JP5963702B2 - Medical equipment - Google Patents

Description

  The present invention relates to a medical device such as an electrode catheter or a catheter sheath device used for, for example, examination (diagnosis) or treatment of arrhythmia.

  An electrode catheter is inserted into a body (for example, the inside of a heart) through a blood vessel, and is used for arrhythmia examination or treatment. In such electrode catheters, in general, the shape near the tip (distal end) of the catheter tube inserted into the body is attached to the proximal end (proximal end, rear end, hand side) placed outside the body. Depending on the operation of the part, it changes (deflects, curves, bends) in one direction or both directions. In addition to the type in which the shape near the tip is arbitrarily changed according to the operation in this way, there is a type in which the shape near the tip is fixed.

  In addition, a catheter sheath device including a sheath (sheath tube) that plays a role of assisting insertion of a catheter while expanding a blood vessel when a catheter such as an electrode catheter is inserted into the body is known.

  As an example of a handle for a medical device such as an electrode catheter or a catheter sheath device, for example, as disclosed in Patent Document 1, a rotating plate that is rotatably attached to the handle body is used as an operation unit. What was used is mentioned. On the rotating plate, a proximal end side of an operation wire for bending the vicinity of the distal end of a tubular member such as a catheter tube or a sheath tube is extended from the inside of these tubular members. A wire fastener for fixing the proximal end of the operation wire is provided on the rotating plate.

JP 2013-17893 A

  By the way, in such a wire fastener, when the pull-in length near the base end at the time of fixing can be arbitrarily adjusted, there are the following advantages. That is, it becomes possible to finely adjust the tension of the operation wire, and as a result, it is possible to finely adjust the degree of bending (curved shape or the like) near the tip of the tubular member.

  Here, the fine adjustment of the degree of bending near the tip using such a wire fastener (adjustment fastener) is performed at the time of assembly of the handle (before completion of assembly). However, even after the handle is assembled, such fine adjustment work may be required again. In this case, since the handle is assembled, it is necessary to disassemble the handle once before performing the fine adjustment operation. For this reason, work efficiency will fall and the convenience will be impaired.

  The present invention has been made in view of such problems, and an object thereof is to provide a medical device capable of improving convenience.

  The medical device of the present invention includes a tubular member having flexibility, a handle provided on the proximal end side of the tubular member, and a proximal end side extending from the inside of the tubular member to the handle side, thereby forming a tubular shape. And an operation wire for bending the vicinity of the distal end of the member. The handle includes a handle main body, a rotating plate rotatably attached to the handle main body, and provided on the rotating plate to fix a proximal end of the operation wire and a proximal end at the time of fixing. It has an adjustment fastener capable of arbitrarily adjusting the pull-in length near the end, and an opening formed in the handle body for communicating the adjustment fastener with the outside.

  In the medical device of the present invention, the adjustment fastener provided on the rotating plate is communicated with the outside through an opening formed in the handle body. Accordingly, even after the handle is assembled, the pull-in length near the proximal end of the operation wire can be arbitrarily adjusted using the adjustment fastener, and the tension of the operation wire can be finely adjusted. . That is, it is possible to finely adjust the degree of bending near the distal end of the tubular member without disassembling the handle once.

  In the medical device of the present invention, the formation position of the opening is set so that the adjustment fastener communicates with the outside in a state where the rotating plate is rotated and the vicinity of the distal end of the tubular member is bent. Is desirable. When comprised in this way, the bending condition can be finely adjusted in the state where the vicinity of the distal end of the tubular member is bent. That is, since the fine adjustment work of the bending state can be performed simultaneously (collectively) during the rotation operation, the work efficiency is further improved, and the convenience can be further improved.

  Further, in this case, a knob for rotating the rotating plate is provided on the side surface of the rotating plate, and the position of the adjustment fastener and the position of the opening are formed in a state where the knob is in contact with the handle body. It is more desirable that and overlap each other. When configured in this way, the position where they overlap each other (rotational operation angle when performing the fine adjustment work of the bending state) becomes easy to understand, so that the operator can move to the work position without checking the hand. Become. Therefore, working efficiency is further improved, and convenience is further improved.

  In the medical device of the present invention, when the adjustment fastener is configured using a lock pin and a screw, the pull-in length is adjusted according to the degree of rotation of the lock pin, and after the pull-in length is adjusted, The proximal end of the operating wire may be fixed by a screw. When configured in this manner, the adjustment operation of the pull-in length, that is, the fine adjustment operation of the bending state is facilitated. Therefore, work efficiency can be further improved and convenience can be further improved.

  According to the medical device of the present invention, the opening for allowing the adjustment fastener to communicate with the outside is formed in the handle main body, so that the bending near the distal end of the tubular member even after the handle is assembled. The condition can be finely adjusted. Therefore, it is possible to improve work efficiency and improve convenience.

It is a schematic diagram showing the example of schematic structure of the electrode catheter as a medical device which concerns on one embodiment of this invention. It is a schematic diagram showing the detailed structural example of the rotating plate vicinity in the electrode catheter shown in FIG. It is a schematic diagram showing the example of a structure at the time of rotation operation of the rotating plate shown in FIG. It is a schematic diagram showing the other structural example at the time of rotation operation of the rotating plate shown in FIG. It is a schematic diagram showing schematic structure of the electrode catheter which concerns on a comparative example. It is a schematic diagram for demonstrating the effect | action of the electrode catheter shown in FIG. It is another schematic diagram for demonstrating the effect | action of the electrode catheter shown in FIG. It is a schematic diagram showing the schematic structural example of the catheter sheath apparatus as a medical device which concerns on the modification of this invention.

Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. The description will be given in the following order.
1. Embodiment (example when medical device is electrode catheter)
2. Modification (example when medical device is a catheter sheath device)
3. Other variations

<Embodiment>
[Constitution]
FIG. 1 schematically shows a schematic configuration example of an electrode catheter 1 as a medical device according to an embodiment of the present invention. The electrode catheter 1 is inserted into a body (for example, the inside of the heart) through a blood vessel, and is used for arrhythmia examination or treatment. The electrode catheter 1 includes a catheter tube 2 (catheter shaft) as a catheter main body (long portion), and a handle 3 attached to the proximal end side of the catheter tube 2.

(Catheter tube 2)
The catheter tube 2 is made of a flexible tubular structure (hollow tubular member) and has a shape extending along its own axial direction (Z-axis direction). Specifically, the length of the catheter tube 2 in the axial direction is several times to several tens of times longer than the length of the handle 3 in the axial direction (Z-axis direction). The catheter tube 2 may be composed of tubes having the same characteristics in the axial direction, but the distal end portion having relatively high flexibility and the axis with respect to the distal end portion. It is preferred to have a proximal end portion that is integrally formed in the direction and is relatively stiffer than the distal end portion.

  The catheter tube 2 is also formed with a so-called single lumen structure in which one lumen (pore, through-hole) is formed so as to extend along the axial direction of the catheter tube 2 or a plurality of (for example, four) lumens. So-called multi-lumen structure. In addition, in the inside of the catheter tube 2, both the area | region which consists of a single lumen structure, and the area | region which consists of a multi-lumen structure may be provided. Various thin wires (operation wires 41a and 41b to be described later, conducting wires (not shown) and the like) are inserted into the lumen of the catheter tube 2 in a state of being electrically insulated from each other.

  The catheter tube 2 is made of a synthetic resin such as polyolefin, polyamide, polyether polyamide, or polyurethane. The axial length of the catheter tube 2 is about 500 to 1200 mm (for example, 1170 mm), and the outer diameter of the catheter tube 2 (outer diameter of the XY cross section) is about 0.6 to 3 mm ( For example, 2.0 mm).

  In the vicinity of the distal end of the catheter tube 2, a plurality of electrodes (here, three ring electrodes 21 and one distal electrode 22) are arranged at a predetermined interval. Specifically, the ring electrode 21 is fixedly disposed on the outer peripheral surface of the catheter tube 2, while the tip electrode 22 is fixedly disposed at the forefront of the catheter tube 2. These electrodes are electrically connected to the inside of the handle 3 through a plurality of conductive wires (not shown) inserted into the lumen of the catheter tube 2 described above. Such a conductive wire is made of, for example, a metal material such as copper and is covered with an insulating resin, and has a diameter of about 50 to 200 μm (for example, 100 μm).

  Each of the ring electrode 21 and the tip electrode 22 is a metal having good electrical conductivity, such as aluminum (Al), copper (Cu), stainless steel (SUS), gold (Au), platinum (Pt), etc. It is composed of materials. In addition, in order to make the contrast property with respect to X-rays favorable at the time of use of the electrode catheter 1, it is preferable to be comprised with platinum or its alloy. Further, the outer diameters of the ring-shaped electrode 21 and the tip electrode 22 are not particularly limited, but it is desirable to be approximately the same as the outer diameter of the catheter tube 2 described above.

(Handle 3)
The handle 3 is a portion that is gripped (gripped) by an operator (doctor) when the electrode catheter 1 is used. As shown in FIG. 1, the handle 3 includes a handle main body 31 (gripping part) attached to the proximal end side of the catheter tube 2, and a rotary plate (operating part) rotatably attached to the handle main body 31. 32).

  The handle body 31 has a divided structure composed of two divided pieces (not shown) extending along the Z-axis direction, and the rotating plate 32 is sandwiched between the two divided pieces. The length of the entire handle body 31 in the axial direction is preferably such that the operator can hold it with one hand, but is not particularly limited. Such a handle body 31 is made of a synthetic resin such as polycarbonate or acrylonitrile-butadiene-styrene copolymer (ABS).

  Here, in the present embodiment, as shown in FIG. 1, the handle main body 31 has a pair of openings 310 a for connecting adjustment fasteners 323 a and 323 b to be described later on the rotary plate 32 to the outside. 310b is formed. Each of the openings 310a and 310b is a circular opening in this example, and in this example, the openings 310a and 310b are formed at positions that are line targets with respect to the axis of the handle body 31. The details of the positional relationship between the openings 310a and 310b and the adjustment fasteners 323a and 323b will be described later (FIGS. 3A, 3B, etc.).

  The rotating plate 32 is a member for performing a deflection movement operation (swing operation), which is an operation for deflecting the vicinity of the distal end of the catheter tube 2, and has a substantially disk shape. Specifically, in this example, as indicated by arrows d1a and d1b in FIG. 1, an operation of rotating the rotating plate 32 bidirectionally on the XY plane with respect to the handle main body 31 (a rotating shaft 320 described later is operated). Rotation operation around the center of rotation) is possible. Such a rotating plate 32 is made of, for example, the same material (synthetic resin or the like) as that of the handle body 31 described above.

  FIG. 2 schematically shows a detailed configuration example of the rotating plate 32 in a plan view. As shown in FIG. 2, the rotary plate 32 is provided with a rotary shaft 320, a pair of knobs 321a and 321b, a guide rail 322, and a pair of adjustment fasteners 323a and 323b. On the rotating plate 32, two operation wires 41a and 41b are extended from the catheter tube 2. It should be noted that the adjustment fasteners 323a and 323b in FIG. 2 and the subsequent drawings are schematically shown as a superordinate concept including “lock pins” and “screws” described later.

  Each of the operation wires 41a and 41b is drawn out from the operation tube 40 extended from the catheter tube 2, and is used when the distal end portion of the catheter tube 2 is deflected. In other words, it is used for bending the vicinity of the distal end of the catheter tube 2. The distal ends of these operation wires 41a and 41b are fixed to the distal end side of the catheter tube 2 (for example, on the inner peripheral surface of the distal end electrode 22) by an anchor, solder, or the like. Moreover, each base end side is extended | stretched on the rotating plate 32 from the inside of the catheter tube 2, as above mentioned. Each of these operation wires 41a and 41b is made of a superelastic metal material such as SUS or NiTi (nickel titanium), and has a diameter of about 100 to 500 μm (for example, 200 μm). However, it does not necessarily need to be comprised with a metal material, for example, may be comprised with the high intensity | strength nonelectroconductive wire.

  The knobs 321a and 321b are provided integrally with the rotary plate 32 on the side surface of the rotary plate 32. In this example, the knobs 321a and 321b are point-symmetric with respect to the rotary shaft 320. Has been placed. Each of these knobs 321a and 321b corresponds to a portion operated (pressed) with a finger of one hand when the operator rotates the rotary plate 32, for example.

  The guide rail 322 is a member that defines (guides) each path to the adjustment fasteners 323a and 323b in the operation wires 41a and 41b drawn from the proximal end of the operation tube 40. In this example, the guide rail 32 has an arc shape (a shape arranged so as to have an arc on the catheter tube 2 side) with the rotation shaft 320 as the center on the rotating plate 32.

  The adjustment fasteners 323a and 323b are members (wire fasteners) for individually fixing the base ends of the operation wires 41a and 41b, respectively. Specifically, the operation wire 41a passes through the rail on the knob 321a side of the guide rail 32, and the base end thereof is fixed to the adjustment fastener 323a. On the other hand, the operation wire 41b passes through the rail on the knob 321b side of the guide rail 32, and the base end thereof is fixed to the adjustment fastener 323b. In addition, in each of these adjustment fasteners 323a and 323b, as described above, it is possible to arbitrarily adjust the pull-in length in the vicinity of the base ends when the base ends of the operation wires 41a and 41b are fixed. ing.

  Specifically, in this example, the adjustment fasteners 323a and 323b are each configured using a lock pin and a screw (tapping screw). Further, both of these lock pins and screws are of the “− (minus)” type in this example. The operation wires 41a and 41b are drawn through the lock pins, and the base ends of the operation wires 41a and 41b are wound around the lock pins and fixed, or by soldering. It is fixed to the lock pin. Then, in accordance with the degree of rotation of the lock pin, the pull-in lengths near the respective base ends of the operation wires 41a and 41b are adjusted, and the lock pin (the degree of rotation) after the pull-in length adjustment is adjusted by a screw. It is fixed.

  Here, in the present embodiment, for example, as shown in FIGS. 3A and 3B, the adjustment fasteners 323 a and 323 b are connected to the outside in a state where the rotating plate 32 is rotated and the vicinity of the distal end of the catheter tube 2 is bent. The formation positions of the openings 310a and 310b in the handle main body 31 are set so as to communicate with each other. In other words, the position of the adjustment fasteners 323a and 323b and the position where the openings 310a and 310b are formed are set so as to overlap each other in the state of such a rotation operation. 3A and 3B, the positions of the adjustment fasteners 323a and 323b and the positions where the openings 310a and 310b are formed are in a state where the knob 321a or the knob 321b is in contact with the handle body 31. It is supposed to overlap.

  Specifically, in the example shown in FIG. 3A, the opening 310a is connected so that the adjustment fastener 323a communicates with the outside while the rotating plate 32 is rotated in the direction (clockwise) indicated by the arrow d1a. The formation position is set. In addition, in a state where the knob 321a is in contact with the handle body 31, the position of the adjustment fastener 323a and the position where the opening 310a is formed overlap each other.

  On the other hand, in the example shown in FIG. 3B, the position where the opening 310b is formed so that the adjustment fastener 323b communicates with the outside while the rotating plate 32 is rotated in the direction (counterclockwise) indicated by the arrow d1b. Is set. Further, in a state where the knob 321b is in contact with the handle main body 31, the position of the adjustment fastener 323b and the position where the opening 310b is formed overlap each other.

[Action / Effect]
(basic action)
In this electrode catheter 1, the catheter tube 2 is inserted into the patient's body through the blood vessel when examining or treating arrhythmia or the like. At this time, the shape of the vicinity of the distal end of the catheter tube 2 inserted into the body changes in both directions according to the rotation operation of the rotary plate 32 by the operator.

  Specifically, for example, when the operator grabs the handle 3 with one hand and operates the knob 321a with the finger of the one hand to rotate the rotating plate 32 in the d1a direction (clockwise) in FIG. It becomes as follows. That is, in the catheter tube 2, the operation wire 41a is pulled toward the proximal end side (adjustment fastener 323a side) (see FIG. 3A). Then, the vicinity of the distal end of the catheter tube 2 bends (bends) along the direction indicated by the arrow d2a in FIG.

  Further, for example, when the rotating plate 32 is rotated in the d1b direction (counterclockwise) in FIG. 1 by operating the knob 321b, the operation is as follows. That is, in the catheter tube 2, the operation wire 41b is pulled to the proximal end side (adjustment fastener 323b side) (see FIG. 3B). Then, the vicinity of the distal end of the catheter tube 2 is curved along the direction indicated by the arrow d2b in FIG.

  Thus, the operator can perform the swing deflection operation of the catheter tube 2 by rotating the rotating plate 32. In addition, by rotating the handle body 31 around the axis (within the XY plane in FIG. 1), the direction of the bending direction in the vicinity of the distal end of the catheter tube 2 while the catheter tube 2 is inserted into the patient's body. Can be set freely.

  Here, for example, when used for examination of arrhythmia or the like, the cardiac potential is measured using the electrode (tip electrode 22 or ring electrode 21) of the catheter tube 2 inserted into the body of the patient. Then, based on the information on the electrocardiogram, an examination regarding the presence and degree of arrhythmia or the like at the examination site is performed.

  On the other hand, when used for the treatment of arrhythmia, for example, a high frequency (RF) between a counter electrode (not shown) mounted on the patient's body surface and the electrode of the electrode catheter 1 inserted into the patient's body. Radio Frequency) is energized. By such high-frequency energization, a site to be treated (blood vessel or the like) is selectively cauterized (ablated), and percutaneous treatment such as arrhythmia is performed.

(Operation in the handle 3)
By the way, in this electrode catheter 1, in the fixing fasteners 323a and 323b on the rotating plate 32, the pull-in lengths near the base ends when the base ends of the operation wires 41a and 41b are fixed can be arbitrarily adjusted. Is possible. As a result, the tension of the operation wires 41a and 41b can be finely adjusted, and as a result, the degree of bending (curved shape or the like) near the distal end of the catheter tube 2 can be finely adjusted.

  Here, such fine adjustment of the degree of deflection near the distal end of the catheter tube 2 using the adjustment fasteners 323a and 323b is performed when the handle 3 is assembled (before assembly is completed). However, even after the handle 3 is assembled, such fine adjustment work may be required again.

  Therefore, for example, in the electrode catheter 101 according to the comparative example shown in FIG. That is, in the handle 103 of the electrode catheter 101, unlike the handle body 31 of the handle 3 in the electrode catheter 1 of the present embodiment, the openings 310a and 310b are not formed in the handle body 102. That is, in the handle 103 of this comparative example, the adjustment fasteners 323a and 323b on the rotating plate 32 are covered by the handle body 102 after being assembled, and cannot be visually recognized from the outside as they are (finely). Adjustment work is not possible). Therefore, after the handle 103 is assembled, when the fine adjustment operation is performed using the adjustment fasteners 323a and 323b, the handle 103 needs to be disassembled once before that. For this reason, in this comparative example, work efficiency falls and the convenience will be impaired.

  On the other hand, in the electrode catheter 1 of the present embodiment, as shown in FIGS. 1 and 2, the openings 310a and 310b for communicating the adjustment fasteners 323a and 323b on the rotating plate 32 with the outside are provided. The handle body 31 is formed. Therefore, for example, as shown in FIGS. 3A and 3B, the adjustment fasteners 323a and 323b can be visually recognized (accessed) from the outside through the openings 310a and 310b, respectively.

  Thus, in the present embodiment, unlike the comparative example described above, even after the handle 3 is assembled, the pull-in lengths near the tips of the operation wires 41a and 41b can be reduced using these adjustment fasteners 323a and 323b. It can be arbitrarily adjusted. As a result, the tensions of the operation wires 41a and 41b can be finely adjusted, and the distal end of the catheter tube 2 can be obtained without disassembling the handle 3 as in the comparative example (while maintaining the assembled state). Fine adjustment of the degree of deflection in the vicinity can be performed.

  In particular, in this electrode catheter 1, for example, as shown in FIGS. 5 and 6, the adjustment fasteners 323a and 323b are externally attached while the rotating plate 32 is rotated and the vicinity of the distal end of the catheter tube 2 is bent. The positions where the openings 310a and 310b are formed are set so as to communicate with each other. In other words, the position of the adjustment fasteners 323a and 323b and the position where the openings 310a and 310b are formed overlap each other in the above-described swing deflection operation state of the catheter tube 2.

  Specifically, for example, as shown in FIGS. 3A and 5, the rotating plate 32 is rotated in the d1a direction, and the vicinity of the distal end of the catheter tube 2 is bent along the direction indicated by the arrow d2a in FIG. In the case of a state, it is as follows. That is, as a result of the position of the adjustment fastener 323a and the formation position of the opening 310a overlapping each other, the adjustment fastener 323a communicates with the outside. Therefore, by using the adjustment fastener 323a, for example, as shown by arrows d21a and d22a in FIG. 5, the bending condition can be finely adjusted in a state where the vicinity of the distal end of the catheter tube 2 is bent. become.

  On the other hand, as shown in FIGS. 3B and 6, for example, the rotating plate 32 is rotated in the d1b direction and the vicinity of the distal end of the catheter tube 2 is bent along the direction indicated by the arrow d2b in FIG. It becomes as follows. That is, as a result of the position of the adjustment fastener 323b and the position where the opening 310b is formed overlapping each other, the adjustment fastener 323b communicates with the outside. Therefore, by using the adjustment fastener 323b, for example, as shown by arrows d21b and d22b in FIG. 6, the bending degree can be finely adjusted in a state where the vicinity of the distal end of the catheter tube 2 is bent. become.

  Thus, in the electrode catheter 1, since the fine adjustment work of the deflection state of the catheter tube 2 can be performed simultaneously (collectively) during the rotation operation of the rotary plate 32, the work efficiency is further improved and the convenience is improved. It will be improved.

  In addition, in this electrode catheter 1, for example, as shown in FIGS. 3A and 3B, the adjustment fasteners 323a and 323b are provided with the knobs 321a and 321b on the side surface of the rotating plate 32 in contact with the handle body 31. And the positions where the openings 310a and 310b are formed are set so as to overlap each other. As a result, the position where they overlap each other (the rotational operation angle of the rotating plate 32 when performing the fine adjustment work of the bending state) can be easily understood, and the operator can move to the work position without checking the hand. Become. Therefore, working efficiency is further improved, and convenience is further improved.

  As described above, in the present embodiment, the openings 310a and 310b for allowing the adjustment fasteners 323a and 323b to communicate with the outside are formed in the handle main body 31. Therefore, even after the handle 3 is assembled, the catheter The degree of bending near the tip of the tube 2 can be finely adjusted. Therefore, it is possible to improve work efficiency and improve convenience.

  Further, since the adjustment fasteners 323a and 323b are configured using lock pins and screws, the pull-in lengths of the operation wires 41a and 41b can be adjusted according to the degree of rotation of the lock pins. . Therefore, the adjustment operation of the pull-in length, that is, the fine adjustment operation of the degree of bending near the distal end of the catheter tube 2 is facilitated. As a result, the work efficiency can be further improved and the convenience can be further improved.

<Modification>
Then, the modification of this invention is demonstrated. In addition, the same code | symbol is attached | subjected to the same thing as the component in the said embodiment, and description is abbreviate | omitted suitably.

[Constitution]
FIG. 7 schematically illustrates a schematic configuration example of a catheter sheath device 5 as a medical device according to a modification. The catheter sheath device 5 is used to assist insertion of a catheter while expanding a blood vessel when a catheter such as the electrode catheter 1 is inserted into the body.

The catheter sheath device 5 includes a sheath tube 6 (sheath shaft) as a sheath main body (long portion), and a handle 3 attached to the proximal end side of the sheath tube 6. The distal end side of the extension tube 70 is inserted into the handle main body 31 of the catheter sheath device 5, and a three-way cock 71 having two branch paths 721 and 722 is provided on the proximal end side of the extension tube 70. ing.

  Similar to the catheter tube 2, the sheath tube 6 has a flexible tubular structure (hollow tubular member) and has a shape extending along its own axial direction (Z-axis direction). For example, as shown in FIG. 7, the catheter tube 2 or the like in the electrode catheter 1 can be inserted into the sheath tube 6. In addition, as in the case of the catheter tube 2, the distal ends of the operation wires 41 a and 41 b are fixed to the distal end side of the sheath tube 6. The proximal ends of the operation wires 41 a and 41 b are also extended from the sheath tube 6 onto the rotating plate 32, as in the case of the catheter tube 2. In addition, such a sheath tube 6 is comprised by the material (synthetic resin etc.) similar to the catheter tube 2, for example.

  The extension tube 70 is a tubular member that serves as a flow path for the chemical liquids L1, L2 and the like when the chemical liquids L1, L2 and the like described below are injected into the sheath tube 6 through the handle main body 31. The extension tube 70 is also made of, for example, the same synthetic resin as the catheter tube 2.

  The three-way stopcock 71 is a member (branch connector) that can selectively switch the connection state and the blocking state of the flow path between the branch paths 721 and 722 and the extension tube 70. Thereby, in this example, the chemical liquid L1 injected from the branch path 721 side is selectively injected into the extension tube 70 side, or the chemical liquid L2 injected from the branch path 722 side is selectively injected into the extension tube 70 side. It is possible to block both the branch paths 721 and 722. In addition, as such chemical | medical solution L1, L2, a contrast agent etc. are mentioned, for example.

[Action / Effect]
Also in this modified example, basically the same effect can be obtained by the same operation as in the above embodiment. Specifically, also in the catheter sheath device 5 of the present modification, as in the electrode catheter 1, the openings 310 a and 310 b for communicating the adjustment fasteners 323 a and 323 b with the outside are provided in the handle body 31 in the handle 3. Therefore, the following effects can be obtained. That is, even after the handle 3 is assembled, the degree of bending in the vicinity of the distal end of the sheath tube 6 can be finely adjusted. As a result, the working efficiency can be improved and the convenience can be improved.

<Other variations>
While the present invention has been described with reference to the embodiments and modifications, the present invention is not limited to these embodiments and the like, and various modifications can be made.

  For example, the material and manufacturing method of each layer and each member described in the above embodiments are not limited, and other materials, other manufacturing methods, and the like may be used.

  Moreover, in the said embodiment, although the structure of the catheter tube 2 was mentioned concretely and demonstrated, it is not necessary to necessarily provide all the members and you may further provide other members. Specifically, for example, a leaf spring that can be deformed in the bending direction may be provided inside the catheter tube 2 as a swinging member. In addition, the configuration of the electrodes in the catheter tube 2 (arrangement, shape, number, etc. of the ring-shaped electrode 21 and the tip electrode 22) is not limited to that described in the above embodiment.

  Furthermore, in the above-described embodiment and the like, the configuration of the handle 3 (the handle body 31 and the rotating plate 32) has been specifically described, but it is not always necessary to include all the members, and other members may be further provided. You may have. Specifically, for example, the shape of the guide rail 322 on the rotating plate 32 is not limited to the arc shape described in the above-described embodiment, and may be, for example, an annular shape. Further, the guide race 322 may be formed integrally with the rotating plate 32. Furthermore, the shapes of the screws and the lock pins constituting the adjustment fasteners 323a and 323b are not limited to the “−” type mentioned in the above-described embodiment and the like, for example, the “+ (plus)” type It may be. In addition, the adjustment fasteners 323a and 323b may be configured using members other than screws and lock pins. Further, the positions where the openings 310a and 310b are formed in the handle main body 31 are adjusted in the state where the rotating plate 32 is rotated and the vicinity of the distal end of the tubular member is bent as described in the above embodiment. The positions where 323a and 323b communicate with the outside are not limited, and may be other positions. That is, for example, when the rotary plate 32 is not rotated, the positions of the adjustment fasteners 323a and 323b and the positions where the openings 310a and 310b are formed may overlap each other.

  In addition, the shape of the shape near the distal end of the catheter tube 2 is not limited to that described in the above embodiment and the like. Specifically, in the above-described embodiment and the like, medical treatment of a type (bi-direction type) in which the shape near the tip of the tubular member (catheter tube 2 or sheath tube 6) changes in both directions according to the operation of the rotating plate 32. The device has been described as an example, but is not limited thereto. That is, the present invention can be applied to, for example, a medical device of a type (single direction type) in which the shape near the tip of the tubular member changes in one direction according to the operation of the rotating plate 32. In this case, only one (one) operation wire, adjustment fastener, and opening are provided.

  The electrode catheter as a specific example of the medical device according to the present invention is any of an electrode catheter for testing arrhythmia (so-called EP catheter) and an electrode catheter for treating arrhythmia (so-called ablation catheter). It is possible to apply.

  Furthermore, in the above-described embodiments and the like, the electrode catheter and the catheter sheath device have been described as specific examples of the medical device according to the present invention. However, the present invention is not limited thereto. That is, the present invention (the handle in the present invention) can be applied to other medical devices such as a guide catheter (guiding catheter), an angiographic catheter, a sheath catheter (sheath introducer), and a microcatheter. It is.

  DESCRIPTION OF SYMBOLS 1 ... Electrode catheter, 2 ... Catheter tube, 21 ... Ring-shaped electrode, 22 ... Tip electrode, 3 ... Handle, 31 ... Handle body, 310a, 310b ... Opening, 32 ... Rotating plate, 320 ... Rotating shaft, 321a, 321b ... Picking, 322 ... Guide rails, 323a, 323b ... Adjustment fasteners, 40 ... Operation tubes, 41a, 41b ... Operation wires, 5 ... Catheter sheath devices, 6 ... Sheath tubes, 70 ... Extension tubes, 71 ... Three sides Stopcock, 721,722 ... branch, L1, L2 ... chemical solution.

Claims (4)

A tubular member having flexibility;
A handle provided on the proximal end side of the tubular member;
A proximal end side extending from the inside of the tubular member to the handle side, and an operation wire for bending the vicinity of the distal end of the tubular member,
The handle is
The handle body,
A rotating plate rotatably mounted on the handle body;
An adjustment fastener that is provided on the rotating plate and fixes the proximal end of the operation wire and can arbitrarily adjust the pull-in length near the proximal end at the time of fixing;
A medical device formed on the handle body and having an opening for communicating the adjustment fastener with the outside. 2. The formation position of the opening is set so that the adjustment fastener communicates with the outside in a state where the rotating plate is rotated and the vicinity of the distal end of the tubular member is bent. Medical device as described in. On the side surface of the rotating plate, a knob for rotating the rotating plate is provided,
The medical device according to claim 2, wherein the position of the adjustment fastener and the position where the opening is formed overlap each other in a state where the knob is in contact with the handle body. The adjustment fastener is configured using a lock pin and a screw,
The pull-in length is adjusted according to the degree of rotation of the lock pin,
The medical device according to any one of claims 1 to 3, wherein the lock pin after adjustment of the pull-in length is fixed by the screw.

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