JP3659503B2 - Left coronary catheter - Google Patents

Description

  The present invention relates to a catheter for a left coronary artery for treating and contrasting the heart or surrounding tissue.

  Conventionally, as catheters for coronary angiography, there are Judkins type and Anplatz type catheters, etc. These catheters are usually introduced from the femoral artery by the Seldinger method or sheath method, and the coronary artery is selectively selected. Contrast is being performed.

  In addition, treatment of peripheral sites using a catheter is now widely used. One example is percutaneous coronary angioplasty (PTCA) for treatment of ischemic heart disease using a catheter with a balloon. In such treatment, in order to insert the treatment catheter safely and efficiently to the target blood vessel, the performance of the treatment catheter is very important, and the reaction caused by the insertion is alleviated and sufficient backup force is provided. There is a need for a guiding catheter that provides a smooth introduction. Examples of the shape of such a guiding catheter include the Judkins type and the Anplatz type as in the case of the above-mentioned coronary angiography catheters. Or after introduce | transducing by the sheath method and securing a coronary artery selectively, therapeutic catheters, such as a balloon catheter for PTCA, are introduce | transduced into the inner surface.

  In such conventional catheter imaging and treatment, since the introduction site is the thigh, the puncture site is hemostasis after the operation, so absolute rest is necessary. Therefore, urination, defecation, and eating and drinking are also difficult. There was a problem that it had to be performed in a prone position and was accompanied by considerable pain such as low back pain. Furthermore, if a catheter is introduced from the thigh, bleeding may occur even if absolute rest is maintained, and if the bleeding reaches the retroperitoneal cavity, there is a risk of life, and urination is difficult in the supine position. In some cases, the use of a urinary catheter may cause urinary tract infections.

  As a method for solving these problems, introduction from the arm artery, particularly the brachial artery (Brachial Artery) or the radial artery (Radial Artery) is considered to be effective. In other words, it is possible to walk immediately after the operation only by keeping the upper arm puncture part stretched, and can urinate, defecate, eat and drink as usual without back pain, etc. In addition, bleeding of the retroperitoneal cavity and urinary tract infection described above No worries.

However, the introduction of the catheter from the femoral artery is now common, and the shape of the catheter, which should be different depending on the introduction site, satisfies the performance of being able to introduce the catheter from the arm artery easily, safely and quickly. The current situation is that nothing is known. When such a catheter for a femoral artery is used as it is, it is difficult to introduce the catheter, which requires a lot of labor, and it may be necessary to introduce the catheter several times. This leads to an increase in the burden on the patient. In addition, due to the lack of backup force, the tip of the catheter may be dislocated from the coronary ostium during imaging or when the treatment catheter is advanced to the distal side, so that sufficient imaging cannot be performed or the treatment catheter is difficult to operate. May be.
Therefore, development of a catheter having a shape suitable for introduction from the arm is strongly desired.

  The object of the present invention is to eliminate the above-mentioned drawbacks of the prior art, and to introduce a catheter from the arm artery, for example, the brachial artery or radial artery, into the coronary artery opening without going through the femoral artery, thereby making it easier and safer. Another object of the present invention is to provide a catheter that can be introduced quickly and can reduce the postoperative burden on the patient. Another object of the present invention is to provide a guiding catheter that can reliably assist the operation of the therapeutic catheter.

  In order to achieve such an object, the present inventors have reached the present invention as a result of intensive studies on the shape of the distal end portion of the catheter.

That is, the present invention is a catheter for a left coronary artery having an outer diameter of 2.7 mm or less over the entire length and for introducing a distal end from the arm artery to the left coronary artery ostium, wherein the catheter body is a substantially linear body portion. And a tip portion having a curved shape in a natural state, and the tip portion includes a first substantially straight portion continuing from the main body portion via a first bent portion, and the first substantially straight portion from the first substantially straight portion. A second substantially linear portion that continues through a second bent portion that curves in a direction opposite to the first bent portion, and a third curve that curves in the same direction as the second bent portion from the second substantially straight portion. A third substantially straight portion that continues through the bent portion, and a substantially straight leading edge that continues from the third substantially straight portion through the fourth bent portion that curves in the same direction as the third bent portion. An angle formed by the first substantially straight portion and the second substantially straight portion is 30 to 150 °, and the second substantially straight portion and When the angle formed by the third substantially linear portion is 60 to 120 ° and the distal end of the catheter is located at the left coronary artery opening, the first bent portion is introduced from the brachiocephalic artery to the aortic arch. It is shaped and shaped so that the second substantially straight portion can contact the aortic arch wall on the opposite side to the left coronary artery ostium, and substantially the entire length excluding a predetermined length from the distal end of the catheter body. The left coronary artery catheter is characterized in that a reinforcing material is embedded in the catheter body.

  In the catheter, an angle formed by the main body portion and the first substantially straight portion is preferably 90 to 150 °. Moreover, it is preferable that the angle which the said 3rd substantially linear part and the said most advanced part make is 30-150 degrees.

  Moreover, it is preferable that the curvature radius of the said 1st bending part is 30-100 mm in the said catheter. Moreover, it is preferable that the curvature radius of a said 2nd bending part is 5-20 mm. Moreover, it is preferable that the curvature radius of a said 3rd bending part is 5-20 mm. Furthermore, it is preferable that a curvature radius of the fourth bent portion is 5 to 20 mm.

  In the catheter, the length of the first substantially linear portion is preferably 30 to 80 mm. Moreover, it is preferable that the length of said 2nd substantially linear part is 10-50 mm. Moreover, it is preferable that the length of said 3rd substantially linear part is 10-100 mm. Furthermore, the length of the most advanced part is preferably 5 to 50 mm.

  In order to make the best use of the above characteristics, the catheter of the present invention is a catheter intended to be introduced from the brachial artery or radial artery.

  Further, in the catheter, it is preferable that the reinforcing material is constituted by a thin wire. The reinforcing material is preferably a metal mesh. The catheter body preferably has a structure in which an inner layer, a middle layer, and an outer layer are concentrically stacked from the inside. Moreover, it is preferable that the said reinforcing material is embed | buried in the said middle layer over the perimeter.

  Since the shape and dimensions of the catheter of the present invention are defined as described above, when the distal end of the catheter is located at the left coronary artery mouth, the first bent portion is introduced from the brachiocephalic artery to the aortic arch, The second substantially straight line portion reliably contacts the aortic arch wall opposite the left coronary ostia. For this reason, it can be quickly and easily inserted into the left coronary artery from the artery of the arm. In addition, when the guide wire is pulled out from the state of being stretched by insertion of the guide wire and returned to the original curved shape, an appropriate repulsive force that directs the catheter tip toward the left coronary artery can be obtained. Using the repulsive force, it can be easily, safely and quickly introduced into the left coronary artery ostium. Furthermore, a high back-up force can be obtained when the tip of the catheter is positioned at the left coronary ostium, so that it is possible to provide a catheter that is not easily detached from the left coronary ostium and can be securely fixed and placed in the left coronary artery.

  That is, the catheter of the present invention can be easily, safely, and rapidly introduced into the left coronary artery mouth by percutaneous puncture from an arterial artery of the arm, for example, the brachial artery, or the radial artery, which has been conventionally difficult. Therefore, imaging of the left coronary artery and introduction and assistance of a treatment catheter can be performed safely and reliably, post-operative management is facilitated, the burden on the patient associated with the procedure is significantly reduced, and complications can be prevented.

  In addition, since the catheter of the present invention has a reinforcing material (preferably a metal mesh) embedded in the inside of the catheter body over substantially the entire length excluding a predetermined length from the tip of the catheter body, a blood vessel is formed at the tip of the catheter. There is no fear of damaging the wall, the catheter body is prevented from being bent, and the torque transmission when the catheter body is rotated is excellent.

If the angle formed by the main body portion and the first substantially straight portion is 90 to 150 °, the insertion into the left coronary artery opening becomes easier, and more appropriate repulsive force and backup force can be obtained.
Moreover, if the angle formed by the third substantially straight portion and the most distal portion is 30 to 150 °, insertion from the artery of the arm to the left coronary artery opening becomes easier.

In addition, when the radius of curvature of the first bent portion is 30 to 100 mm, insertion from the artery of the arm into the left coronary artery opening becomes easier.
Further, when the radius of curvature of the second bent portion is 5 to 20 mm, insertion from the artery of the arm into the left coronary artery opening becomes easier.
When the radius of curvature of the third bent portion is 5 to 20 mm, insertion from the artery of the arm to the left coronary artery opening becomes easier.
Further, when the radius of curvature of the fourth bent portion is 5 to 20 mm, insertion from the artery of the arm to the left coronary artery opening becomes easier.

In addition, when the length of the first substantially straight portion is 30 to 80 mm, insertion from the artery of the arm to the left coronary artery opening becomes easier.
In addition, when the length of the second substantially straight portion is 10 to 50 mm, the contact of the second substantially straight portion with the aortic arch wall becomes more reliable, and a sufficient backup force can be more reliably obtained. be able to.
Further, if the length of the third substantially straight portion is 10 to 100 mm, it is possible to prevent the second substantially straight portion from reliably hitting the aortic wall and detaching the catheter tip from the left coronary artery opening.
In addition, when the length of the most distal portion is 5 to 50 mm, the catheter does not enter the left coronary artery excessively and can be reliably inserted and placed in the left coronary artery.

  When the catheter body has a structure in which the inner layer, the middle layer and the outer layer are concentrically laminated from the inside, the catheter body can be prevented from being bent, and the constituent materials, compounding agents, surface properties, etc. of each layer are changed, You can share those benefits.

Hereinafter, the catheter of this invention is demonstrated in detail about the suitable structural example shown to an accompanying drawing.
FIG. 1 is a plan view showing a configuration example of the catheter, and FIG. 2 is a cross-sectional view taken along the line II-II in FIG.

  As shown in these drawings, the catheter 1 of the present invention is a catheter for the left coronary artery having an outer diameter of 2.7 mm or less over its entire length and having a distal end introduced into the left coronary artery opening. A main body 2 and a tip 3 having a curved shape in a natural state. The tip 3 is connected to a first substantially straight portion 31 extending from the main body 2 via a first bent portion 4, and a first The second substantially straight portion 32 that continues from the straight portion 31 through the second bend portion 5 that curves in the direction opposite to the first bend portion 4, and the second substantially straight portion 32 to the second bend portion. A third substantially straight portion 33 that continues through a third bent portion 6 that curves in the same direction as 5, and a fourth bent that curves in the same direction as the third bent portion 6 from the third substantially straight portion 33. The catheter is characterized by comprising a substantially straight most distal portion 34 continuing through the portion 7.

  In the catheter 1 of the present invention, the angle formed by the first substantially straight portion 31 and the second substantially straight portion 32 is 30 to 150 °, and the second substantially straight portion 32 and the third substantially straight portion 33. And the first bent portion 4 is shaped to be introduced from the brachiocephalic artery into the aortic arch when the distal end of the catheter 1 is located at the left coronary artery ostium, and The two substantially straight portions 32 are shaped so as to be in contact with the aortic arch wall opposite to the left coronary artery ostium, and are formed in the inside of the catheter body 1a over substantially the entire length except for a predetermined length from the distal end of the catheter body 1a. A catheter for a left coronary artery in which a reinforcing material (metal mesh 12) is embedded.

Hereinafter, it demonstrates concretely based on drawing.
The catheter 1 has a flexible catheter body 1a.
The outer diameter of the catheter body 1a is 2.7 mm or less (preferably 2.1 mm or less) over the entire length of the catheter. If the catheter 1 can be inserted into the blood vessel using a sheath from the brachial artery, preferably the radial artery, it is preferable to reduce the burden on the patient. For this purpose, it is necessary to make the outer diameter of the catheter as thin as possible. is there. However, if the catheter is made thinner, its operability will inevitably deteriorate, and it will be difficult to select the coronary ostia. Also, many existing catheters required torque transmission to rotate the tip by rotating the hand part in order to select the coronary ostium. However, if the catheter is made thinner, its transmission is reduced. In addition, due to the lack of strength due to the thinness of the catheter, kinking, twisting, etc. of the catheter during operation occur, and thus a thick catheter was inevitably mainstream.
On the other hand, since the catheter 1 of the present invention basically does not require torque transmission because of its shape, the outer diameter of the catheter body 1a can be reduced, bleeding can be reduced, and the burden on the patient can be reduced.

  The catheter main body 1a has a substantially straight main body portion 2 and a distal end portion 3 having a curved shape in a natural state (a state in which no external force is applied). And the front-end | tip part 3 curves in the direction opposite to the 1st substantially linear part 31 which continues via the 1st bending part 4 from the main-body part 2, and the 1st bending part 4 from the 1st linear part 31. A second substantially straight portion 32 that continues through the second bent portion 5 and a third bent portion 6 that curves from the second substantially straight portion 32 in the same direction as the second bent portion 5. Three substantially straight portions 33 and a substantially straight most distal portion 34 continuing from the third substantially straight portion 33 through the fourth bent portion 7 curved in the same direction as the third bent portion 6. ing.

  The main body 2 is substantially linear (substantially linear) in a state where no external force is applied. Although the length of this main-body part 2 is not specifically limited, If it is 400-1000 mm, it is preferable.

The 1st bending part 4 exhibits the shape (shape curved in the clockwise direction from the main-body part 2 in FIG. 1) in the state which does not apply external force. In the first bent portion 4, the angle α ₁ formed by the main body portion 2 and the first substantially linear portion 31 is 90 to 150 ° in a state where no external force is applied. If this angle exceeds 150 °, the catheter 1 may extend the subclavian artery and brachiocephalic arteries and cause pain to the patient, and if it is less than 90 °, the left side of the distal end of the catheter body 1a Insertion into the coronary ostium becomes difficult, and even if inserted, it is difficult to obtain sufficient backup force. By setting the above range, when the guide wire is pulled out from the brachiocephalic artery to the ascending aorta and returned to its original shape, a sufficient repulsive force is generated and an operation such as applying torque is required. Without using this repulsive force alone, the catheter tip can be easily and safely and quickly introduced toward the left coronary artery ostium. Further, the radius of curvature (curvature radius) R ₁ of the first bent portion 4 is not particularly limited, but is preferably about 30 to 100 mm in a state where no external force is applied.

The first substantially linear portion 31 is substantially linear (substantially linear) in a state where no external force is applied. The length L ₁ of the first substantially linear portion 31 is not particularly limited, but is preferably about 30 to 80 mm.

The second bent portion 5 exhibits a direction opposite to the first bent portion 4 (a shape curved in a counterclockwise direction from the first substantially straight portion 31 in FIG. 1) without applying an external force. . The angle α ₂ formed by the main body 2 and the first substantially linear portion 31 in the second bent portion 5 is about 30 to 150 °, preferably about 50 to 100 °, without applying an external force. . The radius of curvature (curvature radius) R ₂ of the second bent portion 5 is not particularly limited, but is preferably about 5 to 20 mm in a state where no external force is applied.

The second substantially linear portion 32 is substantially linear (substantially linear) in a state where no external force is applied. The second substantially straight portion 32 is shaped so as to always contact the aortic arch wall on the opposite side of the left coronary artery mouth when indwelling, so that the distal end of the catheter is not detached from the left coronary artery mouth. In the guide catheter used together with the therapeutic catheter, the operation of the therapeutic catheter inserted into the lumen can be surely assisted. The length L ₂ of the second substantially linear portion 32 is preferably about 10 to 50 mm.

The third bent portion 6 exhibits the same direction as the second bent portion 5 (a shape curved in a counterclockwise direction from the second substantially straight portion 32 in FIG. 1) without applying an external force. The angle α ₃ formed by the second substantially straight portion 32 and the third substantially straight portion 33 in the third bent portion 6 is about 60 to 120 °. Further, the radius of curvature (curvature radius) R ₃ of the third bent portion 6 is not particularly limited, but is preferably about 5 to 20 mm in a state where no external force is applied.

The third substantially linear portion 33 is substantially linear (substantially linear) in a state where no external force is applied. The length L ₃ of the third substantially straight portion 33 is set so as to substantially coincide with the distance from the aortic arch wall on the opposite side of the left coronary artery mouth to the left coronary artery when indwelling. As a result, it is possible to prevent the second substantially straight portion from reliably hitting the aortic wall and detaching the catheter tip from the left coronary artery opening. Specifically, the length L3 is about 10 to 100 mm, and more preferably ₃₀ to 50 mm.

The fourth bent portion 7 exhibits the same direction as the third bent portion 6 (a shape curved in a counterclockwise direction from the third substantially straight portion 33 in FIG. 1) without applying an external force. In the fourth bending portion 7, the angle alpha ₄ of the third substantially straight portion 33 and the cutting edge portion 34 is not particularly limited, is preferably about 30 to 150 ° with no external force is applied, more preferably It is about 90-130 degrees. Further, the radius of curvature (curvature radius) R ₄ of the fourth bent portion 7 is not particularly limited, but is preferably about 5 to 20 mm in a state where no external force is applied.

The most advanced portion 34 is substantially linear (substantially linear) in a state where no external force is applied. The length L ₄ of the most distal portion 34 is set to such an extent that it does not go too far into the left coronary artery opening and can be reliably inserted and placed, and is specifically about 5 to 50 mm.

  A hub 8 for injecting a contrast medium or the like is formed at the proximal end of the catheter body 1a.

  As shown in FIG. 2, the catheter body 1a has a structure in which an inner layer 9, a middle layer 10, and an outer layer 11 are concentrically stacked from the inside. By having such a configuration, there is an advantage that the catheter body 2 can be prevented from being bent, and the constituent materials, compounding agents, surface properties, etc. of each layer can be changed to share their advantages.

  Constituent materials for the inner layer 9, the middle layer 10 and the outer layer 11 include polyamide resins (for example, nylon 11, nylon 12, nylon 6), polyester-based polyamide resins (for example, Gleasing (trade name, manufacturer DIC)), poly Ether-based polyamide resins (for example, Pebax (trade name, manufacturer / Atchem), polyurethane, ABS resin, fluorine resins (PFA, PTFE, ETFE, etc.) can be used. The use of PTFE improves the operability of the guide wire inserted into the lumen and the treatment catheter, and the use of ABS resin or nylon 12 allows the distal end of the catheter body 1a to have a curved shape. Appropriate strength can be imparted to the portion 3. The insertion of the catheter 1 Under fluoroscopy, to perform while checking the position, the material forming the catheter body 2, for example, barium sulfate, bismuth oxide, is that you blending an X-ray opaque material such as tungsten preferred.

  The thickness of each layer 9, 10, 11 is not particularly limited, but in the illustrated example, the inner layer 9 is thinner than the middle layer 10 and the outer layer 11.

  The layers 9, 10, and 11 are each bonded by an appropriate adhesive or fused by heat, or integrally formed by covering molding or the like.

  A metal mesh 12 having a role as a reinforcing material is embedded in the middle layer 10 over the entire circumference. In the longitudinal direction of the catheter, the metal mesh 12 is buried over substantially the entire length excluding a predetermined length from the distal end of the catheter body 2. The position of the tip of the metal mesh 12 may be in the range of 5 to 150 mm (preferably 5 to 100 mm) from the tip of the catheter body 1a.

  By embedding such a metal mesh 12, it is possible to prevent the catheter body 2 from being bent and to improve torque transmission when the catheter body is rotated.

  The reason why the metal mesh 12 of a predetermined length is not embedded from the distal end of the catheter body 2 is that the blood vessel wall may be damaged at the distal end portion of the catheter if the metal mesh 12 is inserted to the most distal end of the catheter body. This is because, depending on the material, when the mesh is inserted to the vicinity of the distal end, the catheter becomes hard, and the catheter 1 does not enter the coronary ostium and becomes easy to enter the left ventricle in the procedure described later.

  However, if the metal mesh 12 does not exist in a portion having a length exceeding 150 mm from the distal end of the catheter body 2, the torque transmission property may not be sufficiently obtained.

  The length of the portion where the metal mesh 12 is not provided is appropriately determined depending on the material of the catheter body 2, the inner and outer diameters (total thickness of the inner, middle, and outer layers). For example, the larger the difference between the inner and outer diameters of the catheter body 1a or the larger the elastic force, the longer the length of the portion where the metal mesh 12 is not provided.

  Specific examples of the metal mesh 12 include those composed of thin wires such as stainless steel, tungsten, Ni-Ti, and carbon fiber. The wire diameter is, for example, about 0.01 to 0.2 mm. belongs to.

  A lumen 13 is formed substantially at the center of the tube body 1a. The lumen 13 is open to the distal end of the tube body 1a and communicates with a side hole (not shown) formed on the outer periphery of the distal end portion 3 at an arbitrary position.

When the catheter 1 is inserted into the target site, a treatment catheter is inserted into the lumen 13. Further, when the contrast medium is injected, the contrast medium is injected into the target site through the lumen 13 from the opening of the distal end of the lumen.
Two or more side holes may be formed along the longitudinal direction of the catheter body, or the side holes may not be formed at all.

  Next, a method of using the catheter of the present invention will be described by taking as an example a case of using it as a guiding catheter used together with a therapeutic catheter.

  As shown in FIG. 3, the catheter introducer 14 is inserted into the brachial artery or radial artery 17 by the Seldinger method, and the guide wire 16 is inserted into the lumen 13 in the sheath 15 of the catheter introducer 14. The catheter 1 of the invention is inserted, the guide wire 16 is advanced, and the distal end of the catheter body 2 is inserted into the brachial artery or radial artery 17 from the distal end opening 130 of the sheath.

Next, the catheter 1 and the guide wire 16 are gradually sent in the direction of the arrow in the figure and inserted into the ascending aorta.
At this time, in order for the distal end of the catheter body 2 to pass through the bent portion of the blood vessel, an operation in which the guide wire is taken in and out and the catheter 1 is advanced and retracted and rotated is appropriately combined.

A specific example of the insertion operation to the left coronary artery will be described with reference to FIGS.
4 and 5 are explanatory views schematically showing how to use the catheter 1.

  As shown in FIG. 4, the catheter 1 introduced into the ascending aorta 21 from the brachiocephalic artery 20 is introduced toward the left ventricle. When the catheter 1 is inserted as it is, the bent portion A of the catheter 1 comes into contact with the Valsalva sinus 24. At this time, the distal end portion 3 of the catheter 1 is extended by the guide wire 16 inserted into the lumen 13 and has a substantially linear shape.

  Thereafter, when the guide wire 16 is pulled out from the lumen 13, the distal end portion 3 returns to the original curved shape. By the repulsive force generated by the shape restoration, the distal end of the catheter 1 is directed to the coronary artery opening of the left coronary artery 23 and inserted as shown in FIG. If the catheter tip is not inserted into the left coronary artery 23, the catheter tip is easily inserted into the left coronary artery 23 by appropriately applying a slight rotation to the proximal portion of the catheter counterclockwise.

  In this state, the second substantially straight line portion 32 contacts the ascending aorta right wall 26 located on the opposite side of the left coronary artery 23 from the coronary artery ostium. Since it is shaped in this way, a high backup force is generated in the catheter 1, the catheter 1 is fixed well, and the distal end of the catheter is unlikely to come off from the coronary artery opening of the left coronary artery 23.

  After the distal end of the catheter 1 is inserted into the left coronary artery 23 by such an operation, the guide wire is removed from the lumen 13, and the connector is connected to the Y connector 18 attached to the rear end of the catheter hub 8 for imaging. Inject the agent. The injected contrast medium passes through the lumen 13 and is ejected into the left coronary artery 23, which is the target site, from the distal end opening thereof. Thereby, confirmation of the insertion position to the left coronary artery 23 and imaging can be performed.

  Next, a treatment catheter (not shown) such as a PTCA balloon catheter is inserted through the rear end portion of the Y connector 18 and the lumen 13. Generally, these therapeutic catheters have a rigid catheter body, and the catheter 1 is often pushed back from the left coronary artery 23, which is a target indwelling site, by the reaction of the therapeutic catheter. When this action occurs, it becomes difficult to insert the therapeutic catheter into the target site, and therefore the backup force of the catheter 1 is very important.

  Since the shape of the catheter of the present invention is defined as described above, it is not necessary to perform complicated operations or provide high torque transmission to the catheter by the operations described above, and it is easy, safe and quick. Can be introduced into the mouth.

  Hereinafter, specific examples of the present invention will be described in detail.

A catheter with the following specifications was prepared and used for clinical practice.
Total length: 100cm
Outer diameter: 2.0mm
Inner diameter (lumen diameter): 1.60mm
Cross-sectional structure: laminate of inner layer, middle layer, outer layer Material: inner layer / fluororesin middle layer / ABS kneaded polyurethane outer layer / polyurethane Tip length: 40 mm
Angle formed by the main body and the first substantially straight portion: 115 °
Angle formed by the first substantially straight portion and the second substantially straight portion: 120 °
Angle formed by the second substantially straight portion and the third substantially straight portion: 90 °
Angle between the third substantially straight line part and the most advanced part: 110 °
Curvature radius of the first bent part: 60 mm
Curvature radius of second bent part: 18 mm
Curvature radius of third bent part: 11 mm
Curvature radius of the fourth bent part: 14 mm
The length of the first substantially straight portion: 53 mm
Length of second substantially straight part: 20 mm
The length of the third substantially straight portion: 20 mm
Cutting edge length: 10mm
Reinforcing material: A metal mesh with a stainless wire blade (diameter 50 μm) is embedded at the boundary between the inner layer and the middle layer of the entire length excluding 20 mm from the tip of the catheter body.

  Using a catheter with a tip length of 40 mm, a 6F (F = about 1/3 mm) sheath is percutaneously applied to the brachial artery for 5 male patients aged 55 to 65 and 2 female patients aged 60 to 70 years. Indwelling and performing imaging of blood vessels and the like by the above operation, all patients can be efficiently inserted into the left coronary artery, effectively assisting the subsequent operation of the treatment catheter, and a contrast agent The catheter 1 was not pulled out or shaken due to the reaction of the injection and treatment of the treatment catheter, and the procedure could be completed safely and easily for all patients.

  He stated that no absolute rest was needed after the procedure and all patients were very comfortable. There were no complications such as bleeding.

  It can be used as a guiding catheter for introducing a contrast catheter for imaging the heart or its surrounding tissue or a therapeutic catheter such as a PTCA catheter into the coronary artery by introducing it from the artery of the arm to the left coronary artery ostium.

It is a general view which shows the Example of the catheter of this invention. It is sectional drawing in the II-II line of the catheter 1 shown in FIG. It is explanatory drawing which shows the introduction method to the blood vessel of the catheter of this invention. It is explanatory drawing which shows typically the usage method of the catheter of this invention. It is explanatory drawing which shows typically the usage method of the catheter of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Catheter 1a Catheter main body 2 Main body part 3 The front-end | tip part 31 The 1st substantially linear part 32 The 2nd substantially linear part 33 The 3rd substantially linear part 34 The most distal part 4 The 1st bending part 5 The 2nd bending part 6 1st 3 bent portions 7 4 bent portions 8 hub 9 inner layer 10 middle layer 11 outer layer 12 metal mesh 13 lumen 14 catheter introducer 15 sheath 16 guide wire 17 brachial artery (radial artery)
18 Y connector 20 Brachiocephalic artery 21 Ascending aorta 22 Right coronary artery 23 Left coronary artery 24 Valsalva sinus 25 Left ventricle 26 Ascending aortic arch wall

Claims (16)

A catheter for a left coronary artery having an outer diameter of 2.7 mm or less over the entire length, for introducing a tip from an artery of an arm to the left coronary artery ostium,
The catheter body consists of a substantially straight main body part and a distal end part having a curved shape in a natural state,
The tip portion includes a first substantially straight portion that continues from the main body portion via a first bent portion, and a second curve that curves in a direction opposite to the first bent portion from the first substantially straight portion. A second substantially linear portion that continues through the bent portion, and a third substantially linear portion that continues from the second substantially straight portion through a third bent portion that curves in the same direction as the second bent portion; A substantially straight leading edge portion that continues from the third substantially straight portion through a fourth bend portion that curves in the same direction as the third bend portion,
The angle formed by the first substantially straight portion and the second substantially straight portion is 30 to 150 °, and the angle formed by the second substantially straight portion and the third substantially straight portion is 60 to 120 °. And the first bent portion is shaped to be introduced from the brachiocephalic artery to the aortic arch when the distal end of the catheter is located at the left coronary artery ostium, and the second substantially straight portion is the left coronary artery Shaped to contact the aortic arch wall opposite the mouth,
A left coronary artery catheter characterized in that a reinforcing material is embedded in the inside of the catheter body over substantially the entire length excluding a predetermined length from the distal end of the catheter body. The left coronary catheter according to claim 1, wherein an angle formed by the main body portion and the first substantially straight portion is 90 to 150 °. The catheter for the left coronary artery according to claim 1 or 2, wherein an angle formed by the third substantially straight portion and the most distal portion is 30 to 150 °. The catheter for a left coronary artery according to any one of claims 1 to 3, wherein a radius of curvature of the first bent portion is 30 to 100 mm. The catheter for a left coronary artery according to any one of claims 1 to 4, wherein a curvature radius of the second bent portion is 5 to 20 mm. The left coronary catheter according to any one of claims 1 to 5, wherein a curvature radius of the third bent portion is 5 to 20 mm. The catheter for a left coronary artery according to any one of claims 1 to 6, wherein a curvature radius of the fourth bent portion is 5 to 20 mm. The left coronary catheter according to any one of claims 1 to 7, wherein a length of the first substantially straight portion is 30 to 80 mm. The catheter for a left coronary artery according to any one of claims 1 to 8, wherein a length of the second substantially straight portion is 10 to 50 mm. The catheter for a left coronary artery according to any one of claims 1 to 9, wherein a length of the third substantially linear portion is 10 to 100 mm. The left coronary artery catheter according to any one of claims 1 to 10, wherein the length of the most distal portion is 5 to 50 mm. The catheter for a left coronary artery according to any one of claims 1 to 11, wherein the catheter can be introduced from a brachial artery or a radial artery. The left coronary artery catheter according to any one of claims 1 to 12, wherein the reinforcing member is formed of a thin wire. The left coronary catheter according to claim 13, wherein the reinforcing material is a metal mesh. The catheter for a left coronary artery according to any one of claims 1 to 14, wherein the catheter body has a structure in which an inner layer, a middle layer, and an outer layer are concentrically stacked from the inside. The left coronary artery catheter according to claim 15, wherein the reinforcing material is embedded in the middle layer over the entire circumference.

Images