JP2022075134A - Light irradiation device and light irradiation system - Google Patents

Abstract

To provide a light irradiation device for applying light within an organism, which enables an operator to check whether or not the light is correctly applied toward object tissue within the organism.SOLUTION: A medical light irradiation device comprises: a long body part; a light irradiation part that is provided in one part of a side surface on the tip side of the body part and that applies light to an object substance within an organism; and a detection part that is provided in proximity to the light irradiation part in the body part and that detects a physicochemical phenomenon caused because the object substance is irradiated with the light.SELECTED DRAWING: Figure 1

Description

The present invention relates to a light irradiation device and a light irradiation system.

In cancer treatment, surgical, radiological, and drug (chemical) methods are used alone or in combination, and each technique has been developed in recent years. However, there are many cancers for which a satisfactory treatment technique has not yet been found, and further development of the treatment technique is expected. As one of the cancer treatment techniques, a method called PDT (Photodynamic Therapy) is known. In PDT, a light-sensitive substance is intravenously administered and then irradiated with light to generate active oxygen in cancer cells and kill the cancer cells (see, for example, Non-Patent Document 1). However, PDT has low selectivity for accumulation of photosensitizers in cancer cells, and the magnitude of side effects due to its uptake into normal cells has become an issue, and PDT has not been widely used as a therapeutic technique.

Therefore, as a treatment technique that has been attracting attention in recent years, there is NIR-PIT (Near-infrared photoimmunotherapy). In NIR-PIT, a complex in which two compounds of an antibody against a specific antigen of cancer cells and a photosensitizer (for example, IRDye700DX) are bound is used. When administered intravenously, this complex selectively accumulates in cancer cells in vivo. Then, by irradiating the complex with light having an excitation wavelength (for example, 690 nm) of the photosensitizer, the complex is activated and exhibits an anticancer effect (see, for example, Patent Document 1). In NIR-PIT, side effects can be reduced as compared with PDT due to the accumulation selectivity to cancer by the antibody and the double selectivity by local light irradiation. Further, in NIR-PIT, cell death occurs in a short period of time and cells cause necrosis, so that NIR irradiation can be expected to have an effect on the immune system (see, for example, Non-Patent Document 2).

The predetermined wavelength region including 690 nm exemplified above is also called a spectroscopic window of a living body, and although it is a wavelength region in which light absorption by biological components is less than that of other wavelength regions, light irradiation from the body surface is performed. However, there was a problem that it could not be applied to cancer deep inside the body due to insufficient light permeability. Therefore, in recent years, research has been conducted on NIR-PIT that irradiates light at a position closer to cancer cells instead of irradiating light from the body surface (see, for example, Non-Patent Document 3). For example, Patent Documents 2 to 4 disclose devices that can be used in such PDTs and NIR-PITs. All of the devices described in Patent Documents 2 to 4 are inserted into a blood vessel and used, and can irradiate light in a deep part of the body.

Special Table 2014-523907 Gazette Japanese Unexamined Patent Publication No. 2018-867 Special Table 2007-528752 Japanese Patent No. 4966640

Makoto Mitsunaga, Mikako Ogawa, Nobuyuki Kosaka Lauren T. Rosenblum, Peter L. Choyke, and Hisataka Kobayashi, Cancer Cell-Selective In Vivo Near Infrared Photoimmunotherapy Targeting Specific Membrane Molecules, Nature Medicine 2012 17 (12) :, p.1685-1691 Kazuhide Sato, Noriko Sato, Biying Xu, Yuko Nakamura, Tadanobu Nagaya, Peter L. Choyke, Yoshinori Hasegawa, and Hisataka Kobayashi, Spatially selective depletion of tumor-associated regulatory T cells with near-infrared photoimmunotherapy, Science Translational Medicine 2016 Vol.8 Issue352, ra110 Shuhei Okuyama, Tadanobu Nagaya, Kazuhide Sato, Fusa Ogata, Yasuhiro Maruoka, Peter L. Choyke, and Hisataka Kobayashi, Interstitial near-infrared photoimmunotherapy: effective treatment areas and light doses needed for use with fiber optic diffusers, Oncotarget 2018 Feb 16; 9 (13) :, p.11159-11169

Here, in PDT and NIR-PIT, as described above, the cancer cells in which the complex is accumulated are irradiated with light having the excitation wavelength of the photosensitizer in the complex to generate the cancer cells. Kill it. Therefore, in PDT and NIR-PIT, there is a demand to confirm whether or not the target tissue in the living body (specifically, the cancer cell in which the complex is accumulated) is correctly irradiated with light. there were. In this regard, in the devices described in Patent Document 2 and Patent Document 3, no consideration is given to confirming whether or not the target tissue in the living body is irradiated with light. Further, in the device described in Patent Document 4, when a living tissue is irradiated with a pulsed laser beam, the intensity and wavelength of the light are controlled by utilizing the property that the blood flow volume temporarily decreases due to spasm. Specifically, the device described in Patent Document 4 has a detection means for detecting blood flow in a shallow part of the body, and when blood flow is confirmed in the shallow part of the body, the intensity of light is increased to make the shallow part of the body shallow. If no blood flow is found in the area, maintain the light intensity. However, even with Patent Document 4 as described above, there is a problem that it is not possible to confirm whether or not the target tissue in the living body is irradiated with light.

Further, in PDT and NIR-PIT, it is preferable to avoid light irradiation for normal cells other than cancer cells in order to reduce the risk of cell damage. In this regard, in the techniques described in Patent Document 2 and Patent Document 3, it is difficult to position the light irradiation site in the blood vessel, so that it is not possible to selectively irradiate the site where the cancer cells are present. There was a challenge.

It should be noted that such a problem is not limited to PDT and NIR-PIT, but is a test or treatment including a process of irradiating light in the living body for a test or treatment for cancer, cerebral aneurysm, arrhythmia, Alzheimer's disease, etc. Common to all devices used in. Further, such a problem is not limited to the device inserted into the blood vessel, but also in the biological lumen such as the vascular system, the lymph gland system, the biliary system, the urinary tract system, the airway system, the digestive system, the secretory gland and the reproductive organ. Common to all devices inserted in.

The present invention has been made to solve at least a part of the above-mentioned problems, and is the light irradiation device that irradiates light in the living body correctly irradiating the target tissue in the living body with light? The purpose is to make it possible to confirm whether or not it is.

The present invention has been made to solve at least a part of the above-mentioned problems, and can be realized as the following forms.

(1) According to one embodiment of the present invention, a medical light irradiation device is provided. This light irradiation device is provided on a long main body portion, a part of a side surface on the tip side of the main body portion, and a light irradiation unit that irradiates a target substance in a living body with light, and the light irradiation on the main body portion. It is provided close to the detection unit, and includes a detection unit for detecting a physicochemical phenomenon generated due to the irradiation of the target substance with light.

According to this configuration, the light irradiation device is a physicochemical phenomenon (for example, light, ultrasonic waves, ph of body fluid) generated by the target substance irradiated with light from the light irradiation unit being irradiated with light. It is equipped with a detector that detects changes, temperature changes, pressure changes, etc.). Here, for example, in NIR-PIT, the target substance (for example, a photosensitive substance such as IRDye700DX) in the complex accumulated in the target tissue (cancer cell) in the living body is the light of the excitation wavelength of the target substance. When irradiated, it emits light and emits ultrasonic waves due to the photoacoustic effect. For this reason, the surgeon correctly emits light from the light irradiation unit toward the target tissue (cancer cells in which the complex containing the target substance is accumulated) in the living body depending on whether or not the physicochemical phenomenon is detected by the detection unit. You can check whether it is irradiated or not. As a result, it becomes possible to reliably irradiate the target tissue with light, and the efficiency of the procedure can be improved. The effect of such a light irradiation device is not limited to NIR-PIT using IRDye700DX, but in examination or treatment using any target substance having a property of emitting light or ultrasonic waves when irradiated with light. Is obtained in the same way.
In addition, in IRDye700DX as a target substance, as the cumulative irradiation dose of light to the target substance increases, the target substance undergoes irreversible structural changes, inducing the death of the target tissue (cancer cells), and at the same time, the target substance. The amount of light emitted from the substance and the amount of ultrasonic waves emitted from the target substance are reduced. Therefore, the surgeon can grasp the degree of death of the target tissue (in other words, the degree of progress of the treatment) from the detected value regarding the physicochemical phenomenon by the detection unit. As a result, it is possible to suppress excessive irradiation of the target tissue with light, and it is possible to improve the safety and efficiency of the procedure. The effect of such a light irradiation device is not limited to NIR-PIT using IRDye700DX, and any target substance having a property of reducing the amount of light or ultrasonic waves emitted when irradiated with light can be used. The same can be obtained with the tests or treatments that have been performed.
Further, since the light irradiation unit is provided on a part of the side surface on the tip end side of the main body portion, the light irradiation is performed as compared with the configuration in which the light irradiation unit is provided on the entire circumferential direction of the main body portion. The range of the living tissue can be limited, and it is possible to contribute to the suppression of the damage to the living tissue due to the irradiation of unnecessary living tissue with light.

(2) In the light irradiation device of the above embodiment, the detection unit has a detection element for detecting the physicochemical phenomenon, and is the side of the front end side of the main body where the light irradiation unit is provided. In the above, the direction of the detection element and the irradiation direction of the light in the light irradiation unit may be arranged to be parallel to each other.
According to this configuration, in the detection unit, the direction of the detection element and the light irradiation direction in the light irradiation unit are parallel to each other on the side of the front end side of the main body where the light irradiation unit is provided. It is arranged like this. Therefore, the detection accuracy by the detection unit can be improved as compared with the case of non-parallel arrangement.

(3) In the light irradiation device of the above embodiment, the detection element of the detection unit may detect light as the physicochemical phenomenon or ultrasonic waves as the physicochemical phenomenon.
According to this configuration, the detection unit correctly irradiates the light from the light irradiation unit by detecting the light or ultrasonic waves emitted when the target substance in the complex is irradiated with the light of the excitation wavelength. You can check if it is.

(4) In the light irradiation device of the above embodiment, the detection unit is a coil-shaped detection element formed by winding an optical fiber, and has a detection element that detects ultrasonic waves as the physicochemical phenomenon. By inserting the light irradiation unit inside the detection element on the side surface on the tip end side of the main body portion, the direction of the detection element and the light irradiation direction in the light irradiation unit are arranged to be the same. It may have been done.
According to this configuration, in the detection unit, the direction of the detection element and the light irradiation direction in the light irradiation unit are the same by inserting the light irradiation unit inside the detection element on the side surface on the tip end side of the main body unit. It is arranged so that it becomes. Therefore, the detection accuracy of the ultrasonic wave by the detection unit can be further improved as compared with the case of the non-coaxial arrangement.

(5) In the light irradiation device of the above-described embodiment, the directional marker portion having radiation opacity provided on the side surface of the main body portion is the directional marker portion when viewed from an arbitrary direction. A directional marker unit that can recognize the position of the light irradiation unit in the circumferential direction may be provided depending on the shape or position.
According to this configuration, the light irradiation device has radiation opacity and includes a directional marker unit capable of recognizing the position of the light irradiation unit in the circumferential direction according to the shape or position when viewed from an arbitrary direction. .. Therefore, the surgeon can easily grasp the position (orientation) of the light irradiation unit in the circumferential direction by confirming the shape or position of the directional marker portion reflected in the X-ray photographed image. As a result, according to the light irradiation device of this configuration, for example, in NIR-PIT, the target tissue (cancer cell) can be selectively irradiated with light.

(6) According to one embodiment of the present invention, a medical light irradiation system is provided. This light irradiation system includes a long tube-shaped catheter and a long-shaped light irradiation device which is the light irradiation device of the above-mentioned form and is used by being inserted into the catheter, and the catheter has a tip. It has a light transmitting portion provided on at least a part of the side surface and allowing light inside the tube to be transmitted to the outside, and a first marker portion having radiation opacity provided close to the light transmitting portion. However, the light irradiation device further has a second marker portion having a radiation opacity provided in the vicinity of the light irradiation portion.
According to this configuration, since the catheter and the light irradiation device have a light transmitting portion and a radiation opaque first and second marker portions provided in the vicinity of the light transmitting portion, the operator can perform an X-ray. By confirming the positions of the first and second marker portions in the living body by radiography, it is possible to easily position the light irradiation site (light transmitting portion and light irradiation portion) in the living body cavity. Therefore, according to this light irradiation system, for example, in NIR-PIT, the target tissue (cancer cell) is selectively irradiated with light, and the light is selectively applied to a specific position in the biological lumen. Can be irradiated. Further, a first marker portion is provided close to the light transmitting portion, and a second marker portion is provided close to the light irradiation portion. Therefore, when using the light irradiation system, after inserting the light irradiation device into the catheter, the operator confirms the positional relationship between the first marker part and the second marker part by X-ray photography. The alignment between the light transmitting portion and the light irradiation portion can be easily performed. Further, by separately providing the catheter and the light irradiation device, the degree of freedom in device design can be improved and the range of the procedure can be expanded.

(7) In the light irradiation system of the above embodiment, the first marker portion may be provided at at least two locations, the distal end side and the proximal end side, of the light transmitting portion in the axial direction of the catheter.
According to this configuration, since the first marker portion is provided at at least two locations, the tip end side and the base end side of the light transmitting portion, it is easier to align the light transmitting portion and the light irradiation portion. Can be done.

(8) In the light irradiation system of the above embodiment, even if the second marker portion is provided at at least two positions, the tip end side and the base end side, of the light irradiation portion in the axial direction of the light irradiation device. good.
According to this configuration, since the second marker portion is provided at least at two positions, the tip end side and the base end side of the light irradiation portion, it is easier to align the light transmitting portion and the light irradiation portion. Can be done.

(9) In the light irradiation system of the above embodiment, the light irradiation device is inserted into the catheter, and the tip side is in a state where the light transmitting portion and the light irradiation portion are aligned in the axial direction of the light irradiation system. The first marker portion of the above is arranged on the distal end side in the axial direction from the second marker portion on the distal end side, and the first marker portion on the proximal end side is closer to the second marker portion on the proximal end side. It may be arranged on the base end side in the axial direction.
According to this configuration, when the light irradiation device is inserted into the catheter and the light transmitting portion and the light irradiation portion are aligned, the first marker portion on the distal end side is more axial than the second marker portion on the distal end side. The first marker portion on the proximal end side is arranged on the distal end side in the direction, and is arranged on the proximal end side in the axial direction with respect to the second marker portion on the proximal end side. In other words, in the aligned state, the first marker portion of the catheter is arranged at both ends of the second marker portion of the light irradiation device inserted inside, so that the light transmission portion and the light irradiation are performed. It is possible to intuitively grasp the positional relationship with the department.

(10) In the light irradiation system of the above embodiment, the first marker portion may have a shape surrounding the circumferential direction of the catheter, and the second marker portion may have a shape surrounding the circumferential direction of the light irradiation device. good.
According to this configuration, since both the first and second marker portions have a shape surrounding the circumferential direction of the catheter and the light irradiation device, it is possible to easily grasp the orientation of the catheter and the light irradiation device in the living lumen. Therefore, the alignment between the light transmitting portion and the light irradiation portion can be easily and highly accurately performed.

(11) In the light irradiation system of the above embodiment, the catheter may be provided with a plurality of sets of the light transmitting portion and the first marker portion in the axial direction of the catheter.
According to this configuration, the catheter is provided with a plurality of sets of a light transmitting portion and a first marker portion. Therefore, by moving only the light irradiation device in the axial direction inside the catheter without moving the catheter, it is possible to irradiate light in different regions in the axial direction of the catheter. Further, since the first marker portion is provided in each of the plurality of light transmitting portions, it is possible to easily align the light irradiating portion with respect to each light transmitting portion.

(12) In the light irradiation system of the above embodiment, the catheter further includes a tip tip joined to the tip side, and the tip tip has a through hole penetrating the tip tip in the axial direction of the catheter. Therefore, a through hole having a diameter smaller than the outer diameter of the light irradiation device may be formed.
According to this configuration, a through hole is formed in the tip end joined to the tip side of the catheter, and by inserting a guide wire through this through hole, the catheter can be easily reached to the target site in the living lumen. Can be delivered to. Further, since the diameter of the through hole is smaller than the outer diameter of the light irradiation device, when the light irradiation device is inserted into the catheter, the tip of the light irradiation device abuts on the tip tip, so that the tip side of the light irradiation device is reached. Can suppress omission.

(13) In the light irradiation system of the above embodiment, the catheter may further include a temperature sensor that measures a temperature at least in the vicinity of the light transmitting portion.
According to this configuration, since a temperature sensor that measures the temperature at least in the vicinity of the light transmitting portion is provided, the temperature change of the living tissue due to light irradiation can be observed in real time, and blood coagulation and damage to the living tissue due to light irradiation are suppressed. Can contribute to.

The present invention can be realized in various aspects, for example, a light irradiation device, a catheter, a light irradiation system in which these are separate or integrated, and control of a light source used in these devices or systems. It can be realized in the form of a method, a method of manufacturing these devices or systems, and the like.

It is explanatory drawing which illustrates the structure of the light irradiation system of 1st Embodiment. It is explanatory drawing which illustrates the cross-sectional structure in line AA (FIG. 1). It is explanatory drawing which illustrated the structure of the tip side of a light irradiation device. It is explanatory drawing which illustrates the use state of a light irradiation system. It is a figure which shows the relationship between the ultrasonic wave emitted from the target substance, and the integrated radiation amount of light. It is explanatory drawing which illustrates the structure of the tip side of the light irradiation device of 2nd Embodiment. It is explanatory drawing which illustrates the structure of the tip side of the light irradiation device of 3rd Embodiment. It is explanatory drawing which illustrates the structure of the light irradiation device of 4th Embodiment. It is explanatory drawing which illustrates the structure of the light irradiation device of 5th Embodiment. It is explanatory drawing which illustrates the structure of the light irradiation device of 6th Embodiment. It is explanatory drawing which illustrates the structure of the tip side of the light irradiation system of 7th Embodiment. It is explanatory drawing which illustrated the structure of the tip side of the light irradiation system of 8th Embodiment. It is explanatory drawing which illustrates the structure of the catheter seen from the B direction (FIG. 12). It is explanatory drawing which illustrates the structure of the light irradiation system of 9th Embodiment. It is explanatory drawing which illustrates the structure of the tip side of the light irradiation system of 10th Embodiment. It is explanatory drawing which illustrated the structure of the tip side of the light irradiation system of 11th Embodiment. It is explanatory drawing which illustrates the cross-sectional structure of a catheter in line CC (FIG. 16). It is explanatory drawing which illustrates the structure of the tip side of the light irradiation device of 12th Embodiment. It is explanatory drawing which illustrates the structure of the tip side of the light irradiation device of 13th Embodiment.

<First Embodiment>
FIG. 1 is an explanatory diagram illustrating the configuration of the light irradiation system of the first embodiment. The light irradiation system is used by inserting it into the biological lumen such as the vascular system, lymph gland system, biliary tract system, urinary tract system, airway system, digestive organ system, secretory gland and reproductive organ, and the living body is used from inside the biological lumen. It is a system that irradiates light toward the tissue. The light irradiation system includes a catheter 1 and a light irradiation device 2 used by being inserted into the catheter 1. In FIG. 1, the catheter 1 and the light irradiation device 2 are shown separately.

In this embodiment, a case where the light irradiation system is used in NIR-PIT (Near-infrared photoimmunotherapy) will be described. In NIR-PIT, a complex in which two compounds of an antibody against a specific antigen of cancer cells and a light-sensitive substance (for example, IRDye700DX) are bound is intravenously administered to a patient in advance. The intravenously administered complex selectively accumulates in cancer cells in vivo. Then, a light irradiation system is inserted into the living body cavity, and a laser beam having an excitation wavelength (for example, 690 nm) of the photosensitive substance in the complex is irradiated toward the cancer cells in the living body. As a result, the complex accumulated in the cancer cells in the living body is activated and exhibits an anticancer effect. Hereinafter, a biological tissue to be treated by a light irradiation system, such as a cancer cell, is also referred to as a “target tissue”. Further, a light-sensitive substance activated by light irradiation, such as IRDye700DX, is also referred to as a "target substance".

In this embodiment, a laser beam having a wavelength of 690 nm is exemplified as an example of light, but the wavelength of the laser beam may be arbitrarily changed. Further, the light irradiation system is not limited to laser light, and for example, LED light or white light may be used. Furthermore, the light irradiation system is not limited to NIR-PIT, but is used in vivo for examination or treatment of, for example, PDT (Photodynamic Therapy), cancer, cerebral aneurysm, arrhythmia, Alzheimer's disease, and the like. It may be used in a test or treatment involving the process of irradiating light in.

In FIG. 1, an axis passing through the center of the catheter 1 and an axis passing through the center of the light irradiation device 2 are represented by an axial line O (dashed-dotted line), respectively. Hereinafter, in the state where the light irradiation device 2 is inserted into the catheter 1, the axes passing through the centers of each other will be described as being aligned with the axis O, but the axes passing through the centers of the two in the inserted state will be different from each other. good. Further, FIG. 1 shows XYZ axes that are orthogonal to each other. The X-axis corresponds to the axial direction (longitudinal direction) of the catheter 1 and the light irradiation device 2, the Y-axis corresponds to the height direction of the catheter 1 and the light irradiation device 2, and the Z-axis corresponds to the catheter 1 and the light irradiation device 2. Corresponds to the width direction. The left side (-X-axis direction) of FIG. 1 is referred to as the catheter 1, the light irradiation device 2, and the "tip side" of each component, and the right side (+ X-axis direction) of FIG. 1 is the catheter 1, the light irradiation device 2, and the light irradiation device 2. It is called the "base end side" of each component. Further, among both ends of the catheter 1, the light irradiation device 2, and each component in the longitudinal direction (X-axis direction), one end located on the distal end side is referred to as "tip", and the other end located on the proximal end side is referred to as "tip". Called "base". The tip and its vicinity are referred to as a "tip portion", and the proximal end and its vicinity are referred to as a "base end portion". The distal end side is inserted into the living body, and the proximal end side is operated by a surgeon such as a doctor. These points are also common to FIGS. 1 and later.

The catheter 1 has a long tube shape and includes a shaft 110, a tip tip 120, and a connector 140.

The shaft 110 is a long member extending along the axis O. The shaft 110 has a hollow substantially cylindrical shape in which both ends of the tip portion 110d and the base end portion 110p are open. The shaft 110 has a lumen 110L inside. The lumen 110L functions as a guide wire lumen for inserting the guide wire through the catheter 1 at the time of delivery of the catheter 1. The lumen 110L functions as a device lumen for inserting the light irradiation device 2 through the catheter 1 after the delivery of the catheter 1. In this way, the diameter of the catheter 1 can be reduced by using both the guide wire lumen and the lumen for the device as a single lumen. The outer diameter, inner diameter and length of the shaft 110 can be arbitrarily determined.

The tip tip 120 is a member that is joined to the tip of the shaft 110 and advances in the living lumen ahead of other members. The tip tip 120 has an outer shape whose diameter is reduced from the proximal end side to the distal end side in order to facilitate the progress of the catheter 1 in the living lumen. A through hole 120h is formed in a substantially central portion of the tip tip 120 so as to penetrate the tip tip 120 in the O-axis direction. Here, the opening diameter Φ1 of the through hole 120h is smaller than the inner diameter Φ2 of the lumen 110L of the shaft 110. Therefore, at the boundary between the shaft 110 and the tip tip 120, a step is formed due to the protrusion of the inner surface 120i of the tip tip 120. The opening 120o of the tip tip 120 leads to the through hole 120h and is used when inserting a guide wire (not shown) into the catheter 1. The outer diameter and length of the tip tip 120 can be arbitrarily determined.

The connector 140 is a member arranged on the proximal end side of the catheter 1 and gripped by the operator. The connector 140 includes a substantially cylindrical connection portion 141 and a pair of blades 142. The base end portion 110p of the shaft 110 is joined to the tip end portion of the connection portion 141, and the blade 142 is joined to the base end portion. The blade 142 may have a structure integrated with the connector 140. The opening 140o of the connector 140 leads to the lumen 110L through the inside of the connector 140, and is used when the light irradiation device 2 is inserted into the catheter 1. The outer diameter, inner diameter and length of the connecting portion 141 and the shape of the blade 142 can be arbitrarily determined.

The shaft 110 of the catheter 1 is further provided with a light transmitting portion 139 and first marker portions 131 and 132.

The light transmitting portion 139 transmits the light (laser light) emitted from the inside of the shaft 110 to the outside. The light transmitting portion 139 is a hollow member having a substantially cylindrical shape, has an outer diameter substantially the same as the outer diameter of the shaft 110, and has an inner diameter substantially the same as the inner diameter Φ2 of the lumen 110L of the shaft 110. The light transmitting portion 139 is provided in the entire circumferential direction, and transmits the light inside the shaft 110 to the outside in the entire circumferential direction. The light transmitting portion 139 is joined to the shaft 110 at the proximal end side and the distal end side, respectively. The light transmitting portion 139 can be formed of a transparent resin material having light transmission, for example, acrylic resin, polyethylene terephthalate, polyvinyl chloride, or the like. An interference filter may be provided on the inner surface or the outer surface of the light transmitting portion 139. The interference filter is a film body having a predetermined transmission band (for example, a wavelength of 600 nm or more and 1000 nm or less). The interference filter transmits (blocks) light having a wavelength outside the transmission band while transmitting light having a wavelength within the transmission band.

The first marker portions 131 and 132 function as marks indicating the positions of the light transmitting portions 139. The first marker portion 131 is provided close to the tip portion of the light transmitting portion 139, and functions as a mark indicating the position of the tip portion of the light transmitting portion 139. The first marker portion 132 is provided close to the proximal end portion of the light transmitting portion 139, and functions as a mark indicating the position of the proximal end portion of the light transmitting portion 139. The first marker portions 131 and 132 are hollow members having a substantially cylindrical shape, respectively. In the example of FIG. 1, the first marker portions 131 and 132 are respectively arranged in recesses formed on the outer surface of the shaft 110 and are joined to the outer surface of the shaft 110. In other words, the first marker portions 131 and 132 are embedded in the outer surface of the shaft 110 so as to surround the circumferential direction of the shaft 110, respectively. The first marker portions 131 and 132 may be provided so as to project from the outer surface of the shaft 110 by being joined to the outer surface of the shaft 110 having no recess.

The light irradiation device 2 has a long outer shape, and has a main body portion 210, a tip tip 220, a connector 240, a light transmission portion 250, a detection portion 260, and a reinforcing member 272 (described later in FIG. 2). ) And.

The main body 210 is a long member extending along the axis O. The main body 210 has a hollow substantially cylindrical shape (tube shape) in which both ends of the tip 210d and the base 210p are open. A light irradiation unit 239 and a detection element 261 are provided on the outer surface of the main body 210 on the distal end side (described later in FIG. 3). The lumen 210L inside (inside) the main body 210 houses a light transmitting unit 250, a detecting unit 260, and a reinforcing member 272, respectively. Further, the sealing member 271 is filled in the void portion of the inside of the main body portion 210 except for the light transmission portion 250, the detection portion 260, and the reinforcing member 272. As the sealing member 271, for example, any resin material such as polyurethane can be used.

The tip tip 220 is a member that is joined to the tip portion 210d of the main body portion 210 and advances the lumen 110L of the catheter 1 ahead of other members. The tip tip 220 is a substantially cylindrical member extending in the longitudinal direction of the light irradiation device 2. Here, the outer diameter Φ3 of the tip tip 220 and the main body 210 (in other words, the outer diameter Φ3 of the light irradiation device 2) is larger than the opening diameter Φ1 of the through hole 120h of the catheter 1, and the shaft of the catheter 1 is used. It is preferably smaller than the inner diameter Φ2 of 110 and the light transmitting portion 139 (Φ1 <Φ3 <Φ2).

The connector 240 is a member that is arranged on the proximal end side of the light irradiation device 2 and is gripped by the operator. The connector 240 includes a substantially cylindrical connection portion 241 and a pair of blades 242. The base end portion 210p of the main body portion 210 is joined to the tip end portion of the connection portion 241 and the blade 242 is joined to the base end portion of the connection portion 241. The blade 242 may have a structure integrated with the connector 240.

FIG. 2 is an explanatory diagram illustrating the cross-sectional configuration of the line AA (FIG. 1). FIG. 3 is an explanatory diagram illustrating the configuration of the tip side of the light irradiation device 2. FIG. 3A shows a cross-sectional configuration on the tip side of the light irradiation device 2. FIG. 3B shows the configuration of the light irradiation device 2 as seen from the direction B of FIG. 3A.

The light transmission unit 250 receives from the light irradiation unit 239 formed at the tip to the target tissue (cancer cells) in the living body and the target substance (for example, IRDye700DX) in the complex accumulated in the target tissue. , Irradiate with light. As shown in FIG. 2, the light transmission unit 250 is composed of an optical fiber having a core 250c extending in the longitudinal direction of the light irradiation device 2 and a clad 250cl covering the outer surface of the core 250c. The core 250c is located substantially in the center of the clad 250cl and has a higher refractive index than the clad 250cl. The core 250c and the clad 250cl have a uniform refractive index. The light transmission unit 250 transmits light by total internal reflection of light utilizing the difference in refractive index between the core 250c and the clad 250cl.

As shown in FIG. 1, the tip end side of the light transmitting portion 250 is inserted inside the main body portion 210 and fixed by the sealing member 271. Further, as shown in FIG. 3A, a curved portion in which the light transmitting portion 250 is curved in the + Y axis direction is formed at the tip portion of the light transmitting portion 250. Then, as shown in FIG. 3B, the tip end (tip surface) of the light transmission portion 250 is arranged so as to be exposed on the outer surface of the main body portion 210. At the tip of the light transmission unit 250, the core 250c is exposed. From the exposed core 250c, the laser light LT generated by the light source 3 and transmitted via the light transmission unit 250 is irradiated. That is, the core 250c exposed at the tip of the light transmission unit 250 functions as a light irradiation unit 239 that irradiates the light LT to the outside. As described above, in the configuration of the present embodiment, by bending the tip portion of the light transmission unit 250, the irradiation direction of the light LT from the light irradiation unit 239 is set to the longitudinal direction (axis O direction) of the light irradiation device 2. The direction of intersection, in other words, one direction of the side surface of the light irradiation device 2. The core 250c of the light irradiation unit 239 may be subjected to well-known processing (for example, processing for cutting the tip surface diagonally, processing for forming notches, sandblasting, chemical treatment). Further, a resin body or a light reflection mirror for transmitting, refracting, and amplifying the laser light LT may be provided at or near the tip of the core 250c. The resin body can be formed, for example, by applying it to an acrylic ultraviolet curable resin in which fine quartz powder is dispersed and curing it with ultraviolet light.

As shown in FIG. 1, the proximal end side of the optical transmission unit 250 passes through the inside of the connector 240 and is pulled out to the outside. The base end portion of the light transmission unit 250 is connected to the light source 3 directly or indirectly via another optical fiber via a connector (not shown). The light source 3 is, for example, a laser light generator that generates laser light of an arbitrary wavelength. The length of the light transmission unit 250 may be arbitrarily determined.

The detection unit 260 is a sensor that detects ultrasonic waves emitted from a target substance (for example, IRDye700DX). The detection unit 260 of the present embodiment is an optical fiber Doppler sensor (FOD) composed of an optical fiber having a core 260c extending in the longitudinal direction of the light irradiation device 2 and a clad 260cl covering the outer surface of the core 260c. (Fig. 2).

As shown in FIG. 3A, the detection unit 260 has a detection element 261 and an extension unit 262. As shown in FIG. 3B, the detection element 261 is a coil-shaped detection element formed by winding a part of the tip side of the optical fiber. The detection element 261 utilizes the laser Doppler effect to detect ultrasonic waves emitted from an object to be measured (here, a target substance in a complex accumulated in a living tissue). Further, as shown in FIG. 1, the stretched portion 262 is composed of the remaining portion of the optical fiber, and connects the detection element 261 and the detection device 4 provided outside, and the detection value by the detection element 261 ( The detection signal) is transmitted to the detection device 4.

As shown in FIG. 1, the tip end side of the stretched portion 262 is inserted inside the main body portion 210 and fixed by the sealing member 271. Further, as shown in FIG. 3A, at the tip end portion of the stretched portion 262, a curved portion in which the stretched portion 262 is curved in the + Y axis direction (in other words, the same direction as the bending direction of the light irradiation portion 239) is provided. It is formed. The detection element 261 provided at the tip of the stretched portion 262 is exposed and arranged on the outer surface of the main body portion 210. Specifically, as shown in FIG. 3B, the detection element 261 is provided at a position adjacent to the light irradiation unit 239 on the side surface on the tip end side of the main body unit 210 in the X-axis direction. In other words, the detection unit 260 and the light irradiation unit 239 are provided close to each other. Here, as shown in FIG. 3A, the orientation ED of the detection element 261 is parallel to the light irradiation direction LTD in the light irradiation unit 239 on the side surface on the tip end side of the main body portion 210. Here, the "direction ED of the detection element 261" means the direction of the central axis of the coil of the detection element 261. Further, the "light irradiation direction LTD" means the center of the light irradiation range from the light irradiation unit 239.

As shown in FIG. 1, the proximal end side of the stretched portion 262 is pulled out to the outside through the inside of the connector 240. The base end portion of the stretched portion 262 is directly connected to the detection device 4 via a connector (not shown) or indirectly via another optical fiber. The detection device 4 is a device that detects ultrasonic waves and guides the intensity of the detected ultrasonic waves to the operator by any means such as screen display, LED (Light Emitting Diode) display, and voice guidance. The number of turns of the detection element 261 and the length of the stretched portion 262 may be arbitrarily determined.

The optical transmission unit 250 and the detection unit 260 of the present embodiment are composed of a plastic optical fiber whose core and clad are both made of resin. The core can be formed of, for example, a polymethylmetacrylate resin (PMMA), polystyrene, polycarbonate, a weighted hydride polymer, a fluoropolymer, a silicon polymer, a norbornene polymer and the like. The core is classified into a single mode and a multi-mode according to the number of modes in which light propagates, but in this embodiment, either one may be used. Further, in the case of a multi-mode core, it is classified into a step index and a graded index according to the refractive index distribution, but in this embodiment, either of them may be used. The clad can be formed, for example, by a fluoropolymer. Instead of the plastic optical fiber, a quartz glass optical fiber or a multi-component glass optical fiber may be used for the optical transmission unit 250 and the detection unit 260.

The reinforcing member 272 is a member for reinforcing the long light irradiation device 2 and suppressing excessive bending of the light irradiation device 2. The reinforcing member 272 is a long core wire extending along the axis O and having a solid substantially cylindrical shape. The reinforcing member 272 is arranged inside the main body 210 so that the tip end portion is located in the vicinity of the tip end tip 220 and the base end portion is located inside the connector 240. The reinforcing member 272 can be formed of any material, for example, any hard resin material such as reinforced plastic (PEEK), or a metal material. The length of the reinforcing member 272 can be arbitrarily determined.

The main body 210 of the light irradiation device 2 is further provided with second marker portions 231 and 232. The second marker units 231 and 232 function as marks indicating the positions of the light irradiation units 239. The second marker portion 231 is provided close to the tip portion of the light irradiation unit 239, and functions as a mark indicating the position of the tip portion of the light irradiation unit 239. The second marker unit 232 is provided close to the base end portion of the light irradiation unit 239 (more specifically, the base end portion of the detection element 261), and the position of the base end portion of the light irradiation unit 239 can be determined. It functions as a marker to represent. The second marker portions 231 and 232 are hollow members having a substantially cylindrical shape, respectively. In the example of FIG. 1, the second marker portions 231 and 232 are respectively arranged in the recesses formed on the outer surface of the main body portion 210 and are joined to the outer surface of the main body portion 210. In other words, the second marker portions 231 and 232 are embedded in the outer surface of the main body portion 210 so as to surround the circumferential direction of the main body portion 210, respectively. The second marker portions 231 and 232 may be provided so as to project from the outer surface of the main body portion 210 by being joined to the outer surface of the main body portion 210 having no recess.

The first marker portions 131 and 132 of the catheter 1 and the second marker portions 231 and 232 of the light irradiation device 2 can be formed of a resin material or a metal material having radiation opacity. For example, when a resin material is used, it can be formed by mixing a radiation-impermeable material such as bismuth trioxide, tungsten, or barium sulfate with a polyamide resin, a polyolefin resin, a polyester resin, a polyurethane resin, a silicon resin, a fluororesin, or the like. For example, when a metal material is used, it can be formed of a radiation-impermeable material such as gold, platinum, tungsten, or an alloy containing these elements (for example, platinum-nickel alloy).

The shaft 110 of the catheter 1 and the main body 210 of the light irradiation device 2 preferably have antithrombotic properties, flexibility, and biocompatibility, and can be formed of a resin material or a metal material. As the resin material, for example, polyamide resin, polyolefin resin, polyester resin, polyurethane resin, silicon resin, fluororesin and the like can be adopted. As the metal material, for example, stainless steel such as SUS304, nickel-titanium alloy, cobalt-chromium alloy, tungsten steel and the like can be adopted. Further, the shaft 110 and the main body 210 may be a joint structure in which a plurality of the above-mentioned materials are combined. The tip tip 120 of the catheter 1 and the tip tip 220 of the light irradiation device 2 are preferably flexible, and can be formed of, for example, a resin material such as polyurethane or polyurethane elastomer. The connector 140 of the catheter 1 and the connector 240 of the light irradiation device 2 can be formed of a resin material such as polyamide, polypropylene, polycarbonate, polyacetal, and polyether sulfone.

FIG. 4 is an explanatory diagram illustrating a usage state of the light irradiation system. The upper part of FIG. 4 shows a state in which the light irradiation device 2 is inserted into the catheter 1. The lower part of FIG. 4 shows an enlarged state of a part on the tip side. A method of using the light irradiation system will be described with reference to FIGS. 1 and 4. First, the operator inserts a guide wire into the lumen of the living body. Next, the operator inserts the proximal end side of the guide wire from the opening 120o of the tip tip 120 of the catheter 1 shown in FIG. 1 into the lumen 110L and projects it from the opening 140o of the connector 140. Next, the surgeon pushes the catheter 1 into the living lumen along the guide wire, and the light transmitting portion 139 of the catheter 1 is directed to the target site of light irradiation (for example, in the case of NIR-PIT, the cancer cell). Deliver to (nearby). By inserting the guide wire through the through hole 120h formed in the tip tip 120 of the catheter 1 in this way, the operator can easily deliver the catheter 1 to the target site in the living lumen. At the time of delivery, the operator positions the catheter 1 in the lumen of the living body while confirming the positions of the first marker portions 131 and 132 arranged in the vicinity of the light transmitting portion 139 in the X-ray image. be able to. The surgeon then removes the guide wire from the catheter 1.

Next, as shown in FIG. 4, the operator inserts the light irradiation device 2 through the opening 140o of the connector 140 of the catheter 1. The surgeon pushes the light irradiation device 2 toward the tip of the catheter 1 along the lumen 110L of the catheter 1. Here, as described above, if the outer diameter Φ3 of the light irradiation device 2 is smaller than the inner diameter Φ2 of the lumen 110L of the catheter 1 and larger than the opening diameter Φ1 of the through hole 120h of the tip tip 120, the catheter 1 When the light irradiation device 2 is inserted into the light irradiation device 2, the tip surface 220e of the light irradiation device 2 abuts on the inner surface 120i of the tip chip 120, so that the light irradiation device 2 can be prevented from coming off to the tip side (lower part of FIG. 4). : Broken circle frame).

After that, the surgeon confirms the positional relationship between the first marker units 131 and 132 and the second marker units 231,232 in the X-ray image, so that the axis line between the light transmitting unit 139 and the light irradiation unit 239 can be confirmed. Align the position in the O direction (X-axis direction). As a result, the laser light LT transmitted via the light transmission unit 250 and emitted from the light irradiation unit 239 can be transmitted through the light transmission unit 139 of the catheter 1 and emitted to an external living tissue. In the catheter 1 of the present embodiment, the light transmitting portion 139 is provided in the entire circumferential direction. Therefore, in the light irradiation system of the present embodiment, the operator only needs to align the light transmitting portion 139 and the light irradiation portion 239 in the axis O direction (X-axis direction), and the light transmitting portion in the circumferential direction. It is not necessary to align the 139 with the light irradiation unit 239.

FIG. 5 is a diagram showing the relationship between the ultrasonic wave emitted from the target substance and the integrated radiation amount of light. The horizontal axis of FIG. 5 represents the integrated radiation amount of light from the light irradiation system (FIG. 4: laser light LT), and the vertical axis represents the amount of ultrasonic waves emitted from the target substance. As described in FIG. 4, in the NIR-PIT procedure using the light irradiation system, the target substance (for example, IRDye700DX) in the complex is light sensitive to the target tissue (cancer cell) in the living body. Irradiate light with the excitation wavelength of the substance). Upon irradiation with light, the target substance (IRDye700DX) undergoes an irreversible structural change from hydrophilic to hydrophobic, inducing necrosis of the target tissue. That is, irradiation with light activates the complex accumulated in the target tissue in the living body, and an anticancer effect can be obtained.

Here, the target substance (IRDye700DX) has a property of emitting light and emitting ultrasonic waves by a photoacoustic effect when irradiated with light having an excitation wavelength of the target substance. The property of "emitting light and ultrasonic waves" of the target substance disappears as the structural change of the target substance progresses. Therefore, as shown in FIG. 5, as the integrated radiation amount of light from the light irradiation system increases, the ultrasonic waves released from the target substance in the complex accumulated in the target tissue (cancer cell) in the living body. The amount of ultrasonic waves gradually decreases. Although the amount of ultrasonic waves emitted from the target substance is shown in FIG. 5, the same applies to the amount of light emitted from the target substance.

The light irradiation system can detect the ultrasonic wave emitted from the target substance (IRDye700DX) by the detection unit 260. The detection device 4 performs processing such as the following a1 and a2 by using the detection value by the detection unit 260.
(A1) The detection device 4 acquires and stores the standard value of the detection unit 260. The standard value is a value of ultrasonic waves emitted from a biological tissue other than the target substance (for example, hemoglobin in blood). The standard value is obtained by irradiating the target tissue (cancer cell) in the living body with light from the light irradiation unit 239 and acquiring the detection value of the detection unit 260 at that time before administering the complex. be able to. The standard value is not limited to the value directly acquired from the target patient of the procedure, but any data such as a value acquired from a healthy person or a value input by the operator may be used.
(A2) The detection device 4 acquires the detection value obtained from the detection unit 260 in real time during the NIR-PIT procedure after administration of the complex. The detection device 4 guides the operator in real time to a value obtained by excluding the standard value of the process a1 from the acquired detected value. As the guidance, any means such as screen display, LED display, voice guidance and the like can be used.

In the above-mentioned example, the detection unit 260 is a sensor that detects "ultrasonic waves" emitted from the target substance (IRDye700DX). However, the detection unit 260 may be a sensor that detects "light" emitted from the target substance. In this case, as in the process a1, the detection device 4 acquires and stores in advance the standard values of the light emitted from the light irradiation unit 239 and the reflected light from the living tissue. Then, as in the process a2, the detected value obtained from the detection unit 260 may be acquired in real time, and the value obtained by excluding the standard value of the process a1 from the detected value may be guided to the operator. As described with reference to FIG. 5, the light emitted from the target substance has the same properties as ultrasonic waves. Therefore, even if the detection unit 260 is a sensor that detects light, the same processing can be performed.

In addition to the "ultrasonic waves" and "light" emitted from the target substance, the detection unit 260 has various types of light generated by the target substance or biological tissue due to the irradiation of the target substance with light. It may be a sensor that detects a physicochemical phenomenon. Examples of the physicochemical phenomenon caused by the target substance include the above-mentioned ultrasonic waves and light emission. Physicochemical phenomena caused by living tissue include, for example, changes in the ph (paher) of body fluid existing around the target tissue (cancer cells), and living tissue caused by the emission of light or ultrasonic waves from the target substance (biological tissue). Changes in temperature (including body fluids) can be mentioned. Further, the physicochemical phenomenon caused by the living tissue includes a change in the pressure of the body fluid due to the cell rupture of the target tissue that occurs in the process of killing the target tissue by the anticancer action of the complex. The detection unit 260 may be configured as a sensor for detecting a physicochemical phenomenon (pH change, temperature change, pressure change of body fluid) caused by a living tissue caused by irradiation of a target substance with light.

As described above, in the light irradiation device 2 of the first embodiment, the target substance irradiated with the light LT from the light irradiation unit 239 is irradiated with the light LT, which causes a physicochemical phenomenon (for example, for example). It is provided with a detection unit 260 that detects light, ultrasonic waves, ph changes in body fluids, temperature changes, pressure changes, etc.). Here, for example, in NIR-PIT, the target substance (for example, a photosensitive substance such as IRDye700DX) in the complex accumulated in the target tissue (cancer cell) in the living body is the light LT having the excitation wavelength of the target substance. When it is irradiated with light, it emits light and also emits ultrasonic waves due to the photoacoustic effect. Therefore, the surgeon correctly directs the light irradiation unit 239 toward the target tissue (cancer cell in which the complex containing the target substance is accumulated) in the living body depending on whether or not the physicochemical phenomenon is detected by the detection unit 260. It can be confirmed whether or not the light LT is irradiated. As a result, it becomes possible to reliably irradiate the target tissue with optical LT, and the efficiency of the procedure can be improved. The effect of such a light irradiation device 2 is not limited to NIR-PIT using IRDye700DX, and inspection or inspection using any target substance having a property of emitting light or ultrasonic waves when irradiated with light LT. The same can be obtained in treatment.

In addition, in IRDye700DX as a target substance, as the cumulative irradiation dose of optical LT to the target substance increases, the target substance undergoes irreversible structural changes, inducing the death of the target tissue (cancer cells) and the target. The amount of light emitted from the substance and the amount of ultrasonic waves emitted from the target substance decrease (Fig. 5). Therefore, the surgeon can grasp the degree of death of the target tissue (in other words, the degree of progress of the treatment) from the detection value regarding the physicochemical phenomenon by the detection unit 260. As a result, it is possible to suppress excessive irradiation of the target tissue with light LT, and it is possible to improve the safety and efficiency of the procedure. The effect of such a light irradiation device 2 is not limited to NIR-PIT using IRDye700DX, and any target substance having a property of reducing the amount of light or ultrasonic waves emitted when irradiated with light LT. The same can be obtained in the examination or treatment using.

Further, in the light irradiation device 2, since the light irradiation unit 239 is provided on a part of the side surface on the tip end side of the main body portion 210, the light irradiation unit 239 is provided on the entire circumferential direction of the main body portion 210. In comparison with the above, the range of the biological tissue to be irradiated with light can be limited, and it is possible to contribute to the suppression of the damage to the biological tissue due to the irradiation of unnecessary biological tissue with light.

Further, according to the light irradiation device 2 of the first embodiment, the detection unit 260 has the orientation ED of the detection element 261 on the side of the front end side of the main body 210 where the light irradiation unit 239 is provided. , The light LT in the light irradiation unit 239 is arranged so as to be parallel to the irradiation direction LTD (FIG. 3). Therefore, the detection accuracy by the detection unit 260 can be improved as compared with the case of the non-parallel arrangement. Here, "parallel" is sufficient if it is generally parallel, and blurring due to manufacturing error or the like is allowed. Further, the detection unit 260 of the first embodiment correctly detects the ultrasonic waves emitted when the target substance in the complex is irradiated with the light LT of the excitation wavelength, so that the light LT from the light irradiation unit 239 can be correctly detected. Can be confirmed whether or not is irradiated.

Further, according to the light irradiation system of the first embodiment, the catheter 1 and the light irradiation device 2 are the radiation opaque first marker unit 131 provided in the vicinity of the light transmission unit 139 and the light irradiation unit 239. , 132 and second marker portions 231 and 232. Therefore, the surgeon confirms the positions of the first marker portions 131 and 132 and the second marker portions 231 and 232 in the living body by X-ray photography, so that the surgeon confirms the position of the light irradiation site (light transmitting portion 139) in the living body lumen. And the positioning of the light irradiation unit 239) can be easily performed. Therefore, according to the light irradiation system of the first embodiment, for example, in NIR-PIT, the target tissue (cancer cell) is selectively irradiated with light, for example, with respect to a specific position in the biological lumen. It is possible to selectively irradiate light. Further, the first marker units 131 and 132 are provided in close proximity to the light transmitting unit 139, and the second marker units 231 and 232 are provided in close proximity to the light irradiation unit 239. Therefore, when using the light irradiation system, after inserting the light irradiation device 2 into the catheter 1, the operator takes an X-ray image of the first marker units 131, 132 and the second marker units 231, 232. By confirming the positional relationship, the alignment between the light transmitting portion 139 and the light irradiating portion 239 can be easily performed. Further, by separately providing the catheter 1 and the light irradiation device 2, the degree of freedom in device design can be improved and the range of the procedure can be expanded.

Further, in the catheter 1, the first marker portions 131 and 132 are provided at at least two locations, the distal end side and the proximal end side of the light transmitting portion 139, so that the operator can irradiate the light transmitting portion 139 with light. The alignment with the portion 239 can be made even easier. Similarly, in the light irradiation device 2, the second marker portions 231 and 232 are provided at at least two locations, the tip end side and the proximal end side of the light irradiation unit 239, so that the operator can perform the light transmission unit 139. And the light irradiation unit 239 can be more easily aligned.

Further, in the light irradiation system of the present embodiment, as shown in FIG. 4, in a state where the light irradiation device 2 is inserted into the catheter 1 and the light transmission unit 139 and the light irradiation unit 239 are aligned, the tip side is The first marker portion 131 is arranged on the distal end side in the axis O direction with respect to the second marker portion 231 on the distal end side, and the first marker portion 132 on the proximal end side is more axial than the second marker portion 232 on the proximal end side. It is arranged on the base end side in the O direction. In other words, in the light irradiation system of FIG. 4, in the aligned state, the first marker portions 131 and 132 of the catheter 1 are both ends of the second marker portions 231 and 232 of the light irradiation device 2 inserted inside. It is said to be located in. Therefore, the operator can easily intuitively grasp the positional relationship between the light transmitting portion 139 and the light irradiating portion 239.

Further, in the light irradiation system of the present embodiment, the first marker portions 131 and 132 and the second marker portions 231 and 232 both have a shape surrounding the catheter 1 and the light irradiation device 2 in the circumferential direction. By radiography, it is possible to easily grasp the orientation of the catheter 1 and the light irradiation device 2 in the living cavity. Therefore, the operator can easily and highly accurately align the light transmitting portion 139 and the light irradiating portion 239.

Further, in the light irradiation system of the present embodiment, since the tip tip 120 joined to the tip end side of the catheter 1 has a through hole 120h, the catheter 1 is formed by inserting a guide wire through the through hole 120h. Can be easily delivered to the target site in the living lumen. Further, since the opening diameter Φ1 of the through hole 120h is smaller than the outer diameter Φ3 of the light irradiation device 2, when the light irradiation device 2 is inserted into the catheter 1, the tip of the light irradiation device 2 abuts on the tip tip 120. , It is possible to suppress the light irradiation device 2 from coming off to the tip side. Further, as shown in the lower part of FIG. 4, when the light irradiation device 2 abuts on the catheter 1, the position of the light irradiation unit 239 in the axis O direction is located substantially at the center of the light transmission unit 139 in the axis O direction. As described above, the light transmitting unit 139 and the light irradiation unit 239 are arranged. Therefore, the operator can more easily align the light transmitting portion 139 and the light irradiating portion 239.

<Second Embodiment>
FIG. 6 is an explanatory diagram illustrating the configuration of the tip side of the light irradiation device 2A of the second embodiment. FIG. 6A shows a cross-sectional configuration on the tip side of the light irradiation device 2A. FIG. 6B shows the configuration of the light irradiation device 2A seen from the direction B of FIG. 6A. The light irradiation system of the second embodiment includes a light irradiation device 2A shown in FIG. 6 and a catheter 1 having the same configuration as that of the first embodiment. The light irradiation device 2A includes a detection unit 260A instead of the detection unit 260.

The detection unit 260A has a detection element 261A and an extension unit 262. The detection element 261A is a coil-shaped detection element formed by winding a part of the optical fiber on the tip end side. As shown in FIG. 6B, the detection element 261A is arranged at the same position as the light irradiation unit 239 so as to surround the periphery of the light irradiation unit 239 on the side surface of the main body 210 on the distal end side. In other words, the light irradiation unit 239 is inserted inside the coiled detection element 261A. Therefore, as shown in FIG. 6A, the orientation ED of the detection element 261A is the same (coaxial) as the light irradiation direction LTD in the light irradiation unit 239 on the side surface on the tip end side of the main body portion 210. .. Here, "coaxial" is sufficient if it is generally coaxial, and blurring due to manufacturing error or the like is allowed. In FIG. 6A, for convenience of illustration, the broken line arrow indicating the direction ED of the detection element 261A and the solid line arrow indicating the light irradiation direction LTD are slightly offset from each other, but they have the same position. show. The configuration of the stretched portion 262 is as described in the first embodiment.

As described above, the configuration of the detection unit 260A can be variously changed, and the detection element 261A may be arranged at the same position as the light irradiation unit 239. The light irradiation system of the second embodiment as described above can also achieve the same effect as that of the first embodiment described above. Further, according to the light irradiation device 2A of the second embodiment, the detection unit 260A inserts the light irradiation unit 239 into the inside of the detection element 261A on the side surface on the tip end side of the main body unit 210, whereby the detection element 261A has a light irradiation unit 261A. The orientation ED and the light irradiation direction LTD in the light irradiation unit 239 are arranged so as to be the same. Therefore, the detection accuracy of the ultrasonic wave by the detection unit 260A can be further improved as compared with the case of the non-coaxial arrangement.

<Third Embodiment>
FIG. 7 is an explanatory diagram illustrating the configuration of the tip side of the light irradiation device 2B of the third embodiment. FIG. 7A shows a cross-sectional configuration on the tip side of the light irradiation device 2B. FIG. 7B shows the configuration of the light irradiation device 2B as seen from the direction B of FIG. 7A. The light irradiation system of the third embodiment includes a light irradiation device 2B shown in FIG. 7 and a catheter 1 having the same configuration as that of the first embodiment. The light irradiation device 2B includes a detection unit 260B instead of the detection unit 260.

The detection unit 260B has a detection element 261B and an extension unit 262. The detection element 261B is a coil-shaped detection element formed by winding a part of the optical fiber on the tip end side. As shown in FIG. 7B, the detection element 261B is provided at a position on the side surface of the main body 210 on the distal end side, in the vicinity of the light irradiation unit 239, but at a position away from the light irradiation unit 239. In the illustrated example, the detection element 261B is arranged at a position different from that of the light irradiation unit 239 in both the axis O direction (X-axis direction) and the circumferential direction (YZ axis direction). As a result, as shown in FIG. 7A, the direction of the detection element 261B on the front end side side surface of the main body 210 is neither parallel to nor coaxial with the light irradiation direction LTD in the light irradiation unit 239.

As described above, the configuration of the detection unit 260B can be variously changed, and the detection element 261B need only be provided in the vicinity of the light irradiation unit 239 in the main body unit 210, and can be arranged arbitrarily. For example, as described with reference to FIG. 7, the detection element 261B and the light irradiation unit 239 may be arranged apart from each other. The light irradiation system of the third embodiment as described above can also achieve the same effect as that of the first embodiment described above.

<Fourth Embodiment>
FIG. 8 is an explanatory diagram illustrating the configuration of the light irradiation device 2C of the fourth embodiment. The light irradiation system of the fourth embodiment includes a light irradiation device 2C shown in FIG. 8 and a catheter 1 having the same configuration as that of the first embodiment. The light irradiation device 2C further includes a directional marker unit 280 in addition to the configuration described in the first embodiment.

The directional marker unit 280 represents the orientation of the light irradiation device 2C in the circumferential direction, and functions as a marker for the operator to recognize the position of the light irradiation unit 239 in the circumferential direction. The directional marker portion 280 is formed by bending a wire made of a resin material or a metal material having radiation opacity into an arc shape. The directional marker portion 280 is embedded in the thick portion of the main body portion 210 on the side surface of the main body portion 210. In the illustrated example, the directional marker portion 280 is arranged at a substantially central portion of the main body portion 210 in the axis O direction. However, the directional marker unit 280 may be arranged at an arbitrary position such as in the vicinity of the light irradiation unit 239. The directional marker portion 280 shown in FIG. 8 is arranged so that the opening 280c faces in the direction opposite to the light irradiation portion 239 (-Y-axis direction). Therefore, the surgeon confirms the shape of the directional marker portion 280 (specifically, the orientation of the opening 280c) from an arbitrary direction reflected in the X-ray image, and thereby the position of the light irradiation portion 239 in the circumferential direction (specifically, the orientation of the opening 280c). In other words, the orientation of the light irradiation unit 239) can be recognized.

As described above, the configuration of the light irradiation device 2C can be variously changed, and the configuration (directionality) for recognizing the position of the light irradiation unit 239 in the circumferential direction by the shape when viewed from an arbitrary direction. It may have a marker portion 280). The shape of the directional marker portion 280 can be changed in various ways such as a spiral shape and a wavy shape in addition to the arc shape described above. The light irradiation system of the fourth embodiment as described above can also achieve the same effect as that of the first embodiment described above. Further, according to the light irradiation device 2C of the fourth embodiment, the directional marker has radiation opacity and can recognize the position of the light irradiation unit 239 in the circumferential direction by the shape when viewed from an arbitrary direction. A unit 280 is provided. Therefore, the surgeon can easily grasp the position (orientation) of the light irradiation unit 239 in the circumferential direction by confirming the shape of the directional marker unit 280 reflected in the X-ray photographed image. As a result, according to the light irradiation device 2C of the fourth embodiment, the target tissue (cancer cell) can be selectively irradiated with light, for example, in NIR-PIT.

<Fifth Embodiment>
FIG. 9 is an explanatory diagram illustrating the configuration of the light irradiation device 2D according to the fifth embodiment. The light irradiation system of the fifth embodiment includes the light irradiation device 2D shown in FIG. 9 and the catheter 1 having the same configuration as that of the first embodiment. The light irradiation device 2D includes the directional marker unit 280D in place of the directional marker unit 280 in the configuration described in the fourth embodiment.

The directional marker portion 280D has radiation opacity and includes a plurality of strands (hereinafter, also referred to as “sub-markers”) bent into an arc shape. Each sub-marker is embedded in the thick portion of the main body 210 on the side surface of the main body 210 in a state of being spaced apart at equal intervals in the axis O direction. Further, each sub-marker is arranged so that the opening 280c faces in the direction opposite to that of the light irradiation unit 239. In the illustrated example, the directional marker unit 280D is composed of three sub-markers, but the number of sub-markers constituting the directional marker unit 280D can be arbitrarily changed.

As described above, the configuration of the light irradiation device 2D can be variously changed, and a configuration (directional marker unit 280D) for recognizing the position of the light irradiation unit 239 in the circumferential direction by a plurality of sub-markers is provided. It may be realized. The light irradiation system of the fifth embodiment as described above can also achieve the same effects as those of the first and fourth embodiments described above. Further, according to the light irradiation device 2D of the fifth embodiment, since the directional marker unit 280D includes a plurality of sub-markers, it is possible to easily confirm the shape of the directional marker unit 280D reflected in the X-ray photographed image. .. As a result, the operator can more easily grasp the position (orientation) of the light irradiation unit 239 in the circumferential direction.

<Sixth Embodiment>
FIG. 10 is an explanatory diagram illustrating the configuration of the light irradiation device 2E according to the sixth embodiment. The light irradiation system of the sixth embodiment includes a light irradiation device 2E shown in FIG. 10 and a catheter 1 having the same configuration as that of the first embodiment. The light irradiation device 2E includes the directional marker unit 280E instead of the directional marker unit 280 in the configuration described in the fourth embodiment.

The directional marker portion 280E is formed of a substantially linear strand having radiation opacity. The directional marker portion 280E is embedded in the thick portion of the main body portion 210 on the side surface of the main body portion 210. Further, as shown in FIG. 10, the directional marker portion 280E is arranged on the side surface of the main body portion 210 in the same direction (+ Y-axis direction) as the light irradiation portion 239. Therefore, the operator can see the position of the directional marker unit 280E from an arbitrary direction reflected in the X-ray image (specifically, the positional relationship between the position of the directional marker unit 280E and the second marker unit 231,232). By confirming, the position of the light irradiation unit 239 in the circumferential direction (in other words, the direction of the light irradiation unit 239) can be recognized.

As described above, the configuration of the light irradiation device 2E can be variously changed, and the configuration (directionality) for recognizing the position of the light irradiation unit 239 in the circumferential direction depending on the position when viewed from an arbitrary direction. It may have a marker portion 280E). The shape of the directional marker portion 280E can be changed in various ways such as a wavy shape in addition to the linear shape described above. The light irradiation system of the sixth embodiment as described above can also achieve the same effects as those of the first and fourth embodiments described above.

<7th Embodiment>
FIG. 11 is an explanatory diagram illustrating a configuration on the front end side of the light irradiation system of the seventh embodiment. The light irradiation system of the seventh embodiment includes the catheter 1F shown in FIG. 11 and the light irradiation device 2F. FIG. 11 shows a state in which the light irradiation device 2F is inserted into the catheter 1F. The catheter 1F does not have the first marker portion 132 described in the first embodiment. Similarly, the light irradiation device 2F does not have the second marker portion 232 described in the first embodiment.

As described above, various configurations can be adopted for the first marker portion and the second marker portion. For example, instead of omitting the first and second marker portions 132 and 232, the first and second marker portions are omitted. The marker portions 131, 231 may be omitted. The light irradiation system of the seventh embodiment as described above can also achieve the same effect as that of the first embodiment described above. Further, in the light irradiation system of the seventh embodiment, the manufacturing cost of the catheter 1F and the light irradiation device 2F can be reduced as compared with the configuration in which the marker portions are provided at both ends of the light transmission unit 139 and the light irradiation unit 239.

<8th Embodiment>
FIG. 12 is an explanatory diagram illustrating a configuration on the front end side of the light irradiation system of the eighth embodiment. The light irradiation system of the eighth embodiment includes the catheter 1G shown in FIGS. 12 and 13 and the light irradiation device 2G shown in FIG. FIG. 12 shows a state in which the light irradiation device 2G is inserted into the catheter 1G. The catheter 1G includes first marker portions 131G and 132G in place of the first marker portions 131 and 132 described in the first embodiment. The light irradiation device 2G includes second marker units 231G and 232G in place of the second marker units 231 and 232 described in the first embodiment.

FIG. 13 is an explanatory diagram illustrating the configuration of the catheter 1G as viewed from the B direction (FIG. 12). 13 (A) shows an example of the configuration of the catheter 1G viewed from the B direction, and FIG. 13 (B) shows another example of the configuration of the catheter 1G viewed from the B direction. The first marker portions 131G and 132G are provided on a part of the catheter 1G in the circumferential direction, respectively. In the example of FIG. 13A, the first marker portion 131G is provided along one side of the tip end side of the light transmitting portion 139 in substantially the same range as the light transmitting portion 139. Similarly, the first marker portion 132G is provided along one side of the base end side of the light transmitting portion 139 in substantially the same range as the light transmitting portion 139. In the example of FIG. 13B, the first marker portions 131G and 132G are provided so as to surround the periphery of the light transmitting portion 139. Although the first marker units 131G and 132G have been described in FIG. 13, the second marker units 231G and 232G of the light irradiation device 2G are also similarly along one side of the light irradiation unit 239 or the light irradiation unit. It is provided so as to surround the circumference of 239.

As described above, various configurations can be adopted for the first marker portions 131G and 132G and the second marker portions 231G and 232G, and as shown in the figure, they may be provided only in a part in the circumferential direction. The light irradiation system of the eighth embodiment as described above can also achieve the same effect as that of the first embodiment described above. Further, in the light irradiation system of the eighth embodiment, the manufacturing cost of the catheter 1G and the light irradiation device 2G can be reduced as compared with the configuration in which the marker portion is provided in the entire circumferential direction.

<9th embodiment>
FIG. 14 is an explanatory diagram illustrating the configuration of the light irradiation system of the ninth embodiment. The light irradiation system of the ninth embodiment includes the catheter 1H shown in FIG. 14 and the light irradiation device 2 having the same configuration as that of the first embodiment. The catheter 1H includes a light transmitting portion 139H in place of the light transmitting portion 139, and includes first marker portions 131H and 132H in place of the first marker portions 131 and 132. As shown in FIG. 14, the light transmitting portion 139H is composed of three light transmitting portions 1391, 1392, and 1393 arranged side by side in the axis O direction (X-axis direction). The configurations of the light transmitting units 1391, 1392, and 1393 are the same as those of the light transmitting unit 139 described in the first embodiment.

Further, the first marker units 131H and 132H have a first marker unit 1311, 1321 that functions as a mark indicating the position of the light transmitting unit 1391 and a first marker unit 1312 that functions as a mark indicating the position of the light transmitting unit 1392. It is composed of 1322 and a first marker unit 1313, 1323 that functions as a mark indicating the position of the light transmitting unit 1393. The first marker portion 1311 is provided close to the tip end portion of the light transmitting portion 1391, and the first marker portion 1321 is provided close to the base end portion of the light transmitting portion 1391. The first marker portion 1312 is provided close to the tip end portion of the light transmission portion 1392, and the first marker portion 1322 is provided close to the base end portion of the light transmission portion 1392. The first marker portion 1313 is provided close to the tip end portion of the light transmitting portion 1393, and the second marker portion 1323 is provided close to the base end portion of the light transmitting portion 1393. The configuration of each of the first marker units 1311 to 1323 is the same as that of the first marker units 131 and 132 described in the first embodiment. The first marker portions adjacent to each other in the axis O direction, specifically, the first marker portions 1321 and 1312, and the first marker portions 1322 and 1313 may be one coupled marker portion.

As described above, the catheter 1H may be provided with a plurality of sets of light transmitting portions 1391 to 1393 and first marker portions 1311 to 1323. In the example of FIG. 14, the case of 3 sets is illustrated, but 2 sets or 4 sets or more may be used. The light irradiation system of the ninth embodiment as described above can also achieve the same effect as that of the first embodiment described above. Further, in the light irradiation system of the ninth embodiment, since a plurality of sets of light transmitting portions 1391 to 1393 and first marker portions 1311 to 1323 are provided, the catheter 1H is not moved in the living cavity. By moving only the light irradiation device 2 in the axis O direction (X-axis direction) inside the 1H, light can be irradiated in different regions of the catheter 1H in the axis O direction. Further, since the first marker units 1311 to 1323 are provided in each of the plurality of light transmitting units 1391 to 1393, it is possible to easily align the light irradiation unit 239 with respect to each of the light transmitting units 1391 to 1393.

<10th Embodiment>
FIG. 15 is an explanatory diagram illustrating a configuration on the front end side of the light irradiation system of the tenth embodiment. The light irradiation system of the tenth embodiment includes the catheter 1I shown in FIG. 15 and the light irradiation device 2 having the same configuration as that of the first embodiment. FIG. 15 shows a state in which the light irradiation device 2 is inserted into the catheter 1I. Catheter 1H does not include the tip tip 120 described in the first embodiment. Similarly, the tip 220 of the tip of the light irradiation device 2 may be omitted.

As described above, various configurations can be adopted for the catheter 1I and the light irradiation device 2, and some of the above-mentioned components may be omitted. Also in the light irradiation system of the tenth embodiment, the first marker portions 131 and 132 provided at both ends of the light transmitting portion 139 and the second marker portions 231 and 232 provided at both ends of the light irradiation unit 239 are used. The position of the light transmitting unit 139 and the light irradiation unit 239 can be aligned, and the same effect as that of the first embodiment can be obtained. Further, in the light irradiation system of the tenth embodiment, the manufacturing cost of the catheter 1I can be reduced as compared with the configuration in which the tip tip 120 is provided.

<11th Embodiment>
FIG. 16 is an explanatory diagram illustrating a configuration on the front end side of the light irradiation system of the eleventh embodiment. FIG. 17 is an explanatory view illustrating the cross-sectional configuration of the catheter 1J on the line CC (FIG. 16). The light irradiation system of the eleventh embodiment includes the catheter 1J shown in FIGS. 16 and 17, and the light irradiation device 2 having the same configuration as that of the first embodiment. FIG. 16 shows a state in which the light irradiation device 2 is inserted into the catheter 1J.

The catheter 1J further includes a temperature sensor 180 in addition to the configurations described in the first embodiment. As shown in FIG. 17, the temperature sensor 180 includes two different types of metal conductors and measures the temperature in the vicinity of the light transmitting portion 139. The temperature sensor 180 is embedded inside the light transmitting portion 139 and the shaft 110. The tip end side of the temperature sensor 180 is arranged inside the light transmitting portion 139, and the base end side is connected to a thermometer (not shown). At least a part of the temperature sensor 180 on the distal end side may protrude from the outer surface of the light transmitting portion 139 or the shaft 110. The temperature sensor 180 may be provided on at least one of the catheter 1J and the light irradiation device 2, or may be provided on both of them.

As described above, the catheter 1J and the light irradiation device 2 can be provided with various configurations not described above, such as the temperature sensor 180. The light irradiation system of the eleventh embodiment as described above can also achieve the same effect as that of the first embodiment described above. Further, since the light irradiation system of the eleventh embodiment includes a temperature sensor 180 that measures the temperature at least in the vicinity of the light transmitting portion 139, the temperature change of the living tissue due to the light irradiation can be observed in real time, so that the blood due to the light irradiation can be observed. Can contribute to coagulation and suppression of biological tissue damage.

<12th Embodiment>
FIG. 18 is an explanatory diagram illustrating the configuration of the tip side of the light irradiation device 2K of the twelfth embodiment. The light irradiation system of the twelfth embodiment includes a light irradiation device 2K shown in FIG. 18 and a catheter 1 having the same configuration as that of the first embodiment. The light irradiation device 2K includes a light transmission unit 250K instead of the light transmission unit 250, and includes a light irradiation unit 239K instead of the light irradiation unit 239.

The light transmitting portion 250K does not have a curved portion formed on the tip end side, and extends linearly inside the main body portion 210. A light irradiation unit 239K is provided at the tip of the light transmission unit 250K. The light irradiation unit 239K is a resin body provided so as to cover the core exposed at the tip of the light transmission unit 250K and to be exposed on a part of the side surface of the main body portion 210. The light irradiation unit 239K can be formed, for example, by applying it to an acrylic ultraviolet curable resin in which quartz fine powder is dispersed and curing it with ultraviolet light. The light irradiation unit 239K may be realized by another embodiment, and may be realized by, for example, a light reflection mirror instead of the resin body.

As described above, the configuration of the light irradiation unit 239K can be variously changed, and instead of the core exposed on the side surface of the main body 210, the optical member (resin body or mirror) exposed on the side surface of the main body 210. May be configured by. The light irradiation system of the twelfth embodiment as described above can also obtain the same effect as that of the first embodiment described above. Further, according to the light irradiation device 2K of the twelfth embodiment, the performance of the light irradiation unit 239K can be adjusted by adjusting the optical characteristics of the optical member used as the light irradiation unit 239K.

<13th Embodiment>
FIG. 19 is an explanatory diagram illustrating the configuration of the tip side of the light irradiation device 2M of the thirteenth embodiment. The light irradiation system of the thirteenth embodiment includes a light irradiation device 2M shown in FIG. 19 and a catheter 1 having the same configuration as that of the first embodiment. The light irradiation device 2M includes a reinforcing member 272M instead of the reinforcing member 272 (FIG. 2). The reinforcing member 272M has a coil shape formed by spirally winding a wire. The reinforcing member 272M is embedded in the thick portion of the main body portion 210. The strands constituting the reinforcing member 272M can be formed of any resin material or metal material.

As described above, the configuration of the light irradiation device 2M can be variously changed, and the reinforcing member 272M for reinforcing the light irradiation device 2M may have a coil shape or a mesh shape in which strands are woven into a mesh. Further, the light irradiation device 2M may be provided with a plurality of reinforcing members 272M. In this case, the shape of one reinforcing member 272M may be the same as or different from the shape of the other reinforcing member 272M. The reinforcing member 272M may be embedded in the thick portion of the main body portion 210, or may be housed inside the main body portion 210 as in the first embodiment. The light irradiation system of the thirteenth embodiment as described above can also obtain the same effect as that of the first embodiment described above. Further, according to the light irradiation device 2M of the twelfth embodiment, the torque transmissibility, flexibility, shape retention and the like of the light irradiation device 2M can be adjusted by changing the shape of the reinforcing member 272M.

<Modified example of this embodiment>
The present invention is not limited to the above embodiment, and can be carried out in various embodiments without departing from the gist thereof, and for example, the following modifications are also possible.

[Modification 1]
In the above 1st to 13th embodiments, an example of the configuration of the catheters 1, 1F to 1J and the light irradiation devices 2, 2A to 2G, 2K, 2M is shown. However, the configurations of the catheter 1 and the light irradiation device 2 can be changed in various ways. For example, the first marker portions 131 and 132 of the catheter 1 and the second marker portions 231 and 232 of the light irradiation device 2 may be omitted. For example, in FIG. 4, a method of using the catheter 1 and the light irradiation device 2 in combination has been described, but the light irradiation device 2 may be used alone (without using the catheter 1 together).

For example, the catheter 1 may be provided with the reinforcing member described in the thirteenth embodiment. For example, the outer surface of the catheter 1 and the outer surface of the light irradiation device 2 may be coated with a hydrophilic or hydrophobic resin. By doing so, the slipperiness of the catheter 1 in the living lumen can be improved. In addition, the slipperiness of the light irradiation device 2 in the lumen 110L of the catheter 1 can be improved. Further, an antithrombotic material such as heparin may be coated on the outer surface of the catheter 1 or the outer surface of the light irradiation device 2. By doing so, it is possible to suppress a decrease in laser output due to thrombus adhesion to the inner and outer surfaces of the catheter 1 and the outer surface of the light irradiation device 2 due to irradiation with emitted light (laser light) LT.

For example, the catheter 1 may be provided with an expansion portion that can be expanded in the radial direction (YZ direction). As the expansion portion, for example, a balloon made of a flexible thin film or a mesh body having a mesh of strands can be used. The expansion portion may be provided on at least one of the tip end side of the light transmitting portion 139 and the proximal end side of the light transmitting portion 139 in the shaft 110. In this way, the catheter 1 can be fixed in the living lumen by expanding the dilated portion after positioning the catheter 1 in the living lumen. Further, if a balloon is used as the expansion portion, the blood flow at the light irradiation site can be blocked, so that the light blocking due to the blood flow can be suppressed. For example, the catheter 1 may be configured as a multi-lumen catheter having a plurality of lumens different from the lumen 110L.

For example, the inner surface 120i of the tip tip 120 of the catheter 1 and the outer surface of the tip 220 of the light irradiation device 2 may be formed of a magnetic material so as to attract each other. By doing so, as shown in FIG. 4, the light irradiation device 2 can be inserted into the catheter 1 and the state in which the tip tip 220 is pressed against the tip tip 120 can be easily maintained.

For example, the arrangement of the light transmitting portion 250, the extending portion 262, and the reinforcing member 272 in the main body portion 210 of the light irradiation device 2 can be arbitrarily changed. For example, the member having the largest diameter (light transmitting portion 250 in the example of FIG. 2) may be arranged at the center of the main body portion 210. For example, the light transmission unit 250, the extension unit 262, and the reinforcing member 272 may be arranged at equal intervals. For example, the main body 210 may further have an inner shaft for forming a fluid lumen or a device lumen. For example, the sealing member 271 in the main body 210 may be omitted.

[Modification 2]
In the above 1st to 13th embodiments, an example of the configuration of the light transmitting unit 139, 139H and the light irradiation unit 239, 239K is shown. However, the configurations of the light transmitting units 139, 139H and the light irradiation units 239, 239K can be changed in various ways. For example, the light irradiation unit 239 may be embedded in a thick portion of the main body portion 210. Even in this case, the light from the light irradiation unit 239 can be sent to the outside by forming the main body 210 with a light-transmitting material or by forming a thin portion of the main body 210 that covers the light irradiation unit 239. Irradiation is possible.

For example, the light transmitting portion 139 and the first marker portions 131 and 132 may be integrally formed by forming the light transmitting portion 139 with a material having radiation opacity. Similarly, by forming at least the tip portion (light irradiation portion 239) of the clad 250cl with a material having radiodensity, the light irradiation portion 239 and the second marker portions 231 and 232 are integrally configured. May be good. By doing so, the number of parts constituting the catheter 1 and the light irradiation device 2 can be reduced, and the man-hours for manufacturing the catheter 1 and the light irradiation device 2 can be reduced.

For example, in the catheter 1, the light transmitting portion 139 may be formed by thinning a part of the shaft 110. For example, the shaft 110 of the catheter 1 may be formed of a light-transmitting resin so that the entire shaft 110 functions as a light-transmitting portion 139. By doing so, the number of parts constituting the catheter 1 can be reduced. For example, at least one of the light transmitting portions 139 may be formed as a notch formed in the shaft 110 (a through hole communicating the inside and outside of the shaft 110). By doing so, the light transmitting portion 139 can be easily formed.

For example, in the catheter 1, the range of the axis O direction (X-axis direction) and the range of the circumferential direction (YZ axis direction) in which the light transmitting portion 139 is provided can be arbitrarily changed. Specifically, for example, the range in which the light transmitting portion 139 is provided in the O direction of the axis may be wider than the range illustrated in FIG. Then, the light irradiation range can be easily changed by moving the light irradiation device 2 (light irradiation unit 239) in the light transmission unit 139 in a wide range. Therefore, even when the target tissue (cancer cell) is widely present in the living body, it is not necessary to move the position of the catheter 1 in the living lumen, and the procedure can be easily performed. Similarly, for example, in the light irradiation device 2K of the twelfth embodiment, the range of the axis O direction (X-axis direction) and the range of the circumferential direction (YZ axis direction) in which the light irradiation unit 239K is provided can be arbitrarily changed. Specifically, for example, the range in which the light irradiation unit 239 is provided in the O direction of the axis may be wider than the range described with reference to FIG. By doing so, the irradiation range of light can be widened, so that the procedure can be easily performed even when the target tissue (cancer cell) is widely present in the living body.

For example, the catheter 1 may further include a separate marker portion arranged at an arbitrary position, such as the distal end side of the light transmitting portion 139 or the proximal end side of the light transmitting portion 139. For example, the light irradiation device 2 may further include a separate marker unit arranged at an arbitrary position such as the tip end side of the light irradiation unit 239 or the base end side of the light irradiation unit 239. The shape of the marker portion of the catheter 1 and the light irradiation device 2 can be arbitrarily determined, and may be a shape extending in the whole or a part of the circumferential direction (YZ direction) or a shape extending in the axis O direction (X-axis direction). , It may be a shape that surrounds the circumference of the shaft or the main body. Further, the tip tip 120 of the catheter 1 and the tip tip 220 of the light irradiation device 2 may be configured as a marker portion.

[Modification 3]
In the above 1st to 13th embodiments, an example of the configuration of the detection units 260, 260A, 260B is shown. However, the configurations of the detection units 260, 260A, and 260B can be changed in various ways. For example, the detection element 261 of the detection unit 260 may be embedded in the thick portion of the main body portion 210. Even in this case, by forming the portion of the main body 210 that covers the detection element 261 thinly, it is possible to suppress a decrease in the detection accuracy due to the detection element 261. By doing so, the safety of the light irradiation device 2 can be further improved. For example, the detection unit 260 may adopt a configuration other than the optical fiber Doppler sensor (FOD). In this case, the detection unit 260 is, for example, an ultrasonic probe (also referred to as an ultrasonic vibrator, a piezoelectric body, an ultrasonic transmission / reception element, or an ultrasonic element) that receives ultrasonic waves propagated and reflected in a living tissue. It may be composed of a lead wire connecting the ultrasonic probe and the detection device 4.

[Modification 4]
The configurations of the catheters 1, 1F to 1J of the first to thirteenth embodiments, the light irradiation devices 2, 2A to 2G, 2K, 2M, and the catheters 1, 1F to 1J of the modifications 1 to 3 and the light. The configurations of the irradiation devices 2, 2A to 2G, 2K, and 2M may be appropriately combined. For example, the detection unit 260 described in any of the second and third embodiments, the directional marker unit 280 described in any of the fourth to sixth embodiments, and the seventh and eighth embodiments will be described. The light irradiation device 2 may be configured by combining the second marker portions 231 and 232 with the above. For example, the light irradiation system may be configured by combining the catheter 1 described in any of the ninth to eleventh embodiments and the light irradiation device 2 described in any of the twelfth and thirteenth embodiments. ..

Although this embodiment has been described above based on the embodiments and modifications, the embodiments described above are for facilitating the understanding of the present embodiment and do not limit the present embodiment. This aspect may be modified or improved without departing from its spirit and claims, and this aspect includes its equivalent. Further, if the technical feature is not described as essential in the present specification, it may be deleted as appropriate.

1,1F-1J ... Cauterus 2,2A-2G, 2K, 2M ... Light irradiation device 3 ... Light source 4 ... Detection device 110 ... Shaft 120 ... Tip tip 131, 131G, 131H, 132, 132G, 132H ... First marker unit 139, 139H ... Light transmission part 140 ... Connector 141 ... Connection part 142 ... Blade 180 ... Temperature sensor 210 ... Main body part 220 ... Tip tip 231,231G, 232,232G ... Second marker part 239, 239K ... Light irradiation part 240 ... Connector 241 ... Connection part 242 ... Blade 250 ... Light transmission part 250, 250K ... Light transmission part 250c ... Core 250cl ... Clad 260, 260A, 260B ... Detection part 260c ... Core 260cl ... Clad 261,261A, 261B ... Detection element 262 ... Stretched part 271 ... Sealing member 272,272M ... Reinforcing member 280, 280D, 280E ... Directional marker part

Claims (13)

It is a light irradiation device for medical use.
The long body and
A light irradiation unit provided on a part of the side surface on the tip side of the main body and irradiating a target substance in a living body with light.
A detection unit provided in the main body portion close to the light irradiation unit, which detects a physicochemical phenomenon generated due to the irradiation of the target substance with light, and a detection unit.
A light irradiation device. The light irradiation device according to claim 1.
The detector is
It has a detection element that detects the physicochemical phenomenon.
Of the side surface on the tip end side of the main body, the direction of the detection element and the light irradiation direction of the light irradiation unit are arranged to be parallel to each other on the side where the light irradiation unit is provided. , Light irradiation device. The light irradiation device according to claim 2.
The detection element of the detection unit is a light irradiation device that detects light as the physicochemical phenomenon or ultrasonic waves as the physicochemical phenomenon. The light irradiation device according to claim 1.
The detector is
It is a coil-shaped detection element formed by winding an optical fiber, and has a detection element that detects ultrasonic waves as the physicochemical phenomenon.
By inserting the light irradiation unit inside the detection element on the side surface on the tip end side of the main body portion, the direction of the detection element and the light irradiation direction in the light irradiation unit are arranged to be the same. It is a light irradiation device. The light irradiation device according to any one of claims 1 to 4, and further.
A directional marker portion having radiation opacity provided on the side surface of the main body portion, and depending on the shape or position of the directional marker portion when viewed from an arbitrary direction, in the circumferential direction of the light irradiation portion. A light irradiation device equipped with a directional marker unit that can recognize the position. It is a light irradiation system for medical use.
An ulnar canal-shaped catheter and
The light irradiation device according to any one of claims 1 to 5, wherein the long light irradiation device is used by being inserted into the catheter.
Equipped with
The catheter is
A light transmitting portion provided on at least a part of the side surface on the tip side and transmitting light inside the tube to the outside,
It has a first marker portion having radiation opacity provided in the vicinity of the light transmitting portion, and has.
The light irradiation device is a light irradiation system further comprising a second marker portion having radiation opacity provided in the vicinity of the light irradiation portion. The light irradiation system according to claim 6.
The first marker portion is a light irradiation system provided at least at two locations, a distal end side and a proximal end side, of the light transmitting portion in the axial direction of the catheter. The light irradiation system according to claim 6 or 7.
The second marker unit is a light irradiation system provided at least at two locations, one on the tip end side and the other on the proximal end side, in the axial direction of the light irradiation device. The light irradiation system according to claim 8, which is subordinate to claim 7.
In a state where the light irradiation device is inserted into the catheter and the light transmitting portion and the light irradiation portion are aligned in the axial direction of the light irradiation system.
The first marker portion on the distal end side is arranged on the distal end side in the axial direction with respect to the second marker portion on the distal end side.
A light irradiation system in which the first marker portion on the proximal end side is arranged on the proximal end side in the axial direction with respect to the second marker portion on the proximal end side. The light irradiation system according to any one of claims 6 to 9.
The first marker portion has a shape that surrounds the circumferential direction of the catheter.
The second marker portion is a light irradiation system having a shape surrounding the circumferential direction of the light irradiation device. The light irradiation system according to any one of claims 6 to 10.
A light irradiation system in which a plurality of sets of a light transmitting portion and a first marker portion are provided in the catheter in the axial direction of the catheter. The light irradiation system according to any one of claims 6 to 11.
The catheter further comprises an apical tip attached to the apical side.
A light irradiation system in which a through hole penetrating the tip tip in the axial direction of the catheter and having a diameter smaller than the outer diameter of the light irradiation device is formed in the tip. The light irradiation system according to any one of claims 6 to 12.
The catheter is a light irradiation system further comprising a temperature sensor that measures a temperature at least in the vicinity of the light transmitting portion.

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