JP2023166037A - Catheter and cerebral infarction treatment device - Google Patents

Abstract

To provide a catheter which can deliver oxygen to a brain without fluctuations of an intracranial pressure and a cerebral infarction treatment device.SOLUTION: In a catheter 10 having a tube body 20 inserted into a living body, the tube body 20 includes a permeable part 32 provided in a distal end part, an inflow lumen 30 for making a fluid flow from a proximal end side toward the permeable part 32, and an evacuation lumen 31 for making the fluid flow from the permeable part 32 toward the proximal end side. The permeable part 32 has a permeable membrane part 32a for making a specific gas contained in the fluid penetrate to the outside of the tube body 20.SELECTED DRAWING: Figure 2

Description

The present invention relates to a catheter inserted through the spine to inject and drain a high oxygen solution, and a cerebral infarction treatment device.

In the treatment of cerebral infarction, treatment methods such as thrombolytic therapy and thrombus retrieval therapy have been established. However, these treatments are often difficult due to the risk of bleeding and poor access. For this reason, most treatments for cerebral infarction remain medical.

One possible treatment for cerebral infarction is to approach the brain with a high-oxygen solution or a high-oxygen solution (hereinafter collectively referred to as a "high-oxygen solution") and deliver oxygen from a source other than through blood vessels. The concept of such treatment is disclosed in, for example, Patent Document 1.

US Patent No. 4,686,085

Patent Document 1 does not disclose a specific medical device for treatment in which a high oxygen solution approaches the brain. For this treatment, the medical device needs to have the ability to inject a hyperoxic solution into the brain and drain cerebrospinal fluid. However, if a medical device is unable to balance fluid injection and drainage, there is a risk of fluctuations in intracranial pressure.

The present invention was made to solve the above-mentioned problems, and aims to provide a catheter and a cerebral infarction treatment device that can safely send oxygen to the brain without causing fluctuations in intracranial pressure. .

A catheter and cerebral infarction treatment device according to the present invention that achieves the above object are catheters having a tube body inserted into a living body, the tube body having a transparent part provided at a distal end and a cerebral infarction treatment device from a proximal side. The permeation part has an injection lumen that allows the fluid to flow toward the permeation part, and a discharge lumen that allows the fluid to flow from the permeation part toward the proximal end, and the permeation part is configured to release a specific gas contained in the fluid. It has a permeable membrane portion that transmits water to the outside of the tube body.

The catheter and cerebral infarction treatment device configured as described above can release a specific gas without causing liquid to flow out of the tube body, so that intracranial pressure can be prevented from fluctuating.

The injection lumen and the discharge lumen may communicate with each other within the transmission section and may be arranged in parallel. This allows the fluid to flow without flowing out of the tube body.

The inlet lumen and the outlet lumen may be arranged concentrically. This allows the diameter of the tube body to be reduced.

The tube body may have a reservoir section at its distal end that communicates with the injection lumen and the discharge lumen. As a result, the fluid tends to remain in the storage section, so that the specific gas can be efficiently released from the permeation section.

The discharge lumen may be arranged concentrically inside the injection lumen, and may have a communication portion that communicates with the injection lumen on the proximal side of the distal end. As a result, the fluid tends to remain at the tip of the tube body, so that the specific gas can be efficiently released from the permeation section.

A balloon formed of the permeable membrane portion may be provided at the distal end of the injection lumen, and the balloon may be expanded in the radial direction by injecting fluid from the injection lumen. This makes it easier for the fluid to remain within the balloon, and since the radially expanded balloon has a larger surface area, specific gases can be released more efficiently.

The tube body may have a contrast marker at its tip. Thereby, when inserting the tube body into a living body, the tip portion can be reliably delivered to the target site.

FIG. 2 is a front view of the catheter of this embodiment. 2 is a sectional view of FIG. 1. FIG. 3 is a sectional view taken along line AA in FIG. 2. FIG. FIG. 3 is an enlarged view of the catheter tip portion and its vicinity in FIG. 2; FIG. 7 is an enlarged view of the vicinity of the distal end of the catheter of the first modification. 6 is a sectional view taken along line AA in FIG. 5. FIG. FIG. 7 is an enlarged view of the catheter tip portion and its vicinity in a second modified example. FIG. 7 is an enlarged view of the vicinity of the catheter tip of a third modification. It is an enlarged view of the catheter tip part vicinity of the 4th modification.

Embodiments of the present invention will be described below with reference to the drawings. Note that the dimensional ratios in the drawings may be exaggerated and different from the actual ratios for convenience of explanation. Furthermore, in this specification, the side of the catheter 10 that is inserted into a living body is referred to as the "distal end" or "distal end side," and the side on which the catheter is operated is referred to as the "proximal end" or "base end side."

The catheter 10 according to the embodiment of the present invention is inserted into the spinal canal from the lumbar vertebrae, and the distal end is delivered to the vicinity of the brain. A high oxygen solution flows within the catheter 10 and supplies oxygen to the vicinity of the brain, thereby treating cerebral infarction. In this way, catheter 10 functions as a cerebral infarction treatment device.

As shown in FIGS. 1 and 2, the catheter 10 has a long tube body 20. The tube body 20 has a first branch tube section 21 and a second branch tube section 22, each of which has a proximal end branched into two. A port 21a is provided at the base end of the first branch pipe section 21, and a port 22a is provided at the base end of the second branch pipe section 22, respectively.

Inside the tube body 20, there is an injection lumen 30 continuous in the length direction from the port 21a of the first branch tube section 21, and an exhaust lumen 31 continuous in the length direction from the port 22a of the second branch tube section 22. It is formed. As shown in FIG. 3(a), the tube body 20 has an injection lumen 30 and a discharge lumen 31 partitioned by a partition wall 35 formed inside the tube, and arranged in parallel. Further, as shown in FIG. 3(b), the injection lumen 30 and the discharge lumen 31 may be arranged in parallel by coupling the first tube 36 and the second tube 37.

The injection lumen 30 and the discharge lumen 31 communicate with each other at the tip of the tube body 20. Therefore, the fluid injected from the port 21a of the first branch pipe section 21 flows through the injection lumen 30 toward the distal end up to the distal end of the pipe main body 20, and flows into the discharge lumen 31 at the distal end of the pipe main body 20. Then, it flows toward the proximal end to the port 22a of the second branch pipe section 22 and is discharged.

A contrast marker 25 may be provided at the distal end of the tube body 20. The contrast marker 25 allows confirmation of the position of the tube body 20 in the living body. Note that the contrast marker 25 may be provided not only at the distal end of the tube body 20 but also at other locations as necessary.

Preferably, the tube body 20 is formed from a material that has some degree of flexibility. Examples of such materials include polyolefins such as polyethylene, polypropylene, polybutene, ethylene-propylene copolymers, ethylene-vinyl acetate copolymers, ionomers, or mixtures of two or more of these, flexible polyvinyl chloride resins, Examples include polyamide, polyamide elastomer, polyester, polyester elastomer, polyurethane, fluororesin such as polytetrafluoroethylene, engineering plastic such as polyether ether ketone (PEEK), latex rubber, and the like.

The tip of the tube body 20 is closed, and a permeable portion 32 having a permeable membrane portion 32a is provided. The permeable portion 32 has a permeable membrane portion 32a on the outer surface of the tube body 20. The permeable membrane portion 32a is a membrane that can transmit only oxygen contained in the high oxygen solution. As such a permeable membrane portion 32a, for example, an oxygen permeable ceramic membrane, silicone rubber, etc. can be used. Note that the portion of the tube body 20 other than the permeable portion 32 does not transmit oxygen.

As shown in FIG. 4, the oxygen-rich solution flowing through the injection lumen 30 flows into the discharge lumen 31 at the permeation part 32, and oxygen is released to the outside by the permeation membrane part 32a. Thereby, oxygen can be supplied to the vicinity of the brain into which the distal end of the tube body 20 is inserted without injecting liquid into the body.

Next, a treatment method using the catheter 10 of this embodiment will be explained. The catheter 10 is percutaneously inserted into a living body and introduced into the spinal canal through the gap between the lumbar vertebrae or between the lumbar vertebrae and the sacrum. Specifically, the catheter 10 is introduced into the spinal canal using the L3-L4, L4-L5, or L5-S1 spaces. However, the catheter 10 may be introduced into the spinal canal from positions other than these.

The catheter 10 introduced into the spinal canal is inserted toward the brain. The catheter 10 is inserted until it reaches the vicinity of the brain while confirming the position of the tip end of the tube body 20 using a contrast device such as an X-ray. The position of the tip of the tube body 20 can be confirmed using the contrast marker 25. It is desirable that the maximum insertion position of the catheter 10 is up to the cisterna magna.

Once the catheter 10 is inserted, a pump or the like supplies a high oxygen solution to the injection lumen 30 and circulates it inside the tube body 20. In this embodiment, the hyperoxic solution is hyperoxygenated artificial cerebrospinal fluid. The injected high-oxygen solution flows through the injection lumen 30 toward the distal end, releases oxygen to the outside in the permeation section 32, flows through the discharge lumen 31 toward the proximal end, and is discharged. The oxygen released to the outside of the tube body 20 increases the oxygen concentration of cerebrospinal fluid (CSF) and is supplied to the affected area. At this time, since the high oxygen solution liquid does not flow out of the tube body 20 from the permeation part 32, it is possible to prevent the intracranial pressure from changing.

After the high oxygen solution continues to circulate for a certain period of time, the pump is stopped and the catheter 10 is removed from the living body to complete the treatment. Furthermore, the treatment may be terminated on the condition that removal of the thrombus is confirmed.

Next, a first modified example of the catheter will be described. As shown in FIGS. 5 and 6, the tube body 40 of this example is formed by disposing an inner tube 42 inside an outer tube 41. As shown in FIGS. Inside the inner tube 42 is an injection lumen 43, and outside the inner tube 42 and inside the outer tube 41 is a discharge lumen 44. Thereby, the injection lumen 43 and the discharge lumen 44 are arranged concentrically. The tip of the inner tube body 42 is open, and the injection lumen 43 and the discharge lumen 44 communicate with each other at the tip of the tube body 20.

A transparent section 45 with a closed end is provided at the distal end of the tube body 40 . The transmission section 45 has a transmission membrane section 45a on its outer surface. The oxygen-rich solution flowing through the injection lumen 43 releases oxygen to the outside in the permeation section 45 and is discharged through the discharge lumen 44.

In this manner, the inlet lumen 43 and the outlet lumen 44 may be arranged concentrically. By arranging the injection lumen 43 and the discharge lumen 44 concentrically, the inner diameter of the tube body 40 can be reduced. Note that the inside of the outer tube 41 and the outside of the inner tube 42 may be used as an injection lumen, and the inside of the inner tube 42 may be used as a discharge lumen.

Next, a second modified example of the catheter will be described. As shown in FIG. 7, in the tube main body 50 of this example, an inner tube 52 is disposed inside an outer tube 51, and a permeable portion 55 having a permeable membrane portion 55a is provided at the distal end. Inside the inner tube 52 is an injection lumen 53, and inside the outer tube 51 and outside the inner tube 52 is a discharge lumen 54. The distal end of the inner tubular body 52 is located closer to the proximal end than the distal end of the tubular body 20, and the distal end of the tubular body has a spatial storage portion 56 that communicates with the injection lumen 53 and the discharge lumen 54. It is formed. The storage section 56 has a size that occupies most of the area of the transmission section 55. Therefore, the high oxygen solution that has flowed into the reservoir 56 from the injection lumen 53 remains in the reservoir 56 for a relatively long time before being discharged from the discharge lumen 54. Since the high oxygen solution is stored in the permeation part 55 by the storage part 56, oxygen can be released to the outside of the tube body 50 more efficiently. Note that the inside of the outer tube 51 and the outside of the inner tube 52 may be used as an injection lumen, and the inside of the inner tube 52 may be used as a discharge lumen.

Next, a third modified example of the catheter will be described. As shown in FIG. 8, in the tube body 60 of this example, an inner tube 62 is disposed inside an outer tube 61, and a permeable portion 65 having a permeable membrane portion 65a is provided at the tip. Inside the inner tube 62 is a discharge lumen 64, and inside the outer tube 61 and outside the inner tube 62 is an injection lumen 63. A reservoir 66 is formed at the tip of the tube body 60.

The distal end of the inner tubular body 62 is closed, and a communication portion 67 that communicates the injection lumen 63 and the discharge lumen 64 is formed on the proximal side of the distal end of the inner tubular body 62 . The communication portion 67 is a through hole formed in the side surface of the inner tube body 62. In this way, by arranging the communication portion 67 closer to the proximal end than the distal end of the inner tube body 62, the high oxygen solution can more easily remain in the storage portion 66, and oxygen can be more efficiently transferred to the tube body. 60 can be released to the outside.

Next, a fourth modification of the catheter will be described. As shown in FIG. 9, in the tube body 70 of this example, an inner tube body 72 is disposed inside an outer tube body 71. As shown in FIG. Inside the inner tube 72 is a discharge lumen 74, and inside the outer tube 71 and outside the inner tube 72 is an injection lumen 73. The distal end of the outer tubular body 71 is open, and a balloon 76 is fixed to the distal end.

The inside of the balloon 76 communicates with an injection lumen 73 and an exhaust lumen 74, respectively. Balloon 76 can be expanded radially by fluid injected from injection lumen 73 . Fluid within balloon 76 is evacuated through evacuation lumen 74. The balloon 76 is formed of a permeable membrane part 76a and functions as a permeable part.

By having the balloon 76 at the tip of the tube body 70, the balloon 76 serves as a fluid reservoir. By expanding in the radial direction, the balloon 76 increases its volume and surface area, so it is possible to store a large amount of high oxygen solution in the part that becomes the permeation part, and also increases the amount of oxygen permeation, making it more efficient. Oxygen can be released to the outside of the tube body 70.

As described above, the catheter 10 according to the present embodiment is a catheter 10 having a tube main body 20 that is inserted into a living body, and the tube main body 20 has a transparent part 32 provided at the distal end and a transmissive part 32 from the proximal end. The permeation part 32 has an injection lumen 30 that allows fluid to flow toward the permeation part 32 and a discharge lumen 31 that allows the fluid to flow from the permeation part 32 toward the proximal end. It has a permeable membrane part 32a that allows the water to pass through to the outside of the tube body 20. The catheter 10 configured in this manner can release a specific gas without causing liquid to flow out of the tube body 20, so that intracranial pressure can be prevented from fluctuating.

Furthermore, the injection lumen 30 and the discharge lumen 31 may communicate with each other within the transmission section 32 and may be arranged in parallel. This allows the fluid to flow inside the tube body 20 without flowing out to the outside.

Further, the injection lumen 43 and the discharge lumen 44 may be arranged concentrically. Thereby, the diameter of the tube body 40 can be reduced.

Further, the tube body 50 may have a storage portion 56 at the distal end that communicates with the injection lumen 53 and the discharge lumen 54. As a result, the fluid tends to remain in the storage section 56, so that the specific gas can be efficiently released from the permeation section 55.

Further, the discharge lumen 64 may be arranged concentrically inside the injection lumen 63 and may have a communication portion 67 that communicates with the injection lumen 63 on the proximal end side from the distal end. As a result, the fluid tends to remain at the tip of the tube body 60, so that the specific gas can be efficiently released from the permeation section 65.

Further, a balloon 76 formed of a permeable membrane portion 75a is provided at the tip of the injection lumen 73, and the balloon 76 may be expanded in the radial direction by injecting fluid from the injection lumen 73. . As a result, the fluid tends to remain within the balloon 76, and the radially expanded balloon 76 has a larger surface area, so that a specific gas can be released more efficiently.

Further, the tube body 20 may have a contrast marker 25 at the distal end. Thereby, when inserting the tube main body 20 into the living body, the distal end portion can be reliably delivered to the target site.

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.

The fluid (liquid) flowing inside the tube body 20 may be other than artificial cerebrospinal fluid. The solution to be highly oxygenated may be a liquid with high oxygen solubility such as fluorocarbon or an emulsion thereof, or a solution such as physiological saline.

The liquid flowing into the tube body 20 is not limited to only a high oxygen solution. Therefore, the transmission section 32 is not limited to transmitting only oxygen contained in the fluid, but also transmitting only specific gases other than oxygen that have a therapeutic effect on cerebral infarction, such as nitric oxide, hydrogen, helium, and mixed gases thereof. It may also be something that allows you to do so.

The catheter 10 can also be used for treatments other than cerebral infarction. For example, since supplying oxygen is considered effective for spinal cord ischemia, the catheter 10 can be used. Furthermore, if only specific components can pass through, the catheter 10 can be used for other brain diseases such as cerebral hemorrhage, subarachnoid hemorrhage, hydrocephalus, and Alzheimer's disease.

10 catheter 20 tube body 21 first branch tube section 21a port 22 second branch tube section 22a port 25 contrast marker 30 injection lumen 31 discharge lumen 32 transmission section 32a transmission membrane section 35 partition wall section 36 first tube body 37 second tube body

Claims (8)

A catheter having a tube body inserted into a living body,
The tube body includes a permeation part provided at the distal end, an injection lumen that allows fluid to flow from the proximal end toward the permeation part, and a discharge lumen that allows fluid to flow from the permeation part toward the proximal end. has
The catheter has a permeable membrane part in which the permeable part allows a specific gas contained in the fluid to permeate to the outside of the tube body. The catheter of claim 1, wherein the inlet lumen and the outlet lumen communicate with each other within the permeable portion and are arranged in parallel. The catheter of claim 1, wherein the inlet lumen and the outlet lumen are concentrically arranged. The catheter according to any one of claims 1 to 3, wherein the tube body has a reservoir portion at a distal end that communicates with the injection lumen and the discharge lumen. The catheter according to claim 1, wherein the discharge lumen is disposed concentrically inside the injection lumen and has a communication portion communicating with the injection lumen on the proximal side of the distal end. A balloon formed of the permeable membrane portion is provided at the tip of the injection lumen,
The catheter of claim 1, wherein the balloon expands radially upon injection of fluid from the injection lumen. The catheter according to any one of claims 1 to 6, wherein the tube body has a contrast marker at its tip. A cerebral infarction treatment device comprising the catheter according to any one of claims 1 to 7.

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