JP4220339B2 - catheter - Google Patents

Description

  The present invention relates to a catheter whose tip can be bent, and more specifically, the direction of the distal end of the catheter inserted into a body cavity by manipulating the handle on the proximal end side of the catheter disposed outside the body. It is related with the catheter which can change this.

  In cardiac electrophysiology tests for arrhythmia diagnosis, for example, in the case of an electrode catheter used for measurement of intracardiac electrocardiogram, the proximal end (rear end or proximal side) of the catheter that is inserted into the heart through the arterial blood vessel and located outside the body It is necessary to bend the distal end (tip) of the catheter inserted into the heart by bending the handle and accurately position it on the measurement target site.

In response to such a need, a support wire that can be bent is provided inside the catheter tube, and a steering wire is attached to each of the left and right side surfaces of the support wire at different positions so that the distal end of the catheter is bent asymmetrically. Thus, there is known a catheter that can bend the tip of the catheter into two bending patterns (see, for example, Patent Document 1).
Japanese Patent Laid-Open No. 7-59863

  However, in the catheter having the above structure, the attachment position of each steering wire to the support wire is permanently fixed by soldering, and only one bending pattern can be supported by one catheter. Therefore, it is necessary to prepare various catheter variations in which the attachment positions of the left and right steering wires are changed in advance so as to correspond to various shapes of the measurement target region, which may complicate a cardiac electrophysiological examination and the like.

  An object of this invention is to provide the catheter which can make the front-end | tip of a catheter tube into arbitrary shapes.

  In order to achieve the above object, according to the present invention, a catheter tube having a bendable distal end and a first operation wire having one end fixed relative to the distal end of the catheter tube are provided. A first operating means for bending the distal end of the catheter tube by moving the first operating wire, the first operating means having the first operating means There is provided a catheter further comprising a second operating means capable of fixing a wire relative to the catheter tube at an arbitrary position.

  In the present invention, the first operation wire having one end relatively fixed to the bendable tip of the catheter tube is moved to bend the tip of the catheter tube in a predetermined direction. In the catheter provided with the operation means, the first operation wire of the first operation means is fixed relative to the catheter tube at an arbitrary position with respect to the catheter tube by the second operation means. Thus, the point of action of the force acting on the catheter tube from the first operation wire can be varied, so that when the distal end of the catheter tube is bent by the first operation means, the distal end of the catheter tube has an arbitrary shape. It becomes possible to.

  Although not particularly limited in the above invention, the second operating means is preferably provided so as to be movable relative to the catheter tube along the axial direction of the catheter tube. By moving the second operating means relative to the catheter tube with respect to the axial direction of the catheter tube, the fixing position of the first operating wire with respect to the catheter tube by the second operating means is arbitrarily changed. It becomes possible to make it.

  More specifically, it is preferable that the catheter tube has a bendable tubular member at the tip, and one end of the first operation wire is fixed to the tip of the tubular member.

  Although not particularly limited in the above invention, the second operation means includes a deflection member and a second operation wire having one end fixed to a tip of the deflection member, and the second operation means. It is preferable to deflect the deflecting member so as to contact the first operating wire by moving the working wire. By moving the second operation wire, one end of which is fixed to the tip of the deflection member, the deflection member is deflected to contact the first operation wire, and the first operation wire is in contact with the catheter tube. Are relatively fixed.

  Although not particularly limited in the above invention, the deflection member is preferably made of a metal material exhibiting superelasticity. Since the deflection member of the second operating means is made of a metal material exhibiting superelasticity, the deflection member is appropriately elastically deformed and deflected by the movement of the second operation wire without being permanently deformed. Excellent operability in bending operation at the tube tip.

  Although not particularly limited in the above invention, it is preferable that the deflection member has a flexible member at the tip thereof that is relatively flexible with respect to the deflection member. By providing a flexible member at the tip of the deflection member included in the second operating means, the flexible member is fixed to the first operating wire when the first operating wire is fixed by the second operating means. Since it becomes possible to make it closely_contact | adhere, it becomes possible to fix the 1st wire for operation reliably.

  The second operation means includes a support member, a flap portion provided at a tip of the support member so as to be capable of hinge operation with respect to the support member, and a second operation in which one end is fixed to the flap portion. And moving the second operation wire so that the flap portion is hinged to the support member so as to come into contact with the first operation wire. May be. A flap portion that can be hinged with respect to the support member is provided at the tip of the support member, and the second operation wire having one end fixed to the flap portion is moved, whereby the flap portion is moved relative to the support member. The flap portion comes into contact with the first operation wire by the hinge operation, and the first operation wire is fixed to the catheter tube.

  Although not particularly limited in the above invention, the tubular member is preferably formed with a plurality of notches. By forming a plurality of notches in the tubular member constituting the catheter tube, the distal end of the catheter tube can be easily bent even if the distal end of the catheter tube is formed in a tubular shape.

  Although it does not specifically limit in the said invention, It is preferable that the said tubular member is comprised from the metal material which shows super elasticity. By configuring the tubular member of the catheter tube with a metal material exhibiting superelasticity, the tubular member is appropriately elastically deformed and bent without being permanently deformed by the movement of the first operation wire. Excellent operability for bending the tip.

  According to the present invention, the first operating wire of the first operating means is fixed relative to the catheter tube at an arbitrary position with respect to the catheter tube by the second operating means, and By changing the point of action of the force acting on the catheter tube from one operation wire, the distal end of the catheter tube can be formed into an arbitrary shape when the distal end of the catheter tube is bent by the first operation means. Therefore, it is possible to perform electrophysiological diagnosis at many sites with one catheter without preparing various catheter variations in order to cope with the measurement target site in cardiac electrophysiology examination or the like.

  1 is a schematic side view of an electrode catheter according to an embodiment of the present invention, FIG. 2 is a cross-sectional view taken along the line II-II of the catheter tube shown in FIG. 1, and FIG. 3 is III-III of the catheter tube shown in FIG. FIG. 4 is an exploded perspective view of the catheter tube shown in FIG. 1, FIG. 5A is a plan view of the tubular member shown in FIG. 4, and FIG. 5B is a tubular view shown in FIG. FIG. 6 is a schematic perspective view of a distal end of a catheter tube according to an embodiment of the present invention, and FIG. 7 is a schematic perspective view of a catheter tube according to another embodiment of the present invention.

  An electrode catheter 1 according to an embodiment of the present invention is, for example, a catheter used for measurement of an intracardiac electrocardiogram in a cardiac electrophysiology test for arrhythmia diagnosis, and as shown in FIG. 1, on the distal end side (tip side). The distal bending portion 4 that is positioned and bendable so as to match the shape of the measurement target portion, and the distal bending portion 4 is inserted into a predetermined position of the heart located on the proximal end side (rear end side or proximal side). A catheter tube 2 having a proximal rigid portion 5 for guiding, and knobs 7 and 8 that are attached to the proximal end of the proximal rigid portion 5 of the catheter tube 2 and for operating the catheter tube 2 from outside the body are provided. Handle 6.

  The distal bent portion 4 of the catheter tube 2 of the electrode catheter 1 according to the present embodiment is, for example, a tube made of a metal material exhibiting superelasticity of nickel-titanium (Ni-Ti) system, as shown in FIGS. The outer periphery of the member 20 is covered with a distal end side tube 22, and the inner peripheral surface of the tubular member 20 is coated with a fluorine-based resin such as polytetrafluoroethylene (PTFE), for example.

  The tubular member 20 has an axial length of about 50 to 600 mm, a thickness of about 0.05 to 0.2 mm, and an outer diameter of about 0.5 to 1.5 mm. . The distal end side tube 22 covering the tubular member 20 is made of, for example, a tube made of polyolefin, polyamide, polyether block amide, polyurethane, or the like.

  On the other hand, the proximal rigid portion 5 of the catheter tube 2 is configured by covering the outer periphery of a coil 24 made of a metal wire material such as stainless steel with a proximal tube 26 as shown in FIG. The inner peripheral surface of the coil 24 is coated with a fluorine resin such as polytetrafluoroethylene (PTFE).

  The axial length of the coil 24 is about 300 to 1500 mm, and its thickness and outer diameter are not particularly limited, but are preferably about the same as the tubular member 20 described above. Further, the proximal side tube 26 covering the coil 24 is preferably made of the same material as the above-described distal end side tube 22, but from the viewpoint of ensuring a higher rigidity than the distal end bending portion 4, stainless steel or the like. More preferably, the metal wire is braided.

  The catheter tube 2 composed of the above-described distal end bending portion 4 and the proximal rigid portion 5 has the distal end tube that covers the outer periphery after the proximal end of the tubular member 20 is fixed to the distal end of the coil 24. 22 and the hand side tube 26 are configured by being joined by a technique such as heat fusion. The catheter tube 2 configured as described above generally has an outer diameter of about 0.6 to 3 mm, and extends in the inside from the distal end of the tubular member 20 to the proximal end of the coil 24. A lumen 28 having an inner diameter of about 0.5 to 2.5 mm is formed.

  As shown in FIGS. 1 and 2, a distal end electrode 10 and a plurality of intermediate ring electrodes 12 are attached to the distal end portion of the catheter tube 2, and the electrodes 10, 12 are electrically connected. Electrically connected conductors (not shown) are routed through the lumen 28 of the catheter tube 2 in an insulated manner from the handle 6 attached to the proximal end of the catheter tube 2. Each of the electrodes 10 and 12 is made of a metal material having a good thermal conductivity such as aluminum, copper, stainless steel, gold, or platinum. In particular, in order to have a good contrast property for X-rays. It is preferable that it is made of platinum. Although the outer diameter of each electrode 10 and 12 is not specifically limited, It is preferable that it is about the same as the outer diameter of the catheter tube 2, and is about 0.5-3 mm normally.

  Furthermore, the tubular member 20 constituting the distal end bending portion 4 of the catheter tube 2 is provided along the axial direction from the distal end of the tubular member 20 as shown in FIGS. 4, 5 (A) and 5 (B). Thus, the plurality of notches 40 and 42 are alternately formed up and down so as to be shifted from each other by about 180 ° in the circumferential direction by a technique such as cutting, laser processing, or wire electric discharge machining. As described above, by forming the plurality of notches 40 and 42 in the tubular member 20, even if the distal end of the catheter tube 2 is formed in a tubular shape, the distal end of the catheter tube 2 can be easily bent. It has become.

  These notches 40, 42 are adjacent to each other so that stress concentrations generated around the notches 40, 42 are not short-circuited when the distal bent portion 4 of the catheter tube 2 is bent. As shown in FIG. 3, the bottom portions 40 a and 42 a of 42 are arranged so as to overlap each other when viewed in the axial direction of the distal end bending portion 4. The overlapping range L1 between the bottom portions 40a and 42a in the adjacent cutouts 40 and 42 is 0 mm or more and is a distance smaller than the outer diameter L0 of the tubular member 20, and 0.1 × L0 ≦ L1 ≦ 0. Preferably it is in the range of 5 × L0. By providing this overlapping range, it is possible to effectively prevent the stress concentration generated at the bottom portions 40a and 42a of the notches 40 and 42 from being short-circuited. In addition, when this overlapping range is too small, it tends to be difficult to operate the bending of the catheter tube. On the other hand, if the overlapping range is too large, the mechanical strength of the distal end of the catheter tube 2 tends to be weakened.

  The widths W1 and W2 of the notches 40 and 42 depend on the outer diameter L0 of the tubular member 20 as shown in FIG. 5B, but are preferably 0.01 to 2 mm and adjacent to each other. The interval P1 between the matching notches 40 and 42 is 1 to 100 times, preferably 2 to 10 times the width W1 or W2. If the widths W1 and W2 of the notches 40 and 42 are too narrow or the interval P1 is too wide, it tends to be difficult to manipulate the distal end of the catheter tube. On the other hand, when the widths W1 and W2 are too wide or the interval P1 is too narrow, the mechanical strength at the distal end of the catheter tube 2 tends to be lowered.

  As shown in FIGS. 2 to 4, on the inner peripheral surface of the distal end of the tubular member 20, the distal ends of a pair of first operation wires 30 </ b> R and 30 </ b> L (first operation means) are, for example, The joints 31R and 31L are joined by a technique such as laser welding. The first operation wires 30R and 30L are respectively inserted into an operation tube (not shown) provided in the lumen 28 of the catheter tube 2 so as to be movable in the axial direction, and the distal end of the catheter tube 2 is inserted. Not only the bent part 4 but also the entire length of the proximal rigid part 5 extends to the handle 6 shown in FIG.

  As shown in FIG. 3, the positions of the joint portions 31R and 31L of the pair of first operation wires 30R and 30L are shifted from each other by 180 ° in the circumferential direction. The joint 31R of the first operating wire 30R is positioned so as to overlap the approximate center of the notch 40, while the other first operation is positioned approximately in the center of the notch 42 when viewed in the axial direction. The connecting portion 31L of the wire 30L is positioned so as to overlap.

  The first operation wires 30R and 30L are made of, for example, stainless metal or nickel-titanium (Ni-Ti) metal, and the outer diameters of the first operation wires 30R and 30L are particularly large. Although not limited, Preferably, it is about 0.01-0.2 mm, More preferably, it is about 0.03-0.08 mm. The operation tube through which the first operation wires 30R and 30L are inserted is, for example, a low friction coefficient fluororesin tube such as polytetrafluoroethylene (PTFE), and the inner diameter thereof is the first Although it is slightly larger than the outer diameter of the operation wires 30R and 30L, and the thickness thereof is not particularly limited, it is preferably about 0.03 to 0.08 mm.

  As shown in FIGS. 2 to 4, when one first operation wire 30 </ b> R is pulled, the distal end bending portion 4 of the catheter tube 2 bends in the direction of arrow A, and the other first operation wire 30 </ b> R. By pulling the wire 30L, the distal end bending portion 4 of the catheter tube 2 is bent in the arrow B direction.

  Furthermore, as shown in FIGS. 2 to 4, the first operation wires 30 </ b> R and 30 </ b> L are fixed to the catheter tube 2 of the electrode catheter 1 according to the embodiment of the present invention at an arbitrary position with respect to the catheter tube 2. And a pair of second operation wires 52R and 52L for deflecting the deflection member 50 to the first operation wires 30R and 30L (first operation). 2 operation means).

  The deflecting member 50 is made of, for example, a nickel-titanium (Ni-Ti) superelastic metal material. As shown in FIGS. 2 and 4, the distal end of the deflecting member 50 is the catheter tube 2. It is located at the distal end bending portion 4 and is located at the approximate center of the lumen 28 away from the inner peripheral surface of the tubular member 20. The deflection member 50 extends not only at the distal end bending portion 4 of the catheter tube 2 but also along the entire length of the proximal rigid portion 5, and further extends to the handle 6 shown in FIG. Is provided so as to be relatively movable along the axial direction with respect to the catheter tube 2.

  As shown in FIGS. 2 to 4, the distal ends of the pair of second operation wires 52 </ b> R and 52 </ b> L are formed on both surfaces of the distal end portion of the deflecting member 50 by a technique such as laser welding. The second operation wires 52R and 52L are joined at the joint portions 53R and 53L, respectively, and are movable in the axial direction inside the operation tubes (not shown) provided on both surfaces of the deflection member 50, respectively. It is inserted and extends not only at the distal end bending portion 4 of the catheter tube 2 but also along the entire length of the proximal rigid portion 5, and further extends to the handle 6 shown in FIG. As shown in FIG. 3, the pair of second operation wires 52R and 52L is arranged so that one second operation wire 52R faces the first operation wire 30R located on the upper side in FIG. On the other hand, the other second operation wire 52L is disposed so as to face the first operation wire 30L located on the lower side in FIG.

  The second operation wire is made of, for example, a stainless metal or a nickel-titanium (Ni-Ti) metal material, and the outer diameter is not particularly limited, but is preferably 0.01 to 1 mm. The degree is more preferably about 0.1 to 0.5 mm. The operation tube through which the second operation wires 52R and 52L are inserted is, for example, a fluororesin tube having a low friction coefficient such as polytetrafluoroethylene (PTFE), and its inner diameter is 2 is slightly larger than the outer diameter of the operation wires 52R and 52L, and the thickness thereof is not particularly limited, but is preferably about 0.03 to 0.08 mm. Further, as shown in FIGS. 2 and 4, a flexible member 54 made of a flexible material such as synthetic rubber, natural rubber, or elastomer is provided at the distal end portion of the deflection member 50. 50 is attached to cover the distal end.

  4 and 6, when one of the second operation wires 52R is pulled, the deflection member 50 is deflected in the direction of the arrow C in the figure, and is positioned at the distal end of the deflection member 50. The flexible member 54 to be brought into contact with one first operation wire 30 </ b> R, and the deflection member 50 fixes the first operation wire 30 </ b> R to the catheter tube 2.

  On the other hand, by pulling the other second operation wire 52L shown in FIG. 4, the deflecting member 50 is deflected in the direction of the arrow D in the figure, and the flexible member 54 located at the distal end of the deflecting member 50. Comes into contact with the other first operation wire 30 </ b> L, and the deflection member 50 fixes the first operation wire 30 </ b> L to the catheter tube 2.

  By fixing the first operation wires 30R and 30L by the deflection member 50, the point of action of the tensile force acting on the catheter tube 2 from the first operation wires 30R and 30L is deflected from the joint portions 31R and 30L. It changes to a fixed position by the member 50.

  In particular, in the present embodiment, the deflection member 50 is made of a metal material exhibiting superelasticity, so that the deflection member 50 is appropriately elastically deformed without being permanently deformed by the tension of the second operation wires 52R and 52L. Since it is deflected, the operability of the bending operation of the distal end of the catheter tube 2 is excellent.

  Further, in the present embodiment, since the flexible member 54 is provided at the tip of the deflecting member 50, the flexible member 54 is deformed and fixed so as to come into close contact with the first operation wire 30R. 1 operation wire 30R, 30L can be fixed reliably.

  Further, in the present embodiment, the deflection member 50 is provided so as to be movable relative to the catheter tube 2 along the axial direction, whereby the first operation wires 30R and 30L by the deflection member 50 are provided. Therefore, the point of action of the tensile force from the first operation wires 30R and 30L to the catheter tube 2 can be arbitrarily set.

  As shown in FIG. 1, the handle 6 of the electrode catheter 1 according to the present embodiment includes a first knob 7 that performs a bending operation of the distal end bending portion 4 of the catheter tube 2 and a second operation that performs a deflection operation of the deflecting member 50. The knob 8 is provided.

  The proximal ends of the first operating wires 30R and 30L are connected to the circumference of the first knob 7 of the handle 6. Then, by rotating the first knob 7 in one direction, the upper first operation wire 30R in FIGS. 2 and 3 is wound around the first knob 7 and pulled. In the same figure, the lower first operation wire 30L is unwound by the same amount as the tensile amount, and the distal end bending portion 4 of the catheter tube 2 is bent in the direction of arrow A shown in FIGS. It is possible.

  On the other hand, by rotating the first knob 7 in the other direction, the lower first operation wire 30L in FIG. 2 and FIG. 3 is wound around the first knob 7 and pulled. At the same time, the first operation wire 30R on the upper side is unwound from the first knob 7 in the same amount as the tensile amount, and the distal bent portion 4 of the catheter tube 2 is shown in FIGS. It is possible to bend in the direction of arrow B.

  Therefore, the distal end bending portion 4 of the catheter tube 2 can be bent in an arbitrary A direction or B direction by rotationally driving the first knob 7 of the handle 6 shown in FIG. If the handle 6 is rotated about the axis, the direction of the A direction or the B direction with respect to the catheter tube 2 can be freely set while being inserted into the body cavity.

  Further, the proximal end of each of the second operation wires 52R and 52L is connected to the circumference of the second knob 8 of the handle 6, and the proximal end of the deflection member 50 is connected to the rotation axis thereof. Is fixed. Then, by rotating the second knob 8 in one direction, the upper second operation wire 52R in FIG. 2 and FIG. 3 is wound around the second knob 8 and pulled. In the same figure, the lower second operating wire 52L is unwound from the second knob 8 by the same amount as the tensile amount, and the deflection member 50 is deflected in the direction of arrow C shown in FIGS. 2 and 3, the upper first operation wire 30 </ b> R can be fixed to the catheter tube 2.

  On the other hand, by rotating the second knob 8 in the other direction, the second operation wire 52L on the lower side in FIGS. 2 and 3 is wound around the second knob. In the figure, the upper second operation wire 52R is unwound from the second knob 8 in the same amount as the tensile amount, and the deflection member 50 is deflected in the direction of arrow D shown in FIGS. 2 and 3, the lower first operation wire 30 </ b> L can be fixed to the catheter tube 2.

  Accordingly, the tip of the deflection member 50 is deflected in an arbitrary C direction or D direction by rotationally driving the second knob 8 of the handle 6 shown in FIG. 1, and the first operation wire 30R or 30L is catheterized. It can be fixed to the tube 2.

  Furthermore, as shown in FIG. 1, the handle 6 is formed with a slide hole 9 along the axial direction, and the second knob 8 can be slid along the slide hole 9. ing. When the second knob 8 is slid to the distal end side along the slide hole 9, the deflecting member 50 is relatively moved with respect to the catheter tube 2 in the direction of arrow E shown in FIGS. It can be moved.

  On the other hand, when the second knob 8 is slid toward the proximal end side along the sliding hole 9, the deflecting member 50 is relatively moved with respect to the catheter tube 2 in the direction of the arrow F shown in FIGS. It is possible to move it.

  Accordingly, the tip of the deflection member 50 is moved relative to the catheter tube 2 in any E direction or F direction by sliding the second knob 8 of the handle 6 shown in FIG. 1 in the axial direction. Thus, the fixed positions of the first operation wires 30R and 30L by the deflection member 50 can be varied.

  As another embodiment of the present invention, as shown in FIG. 7, a flap portion 58 that can be hinged to the support member 56 is provided at the distal end of the support member 56 inserted into the lumen 28 of the catheter tube 2. The catheter tube 2 may be configured by fixing the distal ends of the second operation wires 52R and 52L on both surfaces of the flap portion 58. In this catheter tube 2, by pulling one second operation wire 52 </ b> R or 52 </ b> L, the flap portion 58 is hinged with respect to the support member 56, so that the flap portion 58 is one first operation wire. The first operating wire 30R or 30L is fixed to the catheter tube 2 in contact with 30R or 30L. A flexible member 54 may be provided at the tip of the flap portion 58 to securely fix the first operation wires 30R and 30L to the catheter tube 2.

  Examples of various bending patterns at the distal end of the catheter tube according to the embodiment of the present invention will be described below.

  8 to 12 are conceptual diagrams for explaining various bending patterns of the distal end of the catheter tube according to the embodiment of the present invention, and FIGS. 8A to 8C are concepts showing the first bending pattern. FIGS. 9A to 9C are conceptual diagrams showing the second bent pattern, FIGS. 10A to 10C are conceptual diagrams showing the third bent pattern, and FIGS. 11A and 11B. ) Is a conceptual diagram showing a fourth bending pattern, and FIGS. 12A to 12D are conceptual diagrams showing a fifth bending pattern.

  First, the distal end bent portion 4 of the catheter tube 2 according to the embodiment of the present invention has a first bent pattern bent in a curved shape having a radius R1 in the A direction as shown in FIG. 8B. I can do it.

  In order to bend the distal bending portion 4 of the catheter tube 2 in this first bending pattern, the distal bending portion 4 and the deflecting member 50 of the catheter tube 2 are linear as shown in FIG. In this state, as shown in FIG. 8B, when the first knob 7 of the handle 6 is driven to rotate in the clockwise direction, the distal end bent portion 4 is bent in the A direction with the radius R1.

  On the other hand, the distal end bending portion 4 of the catheter tube 2 according to the present embodiment turns the first knob 7 counterclockwise from the state of FIG. 8A in the same manner as the first bending pattern. By rotationally driving, it is possible to obtain a shape symmetrical to that of FIG. 8B, which is bent in a curved shape having a radius R1 in the B direction as shown in FIG. 8C.

  The distal end bending portion 4 of the catheter tube 2 according to the embodiment of the present invention has a linear shape STR on the distal end side of the distal end bending portion 4 as shown in FIG. It can be set as the 2nd bending pattern bent to the curve shape of radius R1 to A direction.

  In order to bend the distal end bending portion 4 of the catheter tube 2 in the second bending pattern, first, in the state shown in FIG. 8A, as shown in FIG. 9A, the second knob of the handle 6 is used. 8 is rotated clockwise to deflect the deflecting member 50 in the C direction, and the first operation wire 30R is fixed to the catheter tube 2. By fixing the first operation wire 30R by the deflecting member 50, the shape from the distal end of the catheter tube 2 to the joint portion 31R is fixed in a linear shape STR, and from the first operation wire 30R. The point of action of the tensile force on the catheter tube 2 moves from the joint 31R to a fixed position by the deflecting member 50. Next, from this state, as shown in FIG. 9B, by rotating the first knob 7 of the handle 6 clockwise, the proximal end side of the tip bending portion 4 has a radius R1 in the A direction. Bend.

  On the other hand, the distal end bending portion 4 of the catheter tube 2 according to the present embodiment turns the second knob 8 counterclockwise from the state of FIG. 8A in the same manner as the second bending pattern. By rotating and then rotating the first knob 7 counterclockwise, the distal end side of the tip bending portion 4 as shown in FIG. It is also possible to make it a symmetrical shape with FIG. 9B in which the distal end side is bent in the B direction into a curved shape with a radius R1.

  Further, the distal end bending portion 4 of the catheter tube 2 according to the present embodiment bends the distal end side of the distal end bending portion 4 as shown in FIG. It can be set as the 3rd bending pattern which made the proximal end side the linear shape STR.

  In order to bend the distal end bending portion 4 of the catheter tube 2 in this third bending pattern, first, as shown in FIG. 8B, the first knob of the handle 6 is moved from the state shown in FIG. 7 is rotated in the clockwise direction, and the distal end bending portion 4 of the catheter tube 2 is bent in a curve shape having a radius R1 in the A direction. Next, as shown in FIG. 10A, the second knob 8 of the handle 6 is rotationally driven clockwise to deflect the deflecting member 50 in the C direction and bend at the radius R1. One first operation wire 30 </ b> R is fixed to the catheter tube 2. By fixing the first operation wire 30R by the deflection member 50, the shape from the distal end of the catheter tube 2 to the joint portion 31R is fixed in a curved shape having a radius R1, and the first operation wire is fixed. The point of action of the tensile force from 30R to the catheter tube 2 moves from the joint 31R to a fixed position by the deflecting member 50. From this state, as shown in FIG. 10B, when the first knob 7 of the handle 6 is driven to rotate counterclockwise, the proximal end side of the tip bending portion 4 returns to a linear shape, the tip The distal end side of the bent portion 4 has a radius R1, and the proximal end side thereof has a linear shape STR.

  On the other hand, the distal end bending portion 24 of the catheter tube 2 according to this embodiment is configured to turn the first knob 7 counterclockwise from the state of FIG. 8A in the same manner as the third bending pattern. By rotating and rotating the second knob 8 counterclockwise, the first knob 7 of the handle 6 is returned to the clockwise direction, whereby the bent end portion 4 as shown in FIG. It is also possible to make the distal end side of FIG. 10B bend left and right in the B direction into a curved shape having a radius R1, and to make the proximal end side a straight shape STR, and to have a symmetrical shape in FIG.

  Further, the distal bent portion 4 of the catheter tube 2 according to the present embodiment has a radius R1 in the A direction at the distal end side of the distal bent portion 4 as shown in FIG. A radius R2 smaller than the radius R1 in the A direction (R1> R2) can be formed as a fourth bent pattern having a multi-stage curved shape as a whole.

  In order to bend the distal end bending portion 4 of the catheter tube 2 into the fourth bending pattern, first, as shown in FIG. 8 (B), the first knob of the handle 6 in the state shown in FIG. 8 (A). 7 is rotated in the clockwise direction, and the distal end bending portion 4 of the catheter tube 2 is bent in a curve shape having a radius R1 in the A direction. Next, as shown in FIG. 10A, the second knob 8 of the handle 6 is rotationally driven clockwise to deflect the deflecting member 50 in the C direction and bend at one radius R1. The one operation wire 30 </ b> R is fixed to the catheter tube 2. By fixing the first operation wire 30R by the deflection member 50, the shape from the distal end of the catheter tube 2 to the joint portion 31R is fixed in a curved shape having a radius R1, and the first operation wire is fixed. The point of action of the tensile force from 30R to the catheter tube 2 moves from the joint 31R to a fixed position by the deflecting member 50. From this state, as shown in FIG. 11A, the first knob 7 of the handle 6 is further rotated in the clockwise direction, whereby the proximal end side of the tip bending portion 4 is bent in the A direction with a radius R2. .

  On the other hand, the distal end bending portion 4 of the catheter tube 2 according to the present embodiment turns the first knob 7 counterclockwise from the state of FIG. 8A in the same manner as the fourth bending pattern. After the second knob 8 is rotated and driven in the counterclockwise direction, the first knob 7 is further driven to rotate in the counterclockwise direction, whereby the bent end portion as shown in FIG. 4 has a radius R1 in the B direction and a radius R2 in the B direction, and has a multi-stage curved shape as a whole, and has a symmetrical shape in FIG. Is also possible.

  Furthermore, the distal end bending portion 4 of the catheter tube 2 according to the present embodiment has a long linear shape STR on the distal end side of the distal end bending portion 4 as shown in FIG. A fifth bent pattern that is bent in a curve shape having a radius R1 in the A direction can be obtained. In the fifth bent pattern, the linear shape STR on the distal end side of the tip bent portion 4 is formed longer than the above-described second bent pattern shown in FIG. 9B.

  In the state shown in FIG. 8 (A), the distal end bent portion 4 of the catheter tube 2 is in the state shown in FIG. 8 (A). First, as shown in FIG. 12 (A), the second knob 8 of the handle 6 is slid. The deflecting member 50 is moved in the F direction relative to the catheter tube 2 by sliding toward the proximal end side along the use hole 9. Next, as shown in FIG. 12B, the second knob 8 of the handle 6 is driven to rotate clockwise, the deflection member 50 is deflected in the C direction, and the first operation wire 30R is moved to the catheter. Fix to the tube 2. By fixing the first operation wire 30R by the deflecting member 50, the shape from the distal end of the catheter tube 2 to the joint portion 31R is fixed in a linear shape STR, and from the first operation wire 30R. The point of action of the tensile force on the catheter tube 2 moves from the joint 31R to a fixed position by the deflecting member 50. From this state, as shown in FIG. 12 (C), the first knob 7 of the handle 6 is driven to rotate clockwise, whereby the proximal end side of the tip bending portion 4 is bent in the A direction with a radius R1.

  On the other hand, the distal end bending portion 4 of the catheter tube 2 according to the present embodiment moves the second knob 8 from the state shown in FIG. 8A to the proximal end side in the same manner as the fifth bent shape. After the second knob 8 is driven to rotate counterclockwise, the first knob 7 is driven to rotate counterclockwise, so that the tip bent portion 4 as shown in FIG. The distal end side may be a linear shape STR, and the proximal end side may be bent in a symmetrical shape with FIG. In this bending pattern, the linear shape STR on the distal end side of the tip bending portion 4 is formed longer than the bending pattern shown in FIG.

  In any of the above bending patterns, the radius R1 of the tip bending portion 24 is reduced by increasing the tensile amount of the first operating wires 30R and 30L by the first knob 7, and the tip bending portion is reduced. 24 can be a curved shape with a small curvature. On the other hand, by reducing the amount of tension of the first operating wires 30R and 30L by the first knob 7, the radius R1 of the distal end bending portion 24 is increased, and the distal end bending portion 24 is curved with a large curvature. It can be. Therefore, the distal end bending portion 24 of the catheter tube 2 according to the present embodiment can have a curved shape with an arbitrary curvature by changing the tensile amount of the first operation wires 30R and 30L. .

  As described above, in the catheter according to the embodiment of the present invention, the deflection member is deflected by the second operation wire, and the first operation wire is fixed relatively to the catheter tube at an arbitrary position. Then, by changing the point of action of the tensile force acting on the catheter tube from the first operation wire, the distal end of the catheter tube can be arbitrarily shaped when the distal end of the catheter tube is bent by the first operation wire. Therefore, it is possible to perform electrophysiological diagnosis in many parts with one catheter without preparing various bending pattern variations corresponding to the part to be measured in cardiac electrophysiology examination etc. It becomes.

  The embodiment described above is described for facilitating the understanding of the present invention, and is not described for limiting the present invention. Therefore, each element disclosed in the above embodiment is intended to include all design changes and equivalents belonging to the technical scope of the present invention.

  In the above-described embodiment, the electrode catheter used for the measurement of the intracardiac electrocardiogram has been described. However, the present invention is not particularly limited to this. For example, the present invention is applied to a catheter used for excision of heart tissue. May be.

  In the above-described embodiment, the first tube for operation is used to bend the tip of the catheter tube in the A direction or the B direction. However, the present invention is particularly limited to this. For example, the distal end of the catheter tube may be bent in four directions using, for example, four first operation wires, and in that case, the first operation wires are opposed to each first operation wire. As described above, four second operation wires may be provided.

  Furthermore, in the above-described embodiment, the first operation wire is fixed to the catheter tube by deflecting the second operation wire. However, the present invention is not particularly limited to this. For example, instead of the second operation wire, a balloon that can be inflated / deflated is provided at the tip of a support member that is movable in the axial direction, and the balloon is inflated, whereby the first operation wire is It is good also as a structure fixed with respect to a catheter tube in arbitrary positions.

FIG. 1 is a schematic side view of an electrode catheter according to an embodiment of the present invention. 2 is a cross-sectional view of the catheter tube shown in FIG. 1 taken along the line II-II. 3 is a schematic cross-sectional view of the catheter tube shown in FIG. 1 along the III-III direction. FIG. 4 is an internal exploded perspective view of the catheter tube shown in FIG. 5A is a plan view of the tubular member shown in FIG. 4, and FIG. 5B is a side view of the tubular member shown in FIG. FIG. 6 is a schematic perspective view of the distal end of the catheter tube according to the embodiment of the present invention. FIG. 7 is a schematic perspective view of the distal end of a catheter tube according to another embodiment of the present invention. FIGS. 8A to 8C are conceptual diagrams for explaining various bending patterns at the tip of the catheter tube according to the embodiment of the present invention, and a concept showing a first bending pattern at the tip of the catheter tube. FIG. FIGS. 9A to 9C are conceptual diagrams for explaining various bending patterns at the distal end of the catheter tube according to the embodiment of the present invention, and a concept showing a second bending pattern at the distal end of the catheter tube. FIG. 10A to 10C are conceptual diagrams for explaining various bending patterns at the distal end of the catheter tube according to the embodiment of the present invention, and a concept showing a third bending pattern at the distal end of the catheter tube. FIG. 11A and 11B are conceptual diagrams for explaining various bending patterns at the distal end of the catheter tube according to the embodiment of the present invention, and a concept showing a fourth bending pattern at the distal end of the catheter tube. FIG. 12A to 12D are conceptual diagrams for explaining various bending patterns at the distal end of the catheter tube according to the embodiment of the present invention, and a concept showing a fifth bending pattern at the distal end of the catheter tube. FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Electrode catheter 2 ... Catheter tube 4 ... Tip bending part 5 ... Hand rigid part 6 ... Operation handle 7 ... 1st knob 8 ... 2nd knob 9 ... Slide hole 10, 12 ... Electrode 20 ... Tubular member 22 ... distal end side tube 24 ... coil 26 ... proximal side tube 28 ... lumens 30R and 30L ... first operation wires 31R and 31L ... joints 40 and 42 ... notches 40a and 42a ... bottom 50 ... deflection members 52R and 52L ... Second operation wire 53R, 53L ... Junction 54 ... Flexible member 56 ... Support member 58 ... Flap part

Claims (10)

A catheter tube having a bendable tip;
A first operation wire having one end relatively fixed with respect to the distal end of the catheter tube, and the first operation wire is moved to bend the distal end of the catheter tube; And a second operation means capable of fixing the first operation wire of the first operation means relative to the catheter tube at an arbitrary position. In addition ,
The second operation means includes a deflection member and a second operation wire having one end fixed to a tip of the deflection member, and moving the second operation wire A catheter for deflecting the deflecting member so as to contact the first operating wire . The catheter according to claim 1 , wherein the second operation means is provided to be movable relative to the catheter tube along an axial direction of the catheter tube. The catheter tube has a bendable tubular member to the distal end, said one end of the first operating wire is catheter according to claim 1 or 2 is fixed to the distal end of the tubular member. The catheter according to any one of claims 1 to 3, wherein the deflecting member is made of a metal material exhibiting superelasticity. The catheter according to any one of claims 1 to 4, wherein the deflection member has a flexible member at a tip thereof that is relatively flexible with respect to the deflection member. A catheter tube having a bendable tip;
A first operation wire having one end relatively fixed with respect to the distal end of the catheter tube, and the first operation wire is moved to bend the distal end of the catheter tube; A catheter comprising:
A second operation means capable of fixing the first operation wire of the first operation means relative to the catheter tube at an arbitrary position;
The second operation means includes a support member, a flap portion provided at a tip of the support member so as to be capable of hinge operation with respect to the support member, and a second operation in which one end is fixed to the flap portion. And a catheter that hinges with respect to the support member so that the flap portion contacts the first operation wire by moving the second operation wire. The catheter according to claim 6 , wherein the second operation means is provided to be movable relative to the catheter tube along an axial direction of the catheter tube. The catheter according to claim 6 or 7 , wherein the catheter tube has a bendable tubular member at a distal end, and one end of the first operation wire is fixed to the distal end of the tubular member. The catheter according to any one of claims 3 to 5 and 8, wherein the tubular member is formed with a plurality of notches. The catheter according to claim 3 , wherein the tubular member is made of a metal material exhibiting superelasticity.

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