JP5230223B2 - Transport device for tubular organ treatment tools - Google Patents

Description

  The present invention relates to a transport device for a tubular organ treatment tool used for transporting a tubular organ treatment tool such as a stent used for treatment of tubular organs such as blood vessels, ureters, bile ducts, and trachea to a predetermined location.

  In recent years, in order to prevent stenosis or occlusion, rupture of an aneurysm, etc. in tubular organs of the human body such as blood vessels, ureters, bile ducts, trachea, etc., tubular organ treatment tools such as stents are placed at predetermined locations in the tubular organs. It is widely done.

  For example, in order to place a stent in a tubular organ, in Patent Document 1 below, an outer sheath having an enlarged portion capable of accommodating the stent on the distal end side and a slidable arrangement within the outer sheath, the enlarged portion is provided. A self-expanding stent delivery device is disclosed that includes an inner shaft with a more proximal stop attached thereto. The inner shaft has a base end portion (proximal portion) made of a metal material such as stainless steel or Ni-Ti, and a tip end portion (distal portion) made of a resin material such as polyurethane. Formed and connected by a joint.

When using the stent delivery device, the distal end of the device is made to reach the target location of the tubular organ via a guide wire or the like, and then the proximal end portion of the inner shaft is held and fixed, and the outer sheath is moved to the inner side. Slide to the base end side of the shaft. At this time, the proximal end of the stent is held by the stopper of the inner shaft, the stent is prevented from moving along with the sliding of the outer sheath, and is released so that the stent is pushed out from the distal end opening of the outer sheath. It is designed to be placed at the target location of the tubular organ.
JP 2000-245846 A

  In the conveyance device described in Patent Document 1, as described above, the proximal end side of the inner shaft is formed of a highly rigid metal material, but the distal end side is formed of a softer resin material than the metal material. Yes.

  For this reason, when the outer sheath is slid to the proximal end side of the inner shaft in order to push the stent out of the outer sheath, the distal end side of the inner shaft may contract in the axial direction. As a result, even if the outer sheath is slid, the stent is not pushed out unless the distal end side of the inner shaft is considerably contracted. Therefore, it is difficult to accurately grasp how much of the slide is pushed out. It was happening.

  Furthermore, when the stent is released, the distal end side of the inner shaft is contracted and protrudes from the distal end opening of the outer sheath, so that the stent suddenly pops out due to the repulsive force of the inner shaft extending to the original length. As a result, the stent placement work may be hindered.

  Accordingly, an object of the present invention is to provide a transporter for a tubular organ treatment tool that can place a tubular organ treatment tool such as a stent smoothly and with good workability at a target site of the tubular organ.

  In order to achieve the above object, a first aspect of the present invention includes an outer sheath and an inner sheath slidably disposed within the outer sheath, and a tubular organ treatment instrument is disposed on the inner periphery of the distal end portion of the outer sheath. Then, the tubular organ treatment instrument can be opened from the distal end portion of the outer sheath by sliding the outer sheath while the tubular organ treatment instrument is in contact with the distal end portion of the inner sheath. In the transport device for a tubular organ treatment instrument, the inner sheath has a metal tube, and the metal tube has a kerf formed on the distal end side, and is made more flexible than the proximal end side. It further has a guide tube made of a resin that can be inserted through the inner circumference of the metal tube and through which a guide wire can be inserted or a liquid can flow, and the guide from the tip of the metal tube. The distal end portion of the tube is inserted, the distal end surface of the metal tube is stepped, and the tubular organ treatment instrument is arranged on the outer periphery of the distal end portion of the guide tube. The present invention provides a transport device for a tubular organ treatment device.

According to the above invention, the tubular organ treatment tool is held on the inner periphery of the distal end portion of the outer sheath, and the inner sheath is inserted and moved into the tubular organ in a state where the inner sheath is inserted into the outer sheath. After reaching the target treatment site, the outer sheath is slid toward the proximal end side with respect to the inner sheath, so that the tubular organ treatment tool is gradually pushed out from the distal end of the outer sheath by the inner sheath, and the target treatment is released. Can be placed in place. At this time, since the inner sheath has a metal tube, the inner sheath is restrained from contracting in the axial direction, and the tubular organ treatment tool can be reliably pushed out according to the sliding amount of the outer sheath with respect to the inner sheath, Indwelling work can be performed easily and accurately.
Furthermore, the guide wire can be inserted into the guide tube disposed on the inner periphery of the metal tube so that the guide wire can protrude from the distal end of the inner sheath, and can be introduced into the tubular organ using the guide wire. . Further, the guide wire can be smoothly inserted. Furthermore, a liquid such as a contrast agent or an anticancer agent can be injected into a desired position without flowing out of the kerf.

  According to a second aspect of the present invention, in the first aspect, the kerfs are formed at predetermined intervals in the axial direction of the inner sheath, and an interval between adjacent kerfs on the distal end side is: It is an object of the present invention to provide a transport device for a tubular organ treatment tool that is formed so as to be narrower than the interval between the kerfs on the proximal end side.

  According to the above invention, the distance between the adjacent kerfs on the distal end side is narrower than the distance between the kerfs on the proximal end side, so that the distal end side of the inner sheath is more flexible than the proximal end side. It is possible to facilitate movement within the tubular organ without impairing pushability.

  According to a third aspect of the present invention, in the first or second aspect of the invention, the inner sheath transports a tubular organ treatment instrument having the metal tube and a resin tube connected to the tip of the metal tube. It provides tools.

  According to the above invention, since the most distal end portion of the inner sheath is made of a resin tube, the most distal end portion of the inner sheath is made more flexible, and the flexibility of the distal end portion of the transport device of the tubular organ treatment instrument is increased. The bending angle can be made smaller.

  According to a fourth aspect of the present invention, in any one of the first to third aspects, the groove of the metal tube has a spiral shape as a whole, and the spiral groove is along a line direction of the spiral. It is an object of the present invention to provide a transport device for a tubular organ treatment tool having a cut portion and a non-cut portion formed by being cut intermittently.

  According to the above invention, the kerf is cut intermittently and has a spiral shape in which a cut part and an uncut part are provided, so compared to a case in which a spiral kerf is provided continuously. The inner sheath is less likely to shrink, and the tubular organ treatment tool can be pushed out more accurately according to the sliding amount of the outer sheath relative to the inner sheath, and the torque transmission property that transmits the rotational force from the inner sheath proximal end to the distal end is improved. Can be made.

  According to a fifth aspect of the present invention, in the fourth aspect, the uncut portion of the cut groove of the metal tube is formed such that the angle in the circumferential direction is shifted depending on the axial position. Is to provide.

  According to the above invention, since the uncut portion is formed so that the angle in the circumferential direction is shifted depending on the axial position, it is suppressed from being easily bent only in a predetermined direction, and uniform flexibility in the circumferential direction is provided on the inside. It can be applied to the sheath.

  According to a sixth aspect of the present invention, in any one of the first to fifth aspects of the present invention, a delivery device for a tubular organ treatment device is provided in which a reinforcing body is disposed on the outer sheath.

  According to the above-described invention, the rigidity of the outer sheath is improved by the reinforcing body, and the expansion of the outer sheath is suppressed. Therefore, in combination with the difficulty of contraction of the inner sheath, the tubular organ according to the sliding amount of the outer sheath relative to the inner sheath. The treatment tool can be pushed out more accurately.

  According to the transport device of the tubular organ treatment tool of the present invention, the tubular organ treatment tool is held in the outer sheath, moved into the tubular organ, and after the distal end portion of the outer sheath reaches the target location, When the outer sheath is slid toward the proximal end with respect to the inner sheath, the tubular organ treatment tool can be pushed out from the distal end of the outer sheath and can be placed at the target location. At this time, since the inner sheath has a metal tube, the inner sheath is restrained from contracting in the axial direction, and the tubular organ treatment tool can be reliably pushed out according to the sliding amount of the outer sheath with respect to the inner sheath, Indwelling work can be performed easily and accurately.

  Hereinafter, with reference to FIGS. 1-8, one Embodiment of the insertion tool of the tubular organ treatment tool of this invention is described.

  As shown in FIG. 1, this tubular organ treatment device carrier 1 (hereinafter referred to as “transport device 1”) is a tubular organ treatment device such as a stent, and a tubular body of a human body such as a blood vessel, a ureter, a bile duct, or a trachea. It is for transporting to a predetermined part of an organ. A so-called self-expanding stent 7 is used as the tubular organ treatment tool in this embodiment. The stent 7 is formed into a cylindrical shape by knitting and / or assembling a metal wire, and a shape memory alloy to which a shape memory effect by heat treatment or superelasticity is imparted is preferably adopted as the material. However, stainless steel, Ta, Ti, Pt, Au, W, or the like may be used depending on the application. As the shape memory alloy, Ni—Ti, Cu—Al—Ni, Cu—Zn—Al, and the like are preferably used. In this embodiment, the X-ray marker (not shown) is attached to the stent 7 or the surface of the shape memory alloy is coated with a radiopaque material such as Au or Pt by means such as plating. The stent 7 imparted with radiopacity is used.

  As shown in FIG. 1, the carrier 1 includes an outer sheath 10 that houses the stent 7 in a reduced diameter state on the inner periphery of the distal end portion, and an inner sheath 20 that is slidably disposed in the outer sheath 10. have.

The outer sheath 10 is made of thermoplastic elastomer such as polyurethane, nylon elastomer, styrene elastomer, polyethylene, polypropylene, silicone, polyether block amide, polyvinyl chloride, vinyl acetate, and further polytetrafluoroethylene (PTFE), par A hollow formed from a synthetic resin such as fluororesin such as fluoroalkoxy resin (PFA), tetrafluoroethylene-hexafluoropropylene copolymer (FEP), tetrafluoroethylene-ethylene copolymer (ETFE), etc. It has a tube shape. Furthermore, the outer sheath 10 may contain a powder of BaSO ₄ , Bi, W, etc. to form a radiopaque tube, and on the outer periphery thereof, polyvinyl pyrrolidone, polyethylene glycol, methyl vinyl ether, maleic anhydride You may coat hydrophilic resins, such as coalescence. Moreover, it is good also as the outer sheath 10 which laminated | stacked the tube formed from said each resin material, and made | formed the multilayer structure.

  Further, as shown in FIG. 3, a reinforcing body 12 having a tubular braid shape is embedded in the outer sheath 10 by knitting and / or assembling a metal wire or a resin wire. As a result, the rigidity of the outer sheath 10 is improved, and the outer sheath 10 is configured not to easily expand and contract. As shown in FIG. 2, the reinforcing body 12 is disposed from a position slightly proximal to the distal end of the outer sheath 10 that houses the stent 7 to a position that reaches the proximal end of the outer sheath 10 (not shown). Has been. The reinforcing body 12 is not limited to the above braided shape, and a cylindrical body made of metal or resin may be fixed to the inner periphery or outer periphery of the outer sheath 10. Further, on the outer periphery of the proximal end portion of the outer sheath 10, a holder 14 having a substantially cylindrical shape, which is a portion to be gripped when the outer sheath 10 is slid toward the proximal end side of the inner sheath 20, is mounted.

  Next, the inner sheath 20 that is slidably arranged in the outer sheath 10 will be described. The inner sheath 20 has a hollow tube shape that is formed longer than the outer sheath 10 by a predetermined length. The inner sheath 20 has a metal tube 23 made of a metal material such as a shape memory alloy such as stainless steel, Ni—Ti, Cu—Al—Ni, or Cu—Zn—Al. A hollow tube-shaped guide tube 25 that is formed of the same material as the outer sheath 10, for example, polyurethane, nylon elastomer, and the like, through which the guide wire W can be inserted, is inserted and arranged on the inner periphery of the metal tube 23. ing.

  The guide tube 25 extends longer than the metal tube 23 by a predetermined length, and the guide tube 25 is inserted from the distal end portion and the proximal end portion of the metal tube 23 as shown in FIGS. That is, when the distal end portion of the guide tube 25 is inserted from the distal end portion of the metal tube 23, the distal end surface 23a of the metal tube 23 has a step shape, and the inner periphery of the distal end portion of the outer sheath 10 is formed on the stepped distal end surface 23a. The proximal end portion of the stent 7 whose diameter is reduced is abutted and supported.

  Moreover, as shown in FIGS. 1-3, the head 29 which diameter-expanded rather than the guide tube 25 and made the taper taper shape to the front-end | tip part outer periphery of the guide tube 25 is mounted | worn. As shown in FIG. 3, the head 29 is in contact with the distal end of the outer sheath 10. A communication hole 29 a that communicates with the guide tube 25 of the inner sheath 20 is formed at the center of the head portion 29, so that the guide wire W inserted into the guide tube 25 can be inserted.

  Further, on the outer periphery of the proximal end portion of the metal tube 23 and the proximal end portion of the guide tube 25 inserted from the proximal end portion, the outer sheath 10 is placed on the proximal end portion side of the inner sheath 20 as shown in FIG. A hub 31 having a substantially cylindrical shape is mounted for gripping and fixing the inner sheath 20 when it is slid. As shown in FIG. 2, an insertion hole 31 a communicating with the inner cavity of the guide tube 25 is formed from the center of the rear end of the hub 31, so that the guide wire W can be inserted into the guide tube 25.

  As shown in FIG. 2, the metal tube 23 constituting the inner sheath 20 has a cut groove 35 formed on the distal end side thereof, and is formed to be more flexible than the proximal end side. FIG. 4 (A) shows a front view of the metal tube 23, and FIG. 4 (B) shows each formation location (a, b,... G) of the kerf 35 in FIG. 4 (A). An enlarged view of is shown.

  Referring to FIGS. 4A and 4B, the groove 35 of the metal tube 23 will be described in detail. The groove 35 in this embodiment is in the axial direction from a predetermined position on the tip side of the metal tube 23. A spiral shape swung at a predetermined interval along the axial direction is formed up to a position up to.

  Further, the gap between the adjacent cut grooves 35 and 35 on the distal end side of the metal tube 23 is formed to be narrower than the gap between the cut grooves 35 and 35 on the proximal end side. In this embodiment, as shown in FIG. 4 (B), the intervals P1 to P7 between the adjacent kerfs 35 and 35 in each kerf formation location are from the distal end side of the metal tube 23 toward the proximal end side. The width is gradually increased (P1 <P2 <... <P6 <P7).

  Furthermore, the spiral kerf 35 in this embodiment is not formed by a single continuous line along the axial direction of the metal tube 23, but the spiral linear direction (the direction of the line along the spiral traveling direction). ) Along a cut portion 37 formed by intermittent cutting, and an uncut portion 39.

  This will be described with reference to an explanatory diagram showing the relationship between the cut portion 37 and the uncut portion 39 of the cut groove 35 in FIG. As shown in the figure, when the cutting angle of the cutting portion 37 with respect to the axis S of the metal tube 23 is θ1, and the uncut angle of the uncut portion 39 with respect to the coaxial core S is θ2, The angle θ1 is 180 °, and the uncut angle θ2 is 20 °. By selecting the cutting angle θ1 and the uncut angle θ2, the uncut portion 39 of the kerf 35 is formed so that the uncut angle θ2 in the circumferential direction is shifted depending on the axial position of the metal tube 23. Yes.

  The position of the uncut portion 39 is displaced by the selected cutting angle θ1 and uncut portion angle θ2. For example, when the cutting angle θ1 of the cutting portion 37 is 220 ° and the cutting angle θ2 of the uncut portion 39 is 20 °, as shown in FIG. The uncut portion 39 is arranged, and the uncut portion 39 is arranged so as to be aligned at substantially the same position in the circumferential direction of the metal tube 23.

  Further, the kerf 35 in this embodiment has a spiral shape as described above. For example, an annular kerf that is partially left uncut is provided at a predetermined interval along the axial direction of the metal tube 23. A plurality of arrangements may be used, and there is no particular limitation.

  Next, the usage method of the carrier 1 of the present invention having the above structure will be described with reference to FIGS.

  The transport device 1 of the present invention employs a method of using a puncture needle, a sheath-like sheath, or the like to insert percutaneously through the skin or through an endoscope at a predetermined location of a human tubular organ. In this embodiment, the carrier 1 can be inserted into a tubular organ through an endoscope.

  As shown in FIG. 6, the transport device 1 of this embodiment is inserted into a tubular organ V having a branch portion F among the tubular organs of the human body, and a narrowed portion N formed therein is a tubular organ treatment device. A stent 7 is placed and used to expand the stenosis N, and is inserted through a lumen (not shown) formed in the endoscope 5. Moreover, when conveying this conveyance tool 1, the guide wire W is also used together. As the guide wire W, a known one made of a superelastic alloy, stainless steel or the like is used.

  First, the endoscope 5 is inserted into the tubular organ V, and the distal end thereof is made to reach a little deeper than the branching portion F. Thereafter, a cannula (not shown) arranged in the lumen of the endoscope 5 is inserted into another tubular organ V1 branched from the branching portion F, and a guide wire W is introduced into the tubular organ V1 through the cannula. Then, the tip is inserted until it reaches the back of the tubular organ V1 (see FIG. 6). In this state, a cannula (not shown) is pulled out from the lumen of the endoscope 5.

  After arranging the guide wire W as described above, the proximal end portion of the guide wire W is inserted into the guide tube 25 of the inner sheath 20 from the distal end portion side, and the carrier 1 is packaged on the outer periphery of the guide wire W. Let Then, the carrier 1 is slid along the outer periphery of the guide wire W and inserted into the lumen of the endoscope 5. As described above, since the guide wire W is inserted into the guide tube 25 disposed in the metal tube 23 and the carrier 1 is slid along the guide wire W through the guide tube 25, the kerf is formed. The conveying tool 1 can be smoothly moved without the guide wire W being caught on the wire 35.

  And the front-end | tip part of the conveyance tool 1 is protruded from the opening part through the lumen | rumen of the endoscope 5, the conveyance tool 1 is pushed in visually recognizing with the endoscope 5, and the front-end | tip part is shown in FIG. It reaches a position slightly beyond the stenosis N, which is the target indwelling location.

  At this time, as shown in FIG. 6, the transport tool 1 moves in the bent tubular organ V1, but in the transport tool 1 of this embodiment, as described above, the adjacent kerf 35 , 35 are formed so as to gradually increase in width from the distal end side to the proximal end side of the metal tube 23 (see FIG. 4B). Therefore, the metal tube 23 is configured so that the proximal end side is hard and gradually becomes flexible toward the distal end side, and therefore push ability (ability to transmit the pushing force applied from the proximal end side to the distal end side) is achieved. In addition to being able to be pushed in without any damage, it is possible to smoothly insert even the bent tubular organ V1 due to its softness that gradually becomes soft, and furthermore, the concentration of bending stress is prevented to prevent kinking (bending). Can be prevented.

  Furthermore, in the carrier 1 of this embodiment, the uncut portion 39 of the cut groove 35 formed in the metal tube 23 is formed so that the angle in the circumferential direction is shifted depending on the axial position (FIG. 4B )reference). Therefore, the inner sheath 20 is suppressed from being easily bent only in a predetermined direction, and uniform flexibility in the circumferential direction can be imparted to the inner sheath 20.

  Then, as shown in FIG. 6, when the carrier 1 is arranged, the hub 31 attached to the proximal end portion of the inner sheath 20 is gripped, and the inner sheath 20 is fixed and held by the operator. On the other hand, the holder 14 of the outer sheath 10 is grasped, and the outer sheath 10 is slid toward the proximal end side with respect to the inner sheath 20 as shown in FIG. Then, the stent 7 abutted and supported on the distal end surface 23 a of the inner sheath 20 is gradually pushed out from the distal end portion of the outer sheath 10 by the distal end surface 23 a of the inner sheath 20 and released.

  At this time, in this transport tool 1, since the inner sheath 20 has the metal tube 23, the inner sheath 20 can be prevented from contracting in the axial direction. It does not shrink as much as an inner shaft made of a conventional resin material. Therefore, the stent 7 can be reliably pushed out according to the sliding amount of the outer sheath 10 relative to the inner sheath 20, and the placement operation of the stent 7 can be performed easily and accurately.

  Further, in this embodiment, the kerf 35 formed in the metal tube 23 is not a continuously formed spiral shape, but a cut portion 37 formed by being cut intermittently along the line direction of the spiral. And the uncut portion 39 is formed in a spiral shape. For this reason, the metal tube 23 is more difficult to shrink by the amount of the uncut portion 39 as compared with the case where continuous spiral kerfs are provided. The stent 7 can be pushed out more accurately.

  Further, in this embodiment, the uncut portion 39 is provided in the kerf 35, so that the rigidity of the metal tube 23 can be maintained as compared with the case in which the spiral kerf 35 is continuously formed. It is possible to improve the torque transmission performance of the carrier 1.

  Furthermore, in this embodiment, in addition to adopting the metal tube 23 for the inner sheath 20, the reinforcing body 12 is also disposed on the outer sheath 10 covering the outer periphery thereof. Thus, the rigidity of the outer sheath 10 is improved, and the shrinkage of the outer sheath 10 can also be suppressed. In this way, both the inner sheath 20 and the outer sheath 10 can be made difficult to shrink together, so that the stent 7 can be pushed out more accurately by their interaction according to the sliding amount of the outer sheath 10 with respect to the inner sheath 20. be able to.

  Then, when the stent 7 is completely pushed out from the distal end portion of the outer sheath 10 and released, the stent N is expanded and expanded from the inner side by the expansion force, as shown in FIG. 7 can be placed to treat stenosis of the tubular organ V1.

  FIG. 9 shows another embodiment of the carrier of the present invention. Note that substantially the same parts as those of the above-described embodiment are denoted by the same reference numerals, and description thereof is omitted.

  This embodiment differs from the previous embodiment in the structure of the inner sheath. That is, the inner sheath 20a in this embodiment has a metal tube 23 in which a kerf 35 is formed, and a resin tube 40 connected to the tip of the metal tube 23. A guide tube 25 is inserted into the inner periphery of the metal tube 23 and the resin tube 40, and the tip of the guide tube 25 is inserted from the tip of the resin tube 40. Therefore, the metal tube 23 and the resin tube 40 are more firmly connected via the guide tube 25. The resin tube 40 is formed of the same material as the outer sheath 10 and the guide tube 25, for example, polyurethane, nylon elastomer or the like.

  And according to this embodiment, since the most distal portion excluding the guide tube 25 of the inner sheath 20 is made of the resin tube 40, the most distal portion of the inner sheath 20 is made more flexible, and the distal end portion of the carrier 1 is more flexible. The bending angle of the tip can be further reduced.

  When the stent 7 was accommodated by the transport tool 1 of the present invention, it was tested how much the pushing force can be pushed out of the stent 7.

(1) Example As an example, a carrier 1 having the structure shown in FIG. 1 and having a stent 7 held in a reduced diameter state at its distal end was prepared. Further, the outer sheath 10 is made of nylon, a braided reinforcing body 12 is embedded, and the inner sheath 20 is made of stainless steel, and a spiral cut groove 35 is formed in the pattern shown in FIG. .

(2) Comparative Example As a comparative example, a transport tool similar to the above example was prepared except that the structure of the inner sheath 20 was different. As the inner sheath 20, a straight base end tube without kerf formed of stainless steel and a distal end tube formed of nylon are connected.

(3) Test apparatus As shown in FIG. 10, a support frame 51 that supports the holder 14 at the proximal end portion of the outer sheath 10, supports the outer sheath 10 in a vertical direction, and supports and fixes the holder 14. A test apparatus was prepared, which was provided with a load cell 53 that was disposed above to hold and fix the proximal end portion of the inner sheath 20 and descend at a predetermined speed to apply a pressing load to the inner sheath 20.

(4) Test method The above examples and comparative examples are set in the test apparatus shown in FIG. 10, and the inner sheath is pushed in at an extrusion speed of 150 mm / min. It was tested whether The result is shown in FIG.

  In the figure, the distance on the horizontal axis indicates the pushing distance of the inner sheath 20, and the load on the vertical axis in the figure indicates the pushing load at that time. Further, the distal end portion of the stent 7 starts to be released from the outer sheath from a position exceeding the maximum load in the figure, and the distance to the maximum load is the amount of contraction of the outer sheath and / or the inner sheath.

  As shown in FIG. 11, the carrier of the comparative example measures a contraction amount as large as 20 mm until the stent 7 is pushed out, and the pushing load is also large. On the other hand, it has been found that the stent 7 is pushed out with the carrier 1 of the example with a small shrinkage amount of about 10 mm and a relatively small pushing load.

It is a perspective view which shows one Embodiment of the conveyance tool of the tubular organ treatment tool of this invention. It is a perspective view of the inner sheath of the carrier. It is an expanded sectional view in the tip part of the carrier. The metal tube which comprises the inner sheath of the conveyance tool is shown, (A) is the front view, (B) is an enlarged view of each formation part of the kerf of (A), (C) is cutting of the kerf It is explanatory drawing which shows the relationship between a part and an uncut part. It is a front view which shows the other shape of the metal tube which comprises the inner sheath of the conveyance tool. It is explanatory drawing which shows the 1st process at the time of inserting the conveyance tool in a tubular organ. It is explanatory drawing which shows the 2nd process at the time of inserting the transport tool in a tubular organ. It is explanatory drawing which shows the state which indwelled the tubular organ treatment tool in the tubular organ using the conveyance tool. It is a perspective view which shows other embodiment of the conveyance tool of the tubular organ treatment tool of this invention. It is explanatory drawing which shows the test method of the pushing test of a stent of the conveyance tool of an Example and a comparative example. It is a chart which shows the result of the pushing test of the stent, and shows the relationship between the pushing distance of the inner sheath and the pushing load.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Transport device for tubular organ treatment device 7 Stent (tubular organ treatment device)
DESCRIPTION OF SYMBOLS 10 Outer sheath 12 Reinforcement body 20 and 20a Inner sheath 23 Metal tube 25 Guide tube 35 Cut groove 37 Cut part 39 Uncut part 40 Resin tube

Claims (6)

An outer sheath; and an inner sheath slidably disposed within the outer sheath, wherein a tubular organ treatment device is disposed on an inner periphery of a distal end portion of the outer sheath, and the tubular organ treatment device is disposed at a distal end portion of the inner sheath. In the transporting device for the tubular organ treatment tool configured to be able to open the tubular organ treatment tool from the distal end portion of the outer sheath by sliding the outer sheath in a state of contacting
The inner sheath has a metal tube, and the metal tube has a kerf formed at the distal end side, is made more flexible than the proximal end side, and is inserted through the inner periphery of the metal tube. A guide tube made of a resin that can be inserted through the guide wire or can flow in a liquid;
The distal end portion of the guide tube is inserted from the distal end portion of the metal tube so that the distal end surface of the metal tube has a stepped shape, and the tubular organ treatment instrument is disposed on the outer periphery of the distal end portion of the guide tube. A transport device for a tubular organ treatment device, characterized in that it is configured as follows.   The kerfs are formed at predetermined intervals in the axial direction of the inner sheath, and the gap between adjacent kerfs on the distal end side is narrower than the gap between kerfs on the proximal end side. The transport device for a tubular organ treatment device according to claim 1, which is formed as described above.   The transport device for a tubular organ treatment instrument according to claim 1 or 2, wherein the inner sheath includes the metal tube and a resin tube connected to the tip of the metal tube.   The metal tube kerf has a spiral shape as a whole, and the spiral kerf has a cut portion and a left uncut portion formed by being cut intermittently along the line direction of the spiral. The transport device for a tubular organ treatment device according to any one of claims 1 to 3.   The transport device for a tubular organ treatment instrument according to claim 4, wherein an uncut portion of the kerf of the metal tube is formed such that an angle in a circumferential direction is shifted depending on an axial position.   The transport device for a tubular organ treatment instrument according to any one of claims 1 to 5, wherein a reinforcing body is disposed on the outer sheath.

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