JP6912323B2 - Basket catheter - Google Patents

Description

The present invention relates to a catheter capable of preferably capturing foreign matter in a basket.

In the treatment of stones occurring in the bile duct and urethra, a basket catheter (basket forceps) made by knitting a shape memory alloy wire such as SUS stranded wire or Ni-Ti into a basket shape or a balloon catheter for removing stones is used. In the basket catheter, in the basket portion for catching foreign matter such as calculus, a plurality of metal wires are bound at two locations on the distal end and proximal side of the distal end, and between the two binding portions. The wire rod is bent or twisted in a spiral shape to form a cage. The basket catheter reaches the treatment site such as in the bile duct through the forceps opening of the endoscope. The basket portion is housed in, for example, a resin sheath at the time of delivery to the affected portion, and is expanded in a cage shape by being exposed from the distal end of the sheath at the time of capturing a foreign substance. After the foreign matter is contained in the basket, the basket catheter is removed from the treatment section to remove the foreign matter. However, the catheter itself may not be removed (incarcerated) from the treated area due to stenosis near the treated area. In such a case, it is possible to temporarily release the foreign substance from the basket, remove only the catheter, and insert a new treatment tool. However, depending on the state of capture, it may not be possible to release the foreign matter from the basket. As a result, the procedure time was lengthened and the invasion to the patient was increased by shifting to the procedure of relieving the patient or the surgical procedure. Therefore, a device for preventing incarceration has been developed.

For example, Patent Document 1 describes a hollow sheath portion that can be inserted into a forceps channel of an endoscope, and a basket-like or net-like expansion that is located on the tip end side of the hollow sheath portion and is formed by a large number of wires. In a biological tissue recovery tool including a tip recovery portion, an opening is formed by making the wire spacing of one set of the large number of wires wider than the other wire spacing in an expanded state forming the tip recovery section. Is disclosed to form.

In Patent Document 2, a basket formed in a basket shape by a plurality of elastic wires is connected to the tip of an operation wire that is inserted and retreated in the flexible sheath so as to be movable in the axial direction, and the basket is connected to the flexible sheath. In a basket-type collector for an endoscope in which the basket expands and contracts due to the elasticity of each elastic wire when it is recessed from the tip of the basket, the gap between adjacent elastic wires forming the basket is formed wider than the others in only one place. It is disclosed to do.

Japanese Unexamined Patent Publication No. 10-137252 Japanese Unexamined Patent Publication No. 2002-11301

However, as described in Patent Documents 1 and 2, by widening the gap between the adjacent elastic wires in advance, it becomes easier to remove the foreign matter from the basket, but the foreign matter having a relatively small size slips through the gap. Therefore, it was sometimes impossible to capture. Therefore, an object of the present invention is to provide a basket catheter capable of easily and efficiently performing both a foreign matter catching operation and a foreign matter removing operation in the basket portion.

The basket catheter of the present invention that has solved the above problems has an outer cylinder member having a distal side and a proximal side, an internalizing member arranged in the lumen of the outer cylinder member, and a distal side of the internalizing member. It has an expandable basket portion that is arranged on the side and is formed by binding three or more elastic wires in a first binding portion and a second binding portion proximal to the first binding portion. A binding member that binds some elastic wires between the first binding portion and the second binding portion of the basket portion and slides with respect to some elastic wires, and a binding member. It has a linear member that is connected and is located in the lumen of the outer cylinder member, and the remaining elastic wire is bound between the first binding portion and the second binding portion of the basket portion. It has a gist in that it does not. In the basket catheter of the present invention, some elastic wires are bound to each other between the first binding portion and the second binding portion of the basket portion, and the remaining elastic wires are not bound, so that the circumferential direction of the catheter is not bound. In, the distance between the plurality of bound elastic wires and the bound elastic wires and the adjacent unbound elastic wires can be separated. Therefore, the captured foreign matter can be easily and efficiently removed from the basket portion, and the occurrence of incarceration can be prevented. Further, by sliding the binding member with respect to a part of the elastic wires and arranging the binding member near the second binding portion at the time of capturing foreign matter, the arrangement interval of three or more elastic wires in the circumferential direction Can be made substantially uniform, so that it is possible to prevent the basket portion from being unintentionally deformed during the operation of capturing foreign matter. Therefore, according to the basket catheter of the present invention, both the capture operation and the removal operation of the foreign matter can be easily and efficiently performed.

In the basket catheter, the binding member preferably slides in a range from the maximum diameter portion of the basket portion to the second binding portion.

It is preferable that the basket catheter is provided with only one binding member.

In the basket catheter, it is preferable that the binding member has a plurality of hollow portions, and elastic wires are arranged in each of the plurality of hollow portions.

In the basket catheter, it is preferable that the binding member is formed in a tubular shape having a plurality of lumens, and elastic wires are inserted into each of the plurality of lumens.

In the basket catheter, it is preferable that the binding member has 1 hollow portion or 1 lumen, and a part of the elastic wire is inserted through the 1 hollow portion or 1 lumen.

In the basket catheter, the binding member is preferably formed so that the outer diameter becomes smaller toward at least one of the distal end and the proximal end.

In the basket catheter, it is preferable that the interpolation member is formed in a hollow shape. In that case, it is more preferable that the linear member is arranged inside or outside the interpolation member.

In the basket catheter, it is preferable that the interpolation member is formed in a solid state, or a plurality of wires are bound or twisted.

In the basket catheter having six elastic wires, the binding member preferably binds two elastic wires.

In the basket catheter having eight elastic wires, the binding member preferably binds two or three elastic wires.

In the basket catheter, a handle having a hollow portion is further provided on the proximal side of the outer cylinder member or the interpolating member, and the handle is connected to the proximal end of the linear member. It has a position adjusting member, and it is preferable that the position adjusting member is in contact with an elastic member arranged in the hollow portion of the handle.

According to the basket catheter of the present invention, both the capture operation and the removal operation of the foreign substance can be easily and efficiently performed, so that incarceration can be prevented, the choice of procedure according to the case can be increased, and the minimally invasive treatment can be promoted. The effect is obtained.

A side view (partial cross-sectional view) of the distal side of the basket catheter according to the embodiment of the present invention is shown. A front view of the basket catheter shown in FIG. 1 as viewed from the distal end is shown. A side view (partial cross-sectional view) of the distal side of the basket catheter according to the embodiment of the present invention is shown. A front view of the basket catheter shown in FIG. 3 as viewed from the distal end is shown. The perspective view of the binding member which concerns on embodiment of this invention is shown. A cross-sectional view of the bundling member shown in FIG. 5 along the VI-VI line is shown. A cross-sectional view showing a modified example of the binding member shown in FIG. 6 is shown. A cross-sectional view showing another modification of the binding member shown in FIG. 6 is shown. A cross-sectional view showing still another modification of the binding member shown in FIG. 6 is shown. A perspective view showing a modified example of the binding member shown in FIG. 5 is shown. A cross-sectional view of the basket catheter shown in FIG. 1 along the XI-XI line is shown. A cross-sectional view showing a modified example of the basket catheter shown in FIG. 11 is shown. A plan view of the proximal side of the basket catheter according to the embodiment of the present invention is shown. A plan view showing a modification of the proximal side of the basket catheter shown in FIG. 13 is shown.

Hereinafter, the present invention will be described in more detail based on the following embodiments. In addition, it is of course possible to carry out, and all of them are included in the technical scope of the present invention. In each drawing, hatching, member reference numerals, and the like may be omitted for convenience, but in such cases, the specification and other drawings shall be referred to. In addition, the dimensions of various members in the drawings may differ from the actual dimensions because priority is given to contributing to the understanding of the features of the present invention.

In the present invention, the basket catheter has a distal side and a proximal side, and is a medical treatment tool having a basket-shaped basket portion for catching foreign substances in the body such as stones. The basket catheter may be simply referred to as a "catheter" below. The catheter of the present invention has an outer cylinder member, an interpolation member, a basket portion, a binding member, and a linear member. 1 and 3 show a side view (partial cross-sectional view) of the catheter according to the embodiment of the present invention, and FIGS. 2 and 4 show distal catheters shown in FIGS. 1 and 3, respectively. Shows the front view when viewed from the edge. FIG. 1 shows a state in which the binding member 30 is arranged in the vicinity of the second binding portion of the basket portion 10, and FIG. 3 shows a state in which the binding member 30 is arranged in the vicinity of the maximum diameter portion 13 of the basket portion 10. .. In addition, in FIG. 2 and FIG. 4, the binding member 30 is omitted.

In the present invention, the proximal side of the catheter 1 refers to the direction toward the hand side of the user (operator) with respect to the extending direction of the catheter 1, and the direction opposite to the distal side (that is, the treatment). (Direction on the target side). Further, the direction from the proximal side to the distal side of the catheter 1 is referred to as an axial direction.

The basket catheter 1 of the present invention is used for treatment using an endoscope, is placed in the body from the distal side of the forceps opening of the endoscope through the forceps opening of the endoscope, and reaches the treated portion. It is desirable that all materials of catheter 1 be biocompatible. The outer cylinder member 2 can accommodate the basket portion 10 (basket forceps) in the lumen. By accommodating the basket portion 10 inside, the outer cylinder member 2 is elastic of the basket portion 10 until the catheter 1 is conveyed from the forceps opening of the endoscope through the forceps channel to the vicinity of the foreign matter. Prevents the wire 15 from damaging the forceps opening in the endoscope, the forceps channel, internal tissues other than foreign substances, and the like.

Examples of the outer cylinder member 2 include a resin tube, a single wire or a plurality of wire rods, a tubular body formed by arranging stranded wire rods in a specific pattern, a metal tube, or a combination thereof. The resin tube can be manufactured, for example, by extrusion molding. As the tubular body in which the wire rods are arranged in a specific pattern, a tubular body having a mesh structure by simply intersecting or knitting the wire rods, or a coil in which the wire rod is wound is shown. The type of network structure is not particularly limited, and the number of coil turns and the density are not particularly limited. The network structure and the coil may be formed at a constant density throughout the axial direction, or may be formed at a different density depending on the position in the axial direction. In order to increase the flexibility of the metal tube, a plurality of annular grooves or spiral grooves may be formed on the outer surface of the metal tube. Above all, it is preferable that the groove is formed on the outer surface (particularly the outer peripheral surface) on the distal side of the center in the axial direction of the metal tube.

The outer cylinder member 2 is preferably made of resin or metal. Examples of the resin constituting the outer cylinder member 2 include polyamide-based resin, polyester-based resin, polyurethane-based resin, polyolefin-based resin, fluorine-based resin, vinyl chloride-based resin, silicone-based resin, and natural rubber. Only one of these may be used, or two or more thereof may be used in combination. Of these, polyamide-based resins, polyester-based resins, polyurethane-based resins, polyolefin-based resins, and fluororesins are preferably used. Examples of the metal constituting the outer cylinder member 2 include stainless steel such as SUS304 and SUS316, platinum, nickel, cobalt, chromium, titanium, tungsten, gold, Ni-Ti alloy, Co-Cr alloy, or these. Combinations can be mentioned. In particular, the wire made of Ni—Ti alloy is excellent in shape memory and high elasticity. Further, the wire rod may be a fiber material such as the above-mentioned metal, polyarylate fiber, aramid fiber, ultra-high molecular weight polyethylene fiber, PBO fiber, carbon fiber and the like. The fiber material may be monofilament or multifilament. Further, a tubular body made of resin on which a reinforcing material such as a metal wire is arranged may be used as the outer cylinder member 2.

The interpolation member 3 is arranged in the lumen of the outer cylinder member 2. The interpolation member 3 is connected to a handle provided on the proximal side and a basket portion 10 on the distal side, and transmits an operation on the hand side to the distal side.

The interpolation member 3 is preferably made of the same resin or metal as the outer cylinder member 2. The material of the interpolation member 3 may be the same as or different from the material of the outer cylinder member 2. The interpolation member 3 is a tubular body, a metal tube, or a combination thereof formed by arranging a resin tube, a single wire or a plurality of wires, and a stranded wire in a specific pattern, similarly to the outer cylinder member 2. Can be used.

It is preferable that the interpolation member 3 is formed in a solid state, or a plurality of wire rods are bound or twisted. As a result, the outer diameter of the interpolation member 3 can be reduced, so that the binding member 30 and the linear member 40, which will be described later, can be easily accommodated in the outer cylinder member 2. The elastic wire 15 forming the basket portion 10 is prepared in a long length, the basket portion 10 is formed in the distal portion of the elastic wire, and the portion proximal to the second binding portion of the basket portion 10 is used as the interpolation member 3. be able to. The proximal portion of the wire can be bound or twisted to form the interpolating member 3.

It is preferable that the interpolation member 3 is formed in a hollow shape. As a result, an auxiliary treatment tool for removing foreign matter captured by the basket portion 10 can be arranged in the interpolation member 3. Other assistive devices can be used to observe intraluminal or foreign bodies and remove captured foreign bodies, such as preventing incarceration, increasing case-specific procedure options, and promoting minimally invasive treatment. The effect is obtained. For example, when removing stones in the bile duct by using an endoscope together, the catheter 1 inserted into the bile duct from an endoscope placed in the duodenum because the endoscope cannot be inserted into the bile duct. Therefore, by inserting an auxiliary treatment tool, which is an additional treatment tool, the efficiency of the treatment can be increased and the minimal invasiveness of the treatment can be promoted. Auxiliary treatment tools include balloon catheters, microcatheter, forceps, laser probes, fiberscopes, electrohydraulic impact crushing probes or guide wires.

As the hollow interpolation member 3, a hollow body formed by spirally winding one or a plurality of wire rods may be used. The interpolation member 3 is preferably a hollow body in a part in the perspective direction, and may be a hollow body in the entire axial direction. The hollow body formed by spirally winding a plurality of wires can also be formed as a hollow body without a core by twisting the plurality of wires. The hollow body is preferably a multi-layer hollow body in which a plurality of hollow bodies are stacked. The multi-layer hollow body can be formed, for example, by winding a wire rod around a core material to form a coil, and further winding a wire rod around the coil to form a coil. With such a hollow body, the torque on the hand side can be easily transmitted to the basket portion 10, and the operation of capturing foreign matter can be easily performed.

Although not shown, the interpolation member 3 may further have a metal tube connected to the proximal end of the hollow coil body. By providing the metal tube, the elongation rate of the interpolation member 3 in the axial direction can be suppressed. When the hollow body is formed in a coil shape, an extension resistance member extending along the perspective direction is arranged inside or outside the hollow coil body, and one end portion and the other end portion of the other wire rod are hollow. It can be fixed to the coil body. As a result, it is possible to suppress the hollow coil body from extending in the axial direction.

The outer cylinder member 2 and the interpolation member 3 may be composed of a single layer or may be composed of a plurality of layers. Further, in the axial direction, a part of the outer cylinder member 2 may be composed of a single layer, and the other part may be composed of a plurality of layers, and the same applies to the interpolation member 3.

In order to protect the outer cylinder member 2 and the inner cylinder member 3 from fluids such as a contrast medium and a chemical solution, a coating agent may be applied to the outer surface and the inner surface of the outer cylinder member 2 and the inner cylinder member 3. Further, in order to improve the slidability of the guide wire with respect to the interpolation member 3, a lubricant may be applied to the inner surface of the interpolation member 3. Further, in order to improve the slidability of the inner cylinder member 3 with respect to the outer cylinder member 2, a lubricant may be applied to the inner surface of the outer cylinder member 2 and the outer surface of the inner cylinder member 3.

The basket portion 10 is provided to capture foreign matter in the body. As shown in FIGS. 1 and 3, the basket portion 10 is formed by binding three or more elastic wires 15 at the first binding portion and the second binding portion. The elastic wire 15 is given a curved shape or a bent shape, and is formed in a basket shape. As a result, a catching portion 16 for catching foreign matter is formed between the two binding portions. By exposing the distal side of the basket portion 10 from the second binding portion from the outer cylinder member 2, the elastic wire 15 expands outward in the radial direction, and the catching portion 16 can catch foreign matter. The shape of the elastic wire 15 may be a shape that passes on the same plane, or may be a shape such as a spiral shape in which the entire wire is not on the same plane.

The elastic wire 15 is a linear member 40 having elasticity, and is preferably made of a shape memory alloy or a shape memory resin. The elastic wire 15 is, for example, a single wire composed of stainless steel such as SUS304 or SUS316, platinum, nickel, cobalt, chromium, titanium, tungsten, aluminum, gold, silver, Ni—Ti alloy, Co—Cr alloy or the like. It may be a stranded metal wire. Of these, a metal wire made of a Ni—Ti alloy is preferred. The number of elastic wires 15 is not particularly limited, but may be, for example, 3 or more, 4 or more, 5 or more, 6 or more, 8 or more, 10 or more, or 20 or less, 15 or less. Permissible.

In the catching portion 16, the elastic wire 15 may be formed in a straight line or in a curved shape. Further, in the catching portion 16, the elastic wire 15 preferably has a bent portion (bent portion). At the bent portion, the elastic wire 15 may be curved or bent. By forming the catching portion 16 in this way, it becomes easy to catch the foreign matter.

In the catching portion 16, the elastic wire 15 may be made of different materials on the distal side and the proximal side of the basket portion 10 with respect to the maximum diameter portion 13. For example, it is preferable that the elastic wire 15 arranged proximal to the maximum diameter portion 13 has a lower hardness than the elastic wire 15 arranged distal to the maximum diameter portion 13. As a result, the elastic wire 15 arranged proximal to the maximum diameter portion 13 is easily deformed, so that the distance between the elastic wire 15 bound by the binding member 30 and the elastic wire 15 not bound is preferably set. Can be separated.

The basket portion 10 may have different numbers of elastic wires 15 on the proximal side and the distal side with the maximum diameter portion 13 interposed therebetween. For example, the number of elastic wires 15 on the distal side of the maximum diameter portion 13 is larger than that on the proximal side. You can do a lot. By forming the basket portion 10 in this way, both the foreign matter catching operation and the foreign matter removing operation can be easily and efficiently performed.

In the basket portion 10, three or more elastic wires 15 are bound in the first binding portion. In the first binding portion, the elastic wires 15 may or may not be in contact with each other. For example, the elastic wire 15 may be bound by the tip 11 at the first binding portion. A plurality of elastic wires 15 may be bound by a method such as heat welding, silver brazing, adhesion, or caulking. Further, these elastic wires 15 may be bound by forming a knot using a plurality of elastic wires 15.

Although not shown, the tip tip 11 preferably has a wire insertion hole into which the distal ends of the plurality of elastic wires 15 are inserted. The tip tip 11 may have a plurality of such wire insertion holes.

Examples of the material constituting the tip tip 11 include a resin, a metal, or a combination thereof constituting the outer cylinder member 2. The metal constituting the tip 11 is preferably stainless steel or a Ni—Ti alloy.

Although not shown, the tip tip 11 may be provided with a treatment tool insertion passage through which an auxiliary treatment tool, which is a treatment tool different from the basket catheter 1, is inserted. The treatment tool insertion passage preferably extends along the axial direction of the interpolation member 3. By providing the treatment tool insertion passage in the tip tip 11, the distal end of the assistive treatment tool can be easily arranged on the distal side of the distal end of the catheter 1.

In the radial direction of the interpolation member 3, the outer diameter of the tip tip 11 is preferably larger than the inner diameter of the outer cylinder member 2. Even if the elastic wire 15 is housed in the outer cylinder member 2, the tip tip 11 is prevented from being caught by the distal end of the outer cylinder member 2 and the basket portion 10 is prevented from being excessively moved to the proximal side of the outer cylinder member 2. .. Further, when performing the procedure after the accommodation, the elastic wire 15 can be immediately exposed from the outer cylinder member 2, so that the procedure can be performed efficiently.

As shown in FIGS. 1 to 4, in the basket portion 10, three or more elastic wires 15 are bound at the second binding portion proximal to the first binding portion. In the second binding portion, the elastic wires 15 may or may not be in contact with each other. For example, the elastic wire 15 may be bound by the connector 20 at the second binding portion. In the second binding portion, it is preferable that three or more elastic wires 15 and the interpolation member 3 are connected by the connector 20. The connector 20 can be formed in a cylindrical shape such as a cylindrical shape or a polygonal tubular shape. The connector 20 can be made of, for example, the same material as the tip 11 and the outer cylinder member 2. Since the connector 20 is housed in the outer cylinder member 2 together with the elastic wire 15, the outer diameter of the connector 20 needs to be smaller than the inner diameter of the outer cylinder member 2. Further, a plurality of elastic wires 15 and connecting tools 20 may be bound to each other at a second binding portion by a method such as heat welding, silver brazing, adhesion, or caulking.

When the interpolation member 3 is formed in a hollow shape, the connector 20 is also formed in a ring-shaped or tubular hollow shape, for example, and the elastic wire 15 is fixed to the peripheral wall of the connector 20. preferable. The connector 20 may have a plurality of wire insertion passages into which the proximal end of the elastic wire 15 is inserted from the distal side. In that case, it is preferable that a plurality of wire insertion passages are arranged side by side in the circumferential direction, and more preferably they are arranged side by side at equal intervals. By connecting the interpolation member 3 and the three or more elastic wires 15 via the tubular connecting tool 20, an auxiliary treatment tool inserted into the lumen of the interpolation member 3 can be used together.

The binding member 30 binds some elastic wires 15 to each other between the first binding portion and the second binding portion of the basket portion 10, and slides the bound elastic wires 15 with respect to the bound elastic wires 15. Here, the binding member 30 is a member provided separately from the tip end 11 that binds the elastic wire 15 at the first binding portion and the connector 20 that binds the elastic wire 15 at the second binding portion. Bundling some elastic wires 15 together does not mean binding a part of one wire and another part, but binding a plurality of different elastic wires.

1 to 4 show a basket catheter 1 having six elastic wires 15 (15a to 15f). As shown in FIGS. 1 and 3, in the basket catheter 1 of the present invention, some elastic wires 15b and 15c are bound to each other by the binding member 30 between the first binding portion and the second binding portion of the basket portion 10. The remaining elastic wires 15a, 15d to 15f are not bound. As a result, as shown in FIG. 3, by moving the binding member 30 in the distal direction, the bound elastic wire (for example, 15c) and the bound elastic wire 15c are adjacent to each other in the circumferential direction of the catheter 1. It can be separated from the unbound elastic wire (eg 15d) (FIG. 4). Such a state can be called an open state. Further, the shape of the basket portion 10 can be returned from the open state to the original state by moving the binding member 30 in the proximal direction. Since such an operation is possible, when it becomes necessary to remove the captured foreign matter from the basket portion 10, the binding member 30 can be operated to open the shape of the basket portion 10 and the basket portion 10 can be opened. The stones inside the 10 can be easily released, and the occurrence of incarceration can be prevented. Further, the binding member 30 is slid proximally to some of the elastic wires 15a to 15c, and as shown in FIG. 1, the binding member 30 is arranged in the vicinity of the second binding portion when the foreign matter is captured. As a result, the arrangement intervals of the three or more elastic wires 15a to 15f in the circumferential direction can be made uniform, so that the basket portion 10 can be prevented from being unintentionally deformed during the operation of capturing foreign matter. Therefore, according to the basket catheter 1 of the present invention, both the capture operation and the removal operation of the foreign matter can be easily and efficiently performed.

In FIGS. 1 to 4, two elastic wires 15b and 15c are bound by the binding member 30, but the number of bound elastic wires 15 is not particularly limited unless the number is 2 or more and the total number is not sufficient. The number of bound elastic wires 15 is preferably less than or equal to the number of unbound elastic wires 15, and preferably less than the number of unbound elastic wires 15. This makes it possible to suppress an increase in the size of the binding member 30. Further, in order to further suppress the increase in the size of the binding member 30, the number of elastic wires bound by one binding member 30 is preferably 4 or less, 3 or less, or 2 or less.

In the basket catheter 1 having the elastic wires 15, the number of elastic wires 15 is generally an even number, and among them, the one having 6 or 8 elastic wires 15 is often used. The total number of elastic wires 15 of one basket catheter 1 and the number of elastic wires 15 bound by the binding member 30 are not particularly limited. For example, in a basket catheter 1 having six elastic wires 15, the binding member 30 preferably binds two elastic wires 15. Further, in the basket catheter 1 having eight elastic wires 15, it is preferable that the binding member 30 binds two or three elastic wires 15. By determining the total number of elastic wires 15 and the number of elastic wires 15 bound by the binding member 30 in this way, it becomes easy to perform the foreign matter catching operation and the removing operation.

The number of bundling members 30 provided in one basket catheter 1 is not particularly limited, and may be, for example, three or less or two or less. Since the binding member 30 is housed in the outer cylinder member 2 together with the basket portion 10, the number of the binding members 30 is preferably smaller and the outer diameter is preferably smaller. Since the clearance in the outer cylinder member 2 is limited, it is more preferable that only one binding member 30 is provided.

The sliding range of the binding member 30 in the axial direction of the catheter 1 is not particularly limited, but the binding member 30 preferably slides in a range from the maximum diameter portion 13 of the basket portion 10 to the second binding portion. As a result, since the binding member 30 is arranged on the proximal side of the maximum diameter portion 13, it is possible to prevent the bound elastic wire 15 from being dispersed on the proximal side of the maximum diameter portion 13 and increasing the gap. By arranging the binding member 30 in the maximum diameter portion 13 of the basket portion 10, the distance between the plurality of bound elastic wires 15 and the adjacent unbound elastic wires 15 can be maximized. ..

The catheter 1 may be provided with a mechanism for preventing the binding member 30 from moving to the distal side beyond the maximum diameter portion 13 of the basket portion 10. This is because when the binding member 30 moves beyond the maximum diameter portion 13 to the distal side, the open state is not maintained and the distance becomes smaller. Therefore, it is preferable that the movement width of the linear member 40 connected to the binding member 30 in the axial direction is controlled. For example, it is preferable that the position adjusting member preferably provided on the handle is provided with a latch.

It is preferable that a part of the elastic wires 15 bound between the first binding portion and the second binding portion of the basket portion 10 has a lower hardness than the unbound elastic wires 15. Since the elastic wires 15 are bound by the binding member 30 but are easily deformed, a plurality of elastic wires 15 can be suitably bundled, and the elastic wires 15 bound by the binding member 30 and the elastic wires 15 not bound can be easily separated from each other. Become.

From the viewpoint of ensuring a circumferential separation distance between the bound elastic wire 15 and the unbound elastic wire 15, the maximum length of the binding member 30 in the major axis direction is the first binding portion and the second binding portion. It is preferably 1/30 or more, and more preferably 1/20 or more of the separation distance of the portions. On the other hand, when the binding member 30 is arranged near the second binding portion, the maximum length of the binding member 30 is set to be constant between the first binding portion and the second binding portion so that the intervals in the circumferential direction of all the elastic wires 15 are constant. It is preferably 1/10 or less, and more preferably 1/15 or less of the separation distance of the portions.

From the viewpoint of facilitating the accommodation of the binding member 30 in the outer cylinder member 2, the outer diameter of the binding member 30 is preferably half or less of the inner diameter of the outer cylinder member 2.

The binding member 30 can be made of resin or metal. As the resin constituting the binding member 30, the same material as the outer cylinder member 2 can be used. As the metal constituting the binding member 30, the same material as the material of the wire rod constituting the elastic wire 15 and the hollow coil body of the interpolation member 3 can be preferably used.

In order to improve the slidability of the elastic wire 15 with respect to the binding member 30, a lubricant is applied to the inner surface of the binding member 30 or the outer surface of the elastic wire 15, or a highly slippery resin is used for the binding member 30. It may be.

Next, a specific configuration of the binding member 30 will be described with reference to FIGS. 5 to 10. FIG. 5 is a perspective view showing a configuration example of the binding member 30, and FIG. 6 is a cross-sectional view taken along the line VI-VI of FIG. 7 to 9 are cross-sectional views showing a modified example of the binding member 30 shown in FIG. 6, and FIG. 10 is a perspective view showing a modified example of the binding member 30 shown in FIG. In order to facilitate understanding of the present invention, FIGS. 6 to 9 show an elastic wire 15 arranged on the binding member 30.

As shown in FIGS. 5 to 10, it is preferable that the binding member 30 is provided with a hollow portion 31 or a lumen 32 in which the elastic wire 15 is arranged. Here, the hollow portion 31 of the binding member 30 is a portion in which the binding member 30 is visible from any outer peripheral surface and communicates with the outside, and the lumen 32 of the binding member 30 is the binding member 30. It communicates with the outside by through holes having inlets and outlets on the distal end face and the proximal end face of the above, and is a part that cannot be seen from the outer peripheral surface. Here, the outer peripheral surface means a surface other than the distal end surface and the proximal end surface of the binding member 30. The shape of the binding member 30 in the cross section perpendicular to the axial direction of the elastic wire 15 is, for example, a circular shape, an elliptical shape, a semicircular shape, a polygonal shape, a semicircular shape with a part cut out, or a combination thereof. You may.

The hollow portion 31 and the cavity 32 of the binding member 30 may extend along the axial direction of the elastic wire 15, may extend parallel to the axial direction of the elastic wire 15, and may extend parallel to the axial direction of the elastic wire 15. It may extend along the curved shape of.

The hollow portion 31 and the lumen 32 of the binding member 30 may have a constant size over the entire axial direction, and are formed so that the inner diameter becomes smaller toward at least one of the distal end and the proximal end. May be.

In one embodiment of the present invention, as shown in FIGS. 5 to 6, the binding member 30 has a plurality of hollow portions 31, and elastic wires 15 are arranged in the plurality of hollow portions 31, respectively. Is preferable. By forming the portion where the elastic wire 15 is arranged in a hollow shape, the binding member 30 can be easily attached and detached. Therefore, it can be attached to a conventional basket gripper.

It is preferable that two or less elastic wires 15 are arranged in one hollow portion 31, for example, the hollow portion 31A of the binding member 30 of the embodiment shown in FIGS. 5 to 6, and one elastic wire 15 is provided. It is preferably arranged. As a result, the elastic wires 15 are arranged at predetermined intervals even when they are bound to the binding member 30, so that the binding member 30 can be easily slid with respect to the elastic wires 15. In addition, it is possible to prevent the elastic wires 15 from rubbing against each other and reducing the strength. In FIG. 6, elastic wires 15 (15a, 15b, 15c) are arranged in the hollow portions 31 (31A, 31B, 31C) of the binding member 30, respectively.

In the present embodiment, it is preferable that the binding member 30 is formed in a semi-cylindrical shape, and the hollow portion 31 is formed on the inner peripheral surface side. As a result, the elastic wire 15 can be pressed against the hollow portion 31 by utilizing the elastic force that the elastic wire 15 naturally expands, so that the elastic wire 15 is prevented from being unintentionally detached from the binding member 30. can. In FIG. 5, the hollow portion 31 is provided with a groove extending in the axial direction of the binding member 30.

In the present embodiment, the shape of the hollow portion 31 in the cross section perpendicular to the axial direction of the binding member 30 can be, for example, a circular shape or a polygonal shape. It is preferable that the shape of the lumen 32 of the binding member 30 of a different embodiment described later is also formed in the same manner. In the present embodiment, as shown in FIG. 6, it is preferable that the shape is a part of the circle cut out. When the binding member 30 is slid with respect to the elastic wire 15, it is possible to prevent the elastic wire 15 from rubbing against the elastic wire 15 and reducing the strength.

As shown in FIG. 7, it is preferable that the binding member 30 is formed in a tubular shape having a plurality of lumens 32, and the elastic wire 15 is inserted into each of the plurality of lumens 32. Compared with the embodiment in which the hollow portion 31 is provided, the risk of the elastic wire 15 being unintentionally detached from the binding member 30 can be reduced. In FIG. 7, the binding member 30 is formed in a semi-cylindrical shape, and three lumens 32 (32A, 32B, 32C) are provided. Similar to the hollow portion 31, two or less (more preferably one) elastic wires 15 are arranged in one lumen 32 of the binding member 30.

As shown in FIGS. 5 to 7, when the binding member 30 has a plurality of hollow portions 31 (or lumens 32), the plurality of hollow portions 31 (or lumens 32) are formed in the circumferential direction of the catheter 1. It is preferably arranged at equal intervals. By providing the hollow portion 31 or the lumen 32 in this way, it is possible to prevent the elastic wire 15 from being excessively deformed even if the binding member 30 is slid to the distal side. Further, even when the binding member 30 is arranged in the vicinity of the second binding portion, the elastic wires 15 are arranged at equal intervals in the circumferential direction, so that it is easy to perform the operation of capturing foreign matter.

As shown in FIGS. 5 to 7, when a plurality of lumens 32 (or hollow portions 31) are arranged in the binding member 30, the distance between adjacent lumens 32 (or hollow portions 31) in the circumferential direction. However, it is preferable that the distance between adjacent elastic wires 15 which are not bound in the maximum diameter portion 13 of the basket portion 10 is narrower than the circumferential distance between them. As a result, when the binding member 30 is arranged in the maximum diameter portion 13 of the basket portion 10, the distance between the elastic wires 15 bound by the binding member 30 in the circumferential direction can be suitably narrowed. Therefore, the distance between the unbound elastic wire 15 and the bound elastic wire 15 in the circumferential direction can be widened, and the foreign matter trapped in the basket portion 10 can be easily removed.

In different embodiments of the present invention, as shown in FIGS. 8-9, the binding member 30 has one hollow portion 31 or one lumen 32, and one hollow portion 31 or one lumen 32. It is preferable that a part of the elastic wire 15 is inserted through the lumen. Since it is not necessary to provide the binding member 30 with a plurality of hollow portions 31 or lumens 32, the manufacturing process of the binding member 30 can be simplified. FIG. 8 shows an example in which one hollow portion 31 is provided in the binding member 30, and FIG. 9 shows an example in which one lumen 32 is provided in the binding member 30.

The binding member 30 having one hollow portion 31 is obtained, for example, by bending, bending, crimping, or partially cutting out a plate-shaped or annular member. The cross-sectional shape of the bundling member 30 having one hollow portion 31 may be, for example, a shape lacking a part of a D-shaped straight line portion. As the binding member 30 having one lumen 32, an annular member can be used.

As shown in FIG. 10, the bundling member 30 is preferably formed so that the outer diameter becomes smaller toward one or both of the distal end and the proximal end. By reducing the outer diameter toward the distal end, when the binding member 30 is moved toward the distal end, the binding member 30 is radially outward from the maximum diameter portion 13 of the basket portion 10. Since the protrusion can be suppressed, the risk of damaging the inner wall of the living body by the binding member 30 can be reduced. On the other hand, by reducing the outer diameter toward the proximal end, the binding member 30 is easily accommodated in the outer cylinder member 2. FIG. 10 shows an example in which the binding member 30 is formed so that the outer diameter becomes smaller toward both the distal end and the proximal end.

The linear member 40 is connected to the binding member 30 and is arranged in the lumen of the outer cylinder member 2. The linear member 40 functions as an operating member for moving the binding member 30 in the perspective direction.

The linear member 40 may be a single wire or a stranded wire composed of a plurality of single wires. The linear member 40 preferably has elasticity so that the binding member 30 does not buckle even when the binding member 30 is repeatedly moved in the perspective direction. The linear member 40 can be made of the resin or metal mentioned as the preferred material of the binding member 30, but is preferably made of metal from the viewpoint of ensuring strength, for example, stainless steel or Ni. Examples include shape memory alloys such as -Ti alloys. From the viewpoint of simplifying the manufacturing process, a wire rod of the same type as the elastic wire 15 may be used for the linear member 40.

The outer diameter of the linear member 40 is preferably a size equal to or larger than the outer diameter of the elastic wire 15, more preferably 1.2 times or more, still more preferably 1.5 times or more. As a result, the strength of the linear member 40 can be ensured, so that the linear member 40 is less likely to buckle even if the binding member 30 is repeatedly slid using the linear member 40.

The binding member 30 is preferably connected to the distal end of the linear member 40. More preferably, the distal end of the binding member 30 is located distal to the distal end of the linear member 40. As a result, since the linear member 40 is not arranged on the distal side of the binding member 30, even if the linear member 40 is moved forward and backward, it is possible to prevent the distal end of the linear member 40 from coming into contact with the inner wall of the living body. It is preferable that the proximal end of the binding member 30 is connected to the linear member 40.

Examples of the method of joining the binding member 30 and the linear member 40 include a method of joining by welding with a laser or the like, welding, brazing, caulking, bonding with an adhesive such as acrylic, epoxy, or urethane. Further, in the joining method, an insertion hole into which the linear member 40 can be inserted is provided on the proximal side of the binding member 30, and the insertion hole portion of the binding member 30 into which the linear member 40 is inserted is crimped (crimped). ) Or a method of injecting an adhesive or the like into the insertion hole. The linear member 40 may be joined to the outer surface or the inner surface of the binding member 30. When the interpolation member 3 is formed in a hollow shape, it is preferable that the linear member 40 is joined to the inner surface of the binding member 30.

As another specific method for joining the binding member 30 and the linear member 40, the binding member 30 is provided with a plurality of lumens 32 or hollow portions 31, and one lumen 32 (or hollow portion 31) is provided with a plurality of lumens 32 or hollow portions 31. The elastic wire 15 may be arranged, and the linear member 40 may be arranged in another lumen 32 (or hollow portion 31). By forming the binding member 30 in this way, the elastic wire 15 can be bound and reliably connected to the linear member 40. In that case, the other lumen 32 (or hollow portion 31) in which the linear member 40 is arranged may or may not penetrate in the perspective direction of the binding member 30.

The arrangement position of the linear member 40 in the outer cylinder member 2 will be described. The linear member 40 may be arranged outside the interpolation member 3 as shown in FIG. 11, or may be arranged inside the interpolation member 3 as shown in FIG. Although not shown, the interpolation member 3 is formed in a solid state, or a plurality of wire rods are bound or twisted, and the linear member 40 is arranged outside the interpolation member 3. May be good. Further, the interpolation member 3 may be formed in a hollow shape, and the linear member 40 may be arranged inside or outside the interpolation member 3. Since the clearance inside the outer cylinder member 2 is limited, as shown in FIG. 12, when the interpolation member 3 is formed in a hollow shape, it is preferably arranged inside the interpolation member 3.

The linear member 40 may be arranged in another tubular member in order to smoothly advance and retreat the linear member 40. For example, as shown in FIGS. It is preferable that the linear member 40 is arranged in the 41. In that case, the sum of the outer diameter of the interpolation member 3 and the outer diameter of the auxiliary cylinder member 41 is smaller than the inner diameter of the outer cylinder member 2. The outer diameter of the auxiliary cylinder member 41 is preferably smaller than the outer diameter of the interpolation member 3, more preferably one-half or less, still more preferably one-third or less. The auxiliary cylinder member 41 can be formed in the same manner as the outer cylinder member 2.

A configuration example of the proximal side of the catheter 1 will be described with reference to FIGS. 13 to 14. As shown in FIGS. 13 to 14, in order to improve the operability of the outer cylinder member 2 and the inner cylinder member 3, a hollow portion 55 is provided on the proximal side of the outer cylinder member 2 or the inner cylinder member 3. It is preferable that the handle 50 is provided. In FIGS. 13 to 14, the handle 50 includes a first handle 51 and a second handle 52, the first handle 51 is connected to the proximal end side of the interpolation member 3, and the second handle 52 is outside. It is connected to the proximal end side of the tubular member 2. The first handle 51 and the second handle 52 are preferably formed in a tubular shape so that the proximal end side of the interpolation member 3 and the outer cylinder member 2 can be inserted.

As the material of the handle 50, for example, a synthetic resin such as ABS or polycarbonate, or a foamed plastic such as a polyurethane foam can be used.

The lumen of the first handle 51 may communicate with the lumen of the interpolation member 3. The lumen of the first handle 51 may function as a passage for a drug, a fluid in the living body cavity, or the like, in addition to the insertion passage for the guide wire. Further, the lumen of the second handle 52, which is the lumen of the outer cylinder member 2 and communicates with the outside of the interpolation member 3, may function as a passage for a drug, a fluid in the living body cavity, or the like.

The insertion member 3 and the first handle 51, and the outer cylinder member 2 and the second handle 52 can be joined by using a conventionally known joining means such as an adhesive or heat welding. The first handle 51 is arranged proximal to the second handle 52. An annular resistance member 53 may be provided at the proximal end of the second handle 52, for example. As a result, the position of the second handle 52 with respect to the first handle 51 can be prevented from being unintentionally displaced, so that the relative positions of the outer cylinder member 2 and the interpolation member 3 can be fixed.

The handle 50 has a position adjusting member 54 connected to the proximal end of the linear member 40, and the position adjusting member 54 has an elastic member 56 arranged in the hollow portion 55 of the handle 50. It is preferable that they are in contact with each other. As a result, the binding member 30 can be easily slid by operating the position adjusting member 54. In FIG. 13, the second handle 52 is provided with the hollow portion 55, and in FIG. 14, the first handle 51 is provided with the hollow portion 55.

In FIG. 13, the slide lever as the position adjusting member 54 comes into contact with the spring member as the elastic member 56 arranged in the hollow portion 55 provided in the second handle 52 connected to the outer cylinder member 2. is doing. In FIG. 14, the slide lever as the position adjusting member 54 comes into contact with the spring member as the elastic member 56 arranged in the hollow portion 55 provided in the first handle 51 connected to the interpolation member 3. is doing.

It is preferable that the position adjusting member 54 is in contact with the proximal end of the spring member. As a result, when the slide lever is pushed to the distal side, that is, when the spring member is urged, the linear member 40 moves to the distal side, so that the binding member 30 connected to the linear member 40 Can be slid towards the distal end of the basket portion 10. On the other hand, when the hand is released from the slide lever, the urging of the spring member is released, and as a result of the linear member 40 being placed in the latest position, the binding member 30 connected to the linear member 40 is also close to the basket portion 10. It is placed on the position side. By providing the position adjusting member 54 and the elastic member 56 on the handle 50 in this way, the binding member 30 can be easily slid by operating in only one direction.

The position adjusting member 54 is not particularly limited as long as it is a mechanism for axially moving the linear member 40 in the perspective direction, and may be a button, a rotary handle, a rotary knob, or the like in addition to the slide lever. As the material of the position adjusting member 54, the same material as that of the handle 50 can be used.

As the elastic member 56, a spring member such as a coil spring, a leaf spring, or a mainspring, or a rubber member can be used.

1: Basket catheter 2: Outer cylinder member 3: Interpolation member 10: Basket part 11: Tip tip 13: Maximum diameter part 15, 15a, 15b, 15c, 15d, 15e, 15f: Elastic wire 16: Capture part 20: Connection Tool 30: Bundling member 31: Hollow portion 32: Lumen 40: Linear member 41: Auxiliary cylinder member 50: Handle 51: First handle 52: Second handle 53: Resistance member 54: Position adjusting member 55: Hollow portion 56 : Elastic member

Claims (13)

An outer cylinder member having a distal side and a proximal side,
An interpolation member arranged in the lumen of the outer cylinder member and
Expandable, located on the distal side of the interpolation member, with three or more elastic wires bound in a first binding portion and a second binding portion proximal to the first binding portion. A basket catheter having a basket portion and
A binding member that binds some of the elastic wires between the first binding portion and the second binding portion of the basket portion and slides with respect to the partial elastic wires.
It has a linear member that is connected to the binding member and is arranged in the lumen of the outer cylinder member.
The remaining elastic wire is not bound between the first binding portion and the second binding portion of the basket portion.
When the binding member is slid to the proximal side and brought close to the second binding portion, the basket in which the arrangement intervals of all the elastic wires in the circumferential direction when the basket catheter is viewed from the distal end becomes uniform. catheter. The basket catheter according to claim 1, wherein the binding member slides in a range from the maximum diameter portion of the basket portion to the second binding portion. The basket catheter according to claim 1 or 2, wherein only one binding member is provided. The binding member has a plurality of hollow portions, and the binding member has a plurality of hollow portions.
The basket catheter according to any one of claims 1 to 3, wherein the elastic wire is arranged in each of the plurality of hollow portions. The binding member is formed in a tubular shape having a plurality of lumens.
The basket catheter according to any one of claims 1 to 3, wherein the elastic wire is inserted into each of the plurality of lumens. The binding member has 1 hollow portion or 1 lumen.
The basket catheter according to any one of claims 1 to 3, wherein a part of the elastic wire is inserted into the hollow portion of 1 or the lumen of 1. The basket catheter according to any one of claims 1 to 6, wherein the binding member is formed so that the outer diameter becomes smaller toward at least one of the distal end and the proximal end. The basket catheter according to any one of claims 1 to 7, wherein the interpolation member is formed in a hollow shape. The basket catheter according to claim 8, wherein the linear member is arranged inside or outside the interpolation member. The basket catheter according to any one of claims 1 to 7, wherein the interpolation member is formed in a solid state, or a plurality of wires are bound or twisted. In the basket catheter having the six elastic wires
The basket catheter according to any one of claims 1 to 10, wherein the binding member binds the two elastic wires. In the basket catheter having the eight elastic wires
The basket catheter according to any one of claims 1 to 10, wherein the binding member binds two or three elastic wires. Further, a handle having a hollow portion is provided on the proximal side of the outer cylinder member or the insertion member.
The handle has a position adjusting member connected to the proximal end of the linear member.
The basket catheter according to any one of claims 1 to 12, wherein the position adjusting member is in contact with an elastic member arranged in the hollow portion of the handle.

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