JP2023156544A - Catheter and guiding device - Google Patents

Abstract

To provide a catheter comprising a depth marker that is easily detached and moved, and is easily arranged at an appropriate position.SOLUTION: A catheter 1 comprises: a long shaft 2; an operation part 3 arranged on a base end side of the shaft 2; a depth marker 51 capable of sliding on an outer peripheral surface of the shaft 2 in an axial direction of the shaft 2; and a connection part 52 arranged on a base end side of the depth marker 51, and capable of being connected to the operation part 3. A length of the connection part 52 can be changed in the axial direction of the shaft 2. The depth marker 51 or the connection part 52 has a fixing part 53 capable of fixing a position of the depth marker 51 in the axial direction with respect to the shaft 2.SELECTED DRAWING: Figure 1

Description

The present invention relates to a catheter and a guiding device used within a lumen such as a blood vessel.

Currently, interventions are being performed to treat lesions in the heart, blood vessels, liver, brain, digestive organs, urinary organs, etc. using long catheters inserted into blood vessels through holes made in the skin.

In recent years, a procedure using TRI (Trans Radial Intervention) to perform treatment by inserting a catheter from the radial artery of the wrist has been widely performed (see, for example, Patent Document 1). Introducing a catheter through an artery in the arm has the effect of reducing the physical burden on the patient and hastening discharge from hospital.

For example, when using a catheter to treat a lower limb artery from an artery in the wrist, the effective length of the catheter is long, making it difficult to grasp the tip position of the catheter using X-ray fluoroscopy. Therefore, in order to simplify the work and reduce the amount of radiation exposure, there is a need for a visually visible depth marker placed on the surface of a catheter located outside the body. Methods for forming depth markers include printing, laser irradiation, and electrolysis.

For example, when forming a depth marker by printing, there is a possibility that the ink of the formed depth marker will peel off inside the body, and the process is complicated. Further, when the depth marker is formed using a laser, the color of the depth marker is close to black, so the color of the surface of the catheter is limited to colors other than black. Further, when forming the depth marker by electrolysis, the material of the portion of the catheter where the depth marker is formed is limited to metal such as stainless steel, and the process is complicated.

Therefore, for example, Patent Document 1 describes a depth marker that can be attached to a catheter. This depth marker is safe because it does not enter the blood vessel, there are no restrictions on the color or material of the catheter, and it is easy to place.

Japanese Patent Application Publication No. 2016-179029

If the depth marker on the catheter is misaligned, the catheter may not be inserted into the proper position. Therefore, it is necessary to attach the depth marker described in Patent Document 1 while accurately confirming its position on the catheter.

The present invention has been made to solve the above-mentioned problems, and an object of the present invention is to provide a catheter and a guiding device that are easy to move and have a depth marker that is easy to place at an appropriate position.

A catheter that achieves the above object includes a long shaft, an operating section disposed on the proximal end side of the shaft, a depth marker that is slidable on the outer circumferential surface of the shaft in the axial direction of the shaft, and a connecting portion disposed on the base end side of the depth marker and connectable to the operating portion, the connecting portion being able to change length in the axial direction of the shaft, and the connecting portion being able to change the length in the axial direction of the shaft; The connecting part is characterized in that it has a fixing part that can fix the position of the depth marker in the axial direction with respect to the shaft.

In the catheter configured as described above, the depth marker can be easily moved due to the fixing portion, and the depth marker can be easily placed at an appropriate position due to the length-changeable connecting portion.

The depth marker is a tubular body having an inner circumferential surface that is in close contact with the outer circumferential surface of the shaft, and the inner circumferential surface of the depth marker adjusts the position in the axial direction by frictional force against the outer circumferential surface of the shaft. The depth marker can be held and slid in the axial direction by receiving a force from the outside, and the inner circumferential surface of the depth marker may function as the fixing part. Thereby, the position of the depth marker in the axial direction relative to the shaft can be easily fixed or moved.

The depth marker includes a tubular body having an inner circumferential surface that faces the outer circumferential surface of the shaft with a gap therebetween, and the depth marker is inserted between the outer circumferential surface of the shaft and the outer circumferential surface of the tubular body to connect the tubular body to the shaft. and a fixing part provided with a wedge part that can be fixed to the fixing part. Thereby, the position of the depth marker in the axial direction with respect to the shaft can be easily fixed or moved by arranging or removing the fixing part between the shaft and the tubular body.

The connecting portion may be formed in a spiral shape so as to wrap around the shaft. Thereby, even if the depth marker moves in the axial direction along the shaft, the connecting portion can expand and contract along the shaft while changing the winding diameter. Therefore, even if the depth marker is moved, the connecting portion is unlikely to interfere with the operator's operation.

The depth marker and the connecting portion are formed of an integral tubular body, and the tubular body has a cutting guide portion that facilitates cutting at at least one location in the axial direction, and the tubular body abuts on the operating portion. A possible proximal end of the tubular body may function as the fixing part. Thereby, by abutting the proximal end of the tubular body against the operating section, it is easy to arrange the depth marker at an appropriate position. In addition, by cutting the cutting guide portion, the position of the tubular body in contact with the operating portion can be easily changed.

A guiding device that achieves the above object is a guiding device into which a catheter can be inserted, which has an elongated shaft and an operating section disposed on the proximal end side of the shaft, the guiding device having an elongated guiding shaft. a guiding operation section disposed on the proximal side of the guiding shaft; a depth marker extending from the guiding operation section toward the proximal side; and a holding section disposed on the proximal side of the depth marker. and, the depth marker is capable of changing a length in the proximal direction from the guiding operation part, and the holding part is in contact with the operation part when the shaft of the catheter is inserted. It is characterized by being possible.

In the guiding device configured as described above, the operating portion of the inserted catheter comes into contact with the holding portion, so that insertion of the catheter into the guiding device is restricted. That is, when the operating section contacts the holding section, the depth marker disposed immediately on the proximal end side of the guiding device functions as a depth marker that indicates the position reached by the shaft. Further, the depth marker, which is easily movable and whose length can be changed, makes it easy to arrange the holding part at an appropriate position.

FIG. 3 is a plan view showing the catheter according to the first embodiment, in which (A) shows a state in which the depth marker is placed on the proximal end side of the shaft, and (B) shows a state in which the depth marker is moved toward the distal end side. FIG. 3 is a plan view showing a state in which the distal end of the catheter according to the first embodiment is inserted into a guiding device, in which (A) is a state before the depth marker hits the guiding device, and (B) is a state in which the depth marker is in the guiding device. Indicates that the device has been hit. FIG. 7 is a plan view showing a first modified example of the catheter according to the first embodiment, in which (A) is a state in which the depth marker is arranged on the proximal end side of the shaft, and (B) is a state in which the depth marker is moved toward the distal end side. shows. FIG. 7 is a diagram showing a second modified example of the catheter according to the first embodiment, in which (A) is a longitudinal cross-sectional view, and (B) is a cross-sectional view taken along the line AA in (A). FIG. 7 is a vertical cross-sectional view showing a third modified example of the catheter according to the first embodiment, in which (A) shows a state in which the depth marker is fixed to the shaft, and (B) shows a state in which the depth marker is movable from the shaft. FIG. 7 is a plan view showing a modified example of the catheter according to the second embodiment, in which (A) shows a state in which the fixing part at the proximal end of the connecting part is in contact with the operating part, and (B) shows a state in which the cutting guide part of the connecting part is shown. Shows the disconnected state. It is a top view which shows the guiding device based on 3rd Embodiment. FIG. 7 is a plan view showing a guiding device according to a third embodiment, in which (A) shows a state in which the depth marker is extended, and (B) shows a state in which the operating part of the catheter is brought into contact with the holding part.

Embodiments of the present invention will be described below with reference to the drawings. Note that the dimensions in the drawings may be exaggerated and differ from the actual dimensions for convenience of explanation. Further, in this specification and the drawings, constituent elements having substantially the same functional configuration are designated by the same reference numerals and redundant explanation will be omitted. In this specification, the side of the catheter that is inserted into the living body lumen will be referred to as the "distal side," and the side that will be operated will be referred to as the "proximal side."

Here, the guiding device 10 or 81 refers to a device that allows the catheter 1 to be placed inside a blood vessel or near a lesion, such as a guiding catheter, a guiding sheath, a long sheath, an introducer sheath, an angiography catheter, and a microscopic catheter. It may be a catheter or a guide wire support catheter, and may have a hub, a hemostasis valve, a connector, etc. as the guiding operation part 11 or 83.

Further, the depth marker refers to something that is disposed immediately on the proximal side of the guiding device 10 and has a function of indicating the position in the body of the shaft 2 of the catheter 1.

<First embodiment>
The catheter 1 according to the first embodiment is used by being inserted into a guiding device 10, which is a guiding catheter or a guiding sheath, as shown in FIG. The catheter 1 is introduced into a blood vessel from, for example, the radial artery of the arm and into the artery of the lower limb, and is used for treatment, diagnosis, and the like. The arteries of the lower limbs are the arteries near the aortoiliac artery bifurcation and more peripherally. Note that the catheter 1 is a support catheter, a microcatheter, a guiding catheter, etc., but may also be a balloon catheter.

As shown in FIG. 1, the catheter 1 includes an elongated shaft 2, an operating section 3 connected to the proximal end of the shaft 2, and a marker section 5. The operating portion 3 includes a hub 31 and a kink-resistant protector 32 provided at a connecting portion between the shaft 2 and the hub 31.

The shaft 2 is a flexible tubular member, and has a lumen 21 formed therein from the base end to the distal end. A guide wire is inserted through the lumen 21 when the catheter 1 is inserted into a blood vessel. Furthermore, the lumen 21 can also be used as a passage for medical solutions, embolic substances, contrast agents, medical instruments, and the like.

The effective length of the shaft 2 is not particularly limited, but is preferably 1500 mm to 2600 mm, more preferably 1800 mm to 2300 mm, and even more preferably 2100 mm to 2300 mm. Thereby, the catheter 1 can reach the artery of the lower limb from the artery of the arm. Note that the effective length of the shaft 2 is the length of a portion that can be inserted into a blood vessel, the guiding device 10, or the like. In this embodiment, the effective length is the length from the most extreme end of the kink protector 32 to the most extreme end of the shaft 2. The effective length of the shaft 2 is preferably 650 mm or more when introduced from the femoral artery, and 300 mm or more when approached from the distal part of the dorsalis pedis artery or the posterior tibial artery.

The hub 31 has a proximal end portion of the shaft 2 fixed in a liquid-tight manner by adhesive, heat fusion, a fastener (not shown), or the like. The hub 31 functions as an insertion port for guide wires and medical instruments into the lumen 21, an injection port for medical solutions, embolic substances, contrast agents, etc. into the lumen 21, and also serves as a gripping portion when operating the catheter 1. It also functions as

The anti-kink protector 32 is made of an elastic material and is provided so as to surround the shaft 2, and suppresses kinking of the shaft 2 at the connecting portion between the shaft 2 and the hub 31.

The marker portion 5 is used as an index (marker) that allows the length of the catheter 1 inserted into the blood vessel, the guiding device 10, etc. to be visually confirmed. The marker section 5 includes a depth marker 51 that functions as a marker, and a connecting section 52 that is disposed on the base end side of the depth marker 51.

The depth marker 51 is a tubular body that has an inner circumferential surface that can slide on the outer circumferential surface of the shaft 2 and is movable along the axis of the shaft 2 . The depth marker 51 is, for example, a circular tube, but may not be a circular tube. The inner peripheral surface of the depth marker 51 functions as a fixing part 53 that can be fixed to the shaft 2. The inner circumferential surface of the depth marker 51 is in close contact with the outer circumferential surface of the shaft 2, and is fixed by a frictional force to the extent that it will not move from the outer circumferential surface of the shaft 2 unless a certain amount of force is applied. For this reason, the inner diameter of the depth marker 51 is slightly larger than the outer diameter of the shaft 2. As an example, when the outer diameter of the shaft 2 is 1.4 mm, the inner diameter of the depth marker 51 is 1.42 mm.

It is preferable that the depth marker 51 is formed of, for example, a deformable metal tube, a resin tube, or a composite thereof. The depth marker 51 may be formed of an elastic body such as rubber. In this case, the inner diameter of the depth marker 51 may be smaller than the outer diameter of the shaft 2. Thereby, the depth marker 51 comes into close contact with the outer circumferential surface of the shaft 2 in an elastically enlarged state, and can be fixed to the shaft 2 by elastic contraction force.

Furthermore, the depth marker 51 may have a structure that allows sterilization gas to easily enter between the depth marker 51 and the shaft 2. For example, the depth marker 51 may have an internal gear-like shape or a screw-like shape formed on its inner peripheral surface. Further, the depth marker 51 may have at least one hole penetrating from the inner circumferential surface to the outer circumferential surface.

The connecting portion 52 is expandable and retractable in the axial direction of the shaft 2 and connects the depth marker 51 to the kink-resistant protector 32. The distal end of the connecting portion 52 is connected to the proximal end of the depth marker 51, and the proximal end of the connecting portion 52 is connected to the kink-resistant protector 32. The connecting portion 52 is formed in a spiral shape so as to wind around the shaft 2 . When the connecting portion 52 is contracted in the axial direction, the spiral inner diameter of the connecting portion 52 is larger than the outer diameter of the shaft 2 . Therefore, the connecting portion 52 can be extended in the axial direction by deforming so as to reduce the inner diameter of the spiral. Note that the base end of the connecting portion 52 may be connected to the hub 31 or the base end of the shaft 2 instead of the kink-resistant protector 32.

The constituent material of the depth marker 51 is not particularly limited, and examples include silicone rubber.

The outer diameter of the depth marker 51 is preferably larger than the inner diameter of the opening 12 so as not to enter the opening 12 of the guiding operation section disposed on the proximal side of the guiding device 10, for example, 2.3 mm. ~10mm. Although the inner diameter of the depth marker 51 is not particularly limited, it is, for example, 0.7 to 2 mm. The length of the depth marker 51 in the axial direction is not particularly limited, but is, for example, 1 to 30 mm.

The material forming the connecting portion 52 is not particularly limited, and examples thereof include stainless steel.

The length of the connecting portion 52 in the axial direction when it is most extended in the axial direction is not particularly limited, but is, for example, 500 to 1100 mm. The length of the connecting portion 52 in the axial direction when it is most contracted in the axial direction is not particularly limited, but is, for example, 2 to 100 mm.

Next, the operation of the catheter 1 according to the first embodiment will be explained.

First, the operator grasps the depth marker 51 and applies force in the axial direction of the shaft 2 . The depth marker 51 slides and moves on the outer peripheral surface of the shaft 2 as shown in FIG. 1(B) by receiving a force equal to or greater than a predetermined force. At this time, the spiral connecting portion 52 expands. The operator places the depth marker 51 at a desired position in the axial direction of the shaft 2. The depth marker 51 does not slide against the outer circumferential surface of the shaft 2 unless it receives a force equal to or greater than a predetermined force. For this reason, the depth marker 51 is fixed to the shaft 2 by the fixing portion 53, which is the inner peripheral surface. Note that the maximum extendable length of the connecting portion 52 is determined. Therefore, the most distal position that can be reached by the depth marker 51 connected to the anti-kink protector 32 by the connecting portion 52 is determined. Therefore, it is easy to arrange the depth marker 51 at the position where the connecting portion 52 is the most extended. Since the depth marker 51 is not disposed at a position exceeding the maximum length, use beyond an appropriate range is restricted, and deterioration in operability and safety can be suppressed.

Next, as shown in FIG. 2(A), the tip of the catheter 1 is inserted into the opening 12 of the guiding device 10, which is a guiding catheter or guiding sheath inserted into the blood vessel through the patient's skin. . The operator can insert the catheter 1 into the guiding device 10 while checking the position of the depth marker 51 of the marker section 5. Therefore, the operator can easily grasp the insertion length of the catheter 1 into the blood vessel or the guiding device 10 using the depth marker 51.

When the depth marker 51 hits the guiding hub 31, further insertion of the catheter 1 is restricted, as shown in FIG. 2(B). Therefore, deterioration in the safety and operability of the catheter 1 can be suppressed. Note that when the depth marker 51 hits the guiding hub 31, the operator applies a force greater than a predetermined force to the depth marker 51 to move the depth marker 51 toward the proximal end along the shaft 2. It can also be moved. Therefore, the operator can also insert the catheter 1 further toward the distal end of the guiding device 10.

The operator can also cut the connecting portion 52 if necessary. This allows the depth marker 51 to move relative to the shaft 2 without being restricted by the connecting portion 52. Alternatively, the depth marker 51 can also be removed from the shaft 2.

As described above, the catheter 1 according to the first embodiment includes the elongated shaft 2, the operating section 3 disposed on the proximal end side of the shaft 2, and the outer peripheral surface of the shaft 2 in the axial direction of the shaft 2. It has a depth marker 51 that can be slid into the depth marker 51 and a connecting portion 52 that is disposed on the proximal side of the depth marker 51 and can be connected to the operating section 3. The connecting portion 52 is elongated in the axial direction of the shaft 2. The depth marker 51 or the connecting portion 52 has a fixing portion 53 that can fix the position of the depth marker 51 in the axial direction with respect to the shaft 2.

In the catheter 1 configured as described above, the depth marker 51 can be easily removed and moved by the fixing part 53, and the depth marker 51 can be placed at an appropriate position by the length-changeable connecting part 52. It's easy to do.

Further, the depth marker 51 is a tubular body having an inner circumferential surface that is in close contact with the outer circumferential surface of the shaft 2, and the inner circumferential surface of the depth marker 51 is moved to a position in the axial direction by frictional force against the outer circumferential surface of the shaft 2. The inner peripheral surface of the depth marker 51 functions as a fixing part 53. Thereby, the position of the depth marker 51 in the axial direction relative to the shaft 2 can be easily fixed or moved.

Further, the connecting portion 52 is formed in a spiral shape so as to wrap around the shaft 2 . Thereby, even if the depth marker 51 moves in the axial direction along the shaft 2, the connecting portion 52 can expand and contract along the shaft 2 while changing the winding diameter. Therefore, even if the depth marker 51 is moved, the connecting portion 52 is unlikely to interfere with the operator's operation.

Note that the connecting portion 52 may not be in a spiral shape as in the first modification shown in FIG. 3(A), but may be a wire rod that can be flexibly bent. As shown in FIG. 3(B), the operator grasps the depth marker 51 and applies force in the axial direction of the shaft 2, deforming the connecting portion 52 into a shape close to a straight line and removing the depth marker. 51 can be moved to a desired position and fixed.

Further, the structure of the fixing portion 55 of the depth marker 51 is not particularly limited. For example, as in the second modification shown in FIG. 4, the depth marker 51 can be inserted between the tubular body 54, the inner circumferential surface of the tubular body 54, and the outer circumferential surface of the shaft 2 from the distal side or the proximal side. A fixing portion 55 may also be provided. The inner diameter of the tubular body 54 is larger than the outer diameter of the shaft 2, and a gap is formed between the inner circumferential surface of the tubular body 54 and the outer circumferential surface of the shaft 2. The fixing part 55 has a wedge part 56 that can enter between the inner peripheral surface of the tubular body 54 and the outer peripheral surface of the shaft 2 from the distal end side or the proximal end side. The outer circumferential surface of the wedge portion 56 tapers in diameter toward the end in the axial direction. The fixing portion 55 has a substantially C-shaped cross section perpendicular to the axis of the shaft 2 . That is, the fixing part 55 is a circumferentially discontinuous tubular body in which a slit 57 is formed from the distal end to the proximal end. The wall thickness of the thickest portion of the fixed portion 55 in the radial direction is larger than the gap between the inner circumferential surface of the tubular body 54 and the outer circumferential surface of the shaft 2 . The thickness of the thinnest portion of the fixing portion 55 in the radial direction is smaller than the gap between the inner circumferential surface of the tubular body 54 and the outer circumferential surface of the shaft 2 . The inner diameter and outer diameter of the fixed part 55 can be easily changed by changing the gap between the slits 57. By inserting the side of the fixing part 55 on which the wedge part 56 is provided into the gap between the inner circumferential surface of the tubular body 54 and the outer circumferential surface of the shaft 2, the fixing part 55 is inserted between the inner circumferential surface of the tubular body 54 and the outer circumferential surface of the shaft 2. caught between surfaces. Thereby, the depth marker 51 can be fixed to the shaft 2.

Further, as in the third modification shown in FIG. 5, the depth marker 51 may have a fixed portion having a wire gripper structure. As shown in FIG. 5(A), the depth marker 51 includes a cylindrical cover part 61, a moving part 62 movably disposed inside the cover part 61, and a cover part 62 disposed inside the cover part 61. It includes a plurality of balls 63 (fixed part) that are movable together with the part 61 and a spring 64 that is arranged inside the cover part 61 and applies force to the moving part 62. A portion of the moving part 62 protrudes from one end side of the inner cavity passing through the cover part 61. The moving portion 62 has a lumen that communicates with the lumen of the cover portion 61 . Therefore, the shaft 2 can pass through the cover part 61 and the moving part 62. The moving part 62 is formed with an accommodating part 65 that accommodates the ball 63. The spring 64 biases the moving part 62 in a direction in which the moving part 62 protrudes from the cover part 61. Note that the direction in which the moving part 62 protrudes from the cover part 61 can be either the distal direction or the proximal direction. The cover portion 61 has a tapered surface 66 formed on an inner circumferential surface that accommodates the moving portion 62, the diameter of which decreases in the direction in which the moving portion 62 protrudes. The ball 63 is capable of contacting the outer peripheral surface and the tapered surface 66 of the shaft 2 . The ball 63 can move together with the moving part 62 and come into contact with the tapered surface 66 due to the moving part 62 being biased by the spring 64 . Thereby, the plurality of balls 63 are pressed toward the shaft 2 by the tapered surface 66 and fix the depth marker 51 to the shaft 2. That is, the plurality of balls 63 function as a fixed part. As shown in FIG. 5(B), when the moving part 62 protruding from the cover part 61 is pushed into the cover part 61, the force acting on the ball 63 from the tapered surface 66 is removed, and the shaft 2 is fixed by the ball 63. Can be canceled.

<Second embodiment>
A catheter 70 according to the second embodiment differs from the first embodiment in that, as shown in FIG. 6, a marker portion 71 having a depth marker 72 and a connecting portion 73 is formed of one tubular body 54.

The marker portion 71 has an inner circumferential surface that can slide on the outer circumferential surface of the shaft 2, and is movable along the axis of the shaft 2. The marker portion 71 is, for example, a circular tube, but may not be a circular tube. Similar to the first embodiment, the inner circumferential surface of the marker portion 71 is fixed to the outer circumferential surface of the shaft 2 by a frictional force that does not move unless a certain amount of force is applied. That is, the inner circumferential surface of the marker portion 71 functions as a fixing portion. Note that the inner circumferential surface of the marker portion 71 does not need to contact the outer circumferential surface of the shaft 2 with a certain amount of clearance and function as a fixing portion.

The depth marker 72 is arranged on the tip side of the marker section 71. For easy identification, the depth marker 72 has, for example, an outer circumferential surface that widens toward the distal end at the distal end of the marker. Note that the depth marker 72 may have a constant outer diameter continuous from the connecting portion 73.

The connecting portion 73 is arranged on the proximal end side of the depth marker 72 of the marker portion 71 . The connecting portion 73 preferably has a substantially constant outer diameter, but is not limited thereto. In the connecting portion 73, a first cutting guide portion 74 (cutting guide portion) is formed at at least one location in the axial direction, and a second cutting guide portion 75 (cutting guide portion) is formed at at least one location in the circumferential direction. be done. The first cutting guide section 74 and the second cutting guide section 75 are sections that facilitate cutting by the operator, and are formed with lower rigidity than adjacent sections. The first cutting guide part 74 and the second cutting guide part 75 are formed of, for example, a groove, a notch, a plurality of small holes lined up in a perforation shape, a material softer than an adjacent part, or the like. It is preferable that a plurality of each of the first cutting guide section 74 and the second cutting guide section 75 be provided. This increases the options for where to cut. The base end of the connecting portion 73 can come into contact with the kink-resistant protector 32 of the operating portion 3 . Therefore, the base end of the connecting portion 73 can also function as a fixing portion. Further, the cutting guide portion may be provided in a spiral shape along the long axis of the marker portion 71 with the long axis as the center.

Next, the operation of the catheter 70 according to the second embodiment will be explained.

First, the operator grasps the marker portion 71 and applies force in the axial direction of the shaft 2 . The marker portion 71 slides and moves on the outer circumferential surface of the shaft 2 by receiving a force equal to or greater than a predetermined force. The operator can bring the proximal end of the connecting part 73 disposed on the proximal side of the marker part 71 into contact with the operating part 3 . As a result, the marker section 71 including the depth marker 72 is restricted from moving any further toward the proximal end. That is, the base end of the connecting portion 73 functions as a fixing portion that fixes the position of the depth marker 72 in the axial direction. Therefore, it is easy to arrange the depth marker 72 at the position when the connecting part 73 is brought into contact with the operating part 3.

As shown in FIG. 6(B), the operator removes a portion of the proximal end of the marker section 71 by cutting the first cutting guide section 74 of one of the marker sections 71. The length in the axial direction can be changed. Note that the portion on the tip side of the marker portion 71 can also be removed. When cutting the first cutting guide portion 74, the second cutting guide portion 75 of the portion to be removed is also cut, thereby making it easier to separate the portion to be removed from the shaft 2. After changing the length of the marker section 71, the operator can move the marker section 71 toward the proximal end and bring the new proximal end of the marker section 71 into contact with the operating section 3. Thereby, the position of the depth marker 72 arranged at the tip of the marker section 71 can be set to a desired position.

Next, the distal end of the catheter 70 is inserted into the opening 12 of the guiding device 10, which is a guiding catheter 70 or a guiding sheath inserted into the blood vessel through the patient's skin. The operator can insert the catheter 70 into the guiding device 10 while checking the position of the depth marker 72 of the marker section 71. Therefore, the operator can easily grasp the insertion length of the catheter 70 into the blood vessel or the guiding device 10 using the depth marker 72.

When the depth marker 72 abuts the guiding hub 31, further insertion of the catheter 70 is restricted. Therefore, deterioration in the safety and operability of the catheter 70 can be suppressed.

As described above, the depth marker 72 and the connecting part 73 are formed by the integral tubular body 54, and the tubular body 54 has a cutting guide part that facilitates cutting at at least one location in the axial direction. The base end of the tubular body 54 that can come into contact with the portion 3 functions as a fixing portion. Thereby, by abutting the proximal end of the tubular body 54 against the operating section 3, it is easy to arrange the depth marker 72 at an appropriate position. Further, by cutting the cutting guide portion, the position of the tubular body 54 in contact with the operating portion 3 can be easily changed. Note that the base end of the connecting portion 73 functions as a fixing portion, and the inner circumferential surface of the tubular body 54 may also function as a fixing portion.

<Third embodiment>
In the third embodiment, the depth marker 84 is provided on the guiding device 81, which is the guiding catheter 101 or the guiding sheath, as shown in FIG. This is different from the first and second embodiments in which a marker 51 is provided. The guiding device 81 is used to insert the catheter 101 and guide the catheter 101 to a desired position, as shown in FIG. 8 .

As shown in FIG. 7, the guiding device 81 includes a guiding shaft 82 that is a long tubular body, a guiding operating section 83 disposed on the proximal end side of the guiding shaft 82, and a guiding operating section 83. It has a depth marker 84 extending from the depth marker 84 to the proximal end side, and a tubular holding portion 85 disposed on the proximal end side of the depth marker 84. The guiding operation section 83 includes an anti-kink protector 86 and a guiding hub 87.

The depth marker 84 is a spiral wire extending from the guiding hub 87 toward the proximal end. The depth marker 84 is formed of, for example, a material that plastically deforms when subjected to a certain amount of force. Thereby, the depth marker 84 can change its length by deforming itself, and can maintain the changed length. The constituent material of the depth marker 84 is not particularly limited, and examples thereof include stainless steel. Note that the depth marker 84 may have a structure that does not change from a preset length. In this case, the depth marker 84 may be formed of a material that is easily elastically deformed.

The holding portion 85 is capable of abutting against an operating portion 103 disposed on the proximal end side of the shaft 102 into which the shaft 102 of a catheter 101 different from the guiding device 81 is inserted. The holding portion 85 can be formed of, for example, a deformable metal tube, a resin tube, or a composite thereof. The holding part 85 does not need to be tubular, and may be ring-shaped, for example, as long as it can reliably abut against the operating part 103. The material of the holding portion 85 is not particularly limited, and examples thereof include nylon. The inner diameter of the holding portion 85 is larger than the outer diameter of the shaft 102, and a gap is formed between the inner circumferential surface of the holding portion 85 and the outer circumferential surface of the shaft 102. Therefore, the outer peripheral surface of the shaft 102 can smoothly slide on the inner peripheral surface of the holding part 85. Therefore, when the shaft 102 moves inside the holding part 85, the holding part 85 does not receive a large frictional force from the shaft 102 and does not move together with the shaft 102.

The guiding shaft 82 is a flexible tubular member, and has a guiding lumen 88 formed therein from the base end to the distal end. The guiding lumen 88 allows the catheter 101 to be passed to the desired location.

The guiding hub 87 has a proximal end portion of the guiding shaft 82 fixed in a fluid-tight manner by adhesive, heat fusion, a fastener (not shown), or the like. The guiding hub 87 functions as an insertion port for the catheter 101 and the guide wire into the guiding lumen 88, and also functions as a grip when operating the guiding device 81.

Next, the operation of the guiding device 81 in the third embodiment will be explained.

First, the operator grasps the holding portion 85 or the depth marker 84 and moves it toward the proximal end along the axis of the guiding shaft 82 so as to separate it from the guiding hub 87 . As a result, the spiral depth marker 84 is plastically deformed and elongated by receiving a force greater than a predetermined force. The operator places the holding portion 85 at a desired position closer to the proximal end than the guiding hub 87 . Note that the maximum extendable length of the depth marker 84 is determined. Therefore, the most proximal position that the holding portion 85 connected to the proximal end of the depth marker 84 can reach is determined. Therefore, since the holding portion 85 is not disposed at a position exceeding the maximum length, use beyond an appropriate range is restricted, and deterioration in operability and safety can be suppressed.

Next, as shown in FIG. 8(A), the operator inserts the catheter 101 into the lumen of the holding part 85 and moves it toward the distal end. The catheter 101 can pass inside the helical depth marker 84, pass through the opening 12 of the guiding hub 87 and the guiding lumen 88, and reach the distal side of the guiding shaft 82. The shaft 102 does not receive a large frictional force from the holding part 85 when it slides inside the holding part 85. Therefore, the shaft 102 can move toward the distal end without being hindered by the holding portion 85. Therefore, the distance from the guiding hub 87 to the holding portion 85 is maintained.

The operator can insert the catheter 101 into the guiding device 81 while checking the position of the depth marker 84 of the marker section 71. Therefore, the operator can easily grasp the insertion length of the catheter 101 into the blood vessel or the guiding device 81 using the depth marker 84.

When the operating portion 103 of the catheter 101 hits the holding portion 85, further insertion of the catheter 101 is restricted, as shown in FIG. 8(B). Therefore, deterioration in the safety and operability of the catheter 101 can be suppressed. When the operating section 103 comes into contact with the holding section 85, the depth marker 84 disposed immediately on the proximal side of the guiding device 81 functions as the depth marker 84 indicating the position reached by the shaft 102. Further, the depth marker 84, which is easily movable and whose length can be changed, makes it easy to arrange the holding part 85 at an appropriate position.

When the depth marker 84 hits the guiding hub 87, the operator can also contract the depth marker 84 along the shaft 102 by applying a force greater than a predetermined force to the depth marker 84. Therefore, the operator can also insert the catheter 101 further toward the distal end of the guiding device 81.

As described above, the guiding device 81 in the third embodiment is a guiding device 81 into which a catheter 101 can be inserted, which has an elongated shaft 102 and an operating section 103 disposed on the proximal end side of the shaft 102. A long guiding shaft 82, a guiding operating section 83 disposed on the proximal side of the guiding shaft 82, and a depth marker 84 extending from the guiding operating section 83 toward the proximal end, The depth marker 84 has a holding part 85 disposed on the proximal end side of the depth marker 84, the length of the depth marker 84 in the proximal direction from the guiding operation part 83 can be changed, and the holding part 85 has a The shaft 102 of 101 is inserted and can come into contact with the operating section 103.

In the guiding device 81 configured as described above, the operation section 103 of the inserted catheter 101 comes into contact with the holding section 85, so that insertion of the catheter 101 into the guiding device 81 is restricted. That is, when the operating section 103 comes into contact with the holding section 85, the depth marker 84 disposed immediately on the proximal end side of the guiding device 81 functions as the depth marker 84 indicating the position reached by the shaft 102. Further, the depth marker 84, which is easily movable and whose length can be changed, makes it easy to arrange the holding part 85 at an appropriate position.

Note that the present invention is not limited to the embodiments described above, and various modifications can be made by those skilled in the art within the technical idea of the present invention. For example, the catheter may be inserted through a blood vessel other than the arm artery. Further, the catheter may be used for treatment or diagnosis of blood vessels other than the arteries of the lower limbs. Further, the catheter may be inserted into the bile duct, trachea, esophagus, urethra, or other living body lumen or body cavity to be used for treatment, diagnosis, and the like.

1, 70, 101 catheter 10, 81 guiding device 11, 83 guiding operation part 12 opening 2, 102 shaft 21 lumen 3, 103 operation part 31 hub 32, 86 anti-kink protector 5, 71 marker part 51, 72, 84 depth marker 52, 73 connecting part 53, 55 fixed part 54 tubular body 56 wedge part 57 slit 61 cover part 62 moving part 63 ball (fixed part)
64 Spring 65 Accommodation part 66 Tapered surface 74 First cutting guide part (cutting guide part)
75 Second cutting guide part (cutting guide part)
82 Guiding shaft 85 Holding part 87 Guiding hub 88 Guiding lumen

Claims (6)

a long shaft,
an operating section disposed on the proximal end side of the shaft;
a depth marker that is slidable on the outer peripheral surface of the shaft in the axial direction of the shaft;
a connecting portion disposed on the proximal side of the depth marker and connectable to the operating portion;
The length of the connecting portion can be changed in the axial direction of the shaft,
A catheter characterized in that the depth marker or the connecting portion has a fixing portion capable of fixing the position of the depth marker in the axial direction with respect to the shaft. The depth marker is a tubular body having an inner circumferential surface in close contact with an outer circumferential surface of the shaft,
The inner circumferential surface of the depth marker is capable of maintaining its position in the axial direction by frictional force against the outer circumferential surface of the shaft, and is also capable of sliding in the axial direction in response to external force;
The catheter according to claim 1, wherein an inner circumferential surface of the depth marker functions as the fixing part. The depth marker includes a tubular body having an inner circumferential surface that faces the outer circumferential surface of the shaft with a gap therebetween, and the depth marker is inserted between the outer circumferential surface of the shaft and the outer circumferential surface of the tubular body to connect the tubular body to the shaft. The catheter according to claim 1, further comprising: a fixing part having a wedge part that can be fixed to the fixing part. The catheter according to any one of claims 1 to 3, wherein the connecting portion is formed in a spiral shape so as to wrap around the shaft. the depth marker and the connecting portion are formed of an integral tubular body;
The tubular body has a cutting guide part that facilitates cutting at at least one location in the axial direction,
The catheter according to claim 1, wherein a proximal end of the tubular body that can come into contact with the operating section functions as the fixing section. A guiding device into which a catheter can be inserted, which has an elongated shaft and an operating section disposed on the proximal end side of the shaft,
A long guiding shaft,
a guiding operation section disposed on the proximal end side of the guiding shaft;
a depth marker extending from the guiding operation section toward the proximal end;
a holding part disposed on the proximal side of the depth marker,
The depth marker is changeable in length from the guiding operation section to the proximal direction,
The guiding device is characterized in that the holding portion is capable of being inserted with the shaft of the catheter and abutting the operating portion.

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