JP2023141918A - Medical device and balloon catheter - Google Patents

Abstract

To provide a medical device capable of controlling a therapeutic device including a balloon or the like to have a desired shape in a living body, and a balloon catheter.SOLUTION: A medical device 1A includes: a body assembly 2A at least including a body part 20 including a cavity 20L; guide members 3A provided in plural at an outer surface of the body part 20, each having a through hole 30H, and arranged so as to be spaced in a first direction D1 along the outer surface of the body part 20; and a string body 4A inserted to each through hole 30H of the guide member 3A and movable to one side or the other side of the first direction D1. In the medical device 1A, when the string body 4A moves, the space of the guide members 3A in the first direction D1 changes, so that the body part 20 deforms.SELECTED DRAWING: Figure 1

Description

TECHNICAL FIELD The present invention relates to medical devices and balloon catheters.

There is a desire to control the shape of devices (balloon catheters, stents, etc., hereinafter referred to as treatment devices) for treating stenotic lesions in vivo. The balloon catheter described in Patent Document 1 has a balloon and a pull wire. The tip of the pull wire is secured near the tip of the balloon. A wire cover portion on the outer surface of the balloon covers the pull wire along its length. When the pull wire is pulled toward the proximal end with the balloon inflated, the side with the wire cover faces the inner circumference, and the side opposite to the wire cover faces the outer circumference. Curve to face.

JP 2019-146599 Publication

In the above-mentioned balloon catheter, the entire portion of the pull wire disposed along the balloon is covered by the wire cover portion. In this case, it may not be possible to increase the curvature of the balloon by pulling the pull wire. Therefore, for example, it may not be possible to meet a request to curve the balloon with a large curvature. As described above, the balloon catheter described above has a problem in that the balloon cannot be curved into a shape desired by the user.

An object of the present invention is to provide a medical device and a balloon catheter that can control a therapeutic device including a balloon or the like into a desired shape in vivo.

A medical device according to a first aspect of the present invention includes a main body assembly including at least a main body having a lumen, a plurality of bodies provided on the outer surface of the main body, each having a through hole, a plurality of guide members arranged at intervals in a first direction along the direction; and a string that is inserted into the through hole of each of the plurality of guide members and movable to one side or the other side in the first direction. The main body section is characterized in that, as the string moves, the distance between each of the plurality of guide members in the first direction changes and the main body section deforms.

The medical instrument has a plurality of guide members provided on the main body, and the main body is deformed by changing the distance between the guide members using a string. Therefore, the main body of the medical device can be curved with a large curvature, so that the shape of the main body can be deformed into a desired shape. Further, when the main body portion deforms a therapeutic device in a living body, the medical instrument can transform the shape of the therapeutic device into a desired shape.

In the first aspect, the plurality of guide members include a plurality of first guide members whose intervals in the first direction are larger than a first threshold value, and a plurality of second guide members whose intervals in the first direction are smaller than a second threshold value. and a guide member, and the first threshold value may be larger than the second threshold value. Due to the movement of the string, the portion of the main body portion where the plurality of first guide members are provided deforms more than the portion where the plurality of second guide members are provided. Therefore, in the medical device, the main body can be deformed into a desired shape by adjusting the positions where the plurality of first guide members and the plurality of second guide members are provided in the main body.

In the first aspect, the plurality of first guide members are provided at a central portion of the main body in the first direction, and the plurality of second guide members are provided in the plurality of first guides of the main body. It may be provided on one side in the first direction and on the other side in the first direction with respect to the member. In this case, in the medical device, the central portion of the main body in the first direction can be deformed more greatly.

In the first aspect, the plurality of guide members may be arranged at equal intervals in the first direction. In this case, the medical device can uniformly deform the main body.

In the first aspect, the plurality of guide members are arranged with respect to the plurality of third guide members lined up in the first direction and the plurality of third guide members about an axis extending along the center of the main body. It may include a plurality of fourth guide members arranged at different positions in the circumferential direction and aligned in the first direction. In this case, the medical device can deform the main body over a wide area in the circumferential direction.

In the first aspect, the string may be inserted alternately into the through holes of each of the plurality of third guide members and the through hole of each of the plurality of fourth guide members. In this case, the medical device can deform the main body by applying a force corresponding to the movement of the string equally to the plurality of third guide members and the plurality of fourth guide members.

In the first aspect, a cross section of the plurality of guide members taken along a plane perpendicular to the first direction may have a sharp shape on the opposite side to an axis extending along the center of the main body. . In this case, the medical instrument can treat an affected area within a living body by causing the sharp portions of each of the plurality of guide members to act on the affected area within the living body.

In a first aspect, the string may have one end connected to the main body assembly and move in the first direction in response to a force acting on the other end. In this case, in the medical device, the force when moving the string can also be applied to the main body assembly to deform the main body.

In the first aspect, the string may have one end connected to a portion of the string other than the one end, and may move in the first direction in response to a force acting on the other end. In this case, in the medical device, the amount of movement of the string required to deform the main body can be suppressed, so the main body can be deformed efficiently.

In the first aspect, the one end of the string may be movably connected to a portion of the string other than the one end. In this case, the string can efficiently transmit the force acting on the other end to the plurality of guide members, thereby deforming the main body.

The first aspect may further include a protective film disposed between the main body and the string. Thereby, the main body of the medical device can be protected from the string.

In the first aspect, an elastic body may be provided in the main body at a position different from the plurality of guide members in a circumferential direction centered on an axis extending along the center of the main body. In this case, the main body of the medical device can be easily returned to its original state after deformation due to the elastic force of the elastic body.

In the first aspect, the device may further include a shaft connected to the main body, and the shaft may have an insertion hole through which the string is inserted. In this case, it is possible to prevent the medical device from being hindered from moving due to the string getting caught in the living body.

In the first aspect, the device may further include a regulating member that regulates movement of the cord along the first direction. In this case, the state of the medical instrument after the string moves can be maintained by the regulating member. Therefore, the medical device can maintain the state in which the body portion is deformed due to the movement of the string.

In the first aspect, the main body portion may have an inflatable bag shape. In this case, when treating an affected area by expanding the main body, the medical instrument can deform the main body into a shape optimal for the affected area.

A balloon catheter according to a second aspect of the present invention includes a balloon, a shaft to which the balloon is connected, and a plurality of shafts provided on the outer surface of the balloon, each having a through hole, and a plurality of shafts provided along the outer surface of the balloon. A plurality of guide members arranged at intervals in the longitudinal direction, and a string that is inserted into the through hole of each of the plurality of guide members and movable to one side or the other side in the longitudinal direction. , when the string moves in the longitudinal direction, the distance between the plurality of guide members in the longitudinal direction changes and the balloon deforms.

In the second aspect, the balloon catheter has a plurality of guide members provided on the balloon, and the balloon is deformed by changing the distance between the guide members using strings. Therefore, since the balloon catheter can curve the balloon with a large curvature, the shape of the balloon can be changed to a desired shape.

It is a figure which shows 1 A of medical instruments, and sectional drawing of each part. 3 is a diagram showing a balloon catheter 9. FIG. It is a figure showing medical instrument 1A and balloon catheter 9 (state where string 4A is not pulled). It is a figure showing medical instrument 1A and balloon catheter 9 (state where string 4A is pulled). FIG. 3 is a diagram showing how the medical device 1A and the balloon catheter 9 are used. FIG. 7 is a diagram showing Modifications 1 to 3 of the medical device 1A. It is a figure which shows the modification 4 of 1 A of medical instruments. It is a figure which shows the modification 5 and 6 of 1 A of medical instruments. It is a figure showing medical instrument 1B. It is a figure showing medical instrument 1C. It is a figure showing medical instrument 1D. It is a figure showing medical instrument 1E. 9 is a diagram showing a balloon catheter 90. FIG.

<Overview of medical device 1>
An embodiment of a medical device 1 according to the present invention will be described with reference to the drawings. The drawings referred to are used to explain technical features that can be adopted by the present invention, and the configuration of the device described is not intended to be limited thereto, but is merely an illustrative example.

Balloon catheters are used to dilate stenotic lesions (hereinafter referred to as "stenotic lesions") formed in blood vessels, vas deferens, fallopian tubes, lymphatic vessels, etc., and to reperfuse the vasculature. be done.

Stenotic lesions formed in blood vessels often have a complex structure, especially at bends. When treating a stenotic lesion with a balloon catheter, it is preferable that the balloon in an inflated state sufficiently follows the shape of the blood vessel. However, the balloon in conventional balloon catheters is often straight when inflated. Therefore, it is structurally difficult to apply an appropriate force to the balloon over the entire inner wall of the stenotic lesion. On the other hand, for example, when a balloon in a pre-curved state is inflated, a force that tends to expand the balloon acts on the balloon. For this reason, there is a possibility that a portion of the stenotic lesion will be subjected to excessive force from the balloon. In addition, excessive force may be applied that deforms the structures used to fix the blood vessel (e.g., the pericardium if the blood vessel is a coronary artery, the mesentery if the blood vessel is an intestinal tract, etc.) There is sex. Furthermore, there are problems such as it is difficult to accurately grasp the bending angle of the vessel in advance, and the bending angle cannot be changed during treatment, so it is difficult to predict in advance the appropriate balloon catheter for the stenotic lesion. difficult.

Note that there is also known a method of dilating a stenotic lesion by repeatedly using a balloon with a shortened overall length. However, in this case, the treatment time becomes longer and the burden on the user (operator) and patient increases. Furthermore, by repeatedly inflating and deflating the same balloon, the balloon catheter itself may be damaged.

In contrast, in the medical device 1 according to the present embodiment, the degree of curvature of the balloon 9B of the balloon catheter 9 can be adjusted depending on the state of the stenotic lesion. Therefore, the medical device 1 can effectively treat a bent portion of a stenotic lesion with a complicated structure using the balloon catheter 9.

<First embodiment - medical device 1A>
As shown in FIG. 1, the medical device 1A includes a main body assembly 2A, guide members 31A, 32A, 33A, 34A, 35A, 36A, 37A, and 38A (hereinafter referred to as "guide members 3A" if not distinguished from each other). , a string 4A, and a shaft 5A.

The main body assembly 2A has a bag-shaped main body portion 20 that is long in a predetermined direction. The main body portion 20 is expandable and contractible. FIG. 1 shows the main body portion 20 in an expanded state. A lumen 20L is formed inside the main body portion 20. Hereinafter, unless otherwise specified, each portion will be described assuming that the main body portion 20 is in an expanded state. The predetermined direction is referred to as the "stretching direction."

The main body portion 20 has a distal cone portion 21, an inflatable portion 22, and a proximal cone portion 23. The expansion part 22 has a cylindrical shape extending in the stretching direction. The distal cone portion 21 extends from one end of the inflatable portion 22 toward the opposite side of the inflatable portion 22 while decreasing in diameter. The proximal cone portion 23 extends from the other end of the inflatable portion 22 toward the side opposite to the inflatable portion 22 while decreasing in diameter. Hereinafter, the side from the expansion part 22 toward the distal cone section 21 in the stretching direction will be referred to as the "distal side." The side from the expansion part 22 toward the proximal cone part 23 in the stretching direction is referred to as the "proximal side." A virtual axis extending through the center of the main body portion 20 is referred to as a "central axis C11."

A circular through-hole 21H is formed at the distal end of the distal cone portion 21 (hereinafter referred to as "the distal end 20D of the main body section 20"). A circular through hole 23H is formed at the base end of the base end cone portion 23 (hereinafter referred to as “the base end portion 20P of the main body portion 20”). The direction extending along the outer surface of the main body portion 20 between the distal end portion 20D and the proximal end portion 20P is referred to as a “first direction D1”.

The shaft 5A is a flexible tubular member. The shaft 5A extends in the stretching direction between the distal end 50D and the proximal end 50P. The shaft 5A has an inner cavity 50L with a circular cross-sectional shape. A distal end portion 50D of the shaft 5A is connected to a proximal end portion 20P of the main body portion 20 of the main body assembly 2A. The inner cavity 50L of the shaft 5A communicates with the inner cavity 20L of the main body portion 20 via the through hole 23H. A virtual axis extending through the center of the shaft 5A is referred to as a "center axis C12." The central axis C12 coincides with the central axis C11 of the main body portion 20.

The guide member 3A is provided on the outer surface of the main body portion 20 of the main body assembly 2A. The material of the guide member 3A is metal, hard resin, or the like. A radially outer portion of the guide member 3A about the central axis C11 is curved. A through hole 30H penetrating in the first direction D1 is formed in the guide member 3A. The cross-sectional shape of the through hole 30H is circular.

The guide member 31A is provided at the distal end cone portion 21 of the main body portion 20. The guide member 38A is provided on the proximal cone portion 23 of the main body portion 20. The guide members 32A to 37A are provided in the inflatable portion 22 of the main body portion 20. The guide members 31A to 38A are arranged in this order in the first direction D1 from the distal end side to the proximal end side. The distance in the first direction D1 between the guide member 3A and another guide member 3A adjacent to the guide member 3A in the first direction D1 (hereinafter referred to as "the distance between the guide members 3A") is S11. It is. The guide members 31A to 38A are arranged at equal intervals in the first direction D1.

The string body 4A has a flexible elongated string shape. The material of the string 4A is suture thread, metal, resin, etc. The tip 40D of the string 4A is connected to the vicinity of the through hole 21H formed in the tip 20D of the main body 20 of the main body assembly 2A. The string 4A extends along the first direction D1 from the distal end 40D toward the base end while sequentially passing through the through holes 30H of the guide members 31A to 38A. Furthermore, the string 4A extends in the vicinity of the shaft 5A along the stretching direction from the portion passing through the through hole 30H of the guide member 38A toward the base end 40P. The cross-sectional shape of the string 4A is circular. The diameter of the string 4A is smaller than the inner diameter of the through hole 30H of the guide member 3A.

The string 4A is movable in the first direction D1 with respect to the guide members 31A to 38A in a portion overlapping with the main body assembly 2A in the stretching direction. Furthermore, the string 4A is movable in the stretching direction with respect to the shaft 5A at a portion where it overlaps with the shaft 5A in the stretching direction.

Referring to FIG. 2, the balloon catheter 9 will be described. The balloon catheter 9 is used while being placed inside the medical device 1A. Balloon catheter 9 has catheter shaft 9A and balloon 9B.

Catheter shaft 9A has an outer tube 91 and an inner tube 92. The outer tube 91 and the inner tube 92 are each flexible tubular members. The inner diameter of outer tube 91 is larger than the outer diameter of inner tube 92. The inner tube 92 is arranged in the inner lumen of the outer tube 91 except for a predetermined portion on the distal end side. A portion of the inner tube 92 on the distal end side protrudes from the distal end portion of the outer tube 91 toward the distal end side. A portion of the inner tube 92 on the distal side is disposed closer to the distal end than the distal end of the outer tube 91. A guide wire W (see FIG. 5) is inserted into the inner lumen of the inner tube 92. A fluid hub (not shown) is connected to the proximal end of the catheter shaft 9A.

Balloon 9B is connected to the distal end of catheter shaft 9A. The distal end of the balloon 9B is connected to the distal end of the inner tube 92. A portion of the inner tube 92 including the distal end protrudes further toward the distal end than the distal end of the balloon 9B. The proximal end of the balloon 9B is connected to the distal end of the outer tube 91. The balloon 9B covers a portion of the inner tube 92 that protrudes further toward the distal end than the outer tube 91.

The fluid hub supplies compressed fluid to a space in the lumen of the outer tube 91 other than the lumen of the inner tube 92 . In response to the supply of compressed fluid, the balloon 9B deforms from a deflated state to an expanded state. FIG. 2 shows balloon 9B in an inflated state.

Balloon 9B has a distal cone portion 93, an inflatable portion 94, and a proximal cone portion 95. When the balloon 9B is inflated, the distal cone portion 93 extends from the connection portion with the inner tube 92 toward the proximal end while expanding in diameter. The proximal cone portion 95 extends from the connection portion with the outer tube 91 toward the distal end while increasing its diameter. The expansion portion 94 extends in the stretching direction between the proximal end of the distal cone portion 93 and the distal end of the proximal cone portion 95 .

As shown in FIG. 3, when the balloon catheter 9 is used with the medical device 1A, the balloon 9B is placed in the lumen 20L (see FIG. 1) of the main body portion 20 of the main body assembly 2A of the medical device 1A. A portion of the inner tube 92 of the balloon catheter 9 that protrudes further toward the distal end than the distal end of the balloon 9B is inserted into the through hole 21H provided in the distal end 20D of the main body 20 of the medical device 1A. placed outside.

The catheter shaft 9A of the balloon catheter 9 is arranged in the lumen 50L (see FIG. 1) of the shaft 5A of the medical device 1A. The catheter shaft 9A is inserted into a through hole 23H provided in the proximal end 20P of the main body 20, extends toward the distal end, and is connected to the balloon 9B disposed in the inner cavity 20L of the main body 20.

FIG. 3 shows a state in which no force is applied to the string 4A of the medical device 1A. In this state, the main body portion 20 is in a state of being extended in the stretching direction, and the interval S11 between the guide members 3A is maintained. In this case, no force from the main body portion 20 of the main body assembly 2A acts on the balloon 9B in a direction intersecting the central axis C11. Therefore, the shape of the inflated portion 94 of the balloon 9B in the inflated state extends in the stretching direction, similar to the shape when used alone.

FIG. 4 shows a state in which a force in a direction toward the proximal end is applied to the proximal end 40P of the string 4A of the medical device 1A. The string 4A is pulled toward the proximal end and moves toward the proximal end. In this case, a force in a direction toward the proximal end is applied to the portion of the main body 20 of the medical device 1A to which the distal end 40D of the string 4A is connected. Further, the string 4A applies a force to the guide member 3A in a direction that causes the guide member 3A to approach another guide member 3A adjacent to the guide member 3A in the first direction D1. A portion of the main body portion 20 that is sandwiched between a portion where the guide member 3A is provided and a portion where another guide member 3A adjacent to this guide member 3A in the first direction D1 is provided is flexible. nothing. The distance between the guide members 3A is S12, which is smaller than the distance S11 (see FIG. 3) when no force is applied to the string 4A of the medical device 1A.

According to the change in the interval between the guide members 3A from the interval S11 to the interval S12, the length in the first direction D1 of the portion of the main body 20 where the guide members 3A are provided is set to the length of the guide members across the central axis C11. It is smaller than the length in the first direction D1 of the portion located on the opposite side to 3A. As a result, the main body portion 20 is deformed and curved. Note that the guide members 31A to 38A are arranged at equal intervals in the first direction D1. Therefore, the main body portion 20 is uniformly curved with substantially the same curvature from the distal end portion 20D to the proximal end portion 20P.

Note that the curvature of the main body portion 20 changes depending on the amount of movement when the string 4A is pulled. The curvature of the main body 20 when the amount of movement of the string 4A is large is larger than the curvature of the main body 20 when the amount of movement of the string 4A is small.

As the main body 20 deforms, the balloon 9B disposed in the inner cavity 20L of the main body 20 receives a force from the main body 20 in a direction intersecting the central axis C11. As a result, the balloon 9B deforms and curves following the main body portion 20.

On the other hand, when the force acting on the proximal end 40P of the string 4A is released from the state shown in FIG. 4, the main body 20 returns to its original state shown in FIG. Return to state. The main body portion 20 is in an extended state in the stretching direction. Further, the balloon 9B disposed in the inner cavity 20L of the main body part 20 also returns to the original state shown in FIG. 3 following the main body part 20, and becomes a state extending in the stretching direction.

With reference to FIG. 5, a method of using the medical device 1A and the balloon catheter 9 will be described. A case will be illustrated in which the medical instrument 1A and the balloon catheter 9 are used to dilate a portion occluded by a stenotic lesion 80 that has occurred on the inner wall of a bent portion of the blood vessel 8.

The user prepares the medical device 1A with the balloon catheter 9 disposed inside. Balloon 9B is in a deflated state. The main body 20 of the medical device 1A is in a contracted state due to its own elastic force. The user passes the guide wire W into the vessel 8 . The user also places the main body assembly 2A of the medical device 1A and the balloon 9B of the balloon catheter 9 in the blood vessel 8. A guide wire W is inserted through the inner tube 92 of the balloon catheter 9.

The user pushes the shaft 5A of the medical device 1A and the catheter shaft 9A of the balloon catheter 9 into the blood vessel 8. Thereby, the medical device 1A and the balloon catheter 9 move distally along the guide wire W toward the stenotic lesion 80 within the blood vessel 8. As shown in FIG. 5A, when the main body assembly 2A of the medical device 1A and the balloon 9B of the balloon catheter 9 reach the stenotic lesion 80, the user stops the movement of the medical device 1A and the balloon catheter 9.

Next, the user pulls the proximal end 40P (see FIG. 1) of the string 4A of the medical device 1A toward the proximal end. At the same time, the user operates the fluid hub to supply compressed fluid to the catheter shaft 9A of the balloon catheter 9. Balloon 9B expands from a deflated state to an inflated state. In response to the expansion of the balloon 9B, the main body portion 20 also expands. Note that since the string 4A is pulled toward the proximal end, the main body 20 curves and applies a force in a direction intersecting the central axis C11 (see FIG. 1) to the inflating balloon 9B. As a result, the balloon 9B deforms and curves following the main body portion 20.

As shown in FIG. 5B, the curved and inflated balloon 9B contacts the stenotic lesion 80 that has occurred at the bend of the blood vessel 8 from the inside and pushes it outward. Further, as a result, the portion of the blood vessel 8 that is occluded by the stenotic lesion 80 is expanded. Note that the user adjusts the amount of movement of the string 4A depending on the state of the bent portion of the blood vessel 8. As a result, the balloon 9B is deformed into the shape desired by the user, and the portion occluded by the stenotic lesion 80 is appropriately expanded.

Next, the user operates the fluid hub to remove compressed fluid from balloon 9B. The balloon 9B deflates from the inflated state and enters the deflated state. Moreover, the main body part 20 contracts by its own elastic force in response to the contraction of the balloon 9B. At the same time, the user releases the force applied to the string 4A. Thereby, the main body portion 20 returns to the state before being curved (see FIG. 5C).

Next, the user moves the medical device 1A and the balloon catheter 9 to the proximal side by operating the shaft 5A of the medical device 1A and the catheter shaft 9A of the balloon catheter 9, and takes them out of the body. Next, the user takes the guide wire W out of the body.

<Actions and effects of the first embodiment>
As described above, the medical instrument 1A includes the guide member 3A provided in the main body portion 20. The distance between the guide members 3A changes from the distance S11 to the distance S12 in accordance with the operation of pulling the string 4A toward the proximal end. As a result, the main body portion 20 is deformed and curved. Therefore, the medical device 1A can curve the main body 20 with a larger curvature than, for example, when a single guide member is provided over the entire area of the main body 20 in the first direction D1. Therefore, the medical device 1A can curve the balloon 9B disposed in the inner cavity 20L of the main body 20 with a large curvature.

Further, the curvature of the main body portion 20 that curves in response to the string 4A being pulled and moved changes depending on the amount of movement of the string 4A. Therefore, the user can curve the main body portion 20 with an appropriate curvature by adjusting the amount of movement of the string 4A depending on the state of the bent portion of the blood vessel 8. Therefore, the user can deform the balloon 9B, which is used to expand the portion of the blood vessel 8 that is occluded by the stenotic lesion 80, into a desired shape using the medical instrument 1A.

The guide members 31A to 38A are arranged at equal intervals in the first direction D1. Thereby, the medical device 1A can uniformly deform and curve the main body portion 20 with substantially the same curvature from the distal end portion 20D to the proximal end portion 20P.

A distal end portion 40D of the string 4A is connected to the main body portion 20 of the main body assembly 2A. As the string 4A moves toward the proximal end, the string 4A directly applies force to the main body 20 via the distal end 40D. In this way, the medical device 1A can deform the main body 20 by directly applying a force to the main body 20 to pull the string 4A toward the proximal end.

The main body portion 20 of the main body assembly 2A has an inflatable bag shape. When the balloon 9B disposed in the inner cavity 20L of the main body 20 is in a deflated state, the main body 20 contracts due to its own elastic force. Therefore, it is possible to reduce the possibility that the medical instrument 1A moving through the blood vessel 8 will be caught on the inner wall and its movement will be inhibited. Further, when the balloon 9B is in an inflated state, the main body portion 20 is also inflated. Therefore, the medical device 1A can achieve the function of deforming the balloon 9B using the main body 20, and can perform treatment by pushing the stenotic lesion 80 outward with the inflated balloon 9B.

<Special notes on the first embodiment>
The present invention is not limited to the above embodiments, and various modifications are possible. In the embodiment described above, the medical device 1A was used to deform the balloon 9B of the balloon catheter 9. On the other hand, the medical device 1A may be used to deform a catheter other than a balloon catheter (eg, a guiding catheter, a support catheter, etc.) or an intravascular stent. Note that when the medical device 1A is used to deform an intravascular stent, the main body portion 20 of the main body assembly 2A may be placed inside the intravascular stent.

The main body portion 20 may be curved in advance. The shape of the main body portion 20 is not limited to a bag shape. For example, the main body portion 20 may not be provided with the distal cone portion 21 and the proximal cone portion 23, and may be configured only with the inflatable portion 22. The main body portion 20 may have a cylindrical shape with an open base end and a distal end. The main body 20 has the same shape as the balloon 9B in the inflated state, and does not need to be deflated.In this case, the main body 20 may be folded when the balloon 9B is in the deflated state.

Of the guide members 31A to 38A, only the guide members 32A to 37A provided in the inflatable portion 22 of the main body portion 20 may be arranged at equal intervals. The distance between the guide members 31A and 32A and the distance between the guide members 31A and 32A may be smaller than the distance between the guide members 32A to 37A. The number of guide members 3A is not limited to eight, and may be one to seven, nine or more.

In addition,. By adjusting the width and number of guide members 3A in the first direction D1, the maximum bending angle of the main body 20 when the string 4A is pulled to the maximum can be controlled. For example, the greater the number of guide members 3A and the greater the width in the first direction D1, the smaller the curvature of the main body portion 20. On the other hand, the smaller the number of guide members 3A and the smaller the width in the first direction D1, the larger the curvature of the main body portion 20. In addition, in order to curve the main body part 20 with a large curvature, the guide member 3A (for example, the guide member 31A) located at the distal end side is brought close to the distal end part 20D of the main body part 20, and the guide member 3A (for example, the guide member 31A) located at the distal end side is brought close to the distal end part 20D, and It is preferable that the positioned guide member 3A (for example, the guide member 38A) be brought close to the proximal end portion 20P of the main body portion 20.

The guide member 3A may be embedded in the main body portion 20. In this case, the material of the guide member 3A is the same as that of the main body portion 20. In this case, the holding force of the string 4A when the main body portion 20 is bent can be improved. Further, when the balloon 9B is inflated, the inner wall of the blood vessel 8 can be prevented from being damaged by the guide member 3A.

The number of strings 4A is not limited to one, and two or more strings may be used. It is preferable that the string 4A has a smooth surface and a circular cross-sectional shape so as to reduce the possibility of damaging the blood vessel 8. On the other hand, the cross-sectional shape of the string 4A may be a polygon, a plate, a hollow fiber, or other shapes.

Note that it is preferable to make the cross-sectional shape of the string 4A triangular because the expansion function of the blood vessel 8 can be strengthened. The reason is as follows. A stenotic lesion 80 is likely to occur inside the bent portion of the blood vessel 8 due to the characteristics of body fluid flow within the tube. On the other hand, when the medical device 1A is used to expand the blood vessel 8, the string 4A is placed inside the bend of the blood vessel 8. Here, by forming the string 4A in a triangular shape, the sharp portion of the string 4A can bite into the inside of the bent portion of the blood vessel 8. Therefore, the blood vessel 8 can be expanded efficiently. In addition, the material of the string 4A is preferably metal, hardened resin, animal material, vegetable material, etc. so that the blood vessel 8 can be expanded by the string 4A.

Further, it is preferable to provide a plurality of cords 4A at different positions in the circumferential direction of the main body 20, since the dilation function of the blood vessel 8 can be realized in a wider area of the main body 20 in the circumferential direction.

It is preferable that the string 4A has flexibility so that it can follow the main body portion 20 and the blood vessel 8. Moreover, it is preferable that the string 4A has rigidity so that it can withstand the reaction force and tension that act when the main body portion 20 is bent.

For example, as in Modification 1 shown in FIG. 6A, the main body portion 20 may have a protective film 26 in a portion facing the string 4A. As the material of the protective film 26, resin, gel, metal, etc. may be used. The protective film 26 is disposed between the main body 20 and the string 4A, and prevents the string 4A from coming into direct contact with the main body 20. Thereby, when the string 4A moves, the medical device 1A can protect the main body 20 by preventing the main body 20 from being rubbed due to friction generated when the string 4A moves.

Note that the protective film 26 may be provided on the string 4A, or may be provided on both the main body portion 20 and the string 4A. Instead of the protective film 26, a protective body having the same function and having a different shape may be provided. The shape of the protector may be rod-like, paving stone-like, or the like.

For example, as in Modification 2 shown in FIG. 6B, a regulating member 51 may be provided on the shaft 5A. The regulating member 51 is a roller that comes into contact with the string 4A, and has a ratchet function. The regulating member 51 rotates in the normal direction Y11 when the string 4A moves toward the proximal end, and rotates in the reverse direction Y12 when the string 4A moves toward the distal end. Further, the regulating member 51 can be switched between a state where rotation in the reversing direction Y12 is permitted and a state where rotation is prohibited.

For example, the user puts the restriction member 51 in a state where rotation in the reversing direction Y12 is prohibited, and pulls the string 4A toward the proximal end. In this case, when the regulating member 51 rotates in the normal rotation direction Y11, the string 4A can move toward the proximal end, but the movement of the string 4A toward the distal end is restricted. Therefore, even if the user releases the force applied to the string 4A, for example, the string 4A is held in a state moved toward the proximal end. Therefore, the main body portion 20 and the balloon 9B are maintained in a deformed state. Further, after dilating the blood vessel 8 with the medical instrument 1A and the balloon 9B, the user switches to a state in which rotation of the regulating member 51 in the reverse direction Y12 is permitted. This allows the string 4A to move toward the tip. The string 4A moves toward the distal end, and the main body 20 and balloon 9B return to their original states. In this way, in the medical device 1A, the state in which the string 4A moves toward the proximal end can be maintained by the regulating member 51, so that the state in which the main body portion 20 and the balloon 9B are deformed due to the movement of the string 4A can be maintained.

Note that it is preferable that the regulating member 51 is provided in a portion of the shaft 5A that is always exposed to the outside of the body. The regulating member 51 is not limited to a roller having a ratchet function. For example, the regulating member 51 may be a hook or the like that regulates the movement of the string 4A toward the distal end side.

For example, as in Modification 3 shown in FIG. 6C, the shaft 5A may be provided with insertion holes 52 and 53 that communicate with the inner cavity 50L. The insertion hole 52 may be provided near the distal end 50D of the shaft 5A, and the insertion hole 53 may be provided near the proximal end 50P of the shaft 5A. The string 4A, which passes through the guide member 38A and extends toward the proximal end, may be inserted through the insertion hole 52, extend within the inner cavity 50L toward the proximal end, and be discharged to the outside through the insertion hole 53. The user may grasp the portion of the cord 4A discharged from the insertion hole 53 and pull it toward the proximal end.

With the above configuration, the medical device 1A can prevent the string 4A from getting caught on the inner wall within the blood vessel 8 and hinder its movement, and prevent the string 4A from damaging the blood vessel 8. Further, since the inner cavity 50L of the shaft 5A and the string 4A come into contact with each other, the force applied to the proximal end 40P of the string 4A can be appropriately transmitted to the main body 20 and the guide member 3A.

Note that instead of the insertion holes 52 and 53, a cover that covers the string 4A may be provided on the outer surface of the shaft 5A. A cylindrical member having an inner cavity through which the string 4A passes may be provided on the outer surface of the shaft 5A.

For example, as in Modification 4 shown in FIG. 7, the main body portion 20 may include an elastic body 27. The elastic body 27 may be provided on the outer surface of the main body portion 20 at a position opposite to the guide member 3A across the central axis C11, and may extend along the first direction D1. The elastic body 27 may be an elastically deformable member. As the material of the elastic body 27, a rigid body such as metal or hard resin may be used.

As shown in FIG. 7A, the elastic body 27 extends linearly when no force is applied to the string 4A and the main body 20 is not bent. In this state, no elastic force acts on the elastic body 27. On the other hand, as shown in FIG. 7B, when the string 4A is pulled toward the proximal end and the main body portion 20 is curved, the elastic body 27 is also curved. In this case, an elastic force acts on the elastic body 27 to return it to its original linear shape.

Therefore, for example, when the force applied to the string 4A is released from the state shown in FIG. 7B, the main body portion 20 returns to the state shown in FIG. 7A due to the elastic force received from the elastic body 27. In this manner, in the medical device 1A, the elastic force of the elastic body 27 allows the main body portion 20 to easily return to its original state after deformation.

Note that the position where the elastic body 27 is provided is not limited to the position on the outer surface of the main body 20 opposite to the guide member 3A, but may be any position on the outer surface of the main body 20. The elastic body 27 may be embedded inside the main body portion 20. The elastic body 27 may be of the same quality as the main body portion 20.

The elastic body 27 may be made of a material (such as crystal, magnetic particles, etc.) that can be deformed by any external stimulus (such as ultrasonic waves, electric current, voltage, magnetic field, etc.), or may be made of a material that has the ability to deform itself (such as porous gel, water-absorbing gel, temperature-responsive polymer, pH-responsive polymer, etc.).

For example, as in Modification 5 shown in FIG. 8A, the main body portion 20 may be deformed by using a rigid string 4A and moving the string 4A toward the distal end. In this case, the force corresponding to the movement of the string 4A toward the distal end is transmitted to the distal end 20D of the main body 20 via the distal end 40D of the string 4A. As a result, the main body portion 20 is deformed and curved. The direction in which it curves at this time is opposite to the direction in which it curves when the string 4A is pulled toward the proximal end.

Furthermore, as in a sixth modification shown in FIG. 8B, an elastic body 28 extending along the first direction D1 may be provided on the outer surface of the main body 20 near the guide member 3A. The elastic body 28 may provide the main body 20 with an elastic force that promotes deformation of the main body 20 in accordance with the movement of the string 4A. As the material of the elastic body 28, a rigid body such as metal or hard resin may be used.

Note that the elastic body 28 may be embedded inside the main body portion 20. The elastic body 28 may be of the same quality as the main body portion 20. Furthermore, the elastic body 27 may be made of a material (e.g., crystal, magnetic particles, etc.) that can be deformed by any external stimulus (e.g., ultrasonic waves, electric current, voltage, magnetic field, etc.), or may be made of a material that has the ability to deform itself (e.g., , porous gel, water-absorbing gel, temperature-responsive polymer, pH-responsive polymer, etc.).

<Second embodiment - medical device 1B>
With reference to FIG. 9, a medical device 1B according to the second embodiment will be described. The medical device 1B includes a main body assembly 2B, guide members 31B, 32B, 33B, 34B, 35B, 36B, 37B, and 38B (hereinafter referred to as "guide members 3B" if not distinguished from each other), a string 4B, and a shaft. It has 5B. The main body assembly 2B, the string 4B, and the shaft 5B are the same as the main body assembly 2A, the string 4A, and the shaft 5A in the medical device 1A.

The guide member 3B has a triangular cross section when cut along a plane perpendicular to the first direction D1. One of the three side surfaces of the guide member 3B (hereinafter referred to as "bottom surface 361") is close to the central axis C11. Among the three corners of the guide member 3B, a corner 362 excluding the corners corresponding to both ends of the bottom surface 361 is located on the opposite side of the central axis C11 with respect to the bottom surface 361. Therefore, a cross section of the guide member 3B taken along a plane perpendicular to the first direction D1 has a sharp shape on the side opposite to the central axis C11. In this case, the medical instrument 1B can treat the stenotic lesion 80 of the blood vessel 8 by causing each sharp portion of the guide member 3B to act on the stenotic lesion 80.

Note that it is preferable to make the cross-sectional shape of the guide member 3B triangular because the expansion function of the blood vessel 8 can be strengthened. This is because, when the medical instrument 1A is used to dilate the blood vessel 8, the guide member 3B is disposed inside the bent portion of the blood vessel 8 where stenotic lesions 80 are likely to occur. That is, by making the cross-sectional shape of the guide member 3B triangular, the sharp portion of the guide member 3B can be inserted into the inside of the bent portion of the blood vessel 8. Therefore, the blood vessel 8 can be expanded efficiently. Note that the guide member 3B preferably has rigidity so that the guide member 3B can expand the blood vessel 8.

Note that the cross-sectional shape of the guide member 3B is not limited to a triangle, but may be a polygon of quadrangle or more. The guide member 3B may be coated in advance with a drug that acts on the stenotic lesion 80 of the blood vessel 8 to efficiently perform treatment.

<Third Embodiment - Medical instrument 1C>
With reference to FIG. 10A, a medical device 1C according to the third embodiment will be described. The medical device 1C includes a main body assembly 2C, guide members 31C, 32C, 33C, 34C, 35C, 36C, 37C, and 38C (hereinafter referred to as "guide members 3C" if not distinguished from each other), a string 4C, and a shaft. It has 5C. Main body assembly 2C, guide members 31C to 38C, and shaft 5C are the same as main body assembly 2A, guide members 31A to 38A, and shaft 5A in medical instrument 1A.

The string 4C differs from the string 4A of the medical device 1A in that the tip 40D is not connected to the main body 20. In the string 4C, an annular connecting member 41 is provided at the distal end portion 40D. A portion of the string 4C closer to the proximal end than the guide member 38C (hereinafter referred to as the connecting portion 42) is inserted into the through hole 40H of the connecting member 41. The distal end portion 40D of the string 4C is movably connected to the connecting portion 42 of the string 4C. An annular portion is formed in a portion of the string 4C that is closer to the tip than the connecting portion 42.

As shown in FIG. 10B, with the balloon catheter 9 placed inside the medical device 1C, the user pulls the proximal end 40P of the string 4C toward the proximal end, and at the same time deflates the balloon 9B. Inflate from state to inflated state. In response to the cord 4C being pulled toward the base end, the base end 40P of the cord 4C moves toward the base end. On the other hand, the portion of the string 4C that is closer to the distal end portion 40D than the guide member 31C is folded back by the guide member 31C, and therefore moves toward the distal end side. In this case, the annular portion formed on the string 4C is reduced.

The string 4C brings the guide member 3C and another guide member 3C adjacent to the guide member 3C in the first direction D1 close to each other. The portion of the main body portion 20 where the guide member 3C is provided is bent. This causes the main body portion 20 to curve. According to the curvature of the main body 20, the balloon 9B inside the main body 20 also deforms and curves following the main body 20.

As described above, in the string 4C, the connecting member 41 provided at the distal end portion 40D is movably connected to the connecting portion 42 of the string 4C. By pulling the proximal end 40P of the string 4C toward the proximal end, the annular portion formed on the string 4C contracts. In this case, in the medical device 1C, the distal end portion 40D of the string 4C connects to the main body 20 to reduce the amount of movement of the string 4C necessary for deforming the main body 20 by bringing the distance between the guide members 3C close. It can be suppressed more than if it were to be used. Therefore, the user can efficiently deform the main body portion 20 with a small amount of movement of the string 4C. In addition, since the string 4C reduces the annular portion formed and brings the distance between the guide members 3C closer, the force acting on the proximal end 40P is efficiently transmitted to the guide member 3C, and the main body 20 is It can be transformed.

The connecting member 41 of the string 4C is preferably made of a highly rigid material and has a shape so that it can maintain a connected state with the connecting portion 42 when the main body portion 20 is bent. The connecting member 41 is preferably formed as a part of the string 4C, but may be formed of a material different from the main body 20 and the string 4C, such as metal or hard resin.

The tip portion 40D of the string 4C may be connected to the connecting portion 42 in an immovable manner. In this case, in response to the proximal end 40P of the string 4C being pulled toward the proximal end, the distal end 40D of the string 4C also moves toward the proximal end. Further, the size of the annular portion formed on the string 4C does not change even when the string 4C is pulled toward the proximal end.

<Fourth embodiment - medical device 1D>
With reference to FIG. 11, a medical device 1D according to the fourth embodiment will be described. The medical device 1D includes a main body assembly 2D, guide members 31D, 32D, 33D, 34D, 35D, 36D, 37D, 38D, and 39D (hereinafter referred to as "guide members 3D" if not distinguished from each other), a string 4D, and a shaft 5D. The main body assembly 2D, the string 4D, and the shaft 5D are the same as the main body assembly 2A, the string 4A, and the shaft 5A in the medical device 1A.

The guide members 34D, 35D, and 36D are provided in the expansion portion 22 of the main body portion 20 of the main body assembly 2D. The guide members 34D to 36D are arranged in this order at equal intervals in the first direction D1 from the distal end side to the proximal end side. The distances in the first direction D1 between the guide members 34D and 35D and between the guide members 35D and 36D are S21. The interval S21 is larger than a predetermined first threshold Th1 (S21>Th1).

The guide members 31D, 32D, and 33D are provided in the tip side cone portion 21 of the main body portion 20 of the main body assembly 2D. The guide members 31D to 33D are arranged in this order from the distal end to the proximal end at equal intervals in the first direction D1. The guide members 37D, 38D, and 39D are provided in the proximal cone portion 23 of the main body portion 20 of the main body assembly 2D. The guide members 37D to 39D are arranged in this order from the distal end to the proximal end at equal intervals in the first direction D1. The distances in the first direction D1 between the guide members 31D and 32D, between the guide members 32D and 33D, between the guide members 37D and 38D, and between the guide members 38D and 39D are S22. The interval S22 is smaller than a predetermined second threshold Th2 (Th2>S22). Note that the second threshold Th2 is smaller than the first threshold Th1 (S21>Th1>Th2>S22).

As described above, the medical device 1D differs from the medical device 1A in that the distance between the guide members 3D is divided into a portion where the distance is S21 (guide members 34D to 36D) and a portion where the distance is S22 (guide members 31D to 33D, 37D to 39D). exists. The distance S21 between the guide members 34D to 36D provided at the center of the main body 20 in the first direction D1 is the same as the distance S21 between the guide members 31D to 33D provided at the distal ends of the guide members 34D to 36D in the first direction D1, and the base It is larger than the interval S22 between the guide members 37D to 39D provided on the end side. In this case, when the string 4D is pulled toward the proximal end, the portion of the main body portion 20 where the guide members 33D to 36D are provided is larger than the portion where the guide members 31D to 33D and the guide members 37D to 39D are provided. is also significantly deformed.

Therefore, in the medical device 1D, the central portion of the main body portion 20 in the first direction D1 can be curved to have a larger curvature than both end portions in the first direction D1. In this way, the medical device 1D can deform the main body 20 into a desired shape by appropriately adjusting the interval between the guide members 3D in the main body 20.

Note that when treating a stenotic lesion 80 formed at a bent portion of the blood vessel 8 with the balloon catheter 9, the blood vessel 8 is effectively Can be expanded. On the other hand, in the medical device 1D, the center portion of the main body 20 where the guide members 33D to 36D are provided has a larger curvature than the both end portions where the guide members 31D to 33D and the guide members 37D to 39D are provided. to curve. Therefore, the medical device 1D can effectively dilate the blood vessel 8 using the balloon catheter 9. Furthermore, the possibility of damaging the inner wall of the blood vessel 8 due to the expansion of the balloon 9B can be reduced.

Note that the arrangement of the portion where the distance between the guide members 3D is larger than the first threshold Th1 and the portion where the distance between the guide members 3D is smaller than the second threshold Th2 is not limited to the above embodiment. Depending on the shape of the blood vessel 8, the arrangement of the guide members 3D and the spacing between the guide members 3D may be changed as appropriate. The first threshold Th1 and the second threshold Th2 may be the same value.

Note that in the fourth embodiment, the guide members 34D to 36D are an example of "a plurality of first guide members" of the present invention. The guide members 31D to 33D and 37D to 39D are examples of "a plurality of second guide members" of the present invention.

<Fifth embodiment - medical device 1E>
With reference to FIG. 12, a medical device 1E according to a fifth embodiment will be described. The medical instrument 1E includes a main body assembly 2E, guide members 31E to 36E (hereinafter referred to as "guide members 3E" if not distinguished from each other), and guide members 31F to 36F (hereinafter referred to as "guide members 3F" if not distinguished from each other). ), a cord 4E, and a shaft 5E. The main body assembly 2E is the same as the main body assembly 2A in the medical device 1A. The shaft 5E is the same as the shaft 5A of the medical device 1A in the third modification.

The guide member 31E is provided on the outer surface of the main body portion 20. The guide member 31E is provided at the distal end cone portion 21 of the main body portion 20. The guide member 36E is provided on the proximal cone portion 23 of the main body portion 20. The guide members 32E to 35E are provided in the inflatable portion 22 of the main body portion 20. The guide members 31E to 36E are arranged at equal intervals in the first direction D1.

The guide member 31F is disposed on the outer surface of the main body portion 20 at a different position from the guide member 3E in the circumferential direction around the central axis C11. The guide member 31F is provided at the tip side cone portion 21 of the main body portion 20. The guide member 36F is provided at the proximal cone portion 23 of the main body portion 20. The guide members 32F to 35F are provided in the inflatable portion 22 of the main body portion 20. The guide members 31F to 36F are arranged at equal intervals in the first direction D1.

The guide members 31E, 31F, the guide members 32E, 32F, the guide members 33E, 33F, the guide members 34E, 34F, the guide members 35E, 35F, and the guide members 36E, 36F are respectively arranged at the same position in the first direction D1, They are arranged in the circumferential direction around the central axis C11.

The string 4E passes through the respective through holes 30H in the order of the guide members 36E, 35F, 34E, 33F, 32E, 31F, 31E, 32F, 33E, 34F, 35E, and 36F, and reaches the tip portion 40D. That is, the string 4E is inserted alternately into the through hole 30H of the guide member 3E and the through hole 30H of the guide member 3F.

An annular connecting member 41 is connected to the tip 40D of the string 4E. A connecting portion 43 of the string 4E that is closer to the proximal end than the guide member 36E is inserted into the through hole 40H of the connecting member 41. The tip portion 40D of the string 4E is movably connected to the connecting portion 43 of the string 4E.

With the balloon catheter 9 placed inside the medical device 1E, the user pulls the proximal end 40P of the string 4E toward the proximal end, and at the same time inflates the balloon 9B from the deflated state to the inflated state. . The string 4E brings the guide member 3E and another guide member 3E adjacent to the guide member 3E in the first direction D1 close to each other. Further, the string 4F brings the guide member 3F and another guide member 3F adjacent to the guide member 3F in the first direction D1 close to each other. Furthermore, the string 4E brings the guide members 31E, 31F, the guide members 32E, 32F, the guide members 33E, 33F, the guide members 34E, 34F, the guide members 35E, 35F, and the guide members 36E, 36F closer to each other in the circumferential direction.

As a result, the region of the main body 20 including the portion where the guide members 3E and 3F are provided is bent. This causes the main body portion 20 to curve. According to the curvature of the main body 20, the balloon 9B inside the main body 20 also deforms and curves following the main body 20.

Therefore, the medical device 1E can deform the main body 20 over a wide area in the first direction D1 and in the circumferential direction. Therefore, the medical device 1E can be appropriately expanded using the balloon catheter 9 even when the portion of the vessel 8 in which the stenotic lesion 80 is formed has a complicated shape.

Moreover, the string 4E is inserted alternately into the through hole 30H of the guide member 3E and the through hole 30H of the guide member 3F. In this case, the medical instrument 1E can apply a force corresponding to the movement of the string 4E equally to the guide members 3E and 3F. Therefore, the medical device 1E can smoothly deform the main body portion 20.

In the above, the intervals between the guide members 3E and the intervals between the guide members 3F do not need to be equal intervals. The guide members 3E and 3F may be arranged at different positions in the first direction D1. The guide members 3E and 3F may be arranged alternately in the first direction D1. The string 4E may be inserted into each through hole 30H of the guide members 36E, 35E, 34E, 33E, 32E, 31E, 31F, 32F, 33F, 34F, 35F, and 36F in this order.

Although the medical instrument 1E has two rows of guide members 3E and 3F arranged in the first direction D1, three or more rows of guide members may be provided. The tip portion 40D of the string 4E may be connected to the connecting portion 43 in an immovable manner.

Note that in the fifth embodiment, the guide member 3E is an example of "a plurality of third guide members" of the present invention. The guide member 3F is an example of "a plurality of fourth guide members" of the present invention.

<Sixth embodiment-balloon catheter 90>
The balloon catheter 90 shown in FIG. 13 has guide members 31G, 32G, 33G, 34G, 35G, 36G, 37G, and 38G (hereinafter referred to as "guide members 3G" when not distinguished from each other) with respect to the balloon catheter 9 (see FIG. 2). ), and a string 4F. The guide member 3G and string 4F are the same as the guide member 3A and string 4A in the medical instrument 1A. The direction extending along the outer surface of the balloon 9B between the distal end and the proximal end of the balloon 9B is referred to as a "second direction D2."

The guide member 31G is provided at the distal end cone portion 93 of the balloon 9B. The guide member 38G is provided at the proximal cone portion 95 of the balloon 9B. The guide members 32G to 37G are provided in the inflation section 94 of the balloon 9B. The guide members 31G to 38G are arranged in the second direction D2 from the distal end side to the proximal end side in this order. The shape and arrangement of guide members 31G to 38G correspond to guide members 31A to 38A of medical instrument 1A.

In the balloon catheter 90, the distance between the guide members 3G provided on the balloon 9B becomes smaller in response to the operation of pulling the string 4F toward the proximal end. This deforms the balloon 9B. Since the balloon catheter 90 can curve the balloon 9B with a large curvature by manipulating the string 4F, the shape of the balloon 9B can be changed to a desired shape. Note that the balloon 9B can be deformed not only in the inflated state but also in the deflated state.

Note that the guide member and the string are not limited to being provided on a balloon catheter, but may be provided on a well-known medical device used for intravascular intervention, such as a scoring balloon catheter or a stent.

1, 1A, 1B, 1C, 1D, 1E: Medical instruments 2A, 2B, 2C, 2D, 2E: Main body assembly 3A, 3B, 3C, 3D, 3E, 3F, 3G: Guide members 4A, 4B, 4C, 4D, 4E, 4F: Strings 5A, 5B, 5C, 5D, 5E: Shafts 9, 90: Balloon catheter 9A: Catheter shaft 9B: Balloon 26: Protective membranes 27, 28: Elastic body 51: Regulation members 52, 53: Through holes

Claims (16)

a body assembly including at least a body portion having a lumen;
a plurality of guide members provided on the outer surface of the main body, each having a through hole, and arranged at intervals in a first direction along the outer surface of the main body;
a string that is inserted into the through hole of each of the plurality of guide members and is movable to one side or the other side in the first direction, and when the string moves, each of the plurality of guide members The medical device is characterized in that the main body portion is deformed by changing the distance in the first direction. The plurality of guide members are
a plurality of first guide members whose intervals in the first direction are larger than a first threshold;
a plurality of second guide members whose intervals in the first direction are smaller than a second threshold;
The medical device of claim 1, wherein the first threshold is greater than the second threshold. The plurality of first guide members are provided at a central portion of the main body in the first direction,
The plurality of second guide members are provided on one side in the first direction and on the other side in the first direction with respect to the plurality of first guide members in the main body portion. 2. The medical device according to 2. The medical device according to claim 1, wherein the plurality of guide members are arranged at equal intervals in the first direction. The plurality of guide members are
a plurality of third guide members arranged in the first direction;
A plurality of fourth guide members arranged in different positions in a circumferential direction centering on an axis extending along the center of the main body portion and aligned in the first direction with respect to the plurality of third guide members. The medical device according to any one of claims 1 to 4. The string is
The medical device according to claim 5, wherein the medical device is inserted alternately into the through holes of each of the plurality of third guide members and the through hole of each of the plurality of fourth guide members. 2. A cross section of the plurality of guide members taken along a plane orthogonal to the first direction has a sharp shape on the opposite side to the axis extending along the center of the main body. 6. The medical device according to any one of 6. The string is
one end is connected to the main body assembly;
The medical device according to any one of claims 1 to 7, wherein the medical device moves in the first direction in response to a force acting on the other end. The string is
one end portion is connected to a portion of the string excluding the one end portion,
The medical device according to any one of claims 1 to 7, wherein the medical device moves in the first direction in response to a force acting on the other end. The medical device according to claim 9, wherein the one end of the string is movably connected to a portion of the string other than the one end. The medical device according to any one of claims 1 to 10, further comprising a protective film disposed between the main body and the string. Any one of claims 1 to 11, characterized in that an elastic body is provided in the main body at a position different from the plurality of guide members in a circumferential direction about an axis extending along the center of the main body. Medical equipment described in Crab. further comprising a shaft connected to the main body,
The shaft is
The medical device according to any one of claims 1 to 12, further comprising an insertion hole through which the cord is inserted. The medical device according to any one of claims 1 to 13, further comprising a regulating member that regulates movement of the string along the first direction. 15. The medical device according to claim 1, wherein the main body has an inflatable bag shape. Balloon and
a shaft to which the balloon is connected;
a plurality of guide members provided on the outer surface of the balloon, each having a through hole, and arranged at intervals in the longitudinal direction along the outer surface of the balloon;
a string that is inserted into the through hole of each of the plurality of guide members and is movable to one side or the other side in the longitudinal direction, and when the string moves in the longitudinal direction, the plurality of The balloon catheter is characterized in that the balloon is deformed by changing the distance between the guide members in the longitudinal direction.

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