JPH02211139A - Laser beam irradiating device - Google Patents

Abstract

PURPOSE:To prevent burnt refuse generated at the time of laser treatment from scattering widely in a tubular cavity by mounting on the peripheral surface of a catheter, a filter allowing blood corpuscles in blood flowing in the cavity to pass through and preventing permeation of foreign matter larger than these blood corpuscles. CONSTITUTION:A laser guide 6 is inserted into a catheter 1 inserted into a tubular cabity 2 (for instance, blood vessel) of a human body, and laser beam, emitted from this laser guide 6, is irradiated to a treated location in the cavity 2. A filter 8, which permeates corpuscles in blood flowing in the cavity 2 and prevents permeation of foreign matter larger than these corpuscles, is mounted on the peripheral surface of the catheter q. As a result, flow of the corpuscles in the cavity 2 can be prevented from deteriorating while preventing burning refuse, generated at the time of laser treatment, from scattering widely in the cavity 2.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to an improvement in a laser beam irradiation device for performing observation treatment within a lumen of a blood vessel or the like.

[Prior Art] Generally, a laser beam irradiation device has been developed that introduces a laser probe into a body cavity and guides a laser beam using a laser guide of the laser probe to treat an affected area within the body cavity. As a device of this kind, Japanese Patent Application Laid-open No. 63-206237 discloses that a space is provided in front of the output end face of a laser guide that guides the laser light to take in the treatment area, and a laser light shielding member is provided in front of this space. The configuration provided is shown. In this case, when the laser beam irradiation device is used, the laser beam is emitted from the emission end surface of the laser guide with a treatment site, such as a thrombus in a blood vessel, inserted into the space between the emission end surface of the laser guide and the shielding member. By irradiating the treatment site with laser light, the treatment site such as a blood clot is cauterized and removed, and the laser light that has penetrated the treatment site is absorbed by the shielding member, so that the laser light that has penetrated the treatment site can be used to treat the treatment site. This is designed to prevent damage to healthy tissues other than the affected area, such as the inner walls of blood vessels, from being irradiated with the radiation.

In addition, USP No. 4,448,188 discloses that a balloon is attached to the outer circumferential surface of a catheter inserted into a blood vessel, and during observation and treatment inside the blood vessel, the balloon is expanded to temporarily occlude the blood vessel. A configuration is shown in which a physiologically compatible oxygen-bearing liquid is introduced downstream of the blood vessel, and intravascular observation and laser treatment are performed while this physiologically compatible oxygen-bearing liquid is substantially clear.

[Problems to be Solved by the Invention] In the case of JP-A No. 63-206237, most of the burn marks that occur during laser treatment in which a treatment site such as a thrombus within a blood vessel is irradiated with laser light and removed by cauterization are removed. The particles are collected in the space between the emission end face of the laser guide and the shielding member. However, since a gap is formed between the inner peripheral surface of the blood vessel wall and the sheath of the laser probe,
There is a risk that some of the burn residue generated during laser treatment will scatter relatively widely into the blood vessel through the gap between the inner peripheral surface of the blood vessel wall and the sheath of the laser probe, and may flow into other peripheral blood vessels. Ta. Furthermore, since no closing member such as a cover is specifically provided in the space between the emission end face of the laser guide and the shielding member, the laser guide is closed when the laser probe is removed from the blood vessel after laser treatment. There is a risk that the burn residue may spill out from within the space between the emission end face and the shielding member, and there is a problem in that it is not possible to prevent the burn residue generated during laser treatment from being widely scattered within the blood vessel.

Further, in the case of USP No. 4,448,188, the blood vessel is temporarily occluded by the expansion of the balloon, so there is a problem in that the flow of blood cells within the blood vessel becomes poor.

This invention was made in view of the above-mentioned circumstances, and it is possible to prevent the burn particles generated during laser treatment from being widely scattered within the lumen, and there is no risk that the flow of blood cells within the lumen will be impaired. The object of the present invention is to provide a laser beam irradiation device.

[Means for Solving the Problems] The present invention includes a laser guide 6 inserted into a catheter 1 inserted into a lumen 2 of a human body, and a laser beam emitted from the laser guide 6 used to treat the inside of the lumen 2. In a laser beam irradiation device for irradiating a region 7, a filter 8 is attached to the outer peripheral surface of the catheter 1, which allows blood cells in the blood flowing in the lumen 2 to pass through and prevents foreign matter e larger than the blood cells from passing through. .

[Operation] During laser treatment in which the treatment site 7 in the lumen 2 is irradiated with laser light emitted from the laser guide 6, blood cells in the blood flowing in the lumen 2 are transmitted through the filter 8 on the outer peripheral surface of the catheter 1, By preventing foreign matter e larger than blood cells from passing through, it prevents the burn particles e generated during laser treatment from widely scattering within the lumen 2, and also prevents the flow of blood cells within the lumen 2 from worsening. It was designed to do so.

[Embodiment] A first embodiment of the present invention will be described below with reference to FIGS. 1 to 10. FIG. 1 shows a schematic configuration of the main parts of a laser beam irradiation device, and 1 is a catheter inserted into a lumen of a human body (for example, a blood vessel 2, etc.). A substantially disc-shaped laser guide holding plate 3 is provided at the distal end of the catheter 1.

Furthermore, as shown in FIGS. 2 and 3, a laser guide insertion hole 4 is formed in the laser guide holding plate 3 at a substantially central position, and a plurality of feeding holes are formed around the laser guide insertion hole 4. A water outlet 5... is formed.

Further, a laser guide 6 is inserted into the interior of the catheter 1, and the distal end portion of the laser guide 6 extends to the outside through the laser guide insertion hole 4 of the laser guide holding plate 3. In this case, the base end of the laser guide 6 is connected to a laser device (not shown). During laser treatment, the laser beam emitted from this laser device is guided by a laser guide 6, and is emitted from the laser beam emitting end surface 6a at the tip of the laser guide 6 to the outside to form a thrombus 7 in the blood vessel 2. It is designed to irradiate foreign objects in the lumen of the body.

Further, a filter 8 is attached to the outer circumferential surface of the catheter 1 to allow blood cells in blood flowing in the lumen of the blood vessel 2 to pass therethrough and to prevent foreign substances larger than the blood cells from passing through.

In this case, the inner peripheral edge of the filter 8 is fixed on the outer peripheral surface of the catheter 1 at a position separated from the distal end of the catheter 1 by an appropriate distance. Further, a filter operation ring 9 formed of, for example, a ring-shaped wire spring is attached to the outer peripheral edge of the filter 8. The filter 8 is normally held in an expanded state as shown in FIGS. 4 and 5 by the spring force of the filter operation ring 9.

Further, the tip of a ring operating wire 10 for variably adjusting the outer diameter of the filter operating ring 9 is connected to one end of the filter operating ring 9.

Furthermore, a small diameter wire insertion ring 11 is formed at the other end of the filter operation ring 9.

Further, a wire insertion hole 12 is formed in the tube wall of the catheter 1 closer to the proximal end than the fixing part of the inner peripheral edge of the filter 8 . The ring operation wire 10 of the filter operation ring 9 is connected to the wire insertion ring 11 of the filter operation ring 9.
The wire is introduced into the catheter 1 through the wire insertion hole 12. Further, the proximal end of the ring operating wire 10 is connected to, for example, an appropriate filter operating member on the hand side. As the filter operating member is operated, the ring operating wire 10 is pulled as shown by arrow a in FIGS. 2 and 3, and as the ring operating wire 10 is pulled, the filter operating ring 9 is The filter 8 is deformed into a reduced shape with a reduced outer diameter as shown in FIGS. 2 and 3 against the spring force, and the filter 8 is also simultaneously deformed into a reduced state. There is.

Further, the tip of an aperture operation wire 13 is connected to the filter operation ring 9 . This throttle operation wire 13 is introduced into the interior of the catheter 1 via a throttle wire insertion hole 14 formed in the tube wall of the catheter 1. In this case, the squeeze wire insertion hole 14 is formed at a position closer to the distal end of the catheter 1 than the wire insertion hole 12 is. Furthermore, the base end of this aperture operation wire 13 is connected to, for example, an appropriate aperture operation member on the hand side.

As the diaphragm operation member is operated, the diaphragm operation wire 13 is pulled as shown by the arrow in FIG. 7, and the filter operation ring 9 is pulled as shown in FIGS. The filter 8 is deformed into the diaphragm shape shown in FIG. 10, and the outer peripheral edge of the filter 8 is also deformed into the diaphragm shape at the same time.

Next, the operation of the above configuration will be explained.

First, when inserting the catheter 1 into a patient's lumen, for example, into a blood vessel 2, an appropriate filter operating member on the proximal side is operated in advance, and the ring operating wire 10 is inserted into the patient's lumen, for example, into a blood vessel 2.
As the ring operation wire 10 is pulled, the filter operation ring 9 is pulled as shown by the arrow a in the figure, and the outer diameter of the filter operation ring 9 is changed as shown in FIGS. 2 and 3. Transform into a reduced shape. Therefore, in this case, the filter 8 is also held in a reduced state in which the outer diameter dimension is reduced as shown in FIGS. 2 and 3. Then, in this state, the catheter 1 is inserted into the patient's lumen, for example, into the blood vessel 2.

Further, with the catheter 1 inserted into the target location within the blood vessel 2, the filter operating member on the proximal side is returned to its original state.

In this case, the tensile operating force of the ring operating wire IO is released, so the filter operating ring 9 is deformed in a direction that increases its outer diameter due to the elastic restoring force of the filter operating ring 9. It deforms to a state in which it is in contact with the inner circumferential surface of the tube wall of the blood vessel 2 (a state in which the inner diameter dimension is approximately the same as the inner circumference of the inner circumferential surface of the tube wall of the blood vessel 2). Therefore, as the filter operation ring 9 expands, the filter 8 also expands as shown in FIGS. 4 and 5.
As shown in the figure, the entire gap between the inner circumferential surface of the tube wall of the blood vessel 2 and the outer circumferential surface of the catheter 1 can be occluded by the filter 8.

Furthermore, in this way, the inner circumferential surface of the tube wall of the blood vessel 2 and the catheter 1
While the entire gap between the filter 8 and the outer circumferential surface of the laser guide 6 is closed by the filter 8, a laser beam is emitted from the laser beam emitting end surface 6a at the tip of the laser guide 6 to eliminate the thrombus 7 and other tubes formed within the blood vessel 2. Laser treatment is performed to irradiate the foreign body within the cavity. In this case, the catheter 1 is inserted from the direction opposite to the direction of blood flow in the blood vessel 2 shown by arrow C in FIG. As shown by the arrow d, the water is held in such a state that it is ejected into the blood vessel 2 through the water supply ports 5 of the laser guide holding plate 3. Therefore, in this case, the burn e caused by the laser treatment can be pushed by the flow of blood in the blood vessel 2 and completely adhere to the filter 8 as shown in FIG. It is possible to prevent the debris e from widely scattering within the blood vessel 2 as in the conventional case, and it is possible to prevent the peripheral blood vessels from being occluded. Further, during laser treatment, blood cells in the blood flowing in the blood vessel 2 pass through the filter 8, so that the flow of blood cells in the blood vessel 2 can be prevented from becoming impaired during the laser treatment.

After the laser beam irradiation is completed, the catheter 1 is pulled slightly toward the proximal side while the filter operation ring 9 is in contact with the inner peripheral surface of the wall of the blood vessel 2. And the seventh
As shown in the figure and FIG.
With the entire filter 8 tilted, the diaphragm operation member is operated to pull the diaphragm operation wire 13 toward the user's hand as indicated by the arrow in FIG. When the diaphragm operation wire 13 is pulled, the diaphragm operation wire 13 is pulled as shown by the arrow in FIG. 7, and the filter operation ring 9 is pulled as shown in FIGS. Since the filter 8 is deformed into the diaphragm shape shown in the figure, the outer peripheral edge of the filter 8 is also simultaneously deformed into the diaphragm state in which the outer diameter dimension is reduced. Therefore, in this case, a bag-shaped sealed space is formed between the outer circumferential surface of the catheter 1 and the filter 8, and the burn residue e from the laser treatment adhering to the filter 8 is removed between the outer circumferential surface of the catheter 1 and the filter 8. Since it can be housed in a sealed bag-like space between the catheters 1 and 2 in a sealed state, it is possible to prevent burnt e from spilling into the blood vessels 2 when the catheter 1 is removed from the blood vessels 2 after the laser treatment is completed. This makes it possible to prevent the burn marks e generated during laser treatment from being widely scattered within the blood vessel 2.

Further, FIG. 11 shows a second embodiment of the present invention. A filter accommodating groove 21 is provided on the outer circumferential surface of the catheter 1, and a filter 8 is provided within this filter accommodating groove 21.
and a filter operation ring 9 are accommodated therein. In this case, when the catheter 1 is inserted into the blood vessel 2, the filter 8 and the filter operation ring 9 can be held in the filter housing groove 21, so that the outer diameter of the catheter 1 can be reduced. In addition, the outer circumferential surface of the catheter 1 can be maintained as a substantially smooth surface. Therefore, the insertion resistance of the catheter 1 can be reduced compared to the case where the filter housing groove 21 is not provided on the outer peripheral surface of the catheter 1, and the operation of inserting the catheter 1 into the blood vessel 2 can be facilitated. . Furthermore, it is also possible to prevent the filter 8 and the filter operation ring 9 from being caught by foreign objects or the like and being damaged during the operation of inserting the catheter 1 into the blood vessel 2.

Further, FIGS. 12 and 13 show a third embodiment of the present invention. This is achieved by providing a laser guide insertion hole 41 at an eccentric position away from the center position 0 of the laser guide holding plate 3 at the tip of the catheter 1, and inserting the laser guide 6 into the laser guide insertion hole 41 at this eccentric position. , the laser guide 6 is held at an eccentric position away from the center position O of the catheter 1.

Therefore, in this case, when the thrombus 42 is formed only on a part of the wall surface of the blood vessel 2, the laser light emitted from the laser light emitting end surface 6a at the tip of the laser guide 6 is applied to the thrombus 42.
The laser beam can be irradiated intensively to the blood clot 4.
It is possible to prevent normal tissues other than 2 from being irradiated.

Furthermore, FIG. 14 shows a fourth embodiment of the present invention. A filter 8 and a filter operation ring 9 are provided at the distal end of the catheter 1, a gap between the catheter 1 and the laser guide 6 is formed by a suction passage 51, and a laser guide holding plate 3 at the distal end of the catheter 1 is provided. Each water supply port 5... is changed to a suction port 52.... In this case, the burn particles e that adhere to the filter 8 during laser treatment can be sucked into the suction passage 51 through the suction ports 52 and collected, so that the aperture operation wire 13 of each of the above embodiments can be etc. can be omitted,
The configuration can be simplified.

Further, FIGS. 15 and 16 show a fifth embodiment of the present invention. This is because the filter operation ring 9 of the first embodiment is formed of a shape memory material such as a shape memory alloy or a shape memory resin, and at room temperature the filter operation ring 9 has its outer diameter as shown in FIG. A configuration in which the filter operation ring 9 is held in a reduced shape state with small dimensions, and then transformed into an expanded shape state in which the outer diameter dimension is greatly expanded as shown in FIG. 15 while heated to a predetermined set temperature or higher. This is what I did. In this case, for example, when inserting the catheter 1 into the blood vessel 2, the filter operation ring 9 is held in a reduced shape with a small outer diameter, and when the catheter 1 is inserted into the blood vessel 2 to the target position. Catheter 1 and laser guide 6
By supplying hot water to the gap between the filter ring 9 and the filter ring 9 through the water supply passage, the filter operating ring 9 is deformed within the blood vessel 2 into an expanded state in which its outer diameter is greatly expanded. In addition, the catheter 1 after the laser beam irradiation is finished.
During the withdrawal operation, the catheter 1 is pulled slightly toward the proximal side with the filter operation ring 9 in contact with the inner peripheral surface of the tube wall of the blood vessel 2, and then the gap between the catheter 1 and the laser guide 6 is removed. By supplying cold water through the gap through the water supply passage and cooling the filter operation ring 9, the filter operation ring 9 can be shaped into a reduced shape with a small outer diameter (
At the same time, the outer peripheral edge of the filter 8 is also transformed into a constricted state that reduces the outer diameter dimension, and the burn residue e from the laser treatment adhering to the filter 8 is removed from the outer peripheral surface of the catheter 1 and the filter 8. It is designed to be housed in a sealed bag-like space between the two. Therefore, in this case as well, the aperture operation wire 13 and the like of the first embodiment can be omitted, and the configuration can be simplified.

It should be noted that this invention is not limited to the above embodiments, and it goes without saying that various modifications can be made without departing from the spirit of the invention.

[Effects of the Invention] According to the present invention, a filter is attached to the outer circumferential surface of the catheter that allows blood cells in the blood flowing through the lumen to pass through and prevents foreign substances larger than the blood cells from passing through, thereby reducing burns that occur during laser treatment. It is possible to prevent the blood cells from scattering widely within the lumen, and it is also possible to prevent the flow of blood cells within the lumen from becoming poor.

[Brief explanation of the drawing]

1 to 10 show a first embodiment of the present invention, in which FIG. 1 is a vertical cross-sectional view showing the main structure of a laser beam irradiation device, and FIG. 2 shows a reduced state of the filter operation ring. 3 is a plan view of the main part, FIG. 4 is a longitudinal sectional view of the main part showing the expanded state of the filter operation ring, FIG. 5 is a plan view of the same, and FIG. 6 is a laser treatment state. Fig. 7 is a vertical cross-sectional view of the main part showing the state of adhesion of burnt particles during laser treatment, Fig. 8 is a perspective view of the same, and Fig. 9 shows the adhered state of burnt particles during laser treatment. Longitudinal cross-sectional view of main parts showing accommodation state, 1st O
The figure is a perspective view of the same, FIG. 11 is a vertical sectional view of the main part showing a second embodiment of the invention, and FIGS. 12 and 13 are a third embodiment of the invention. The figure is a longitudinal sectional view of the main part, FIG. 13 is a plan view showing the distal end surface of the catheter, and FIG.
FIG. 4 is a vertical cross-sectional view of the main part showing the fourth embodiment of the present invention.
15 and 16 show a fifth embodiment of the present invention, FIG. 15 is a plan view showing the expanded state of the filter operation ring, and FIG. 16 is a plan view showing the reduced state of the filter operation ring. It is. 1... Catheter, 2... Blood vessel (lumen), 6...
Laser guide, 6a... Laser light emitting end face, 7...
Thrombus (treatment site), 8...filter. Applicant's representative Patent attorney Jun Tsuboi

Claims (1)

[Claims] In a laser light irradiation device, a laser guide is inserted into a catheter inserted into a lumen of a human body, and a laser beam emitted from the laser guide is irradiated to a treatment site within the lumen. Transmits blood cells in the blood,
A laser beam irradiation device characterized in that a filter that prevents the passage of foreign substances larger than blood cells is attached to the outer peripheral surface of the catheter.