JP4672188B2 - Ultrasound catheter - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an ultrasonic catheter used by being inserted into a body cavity such as a blood vessel and a blood vessel.
[0002]
[Prior art]
In order to examine an affected part in a body cavity such as a blood vessel and a vascular vessel, an ultrasonic catheter that transmits and receives ultrasonic waves in the affected part is used. This ultrasonic catheter has an imaging core including a transducer unit for transmitting and receiving ultrasonic waves and a drive shaft that rotates the transducer unit, and a sheath that covers the imaging core and is inserted into a body cavity. ing. The imaging core is movable in the axial direction within the sheath.
[0003]
When using an ultrasonic catheter, first place the imaging core in the sheath in advance on the most distal side, carry the sheath deeper than the affected area, and then leave only the imaging core with the sheath left. It is moved backward from the affected area. By retracting only the imaging core, the transducer unit moves from the deep part through the affected part, so that ultrasonic observation can be continuously performed before and after the affected part, and three-dimensional data of shapes such as blood vessels and vessels Can be created. It is also possible to reconfirm the affected area and create three-dimensional data by moving the imaging core once retracted.
[0004]
When the imaging core is moved back and forth, the imaging core may bend and meander due to friction between the imaging core and a tube passing through the imaging core, resulting in buckling of the imaging core. In order to prevent this buckling, the conventional ultrasonic catheter has been improved in the buckling strength by impregnating the imaging core with resin or the like.
[0005]
[Problems to be solved by the invention]
However, in the conventional ultrasonic catheter, even if the imaging core is impregnated with resin or the like to prevent buckling, the impregnation tends to cause unevenness, which affects the rotation accuracy of the transducer unit. As a result, there is a problem that an image observed from the vibrator unit is adversely affected.
[0006]
The present invention has been made in view of the above problems, and an object of the present invention is to provide an ultrasonic catheter capable of preventing the imaging core from buckling and maintaining the rotational accuracy of the transducer unit at a high level.
[0007]
[Means for Solving the Problems]
The above object of the present invention is achieved by the following means.
[0008]
(1) An ultrasonic catheter according to the present invention is fixed to a sheath inserted into a body cavity, a drive shaft that is inserted into the sheath and transmits a mechanical driving force, and a sheath-side tip of the drive shaft. An ultrasonic detection means, a hub that moves the drive shaft in the axial direction of the sheath by moving while holding the drive shaft, and an outer portion fixed to the hub side of the sheath or the sheath side of the hub A tube, and an inner tube fixed to a side different from the outer tube on the hub side of the sheath and the sheath side of the hub, and moved relative to the outer tube in the outer tube as the hub moves The drive shaft is fixed to the same side as the outer tube of the hub side of the sheath and the sheath side of the hub, and is moved in the inner tube as the inner tube moves in the outer tube, And having a protective tube passing through the inner.
[0009]
(2) The outer tube is fixed to the sheath, the inner tube is fixed to the hub, and the protective tube is fixed to the outer tube.
[0010]
(3) A hole is formed in the protective tube.
[0011]
(4) The protective tube is a coiled tube.
[0012]
(5) An ultrasonic catheter according to the present invention is fixed to a sheath inserted into a body cavity, a drive shaft that is inserted into the sheath and transmits a mechanical driving force, and a sheath side tip of the drive shaft. An ultrasonic detection means, a hub that moves the drive shaft in the axial direction of the sheath by moving while holding the drive shaft, and an outer portion fixed to the hub side of the sheath or the sheath side of the hub A tube, an inner tube fixed to a side different from the outer tube among the hub side of the sheath and the sheath side of the hub, and moved relative to the outer tube in the outer tube as the hub moves, And a protective tube having a flow path provided at an end portion of the inner tube on which the inner tube is not fixed, allowing the drive shaft to pass through the inside and allowing liquid to be inserted between the inside and the outside.
[0013]
(6) A stopper that prevents the outer tube from coming off is provided at a boundary portion between the inner tube and the protective tube.
[0014]
(7) The protective tube is a coiled tube connected to the inner tube.
[0015]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described below with reference to the drawings.
[0016]
(First embodiment)
FIG. 1 is a view showing an ultrasonic catheter of the present invention, and FIG. 2 is a view showing a joint portion between a distal end portion and a main body portion of the ultrasonic catheter.
[0017]
The ultrasonic catheter 1 includes a sheath 2 that is inserted into a body cavity and an operation unit 3 that is not inserted into the body cavity and is disposed on the user's hand side for operation by the user.
[0018]
The sheath 2 has a sheath tip member 21 and a sheath body 22. As shown in FIG. 2, the sheath tip member 21 and the sheath body portion 22 are bonded to each other via a filling liquid inlet / outlet member 23 so as to cover the sheath tip member 21.
[0019]
An X-ray contrast marker 24 is provided between the sheath distal end member 21 and the sheath main body 22 so that the distal end position of the ultrasonic catheter can be confirmed under fluoroscopy when inserted into a body cavity.
[0020]
A hole 241 is formed in the sheath body 22, and the guide wire 25 inserted into the sheath distal end member 21 passes through the hole 241. The guide wire 25 is inserted into the body cavity in advance, and the ultrasonic catheter 1 is guided to the affected area while passing the guide wire 25 through the sheath distal end member 21.
[0021]
In addition, the filling liquid inlet / outlet member 23 and the sheath main body 22 are formed with a priming lumen 221 that is a hole for allowing a physiological saline solution filled in the sheath main body portion 22 to flow to the outside.
[0022]
An imaging core 40 is incorporated in the sheath 2 so as to be slidable in the axial direction of the sheath 2. The imaging core 40 includes a transducer unit 41 for transmitting and receiving ultrasonic waves toward the body cavity tissue, and a drive shaft 42 that attaches the transducer unit 41 to the tip and rotates the transducer unit 41. The transducer unit 41 includes an ultrasonic transducer 411 that transmits and receives ultrasonic waves, and an ultrasonic transducer housing 412 that houses the ultrasonic transducer 411.
[0023]
The drive shaft 42 is flexible and has a characteristic capable of transmitting the rotational power generated in the operation unit 3 to the vibrator unit 41. For example, the drive shaft 42 is a multilayer such as a three-layer coil in which the right and left and the winding directions are alternated. It consists of a coiled tube. When the driving shaft 42 transmits the rotational power, the vibrator unit 41 rotates, and the affected part in the body cavity such as a blood vessel and a vascular vessel can be observed 360 degrees. The drive shaft 42 has a signal line for transmitting a signal detected by the vibrator unit 41 to the operation unit 3.
[0024]
The operation unit 3 includes a hub 31 having a port 311 for injecting a physiological saline solution for bleeding air, a unit connector 32 connected to the hub 31 via an inner tube 312, and a unit connector 32 via an outer tube 331. And a relay connector 33 for connecting the sheath 2 and the operation unit 3.
[0025]
The hub 31 holds the drive shaft 42 and the inner tube 312. When the inner tube 312 is pushed into or pulled out of the unit connector 32 and the outer tube 331, the drive shaft 42 is interlocked and slides in the operation unit 3 and the sheath 2 in the axial direction. The state of movement of the drive shaft 42 by pushing and pulling out the inner tube 312 is as shown in FIGS.
[0026]
3 is a diagram showing the ultrasonic catheter 1 when the inner tube 312 is most pushed into the unit connector 32, and FIG. 4 is a diagram showing the ultrasonic catheter 1 when the inner tube 312 is most pulled out from the unit connector 32. is there.
[0027]
When the inner tube 312 is pushed in the most, as shown in FIG. 3, the end of the inner tube 312 reaches the vicinity of the end of the outer tube 331 on the sheath 2 side, that is, the vicinity of the relay connector 33. In this state, the transducer unit 41 is located near the distal end of the sheath body 22 of the sheath 2.
[0028]
When the inner tube 312 is pulled out most, as shown in FIG. 4, the stopper 313 formed at the tip of the inner tube 312 is caught by the inner wall of the unit connector 32, and the portions other than the vicinity of the caught tip are exposed. In this state, the transducer unit 41 is pulled back while leaving the sheath 2, so that the transducer unit 41 is positioned at a position facing the operation unit 3 by the amount that the inner tube 312 is pulled out. By moving the transducer unit 41 while rotating, it is possible to create three-dimensional data of shapes such as blood vessels and blood vessels.
[0029]
Next, a specific structure of each part of the ultrasonic catheter 1 will be described.
[0030]
FIG. 5 is a longitudinal sectional view of the hub 31.
[0031]
As shown in FIG. 5, the hub 31 includes a joint 50, a male connector 51, a rotor 52, a connection pipe 53, a signal line 54, a hub body 55, a seal member 56, and a kink protector 57. Have.
[0032]
The joint 50 has an opening 501 on the user's hand side of the ultrasonic catheter 1 and arranges the male connector 51 and the rotor 52 therein. The male connector 51 can connect a female connector of an external drive device (not shown) from the opening 501 side of the joint 50, thereby enabling mechanical and electrical connection between the external drive device and the male connector 51. Become.
[0033]
The rotor 52 holds the connection pipe 53 in a non-rotatable manner and rotates integrally with the male connector 51. The connection pipe 53 holds the drive shaft 42 at the end opposite to the rotor 52 side in order to transmit the rotation of the rotor 52 to the drive shaft 42. A signal line 54 is passed through the connection pipe 53. One end of the signal line 54 is connected to the male connector 51, and the other end is connected to the vibrator unit 41 through the drive shaft 42. The observation result in the transducer unit 41 is transmitted to the external drive device via the male connector 51, subjected to appropriate processing, and displayed as an image.
[0034]
The hub body 55 is injected with physiological saline from the port 311 and introduces the physiological saline into the inner tube 312 without leaking outside. In addition, since the sealing member 56 including the O-ring 58 is installed between the hub main body 55 and the joint 50, the physiological saline does not leak to the opening 501 side of the joint 50.
[0035]
A part of the inner tube 312 is fitted into the hub body 55, and the kink protector 57 is disposed around the inner tube 312 and the hub body 55. The kink protector 57 is formed of a material having an intermediate hardness between the hardness of the inner tube 312 and the hardness of the hub body 55, and the inner tube 312 is bent and twisted at a portion where the inner tube 312 is exposed from the hub body 55. Etc. can be prevented.
[0036]
In the inner tube 312, the protective tube 7 is disposed between the drive shaft 42 and the inner tube 312. The protective tube 7 is open at the end on the hub 31 side and is not held at all, that is, has a free end 71. The protective tube 7 extends to the outer tube 331 shown in FIG.
[0037]
FIG. 6 is a longitudinal sectional view of the unit connector 32 and the relay connector 33.
[0038]
The unit connector 32 includes a unit connector main body 61, a sealing member 62, a cover member 63, and a packing 64.
[0039]
In the unit connector main body 61, an outer tube 331 attached to the relay connector 33 is inserted, and an inner tube 312 extending from the hub 31 is inserted into the outer tube 331. The sealing member 62 is combined with the unit connector main body 61 to hold the packing 64, and the cover member 63 is combined with the unit connector main body 61 to hold the outer tube 331. Since the packing 64 is sealed between the unit connector main body 61 and the sealing member 62, the physiological saline supplied to the port 311 of the hub 31 flows into the outer tube 331 through the inner tube 312. Does not leak out of the unit connector 32.
[0040]
Further, since the inner pipe 312 extending from the hub 31 is formed with a stopper 313 at the tip, even when the hub 31 is most pulled, that is, when the inner pipe 312 is most pulled out from the outer pipe 331, the stopper 313 is provided as a unit. The inner tube 312 is not pulled out from the unit connector 32 by being caught on the inner wall of the connector main body 61.
[0041]
The relay connector 33 includes an outer tube holding portion 65 and a relay connector main body 66. The outer tube holding part 65 holds the outer tube 331. Further, the outer tube holding portion 65 and the relay connector main body 66 are combined to form a drive shaft 42 that passes through the outer tube 331 and a path for introducing physiological saline into the sheath 2. A plurality of tubes are inserted in this path, and these tubes prevent buckling of the drive shaft 42 and leakage of physiological saline.
[0042]
The outer tube 331 held by the outer tube holding portion 65 has a protective tube 7 fixed to the inner wall of the outlet 332 through which the drive shaft 42 passes. The protective tube 7 extends into the inner tube 312 extending from the hub 31. Therefore, when the inner tube 312 is pushed into the outer tube 331, the protective tube 7 is pushed into the inner tube 312 in the direction opposite to the pushing direction. The protective tube 7 is formed of a metal coiled coiled tube. For this reason, physiological saline can flow from the gap between the coils, so that air may remain in the outer tube 331. Absent.
[0043]
As described above, in the ultrasonic catheter 1 of the present invention, since the inner tube 312 can be pushed into the outer tube 331, the user can push and pull the hub 31 toward the unit connector 32, and the imaging core 40 can move in the ultrasound catheter 1. When the inner tube 312 is pushed into or pulled out from the outer tube 331, the protective tube 7 is also pushed or pulled out relative to the inner tube 312 from the opposite direction. Even if friction occurs and a bending force is generated on the drive shaft 42, the bending force can be suppressed by the protective tube 7, and bending or the like can be prevented.
[0044]
Furthermore, since the ultrasonic catheter 1 of the present invention prevents the drive shaft 42 from being bent using the protective tube 7, it is not necessary to cover the drive shaft 42. The accuracy of the image is not affected, and as a result, the image observed from the transducer unit is not adversely affected.
[0045]
Next, the operation of the ultrasonic catheter 1 when observing the inside of the body cavity of the present invention will be described.
[0046]
Before the sheath 2 of the ultrasonic catheter 1 is inserted into the body cavity, a priming operation for filling the ultrasonic catheter 1 with physiological saline is performed. By performing this priming operation, air in the ultrasonic catheter 1 can be removed and air can be prevented from entering into a body cavity such as a blood vessel.
[0047]
In the priming operation, first, physiological saline is injected from the port 311 in a state where the hub 31 is most pulled toward the user's hand, that is, in a state where the inner tube 312 is most pulled out from the outer tube 331. The injected physiological saline solution is filled into the sheath 2 in order from the hub 31. When the ultrasonic catheter 1 is completely filled with physiological saline, the physiological saline is removed from the priming lumen 221 formed on the sheath tip member 21 of the sheath 2. Thereby, filling of the physiological saline is confirmed. The filling of the physiological saline may be confirmed by injecting the physiological saline from the priming lumen 221 and overflowing the physiological saline from the port 311.
[0048]
Next, the hub 31 is pushed in and the sheath 2 is inserted into the body with the inner tube 312 pushed most into the outer tube 331. The insertion of the sheath 2 is stopped after the distal end of the sheath 2 passes over the affected area. While the position is fixed and the hub 31 is pulled toward the hand, the vibrator unit 41 observes the front and rear of the affected area.
[0049]
When the hub 31 that has been pulled once is pushed in again and the affected part is observed, the drive shaft 42 enters the narrow sheath 2 so that the insertion resistance increases. However, in the present invention, the protective tube 7 is provided, so that it is bent. Will not occur. Even if the drive shaft 42 bends, the protection tube 7 is formed in a loosely coiled tubular body, so that the drive shaft 42 does not buckle because it bends gently. Therefore, the hub 31 can be operated smoothly.
[0050]
The ultrasonic catheter 1 of the present invention has been described above, but the present invention is not limited to this. For example, the outer tube 331 is fixed to the relay connector 33 and the inner tube 312 is fixed to the hub 31. On the contrary, the outer tube 331 is fixed to the hub 31 and the inner tube 312 is fixed to the relay connector 33. May be. Further, the protective tube 7 may be attached to any one of the hub 31, the unit connector 32, and the relay connector 33 instead of the outer tube 331, and the protective tube 7 itself is not an independent member but extends the sheath 2. It may be in the form.
[0051]
Further, the protective tube 7 may be a tube formed of a fluororesin such as PTFE instead of a metal. Further, the protective tube 7 may be a tube having at least one slit or hole instead of a loosely coiled tube. In this case, since air tends to remain in the vicinity of the outlet 332 of the outer tube 331, it is desirable that a hole or the like be formed in the vicinity of the outlet 332 so that the air is pushed out. The protective tube 7 may be a composite material such as a metal pipe having a hole in the side surface and a resin tube joined to the metal pipe.
[0052]
Although the ultrasonic catheter 1 of the present invention has the relay connector 33, the protective tube 7 and the outer tube 331 may be directly joined to the sheath 2 by thermal fusion or the like without having the relay connector 33. The positional relationship between the outer tube 331 and the inner tube 312 may be reversed, that is, the inner tube may be attached immediately after the sheath 2 (relay connector 33), and the outer tube may be attached to the hub.
[0053]
Further, the port 311 may be provided in the unit connector 32 or may be connected to both the unit connector 32 and the hub 31. In addition, a lubricant such as silicone oil may be applied to the outer peripheral surface of the inner tube 312 and the inner peripheral surface of the packing 64 in order to improve the sliding between the inner tube 312 and the packing 64. A plurality of O-rings 58 and packings 64 may be provided.
[0054]
(Second Embodiment)
In the first embodiment, the protective tube 7 fixed to the inner wall of the outlet 332 of the outer tube 331 extends so as to pass through the inner tube 312. On the other hand, in the second embodiment, the protective tube 7 is provided at the end portion of the inner tube 312 that is not fixed, that is, the end portion where the stopper 313 is formed.
[0055]
In the following description, the same members as those in the first embodiment are denoted by the same reference numerals, and the description thereof is omitted.
[0056]
FIG. 7 is a longitudinal sectional view of the hub 31 in the second embodiment, and FIG. 8 is a longitudinal sectional view of the unit connector 32 and the relay connector 33 in the second embodiment.
[0057]
Unlike the case shown in FIG. 5, the protective tube 7 does not pass through the inner tube 312 shown in FIG.
Instead, the protective tube 70 is attached to the inner tube 312 via a stopper 313 as shown in FIG. The protective tube 70 extends from the stopper 313 side toward the relay connector 33 side, and passes the drive shaft 42 therein.
[0058]
As described above, as shown in FIGS. 7 and 8, the protective tube 70 extends from the stopper 313 of the inner tube 312, and the drive shaft 42 passes through the protective tube 70, whereby the drive shaft 42 is connected to the protective tube 70 and the inner tube 312. Therefore, buckling of the drive shaft 42 can be prevented.
[0059]
In FIG. 8, the protective tube 70 is formed separately from the inner tube 312. However, the protective tube 70 is not an independent form, but is an extended form of the inner tube 312, and has a plurality of side holes on the tip side from the stopper. Or a slit may be provided as a flow path.
[0060]
The outer pipe 331 is fixed to the relay connector 33 and the inner pipe 312 is fixed to the hub 31. On the contrary, the outer pipe 331 is fixed to the hub 31 and the inner pipe 312 is fixed to the relay connector 33. May be.
[0061]
Moreover, the protective tube 70 shown in FIGS. 7 and 8 is formed of a coiled tubular body. Therefore, the physiological saline solution supplied to the port 311 can freely pass through the inside and outside of the protective tube 70, and the inside of the ultrasonic catheter 1 can be filled with the physiological saline solution.
[0062]
【The invention's effect】
In the first and second aspects of the invention, the inner tube is fixed on a side different from the outer tube, and the protective tube is fixed on the same side as the outer tube. Since the inner tube and the inner tube and the protective tube move in opposite directions, the drive shaft passing through the protective tube does not bend or buckle.
[0063]
In the invention according to claim 3, since the hole is formed in the protective tube, when the physiological saline is introduced into the ultrasonic catheter, the physiological saline can freely pass through the protective tube. .
[0064]
In the inventions according to claims 4 and 7, since the protective tube is a coiled tube, when the physiological saline is introduced into the ultrasonic catheter, the physiological saline can freely move inside and outside the protective tube. You can go through.
[0065]
In the fifth aspect of the invention, the inner tube is fixed to a side different from the outer tube, and a protective tube is provided at an unfixed end of the inner tube. Since the inner tube is relatively moved, the drive shaft passing through the protective tube does not bend or buckle.
[Brief description of the drawings]
FIG. 1 is a view showing an ultrasonic catheter of the present invention.
FIG. 2 is a view showing a joint portion between a distal end portion and a main body portion of an ultrasonic catheter.
FIG. 3 is a view showing an ultrasonic catheter when an inner tube is most pushed into a unit connector.
FIG. 4 is a view showing an ultrasonic catheter when an inner tube is most pulled out from a unit connector.
FIG. 5 is a longitudinal sectional view of a hub.
FIG. 6 is a longitudinal sectional view of a unit connector and a relay connector.
FIG. 7 is a longitudinal sectional view of a hub according to a second embodiment.
FIG. 8 is a longitudinal sectional view of a unit connector and a relay connector according to a second embodiment.
[Explanation of symbols]
1 ... ultrasonic catheter,
2 ... Sheath,
3 ... operation part,
7, 70 ... protection tube,
32 ... Unit connector,
33 ... Relay connector,
40. Imaging core,
41 ... vibrator unit,
42 ... drive shaft,
331: outer tube,
411 ... an ultrasonic transducer.

Claims (7)

A sheath inserted into the body cavity;
A drive shaft inserted into the sheath for transmitting mechanical drive force;
Ultrasonic detection means fixed to the sheath-side tip of the drive shaft;
A hub that moves the drive shaft in the axial direction of the sheath by moving while holding the drive shaft;
An outer tube fixed to the hub side of the sheath or the sheath side of the hub;
An inner tube fixed to a side different from the outer tube among the hub side of the sheath and the sheath side of the hub, and moved relative to the outer tube in the outer tube as the hub moves,
The hub side of the sheath and the sheath side of the hub are fixed to the same side as the outer tube, and are moved in the inner tube as the inner tube moves in the outer tube, and the drive shaft is moved inside. A protective tube to pass through,
An ultrasonic catheter characterized by comprising: The outer tube is fixed to the sheath;
The inner pipe is fixed to the hub;
The ultrasonic catheter according to claim 1, wherein the protective tube is fixed to the outer tube. The ultrasonic catheter according to claim 1, wherein a hole is formed in the protective tube. The ultrasonic catheter according to claim 1, wherein the protective tube is a coiled tube. A sheath inserted into the body cavity;
A drive shaft inserted into the sheath for transmitting mechanical drive force;
Ultrasonic detection means fixed to the sheath-side tip of the drive shaft;
A hub that moves the drive shaft in the axial direction of the sheath by moving while holding the drive shaft;
An outer tube fixed to the hub side of the sheath or the sheath side of the hub;
An inner tube fixed to a side different from the outer tube among the hub side of the sheath and the sheath side of the hub, and moved relative to the outer tube in the outer tube as the hub moves,
A protective tube having a flow path that is provided at an end portion of the inner tube that is not fixed, passes through the drive shaft, and allows liquid to be inserted between the inside and the outside;
An ultrasonic catheter characterized by comprising: The ultrasonic catheter according to claim 5, wherein a stopper that prevents the outer tube from coming off is provided at a boundary portion between the inner tube and the protective tube. The ultrasonic catheter according to claim 5 or 6, wherein the protective tube is a coiled tube connected to the inner tube.

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