JP6322374B2 - Tube stent delivery device - Google Patents

Description

  The present invention relates to a tube stent transport apparatus capable of transporting and placing a tube stent that can be used, for example, as a bile duct drainage to a predetermined position.

  Stents are roughly classified into tube stents and metallic stents. The tube stent advances through the human body by being pushed by the pusher catheter along the guide wire and the inner catheter inserted into the human body. Conventional tube stents cannot be pulled back simply by being pushed by a pusher catheter, and if the stent is mispositioned, the stent must be removed and then restarted.

  Accordingly, a delivery system capable of pulling back the stent has been developed, and for example, Patent Document 1 is known. However, in the invention shown in Patent Document 1, since the tube stent and the delivery catheter are temporarily connected by a thread or string, the thread or string becomes entangled in the body, and the tube stent cannot be removed from the delivery catheter. Has a problem.

JP 2012-239803 A

  The present invention has been made in view of such a situation, and an object of the present invention is to easily adjust the position of the tube stent, and to prevent the thread or string from being entangled in the body and to ensure that the tube stent is accurately attached to the body. It is providing the tube stent delivery apparatus which can be detained in a proper position.

In order to achieve the above object, a tube stent delivery device according to the present invention comprises:
An inner catheter in which a tube stent is attached to the outer periphery of the distal end portion so as to be axially movable;
An outer catheter mounted on the outer circumference of the inner catheter located on the proximal end side of the tube stent so as to be axially movable,
An intermediate stopper having an outer diameter larger than the inner diameter of the distal end of the tube stent is formed at a predetermined position on the proximal end side from the distal end of the inner catheter,
On the proximal end side of the intermediate stopper, a main small diameter portion having an outer diameter smaller than the inner diameter of the distal end of the tube stent is formed on the outer periphery of the inner catheter,
On the proximal end side of the main small diameter portion, a base large diameter portion having an outer diameter larger than the outer diameter of the main small diameter portion is formed on the outer periphery of the inner catheter,
By moving the outer catheter relative to the inner catheter toward the distal end in the axial direction, the distal end of the outer catheter moves relative to the outer circumference of the base large-diameter portion in the axial direction. Abutting the proximal end of the stent,
By moving the inner catheter relative to the outer catheter in the axial direction on the proximal end side, the intermediate stopper of the inner catheter can be inserted through the through hole of the tube stent.

  In the tube stent delivery device according to the present invention, an intermediate stopper having an outer diameter larger than the inner diameter of the distal end of the tube stent is formed on the inner catheter, so that the tube stent is mounted on the proximal end side of the intermediate stopper. This prevents the tube stent from unexpectedly falling off the inner catheter. If you want to return the tube stent insertion position to the proximal end side, move the inner catheter to the proximal end side along the axial direction to lock the intermediate stopper to the distal end of the tube stent. To do. Therefore, if the inner catheter is moved further to the proximal end side along the axial direction, the tube stent engaged with the intermediate stopper also moves to the proximal end side together with the inner catheter, and the tube stent in the body cavity is moved. The insertion position can be finely adjusted.

  After the tube stent is set at a predetermined insertion position in the body cavity, the proximal end of the outer catheter is operated to move the outer catheter relative to the inner catheter in the axial direction. As a result, the distal end of the outer catheter relatively moves in the axial direction on the outer periphery of the base large-diameter portion and abuts on the proximal end portion of the tube stent.

  In this state, the tube stent is moved distally at the distal end surface of the outer catheter by pulling the inner catheter with a certain force or more so as to move the inner catheter relative to the proximal end side relative to the outer catheter. Pushed in the end direction, the intermediate stopper enters the tube stent through-hole from the distal end opening of the tube stent. This is because the axial movement of the tube stent is limited by the outer catheter. Furthermore, when the inner catheter is moved relative to the outer catheter so as to be pulled toward the proximal end side, the distal end of the inner catheter moves relative to the distal end of the outer catheter, and the tube stent moves from the outer circumference of the inner catheter. It is completely removed and left in the body.

  Thus, in the apparatus of the present invention, the insertion position of the tube stent can be finely adjusted without using a thread or string. Therefore, the tube stent can be reliably placed at an accurate position in the body without the thread or string being entangled in the body.

  Preferably, an auxiliary small diameter portion having an outer diameter smaller than the inner diameter of the distal end of the tube stent is formed on the distal end side of the intermediate stopper of the inner catheter. With such a configuration, after the intermediate stopper has entered the tube stent passage hole, the distal end opening of the tube stent is located on the outer periphery of the auxiliary small diameter portion, and the subsequent axial movement of the inner catheter is prevented. Become smooth.

Preferably, a distal end stopper having an outer diameter larger than the inner diameter of the distal end of the tube stent is formed on the distal end side of the auxiliary small diameter portion,
The distal end stopper of the inner catheter can be inserted through the through hole of the tube stent by moving the inner catheter relative to the outer catheter in the axial direction toward the proximal end.

  According to such a configuration, even after the distal end of the tube stent is positioned on the outer periphery of the auxiliary small diameter portion, the tube stent can be returned along the axial direction toward the proximal end in the body cavity. The tube stent insertion position can be finely adjusted. That is, when it is desired to return the insertion position of the tube stent to the proximal end side, if the inner catheter is moved together with the outer catheter along the axial direction to the proximal end side, the distal end stopper becomes the distal end of the tube stent. Lock to. Therefore, if the inner catheter is moved further to the proximal end side along the axial direction, the tube stent engaged with the tip stopper also moves to the proximal end side together with the inner catheter, and the insertion position of the tube stent is delicately changed. Can be adjusted.

  After the tube stent is set at a predetermined insertion position in the body, the inner catheter is pulled with a certain force applied to the outer catheter so as to move the inner catheter relative to the proximal end side in the axial direction. Thus, the distal end stopper of the inner catheter is inserted through the through hole of the tube stent. This is because the axial movement of the tube stent is limited by the outer catheter. Furthermore, when the inner catheter is moved relative to the outer catheter so as to be pulled toward the proximal end side, the distal end of the inner catheter moves relative to the distal end of the outer catheter, and the tube stent moves from the outer circumference of the inner catheter. It is completely removed and left in the body.

  Preferably, the axial length of the main small diameter portion is shorter than the axial length of the tube stent. With this configuration, at the initial attachment position of the tube stent, the proximal end of the tube stent is located on the outer periphery of the base large diameter portion, and the inner periphery of the tube stent is on the outer periphery of the base large diameter portion. In close contact. With this configuration, when the outer catheter is moved to the distal end side in the axial direction along the outer periphery of the base large-diameter portion, the distal end of the outer catheter is securely connected to the proximal end of the tube stent. Abut. The axial length of the auxiliary small diameter portion may be shorter than the axial length of the tube stent.

FIG. 1 is a side view of a tube stent delivery device to which a tube stent according to an embodiment of the present invention is attached. FIG. 2 is a side view of the apparatus shown in FIG. 1 with the tube stent and outer catheter removed. FIG. 3 is a side view of the outer catheter shown in FIG. FIG. 4 is an enlarged side view of the tube stent before being attached to the apparatus shown in FIG. FIG. 5 is an enlarged cross-sectional view of a main part of the apparatus shown in FIG. FIG. 6 is a schematic view showing a use state of the apparatus shown in FIG.

Hereinafter, the present invention will be described based on embodiments shown in the drawings.
As shown in FIG. 1, a tube stent delivery device 2 according to an embodiment of the present invention includes an inner catheter 20 on which a tube stent 10 is attached to an outer periphery of a distal end portion so as to be axially movable.

  An outer catheter 40 is attached to the outer periphery of the inner catheter 20 located on the proximal end side of the tube stent 10 so as to be axially movable. A strainer tube 50 is attached to the outer periphery of the outer catheter 40 so as to be axially movable.

  As shown in FIG. 2 in which the tube stent 10, the strainer tube 50 and the outer catheter 40 shown in FIG. 1 are removed, a distal end taper portion 21 tapering toward the distal end is formed at the distal end of the inner catheter 20. It is formed. A marker 23 is attached to the inner peripheral surface side of the inner catheter 20 at a position on the proximal end side of the tip tapered portion 21. The marker 23 is formed, for example, by attaching a metal ring such as platinum, gold, or platinum / iridium alloy, and the position can be detected by X-rays or the like.

  A tip stopper 22 is formed integrally with the tip tapered portion 21 on the proximal end side of the marker 23. An auxiliary small diameter portion 25 having an outer diameter smaller than the outer diameter of the tip stopper is formed on the proximal end side of the tip stopper 22 with a predetermined axial length. An intermediate stopper 24 having an outer diameter larger than the outer diameter of the auxiliary small diameter portion 25 is integrally formed on the proximal end side of the auxiliary small diameter portion 25.

  A main small diameter portion 26 is integrally formed with a predetermined axial length on the proximal end side of the intermediate stopper 24. On the proximal end side of the main small diameter portion 26, a base large diameter portion 28 having an outer diameter larger than the outer diameter of the main small diameter portion 26 is integrally formed. An inner tube main body 29 is integrally formed on the proximal end side of the base large diameter portion 28, and the proximal end of the inner tube main body 29 is connected to the connector 30. In the present embodiment, the outer diameter of the base large-diameter portion 28 and the outer diameter of the inner tube main body 29 are the same, but the present invention is not limited to this.

  A female fitting portion 32 is formed on the connector 30, and a male fitting portion 48 of the connector 44 of the outer catheter 40 shown in FIG. 3 can be detachably mounted. At the proximal end of the connector 30, a proximal opening 34 communicates with a guide passage 27 shown in FIG. The guide passage 27 is formed over the entire length of the inner catheter 20, and a guide wire or the like can be inserted therethrough so as to be movable in the axial direction.

  The distal end taper portion 21, the distal end stopper 22, the auxiliary small diameter portion 25, the intermediate stopper 24, the main small diameter portion 26, the base large diameter portion 28, and the inner tube main body 29 in the inner catheter 20 are formed by processing a single plastic tube. Alternatively, they may be formed by connecting separate plastic tubes or short tubes. These connections and the connection between the proximal end of the inner tube main body 29 and the connector 30 are performed by means such as adhesion or fusion with an adhesive.

  The material of the plastic tube or short tube used to configure the inner catheter 20 described above is not particularly limited, and includes, for example, a fluororesin (polytetrafluoroethylene or the like), polyethylene, polyurethane, polyamide, or the like. The connector 30 is made of, for example, polycarbonate, polyacetal, high density polyethylene, polymethylpentene, polyamide, polypropylene, or the like.

  As shown in FIG. 3, the outer catheter 40 has an outer tube 42. A distal end opening 42a is formed at the distal end of the outer tube 42, and a proximal end opening 42b is formed at the proximal end thereof. A connector 44 is connected to the proximal end opening 42 b of the outer tube 42.

  A proximal end opening 46 is formed at the proximal end of the connector 44, from which a portion from the distal tapered portion 21 of the inner catheter 20 to the proximal end of the inner tube main body 29 shown in FIG. 2 can be inserted. It has become. That is, a through hole from the base end opening 46 to the distal end opening 42a is formed inside the connector 44 and the outer tube 42 shown in FIG. 3, and the inner diameter thereof is the tip of the inner catheter 20 shown in FIG. It is equal to or larger than the maximum outer diameter of the portion from the tapered portion 21 to the proximal end of the inner tube main body 29.

  The material of the outer tube 42 is not particularly limited, and is made of, for example, a fluororesin (polytetrafluoroethylene or the like), polyethylene, polyurethane, polyamide, or the like. The connector 44 is made of, for example, polycarbonate, high density polyethylene, polymethylpentene, polyacetal, polyamide, polypropylene, or the like. The proximal end of the outer tube 42 and the connector 44 are connected by means such as bonding with an adhesive, fusion bonding, and caulking.

  As shown in FIGS. 4 and 5, the tube stent 10 has a tube body 12 having a through hole 12c that communicates with a distal end opening 12a and a proximal end opening 12b. The tube body 12 is made of, for example, a plastic tube such as a fluororesin (such as polytetrafluoroethylene), polyethylene, polyurethane, or polyamide.

  The distal end side of the tube stent 10 is tapered so that its outer diameter and inner diameter become smaller toward the distal end, and the inner diameter of the distal end opening 12a is smaller than the inner diameter of the tube body 12. Has been. Further, a side hole 18 is formed on the proximal end side of the distal end opening 12a of the tube body 12 and communicates with an internal through hole. The side hole 18 is formed to discharge bile and the like from the inside of the tube stent 10.

  A distal end side flap 14 is formed on the proximal end side of the side hole 18. The flap 14 is formed by cutting the outer periphery of the tube body 12 in the axial direction along the flap opening 14 a and raising the cut piece to the outside of the tube body 12. The through hole of the tube main body 12 communicates with the outside through the flap opening 14a.

  The distal end flap 14 is proximal from the proximal end of the flap 14 so that when the tube stent 10 is inserted into the body cavity in the direction of its distal end, it is folded toward the tube body 12 along the inner wall of the body cavity. It gradually protrudes outward in the end direction.

  A proximal end side flap 15 is formed on the distal end side of the proximal end opening 12 b of the tube body 12. The flap 15 is formed by cutting the outer periphery of the tube main body 12 in the axial direction along the flap opening 15 a and raising the cut piece to the outside of the tube main body 12. The through hole of the tube body 12 communicates with the outside through the flap opening 15a.

  For example, as shown in FIG. 6, the proximal end side flap 15 uses an endoscope 60 and the delivery device 2 to insert the tube stent 10 into the bile duct 64, and then the bile duct 64 from the duodenum 62. It gradually protrudes outward from the proximal end of the flap 14 toward the distal end so as to be caught by the papilla 66 which is the entrance to the head.

  As shown in FIG. 4, a marker 16 is attached to the distal end side of the proximal end side flap 15. In the present embodiment, the marker 16 is colored black to facilitate visual recognition under an endoscope. Further, the marker 16 may be formed by attaching a metal ring, for example, like the marker 23. In that case, the position can be detected by X-ray fluoroscopy or the like.

  The tube body 12 is preferably brazed in an arc shape with a radius of curvature R, for example. The reason for brazing in an arc shape is to match the shape in the body cavity such as the bile duct 64 shown in FIG. The curvature radius R is not particularly limited, but is preferably 40 to 200 mm. As shown in FIG. 1, when the tube stent 10 is attached to the outer periphery of the inner catheter 20, the tube stent 10 becomes linear according to the shape of the inner catheter 20, but if the inner catheter 20 is bent, the stent 10 bends as well.

  When the strainer tube 50 shown in FIG. 1 is positioned on the outer periphery of the proximal end side flap 15 of the tube stent 10 and the delivery device 2 to which the stent 10 is attached is inserted into the endoscope 60 shown in FIG. In addition, the flap 15 does not get in the way. The strainer tube 50 is mounted on the outer circumference of the outer tube 42 and the tube stent 10 so as to be movable along the axial direction. The strainer tube 50 is made of, for example, polyethylene, polyurethane, polyamide, fluororesin (polytetrafluoroethylene, or the like).

  In the tube stent delivery device 2 shown in FIGS. 1 to 6, the dimensional relationship of each part is not particularly limited, but is preferably in the following relationship. That is, the axial length L1 of the tip tapered portion 21 shown in FIG. 2 is preferably 3 to 15 mm, and the axial length L2 of the tip stopper 22 is preferably 5 to 20 mm. Moreover, it is preferable that the axial direction length L3 of the auxiliary | assistant small diameter part 25 shown in FIG. 2 is shorter than the axial direction length L10 of the tube stent 10 shown in FIG. 1, Preferably it is 20-80 mm.

  The axial length L4 of the intermediate stopper 24 shown in FIG. 2 is preferably shorter than the axial length L3 of the auxiliary small-diameter portion 25 and about the same as the axial length L2 of the tip stopper 22, but it is not necessarily the same. Need not be. The axial length L5 of the main small-diameter portion 26 is preferably approximately the same as the axial length L3 of the auxiliary small-diameter portion 25, but is not necessarily the same. The axial length L6 of the base large diameter portion 28 is preferably longer than the axial length L5 of the main small diameter portion 26, but the specific length is not particularly limited. Although the total length L0 of the inner catheter 20 excluding the connector 30 is not particularly limited, for example, in the case of a delivery device for a tube stent inserted into a bile duct, it is preferably 500 to 3500 mm.

  The axial length L7 of the outer tube 42 of the outer catheter 40 shown in FIG. 1 is shorter than the total length L0 of the inner catheter 20 shown in FIG. ). α is preferably 5 to 200 mm, and the distal end opening 42a of the outer tube 42 is positioned on the outer periphery of the base large-diameter portion 28 as shown in FIG.

  Further, the axial length L7 of the outer tube 42 is such that the distance L8 from the distal end opening 42a of the outer tube 42 to the proximal end of the intermediate stopper 24 is the axial length of the tube stent 10 as shown in FIG. It is determined to be longer than the length L10. This is to make the tube stent 10 fit within the range of the distance L8. As the tube stent 10 attached to the device 2 according to the present embodiment, several types of stents having different axial lengths L10 can be used.

  The axial length L10 of the tube stent 10 is preferably larger than the axial length L5 of the main small diameter portion 26 of the inner catheter 20 shown in FIG. As shown in FIG. 5, the distal end opening 12a of the stent 10 is located on the outer periphery of the main small diameter portion 26 located on the proximal end side of the intermediate stopper 24, and the proximal end opening 12b of the stent 10 is the base large diameter portion. 28 is preferably located on the outer periphery.

  The axial length L10 of the tube stent 10 is in the range of 50 to 250 mm, for example. Further, the axial length L9 of the strainer tube 50 shown in FIG. 1 is preferably shorter than the axial length L10 of the tube stent 10.

  As shown in FIG. 5, it is preferable that a taper is formed on the distal end side of the tube stent 10 so that the inner diameter decreases toward the distal end. In the case where such a taper is formed, the inner diameter D12a of the distal end opening 12a of the tube stent 10 may be 75 to 95% of the inner diameter D10 of the tube stent 10 where the taper is not formed. preferable. The inner diameter D12a of the distal end opening 12a of the tube stent 10 is preferably larger than the outer diameter D5 of the main small diameter portion 26 of the inner catheter 20 and smaller than the outer diameter D4 of the intermediate stopper 24.

  The outer diameter D4 of the intermediate stopper 24 is preferably about the same as the outer diameter D2 of the distal end stopper 22, and is larger than the inner diameter D12a of the distal end opening 12a of the tube stent 10, and 0.1 to 5 larger than the inner diameter D12a. It is preferably 0.0% larger. If the outer diameter D4 of the intermediate stopper 24 is too large, the distal end opening 12a of the tube stent 10 exceeds the limit of expansion, making it difficult to insert the intermediate stopper 24 into the distal end opening 12a of the tube stent 10. . Further, if the outer diameter D4 of the intermediate stopper 24 is too small, it becomes difficult to lock the intermediate stopper 24 to the distal end opening 12a of the tube stent 10.

  Further, the outer diameter D5 of the main small diameter portion 26 is preferably smaller than the inner diameter D12a of the distal end opening 12a of the tube stent 10, and preferably about the same as the outer diameter D3 of the auxiliary small diameter portion 25. They do not have to be identical. The outer diameter D6 of the base large diameter portion 28 is preferably larger than the outer diameter D5 of the main small diameter portion 26 and larger than the outer diameter of the intermediate stopper 24. However, when the intermediate stopper 24 is locked to the distal end opening 12 a of the tube stent 10, the proximal end opening 12 b of the tube stent 10 is usually positioned on the outer periphery of the base large-diameter portion 28 of the inner catheter 20. Therefore, if the outer diameter D6 of the base large-diameter portion 28 is too large, the close contact degree of the proximal end opening 12b of the tube stent 10 with respect to the base large-diameter portion 28 becomes too strong, and the axial movement of the tube stent 10 becomes difficult. Become. Therefore, the outer diameter D6 of the base large-diameter portion 28 is preferably 80 to 95% of the inner diameter D10 of the tube stent 10 before being attached to the outer periphery of the base large-diameter portion 28.

  The inner diameter D7 of the outer tube 42 is preferably equal to or greater than the outer diameter D6 of the base large-diameter portion 28. The outer tube 42 is moved in the axial direction with respect to the inner catheter 20 to open the distal end of the outer tube 42. 42 a can be brought into contact with the proximal end opening 12 b of the tube stent 10.

  As shown in FIG. 5, in the present embodiment, at the distal end portion of the inner catheter 20, portions having different outer diameters are integrated along the axial direction. A tapered portion is provided in which the outer diameter gradually decreases toward the smaller diameter side. This is to smoothly move the tube stent 10 in the axial direction on the outer periphery of the distal end portion of the inner catheter 20.

  In the tube stent delivery device 2 according to the present embodiment, since the intermediate stopper 24 having an outer diameter larger than the inner diameter D12a of the distal end opening 12a of the tube stent 10 is formed on the inner catheter 20, the intermediate stopper 24 In addition, by attaching the tube stent 10 to the proximal end side, the tube stent 10 is prevented from unexpectedly falling out of the inner catheter 20. Further, when it is desired to return the insertion position of the tube stent 10 in the body cavity to the proximal end side, if the inner catheter 20 is moved relative to the proximal end side along the axial direction together with the outer catheter 40, an intermediate stopper 24 is locked to the distal end opening 12 a of the tube stent 10. Therefore, if the inner catheter 20 is further moved to the proximal end side along the axial direction, the tube stent 10 engaged with the intermediate stopper 24 is also moved to the proximal end side together with the inner catheter 20, and the tube stent 10 The insertion position can be finely adjusted.

  As shown in FIG. 6, after the tube stent 10 is set at a predetermined insertion position in the bile duct 64, the connector 44 of the outer catheter 40 and the connector 30 of the inner catheter 20 shown in FIG. The catheter 40 is moved toward the distal end with respect to the inner catheter 20. As a result, the distal end 42 a of the outer catheter 40 moves in the axial direction on the outer periphery of the base large-diameter portion 28 and abuts on the proximal end 12 b of the tube stent 10.

  In this state, when the inner catheter 20 is moved relative to the outer catheter 40 in the proximal end direction by applying a certain force (retraction movement), the tube stent 10 is moved distally at the distal end surface of the outer catheter 40. When pushed in the end direction, the intermediate stopper 24 enters the through hole 12c of the stent 10 from the distal end opening 12a of the tube stent 10 shown in FIG. Further, when the inner catheter 20 is moved relative to the outer catheter 40 so as to be pulled toward the proximal end side, the distal end opening 12a of the tube stent 10 is positioned on the outer periphery of the auxiliary small diameter portion 25, and thereafter The axial movement of the inner catheter 20 becomes smooth.

  In this embodiment, even after the distal end opening 12a of the tube stent 10 is positioned on the outer periphery of the auxiliary small diameter portion 25, the tube stent 10 can be returned to the proximal end direction along the axial direction in the body cavity. The insertion position of the tube stent 10 in the body cavity can be finely adjusted. That is, when it is desired to return the insertion position of the tube stent 10 in the body cavity to the proximal end side, the distal end stopper can be obtained by moving the inner catheter 20 together with the outer catheter 40 along the axial direction to the proximal end side. 22 is locked to the distal end opening 12 a of the tube stent 10. Therefore, if the inner catheter 20 is moved further to the proximal end side along the axial direction, the tube stent 10 engaged with the distal end stopper 22 also moves to the proximal end side together with the inner catheter 20, and is moved within the body cavity. The insertion position of the tube stent 10 can be finely adjusted.

  After the tube stent 10 is set at a predetermined insertion position in the body cavity, a certain force or more is applied to the outer catheter 40 so as to move the inner catheter 20 in the axial direction relative to the proximal end side. The catheter 20 may be pulled. By doing so, the tube stent 10 is pushed in the distal direction toward the distal end surface of the outer catheter 40, and the tip stopper 22 of the inner catheter 20 enters the through hole 12 c from the distal end opening 12 a of the tube stent 10. Get in. Further, when the inner catheter 20 is moved relative to the outer catheter 40 so as to be pulled toward the proximal end, the distal end opening 42a of the outer catheter 40 is in contact with the proximal end opening 12b of the stent 10, The distal end of the inner catheter 20 moves relative to the distal end opening 42 a of the outer catheter 40. As a result, the tube stent 10 is completely detached from the outer periphery of the inner catheter 20 and is placed in the bile duct 64 shown in FIG.

  In this embodiment, the axial length L5 of the main small diameter portion 26 shown in FIG. 2 is shorter than the axial length of the tube stent shown in FIG. If comprised in this way, as shown in FIG. 5, the proximal end opening 12b of the tube stent 10 will be located in the outer periphery of the base large diameter part 28 in the initial attachment position of the tube stent 10. As shown in FIG. With this configuration, when the outer catheter 40 is moved along the outer periphery of the base large-diameter portion 28 toward the distal end side in the axial direction, the distal end 42a of the outer catheter 40 Since the proximal end 12b is reliably contacted, the placement operation of the tube stent 10 can be ensured.

  The present invention is not limited to the above-described embodiment, and can be variously modified within the scope of the present invention.

  For example, in the above-described embodiment, the inner catheter 20 is provided with the two stoppers of the intermediate stopper 24 and the tip stopper 22, but the stopper (the distal end opening 12a of the tube stent 10 at the distal end portion of the inner catheter 20) is provided. The number of portions having an outer diameter larger than the inner diameter D12a is not limited to two, but may be one (only the intermediate stopper 24) or may be three or more.

  Moreover, in embodiment mentioned above, although the tube stent 10 was inserted in the inside of the bile duct 64 as shown in FIG. 6 using the tube stent conveying apparatus 2, it is not limited to it. For example, the tube stent transported by the tube stent transport device according to the present invention can be transported to, for example, the pancreatic duct, gallbladder and the like in addition to the bile duct.

2 ... Tube stent delivery device 10 ... Tube stent 12 ... Tube body 12a ... Distal end opening 12b ... Proximal end opening 12c ... Through hole 14, 15 ... Flap 14a, 15a ... Flap opening 16 ... Marker 18 ... Side hole 20 ... Inner catheter 21 ... Tip tapered portion 22 ... Tip stopper 23 ... Marker 24 ... Intermediate stopper 25 ... Auxiliary small diameter portion 26 ... Main small diameter portion 27 ... Guide passage 28 ... Base large diameter portion 29 ... Inner tube main body 30 ... Connector 32 ... Female fitting Joint part 34 ... Base end opening 40 ... Outer catheter 42 ... Outer tube 42a ... Distal end opening 42b ... Proximal end opening 44 ... Connector 46 ... Base end opening 48 ... Male fitting part 50 ... Strainer tube 60 ... Endoscope 62 ... Duodenum 64 ... Bile duct 66 ... Nipple

Claims (4)

An inner catheter in which a tube stent is attached to the outer periphery of the distal end portion so as to be axially movable;
An outer catheter mounted on the outer circumference of the inner catheter located on the proximal end side of the tube stent so as to be axially movable,
On the distal end side of the tube stent, a taper that decreases in inner diameter toward the distal end is formed, and the inner diameter of the distal end opening is smaller than the inner diameter of the through hole in the tube body. ,
A predetermined position of the proximal end side from the distal end of the inner catheter, the much larger than the inner diameter of the distal end opening of the tube stents, an outer diameter a small than the inner diameter of the through hole of the tube stent An intermediate stopper is formed,
Wherein the proximal end side of the intermediate stopper, the main diameter portion having a smaller outer diameter than the inner diameter of the distal end opening of the tube stent Yes formed on an outer periphery of the inner catheter,
On the proximal end side of the main small diameter portion, a base large diameter portion having an outer diameter larger than the outer diameter of the main small diameter portion is formed on the outer periphery of the inner catheter,
By moving the outer catheter relative to the inner catheter toward the distal end in the axial direction, the distal end of the outer catheter moves relative to the outer circumference of the base large-diameter portion in the axial direction. Abutting the proximal end of the stent,
Said axially by relatively moving the near end side of the inner catheter relative to said outer catheter, spread the inner diameter of the distal end opening of the tube stent, the intermediate stopper of said inner catheter, said tube stent A tube stent carrying device that can be inserted through the through hole. Wherein the distal end side of the intermediate stopper of the inner catheter tube stent delivery of claim 1, the auxiliary small diameter portion is formed with a smaller outer diameter than the inner diameter of the distal end opening of the tube stent apparatus. It said auxiliary to the small-diameter portion distal end side of Yes and the tip stopper formed than the inner diameter of the distal end opening of the tube stent having a larger outer diameter,
Relative to the outer catheter, wherein by relatively moving in the axial direction of the inner catheter at the proximal end, the distal end stopper of the inner catheter, the claims are enabled through the hole of the tube stent 2. The tube stent delivery device according to 2.   The tube stent conveyance device according to any one of claims 1 to 3, wherein an axial length of the main small diameter portion is shorter than an axial length of the tube stent.

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