50, for example, the proximal end surface of the distal end inner tube 42 and / or the distal end surface of the proximal end inner tube 43 should be set to 0 degrees with respect to the cross section orthogonal to the central axis of the inner tube 40. It may be tilted at an angle of more than 90 degrees.

The outer diameter of the base end inner tube 43 is not particularly limited, but is, for example, 0.15 to 3.0 mm, preferably 0.3 to 1.5 mm. The outer diameter of the base end inner tube 43 is, as a specific example, 0.6 mm. The inner diameter of the base end inner tube 43 is not particularly limited, but is, for example, 0.1 to 2.0 mm, preferably 0.2 to 1.0 mm. As a specific example, the inner diameter of the base end inner tube 43 is 0.43 mm. The axial length of the proximal end inner tube 43 is not particularly limited, but is, for example, 2.5 to 400 mm, preferably 5 to 200 mm. As a specific example, the length of the base end inner tube 43 in the axial direction is 15 mm. The axial distance between the distal end inner tube 42 and the proximal end inner tube 43 is not particularly limited, but is, for example, 0 to 100 mm, preferably 0 to 10 mm. As a specific example, the axial distance between the distal end inner tube 42 and the proximal end inner tube 43 is 0 mm.

The constituent material of the base end inner tube 43 is not particularly limited, but for example, polyetheretherketone (PEEK), nylon, polyimide, or the like can be preferably used. A braided reinforcing wire may be arranged in the material of the tip inner tube 42.

As shown in FIGS. 4 and 5, the covering tube 90 is a tube body that collectively covers the tip inner tube 42, the proximal inner tube 43, and the reinforcing body 100. The tip of the covering tube 90 is located on the tip side of the through hole 50, and is located on the proximal end side of the tip of the tip inner tube 42. The proximal end of the covering tube 90 is located closer to the proximal end side than the through hole 50, and is located closer to the distal end side than the proximal end of the proximal end inner tube 43. The tip and base of the covering tube 90 are located in the internal space 39 of the outer tube 30. The covering tube 90 collectively covers the reinforcing body 100 that abuts on the outer surfaces of the tip inner tube 42 and the proximal end inner tube 43, and the distal end inner tube 42 and the proximal end inner tube 43. The inner surface of the covering tube 90 is in close contact with the outer surface of the tip inner tube 42, the outer surface of the proximal inner tube 43, and the outer surface of the reinforcing body 100. A passage 91 is formed inside the covering tube 90 and outside the reinforcing body 100 and the proximal end inner pipe 43. The passage 91 communicates with the through hole 50 and also communicates with the internal space 39 of the outer pipe 30 on the proximal end side of the covering tube 90. The inside of the covering tube 90 and the outside of the reinforcing body 100 and the tip inner pipe 42 are filled with a joint portion 92 made of an adhesive or the like. As a result, the covering tube 90, the tip inner tube 42, and the reinforcing body 100 are connected. The joint portion 92 may be inside the coated tube 90 and may not completely fill the space outside the reinforcing body 100 and the tip inner pipe 42. Further, the coated tube 90 may be heat-sealed to the tip inner tube 42. The coated tube 90 is not joined to the proximal inner tube 43. If the joint portion 92 is inside the covering tube 90 and does not completely fill the space outside the reinforcing body 100 and the tip inner tube 42, the covering tube 90 is the reinforcing body 100 or the base end inner tube. It may be adhered or heat-sealed to 43. Further, even when the joint portion 92 is inside the covering tube 90 and completely fills the space outside the reinforcing body 100 and the tip inner pipe 42, it is inside the covering tube 90. The coated tube 90 may be adhered or heat-sealed to the proximal inner tube 43 as long as the space outside the reinforcing body 100 and the proximal inner tube 43 is not completely closed. Further, the reinforcing body 100 may not be sandwiched between the covering tube 90 and the tip inner pipe 42 or the proximal end inner pipe 43. In this case, the reinforcing body 100 is connected to the inner pipe 40 at a position different in the axial direction from the position where the covering tube 90 covers the tip inner pipe 42 or the proximal inner pipe 43.

The outer diameter of the covering tube 90 is not particularly limited, but is, for example, 0.175 to 4.0 mm, preferably 0.35 to 2.0 mm. The outer diameter of the covering tube 90 is, as a specific example, 0.98 mm. The inner diameter of the covering tube 90 is not particularly limited, but is, for example, 0.125 to 3.0 mm, preferably 0.25 to 1.5 mm. The inner diameter of the coated tube 90 is, as a specific example, 0.88 mm. The axial length of the covering tube 90 is not particularly limited, but is, for example, 2.5 to 1000 mm, preferably 5 to 500 mm. The axial length of the covering tube 90 is, as a specific example, 10 mm.

The axial length from the base end of the covering tube 90 to the base end of the internal space 39 is not particularly limited, but is, for example, 0 to 100 mm, preferably 0 to 50 mm. As a specific example, the length in the axial direction from the base end of the covering tube 90 to the base end of the internal space 39 is, for example, 5 mm. The axial length of the region where the axial positions of the joint portion 92 and the covering tube 90 overlap is not particularly limited, but is, for example, 1 to 900 mm, preferably 2 to 400 mm. The axial length of the joint portion 92 is, as a specific example, 5 mm.

As the constituent material of the covering tube 90, for example, a high-rigidity polymer material such as polyamide, polyimide, polyetheretherketone, ultra-high molecular weight polyethylene, polypropylene, and a fluororesin can be preferably used.

As shown in FIG. 2, the proximal end marker 46 is a ring-shaped member fixed to the outer surface of the tip inner tube 42 by an adhesive portion 46A made of an adhesive or the like, and has X-ray contrast property. The adhesive portion 46A may protrude from between the tip inner tube 42 and the proximal end marker 46. The proximal end marker 46 is used to determine the position of the proximal end of the stent 20 under fluoroscopy. The proximal marker 46 is also a locking portion that regulates the movement of the stent 20 toward the proximal end. The outer diameter of the proximal end marker 46 is a size capable of contacting the proximal end of the stent 20 housed in the outer tube 30. When the outer tube 30 moves toward the proximal end side, the proximal end of the stent 20 abuts on the proximal end marker 46 and the axial position of the stent 20 is maintained, resulting in release from the outer tube 30. ..

The tip marker 45 is a ring-shaped member fixed to the outer surface of the tip inner tube 42 by an adhesive portion 45A made of an adhesive or the like, and has X-ray contrast property. The adhesive portion 45A may protrude from between the tip inner tube 42 and the tip marker 45. The tip marker 45 is used to grasp the position of the tip of the stent 20 under fluoroscopy. The outer surface on the distal end side of the distal end marker 45 is in contact with or close to the inner surface of the first distal end outer tube 33. The base end side of the tip marker 45 is tapered toward the base end side. Therefore, the recovery of the deployed delivery system 10 (specifically, the storage in the guiding catheter or the sheath) after the stent 20 is opened becomes easy. In addition, it is possible to prevent the tip marker 45 from damaging the blood vessel during the recovery of the deployed product delivery system 10. The base end marker 46 may have the same shape as the tip end marker 45. As a result, when the deployed product delivery system 10 is recovered, the proximal end marker 46 can be easily recovered, and damage to the blood vessel caused by the proximal end marker 46 can be suppressed.

The constituent materials of the tip marker 45 and the proximal marker 46 are not particularly limited, but are preferably X-ray contrast-enhanced, and for example, stainless steel such as SUS304, platinum-iridium alloy, tantalum and the like can be preferably used.

As shown in FIGS. 3 to 5, the reinforcing body 100 is a member for imparting rigidity to the developed product delivery system 10. The reinforcing body 100 is one or more (one in this embodiment) wire rod. The reinforcing body 100 is preferably thin on the distal end side and thick on the proximal end side. Therefore, it is preferable that the reinforcing body 100 has a portion whose outer diameter is tapered toward the tip side in at least a part in the axial direction. The outer diameter of the reinforcing body 100 is not limited to the above example, and may be constant in the axial direction, for example.

The base end side of the reinforcing body 100 is fixed to the operation unit 110 inside the operation unit 110. The reinforcing body 100 is located inside the base end shaft 70, the through hole 65 of the connecting tube 60, and the outer pipe 30. The tip end side of the reinforcing body 100 comes into contact with the outer surfaces of the tip inner tube 42 and the proximal end inner tube 43, and is covered with the covering tube 90 and comes into contact with the inner surface of the covering tube 90. The tip end side of the reinforcing body 100 is sandwiched between the covering tube 90 and the tip inner tube 42. The tip of the reinforcing body 100 may be located closer to the tip than the covering tube 90. In this case, the tip end side of the reinforcing body 100 may be fixed to the tip inner tube 40 with a tube different from the covering tube 90. The other tube can cover and fix the tip end side of the reinforcing body 100 together with the tip inner tube 42. Further, the tip of the reinforcing body 100 may be aligned with the through hole 50 in the axial direction or located on the proximal end side of the through hole 50 and may be sandwiched between the covering tube 90 and the proximal end inner tube 43.

The outer diameter of the tip side of the reinforcing body 100 is not particularly limited, but is, for example, 0.05 to 1.0 mm, preferably 0.1 to 0.5 mm. The outer diameter of the reinforcing body 100 on the tip end side is, as a specific example, 0.25 mm. The outer diameter of the base end side of the reinforcing body 100 is not particularly limited, but is, for example, 0.2 to 4.0 mm, preferably 0.4 to 2.0 mm. The outer diameter of the base end side of the reinforcing body 100 is, as a specific example, 0.52 mm.

The constituent material of the reinforcing body 100 is preferably a material having hardness and flexibility, for example, stainless steel wire (preferably high tension stainless steel for springs), piano wire (preferably nickel-plated or Chrome-plated piano wire), or with various metals such as superelastic alloy wire, Ni-Ti alloy, Cu-Zn alloy, Ni-Al alloy, tungsten, tungsten alloy, titanium, titanium alloy, cobalt alloy, tantalum, etc. Examples include the formed wire rod.

The tow wire 80 is a wire for pulling the tip outer tube 31 toward the proximal end side and releasing the stent 20 from the tip outer tube 31. One or more tow wires 80 (two in this embodiment) are provided. The base end side of the tow wire 80 is fixed to the operating portion 112 of the operating portion 110, which will be described later. The tow wire 80 is arranged in the lumen of the proximal shaft 70, the through hole 65 of the intermediate portion 63, and the internal space 39 of the outer pipe 30. The tip end side of the tow wire 80 is fixed to the connecting portion 36 of the tip outer pipe 31. The tip end side of the tow wire 80 may be pressed or centerless so that it can be arranged between the first tip outer pipe 33 and the second tip outer pipe 34 where the connecting portion 36 is provided.

As the tow wire 80, a wire rod or a twisted wire rod or a plurality of wire rods can be preferably used. The thickness of the tow wire 80 is not particularly limited, but is, for example, 0.05 to 1.0 mm, preferably 0.1 to 0.5 mm. As a specific example, the outer diameter of the tow wire 80 is 0.26 mm, and the surface thereof is coated with a fluororesin which is a low friction material.

The constituent material of the tow wire 80 is not particularly limited, but is, for example, a stainless steel wire (preferably high tension stainless steel for springs), a piano wire (preferably a nickel-plated or chrome-plated piano wire), or Wires made of various metals such as superelastic alloy wire, Ni-Ti alloy, Cu-Zn alloy, Ni-Al alloy, tungsten, tungsten alloy, titanium, titanium alloy, cobalt alloy, tantalum, polyamide, polyimide, super A relatively high-rigidity polymer material such as high-molecular-weight polyethylene, polypropylene, or a fluororesin, or a combination thereof as appropriate can be preferably applied. Further, the surface of the tow wire 80 may be coated with a low friction resin that increases the slipperiness. As the low friction resin, a fluororesin, nylon 66, polyetheretherketone, high-density polyethylene and the like can be preferably applied.

The stent 20 is formed in a substantially cylindrical shape, and as shown in FIG. 2, is housed in the first tip outer tube 33 in a state of being compressed toward the central axis. The stent 20 is extruded from the opening on the distal end side of the first distal end outer tube 33 to remove the stress load, expand, and restore the shape before compression. The form of the stent 20 is not limited as long as it is a so-called self-expandable stent. As an example, the stent 20 may form one substantially cylindrical shape by connecting a plurality of annular portions that are formed in an annular shape while being bent side by side.

A superelastic alloy is preferably used as the constituent material of the stent 20. The superelastic alloy referred to here is generally called a shape memory alloy, and exhibits superelasticity at least at a biological temperature (around 37 ° C.). As the shape memory alloy, Ni—Ti alloy, Cu—Al—Ni alloy, Cu—Zn—Al alloy and the like can be preferably used.

As shown in FIGS. 1 and 3, the operation unit 110 includes an operation main body unit 111, an operation unit 112, a kink-resistant protector 113, a housing 114, a block 115, and a valve body 116.

The operation body portion 111 is a portion gripped by the operator. The operation main body 111 contains a part of the operation unit 112, a housing 114, a block 115, a valve body 116, and the like inside.

The moving unit 112 is a portion where the user performs a towing operation of the towing wire 80. The operating unit 112 includes a dial 117 operated by an operator, a take-up shaft 118 for winding the tow wire 80, and a rotating shaft 119.

The dial 117 is a portion to be rotated by the operator, is formed in a disk shape, and is arranged in the operation main body 111 so as to be partially exposed from the operation main body 111. The portion exposed from the operation main body 111 of the dial 117 is the portion operated by the operator. It is preferable that the surface portion that the operator may touch when operating the dial 117 is a non-slip surface. For example, it is preferable that the outer peripheral surface of the dial 117 is subjected to knurling treatment, embossing treatment, high friction material coating, or the like.

The rotating shaft 119 is formed coaxially with the dial 117 so as to project from both side surfaces of the dial 117. The rotary shaft 119 is rotatably housed in a hole formed in the operation main body 111.

The take-up shaft 118 is formed coaxially with the dial 117 and having an outer diameter smaller than that of the dial 117. The take-up shaft 118 is formed with a holding hole 120 that penetrates between two locations 180 degrees opposite to each other in the circumferential direction. A tow wire 80 is inserted into the holding hole 120 from one side, and an anchor portion 121 having a diameter larger than that of the towing wire 80 and the holding hole 120 is fixed to the end of the tow wire 80 located on the opposite side. The method of fixing the tow wire 80 to the take-up shaft 118 is not limited to the above method. When the operator rotates the dial 117, the take-up shaft 118 can be rotated to take up the tow wire 80.

The housing 114 is fixed inside the operation body 111 and holds the base end shaft 70, the block 115, and the valve body 116. The housing 114 is closely fixed to the outer surface of the proximal end shaft 70 on the proximal end side. The block 115 is fixed to the proximal end side of the reinforcing body 100 projecting from the proximal end shaft 70 toward the proximal end side. The housing 114 holds the reinforcing body 100 by holding the block 115. The valve body 116 is arranged on the proximal end side of the reinforcing body 100 and the block 115. The valve body 116 maintains the liquidtight state of the tow wire 80 extending from the inside of the base end shaft 70 through the inside of the housing 114 to the base end side while allowing axial movement, and is an operation main body. It is for introducing into the unit 111. The valve body 116 is provided with a hole or a slit through which the tow wire 80 is slidably passed.

The kink-resistant protector 113 partially protrudes from the operation main body portion 111 toward the distal end side while covering the proximal end side of the proximal end shaft 70. The kink-resistant protector 113 suppresses kinking on the proximal end side of the proximal end shaft 70.

Next, a method of using the developed product delivery system 10 according to the present embodiment will be described.

First, the surgeon primes the deployable delivery system 10 in the undeployed state of the stent 20, as shown in FIGS. 1, 2 (A) and 3. Therefore, the operator injects the priming liquid from the tip opening 47 of the tip tip 44 into the guide wire lumen 41 of the inner tube 40. As a result, a part of the priming liquid passes through the guide wire lumen 41 and is discharged from the proximal opening 64. Further, when a part of the priming liquid flows through the guide wire lumen 41 and reaches the through hole 50, as shown in FIG. 4, it moves to the outside of the inner tube 40 through the through hole 50 and inside the coated tube 90. Reach the passage 91 of. Since the passage 91 extends from the through hole 50 toward the proximal end side, the priming liquid flowing into the passage 91 flows inside the covering tube 90 toward the proximal end side. Therefore, the priming liquid flowing through the passage 91 flows into the internal space 39 of the outer tube 30 from the base end of the covering tube 90. Therefore, the priming liquid that has flowed into the passage 91 from the through hole 50 can easily reach the proximal region of the internal space 39, which is normally difficult to reach, by the covering tube 90. Therefore, even if the through hole 50 is not arranged in the proximal end side region of the internal space 39, the priming liquid can be satisfactorily reached in the proximal end side region. The priming liquid that has flowed from the passage 91 into the proximal end side region of the internal space 39 flows from the proximal end side region toward the distal end side, and escapes to the outside through the gap between the outer pipe 30 and the distal end tip 44. As a result, the air in the internal space 39 between the outer pipe 30 and the inner pipe 40 is replaced with the priming liquid.

Next, the operator inserts the guide wire 200 into the blood vessel via a catheter introducer or a guiding catheter that is percutaneously inserted into the blood vessel. Next, the operator inserts the base end of the guide wire 200 into the guide wire lumen 41 from the tip opening 47. The guide wire 200 is led out from the base end opening 64.

Next, the surgeon inserts the deployable delivery system 10 into the blood vessel along the guide wire 200 and projects it from a catheter introducer, a guiding catheter, or the like. Subsequently, the surgeon gradually pushes the deployable delivery system 10 to the target site while leading the guide wire 200. The operator places the stent 20 in the target stenosis while confirming the positions of the distal end marker 45 and the proximal end marker 46 under fluoroscopy.

Next, the operator rotates the dial 117 of the operation unit 110 as shown in FIGS. 1 and 3 (B). As a result, the take-up shaft 118 of the moving portion 112 rotates, and the tow wire 80 is taken up on the outer peripheral surface of the take-up shaft 118. As a result, the tow wire 80 located inside the proximal shaft 70, the connecting tube 60, and the outer tube 30 moves toward the proximal end side.

When the tow wire 80 moves to the proximal end side, as shown in FIG. 2B, since the distal end side of the tow wire 80 is fixed to the distal end outer tube 31, the distal end outer tube 31 moves to the proximal end side. .. At this time, since the inner surface of the base end outer pipe 32 is covered with the base end side low friction layer 38, the sliding portion 37 of the tip end outer pipe 31 slides smoothly on the inner surface of the base end outer pipe 32. It can enter the inside of the base end outer tube 32. Since the proximal outer tube 32 of the outer tube 30 does not move to the proximal side by traction, the deployed product delivery system 10 has low resistance when towed and has high operability. Since the proximal end surface of the stent 20 abuts on the distal end surface of the proximal end marker 46 of the inner tube 40 and is locked, the stent 20 moves toward the distal end side on the inner surface of the distal outer tube 31 when viewed from the distal outer tube 31. do. At this time, since the inner surface of the first tip outer tube 33 is covered with the tip side low friction layer 35, the stent 20 can smoothly slide on the inner surface of the first tip outer tube 33. Therefore, the stent 20 is gradually released from the opening on the distal end side of the first distal end outer tube 33. Due to this release, the stent 20 expands by its own elastic force to expand the stenosis and is placed in the stenosis.

After this, the operator removes the deployable delivery system 10 and the guide wire 200 from the blood vessel to complete the procedure.

As described above, the deployable product delivery system 10 according to the present embodiment is a deployable product delivery system 10 for expanding the stent 20 in the living body by inserting the distal end side into the living body and operating the proximal end side at hand. An outer tube 30 that accommodates the stent 20 and can be expanded radially outward by opening the stent 20 by sliding at least a part toward the proximal end side of the stent 20 and an outer tube. An inner tube 40 arranged inside the 30 and the stent 20 and having a through hole 50 penetrating from the inner surface to the outer surface and having a locking portion (base end marker 46) for restricting the movement of the stent 20 toward the base end side. The covering tube 90 that covers the portion where the through hole 50 of the inner pipe 40 is formed, the operation portion 110 located on the proximal end side of the inner pipe 40 and the outer pipe 30, and the proximal end side are connected to the operation portion 110. The covered tube 90 is fixed to the inner pipe 40 on the tip side of the through hole 50 of the inner pipe 40. A passage 91 is formed between the inner surface of the covering tube 90 and the outer surface of the inner tube 40 to communicate from the through hole 50 to the inner space 39 between the inner tube 40 and the outer tube 30.

The deployable delivery system 10 configured as described above can supply the priming liquid from the lumen of the inner tube 40 to the internal space 39 through the through hole 50 and the passage 91, and when passing through the curved portion, the stent can be supplied. The coated tube 90 can prevent buckling, deformation, or breakage at the portion where the through hole 50 is formed when a compression load is applied to the distal end tube to open the 20. Further, since the position where the priming liquid flowing from the through hole 50 of the inner pipe 40 to the passage 91 flows into the internal space 39 can be adjusted by the covering tube 90, priming can be effectively performed. Further, since the developed product delivery system 10 can adjust the position of the through hole 50 of the inner pipe 40, it is possible to suppress the decrease in strength of the developed product delivery system 10 due to the through hole 50. Further, in the developed product delivery system 10, the coating tube 90 covering the through hole 50 can further suppress the decrease in the strength of the developed product delivery system 10.

At least a part of the tip end side of the reinforcing body 100 is sandwiched between the inside of the covering tube 90 and the outer surface of the inner tube 40. As a result, the area between the inside of the covering tube 90 and the outside of the inner tube 40 and the reinforcing body 100 can be used as the passage 91, and the passage 91 can be easily formed.
It becomes easy to form a passage 91 between the inner pipe 40 and the inner pipe 40.

The passage 91 is formed between the inner surface of the covering tube 90 and the outer surface of the inner tube 40 from the through hole 50 toward the proximal end side. As a result, the priming liquid can easily reach the proximal end side region of the internal space 39 on the proximal end side of the position where the through hole 50 of the inner pipe 40 is formed. Therefore, the developed product delivery system 10 can effectively spread the priming liquid in the internal space 39.

The inner tube 40 has a tip inner tube 42 and a proximal inner tube 43 located on the proximal end side of the distal inner tube 42, and a gap between the distal inner tube 42 and the proximal inner tube 43 is passed through. The hole 50 is formed. Thereby, the through hole 50 can be easily and surely formed between the divided tip inner tube 42 and the proximal end inner tube 43. Since the through hole 50 is formed in the entire circumferential direction (360 degrees) of the inner pipe 40, it can reliably communicate with the passage 91.

The deployed object delivery system 10 further has a tow wire 80 whose tip end side is connected to the outer pipe 30, and the base end side of the tow wire 80 is connected to an operation unit 112 operably provided in the operation unit 110. .. As a result, the operator operates the moving portion 112 to move the tow wire 80 to the proximal end side, so that the outer tube 30 can be easily moved to the proximal end side by the tow wire 80.

The outer tube 30 includes a proximal outer tube 32 and an distal outer tube 31 that is at least partially located on the distal end side of the proximal outer tube 32 and is movable toward the proximal end with respect to the proximal outer tube 32. The tip outer tube 31 accommodates the stent 20, is connected to the traction wire 80, and moves toward the proximal end with respect to the proximal outer tube 32 to open the stent 20 and expand it radially outward. It is possible. As a result, the deployable delivery system 10 releases the stent 20 from the distal end outer tube 31 by moving the distal end outer tube 31 toward the proximal end side by the traction wire 80 without moving the proximal outer tube 32. Can be expanded. Therefore, in the deployable delivery system 10, it is not necessary to move the proximal outer tube 32 when opening the stent 20, so that the resistance for moving the outer tube 30 is reduced and the operability is improved.

The present invention is not limited to the above-described embodiment, and various modifications can be made by those skilled in the art within the technical idea of the present invention. For example, the deployable product is not limited to the stent 20 as long as it can be deployed in vivo. The deployable material may be, for example, an embolic coil, a snare wire, a filter, a balloon, or the like. The developed product may or may not be indwelled in vivo. The deploy may or may not leave the deploy delivery system by deploying.

Further, as in the first modification shown in FIG. 6A, the coated tube 90 may be formed with a side hole 93 penetrating from the inner surface to the outer surface. The side hole 93 communicates with the passage 91. The position of the side hole 93 is not particularly limited, but is, for example, located closer to the proximal end side than the position where the through hole 50 of the inner pipe 40 is formed in the axial direction. As a result, the priming liquid that has flowed into the passage 91 from the through hole 50 of the inner pipe 40 reaches the internal space 39 between the inner pipe 40 and the outer pipe 30 from the base end of the side hole 93 and the covering tube 90. Therefore, the priming liquid can be dispersed and discharged from a plurality of places of the covering tube 90 and effectively spread in the internal space 39.

Further, as in the second modification shown in FIG. 6B, the tip inner tube 42 and the proximal end inner tube 43 may be separated from each other. As a result, the through hole 50 is formed large, and the amount of priming liquid flowing from the through hole 50 into the passage 91 increases. As a result, the priming liquid can be effectively spread in the internal space 39 between the inner pipe 40 and the outer pipe 30.

Further, as in the third modification shown in FIG. 6C, the inner pipe 40 is one pipe body that is not divided into the tip inner pipe 42 and the proximal end inner pipe 43, and the through hole 50 is the inner pipe 40. It may be an opening provided in a part of the circumferential direction of the. The through hole 50 is formed at a position communicating with the passage 91.

Further, as in the fourth modification shown in FIG. 6D, the reinforcing body may be formed by a tow wire 80 whose tip end side is connected to the outer pipe 30. The base end side of the tow wire 80 is connected to an operating portion 112 operably provided in the operating portion 110. As a result, the tow wire 80 for moving the outer pipe 30 also functions as a reinforcing body. Therefore, the number of parts constituting the developed product delivery system 10 is smaller than that in the case where the tow wire and the reinforcing body are separately provided, and it is possible to reduce the diameter and the manufacturing cost.

Further, as in the fifth modification shown in FIG. 7, the outer tube 30 is not divided into the tip outer tube 31 and the proximal outer tube 32 that are relatively movable in the axial direction, and the entire outer tube 30 is formed. It may be movable toward the proximal end side by being towed by the tow wire 80. The outer tube 30 is movable toward the proximal end side together with the connecting tube 60 in which the proximal end opening 64 is formed and the proximal end shaft 70. The base end shaft 70 is slidably supported by a support tube 122 provided in the operation portion 110, and is movable toward the base end side with respect to the operation portion 110. When the outer tube 30 is towed to the proximal end side by the tow wire 80, the outer tube 30 moves toward the proximal end side together with the connecting tube 60 and the proximal end shaft 70, as shown in FIG. As a result, the stent 20 housed in the outer tube 30 is released from the outer tube 30.

Further, the passage 91 may be formed extending from the through hole 50 to the distal end side instead of the proximal end side of the covering tube 90. Further, the passage 91 may be formed extending from the through hole 50 to both the distal end side and the proximal end side of the covering tube 90. Therefore, the joint portion 92 that joins the coated tube 90 and the inner tube 40 does not have to completely block the space inside the coated tube 90 and outside the inner tube 40 and the reinforcing body 100. In this case, it is preferable that the flow rate flowing from the through hole 50 to the proximal end side is larger than the flow rate flowing to the distal end side. As a result, the tip region of the internal space 39 can be effectively primed. For example, the minimum flow path cross-sectional area in the passage 91 from the through hole 50 toward the proximal end side is larger than the minimum flow path cross-sectional area in the passage 91 from the through hole 50 toward the distal end side.

Further, the moving unit 112 does not have to have a structure in which the tow wire 80 is wound by a rotation operation, and may have a structure in which the tow wire 80 slides, for example.

Further, the tow wire 80 for pulling the outer pipe 30 may be, for example, a strip-shaped body such as a belt, or may be a pipe body continuously formed from the outer pipe 30.

10 Deployment delivery system 20 Stent (deployment)
30 Outer pipe 31 Tip outer pipe 32 Base outer pipe 33 First tip outer pipe 34 Second tip outer pipe 39 Internal space 40 Inner pipe 41 Guide wire lumen 42 Tip inner pipe 43 Base inner pipe 46 Base marker (locking) Department)
47 Tip opening 50 Through hole 64 Base end opening 80 Tow wire 90 Covered tube 91 Passage 92 Joint 100 Reinforcing body 110 Operation part 112 Operating part

Claims (7)

It is a deployment delivery system for expanding a medical deployment in the living body by inserting the tip side into the living body and operating the base end side at hand.
An outer tube that accommodates the deployable object and can be expanded radially outward by opening the deployable object by sliding at least a part toward the proximal end side with respect to the deployable object.
An inner tube arranged inside the outer tube and the deployable object, having a through hole penetrating from the inner surface to the outer surface, and having a locking portion for restricting the movement of the deployable object to the proximal end side.
A covering tube that covers the portion of the inner tube where the through hole is formed, and
An operation unit located on the base end side of the inner pipe and the outer pipe,
It has a long reinforcing body whose base end side is connected to the operation portion and at least a part of the tip end side is connected to the inner pipe.
The coated tube is fixed to the inner tube on the distal end side and / or the proximal end side of the through hole of the inner tube.
A deployable delivery system characterized in that a passage communicating from the through hole to the internal space between the inner tube and the outer tube is formed between the inner surface of the coated tube and the outer surface of the inner tube. The developed product delivery system according to claim 1, wherein at least a part of the distal end side of the reinforcing body is sandwiched between the inner surface of the coated tube and the outer surface of the inner tube. The developed product delivery system according to claim 1 or 2, wherein the passage is formed between the inner surface of the coated tube and the outer surface of the inner tube from the through hole toward the proximal end side. .. The inner tube has a distal end inner tube and a proximal inner tube located on the proximal end side of the distal end inner tube.
The developed product delivery system according to any one of claims 1 to 3, wherein the gap between the distal end inner tube and the proximal end inner tube forms the through hole. The tip side further has a tow wire connected to the outer tube,
The developed product delivery system according to any one of claims 1 to 4, wherein the base end side of the tow wire is connected to an operating portion operably provided in the operating portion. The outer tube has a proximal outer tube and a distal outer tube that is at least partially located on the distal end side of the proximal outer tube and is movable toward the proximal side with respect to the proximal outer tube. ,
The tip outer tube accommodates the deployable object, is connected to the tow wire, and moves toward the proximal end side with respect to the proximal outer tube to open the deployable object and expand it radially outward. The developed product delivery system according to claim 5, wherein the development is possible. The reinforcing body is formed by a tow wire whose tip end side is connected to the outer pipe.
The developed product delivery system according to any one of claims 1 to 4, wherein the base end side of the tow wire is connected to an operating portion operably provided in the operating portion.

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