JP4010798B2 - Sheath positioning instrument for introduction - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an introduction sheath positioning device for positioning the distal end of an introduction sheath for introducing hemostatic means into a hole that percutaneously penetrates to a blood vessel wall.
[0002]
[Prior art]
When performing operations such as cardiac catheterization, heart and angiography, and His bundle electrocardiography, the catheter is percutaneously inserted into the blood vessel for treatment. After the treatment is completed, it is necessary to stop bleeding at the puncture hole. However, since the catheter is usually inserted from the femoral artery, blood pressure during bleeding (bleeding pressure) is high, and the hemostasis work is very difficult. Conventionally, harsh work such as a medical worker holding for one hour with a hand has been performed.
[0003]
In recent years, in order to perform this hemostasis easily and reliably, a method of inserting (filling) a hemostatic material that closes the puncture hole and a method of stitching a hole in a blood vessel wall with a thread using a catheter-like instrument are becoming widespread. is there.
[0004]
When the puncture hole is stopped using such a material or instrument, it is important that the hemostasis means is accurately positioned and arranged on the blood vessel wall to be stopped. For example, in the case of a hemostatic material, if it is inserted too far, the hemostatic material will enter the blood vessel and obstruct blood flow. Conversely, if the insertion position of the hemostatic material is too shallow, a sufficient hemostatic effect cannot be obtained. . In the case of a suturing instrument, it cannot be sewn correctly if the suturing position is wrong.
[0005]
As a device for positioning and inserting a hemostatic material into a blood vessel wall, Japanese Patent Publication No. 6-40877 discloses (1) a device using a balloon catheter, and (2) an inner cylinder capable of holding a hemostatic material and having an expandable tip. A device comprising an outer cylinder is disclosed.
[0006]
However, the device (1) has a troublesome need to separately make a device such as a syringe for inflating a balloon, and the device (2) maintains the expanded state at the tip of the inner cylinder. And there is a possibility that the puncture hole may come out without being positioned on the blood vessel wall, and there is a concern about damage to the delicate vessel wall intima.
[0007]
By the way, when inserting a catheter as described above, an introduction sheath (also referred to as a catheter sheath or an introducer sheath) having a tubular main body portion is usually inserted percutaneously into a blood vessel. A catheter is inserted through the lumen of the sheath and introduced into the blood vessel.
[0008]
If the distal end of the introduction sheath can be positioned on the blood vessel wall, simple and smooth positioning is possible.
[0009]
Then, the hemostatic means can be easily positioned and inserted into the blood vessel wall. That is, the hemostasis means may be inserted so that the hemostasis position coincides with the distal end of the introduction sheath thus positioned.
[0010]
[Problems to be solved by the invention]
An object of the present invention is to provide an introduction sheath positioning device that has a simple structure and can easily, safely and reliably position the distal end of an introduction sheath on a blood vessel wall without damaging tissue. .
[0011]
[Means for Solving the Problems]
Such an object is achieved by the present inventions (1) to (8) below.
[0012]
(1) An introduction sheath positioning device for positioning the distal end of an introduction sheath for introducing hemostasis means into a hole penetrating percutaneously to a blood vessel wall on the blood vessel wall, and can be inserted into the introduction sheath. A main body portion, and a hub provided on the base end side of the main body portion, the main body portion is made of a flexible material, and the hub is inserted into the introduction sheath and the hub is inserted into the introduction sheath. When contacting the proximal end, the distal end of the main body protrudes from the distal end of the introduction sheath, and has a recess on the surface of at least the portion of the main body protruding from the distal end of the introduction sheath. A sheath positioning device for introduction as a feature.
[0013]
(2) The introduction according to (1), wherein the depth of the recess formed in the distal end portion of the introduction sheath positioning device is 0.7 mm or more and 70% or less with respect to the diameter of the main body portion. Sheath positioning instrument.
[0014]
(3) The introduction sheath positioning device according to (1), wherein the shape of the concave portion on the front end side of the main body is a smooth taper.
[0015]
(4) The introduction sheath positioning device according to (1), wherein the base end side of the main body portion of the concave portion is recessed at an angle of 45 ° to 135 ° with respect to the radial direction.
[0016]
(5) The introduction sheath positioning device according to (1), wherein a mark indicating a position of the concave portion in a circumferential direction of the main body is provided on a surface of the hub.
[0017]
(6) When the hub comes into contact with the proximal end portion of the introduction sheath in a state where the main body portion is inserted into the introduction sheath, the concave portion is in the vicinity of the most distal end of the introduction sheath. The introduction sheath positioning device according to (1), wherein the introduction sheath positioning device is positioned.
[0018]
(7) When the hub is in contact with the proximal end portion of the introduction sheath in a state where the main body portion is inserted into the introduction sheath, the proximal end side of the recess is the most distal end of the introduction sheath. The introduction sheath positioning device according to (6), wherein the introduction sheath positioning device is located at a distal end side of 0 to 5 mm.
[0019]
(8) The introduction sheath positioning device according to (1), wherein the main body has a lumen through which a guide wire can be inserted.
[0020]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, the sheath positioning instrument for introduction of the present invention will be described in detail based on a preferred embodiment shown in the accompanying drawings.
(Embodiment 1)
In the first embodiment, an example of an introduction sheath positioning device for introducing a hemostatic material for hemostasis of the femoral artery after completion of various treatments (insertion of the catheter) used by inserting the catheter into the blood vessel. Will be described. Specifically, it is an instrument for positioning the distal end of the introduction sheath on the blood vessel wall in the puncture hole.
[0021]
FIG. 1 is an external view showing an introduction sheath positioning device 1 according to Embodiment 1 of the present invention. 2 is an external view showing the introduction sheath 5, and FIG. 3 is a side view showing a state where the introduction sheath positioning device 1 and the introduction sheath 5 are combined.
[0022]
A sheath positioning instrument 1 for introduction shown in FIG. 1 includes a main body portion 2 formed of a flexible tubular member, a hub 3 attached and fixed to a proximal end of the main body portion 2, and a distal end side of the main body portion. It is comprised by the recessed part 4 formed in the side wall. A lumen 6 through which a guide wire, which will be described later, can be inserted, is provided almost at the center of the main body 2 over the entire length of the main body 2. The lumen 6 is open to the proximal end and the distal end of the main body 2. A mark 7 indicating the position of the recess 4 in the circumferential direction of the main body 2 is formed on the surface of the hub 3. The mark 7 has an arbitrary shape such as a triangle or an arrow, and can be formed by an arbitrary method such as printing or three-dimensional molding.
[0023]
The concave portion 4 is formed in a “F” shape in a form in which the side wall of the main body 2 is cut out, and along the longitudinal direction of the main body 2, the distal end side 9 is recessed at a gentle angle, The proximal side 10 is recessed at an angle that creates a step that can be caught by a tissue such as a blood vessel wall when inserted into a living body.
[0024]
As shown in FIG. 2, the introduction sheath 5 to be positioned includes a tubular sheath body 51, a hub 52 attached to the proximal end of the sheath body 51, and a tube 53 connected to the hub 52. It is configured. The tube 53 is provided with a three-way cock 55 at the end. For example, a blood coagulation inhibitor such as heparin, a physiological saline, an X-ray contrast agent, or the like is injected into the sheath body 51. It can be used when blood pressure is measured invasively. Further, a valve (not shown) is provided inside the hub 52 so as to prevent blood from flowing backward when the distal end of the sheath body 51 is placed in the blood vessel. This valve has a notch through which the main body portion 2 of the introduction sheath positioning device 1 can be inserted, and even when the main body portion 2 is inserted, the flow of the liquid is prevented between the main body portion 2 and the valve. .
[0025]
The introduction sheath positioning device 1 and the introduction sheath 5 having the above-described configuration can be integrally combined as shown in FIG. In the combined state, the main body 2 of the introduction sheath positioning device 1 is inserted into the sheath body 51 of the introduction sheath 5 from the proximal end hub 52 side, and the hub 3 of the introduction sheath positioning device 1 is used for introduction. It fits and is fixed to the hub 52 of the sheath 5. At that time, the main body 2 of the introduction sheath positioning device 1 is sufficiently longer than the sheath main body 51 of the introduction sheath 5 and protrudes from the distal end of the sheath main body 51. In this state, the concave portion 4 formed on the side wall of the main body 2 is positioned on the side protruding from the distal end of the sheath main body 51, and the proximal end side 10 of the concave portion 4 is disposed at a position substantially coincident with the distal end of the sheath main body 51. To be set.
[0026]
In addition, although the suitable value of the length of the main-body part 2 changes with the length of the introduction | transduction sheath 5, etc., it is preferable normally that it is about 30-1000 mm, and it is more preferable that it is about 50-500 mm.
[0027]
The outer diameter (average outer diameter) of the main body 2 is set to be equal to or smaller than the inner diameter (minimum inner diameter) of the introduction sheath 5, and a suitable value varies depending on the inner diameter of the introduction sheath 5, but usually 1 The thickness is preferably about 0.0 to 5.0 mm, and more preferably about 1.3 to 4.5 mm.
[0028]
The depth of the recess 4 provided in the main body 2 is 0.7 mm or more, and preferably 70% or less of the outer diameter of the main body 2. In this case, the lumen 6 may be exposed. The lumen 6 may have any diameter as long as the guide wire can be inserted, and a suitable value thereof varies depending on the outer diameter of the guide wire used, but is preferably about 0.5 to 1.2 mm. More preferably, it is about -1.2 mm.
[0029]
Moreover, it is preferable that the shape of the recessed part 4 is a taper shape where the shape of the front end side is smooth, whereas the shape of the base end side is an angle of 45 ° to 135 ° with respect to the radial direction. The angle of the base end portion is set at an optimum angle for positioning the base end portion of the recess 4 by being caught by the blood vessel wall when the main body portion 2 is inserted into the perforation formed in the blood vessel wall. The tapered shape on the distal end side is designed so that it can be smoothly removed from the blood vessel after positioning on the blood vessel wall.
[0030]
When the introduction sheath positioning device 1 having the recess 4 is combined with the introduction sheath 5 as shown in FIG. 3, the proximal end side of the recess 4 substantially coincides with the distal end of the sheath body 52.
[0031]
Here, the puncture hole after removal of the catheter is generally formed obliquely with respect to the skin. This is because when the catheter is inserted into the blood vessel, consideration is given to introducing the catheter as close as possible to an angle parallel to the blood vessel so that the catheter does not bend. Accordingly, when the assembly of the introduction sheath positioning device 1 and the introduction sheath 5 is inserted into the puncture hole, it is also introduced obliquely. At this time, the mark 7 provided on the hub 3 is Push forward so that it is positioned above.
[0032]
Proceeding in this manner causes resistance when the proximal end of the recess 4 is engaged with the blood vessel wall. By stopping the pushing operation when this resistance is felt, the distal end of the introduction sheath can be positioned on the blood vessel wall.
[0033]
Since the main body 2 is made of a sufficiently flexible material, the positioning does not cause damage to the tissue such as damage to the blood vessel wall.
[0034]
Examples of the constituent material of the main body 2 having such flexibility (flexibility) include polyolefins such as polyethylene, polypropylene, and polybutadiene, polyvinyl chloride, polyurethane, ethylene-vinyl acetate copolymer, polyethylene terephthalate, and poly Polyesters such as butylene terephthalate, polyamides, polyether polyamides, polyester polyamides, soft polyvinyl chloride, ABS resins, AS resins, various resin materials such as polytetrafluoroethylene and other resin materials, shape memory resins, styrene, polyolefins , Polyurethane, polyester, polyamide, polybutadiene, transpolyisoprene, fluororubber, chlorinated polyethylene, and other thermoplastic elastomers, and combinations of two or more of these Ones (polymer alloys, polymer blends, laminates, etc.).
[0035]
Moreover, the main-body part 2 may be comprised with the laminated body which laminated | stacked two or more layers other than the case where it consists of one layer. Moreover, the reinforcing material may be installed in the layer or between the layers. Examples of the reinforcing material include a linear or spiral (coiled) linear body, and a reticulated body. The number of layers constituting the main body 2, the constituent material of each layer, the presence or absence of a reinforcing material, and the like may be different along the longitudinal direction of the main body 2.
[0036]
Next, a specific method of using the introduction sheath positioning device 1 of Embodiment 1 will be described in detail with reference to the drawings.
[0037]
[1] First, the introduction sheath 5 to be positioned will be described. The introduction sheath 5 is used for introducing and placing a hemostatic material as described later, but can also be used for introducing a catheter. Therefore, in this embodiment, it demonstrates on the assumption that the introducer sheath utilized for the catheter operation performed prior to hemostasis is reused as a sheath for hemostatic material introduction.
[0038]
FIG. 4 is a diagram illustrating a state after the catheter operation is completed and the catheter is removed. The introduction sheath 5 used as the introducer sheath is placed in a state where the distal end side penetrates the subcutaneous tissue 100 to the inside of the blood vessel 101 and is percutaneously inserted into the blood vessel 101. At the time of catheter surgery, a catheter (not shown) or the like is introduced into the blood vessel 101 through the lumen of the introduction sheath 5 and treatment by, for example, cardiac catheterization, heart and angiography, His bundle electrocardiography, or the like.・ Measures such as inspection are performed. In FIG. 4, reference numeral 8 denotes a guide wire inserted into the introduction sheath 5. At this time, the tissue 102 of the blood vessel wall in the puncture portion is in a state of being tightly adhered to the sheath body 51 by the insertion angle of the introduction sheath 5 with respect to the traveling direction (axial direction) of the blood vessel 101 as compared with the tissue 103. .
[0039]
[2] Next, as shown in FIG. 5, the introduction sheath positioning device 1 is inserted into the introduction sheath 5, and the hub 3 and the hub 52 are fitted. At the time of insertion, the guide wire 8 is inserted into the lumen 6 of the introduction sheath positioning device 1.
[0040]
At this time, the base end side of the recess 4 is in a positional relationship that substantially coincides with the most distal end of the sheath body 51. Here, during or after insertion, when the rotation operation is performed so that the mark 7 formed on the hub 3 is on the upper side, the recess 4 is positioned on the puncture hole forming side.
[0041]
[3] Next, the assembly of the introduction sheath positioning device 1 and the introduction sheath 5 is pulled toward the proximal side until at least the recess 4 is pulled out of the blood vessel. At this time, the tissue 102 of the blood vessel wall is in close contact with the main body 2 of the introduction sheath positioning device 1 in the same manner as it is in close contact with the sheath main body 51.
[0042]
After pulling, the assembly of the introduction sheath positioning device 1 and the introduction sheath 5 is pushed toward the blood vessel wall. Then, as shown in FIGS. 6 and 7, the proximal end side of the recess 4 is engaged with the tissue 102 of the blood vessel wall and is caught, causing resistance. FIG. 7 is an enlarged view for easy understanding of how the recess 4 engages the tissue 102 of the blood vessel wall. Here, since the concave portion 4 is positioned on the upper side by checking the mark 7, the concave portion 4 comes into contact with the cross section of the tissue 102 of the blood vessel wall that is in close contact with the introduction sheath positioning device 1, and the engagement is strengthened. . The operator stops the pushing operation while feeling this resistance. As a result, the distal end 54 of the introduction sheath 5 (the distal end of the sheath body 52) is positioned at the position of the tissue 102 on the blood vessel wall.
[0043]
Further, the fitting of the hub 3 and the hub 52 is released, and the introduction sheath 5 is slightly moved back and forth with respect to the introduction sheath positioning device 1, so that the distal end 54 of the introduction sheath 5 is reliably positioned on the blood vessel wall 102. Can be confirmed.
[0044]
[4] Next, the introduction sheath positioning device 1 and the guide wire 8 are removed while leaving the introduction sheath 5. At this time, since the distal end side of the concave portion 4 has a smooth taper shape, the drawing can be performed smoothly and smoothly without damaging the blood vessel wall.
[0045]
Next, as an example of the hemostasis operation after the distal end 54 of the introduction sheath 5 is positioned on the blood vessel wall in this way, an operation for filling the puncture hole with a hemostatic material and a hemostatic material filling instrument used for this operation explain.
[0046]
FIG. 8 is a view showing the hemostatic material filling device 20 and shows a state in comparison with the introduction sheath 5 for explanation of the dimensions. As shown in FIG. 8, the hemostatic material filling device 20 includes a holder 21 having a hollow portion penetrating from the distal end to the proximal end, and a hemostatic material 24 loaded in the distal end portion of the holder 21.
[0047]
The holder 21 is composed of a tubular (tube-shaped) holder body 22 and a hub 23 attached to the proximal end of the holder body 22, and the hemostatic material 24 is made of, for example, a cellulosic polymer material or collagen. It is composed of a cotton-like body made of a bioabsorbable material.
[0048]
The holder main body 22 can be inserted into the introduction sheath 5, and the hub 23 has the same structure as the hub 3 of the introduction sheath positioning device 1, and the holder main body 22 is inserted into the introduction sheath 5. The hub 52 of the introduction sheath 5 can be fixed (fitted). In this state, the length of the holder 21 is set so that the distal end of the hemostatic material 24 held by the holder 21 coincides with the distal end 54 of the introduction sheath 5. Therefore, the hemostatic agent filling device 20 is inserted into the introduction sheath 5 placed in a state where the tip is positioned on the blood vessel wall, and the hub 23 and the hub 52 are fitted, thereby positioning the tip of the hemostatic material 24 on the blood vessel wall. can do.
[0049]
Next, as shown in FIG. 9, the discharge member 30 is inserted into the hemostatic material filling device 20. The discharge member 30 includes an elongated insertion portion 31 that can be inserted into the holder 21, and a stopper 32 that is installed at the proximal end portion of the insertion portion 31. The discharge member 30 is set so that the insertion portion 31 is inserted into the holder 21 and the distal end of the insertion portion 31 comes into contact with the proximal end of the hemostatic material 24 held by the holder 21.
[0050]
When the hemostatic material filling device 20 and the discharge member 30 are set in this way, the introduction sheath 5 and the holder 21 are both placed along the insertion portion 31 of the discharge member 40 as shown by the arrows in FIG. Then, it is removed from the living body (subcutaneous tissue 100). Then, the hemostatic material 24 remains in the puncture hole of the subcutaneous tissue 100 because its proximal end is in contact with the distal end of the insertion portion 31 of the discharge member 30. The hemostatic material 24 comes into contact with blood to become wet and gel, closes the puncture hole, and exhibits a hemostatic function.
[0051]
At this time, the distal end of the hemostatic material 24 is accurately positioned before the blood vessel wall as described above. For example, the insertion position of the hemostatic material 24 is too deep and the hemostatic material 24 enters the blood vessel 101. Therefore, the blood flow is not hindered, and conversely, the insertion position of the hemostatic material 24 is not too shallow and the hemostatic effect is not insufficient, so that a high hemostatic effect is obtained and the safety is high.
[0052]
The introduction sheath positioning device 1 has excellent operability and a simple structure. Further, there is no risk of damage to the tissue of the blood vessel wall, and higher safety is achieved.
[0053]
As described above, the sheath positioning instrument for introduction of the present invention has been described with respect to the illustrated embodiment 1. However, the present invention is not limited to this, and each part constituting the sheath positioning instrument for introduction exhibits the same function. It can be replaced with any possible configuration. For example, the cross-sectional shape of the main body 2 is circular in this embodiment, but may be elliptical or the like.
[0054]
(Embodiment 2)
FIG. 10 is a view showing an introduction sheath positioning device 60 according to Embodiment 2 of the present invention. In the first embodiment, the main body portion is a tubular body and has a form in which a guide wire can be inserted into the inner lumen. However, the second embodiment is greatly different in that the inside is solid.
[0055]
An introducer sheath positioning device 60 shown in FIG. 10 includes a main body 61 made of a member having a circular cross section having flexibility, a hub 62 provided at the base end of the main body 61, and a distal end of the main body 61. It is comprised by the recessed part 63 formed in the side. The introduction sheath positioning device 60 is capable of positioning the distal end of the introduction sheath 5 having a distal end portion inserted into the blood vessel percutaneously on the blood vessel wall. Here, since the introduction sheath 5 is the same as that of the first embodiment, the description thereof is omitted.
[0056]
Hereinafter, the configuration of each unit will be described.
[0057]
The main body 61 is a portion that is inserted into the introduction sheath 5 when used, and can be inserted through the introduction sheath 5. The length of the main body 61 is not particularly limited, but is set to a length that allows the recess 63 to protrude from the distal end of the introduction sheath 5 in a state of being inserted into the introduction sheath 5. In addition, although the suitable value of the length of the main-body part 61 changes with length etc. of the sheath 5 for introduction, it is preferable that it is about 30-1000 mm normally, and it is more preferable that it is about 50-800 mm.
[0058]
The outer diameter (average outer diameter) of the main body 61 is set to be smaller than the inner diameter (minimum inner diameter) of the introduction sheath 5, and its preferred value varies depending on the inner diameter of the introduction sheath 5, but usually 1 The thickness is preferably about 0.0 to 5.0 mm, and more preferably about 1.3 to 4.5 mm.
[0059]
As shown in FIG. 10, a concave portion 63 is provided on one side on the tip side of the main body, and the depth is 0.7 mm or more, which is about 70% or less of the outer diameter of the main body. It is preferable.
[0060]
Further, it is preferable that the shape of the concave portion 63 is a tapered shape with a smooth tip side, whereas the shape on the base end side is an angle of 45 ° to 135 ° with respect to the radial direction. The angle on the proximal end side is set at an optimum angle so as to be a step that can be caught by the tissue when the concave portion 63 is pressed against the tissue of the blood vessel wall. The tapered shape on the distal end side is designed so that the introduction sheath 5 can be smoothly removed from the blood vessel after positioning.
[0061]
The hub 62 is the same as the hub 3 of the first embodiment, but may not be hollow. A mark 64 indicating the position of the recess 63 in the circumferential direction of the main body 61 is formed on the surface of the hub 62. The mark 64 has an arbitrary shape such as a triangle or an arrow, and can be formed by an arbitrary method such as printing or three-dimensional molding.
[0062]
The introduction sheath positioning device 60 of the second embodiment described above has the same basic usage as that of the first embodiment. The difference is that a guide wire is not used. After the guide wire 8 is removed from the state of FIG. 4, the introduction sheath positioning device 60 is inserted. Subsequent work is almost the same.
[0063]
In addition, as the constituent material of the introduction sheath positioning device 60, the same material as that of the first embodiment can be used.
[0064]
The introduction sheath positioning device described in the first and second embodiments can be variously improved within the scope described in the claims. For example, the shape of the recess formed in the main body portion may be tapered to the proximal end side, and the engagement of the blood vessel wall with the tissue may be performed at the distal end of the introduction sheath. . However, since the distal end of the introduction sheath is generally thin, the shape of the above-described first and second embodiments that engage with the recess itself is preferable.
[0065]
Moreover, although the introduction sheath introduced the method of reusing the introducer sheath used in the catheter operation in the above-described embodiment, it can be used in exchange for a hemostatic material introduction dedicated one. By doing so, since the dimensions of the introduction sheath positioning device can also be specialized, it is not necessary to perform a large number of assortments in conjunction with a general-purpose introducer sheath.
[0066]
In the above embodiment, a hemostasis method in which a cotton-like hemostatic agent is embedded is introduced. However, the introduction sheath positioning device of the present invention inserts a suture device for sewing a blood vessel wall with a needle and a thread into the introduction sheath. It can also be used in the form of hemostasis.
[0067]
【The invention's effect】
As described above, according to the present invention, the distal end of the introduction sheath inserted percutaneously into the blood vessel can be reliably positioned on the blood vessel wall. In addition, the tissue is not damaged by damaging the blood vessel wall and the safety is high. In addition, the above effects can be achieved with a simple structure and easy operation.
[Brief description of the drawings]
FIG. 1 is an external view showing a sheath positioning instrument for introduction according to a first embodiment.
FIG. 2 is an external view showing an introduction sheath.
FIG. 3 is a view showing an assembly of an introduction sheath and an introduction sheath positioning device;
FIG. 4 is a diagram for explaining a state in which an introduction sheath is inserted percutaneously.
5 is a view for explaining a state where an introduction sheath positioning device is inserted into the introduction sheath of FIG. 4; FIG.
6 is a view for explaining a state in which the assembly of FIG. 5 is positioned on a blood vessel wall.
FIG. 7 is a partially enlarged view of the state of FIG.
FIG. 8 is a partial cross-sectional view of a hemostatic material filling device.
FIG. 9 is a diagram illustrating a state in which a hemostatic material is placed.
10 is an external view showing a sheath positioning instrument for introduction according to Embodiment 2. FIG.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Introduction sheath positioning instrument 2 Body part 3 Hub 4 Recessed part 5 Introduction sheath 6 Lumen 7 Mark 8 Guide wire 51 Sheath body 52 Hub 53 Tube

Claims (7)

An introduction sheath positioning device for positioning the distal end of an introduction sheath for introducing a hemostatic means into a hole penetrating percutaneously to a blood vessel wall on the blood vessel wall,
A main body that can be inserted into the introduction sheath;
A hub provided on the base end side of the main body,
The main body portion is made of a flexible material, and when the hub comes into contact with the proximal end portion of the introduction sheath in a state of being inserted into the introduction sheath,
The front end portion of the main body portion protrudes from the front end of the introduction sheath, and has a concave portion located on the surface of the portion of the main body portion protruding from the front end of the introduction sheath and in the vicinity of the most distal end of the introduction sheath. A sheath positioning instrument for introduction characterized by the above. The introduction sheath positioning device according to claim 1, wherein a depth of a recess formed at a distal end portion of the introduction sheath positioning device is 0.7 mm or more and 70% or less with respect to a diameter of the main body portion. . The introduction sheath positioning device according to claim 1, wherein the shape of the concave portion on the distal end side of the main body portion is a smooth taper shape. 2. The introduction sheath positioning device according to claim 1, wherein a base end side of the main body portion of the concave portion is recessed at an angle of 45 ° to 135 ° with respect to a radial direction. The introduction sheath positioning device according to claim 1, wherein a mark indicating a position of the concave portion in a circumferential direction of the main body portion is provided on a surface of the hub. When the hub comes into contact with the proximal end portion of the introduction sheath in a state where the main body portion is inserted into the introduction sheath, the proximal end side of the recess is 0 to 0 from the most distal end of the introduction sheath. The sheath positioning instrument for introduction according to claim 1, wherein the introducer sheath positioning instrument is located at a distal end side of 5 mm. The introducer sheath positioning device according to claim 1, wherein the main body portion has a lumen through which a guide wire can be inserted.

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