JP5547149B2 - Guide wire with pressing member for sealing member insertion and catheter device for drug solution injection - Google Patents

Description

  The present invention relates to a guide wire with a pressing member for inserting a sealing member and a catheter device for injecting a chemical solution. More specifically, for example, a guide wire with a sealing member used for injecting a chemical solution of a micro catheter with a coaxial balloon is simply inserted and inserted. It relates to technology that can be.

  In recent endovascular treatments, a microcatheter, a thin catheter with an outer diameter of 1.0 mm to 1.3 mm, is guided to the target site along the guide wire, and a medical solution such as an anticancer drug is flowed from the distal end of the catheter. It is carried out. However, blood vessels are branched in several ways, and sometimes when a chemical solution is flowed from the distal end opening of the catheter, the drug solution flows to a blood vessel other than the target and causes a problem. Therefore, a side hole is provided on the proximal side (rear side) from the balloon of the catheter, and the catheter is advanced to the blood vessel on the healthy part, and the balloon is inflated to flow the chemical from the side hole. The inflow is blocked by a balloon, so that the chemical solution can flow only to the target site. A balloon catheter having such a shape is already known as a balloon catheter using a two-lumen or three-lumen tube. However, in a tube with a thin outer diameter such as a microcatheter, each lumen becomes small, and it is difficult to inject a high-viscosity drug solution in an amount that provides a therapeutic effect due to resistance.

  Therefore, the microcatheter uses a coaxial tube, the inner tube lumen is the guide wire and drug solution injection lumen, and the lumen that is the annular gap between the inner tube and outer tube is the balloon lumen. I'm earning money. In addition, since the microcatheter is guided using a guide wire at the time of blood vessel insertion, the distal end of the catheter is opened so that the guide wire can be inserted, and communicates with the side hole on the proximal side from the balloon. Even if the chemical solution is injected into the catheter having this shape, the chemical solution flows from both the side hole and the tip opening.

  Therefore, a sealing member that fits into the lumen of the tube tip is inserted into the catheter lumen before injecting the drug solution, and the catheter tip is closed with the sealing member so that the drug solution flows only from the side hole. Things are also done. Since this sealing member has a shape in which a tip having the same size as the catheter lumen is provided at the tip of a thin guide wire, it is necessary to increase the outer diameter of the guide wire, and the clearance from the catheter lumen The guide wire should have a thin outer diameter as much as possible. However, if the outer diameter of the guide wire with the sealing member is reduced, the rigidity will be reduced and the catheter will be in the body. In the case where it is bent, the guide wire is difficult to insert, or the guide wire is broken and the sealing member cannot be inserted.

  Patent Document 1 discloses a configuration in which a sealing member similar to the sealing member described above can block the lumen of the catheter body at the distal end. This sealing member also has a function similar to the sealing member, but even when the outer diameter of the guide wire is reduced, the rigidity is lowered, and the catheter is bent in the body, making insertion difficult. The above-mentioned problems cannot be solved, and problems to solve the problems still remain. Therefore, as a result of repeated research, the inventors have invented an auxiliary device for supporting insertion of a guide wire with a sealing member.

JP 2000-153000 A

  That is, the object of the present invention is to solve the conventional problems as described above, and to seal the catheter inserted into the distal end lumen of the catheter so that the medicinal solution can be injected from either the distal end opening or the side hole of the catheter. The member can be easily inserted even when the catheter is bent in the body, and the guide wire attached to the sealing member does not break, and the guide wire with the pressing member for inserting the sealing member and the liquid injection It is in providing a catheter apparatus.

  In order to solve the above-mentioned problem, the invention according to claim 1 is characterized in that a balloon is provided at the distal end portion of the catheter body of the distal end opening, a side hole is provided behind the balloon, and any one of the side hole and the distal end opening is provided. A medicinal solution that can be selectively dispensed by sealing with a sealing member provided at the distal end of a guide wire with a sealing member that is inserted from a proximal end side to a predetermined position on the distal end side in the catheter body Used for an infusion catheter, the distal end portion has a pressing member that pushes the sealing member from its rear surface when inserting the sealing member and inserts the sealing member from a proximal end side to a predetermined position on the distal end side in the catheter body. It is characterized by that.

  According to a second aspect of the present invention, in the first aspect, the pressing member has a slit that is inserted through a guide wire attached to the rear surface of the sealing member and is notched in the axial direction from the outer peripheral surface to the inside. It is characterized by being.

  A third aspect of the present invention provides the sealing member according to the first or second aspect, wherein the sealing member has a substantially columnar body, and the outer peripheral surface thereof is slid onto the inner peripheral surface of the distal end portion that is tapered so that the outer peripheral surface is narrowed toward the distal end side of the catheter body. It is tapered so as to be in contact with and seal the tip opening.

  According to a fourth aspect of the present invention, in the first or second aspect, the sealing member has a substantially hollow cylindrical body, the outer peripheral surface of which is tapered on the inner peripheral surface of the distal end portion that is tapered toward the distal end side of the catheter body. It is taper-processed so that a side hole may be sealed by sliding contact.

  The invention according to claim 5 is a catheter device for injecting a chemical solution, wherein a balloon is provided at the distal end portion of the catheter main body at the distal end opening, and a side hole is provided behind the balloon, and the distal end A sealing member is included in the portion, and the sealing member is inserted from the proximal end side to the predetermined position on the distal end side in the catheter body of the catheter for injecting the drug solution to seal either the side hole or the distal end opening. A guide wire with a sealing member that can selectively dispense a chemical solution, and a pressing member at the tip, and by pressing the pressing member from the rear surface of the sealing member when the sealing member is inserted And a guide wire with a pressing member for inserting a sealing member, which inserts the sealing member from a proximal end side to a predetermined position on the distal end side in the catheter body of the drug solution injection catheter.

  This invention is as described above, and according to the inventions of claims 1 to 4, a balloon is provided at the distal end portion of the catheter body of the distal opening, and a side hole is provided behind the balloon, Select a drug solution by sealing either the side hole or the distal end opening with a sealing member provided at the distal end of a guide wire with a sealing member inserted from the proximal end side to the predetermined position on the distal end side in the catheter body. Is used for a medical solution injection catheter that can be poured into the catheter, and when the sealing member is inserted, the sealing member is pushed in from the rear surface and inserted from a proximal end side to a predetermined position on the distal end side in the catheter body. Since the pressing member is provided at the distal end, a sealing member that is inserted into the lumen of the distal end of the catheter so that a medical solution can be injected from either the distal end opening or the side hole of the catheter is bent in the body as in the past. do it It can be inserted in a simple, even if that, moreover and it is expected guide wire that comes with the sealing member nor breakage.

  According to the fifth aspect of the present invention, there is provided a medical solution injection catheter device, wherein a balloon is provided at a distal end portion of a catheter body having a distal end opening, and a side hole is provided behind the balloon. The distal end portion has a sealing member, and the sealing member is inserted from the proximal end side to the predetermined position on the distal end side in the catheter main body of the catheter for injecting the drug solution, thereby either the side hole or the distal end opening A guide wire with a sealing member that seals and allows the chemical solution to be selectively dispensed, and has a pressing member at the tip, and the pressing member is pushed from the rear surface of the sealing member when the sealing member is inserted. A guide wire with a pressing member for inserting a sealing member, which inserts the sealing member from a proximal end side to a predetermined position on the distal end side in the catheter body of the catheter for injecting a drug solution. A guide wire with a pressing member is provided as a set together with a guide wire with a sealing member and a catheter for injecting a chemical solution that can be selectively dispensed by sealing either a side hole or a tip opening with a sealing member. The effect that can be expected.

It is the whole schematic diagram which abbreviate | omitted the part which shows the catheter apparatus for chemical | medical solution injection which concerns on one embodiment of this invention. It is an enlarged vertical front view of a catheter tip part same as the above. The guide wire with a sealing member same as the above is shown, (A) is a partially omitted front view, and (B) is a side view. It is an expansion vertical front view of the catheter front-end | tip part which shows another guide wire with a sealing member. The guide wire with a sealing member same as the above is shown, (A) is a partially omitted front view, and (B) is a side view. The guide wire with the pressing member for sealing member insertion is shown, (A) is the front view which abbreviate | omitted a part, (B) is a side view. It is effect | action explanatory drawing which shows the example of chemical | medical solution injection | pouring from a side hole. It is effect | action explanatory drawing which shows the example of chemical | medical solution injection | pouring from a front-end | tip opening. It is effect | action explanatory drawing which shows the chemical | medical solution injection | pouring state after inserting in the blood vessel.

  Hereinafter, a drug solution injection catheter device according to an embodiment of the present invention will be described with reference to the drawings.

  In FIG. 1, reference numeral 1 denotes a medical solution injection catheter device. This medical solution injection catheter device 1 includes a medical solution injection catheter 2, guide wires 3 and 4 with a sealing member, and a guide with a sealing member insertion pressing member. Wire 5.

  The catheter 2 for injecting medicinal solutions is composed of a thin micro catheter having an outer diameter of 1.0 mm to 1.3 mm. That is, the catheter 2 has an inner tube 6 and an outer tube 7 coaxially as a catheter body, as shown in detail in FIG. The lumen 8 for inserting and filling the medicinal solution and the lumen formed as an annular gap between the inner tube 6 and the outer tube 7 are used as a balloon lumen 9, and the main cavity (the lumen of the inner tube 6) is the distal end side at the distal end of the catheter. The taper is processed to be thin and have a small diameter, and the tip 11 is opened. As is clear from the figure, the outer tube 7 is slightly shorter in the distal direction than the inner tube 6.

  A balloon 12 is provided across the outer periphery between the distal ends of the inner tube 6 and the outer tube 7 which is the distal end portion of the catheter body, and a side hole 13 is provided on the rear side (hand side) from the balloon portion. Yes. The side hole 13 has the side hole edge of the outer tube 7 at the same position of the inner tube 6 and the outer tube 7 so that the drug solution from the drug solution injection lumen 8 does not flow to the balloon lumen 9 but flows directly to the outside. It is provided in a shape bonded to the side hole mouth edge. The tip opening 11 and the side hole 13 serve as a chemical solution inlet. The distal end of the outer tube 7 located in the balloon 12 is also opened. From this opening, sterilized water for inflating the balloon 12 is injected through the balloon lumen 9.

  As shown in FIG. 3, the guide wire 3 with the sealing member is tapered so that its outer peripheral surface is in sliding contact with the inner peripheral surface of the distal end portion of the inner tube 6 and fits in a position where the distal end opening 11 is sealed. The sealing member 16 is provided at the tip, and the sealing member can be inserted into and removed from the lumen of the inner tube 6. The sealing member 16 has a substantially columnar shape, and its outer peripheral surface has a tapered shape with a slightly smaller diameter from the rear end to the front end, and further has a tapered shape (conical shape) with a suddenly smaller diameter toward the tip. Is formed. And the front-end | tip of the guide wire 3 adheres and is attached to the center part of a rear-end surface. Therefore, when the guide wire 3 with the sealing member is inserted into the inner tube 6 from the sealing member 16 side at the distal end, the inner peripheral surface of the distal end portion of the lumen of the inner tube 6 at a predetermined position on the distal end side as shown in FIG. And the outer peripheral surface of the sealing member 16 are slidably in close contact with each other, and the front end opening 11 of the inner tube 6 can be closed without the sealing member 16 protruding from the front end opening 11 of the inner tube 6. Yes.

  Another guide wire 4 with a sealing member is used when closing the side hole 13 instead of the tip opening 11 as shown in FIGS. That is, the guide wire 4 has a sealing member 18 formed at its distal end so that its outer peripheral surface is in sliding contact with the inner peripheral surface of the distal end portion of the inner tube 6 and seals the side hole 13. The sealing member can be inserted into and removed from the lumen of the inner tube 6. The sealing member 18 has a substantially hollow cylindrical body, and the outer peripheral surface thereof is formed in a tapered shape with a very small diameter from the rear end to the front end. And the front-end | tip of the guide wire 4 adheres and is attached to the outer periphery of a rear-end surface. Therefore, when the guide wire 4 with the sealing member is inserted into the inner tube 6, the inner peripheral surface of the distal end portion of the inner tube 6 and the outer peripheral surface of the sealing member 18 are in sliding contact with each other at a predetermined position on the distal end side as shown in FIG. The side holes 13 can be closed by close fitting.

  As shown in FIG. 6, the guide wire 5 with the pressing member for inserting the sealing member has a substantially cylindrical shape as a pusher device that pushes the guide wire 3 with the sealing member or the guide wire 4 with the sealing member into the distal end portion of the inner tube 6. The pressing member 20 is provided at the tip, and the pressing member can be inserted into and removed from the inner tube 6 lumen. The pressing member 20 is formed to have the same outer diameter as the rear ends of the sealing members 16 and 18 or slightly smaller than that, and a guide wire having a tip attached to the rear surface of the sealing member 16 from the outer peripheral surface thereof toward the inside. A slit 21 through which 3 and 4 is inserted communicates with the axial center hole 22 and is cut out in the axial direction. That is, the slit 21 is notched linearly from the outer peripheral surface toward the axial center hole 22 as shown in FIG. 6, and the guide wire 3 passes through the slit 21 from the outer peripheral surface side to pass through the axial center hole. It is located at 22 and can be slidably held in the axial center hole 22. And the front-end | tip of the guide wire 5 adheres and is attached to the outer periphery on the opposite side to the side in which the slit 21 was formed in the rear-end surface.

  The guide wire 5 may have any thickness as long as it passes through the inner tube 6 and has a rigidity capable of pushing the sealing members 16 and 18 through the pressing member 20. The material of the guide wire 5 is preferably made of stainless steel, NI-TI or other metal used for medical treatment, and thermoplastic resin such as PP, PE or PU, or a composite material thereof.

  As described above, by using the guide wire 3 with the sealing member, the sealing member 16 is inserted into the inner tube 6 by the pressing action of the pressing member 20 of the guide wire 5 with the pressing member for inserting the sealing member. When the position is reached, the inner peripheral surface of the distal end portion and the outer peripheral surface of the sealing member 16 are brought into sliding contact with each other and closely fitted, and the distal end opening 11 of the inner tube 6 is closed. Therefore, the chemical solution put into the lumen of the inner tube 6 from the proximal end side of the catheter body is blocked by the sealing member 16 and flows to the outside from the side hole 13 as shown in FIG.

  On the other hand, using the guide wire 4 with the sealing member, when the sealing member 18 is inserted into the inner tube 6 by the pressing action of the pressing member 20 of the guide wire 5 with the pressing member for inserting the sealing member and reaches a predetermined position, The inner peripheral surface of the tip portion and the outer peripheral surface of the sealing member 18 are in sliding contact with each other and are closely fitted, and the side hole 13 of the inner tube 6 is closed. Therefore, the chemical solution put into the lumen of the inner tube 6 from the proximal end side of the catheter body is blocked from being poured out from the side hole 13 by the sealing member 18 as shown in FIG. It flows from the tip opening 11 to the outside.

  In this way, by properly using the two types of guide wires 3 and 4 with sealing members, the treatment range can be expanded by changing the position of drug solution extraction.

  Next, an actual usage example will be described with reference to FIG. FIG. 9 shows an example in which the guide wire 3 with the sealing member is used for treatment of blood vessels in the brain. Before reaching the state of this figure, first, a guide wire for guidance (not shown) is inserted and placed in the blood vessel A in the healthy part to the vicinity of the blood vessel B where the drug solution branched from the blood vessel is to be injected. After that, the medicinal solution injection catheter 2 is inserted from the distal end opening 11 along the guide wire placed. Then, after confirming that the side hole 13 of the catheter 2 has been inserted to a position facing the branch opening of the blood vessel B, the guide wire is pulled out from the blood vessel A and removed.

  Thereafter, the guide wire 3 with the sealing member and the guide wire 5 with the pressing member for inserting the sealing member are inserted from the proximal end side of the catheter body of the catheter 2. That is, the sealing member 16 of the guide wire 3 with the sealing member is placed at the head, and the pressing member 20 of the guide wire 5 with the pressing member for inserting the sealing member is continuously brought into contact with the rear end surface of the sealing member. At this time, the guide wire 3 is slidably held in the axial center hole 22 through the slit 21 of the pressing member 20. As a result, the push-in is smoothly performed without the guide wire 3 being obstructed when the push member 20 is pushed. Then, when the sealing member 16 of the guide wire 3 is pushed close to the distal end portion of the catheter body, and the outer peripheral surface thereof is in sliding contact with the inner peripheral surface of the distal end portion and is closely fitted, the distal end opening 11 becomes the sealing member 16. It is blocked by. After this closed state, the guide wire 5 is removed from the catheter body. Also at this time, the guide wire 5 can be slid and removed along the guide wire 3 held in the axial center hole 22, so that the removal is not hindered. When sterilized water is injected from the balloon lumen 9, the sterilized water enters the balloon 12 through the opening 14 and inflates the balloon. The balloon 12 is fixed in the blood vessel A with appropriate expansion, and the catheter 2 is fixedly placed in the blood vessel A accordingly.

  Thereafter, when a drug solution such as an anticancer drug is introduced from the proximal end side of the catheter body, the drug solution flows from the side hole 13 toward the blood vessel B where the drug solution is to be injected as shown in FIG. The flow is blocked by the balloon 12 on the outer side and the sealing member 16 on the inner side of the blood vessel A on the healthy part side, and the chemical solution does not flow. Thereby, the treatment action of the treatment site | part with the blood vessel B through which a chemical | medical solution flows can be performed smoothly and favorably.

  Contrary to this use example, when the side with the blood vessel A is the treatment site, as described above, the side hole 13 of the inner tube 6 is closed with the sealing member 18 using the guide wire 4 with the sealing member. To do. As a result, the chemical liquid flows from the distal end opening 11 toward the blood vessel A through the sealing member 18.

  As described above, according to the embodiment, the medicinal solution can be injected from either the distal end opening 11 or the side hole 13 of the catheter 2. Further, even if the catheter 2 is bent in the body, the insertion of the guide wires 3 and 4 with the sealing member is not difficult, and the sealing members 16 and 18 to be inserted into the distal end lumen thereof are provided. The guide wires 3 and 4 attached to the sealing member can be easily inserted without being broken and cannot be inserted. In other words, if the guide wires 3 and 4 with the sealing member are not sufficiently small in diameter with respect to the catheter lumen, the resistance at the time of injecting the drug solution becomes high and sufficient drug solution administration cannot be performed. Although it may be difficult to push the sealing member to the tip, these problems can be solved all at once. In addition, if the guide wire 5 with a sealing member insertion pressing member as described above is used, there is an advantage that the guide wires 3 and 4 can be made as thin as extremely fine hair.

  The embodiment described above is merely a preferable example, and other embodiments are not excluded, for example, the catheter is not limited to a microcatheter. In the embodiment, the blood vessel to be used has been described with the treatment in the blood vessel in the brain. However, the treatment site is not limited to the blood vessel in the brain, but can be used for treatment in various blood vessels such as abdominal and thoracic blood vessels. it can. In this way, it goes without saying that the design and the like of the present invention can be arbitrarily changed and modified within the scope described in the claims.

DESCRIPTION OF SYMBOLS 1 Chemical solution injection catheter apparatus 2 Chemical solution injection catheter 3, 4 Guide wire with sealing member 5 Guide wire with sealing member insertion pressing member 6 Inner tube 7 Outer tube 8 Lumen 9 for injection of chemical solution Balloon lumen 11 End opening 12 Balloon 13 Side hole 14 Opening 16, 18 Sealing member 20 Pressing member 21 Slit 22 Axial center hole A Healthy part side blood vessel B Blood vessel to be injected with drug solution

Claims (5)

A balloon is provided at the distal end of the catheter body at the distal end, a side hole is provided behind the balloon, and either the side hole or the distal opening is inserted from the proximal end side to the predetermined position on the distal end side in the catheter body. It is used for a drug solution injection catheter that is sealed with a sealing member provided at the distal end of a guide wire with a sealing member to be able to selectively dispense a drug solution,
A sealing member insertion press characterized by having a pressing member at the distal end portion for inserting the sealing member from the rear surface thereof when inserting the sealing member and inserting the sealing member from a proximal end side to a predetermined position on the distal end side in the catheter body. Guide wire with members.   2. The pressing member for inserting a sealing member according to claim 1, wherein a slit for inserting a guide wire attached to the rear surface of the sealing member is cut out in the axial direction from the outer peripheral surface thereof toward the inside thereof. With guide wire.   The sealing member has a substantially columnar body, and is tapered so that the outer peripheral surface thereof is in sliding contact with the tapered inner peripheral surface of the distal end portion that narrows toward the distal end side of the catheter body and seals the distal end opening. Item 3. A guidewire with a pressing member insertion member according to Item 1 or 2.   The sealing member has a substantially hollow cylindrical body, and is tapered so that the outer peripheral surface thereof is slidably contacted with the tapered inner peripheral surface of the distal end of the catheter body to seal the side hole. A guide wire with a pressing member for inserting a sealing member according to claim 1 or 2.   A catheter for injecting a drug solution in which a balloon is provided at the distal end portion of the catheter main body of the distal end opening and a side hole is provided in the rear of the balloon; and a sealing member at the distal end portion; A guide wire with a sealing member that seals either the side hole or the distal end opening by inserting the catheter from a proximal end side to a predetermined position on the distal end side in the catheter body of the catheter so that the drug solution can be selectively dispensed; The distal end portion has a pressing member, and when the sealing member is inserted, the sealing member is pushed from the rear surface of the sealing member by inserting the sealing member from the proximal end side in the catheter body of the medicinal solution injection catheter. A drug solution injection catheter device comprising: a guide wire with a sealing member insertion pressing member that is inserted to a predetermined position on the distal end side.

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