JPH02152467A - Guide wire - Google Patents

Abstract

PURPOSE:To safely remove the constricted part of the coronary arteries by providing a projection to the part near to the leading end of a guide wire and providing a mechanism for rotating the guide wire around the axis in the longitudinal direction of said wire at a high speed to the other end of the guide wire. CONSTITUTION:A projection 2 is provided to the leading end part of a guide wire 1 so as to be positioned at a place separated by 3mm from the leading end 3 of the guide wire. The length from said leading end 3 to the projection 2 is usually 5-50mm because the guide wire is rotated at a high speed in such a state that the leading end of the guide wire is introduced into a constricted part to be removed. The guide wire is inserted in the femoral artery and the other end thereof is separated from the femoral artery to be present outside the body and connected to a high speed rotary motor outside the body. By this method, the guide wire is rotated at a high speed to introduce the leading end thereof into the constricted part of the artery. The part remote from the guide wire of the projection is made smooth so as not to damage a blood vessel layer.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to a medical device used for percutaneously reconstructing obstructed coronary arteries, so-called percutaneous coronary angioplasty.

[Conventional technology and problems to be improved 3] With the Westernization of dietary habits, heart disease is increasing in Japan, and the number of deaths due to so-called coronary insufficiency caused by occlusion of coronary arteries is rapidly increasing.

When a coronary artery is occluded or narrowed, blood flow to the heart is severely reduced, nutritional support becomes inadequate, and a serious condition called myocardial infarction occurs. Myocardial infarction is an extremely serious symptom, and it is difficult to save life in this condition. When a myocardial infarction occurs, the coronary arteries become narrowed and blood flow decreases, resulting in an attack called angina pectoris.

As a method to prevent or treat this, in addition to medical treatment with drugs, bypassing the patient's saphenous vein is created at the part of the coronary artery where the blockage occurs from the ascending artery.
The so-called A-C bypass has been used exclusively and successfully. However, this method requires surgically opening the chest, so-called open-heart surgery, which is difficult for both the practitioner and the patient undergoing the surgery.

In its place, percutaneous coronary angioplasty (PTCA) was developed. This involves inserting a catheter equipped with a polypropylene or polyethylene balloon into the patient's femoral artery, guiding the balloon to the narrowed part of the coronary artery, and then inflating the balloon by sending gas into it.
The force is used to spread the narrowed part of the coronary artery and secure the blood flow path.

This method quickly became popular because it is relatively simple and does not require troublesome and dangerous open-heart surgery. It has become clear that this method can cause blockage, and a review of this method is required.

[Characteristics and improvements of the present invention]

In conventional coronary angioplasty (PTCA), a narrowed portion of a coronary artery is expanded using the force of a balloon, and is only a temporary procedure. This is because the stenotic state will return immediately.

In order to improve this point, the present inventor thought of maintaining blood flow for a long period of time by completely removing the stenotic part.This method involves crushing the stenotic part with a laser and removing it. A method has been developed to do this, but it is a large device that requires a large laser generator, is difficult to use, and is extremely dangerous as it may damage the coronary artery itself.

The present inventor has conducted extensive research into a new coronary angioplasty technique that is extremely simple, convenient, extremely easy to use, and safe, and has arrived at the present invention.

The present invention provides a protrusion at or near the tip of a guide wire, guides this protrusion to the narrowed part of the coronary artery, and connects the guide wire to a motor that rotates at high speed. A medical device that rotates at high speed around its length and pushes the guide wire toward the stenosed area, scattering the stenosed area of the coronary artery into minute pieces to open the blood flow path and open the blood flow path of the narrowed coronary artery. be.

Further, to explain the present invention in detail, the present invention is mainly based on a guide wire having a protrusion at its tip. A guide wire is inserted into the appropriate femoral artery in a conventional manner, and guided into the coronary artery in a conventional manner. The outer diameter of the guide wire used is between 0.05 mm and 21 IA, preferably Q
, 1 mm to 2.0 mm.

If the outer diameter of the guide wire is thinner than 0.05 mm, there is a risk that the guide wire will be twisted due to high speed rotation when implementing the present invention, and if it is thicker than 2.0 mm, it will be difficult to guide it into the coronary artery. .

Aspects of the present invention are illustrated in a first example. As illustrated in FIG. 1, a protrusion 2 is provided at the distal end of the guide wire 1, and the protrusion 2 is located 3 mm from the distal end 3 of the guide wire. The length from this tip 3 to the protrusion 2 is usually 5+n to 50 mm. This is the first
This is to rotate the guide wire at high speed while the tip of the guide wire is introduced into the stenosis to be removed as shown in the figure.

As a second example, the shape of the protrusion 2 is shown. The shape of the protrusion is such that as the guide wire rotates, it forms a rotating body around the guide wire, so the volume of this rotating body decreases as it tapers toward the tip of the guide wire. Good shape.

Figure 2 shows an example of the shape of the protrusion at the tip, but as shown in (a), the protrusion may not extend around the entire circumference of the guide wire but may extend in a plate shape, or the protrusion may be shaped like a''. It may be curved.

Furthermore, as shown in b, the protrusion may cover the entire circumference of the guide wire, or the protrusion may be cut into a conical surface or formed into a plate-like protrusion to facilitate destruction of the stenosis, as shown in b. Alternatively, this plate-like projection may be curved.

The guide wire is inserted through the femoral artery, but the other end is located outside the body, away from the femoral artery, and is connected to a high-speed rotating motor outside the body, which rotates the guide wire at high speed to allow the tip of the guide wire to enter the narrowed part of the artery. It is. The rotation speed of the guide wire at this time is 30 per minute.
It may be between 0 and 50,000 times, preferably between 1,000 and 3
It is 0000 rotations. If the rotation speed is lower than 300 revolutions per minute, the powder crushed by the rotation of the protrusion is large and may cause damage, and if the rotation speed is higher than 30,000 revolutions, a safety problem arises.

The part of the protrusion furthest from the guide wire is smooth, and the IC is placed so as not to damage the vascular layer. The relationship between the height h of the protrusion and the outer diameter β of the guide wire A.- is 1ON≧11≧0.1β. When h is 10β or more, when the guide wire rotates at high speed, it cannot rotate smoothly at high speed inside a small blood vessel, which may cause damage to the blood vessel.

If the curvature is smaller than 0.112, the effect of enlarging the stenosis will be lacking.

〔Effect of the invention〕

The present invention can safely remove a narrowed portion of a coronary artery using an extremely simple method, so it has a wide range of applications and can be easily operated by a physician.

[Brief explanation of the drawing]

1 and 2 are schematic illustrations of first and second embodiments of the invention, respectively. @Figure 1

Claims (1)

[Claims] A guidewire for reconstructing a coronary artery, characterized in that a protrusion is provided at a portion near the tip of the guidewire, and a mechanism for rotating the guidewire at high speed around the length direction is provided at the other end. guide wire.