JPH0420349A - Thrombus dissolving medical treatment device - Google Patents

Abstract

PURPOSE:To recognize the dissolved state of a thrombus and the restart state of a blood flow without using an X-ray device by inserting a catheter for allowing a resolvent to flow through into the thrombus part, collecting the circulating resolvent by a perfusing means, detecting its concentration or/and pressure of the thrombus part, and displaying its variation. CONSTITUTION:First of all, a catheter 1 is inserted through a skin into a blood vessel 8 in which a thrombus 9 is generated, and its tip part is positioned in the vicinity of the thrombus 9 and a balloon 1a is inflated. By this inflated balloon 1a, the blood vessel 8 is closed up and a liquid collecting part 8a is formed between the blood vessel 8 and the thrombus 9. Thereafter, a thrombus resolvent 2, for instance, of urokinase, etc., is injected into the liquid collecting part 8 by a prescribed quantity by a pump 3. In such a way, when the resolvent 2 is injected into the periphery of the thrombus 9, the thrombus 9 is dissolved as time elapses. Subsequently, the injection and the collection of the resolvent 2 are executed continuously by the pump 3, and pressure of the medical treatment part during this time is measured by a pressure sensor 6, and simultaneously, concentration of the liquefied thrombus per unit quantity of a collected liquid 4 is measured by a concentration sensor 5, and it is displayed on a display of a display means 7.

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial Field of Application] This invention relates to a thrombolytic treatment device, specifically a thrombolytic treatment device that injects a dissolving agent into a blood clot formed in a blood vessel in the body to dissolve the blood clot. It is related to.

[Prior Art] Conventionally, as this type of thrombolytic treatment device, a dissolving agent drip set and an X-ray device have been used. In other words, a catheter is inserted through a blood vessel near the site of occlusion of a coronary artery due to a thrombus, and a small amount of a high-concentration thrombolytic agent is continuously injected locally, and the state of dissolution of the thrombus is observed using an X-ray device. Ta.

[Problem to be solved by the invention] However, in such conventional thrombolytic treatment devices,
Since an X-ray device is used, it is not possible to confirm the dissolution state of the thrombus in real time, and frequent X-ray angiography results in the problem of large amounts of X-ray exposure. Therefore, it has been desired to examine the state of thrombus dissolution without using an X-ray device as much as possible.

SUMMARY OF THE INVENTION In response to such demands, an object of the present invention is to provide a thrombus dissolution treatment device that can recognize the state of dissolution of a thrombus and the state of resumption of blood flow with a simple configuration without using an X-ray device.

[Means and effects for solving the problems] In order to achieve the above-mentioned object, the present invention provides a thrombolytic treatment device that injects a dissolving agent into a thrombus site in the body to dissolve the thrombus, and includes the following: a catheter that is inserted into the catheter and allows a lytic agent to flow therein; a means for perfusing the lytic agent; a means for collecting the lytic agent circulating through the perfusion means and detecting its concentration and/or the pressure at the site of the thrombus; , characterized by comprising display means for displaying the detected change in concentration and/or pressure, further comprising means for determining solubility from the change in concentration and pressure, and controlling the perfusion means according to the solubility. It is characterized by having means.

[Example] The present invention will be explained below with reference to illustrated embodiments.

FIG. 1 is a block diagram of a thrombolytic treatment device showing a first embodiment of the present invention.

This treatment device is a catheter that is inserted percutaneously into a blood vessel 8 in which a thrombus 9 has formed in a human body 10, has a balloon 1a at its tip for preventing outflow, and has a dissolving agent 2 flowing therein.]
, a perfusion means consisting of a pump 3 which sends the lysing agent 2 into the catheter 1 and injects it near the thrombus 9 and collects the lysing agent mixed with the lysed thrombus, and this perfusion means collects the circulating lysing agent. and a concentration sensor 5 for detecting the concentration of the recovered liquid 4, a pressure sensor 6 connected to the pump 3 and detecting the pressure at the thrombus site, and each of the pressure sensor 6 and the concentration sensor 5. The display means 7 includes a display into which sensor output is introduced and displays detected changes in concentration and pressure.

In the thrombolytic treatment device configured as described above, first, the catheter 1 is percutaneously inserted into the blood vessel 8 in which the thrombus 9 has formed, its distal end is positioned near the thrombus 9, and the balloon [a] is inflated. Ru. Then, this inflated balloon 1
The blood vessel 8 is occluded by the blood vessel 8, and a liquid reservoir 8a is formed between the blood vessel 8 and the thrombus 9.

Thereafter, a certain amount of a thrombolytic agent 2 such as urokinase is injected into the liquid reservoir 8a using the pump 3.

When the dissolving agent 2 is injected around the thrombus 9 in this manner, the thrombus 9 dissolves over time.

Subsequently, the pump 3 continuously performs one injection and one recovery of the dissolving agent 2, and the pressure at the treatment site during this period is measured by the pressure sensor 6.
At the same time, the concentration of the liquefied thrombus per unit amount of the collected liquid 4 is measured by the concentration sensor 5.

The measured concentration value and the measured pressure value are displayed on the display of the display means 7.

FIG. 2 shows the display screen of this display means 7. As shown in FIG. That is, the measured concentration value is displayed with concentration on the vertical axis and treatment time on the horizontal axis, and the measured pressure value is displayed with pressure on the vertical axis and time on the horizontal axis, corresponding to the measured concentration value. Ru.

As can be seen from this display screen, from the start of the injection of the dissolving agent 2 to the time when perfusion with the dissolving agent 2 is being performed, the blood vessel 8 is clogged with the thrombus 9, so the pressure rises to the upper limit pressure. On the other hand, the concentration of the recovery liquid 4 gradually increases as the thrombus 9 dissolves and becomes liquefied over time. and,
When the thrombus 9 dissolves, the concentration decreases rapidly. Therefore, knowing that the blood vessel 8 was opened, the balloon 1a
shrink. Then, the blood flow is resumed and the thrombus 9 is completely dissolved and removed, and the treatment ends here.

In this way, the solubility of the thrombus 9 can be seen on the display screen based on changes in concentration and pressure, eliminating the need to use X-rays.

In addition, in the first embodiment, both the concentration of the dissolving agent and the pressure at the treatment site are detected by the sensor, but the purpose can be achieved with just one of them. Although the agent is continuously circulated, intermittent perfusion with separate injection and withdrawal steps may also be used.

In addition, although a balloon catheter having a balloon 1a at the tip of the catheter 1 was used, since the balloon 1a is intended to prevent blood and pressure upstream of the thrombus 9 from being detected, embolization without using the balloon 1a was used. Substances may be injected through a catheter to create a dam upstream.

Furthermore, in the above embodiment, the concentration and pressure changes are displayed on the screen as graphs, but it goes without saying that the numerical values may be simply displayed digitally or analogously displayed using a meter.

FIG. 3 shows a second embodiment of the invention. This thrombolytic treatment device irradiates the above-mentioned dissolving agent with ultrasonic waves from outside the body to obtain a dissolution promoting effect.

That is, a thrombolytic treatment device configured in the same manner as in the first embodiment is further equipped with a well-known ultrasonic applicator 11 for irradiating ultrasonic waves to the body surface corresponding to the thrombus site into which the dissolving agent has been injected. Apply pressure. Then, during perfusion of the dissolving agent, ultrasonic waves are applied from outside the body using the ultrasonic applicator 11 . Then, the dissolving agent generates ultrasonic vibration, and dissolution of the thrombus 9 is promoted. Other functions and effects are similar to those of the first embodiment.

Next, FIG. 4 shows the configuration of essential parts of a thrombolytic treatment device according to a third embodiment of the present invention.

The dissolution treatment device of the third embodiment automates the treatment device of the first embodiment, detects the solubility of the thrombus from the detection output value of the concentration and pressure sensor 5.6, and automatically controls the pump of the perfusion means 3. The system is designed to stop the operation.

That is, the detected outputs of the concentration sensor 5 and the pressure sensor 6 are inputted to an arithmetic circuit serving as the dissolution determining means 12, and the operation of the pump of the perfusion means 3 is controlled by the output of the determining means 12 via the controller 13. Configure.

The operation of this device begins with the input device 14 and the dissolution determining means 12. The pump 3 is operated via the controller 13 to start injection of the dissolving agent. Then, when the pressure at the treatment site reaches a predetermined pressure (or upper limit), injection and suction are controlled to be performed simultaneously. Next, the point in time when the concentration change changes from positive to negative and there is almost no change (or the point in time when the pressure becomes approximately equal to that during injection) is considered to be complete dissolution, and the output from the determining means 12 is used to pump the Stop 3.

In this way, the thrombus can be dissolved and removed automatically.

[Effects of the Invention] As described above, according to the present invention, there is no problem of radiation exposure caused by using an X-ray device, the state of thrombolysis and the state of resumption of blood flow can be recognized in real time, and automation is easy. Thus, it is possible to provide a thrombolytic treatment device that eliminates the drawbacks of conventional devices of this type.

[Brief explanation of the drawing]

FIG. 1 is a block diagram of a thrombolytic treatment device according to a first embodiment of the present invention, and FIG. 2 is a graph diagram showing an example of the display screen of the display means in the thrombolytic treatment device of the first embodiment. , FIG. 3 is a block diagram of a thrombolytic treatment apparatus according to a second embodiment of the present invention, and FIG. 4 is a block diagram of main parts of a thrombolytic treatment apparatus according to a third embodiment of the present invention. 1... Catheter 2... Dissolving agent 3... Perfusion means (pump) 5...
...Concentration sensor (concentration detection means) 6...
...Pressure sensor (pressure detection means) 7...
Display means 8... Blood vessel 9... Thrombus 0... Human body 1... Ultrasonic applicator 2... ... Solubility determination means

Claims (2)

[Claims] (1) A thrombolytic treatment device that injects a dissolving agent into a thrombus site in the body to dissolve the thrombus, which includes a catheter that is inserted through a blood vessel toward the thrombus site and allows the solubilizing agent to flow inside, and a catheter that is perfused with the solubilizing agent. means for collecting the lysing agent circulating through the perfusion means and detecting its concentration and/or pressure at the thrombus site; and display means for displaying changes in the detected concentration and/or pressure. A thrombolytic treatment device characterized by: (2) A thrombolytic treatment device that injects a dissolving agent into the thrombus site in the body to dissolve the thrombus, which includes a catheter that is inserted through a blood vessel toward the thrombus site and allows the dissolving agent to flow inside, and a catheter that is perfused with the dissolving agent. means for collecting the lysing agent circulating through the perfusion means and detecting its concentration and/or pressure at the thrombus site; display means for displaying the detected concentration and/or pressure changes; A thrombolytic treatment device comprising: means for determining solubility from changes in concentration and/or pressure; and means for controlling the perfusion means according to the determined solubility.