JP4159777B2 - Medical guidewire - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a medical guide wire used when a catheter is introduced into a cardiovascular system or the like.
[0002]
[Prior art]
For the purpose of angiography, when inserting a catheter with a very thin flexible tube into a blood vessel, or when inserting a balloon catheter into a blood vessel for treatment of a coronary artery occlusion site, the catheter must be inserted safely. In order to achieve this, a medical guide wire of a flexible striate body is used, and there is a known example shown in Japanese Patent Publication No. 4-25024.
[0003]
This medical guide wire (hereinafter simply referred to as a guide wire) is (see FIG. 6) a front end of a complex path blood vessel / branch blood vessel that is wound in the form of a line consisting of a flexible line 2. Operation feeling that the operator (the person who operates the guide wire) feels with the hand portion 11 while pushing and pulling the hand portion 11 inserted from the portion 10 and rotating outside the body 10 to be inserted into the blood vessel and progressing. Therefore, the distal end portion 5 has a good leading insertion property into the blood vessel, and the behavior of the front end portion 10 in the blood vessel is sharply perceived by the hand portion 11. High mechanical properties such as being possible are required.
[0004]
A coil spring 15 is fitted to the tip portion 5 of the filament 2 so as to meet the above required characteristics, and the entire outer circumference of the coil spring 15 is wrapped with a lubricant coating 16 made of a hydrophilic polymer. The guide wire 1A having a structure for improving the slipperiness with the blood vessel wall and the entire core surface 3 of the metal flexible striated wire are embedded on the entire peripheral surface of the striated material 2 embedded in the resin coating layer 7. A guide wire 1B having a structure provided with the lubricant coating 16 is in widespread use.
[0005]
[Problems to be solved by the invention]
The above-described guide wire 1A according to the prior art is inserted into a blood vessel by hydrolyzing the “coating film 16 which is in a dry state in the atmosphere” by dipping in a saline solution in advance. However, when the coating film 16 is formed, the coil wire valleys 17 are embedded on the coil surface side, and a considerable amount protrudes and is embedded in the coil wire valleys 18 inside the coil due to the capillary phenomenon of the fine gaps between the coil wires. become.
[0006]
Further, in the hydrophilic softening treatment using the saline solution, the skin of the coating film 16 quickly becomes hydrophilic and forms a film to prevent water from entering into the lower layer of the coating film. The existing lubricant exhibits a solidified state or a semi-solidified state, and is configured to be inserted into the blood vessel in a state in which the flexible flexibility of the coil spring 15 is hindered. The distal end portion 5 to be introduced into the blood vessel has a rigid posture, which makes it difficult to introduce, reduces the flexibility and increases the frictional resistance with the blood vessel wall, and worsens the insertion and withdrawal properties. May cause vessel wall damage due to strong conflict resistance.
[0007]
On the other hand, the guide wire 1B has the lubricant coating 16 on the entire circumference of the striatum and becomes excessively slidable with respect to the inner wall of the blood vessel. There is a case where the delicate resistance fluctuation generated in the part 10 is canceled out by the blood pulsation and cannot be detected by the hand part 11, and there is a problem that the behavior information transmission property of the front end part 10 in the hand part 11 is lacking and the therapeutic property is lowered. .
[0008]
The present invention provides a medical guide wire that solves the above-mentioned problems of the prior art.
[0009]
[Means for Solving the Problems]
The present invention that solves the above technical problem is as follows: "In the medical guide wire made of a flexible wire, the flexible wire is provided with a resin coating on the outer periphery of a wire rope having a metal wire stranded structure, In the wire rope, a part of the side strand wire is configured to have a larger diameter than the other side strand wire, and a spiral belt-like lubricant coating portion and the spiral belt-like tip are formed on the outer periphery of the tip portion of the flexible linear body. The medical treatment of “the structure in which the outer peripheral exposed portions of the portions are alternately arranged, and the outer peripheral exposed portions of the annular belt-like lubricant coating portions and the annular belt-like main body portions are alternately arranged on the outer periphery of the main body portion other than the tip portion”. A guide wire for
[0010]
“In the medical guide wire comprising a flexible wire, the flexible wire is provided with a resin coating on the outer periphery of a wire rope having a stranded metal wire structure, and the wire rope is a part of a side strand wire. Is configured to have a diameter larger than that of the other side strand wire, and a spiral strip-shaped lubricant coating portion and an exposed portion of the outer periphery of the spiral strip-shaped tip portion are alternately disposed on the outer periphery of the distal end portion of the flexible linear body. Furthermore, the medical guide wire has a structure in which a stripe-like lubricant coating portion extending in the longitudinal direction of the flexible linear body is provided on the outer periphery of the main body portion other than the tip portion .
[0011]
That is, the medical guidewire of the present invention having the above-described structure is a wire lacking in lubricity due to the absence of a lubricant and a “lubricant-like strip-shaped lubricant coating portion” in the wire length direction of the flexible filament. The strip-shaped outer peripheral exposed portions of the strips are alternately arranged to provide “appropriate slip characteristics in which slipperiness and friction with respect to the blood vessel wall are harmoniously coexisting”.
[0012]
As a common aspect, the band width of the lubricant coating portion gradually decreases and gradually changes from the front end to the rear end, or the band width of the outer peripheral exposed portion gradually increases from the front end to the rear end. Use a gradually changing form.
[0013]
[Action]
The medical guide wire of the present invention having the above-described configuration is provided with a “strip-shaped lubricant coating portion rich in lubricity” and a “strip-shaped outer periphery where friction resistance is present in the absence of a lubricant” on the outer periphery of the flexible linear body. Since the "exposed part" is alternately continuous in the longitudinal direction, the sliding property of the flexible striatum that is inserted into the blood vessel for the most part of the entire length to the blood vessel wall is highly slidable and the outer periphery exposed to the lubricant coating part. Appropriate slidability that is not excessively or excessively biased can be secured based on the offset of the non-slidability of the part.
[0014]
And since the tip part that becomes the leading part of the blood vessel insertion is a “spiral-shaped lubricant coating part”, it has a preferential contact with the blood vessel wall (the diameter of the lubricant layer is expanded from the outer peripheral exposed part, so The spiral form of the lubricant coating part (which is in principle preferential contact with the exposed part) and the rotational advance / retreat operation by the surgeon of the hand part located outside the body generally match, and the sliding function by the contact point and the outer peripheral exposed part The sliding brake function works in harmony, ensuring the appropriate slidability as described above, and ensuring good insertion progress to the blood vessel bent portion and the fine blood vessel.
[0015]
Furthermore, based on the appropriate sliding property, the flexible striatum inserted into the blood vessel exhibits a straight posture with respect to the blood vessel wall (a posture in which excessive bending stress is not generated by excessive bending), To improve the contact resistance change between the leading front end and the vascular wall leading to the contact part of the contact feeling of "Garigari / Rugs", and to understand the behavior of the front end at the vascular bifurcation and vascular lesions The perception and graspability of the front edge information is improved.
[0016]
Furthermore, since the belt-like annular lubricant coating portion and the outer peripheral exposed portion are alternately arranged in the main body portion other than the tip portion, when inserting into the blood vessel sequentially from the tip portion while rotating the main body portion with the fingertip, Since the diameter direction of the exposed outer peripheral portion can be clamped and operated by the fingertip, there is no fingertip slip due to the lubricant, and the insertion operation into the blood vessel can be easily performed accurately. There are the above main effects.
[0017]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, the guide wire 1 of the present invention will be described based on the drawings. That is, FIGS. 1 to 4 show the form of the “lubricant coating portion” of the main component of the guide wire of the present invention. First, in FIG. 1, the metal core wire 3 is coated with a resin coating 7 (polyamide. In the case of the flexible linear member 2 wrapped with polyurethane or the like, strip-like lubricant coating portions 8A and 8B are provided on the outer periphery of the linear member 2 with an interval between adjacent ones in the line length direction. They are generally arranged along the entire length.
[0018]
Specifically, the lubricant coating portions 8A and 8B are coated with a lubricant material having lubricity during lubrication such as “maleic anhydride copolymer / methyl vinyl ether / polyvinyl pyrodrine” along the outer periphery of the resin coating 7. Is formed. The tip portion 5 where high flexibility is indispensable as a guide wire has a spiral band shape in which the lubricant coating portion 8A having the same band width B1 is continuous, and a spiral having the same width C1 is formed between adjacent lubricant coating portions 8A. The outer periphery exposed part 9 which comprises strip | belt shape and represents the outer periphery of the filament 2 is comprised.
[0019]
The main body portion 6 other than the front end portion 5 is formed by connecting the lubricant coating portions 8B of the annular belt having the same band width B2 in the rear end direction at the same pitch, and the lubricant coating portions 8B are connected to each other between the linear coating bodies. 2 is set to the outer periphery exposed portion 9 of the annular band representing the outer periphery of 2.
[0020]
In FIG. 1, the front end portion 10 that functions as a leading portion when the distal end portion 5 is inserted into a blood vessel is set to an exposed head (length = approximately 8 mm) that is not coated with a lubricant. The wire 3 has a known single wire / stranded wire structure of SUS material (stainless steel) or Ni (nickel) -Ti (titanium) material or a wire rope W structure.
[0021]
1, the length of the tip portion 5 = about 300 mm, the band width B1 of the lubricant coating portion 8A = about 5 mm, the band width C1 of the outer peripheral exposed portion 9 = about 2 mm / band width C2. The size is about 20 mm and the width B2 of the lubricant coating portion 8B is about 60 mm.
[0022]
Those having a lubricant coating portion 8A · 8B shown in FIG. 1 described above has an effect of the following this will be illustrated supplement. In other words (see FIGS. 1C to 1E), the conventional guide wire 1B having a high slidability at the branch portion of the blood vessel 20 easily slides and is difficult to guide to the branch blood vessel 21. On the other hand, in the embodiment of FIG. 1, the outer peripheral exposed portion 9 between the lubricant coating portions 8A slides against the blood vessel wall and functions as a brake, so that introduction guidance to the branch blood vessel 21 is facilitated.
[0023]
Then, when the front end portion 10 is introduced and guided to the collagen fiber portion 23 at the central portion of the concave wall of the occlusion lesion P, the front end portion 5 is appropriately slidable and the front end portion 10 is in the absence of lubricant. For this reason, the feeling of “crisp” and “lumpy” due to the joining of the front end portion 10 to the vascular intima 22 is transmitted to the hand portion 11 with high accuracy so that the touch can be easily recognized. The true cavity can be inserted into the front end portion 10 quickly and accurately.
[0024]
The tip portion 5 and the main body portion 6 are formed by alternately arranging the lubricant coating portions 8A and 8B and the outer peripheral exposed portion 9 (see FIG. 1E). When the catheter 24 is externally fitted and the contrast agent L is injected into the gap between the catheter 24 and the guide wire 1, the flow velocity V of the contrast agent L is quickly set to V 1 in the lubricant coating portion 8 A zone due to the difference in contact resistance. The zone 9 zone has a slow speed V2, and turbulence is generated at the joint portion of V1 and V2 to bring about the diffusion effect of the contrast agent L, and the density unevenness of the contrast agent L is eliminated to improve the contrast effect.
[0025]
Next, another form of the lubricant coating portion will be described with reference to FIG. That is, in the same manner as in FIG. 1 , the “spiral belt-like lubricant coating portion 8A” is provided on the outer periphery of the tip portion 5 of the linear member 2, and the lubricant coating portion 8B is provided on the outer periphery of the main body portion 6. The lubricant coating portion 8B of FIG. 2 is located on one diameter of the main body 6 and forms a symmetrical pair, and has a continuous stripe shape from the front end to the rear end of the main body 6. FIG. 2A has a shape in which the stripe width gradually decreases from the front end to the rear end of the main body 6, and the portions other than the stripe are in the longitudinal direction. It consists of a continuous outer periphery exposed portion 9.
[0026]
2 has the same operation as that of FIG. 1 because the main body 6 is “a form in which the lubricant coating portion 8B and the outer peripheral exposed portion 9 coexist in the longitudinal direction” . When the hand portion 11 is sandwiched between the fingertips and rotated and pushed and pulled to be inserted into the blood vessel, the semicircular arc strip-shaped outer peripheral exposed portions 9 exist in a pair in the upper and lower sides. It becomes easy to perform the internal insertion work. In FIG. 2B, the clamping space is widened toward the rear end of the main body 6, so that the clamping operation of the latter half of the main body 6 is improved by inserting the most part into the blood vessel and improving the operation difficulty. It becomes extremely easy to do. There are the above specific effects. The band width of the lubricant coating portion 8B of this embodiment is “0.8 mm for FIG. 2A and maximum width of about 1.0 mm for FIG. 2B, and minimum width = About 0.3cm ".
[0027]
Next, another embodiment will be described with reference to FIG . That is, in the one having the lubricant coating portions 8A and 8B, the spiral belt-like lubricant coating portion 8A of the front end portion 5 shown in FIG. 3A has a band width of B1, B2, and B3 sequentially from the front end toward the rear end. 3B, the spiral-band-like lubricant coating portion 8A of the tip portion 5 shown in FIG. 3B has a width of the outer peripheral exposed portion 9 between the same width B1. Is gradually increasing gradually changing from the front end portion 10 toward the rear end in the order of C1, C2, and C3.
[0028]
Then, the annular belt-like lubricant coating portion 8B of the main body portion 6 shown in FIG. 3 (C) has a gradually decreasing and gradually changing width of the band widths B1, B2, and B3 toward the rear end, and the outer peripheral exposed portion. 9 is a form in which the band width C1 is constant, and the main body 6 shown in FIG. 3 (D) is a band of the circumferentially exposed portion 9 between the annular belt-like lubricant coating portions 8B having the same width C1. The width gradually increases in the order of C1, C2, and C3 in the rear end direction.
[0029]
Since the surface area of the lubricant coating portion 8 per unit length in the length direction of the linear member 2 gradually decreases gradually from the front end portion 10 toward the rear end direction in the configuration shown in FIG. The contact area of the inner wall of the blood vessel and the total bending angle due to the blood vessel bending portion are extremely matched with the usage characteristics of the guide wire 1 that gradually decreases and gradually changes from the front end portion 10 toward the rear end direction, and the excessive slip in each zone in the longitudinal direction of the guide wire 1 This prevents the lubricant from being wasted while ensuring the appropriate slipperiness substantially uniform in the line length direction.
[0030]
Next, another embodiment will be described with reference to FIG. That is, what is shown in FIG. 4 is an example of a change in the shape of the filament 2 of the guide wire 1 having the lubricant coating portions 8A and 8B. The filament 2 shown in FIG. This tip portion is composed of a main body portion 6 made of a known wire rope W in which a plurality of side strand wires 13 are twisted to 12 and a tip portion 5 in which a coil spring 15 is fitted to a core wire 3 having a rectangular cross section. 5 and the outer periphery of the main body 6 are coated with “resin thin film coat C such as polyurethane”, and the same lubricant coating portions 8A and 8B are set on the resin thin film coat C.
[0031]
Next, the guide wire 1 according to the first embodiment of the present invention having the lubricant coating portions 8A and 8B described above as main components will be described with reference to FIG. That is, the guide wire 1 has a distal end portion 5 and a body portion 6 made of a wire rope W, and a part of the side strand wire 13 of the wire rope W is a large-diameter side strand wire 13A. Has a structure that appears in the entire length of the outer periphery of the rope in a protruding spiral. And, on the outer periphery of the wire rope W, “lubricant coating portions 8A and 8B on the resin thin film coat C shown in FIG. 4” are set. In this embodiment, the guide wire 1 has a spiral groove 14 or a spiral groove 14A formed by the side strand wires 13 and 13A on the outer peripheral exposed portion 9 of the wire body 2 (the groove wire appearing at the adjacent joint portion of the side strand wire 13). ) Appears, the concave strip 14 and the concave strip 14A of the guide wire 1 that is rotated when the blood vessel is inserted function as a reservoir and a feed groove for the lubricant to be injected.
[0032]
Further, since the “spiral groove streaks 14A or spiral grooves 14” are present on the outer periphery, the embodiment of FIG. 5 has the following specific effects. That is, (see FIG. 5 (B)) When the catheter 24 is fitted and set after insertion into the blood vessel, and the contrast agent L is injected between the outer periphery of the guide wire 1 and the inner periphery of the catheter 24, the contrast agent L is spirally recessed. A spiral flow is generated by being guided by the streak 14A and the spiral recess 14, and a turbulent flow based on the flow velocity V1 and V2 shown in FIG. 1E is generated. The diffusion effect of the contrast agent L shown in FIG.
[0033]
【The invention's effect】
As described above, the medical guide wire of the present invention has excellent insertion property into the blood vessel, direction control to the bent blood vessel / branch blood vessel / vascular lesioned portion of the blood vessel, and introduction guideability in the blood vessel, and the front end. It is excellent in information transmission to the proximal part of the intravascular contact behavior of the part, and has an effect of particularly improving the therapeutic property.
[Brief description of the drawings]
FIG. 1 shows a medical guide wire provided with a lubricant coating portion as a main component of the present invention , (A) is a front view thereof, (B) is a cross-sectional view of (A), and (C) ( D) (E) shows a medical guide wire with a lubricant coating of the main components of illustration the present invention; FIG its activated condition, (a) (B) is its overall front view, ( (C) is a cross-sectional view of (A) and (B). FIG. 3 shows a medical guide wire having a lubricant coating portion as a main component of the present invention , and (A) to (D) are partial front views thereof. 4A and 4B show a medical guide wire having a lubricant coating portion as a main component of the present invention, in which FIG. 4A is an overall front view, FIG. 4B is an EE cross-sectional view of FIG. FF sectional view of (a) [5] shows a medical guide wire according to the present invention one embodiment, (a) thereof Front view of body, (B) is an explanatory view of the action. FIG. 6 shows a conventional medical guide wire, (A) and (B) are front views of the whole, (C) is a partial sectional view of (A), and (D). Is a cross-sectional view of (B) [Explanation of symbols]
DESCRIPTION OF REFERENCE NUMERALS 1 Medical guide wire provided with lubricant coating portion as main component of the present invention 1A / 1B Conventional medical guide wire
1C Medical guide wire 2 of the present invention 2 striate body 3 core material 5 tip portion 6 body portion 7 resin coating 8A and 8B lubricant coating portion 9 outer peripheral exposed portion 10 front end portion 11 proximal portion 14 spiral groove 20 blood vessel P blood vessel occlusion Part W Wire rope

Claims (5)

In an assembly in which a catheter is externally fitted and set on a medical guide wire made of a flexible striated body, an exposed head of a lubricant-uncoated portion is provided at the front end of the medical guide wire,
The flexible umbilical member is provided with a periphery in the resin coating of the wire rope of the metal wire stranded structure, the wire rope is constructed to a large diameter portion of the side strands line than the other side strands lines, wherein the outer periphery of the distal end portion of the flexible striatum, the outer peripheral exposed portion of the tip portion of the lubricant coating portion and the spiral strip of the spiral strip is alternately arranged,
Further, the the outer periphery of the body portion other than the tip portion, and alternately arranged with a structure in which the outer peripheral exposed portion of the main body portion of the lubricant coating portion and the annular band-shaped annular strip,
A medical guide wire and a catheter, wherein a diffusion effect is enhanced by causing a difference in flow rate in the infusate between the lubricant coating portion and the outer peripheral exposed portion when the infusate is injected into the catheter. Assembly . The assembly of the medical guide wire and the catheter according to claim 1, wherein a band width of the annular belt-like lubricant coating portion gradually decreases gradually from the front end toward the rear end, or the annular assembly of the medical guide wire and catheter, characterized in that the band width of the band-like lubricant coating portion juxtaposed the outer peripheral exposed portion has a gradually increasing gradual change form to be sequentially width size from the front end to the rear end direction. In an assembly in which a catheter is externally fitted to a medical guide wire made of a flexible striate body,
At the distal end portion of the medical guide wire, an exposed head of the lubricant uncoated portion is provided,
The flexible linear body is provided with a resin coating on the outer periphery of a wire rope having a metal wire twisted wire structure, and the wire rope is configured such that a part of the side strand wire has a larger diameter than the other side strand wire, The spiral strip-shaped lubricant coating portion and the outer peripheral exposed portion of the spiral strip-shaped tip portion are alternately disposed on the outer periphery of the distal end portion of the flexible linear body,
Furthermore, the outer periphery of the main body portion other than the tip portion is provided with a stripe-shaped lubricant coating portion extending in the longitudinal direction of the flexible linear body,
A medical guide wire and a catheter, wherein a diffusion effect is enhanced by causing a difference in flow rate in the infusate between the lubricant coating portion and the outer peripheral exposed portion when the infusate is injected into the catheter. Assembly . 4. The medical guide wire and catheter assembly according to claim 3, wherein the stripe width of the stripe-shaped lubricant coating portion gradually decreases from the front end toward the rear end. Guide wire and catheter assembly . The assembly of the medical guide wire and the catheter according to any one of claims 1 to 4, wherein the band width of the strip-like lubricant coating portion at the front end portion is gradually reduced from the front end toward the rear end. Or a gradually increasing and changing shape in which the band width of the outer peripheral exposed portion arranged in parallel with the spiral belt-like lubricant coating portion is gradually increased from the front end toward the rear end. A medical guidewire and catheter assembly.

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