JP6371176B2 - catheter - Google Patents

Description

  The present invention relates to a catheter, and more particularly to a catheter having a relatively short guide wire lumen at the distal end.

  As a catheter used for diagnosis and treatment, there is a catheter having a relatively short guide wire lumen at a distal end portion. This catheter is inserted into the blood vessel with the guide wire inserted through the guide wire lumen, and can be quickly inserted and removed from the guide wire, so-called “rapid exchange type (short monorail type)”. A catheter. As an application of such a catheter, there is an image diagnosis for obtaining an image of a blood vessel lumen. As an apparatus for acquiring an image of a blood vessel lumen, an intravascular ultrasonic diagnostic apparatus (IVUS: IntraVascular Ultra Sound), an optical coherence tomography diagnostic apparatus (OCT: Optical Coherence Tomography), and the like are known. The purpose of obtaining an image of the blood vessel lumen is to determine the position of the blood vessel on which the stent is to be placed, or to diagnose the progress of the stent that has already been placed.

A catheter used in an intravascular ultrasound diagnostic apparatus is an imaging device having an element for transmitting and receiving ultrasonic waves in the vicinity of the distal end thereof, which is rotatable and movable in the axial direction of the rotation axis. Contains the core.
On the other hand, a catheter used for an optical coherence tomography diagnostic apparatus has an optical element that emits light and receives light in the vicinity of the distal end thereof, which is rotatable and movable in the axial direction of the rotation axis. Contains the imaging core.

  Intravascular ultrasound diagnostic devices and optical coherence tomography diagnostic devices have different imaging core structures themselves, but scan while rotating and moving in the axial direction of the rotation axis to obtain intravascular tomographic images. In point, they have a common structure. Therefore, recently, a hybrid type diagnostic imaging apparatus that simultaneously performs imaging tomographic diagnosis using both ultrasound and optical interference using a catheter that houses an imaging core having both an ultrasonic element and an optical element. Has been proposed (Patent Document 1). Hereinafter, these devices are simply referred to as diagnostic imaging devices.

  By the way, in the catheter of the intravascular ultrasonic diagnostic apparatus (IVUS), image information in the blood vessel is observed by radiating an ultrasonic wave from the image core and observing the reflected wave. It is mainly used for preoperative and postoperative diagnosis of endovascular treatment. The image core is located at the distal end of the catheter, and a structure in which a guide wire lumen for radiating ultrasonic waves in the entire circumferential direction is provided at the further distal end of the image core.

WO2014 / 073016A1

  After diagnosing the inside of the blood vessel after placing the stent in the blood vessel with the catheter of the intravascular ultrasonic diagnostic apparatus, when removing this catheter, the opening of the guide wire lumen is caught by the stent strut, and this opening is torn. There is a problem.

  This phenomenon is because the position of the guide wire is easily separated from the position of the catheter sheath because the rigidity of the catheter sheath and the guide wire is different and there is an added load difference. In this way, when the opening is caught, the stent may be deformed, and it is conceivable to remove the stent together with the blood vessel by a surgical procedure.

  Then, an object of this invention is to provide the catheter which can prevent that the opening part of a guide wire lumen tears, when removing a catheter.

The catheter of the present invention includes a linear member for guide , a catheter sheath having a hollow body for passing the linear member for guide at a distal end, the catheter sheath, and the catheter sheath. A magnet disposed outside the range in which the imaging core is moved, and the magnet magnetically attracts the guide linear member to thereby guide the linear member and the catheter sheath. characterized the Turkey be held at a certain distance between.
According to the above configuration, since the magnet disposed in the catheter sheath can keep the distance between the guide linear member and the catheter sheath constant, the rigidity of the catheter sheath and the guide linear member is added differently. Even if there is a difference in load, the guide linear member is not separated from the catheter sheath. For this reason, when removing a catheter, it can prevent that the opening part of the hollow body of a catheter sheath tears.

According to the above Symbol configuration, magnet provided on the catheter sheath, by drawing a linear member for guiding magnetically, can hold the distance between the linear member and the catheter sheath for guiding the constant Therefore, with a simple configuration, the linear member for guide is not separated from the catheter sheath, and the opening of the hollow body of the catheter sheath can be prevented from tearing when the catheter is removed.

According to the above Symbol configuration, the magnet provided on the catheter sheath, the imaging core disposed in the catheter sheath is arranged outside the range of movement, it affects the imaging by the imaging core even with magnets Does not come out.

  The present invention can provide a diagnostic imaging catheter that can prevent the opening of the guide wire lumen from tearing when the catheter is removed.

It is a figure which shows the apparatus for diagnosing the preferable embodiment of the catheter for image diagnosis of this invention, and the image of the blood vessel lumen which can apply this catheter. It is a figure which expands and shows the front-end | tip part of the catheter of 1st Embodiment of this invention. It is a figure which expands and shows the front-end | tip part of the catheter of 2nd Embodiment of this invention. It is a figure which shows the positional relationship of a catheter sheath and a guide wire. It is a figure explaining the example which the opening part of the guide wire lumen which generate | occur | produced conventionally deform | transforms. It is a figure which shows 3rd Embodiment of this invention. It is a figure which shows 4th Embodiment of this invention. It is a figure which shows 5th Embodiment of this invention.

Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the drawings.
The embodiments described below are preferred specific examples of the present invention, and thus various technically preferable limitations are given. However, the scope of the present invention is particularly limited in the following description. Unless otherwise stated, the present invention is not limited to these embodiments.

(First embodiment)
FIG. 1 is a view showing a preferred embodiment of a catheter for image diagnosis of the present invention and an apparatus for diagnosing an image of a blood vessel lumen to which the catheter 1 can be applied.
As an apparatus 100 for diagnosing an image of a blood vessel lumen shown in FIG. 1 (hereinafter referred to as an image diagnostic apparatus), an example of an intravascular ultrasonic diagnostic apparatus (IVUS: IntraVascular Ultra Sound) is shown.

A diagnostic imaging catheter 1 shown in FIG. 1 includes a catheter sheath 2 and a connector portion 3. The catheter sheath 2 is a long, hollow member that can be inserted into and removed from a blood vessel. The connector portion 3 is connected to one end portion of the catheter sheath 2 and is not inserted into the blood vessel, but is disposed on the operator's hand side for operation by the operator. The connector part 3 has a cylindrical connection end part 4.
The diagnostic imaging apparatus 100 includes a scanner / pullback unit 101 and an operation control device 102, and the scanner / pullback unit 101 includes a connection holding unit 103. The operation control device 102 includes an operation panel 104, a monitor 105, and the like. The scanner / pullback unit 101 and the operation control device 102 are connected by a signal line 106.

The catheter 1 shown in FIG. 1 is directly inserted into a patient's blood vessel and measures the state inside the blood vessel using ultrasonic waves irradiated from the imaging core 5. The connection end 4 of the catheter 1 is detachably connected to the connection holding unit 103 of the scanner / pullback unit 1. The scanner / pullback unit 101 is also called a motor drive unit (MDU) or a drive device, and executes a radial scan of the imaging core 5 in the catheter 1.
The operation control device 102 has a function for inputting various set values when performing intravascular ultrasound diagnosis, a function for processing data obtained by measurement, and displaying the result as a cross-sectional image, and the like.

A catheter 1 shown in FIG. 1 has a catheter sheath 2, and an imaging core 5 is accommodated in the vicinity of the distal end portion 6 of the catheter sheath 2. The imaging core 5 is rotatable and movable in the axial direction of the rotation axis, and has an element for transmitting and receiving ultrasonic waves.
A tube-shaped guide wire lumen 10 is provided at the distal end portion 6 of the catheter sheath 2. The guide wire lumen 10 passes through a guide wire (GW) 20 for guiding the catheter 1 to the position of a blood vessel to be diagnosed. The guide wire 20 is an example of a linear member for guide, and is slidably held along the longitudinal direction of the guide wire 20 through the guide wire lumen 10 which is a hollow body.

The catheter sheath 2 is a hollow member that continuously forms a lumen from the guide wire lumen 10 to one end of the connector portion 3. A drive shaft 9 is rotatably disposed in the catheter sheath 2 as indicated by a broken line.
An imaging core 5 is accommodated inside the distal end portion 6 of the catheter sheath 2. The imaging core 5 is rotatable inside the distal end portion 6 and is movable along the axial direction of the catheter sheath 2. The imaging core 5 is fixed to the tip of the drive shaft 9. The imaging core 5 has an ultrasonic element that can transmit an ultrasonic wave and receive a reflected wave of the ultrasonic wave. This ultrasonic element transmits an ultrasonic wave in a direction orthogonal to the axial direction of the catheter sheath 2 and receives a reflected wave of the ultrasonic wave from the blood vessel wall.

  The drive shaft 9 shown in FIG. 1 has a function of transmitting the rotational force from the connector portion 3 to the imaging core 5, and the drive shaft 9 accommodates a signal line that is electrically connected to the ultrasonic element. Yes. The drive shaft 9 rotates the imaging core 5 and moves it in the axial direction, so that the imaging core 5 irradiates the target blood vessel wall with ultrasonic waves and receives the reflected waves of the ultrasonic waves. it can.

Next, the catheter 1 described above will be described in more detail with reference to FIG.
FIG. 2 is an enlarged view of the distal end portion of the catheter 1 according to the first embodiment of the present invention.
As shown in FIG. 2, as already described, the imaging core 5 is accommodated inside the distal end portion 6 of the catheter sheath 2. A tube-shaped guide wire lumen 10 is provided at the distal end portion 6 of the catheter sheath 2. The guide wire lumen 10 passes through a guide wire (GW) 20 for guiding the catheter 1 to the position of a blood vessel to be diagnosed. The guide wire 20 is slidably held along the longitudinal direction of the guide wire 20 through the guide wire lumen 10. The catheter 1 shown in FIG. 2 has a so-called short monorail structure in which this one guide wire lumen 10 is provided with respect to the catheter sheath 2.

As shown in FIG. 2, the distal end portion 21 of the guide wire 20 has flexibility so as to ensure followability in a meandering blood vessel and prevent blood vessel damage. The guide wire 20 is a long member having a circular cross section, and is made of, for example, an alloy or stainless steel. The surface is coated with a hydrophilic coating, but is not particularly limited thereto. The guide wire 20 has excellent recoverability, is unlikely to be bent (kink), and has high operability.
On the other hand, the guide wire lumen 10 has a guide passage 11 having a circular cross section for passing the guide wire 20. The distal end portion 12 of the guide wire lumen 10 is a surface formed orthogonal to the axial direction T of the guide wire lumen 10 (advancing direction of the guide wire 20), but the opening portion 14 of the rear end portion 13 is , An inclined surface formed obliquely.

As shown in FIG. 2, one magnet 30 is disposed at the distal end portion 6 of the catheter sheath 2. The magnet 30 is a permanent magnet, and for example, an alnico magnet, a ferrite magnet, a neodymium magnet, or the like can be adopted. One magnet 30 can attract the guide wire 20 magnetically, thereby attracting the guide wire 20 toward the catheter sheath 2 in the S direction perpendicular to the T direction by a magnetic attraction force. That is, the distance LR between the guide wire 20 and the catheter sheath 2 can be made constant so that the guide wire 20 is not separated from the catheter sheath 2. Accordingly, when the catheter 1 is removed, the opening 14 of the guide wire lumen 10 can be prevented from being torn.
The magnet 30 disposed in the catheter sheath 2 is disposed outside the range in which the imaging core 5 disposed in the catheter sheath 2 moves. Thereby, since the magnet 30 of the catheter sheath 2 is arranged outside the range in which the imaging core 5 arranged in the catheter sheath 2 moves, the imaging by the imaging core 5 is affected even if the magnet 30 is present. Absent.

  As described above, in the first embodiment of the present invention, the magnet 30 is arranged on the catheter sheath 2, and the arrangement position of the magnet 30 faces the guide wire 20 and is in the vicinity of the imaging core 5. When the surgeon operates the catheter 1 in the blood vessel, the guide sheath 20 is operated by following the catheter sheath 2. Even if the guide wire 20 has a factor such as a difference in rigidity of the catheter sheath 2, the opening portion The separation (separation) between the guide wire 20 and the catheter sheath 2 in the vicinity of 14 can be prevented.

  Since peeling (separation) can be prevented in this way, the followability of the catheter sheath 2 following the guide wire 20 can be prevented, and the pushability can be prevented from being lowered. If the opening 14 is deformed, the opening 14 may be trapped by the stent strut, causing the catheter 1 to be stuck, but the catheter 1 can be prevented from being stuck.

  When an operator performs a procedure using the catheter 1, when the catheter 1 is pushed into the blood vessel, it is possible to prevent the guide wire 20 and the catheter sheath 2 from being separated (separated) in the vicinity of the opening 14, The rigidity of the guide wire 20 can be used. For this reason, the passage of the catheter 1 can be improved. Further, the risk of deformation of the opening 14 can be reduced or eliminated. For these reasons, the occurrence frequency of the stack during the procedure of the catheter 1 can be reduced or eliminated.

FIG. 5 is a diagram for explaining an example in which the opening 114 of the guide wire lumen 110 that has been generated conventionally is deformed.
As shown in FIG. 5, in order to confirm the progress of the stent SN placed in the blood vessel, when the catheter 101 is inserted in the T1 direction, the distal end portion of the catheter 101 is guided to a position passing through the stent SN. A scan will be performed. When the series of scanning processes is completed, the guide wire 120 and the catheter lumen 110 are retracted in the T2 direction and discharged outside the body. During the retraction, the inclined opening 114 of the guide wire lumen 110 may get caught in the mesh of the stent SN. This catching phenomenon is because the guide wire is easily separated from the catheter sheath because the rigidity of the catheter sheath 107 and the guide wire 120 differs as shown in FIG.

In this way, when the opening 114 is caught in the mesh of the stent SN, the catheter 1 is pushed again in the T1 direction, and in some cases, the catheter 101 is rotated and pulled again in the T2 direction. Although the catch is released, if the catheter 101 is pulled in the T2 direction without performing such a release operation, the opening 114 may be deformed or the opening 114 may be torn.
Therefore, in the first embodiment of the present invention, as shown in FIG. 2, the magnet 30 can prevent the guide wire 20 and the catheter sheath 2 from being separated (separated) in the vicinity of the opening 14. When the catheter 20 and the catheter 1 are retracted in the T2 direction and discharged outside the body, the inclined opening 14 of the guide wire lumen 10 can be prevented from being caught by the mesh of the stent SN.

(Second Embodiment)
Next, a second embodiment of the present invention will be described with reference to FIG.
In addition, when the component of the catheter 1 in 2nd Embodiment demonstrated below is the same as the component of the catheter 1 shown in FIG. 2, the same code | symbol is attached | subjected and the description is abbreviate | omitted.

FIG. 3 shows a second embodiment of the present invention.
In the first embodiment shown in FIG. 2, one magnet (first magnet) 30 is disposed at the distal end portion 6 of the catheter sheath 2. Another magnet (second magnet) 40 is disposed on the guide wire 20. The magnets 30 and 40 are permanent magnets, and for example, alnico magnets, ferrite magnets, neodymium magnets, and the like can be employed. The magnets 30 and 40 have the same polarity in order to generate a magnetic repulsive force.
Thereby, the distance LR between the guide wire 20 and the catheter sheath 2 can be made constant so that the guide wire 20 is not separated from the catheter sheath 2. Accordingly, when the catheter 1 is removed, the opening 14 of the guide wire lumen 10 can be prevented from being torn.

4 shows the positional relationship between the catheter sheath 2 and the guide wire 20. FIG. 4A shows the case where the distance DS1 between the catheter sheath 2 and the guide wire 20 is small, and FIG. 4B shows the catheter sheath. 2 shows a case where the distance DS2 between the guide wire 20 and the guide wire 20 is larger than the distance DS1.
Referring to FIG. 4, the catheter sheath 2 and the guide wire 20 are arranged in parallel. For this reason, when the imaging core 5 images the inside of the blood vessel, the guide wire 20 is in the imaging range when viewed from the imaging core 5, and in the case of FIG. The defect angle θ1 at the time of imaging is large, and the imaging core 5 cannot obtain a blood vessel image of a fan-shaped region with the defect angle θ1.

  Therefore, in the second embodiment of the present invention, as shown in FIG. 3, one magnet 30 is disposed at the distal end portion 6 of the catheter sheath 2, and another magnet 40 is disposed at the guide wire 20. Thus, the catheter sheath 2 and the guide wire 20 can be arranged in parallel in the blood vessel by the magnetic repulsive force of the magnets 30 and 40. As shown in FIG. 4B, the distance DS2 between the catheter sheath 2 and the guide wire 20 can be set. For this reason, the rear region of the guide wire 20 can theoretically make the defect angle θ2 at the time of imaging shown in FIG. 4B smaller than the defect angle θ1 shown in FIG. A blood vessel image of the region can be obtained in a wider range.

Further, the distance LR between the guide wire 20 and the catheter sheath 2 can be made constant. Accordingly, when the catheter 1 is removed, the opening 14 of the guide wire lumen 10 can be prevented from being torn.
As described above, in the first embodiment of the present invention, the magnet 30 is arranged on the catheter sheath 2, and the arrangement position of the magnet 30 faces the guide wire 20 and is in the vicinity of the imaging core 5. When the surgeon operates the catheter 1 in the blood vessel, the guide sheath 20 is operated by following the catheter sheath 2. Even if the guide wire 20 has a factor such as a difference in rigidity of the catheter sheath 2, the opening portion The separation (separation) between the guide wire 20 and the catheter sheath 2 in the vicinity of 14 can be prevented.

(Third embodiment)
FIG. 6 is a diagram showing a third embodiment of the present invention.
As shown in FIG. 6, in the third embodiment, the magnet 30 is disposed only on the catheter sheath 2. That is, one magnet 30 is disposed in the vicinity of the opening 14 of the rear end portion 13 of the guide wire lumen 10 that is a hollow body at the distal end portion 6 of the catheter sheath 2. Thereby, the magnet 30 prevents the guide wire 20 and the catheter sheath 2 from being separated (separated) due to magnetic attraction of the guide wire 20.
In the embodiment of the present invention, the catheter sheath 2 has a magnet, but the guide wire 20 has no magnet. Therefore, the guide wire 20 is made of a magnetic material. Thereby, if the catheter sheath side is a magnet, the guide wire 20 is sucked.

(Fourth embodiment)
FIG. 7 is a diagram showing a fourth embodiment of the present invention.
As shown in FIG. 7, in the fourth embodiment, magnets are disposed in both the catheter sheath 2 and the guide wire 20. In this example, the magnet 40 is disposed on the guide wire 20. The catheter sheath 2 has a first magnet portion 30A and a second magnet portion 30B. 30 A of 1st magnet parts are arrange | positioned in the front-end | tip part 6 of the catheter sheath 2 in the vicinity of the opening part 14 of the rear-end part 13 of the guide wire lumen 10 which is a hollow body. On the other hand, the 2nd magnet part 30B is arrange | positioned in the position away from 30 A of 1st magnet parts.
The first magnet portion 30 </ b> A has a different polarity from the magnet 40, and the second magnet portion 30 </ b> B has the same polarity as the magnet 40. Thereby, at the time of delivery or collection of the catheter, the first magnet portion 30A and the magnet 40 positioned earlier are moved so as to be magnetically attracted. However, at the time of image capturing, the position of the guide wire 20 is slightly pulled back so that the second magnet portion 30B and the magnet 40 are magnetically repelled so that the catheter sheath 2 and the guide wire 20 are separated by the repulsive force. . As a result, a suction force is generated in the vicinity of the opening portion 14 of the rear end portion 13 of the guide wire lumen 10, and a repulsive force is generated in the vicinity of the imaging core 5, so that it is possible to perform image capturing more easily. it can.
By adopting such a configuration, the magnet 30 prevents the guide wire 20 from being stuck due to the magnetic attraction of the guide wire 20, and at the time of image capturing, the magnet 30 releases the guide wire 20 due to magnetic repulsion, thereby eliminating the shadow. It is possible to reduce the occurrence of (shadow portion during imaging).

(Fifth embodiment)
FIG. 8 is a diagram showing a fifth embodiment of the present invention.
In the fifth embodiment shown in FIG. 8, unlike the fourth embodiment shown in FIG. 7, the length of the magnet 40 arranged on the guide wire 20 is from the first magnet portion 30A to the second magnet portion 30B. You may make it reach.
If the guide wire 20 is a magnetic body, the first magnet portion 30A and the second magnet portion 30B are integrated magnets (the magnet 30 indicated by a dotted line), and the guide wire 20 is just near the imaging core 5. A magnet having the same polarity may be arranged. In any case, it suffices that a magnetic attractive force can be exerted on the distal end 6 side of the catheter sheath 2 and a magnetic repulsive force can be exerted on the rear end side of the catheter sheath 2.

A diagnostic imaging catheter 1 according to an embodiment of the present invention includes a diagnostic imaging apparatus having a guide wire lumen 10 as a hollow body for passing a guide wire 20 as a guide linear member through a distal end portion 6 of a catheter sheath 2. The catheter sheath 2 is provided with a magnet 30 for maintaining a constant distance between the guide linear member and the catheter sheath.
As a result, the distance between the guide linear member and the catheter sheath can be kept constant, so that even if there is a difference in rigidity between the catheter sheath and the guide linear member and an additional load difference is applied. The linear member will not leave the catheter sheath. For this reason, it is possible to prevent the opening of the guide wire lumen from tearing when the catheter is removed.

  The magnet holds the distance between the guide linear member and the catheter sheath constant by magnetically attracting the guide linear member. As a result, the magnet provided on the catheter sheath can keep the distance between the guide linear member and the catheter sheath constant by magnetically attracting the guide linear member. However, it is possible to prevent the guide wire lumen from tearing when the guide linear member is separated from the catheter sheath and the catheter is removed.

  When the magnet on the catheter sheath side is the first magnet, a second magnet is disposed on the guide linear member, and the first magnet and the second magnet are guided linearly by a magnetic repulsive force. The distance between the member and the catheter sheath is kept constant. As a result, the distance between the linear member for guide and the catheter sheath can be kept constant by the magnetic repulsive force of the first magnet and the second magnet, so that the opening is torn by being caught by the stent. Can be prevented. In addition, since the guide linear member can be held at a position further away from the catheter sheath, at the time of imaging, the guide linear member is present at the back of the guide linear member as viewed from the catheter sheath. The imaging defect angle can be further reduced. From this, an imaging defect part (image defect part) can be reduced.

  The first magnet disposed in the catheter sheath is disposed outside the range in which the imaging core disposed in the catheter sheath moves. Thereby, since the 1st magnet of a catheter sheath is arrange | positioned outside the range which the imaging core arrange | positioned in a catheter sheath moves, even if it has a 1st magnet, it does not affect the imaging by an imaging core.

The present invention is not limited to the above embodiment, and various modifications can be made without departing from the scope of the claims.
A part of each configuration of the above embodiment can be omitted, or can be arbitrarily combined so as to be different from the above.
In each of the above-described embodiments, an example of an intravascular ultrasonic diagnostic apparatus (IVUS) is shown as the apparatus 100 that acquires the image of the blood vessel lumen shown in FIG. However, the apparatus 100 for acquiring an image of a blood vessel lumen is not limited to an intravascular ultrasonic diagnostic apparatus (IVUS), but an optical coherence tomographic diagnostic apparatus (OCT), or an imaging core having both ultrasonic elements and optical elements. And a hybrid type diagnostic imaging apparatus that simultaneously performs tomographic diagnosis using both ultrasonic waves and optical interference using the catheter. The catheter 1 for image diagnosis according to the embodiment of the present invention can be applied to the above-described apparatus 100 that acquires images of various blood vessel lumens.
The catheter may be a guiding catheter, a microcatheter, or a therapeutic suction catheter.

  DESCRIPTION OF SYMBOLS 1 ... Catheter for image diagnosis, 2 ... Catheter sheath, 3 ... Connector part, 4 ... Connection end part, 5 ... Imaging core, 6 ... Tip part of catheter sheath, 9 ... Drive shaft, 10 ... Guide wire lumen (hollow body), 20 ... Guide wire (GW) (guide linear member), 102 ... Operation control device, T ... Axial direction (Traveling direction of guide wire 20), 30 ... first magnet, 35 ... second magnet, 40 ... second magnet

Claims (1)

A linear member for the guide;
A catheter sheath having a distal end portion of the hollow body for the passage of the linear member for said guide,
A magnet disposed in the catheter sheath and disposed outside a range in which an imaging core disposed in the catheter sheath moves;
With
The magnet, the catheter characterized by the Turkey be kept constant the distance between the catheter sheath and a linear member for said guide by sucking linear member for said guide magnetically.

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