JP6258914B2 - Controller, catheter kit, and method of using the controller - Google Patents

Description

  The present invention relates to a controller for holding a catheter such as a stent delivery catheter, a catheter kit including the controller and the catheter, and a method of using the controller.

  For the purpose of treating a stenosis or occlusion lesion in a blood vessel or other in vivo lumen, a stent formed of an elastic material such as metal is placed in the lesion. These stents are generally classified into two types: those expanded by a balloon (balloon expandable type) and those expanded by a self-expanding force derived from material properties (self-expandable type).

  A stent delivery catheter for a self-expanding stent includes an outer sheath that stores the stent in a reduced diameter state by pressing the stent from the surface, and an inner shaft that controls an indwelling position by engaging with the stent. The surgeon then secures the hub attached to the proximal end of the inner shaft in place with one hand and pulls the hub attached to the proximal end of the outer sheath with the other hand.

  With this operation, the outer sheath moves relative to the inner shaft, and the stent is released from the outer sheath due to the detachment of the outer sheath holding the surface while engaging with the inner shaft. Therefore, when releasing the stent, controlling the relative movement between the outer sheath and the inner shaft with high accuracy realizes proper stent placement at the target lesion and improves the treatment results.

  Therefore, in recent years, it has become common to attach a controller to the proximal end of the stent delivery catheter in order to improve the relative movement accuracy. The controller includes components such as gears, gears, or ratchets, and uses them to control the relative movement of the outer sheath and the inner shaft with high accuracy.

  However, as an adverse effect of including a controller, parts inside the housing (housing) of the controller may be damaged, and the stent may not be released. An example of a measure for avoiding such a situation is to remove the stent delivery catheter from the controller quickly and easily.

  For example, the stent delivery catheter disclosed in Patent Document 1 is fixed to a container, and this container is further attached to a controller. And the container which fixed the stent delivery catheter can be easily removed from a controller. That is, the stent delivery catheter can be removed from the controller relatively easily.

JP 2007-195963 A

  However, in such a controller, from the viewpoint of safety, it is necessary to prevent the stent delivery catheter from being unintentionally removed from the controller.

  In the controller of Patent Document 1, the attached stent delivery catheter is exposed from the housing of the controller. Therefore, it is easy for the operator to touch the stent delivery catheter unintentionally. This can cause unintentional catheter dropout.

  The present invention has been made to solve the above problems. The object is to provide a controller or the like that can easily remove the catheter when the operator intends, but cannot accidentally remove the catheter when not intended.

  The controller holds the catheter. The controller includes a first housing and a second housing that are opposed to each other with the catheter as a boundary and cover the catheter. Further, the engaging body is engaged with the first housing and the second housing and the housing is fixed, and the engaging body is pushed out to separate the engaging body from the first housing and the second housing. The controller includes an extruded body and a control body that controls the extrusion operation of the extruded body.

  For example, in the controller, as a piece overlapping in the first direction, the first housing includes the first piece, the second housing includes the second piece, and the engaging body is a linear member in the first direction. The first piece and the second piece are engaged with each other. Then, it is desirable that the extruded body is an elastic member and pushes the linear member along the first direction with a repulsive force, and the control body compresses or releases the elastic member to control the pushing operation of the elastic member.

  The first piece has one or more, at least one has a first cavity, the second piece has one or more, at least one has a second cavity, It is desirable to engage with the first piece and the second piece by being accommodated in the first cavity and the second cavity.

  In addition, one end at both ends of the linear member is fixed, and the other end is a free end. The linear member is formed with a grip piece extending in a direction intersecting with the axial direction of the linear member. It is desirable to arrange the free end due to the repulsion of the member.

  In addition, it is desirable that the gripping piece is formed on one of both ends of the linear member and disposed near the surface of at least one of the first housing or the second housing.

  In addition, the control body includes a bifurcated foot portion, the catheter is sandwiched at the fork portion of the foot portion, and is fixed to at least one of the first housing and the second housing. It is desirable to compress

  A catheter kit including the controller as described above and a catheter attached to the controller can also be said to be the present invention.

  The method of the present invention relates to a first housing and a second housing that are arranged opposite to each other with a catheter as a boundary and covers the catheter, and the first housing and the second housing. An engaging body to be fixed, an extruded body that separates the engaging body from the first housing and the second housing by extruding the engaging body, and a control body that is in contact with the extruded body. The control body is a method for operating a controller formed so as to be capable of being pulled out from the first casing and the second casing, and pulls out the control body from the first casing and the second casing. Thus, the method includes a step of releasing the contact between the extruded body and the control body.

  The controller of the present invention can easily remove the catheter if the operator intends, but cannot accidentally remove the catheter if the operator does not intend.

FIG. 3 is an exploded perspective view showing a stent delivery catheter and a controller attached to the stent delivery catheter. FIG. 3 is an exploded perspective view showing a stent delivery catheter and a controller attached to the stent delivery catheter. These are explanatory drawings explaining in detail a part of the stent delivery catheter. FIG. 5 is an explanatory view for explaining a case where the stent delivery catheter expands the diameter of the stent. FIG. 3 is a perspective view of a controller. FIG. 3 is a perspective view of a housing. FIG. 3 is a perspective view showing a controller before placing a stent. FIG. 3 is a perspective view showing the controller after the stent is placed. FIG. 4 is an enlarged view of the proximal end of the controller in a normal state. FIG. 5 is an enlarged view of the proximal end of the controller in an emergency situation.

[Embodiment 1]
The following describes one embodiment with reference to the drawings. For convenience, hatching, member codes, and the like may be omitted, but in such a case, other drawings are referred to. Conversely, for convenience, hatching may be used even if it is not a sectional view. In addition, the dimensions of various members in the drawings are adjusted for easy viewing.

  FIG. 1 and FIG. 2 are exploded perspective views showing a stent delivery catheter 81 which is an example of a catheter and a controller 10 attached to the stent delivery catheter 81 (note that such a controller 10 and its controller 10). A kit including the catheter 81 attached to the catheter is referred to as a catheter kit 80).

  FIG. 3 is a diagram illustrating a part of the stent delivery catheter 81 in detail, and FIG. 4 is a diagram illustrating a case where the stent delivery catheter 81 expands the diameter of the stent 82. FIG. 5 is a perspective view mainly showing the controller 10, and FIG. 6 is a perspective view showing only the housing HG constituting the controller.

  FIG. 7 is a perspective view showing the controller 10 before the stent 82 is placed, and FIG. 8 is a perspective view showing the controller 10 after the stent 82 is placed. FIG. 9 is an enlarged view of a proximal end portion of the controller 10 in a normal state (described later), and FIG. 10 is an enlarged view of a proximal end portion of the controller 10 in an emergency state (described later).

  In the following, in the stent delivery catheter 81, the side on which the stent is disposed is the distal side, and the opposite side of the distal side is the proximal side. Moreover, when clearly showing the side in each member, it may be called a proximal side and a distal side. In each member, the proximal end is the proximal end, the vicinity of the proximal end is the proximal end, the distal end is the distal end, and the vicinity of the distal end is the distal end. And

  First, the stent delivery catheter 81 will be described mainly with reference to FIGS. The stent delivery catheter 81 is a delivery catheter 81 to which a stent 82 is attached (however, the delivery catheter 81 may be referred to as a stent delivery catheter 81).

  As shown in FIGS. 3 and 4, the stent delivery catheter 81 includes an outer shaft 50 and an inner shaft 60 that fits in a lumen 51L of the outer shaft 50 (specifically, the lumen of the outer tube 51 of the outer shaft 50). 51L accommodates the guide wire lumen tube 61 and the inner tube 66 of the inner shaft 60).

  The outer shaft 50 includes an outer tube 51 that houses the stent 82 in a reduced diameter state, and a manifold 52 (see FIG. 1 and the like) that is attached to the proximal end portion of the outer tube 51.

  The outer tube 51 is a member having flexibility (kinking resistance) enough to follow a lumen (blood vessel or the like) to be inserted, or a tensile strength not enough to stretch when the stent delivery catheter 81 is pulled during the procedure ( Tube).

  When the outer tube 51 is moved, the inner layer of the outer tube 51 reduces the movement resistance (sliding resistance) with the stent 82 that is in contact with the inner peripheral surface of the layer, and the outer tube 51 moves. It has low friction so that it can be easily operated.

  As shown in FIG. 1, the manifold 52 forms a manifold structure and has three ports (52A, 52B, 52C). In the manifold 52, one mouth portion 52A serves as a connection port for the outer tube 51, another mouth portion 52B serves as an insertion port for the inner tube 66 exposed from the inner cavity 51L of the outer tube 51B, and yet another mouth portion. 52C serves as an injection port for injecting an angiographic contrast agent, physiological saline, or the like into the blood vessel (for example, the mouth 52C is used to remove physiological air in the outer shaft 50 before surgery). Etc.).

  As shown in FIG. 5, the mouth portion 52 </ b> C is exposed to the outside of the housing HG when the stent delivery catheter 81 is attached to the controller 10. Further, the connection between the manifold 52 and the outer tube 51 is not particularly limited, and examples thereof include adhesion or welding.

  The inner shaft 60 includes a guide wire lumen tube 61, a tip end 62, a stopper 63, a reinforcing portion 64, a core wire 65, an inner tube 66, and a hub 67.

  The guide wire lumen tube 61 is a tube having a hollow (guide wire lumen 61L), and at least a part thereof is inserted into the lumen 41L of the outer tube 51 of the outer shaft 50. Then, by inserting a guide wire (not shown) into the guide wire lumen 61L of the guide wire lumen tube 61, the inner shaft 60 and eventually the stent delivery catheter 81 are guided to the lesioned portion along the guide wire.

  The distal tip 62 is bonded or welded to the distal portion of the guide wire lumen tube 61. The distal tip 62 makes it easier for the stent delivery catheter 81 to pass through the lesion (stenosis).

  The stopper 63 is a resin layer (for example, a tube) attached (adhered or welded or the like) around the inner tube 66 on the proximal side of the distal tip 62, and fits in the lumen of the stent 82. The movement of the stent 82 is regulated by contacting the inner wall (the total length of the stopper 63 is shorter than that of the guide wire lumen tube 61). That is, the stent 82 is sandwiched between the outer surface of the stopper 63 and the inner surface of the outer tube 51.

  The reinforcing portion 64 reinforces the guide wire lumen tube 61 with a resin layer (for example, a tube) attached (adhered or welded or the like) around the guide wire lumen tube 61 on the proximal side of the stopper 63 (note that The total length of the reinforcing portion 64 is shorter than the guide wire lumen tube 61).

  The core wire 65 is a linear member attached (bonded or welded) around the guide wire lumen tube 61 together with the reinforcing portion 64 and reinforces the guide wire lumen tube 61. For example, the core wire 65 is attached between the reinforcing portion 64 and the guide wire lumen tube 61, is longer than the entire length of the reinforcing portion 64, and extends toward the proximal end of the guide wire lumen tube 61.

  The inner tube 66 is attached (adhered or welded or the like) around the guide wire lumen tube 61 on the proximal side of the reinforcing portion 64. More specifically, the inner tube 66 is attached in parallel to the proximal side of the reinforcing portion 64 so as to cover the guide wire lumen tube 61 (in other words, the guide wire lumen tube 61 and the inner tube 66 are disposed in the lumen of the inner tube 66. Core wire 65 is inserted).

  As shown in FIG. 1, the hub 67 is attached to the proximal end portion of the inner tube 66 and has a port 67 </ b> P that communicates with the lumen of the inner shaft 60. The port 67P is for injecting physiological saline or the like in order to remove air inside the inner shaft 60 before surgery.

  The hub 67 is fixed to a predetermined position of the controller 10 (a hub mounting portion 20 described later). More specifically, the hub 67 is fixed at a predetermined position of the controller 10 by a clip CP described later. Therefore, the hub 67 has a slit 67S that engages with a part of the clip CP in order to appropriately engage with the clip CP.

  In the stent delivery catheter 81 as described above, as shown in FIG. 4, for example, when the outer shaft 50 is pulled proximally, relative movement between the inner shaft 60 and the outer shaft 50 occurs. This movement prevents the outer tube 51 of the outer shaft 50 from overlapping the stopper 63 of the inner shaft 60. Then, since the stent 82 sandwiched between the outer tube 51 and the stopper 63 can no longer be pressed by the outer tube 51, the stent 82 is released while expanding in diameter, and as a result, the stenosis or occlusion site is expanded.

  Next, the controller 10 that controls the stent delivery catheter 81 as shown in FIGS. 5 to 10 will be described.

  The controller 10 is a control member for placing the stent 82 sandwiched between the inner surface of the outer tube 51 of the outer shaft 50 and the outer surface of the stopper 63 of the inner shaft 60 at a desired position. More specifically, as shown in FIGS. 7 and 8, the controller 10 moves the outer shaft 50 with respect to the inner shaft 60 to thereby sandwich the stent 82 among the two members (the outer tube 51 and the stopper 63). The outer tube 51 that holds the outside is separated from the stent 82 (see FIG. 4). As a result, the stent 82 is released from the stent delivery catheter 81 and placed at a desired position.

  1 and 2, the controller 10 includes a housing [housing] HG (HG1 and HG2), a clip [control body] CP, a wire [engaging body] 11, a slider 31, a rotating wheel 41, A switch gear 42, a wheel cover 45, and a spring [extruded body] 15 are included. The first housing HG1 and the second housing HG2 are connected and have a structure that can be disassembled relatively easily. Details regarding this will be described later.

  The housing HG is an exterior of the controller 10, holds a part of the stent delivery catheter 81, and holds the slider 31 movably. For example, as shown in FIGS. 1 and 2, a first housing HG <b> 1 and a second housing HG <b> 2 that sandwich a part of the stent delivery catheter 81 are included.

  As shown in FIG. 6, the first housing [first housing] HG1 includes a hub attachment portion 20, a first extension portion EL1, a gear attachment portion 23, and a first piece PP1.

  As shown in FIGS. 1 and 2, the hub attachment portion 20 attaches the hub 67 of the inner shaft 60. The attachment mechanism of the hub attachment portion 20 is not particularly limited as long as it is a structure for attaching and fixing the hub 67 (and thus a structure for fixing the inner tube 66). For example, the slit 20S that sandwiches one piece 67C of the hub 67 serves as an attachment mechanism. The hub mounting portion 20 is formed with fixing holes 20H and 20H for inserting clips CP having bifurcated legs CF1 and CF2 for fixing the hub 67 more firmly.

  The first extending portion EL1 extends from the hub attachment portion 20 in one direction. Specifically, the first extending portion EL1 covers the inner tube 66 and the like extending from the hub 67 attached to the hub attaching portion 20 in order to extend the inner tube 66 (and thus the stent delivery catheter 81). Extend. The first extending portion EL1 has a slide mechanism {first opening rail HR1 and groove rail DR (see FIG. 8); details will be described later) for holding the slider 31 movably.

  The gear attaching portion 23 attaches the rotating wheel 41 and the switch gear 42 (these are referred to as gears) near the middle of the first extending portion EL1. More specifically, the gear attachment portion 23 is a member that has advanced in a direction intersecting with the extending direction of the first extending portion EL1, is an attachment location of the gears 41 and 42, and one of the gears 41 and 42. Cover the part.

  In addition, although the gear attachment part 23 is formed in the middle of the first extending part EL1 in FIGS. 1 and 2, the position thereof is not particularly limited. Moreover, although the shape of the gear attachment part 23 is also a shape containing a semicircle surface, the shape is not specifically limited. However, since the surgeon must rotate the rotating wheel 41, the gear mounting portion 23 is formed with an exposure opening 23H that exposes a part of the rotating wheel 41 (specifically, the thumb wheel 41T). .

  As shown in FIG. 6, the first piece PP1 protrudes from the inner side (side toward the stent delivery catheter 81) at the distal end portion of the first extending portion EL1 toward the opposing second housing HG2, and It is the piece-like member extended also to the longitudinal direction of 1 extending | stretching part EL1. And this 1st piece PP1 is located in a line with the 2nd piece PP2 mentioned later in the 2nd housing HG2 along the longitudinal direction (namely, longitudinal direction of controller 10; 1st direction) of the 1st extension part EL1.

  The first piece PP1 is one of the members used for connecting the first housing HG1 and the second housing HG2, and is the longitudinal direction of the first extending portion EL1 (that is, the entire length of the first piece PP1). The first cavity HE1 extending in the direction) is included, and details will be described later.

  The second housing [second housing] HG2 is connected to the first housing HG1 so as to cover a part of the stent delivery catheter 81 together with the first housing HG1. As shown in FIG. 6, the second housing HG2 includes a second extending portion EL2, a gear facing portion 24, and a second piece PP2.

  The second extending portion EL2 is a member facing the first extending portion EL1 and the hub mounting portion 20, and, like the first extending portion EL1, extends the inner tube 66 in order to cover the inner tube 66 and the like extending from the hub 67. Extend along the direction. Moreover, as shown in FIG. 1 and FIG. 2, the second extending portion EL2 is slidably held by the slider 31 (second opening rail HR2 / projection rail PR; Details will be described later).

  The gear facing portion 24 is a member that faces the gear mounting portion 23 by advancing in a direction intersecting with the extending direction of the second extending portion EL2.

  As shown in FIG. 6, the second piece PP2 protrudes from the inner side (side facing the stent delivery catheter 81) of the proximal end portion of the second extension portion EL2 toward the opposing first housing HG1, 2 is a piece-like member extending in the longitudinal direction of the extending portion EL2. And this 2nd piece PP2 is arrange | positioned so that it may overlap in the gravity direction with respect to the hub attachment part 20 of 1st housing HG1.

  Further, the second piece PP2 is arranged along the longitudinal direction of the second extending portion EL2 (that is, the longitudinal direction of the controller 10; the first direction) together with the first piece PP1 in the first housing HG1.

  For example, as shown in FIG. 6, the first housing HG1 and the second housing HG2 are about to sandwich the stent delivery catheter 81 in a state where the gear attachment portion 23 and the gear opposing portion 24 face each other. The first piece PP1 and the second piece PP2 are displaced in the longitudinal direction of the controller 10 and are arranged along the longitudinal direction {for example, intersect (for example, orthogonal) to the longitudinal direction of the controller 10 , The proximal end of the first piece PP1 and the distal end of the second piece PP2 are associated with each other, and the first piece PP1 and the second piece PP2 are aligned along the longitudinal direction of the controller 10}.

  The second piece PP2 is one of the members used to connect the first housing HG1 and the second housing HG2 like the first piece PP1. For this connection, the second piece PP2 includes a second cavity HE2 extending in the longitudinal direction of the second extending portion EL2, that is, the entire length direction of the second piece PP2 (note that the second piece PP2 is the second piece PP2). In addition to the two-cavity HE2, it also includes a storage portion SD for accommodating the legs CF1 and CF2 of the clip CP, which will be described in detail later.

  The second cavity HE2 is associated with the first cavity HE1 when the second piece PP2 and the first piece PP1 are arranged along the longitudinal direction of the controller 10. More specifically, the distal end of the second cavity HE2 and the proximal end of the first cavity HE1 are brought into contact with each other, and both the cavities HE1 and HE2 are connected (the cross-sectional shape is perpendicular to the extending direction of the cavities HE1 and HE2). It is not particularly limited, and may be circular or polygonal).

  As shown in FIGS. 1 and 2, the wire 11 is inserted into both the cavities HE1 and HE2. (If the wire 11 can be inserted into both the cavities HE1 and HE2, the shape and material of the wire 11 are not particularly limited. ). More specifically, one end of each end of the wire 11 is inserted from the proximal end of the second cavity HE2 and advanced toward the distal side. Then, its one end exceeds the distal end of the second cavity HE2, and further enters the proximal end of the first cavity HE1 and advances distally.

  As a result, the first piece PP1 and the second piece PP2 are connected via the wire 11, and as a result, the first housing HG1 and the second housing HG2 are connected. Conversely, when the wire 11 is pulled out from both the cavities HE1 and HE2, the connection between the first housing HG1 and the second housing HG2 is released (in short, the controller 10 is disassembled).

  In addition, the grasping piece 12 easy to be grasped by the surgeon is formed at the other end of both ends of the wire 11 so that the surgeon can easily handle the wire 11.

  An example of the grip piece 12 is a flat plate (plate). And the side surface 12S of this flat plate and the other end of the both ends of the wire 11 are connected. That is, in the vicinity of the other end of the wire 11, a part of the flat grip piece 12 extends in a direction intersecting the axial direction of the wire 11. Therefore, the grip piece 12 is easier to grip as compared to gripping the linear wire 11.

  In addition, as a space that can accommodate the gripping piece 12, the second piece PP2 includes a storage portion SD that is a depression further on the proximal side than the proximal end of the second cavity HE2, as shown in FIG. . Specifically, the storage portion SD is a level difference from the surface PP2S of the second piece PP2 (in the second piece PP2, the inside of the controller 10, specifically, the surface facing the hub mounting portion 20), which is about the thickness of the gripping piece 12. Has depth.

  And this storage part SD is formed in the proximal end part of the housing HG which is one place near the surface of the housing HG (Note that the surface of the housing HG is one of the first housing HG1 and the second housing HG2). It may be at least one surface).

  In addition, in order to restrict the movement (displacement) of the gripping piece 12 stored in the storage part SD, a restricting portion SC that contacts at least one end of the outer periphery of the gripping piece 12 may be provided. In addition, the shape of the gripping piece 12 is not limited to a flat plate and may be any shape that can be easily gripped by an operator. In addition, it is desirable that the grip piece 12 is formed of a material that is easy for the operator to operate or is subjected to surface processing.

  As shown in FIGS. 1 and 2, the clip CP fixes the hub 67 (and thus the inner shaft 60) to the housing HG and has bifurcated legs CF1 and CF2. The clip CP inserts the legs CF1 and CF2 into the fixed holes 20H and 20H of the hub mounting portion 20 while fitting the space between the legs CF1 and CF2 into the slit 67S of the hub 67.

  As a result, the hub 67 is fixed to the housing HG at the fork portion of the clip CP (note that the hub 67 may be fixed to at least one of the first housing HG1 and the second housing HG2). On the contrary, when the legs CF1 and CF2 of the clip CP are removed from the fixed openings 20H and 20H of the housing HG1, the hub 67 is detached from the housing HG relatively easily.

  As shown in FIG. 9, the feet CF1 and CF2 that have passed through the fixed opening 20H are also accommodated in the storage portion SD that overlaps the hub mounting portion 20 in the direction of gravity. It fits in the storage unit SD located immediately below the unit 20).

  Then, one of the foot portions CF1 and CF2 (for example, the foot portion CF2) that has reached the storage portion SD is a wall portion SDW of the storage portion SD (specifically, the surface PP2S of the second piece PP2 and the bottom surface of the storage portion SD). The spring 15 is sandwiched between the wall portion SDW) that rises so as to connect the SDB. Details of this point will be described later.

  As shown in FIGS. 7 and 8, the slider 31 is for moving the outer shaft 50 with respect to the inner shaft 60 and is held so as to be movable with respect to the housing HG. The slider 31 includes a main body 32, a puller 33 (33 </ b> A / 33 </ b> B), and a rack gear 34.

  The main body 32 has an elongated shape and has a recess 32H along the longitudinal direction. The recess 32H includes a manifold attachment portion 35 as shown in FIGS.

  The manifold attachment portion 35 fixes the manifold 52 (and thus the outer shaft 50) to the main body 32. The attachment mechanism of the manifold attachment portion 35 is not particularly limited as long as the manifold 52 is attached and fixed. For example, the holding portion 35A that sandwiches the shaft portion between the mouth portion 52A and the mouth portion 52C and the sandwiching portion 55B that sandwiches the shaft portion between the mouth portion 52B and the mouth portion 52C serve as the attachment mechanism.

  The pulling hands 33 (33A and 33B) are individually formed on the two side walls 32A and 32B extending along the entire length direction of the main body 32 at a portion held by the operator. For example, at the proximal end portion of the main body 32, the pulling hands 33A and 33B are formed so as to protrude from the side walls 32A and 32B so as to sandwich the main body 32.

  The puller 33A fits into the first opening rail HR1 formed in the first extending portion EL1 of the first housing HG1 facing the side wall 32A, and the puller 33B is the second of the second housing HG2 facing the side wall 32B. (2) The first opening rail HR1 and the second opening rail HR2 are located on the distal side of the hub mounting portion 20 and along the entire length direction of the housing HG. Extend).

  The pullers 33A and 33B are not particularly limited as long as they can fit on the first opening rail HR1 and the second opening rail HR2 and can move on the rails HR1 and HR2.

  The rack gear 34 is plate-shaped and is formed on one side wall 32A of the two side walls 32A and 32B extending along the entire length direction of the main body 32. More specifically, the rack gear 34 has a tooth shape on the top surface, and is fixed to the side wall 32 </ b> A while keeping its longitudinal edge along the entire length direction of the main body 32. The teeth of the rack gear 34 are arranged along the entire length direction of the main body 32, and the power caused by the rotation of the rotary wheel 41 is applied to the switch gear 42 that meshes with the tooth shape, so that the slider 31 moves.

  In the plate-shaped rack gear 34, a long edge 34E facing the first housing HG1 is fitted into a groove rail DR formed on the inner side of the opposed first housing HG1 (as shown in FIG. 8, the groove The rail DR is formed more distally than the first opening rail HR1).

  Further, as shown in FIG. 7, a cut rail SR is formed in the side wall 32B along the entire length direction of the main body 32, and the cut rail SR is provided with a protruding rail PR formed inside the opposing second housing HG2. (In addition, as shown in FIG. 1 and FIG. 2, the protrusion rail PR is formed in the distal side rather than the 2nd opening rail HR2.).

  That is, in the slider 31, the pulling handle 33 is fitted into the opening rail HR, the edge 34E of the rack gear 34 is fitted into one groove rail DR of the first housing HG, and the cut rail SR of the rack gear 34 is the protruding rail PR of the second housing HG2. Fits into. Therefore, when the surgeon grasps the pulling hand 33 and pulls it toward the proximal side, the slider 31 moves along each rail (that is, the slider 31 does not have to rotate the rotating wheel 41 described later). Move).

  As shown in FIGS. 1 and 2, the rotating wheel 41 includes a rotating gear 41G having a shaft hole 41H and a thumb wheel 41T connected to the rotating gear 41G.

  The rotation gear 41G is a spur gear having a disc shape and having teeth on the edge parallel to the shaft hole direction of the shaft hole 41H.

  The thumb wheel 41T is a disk larger than the rotation gear 41G, has a shaft hole 41H common to the shaft hole 41H of the rotation gear 41G, and is continuous with the rotation gear 41G so as to be stacked in the axial hole direction. Therefore, when the thumb wheel 41T rotates, the rotating gear 41G also rotates. Further, the edge of the disc of the thumb wheel 41T is processed so that the operator's finger is easily caught.

  The switch gear 42 is a spur gear having a rotation shaft 42X, and its teeth mesh with the teeth of the rotation gear 41G and the teeth of the rack gear 34. The switch gear 42 is a gear for associating the rotation direction of the thumb wheel 41T by the operator with the moving direction of the rack gear 34 so as to be easy for the operator to use.

  Specifically, the switch gear 42 moves the slider 31 proximally when the thumbwheel 41T is rotated toward the proximal side, while the slider 31 moves the slider 31 when the thumbwheel 41T is rotated toward the distal side. 31 is moved distally.

  The wheel cover 45 has a rotating shaft 45X that communicates with the shaft hole 41H of the rotating wheel 41, and is fixed to the gear mounting portion 23 of the first housing HG1 in a state where the rotating shaft 45X is inserted into the shaft hole 41H. . That is, the rotating wheel 41 rotates around the rotating shaft 45X of the wheel cover 45.

  When the wheel cover 45 is fixed to the gear attachment portion 23, the switch gear 42 engages with the rotation gear 41G and the rack gear 34, and the rotation shaft 42X is inserted into the receiving hole inside the gear attachment portion 23. (Not shown) It is held rotatably. Therefore, when the rotating wheel 41 rotates, the switch gear 42 is also driven, and the rack gear 34 is also driven as the switch gear 42 rotates.

  That is, when the stent delivery catheter 81 is mounted on the controller 10 as described above, the outer shaft 50 is moved relative to the inner shaft 60, that is, the outer shaft 50 with respect to the housing HG that fixes the inner shaft 60. There are two ways to move the slider 31 for fixing the slider to the proximal side.

  In the first method, the operator grasps the handle 33 of the slider 31 and moves the slider 31 to the proximal side, and in the second method, the operator rotates the thumb wheel 41T. This is a method of moving the slider 31 proximally in units of the pitch of the teeth of the rack gear 34.

  In these movement methods, the second method allows the slider 31 to be moved slightly compared to the first method. Therefore, the second method is suitable for determining the placement position of the stent 82. On the other hand, the first method can move the slider 31 at a long distance at a time compared to the second method. Therefore, the first method is suitable when the stent 82 is completely released from the delivery catheter 70. That is, the controller 10 can provide various usage methods of the stent delivery catheter 81.

  Further, the controller 10 includes a mechanism in which the first housing HG1 and the second housing HG2 are disassembled relatively easily. One component of this mechanism is a spring 15 as shown in FIGS.

  The spring 15 is an elastic member, and one end of both ends is fixed to the wall portion SDW of the storage portion SD (Note that the way of fixing is not particularly limited, and mechanical bonding is possible even if bonding is performed. It does not matter.) And this spring 15 orient | assigns the other end of both ends to the proximal side (in other words, the proximal end of 2nd housing HG2) from wall part SDW. That is, the spring 15 is disposed along the longitudinal direction of the controller 10 in the storage portion SD.

  In addition, the grip piece 12 of the wire 11 is also accommodated in the storage portion SD, and the wire 11 is between the grip piece 12 (specifically, the side surface 12S of the grip piece 12) and the wall portion SDW of the storage portion SD. Be placed.

  In addition, the foot portion CF1 and CF2 of the clip CP are also accommodated in the storage portion SD. Located between part SDW}. Therefore, one of the foot portions CF1 and CF2 (for example, the foot portion CF2) comes into contact with the free end that is the other end of both ends of the spring 15, and compresses the spring 15. That is, as shown in FIG. 9, the spring 15 is compressed by the foot portion CF2 and the wall portion SDW.

  When the spring 15 is compressed in this manner, the hub 67 and the inner shaft 60 are fixed to the controller 10 with the clip CP, and the first housing HG1 and the second housing HG2 11 are connected. Further, the grip piece 12 in the wire 11 is completely stored in the storage portion SD and does not protrude outward from the housing HG. That is, the surgeon is unintentionally unable to touch the wire 11.

  Such a state is set to a normal state, that is, a state in which the stent delivery catheter 81 can be normally operated by the controller 10.

  On the other hand, it may be desirable to disassemble the first housing HG1 and the second housing HG2 in the controller 10. For example, when the thumb wheel 31, the switch gear 42, the slider 31, or the like is damaged, or the contact portion between the slider 31 and the housing HG (the first opening rail HR 11, the second opening rail HR 2, the edge 34 E of the rack gear 34, the protrusion A case where the rail PR, the cut rail SR, the groove rail DR, or the like) is damaged.

  Such a state is an emergency state, that is, a state where the stent delivery catheter 81 cannot be normally operated by the controller 10.

  In such an emergency state, when the clip CP is pulled out from the housing HG, as shown in FIG. 10, the gripping piece 12 of the wire 11 protrudes outward from the housing HG. Thereafter, when the operator grasps the grasping piece 12 and pulls out the wire 11 from the housing HG, the housing HG is disassembled into the first housing HG1 and the second housing HG2.

  More specifically, when the clip CP is pulled out from the housing HG, the foot portion CF2 that has compressed the spring 15 is separated from the storage portion SD together with the wall portion SDW of the storage portion SD. Then, the compressed spring 15 is released and restored to a natural state.

  Since the spring 15 arranged along the longitudinal direction of the controller 10 is restored, it extends from the compressed state. Then, the free end (proximal end) of the spring 15 moves toward the gripping piece 12 and contacts and pushes the side surface 12S of the gripping piece 12 (that is, the gripping piece 12 is disposed at the extension destination due to the repulsion of the spring 15). ) As a result, the gripping piece 12 moves along the axial direction of the wire 11 and protrudes outward from the housing HG.

  When the protruding grasping piece 12 is grasped and pulled out by the operator, the wire 11 is pulled out from the housing HG, and the housing HG is disassembled into the first housing HG1 and the second housing HG2.

  The controller 10 that holds the stent delivery catheter 81 as described above can be said as follows.

  The controller 10 includes a first housing HG1 and a second housing HG2 that are opposed to each other with the stent delivery catheter 81 as a boundary and cover the stent delivery catheter 81. Further, the controller 10 includes a wire 11 which is engaged with the first housing HG1 and the second housing HG2 and fixes both the housings HG1 and HG2. The controller 10 includes a spring 15 that separates the wire 11 from the first housing HG1 and the second housing HG2 by pushing out the wire 11, and a clip CP that controls the pushing operation of the spring 15.

  In this case, the surgeon operates one member called the clip CP, so that the wire 11 which is the connecting member of the two housings HG1 and HG2 can be disconnected from the two housings HG1 and HG2, and as a result, the stent delivery. The catheter 81 is detached from the controller 10. Conversely, if the operator pays attention only to one member called the clip CP, the stent delivery catheter 81 cannot be detached from the controller 10. That is, when the surgeon intends, the stent delivery catheter 81 can be easily removed from the controller 10, while when the surgeon does not intend, the stent delivery catheter 81 is difficult to remove by mistake.

  Therefore, the controller 10 protects the stent delivery catheter 81 from external contact by the housing HG in the normal state, while the stent delivery catheter 81 can be easily separated from the housing HG in the emergency state.

  More specifically, the first housing HG1 and the second housing HG2 are pieces that overlap in the longitudinal direction [first direction] of the controller 10, the first housing HG1 is the first piece PP1, and the second housing HG2 is the second piece. The piece PP2 is included. And the wire 11 which is a linear member is arrange | positioned along the longitudinal direction of the controller 10, and it is related with 1st piece PP1 and 2nd piece PP2, and 1st housing HG1 and 2nd housing HG2 are connected. Connect.

  In this case, since the wire 11 is engaged with the first housing HG1 and the second housing HG2 along the longitudinal direction of the controller 10, for example, along the short direction of the controller 10, the wire 11 However, as compared with the case where the first housing and the second housing are engaged, both the housings HG1 and HG2 are stably fixed (the point is that the contact area of the wire 11 with respect to both the housings HG1 and HG2 is relatively large). Both housings HG1 and HG2 are stably fixed).

  In addition, the controller 10 includes a spring 15 and a clip CP as members for separating the wire 11 from the housing HG. The spring 15 is an elastic member, and pushes the wire 11 along the longitudinal direction of the controller 10 by exerting a repulsive force. The spring 15 is controlled by a clip CP. The clip CP compresses or releases the spring 15 to control the pushing operation of the spring 15 with respect to the wire 11.

  With this arrangement, the two housings HG1 and HG2 fixed relatively stably can move the wire 11 as a fixing member simply by removing the clip CP from the housing HG. Then, if the moved wire 11 protrudes toward the outside of the housing HG, the surgeon pulls out the wire 11 so that both the housings HG1 and HG2 can be easily disassembled.

  In the above, the number of the first piece PP1 and the second piece PP2 is singular, but is not limited to this, and may be plural. In short, the first piece PP1 may be singular or plural, and similarly, the second piece PP2 may be singular or plural.

  However, a first cavity is formed in at least one of the first pieces PP1, and a second cavity is formed in at least one of the second pieces PP2. Then, the wire 11 is engaged with the first piece PP1 and the second piece PP2 (as a result, the first housing HG1 and the second housing HG2) by being accommodated in the first cavity HE1 and the second cavity HE2.

  That is, both the housings HG1 and HG2 are fixed only by the wire 11 inserted into the simple cavities HE1 and HE2. That is, both the housings HG1 and HG2 are connected by a relatively simple mechanism and further disassembled, so that the operator can easily handle them.

  In addition, one end at both ends of the spring 15 is fixed and the other end is a free end. The wire 11 is formed with a gripping piece 12 extending in a direction intersecting the longitudinal direction. The gripping piece 12 is a repulsive spring. It is arranged at the extension destination of 15 free ends.

  In this case, the gripping piece 12 pushed out by the spring 15 easily moves along the axial direction of the wire 11, and the gripping piece 12 projects toward the outside of the housing HG as shown in FIG. It becomes easy.

  In particular, the gripping piece 12 is formed at one of both ends of the wire 11 and is disposed in the vicinity of the surface of the housing HG. Therefore, when the gripping piece 12 is pushed by the spring 15, the outside of the housing HG can be easily obtained. Protrusively toward.

  Further, the clip CP in the controller 10 includes bifurcated legs CF1 and CF2. Then, the stent delivery catheter 81 is sandwiched by the fork portions of the foot portions CF1 and CF2 and fixed to the housing HG, and the spring 15 is compressed by the foot portion CF2.

  In this case, the clip CP has both the function of fixing the stent delivery catheter 81 and the function of compressing the spring 15, and no member is required for each function. Is reduced.

[Other embodiments]
The present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the spirit of the present invention.

  For example, in the above description, a stent delivery catheter has been described as an example of a catheter.

  The material of the wire 11 may be resin or metal. Moreover, even if it is other than a linear member like the wire 11, if it is related with 1st piece PP1 and 2nd piece PP2 and 1st housing HG1 and 2nd housing HG2 are connected, the The shape is not particularly limited.

11 Wire [engagement body, linear member]
12 gripping piece 12S side face of gripping piece 15 spring [extruded body, elastic member]
CP clip CF1 foot CF2 foot HG Housing [housing]
HG1 first housing [first housing]
PP1 1st piece HE1 1st cavity HR1 1st opening rail DR groove rail 20 hub attachment part 23 gear attachment part HG2 2nd housing [2nd housing]
PP2 2nd piece HE2 2nd cavity SD storage part SDW storage part wall part SDB storage part bottom face HR2 2nd opening rail PR protrusion rail 24 gears facing part 31 slider 32 main body 32A main body side wall 32B main body side wall 33 puller 33A Puller 33B Puller 34 Rack Gear 34E Rack Gear Edge 35 Manifold Mounting Portion 41 Rotating Wheel 41G Rotating Gear 41T Thumb Wheel 42 Switch Gear 45 Wheel Cover CP Clip 50 Outer Shaft 51 Outer Tube 51L Outer Tube Lumen 52 Manifold 60 Inner Shaft 61 Guide Wire lumen tube 61L Guide wire lumen 62 Tip tip 63 Stopper 64 Reinforcement part 65 Core wire 66 Inner tube 66T Inner tube Outer peripheral surface 67 hub 80 catheter kit 81 stent delivery catheter [catheter]
82 stent

Claims (10)

A controller for holding the catheter,
A first housing and a second housing which are arranged opposite to each other with the catheter as a boundary, and which cover the catheter;
An engaging body that engages the first casing and the second casing and fixes the casing;
A pusher that pushes out the engagement body to separate the engagement body from the first housing and the second housing;
A control body for controlling the extrusion operation of the extruded body;
A part of the control body is present in an internal space formed by the first casing and the second casing, and another part of the control body is the first casing and the second casing. A controller that exists outside the body.   The controller according to claim 1, wherein the control body is formed so as to be able to be pulled out from the first casing and the second casing. The first housing has a first cavity extending in the axial direction of the catheter,
The second housing has a second cavity extending in the axial direction of the catheter,
The controller according to claim 1, wherein the engagement body is inserted through the first cavity and the second cavity. As the pieces overlapping in the first direction, the first casing includes the first piece, and the second casing includes the second piece,
The engaging body is a linear member and is arranged along the first direction so as to be engaged with the first piece and the second piece.
The extruded body is an elastic member, and the repulsive force pushes the linear member along the first direction.
The control body controls the pushing operation of the elastic member by compressing or releasing the elastic member.
The controller according to claim 1. The first piece has one or more, and at least one of the first pieces is formed with a first cavity,
The second piece has one or more, and at least one second cavity is formed,
The engaging body engages with the first piece and the second piece by being accommodated in the first cavity and the second cavity.
The controller according to claim 4. One end at both ends of the extruded body is fixed, the other end is a free end,
The linear member is formed with a grip piece extending in a crossing direction with respect to its own axial direction,
The gripping piece is disposed at an extension destination of the free end due to repulsion of the extruded body.
The controller according to claim 4 or 5. The grip piece is formed on one of both ends of the linear member, and is disposed near the surface of at least one of the first casing or the second casing.
The controller according to claim 6. The control body includes a bifurcated foot,
At the fork portion of the foot, the catheter is sandwiched and fixed to at least one of the first housing and the second housing, and the extrudate is compressed at the foot.
The controller according to claim 1. The controller according to any one of claims 1 to 8,
A catheter attached to the controller;
A catheter kit comprising: A first housing and a second housing which are arranged opposite to each other with a catheter as a boundary and cover the catheter;
An engaging body that engages the first casing and the second casing and fixes the casing;
A pusher that pushes out the engagement body to separate the engagement body from the first housing and the second housing;
A control body in contact with the extruded body;
Including
The first housing has a first cavity extending in the axial direction of the catheter,
The second housing has a second cavity extending in the axial direction of the catheter,
One engagement body is provided for one controller, and the first cavity and the second cavity are provided.
Inserted into the cave,
The control body is a method of operating a controller formed so as to be able to be pulled out from the first housing and the second housing,
A method comprising releasing the contact between the extruded body and the control body by pulling out the control body from the first housing and the second housing.