JPH04261635A - Catheter tube - Google Patents

Abstract

PURPOSE:To facilitate the observation of an internal wall or the like of a blood vessel or a tubular organ and medical treatment along with a smooth operation by a method wherein a rigidity imparting body is housed into a tube body leaving the tip thereof while a linear body having the tip thereof fixed at an eccentric position is provided to bend the tip of an apparatus using a pulling device. CONSTITUTION:Optical fiber bundle 9 is housed into a first lumen 3 and a linear body is housed into a second lumen 6 to bend the tip part 22 of a tube body 2. A rigidity imparting body 61 is provided tubular along an internal wall of the second lumen 6 to heighten rigidity of the tube body 2 and a linear body 13 is housed into an internal cavity 610 of the rigidity imparting body 61. The tip of the linear body 13 reaches a tip closed part 62 of the second lumen 6. The tip fixed position of the linear body 13 is at an eccentric location within a transverse surface of the tube body 2, eventually allowing the bending of the tube tip with a pulling device 14 of the linear body 13. Thus, the rigidity imparting body 61 imparts the tube body 2 rigidity thereby allowing the bending of the tip part 22 alone.

Description

[Detailed description of the invention]

0001

[Industrial Application Field] The present invention is used by being inserted into, for example, a blood vessel or a tubular organ, for example, for observing the inside of a blood vessel and/or
The present invention also relates to a catheter that performs medical treatment from a position outside the body to the inner wall surface of a blood vessel, particularly a catheter tube constituting an endoscope (fiberscope).

0002

[Prior Art] Endoscopes have attracted attention in recent years because they allow observation of the inside of blood vessels and tubular organs inserted from a position outside the body, as well as medical procedures such as administering medicinal solutions to the inner walls and irradiating laser beams. , its development is progressing.

[0003] In this endoscope, a bundle of optical fibers for transmitting and receiving light is housed in a flexible catheter tube, and the catheter tube is inserted into the body cavity to a target site, and a bundle of optical fibers for transmitting light (light guide) is inserted into the body cavity. ) is emitted from the tip of the fiber to the observation section, the reflected light is taken in from the tip of the light-receiving fiber (image fiber), and the image is guided to the image-receiving section for observation.

When observing the inside of a blood vessel or tubular organ using such an endoscope, since the catheter tube and the optical fiber bundle are positioned parallel to the body cavity, it is difficult to observe the inside of a blood vessel or tubular organ in a direction other than the front of the tip of the insertion section (for example, in a direction other than the front of the insertion tube). In order to observe the inner wall surface, the tip of the tube must be bent.

[0005] Conventionally, methods for bending the distal end of a tube from a position outside the body include (1) using a guide wire separate from the catheter tube, or (2) using a plurality of operating wires built into the catheter tube. Ta.

However, in method (2), since the guide wire is originally used to guide the catheter tube to the target site, the operability is poor when bending the tip of the tube, and the curved state cannot be observed for a long time. However, there are drawbacks such as difficulty in keeping the temperature constant.

In addition, the catheter tube (flexible tube for endoscope) used in the method (2) above has a curved portion near the distal end of the tube in which a plurality of joint rings are rotatably connected one after another. The bending section is bent by pulling any one of the plurality of operation wires, one end of which is connected to the bending section, toward the proximal end side by a wire operating device constituted by a tube proximal end pulley, an angle diamond, or the like. (Special Publication No. 60-21734, Utility Publication No. 6
2-23442, Utility Model Publication No. 62-23447).

The purpose of curving the distal end of this catheter tube is not to observe the inner wall surface of the inserted blood vessel or tubular organ, but to guide the distal end of the catheter tube to the destination. It's for a reason. Therefore, the bending angle of the tip of the tube is relatively large, and it is necessary to provide a connecting body of joint rings, etc. at the tip of the tube, and also to provide an operating wire and a device for pulling the wire, resulting in a structure that is It is complicated and the diameter of the tube becomes large. Furthermore, the curved part of the tube requires flexibility, but the part that is not curved (proximal to the curved part) is made of a tube material with hard physical properties to ensure rigidity (
For example, polytetrafluoroethylene, tetrafluoroethylene-hexafluoropropylene polymer, etc.) must be used, which has the disadvantage that the flexibility of the entire tube is limited. For this reason, it could only be used for tubular organs with relatively large inner diameters, such as the digestive system or the bronchial system.

[0009] Furthermore, as a method to prevent the tip of the catheter tube from curving, there is a method in which a minute prism is attached to the tip of the optical fiber bundle inside the catheter tube, and the observation angle is changed to observe blood vessels, tubular organ walls, etc. However, this method complicates the structure of the catheter tube, making it difficult to manufacture and expensive. Furthermore, it is difficult to reduce the diameter of a catheter tube with this structure, and it is difficult to apply it to an endoscope for observing small-diameter tubular organs such as blood vessels and urethral tubes.

[0010] In order to solve the above-mentioned problems, the applicant of the present application, prior to the present application, has filed an application for a catheter tube in which only the distal end of the tube can be bent from a position outside the body (Japanese Patent Laid-Open Publication No. 2003-110002). No. 1292).

[0011] In the present invention, a side hole communicating with the lumen is bored in the outer peripheral wall of the tip of the tube body, a linear body for bending operation is pulled out from the side hole, and the tip of the linear body is connected to the tube body. It has a fixed structure at the tip.

[0012] With such a structure, only the tip portion can be curved. However, because a side hole is provided,
For example, there is a drawback that body fluid within the tubular organ enters the lumen through the side hole, and the lumen is clogged with body fluid components, impeding movement of the linear body.

[0013] In particular, when inserted into a blood vessel, a thrombus may form within the lumen after use, making cleaning difficult.

[0014] Furthermore, the exposed filament may damage the inner wall of the tubular organ, leading to complications such as catheter fever.

On the other hand, in order to avoid such problems, if the linear body is completely housed within the tube body, even if the linear body is pulled, the tip of the tube body will not necessarily be curved. However, there is a problem in that other parts of the tube body (the middle part and the proximal part) are bent.

[0016]

[Problems to be Solved by the Invention] It is an object of the present invention to solve the above-mentioned drawbacks of the prior art, and to provide a simple structure for the observation and medical treatment of tubular organs, especially blood vessels, and the inner walls of other small-diameter tubular organs. An object of the present invention is to provide a catheter tube that allows easy treatment.

[0017]

[Means for Solving the Problems] Such objects are achieved by the present invention as described in (1) to (9) below.

(1) A catheter tube that is used by being inserted into a blood vessel or a tubular organ, which includes a tube body, a first lumen that opens to the distal end of the tube body, a second lumen that is closed at the distal end, and an observation or medical treatment instrument housed in the first lumen; a rigidity imparting body housed within the tube body leaving the distal end of the tube body; At least one linear body installed in the lumen and having a distal end fixed at an eccentric position near the distal end of the tube body, and a tensioning tool capable of pulling the linear body toward the proximal end of the tube body, A catheter tube characterized in that the distal end portion of the observation or medical treatment instrument is bent along with the tube body by pulling the linear body toward the proximal end of the tube body.

(2) The catheter tube according to (1) above, wherein the distal end portion of the tube body where the stiffening member is not present has less bending stiffness than other portions.

(3) The catheter tube according to the above (1) or (2), which has at least one expandable body disposed around the outer circumferential wall of the tube body, which can be expanded and deflated.

(4) The catheter tube according to any one of (1) to (3) above, wherein the distal end of the stiffening body is located on the distal end side of the tube body or at the same position as the expansion body.

(5) Any one of (1) to (4) above, wherein the rigidity imparting body is slidable in the axial direction of the tube body, and has an operating tool for operating the sliding movement of the rigidity imparting body. Catheter tube as described in.

(6) The catheter tube according to (5) above, wherein the stiffening body can be fixed at any position.

(7) The stiffening body is a tubular body, the stiffening body is housed in the second lumen, and the linear body is housed in the inner lumen of the tubular body (1). )～(
The catheter tube according to any one of 6).

(8) The catheter tube according to any one of (1) to (6) above, wherein the stiffening body is a rod-shaped body.

(9) In any one of (1) to (8) above, a plurality of the linear bodies are provided, and the tips of the plurality of linear bodies are respectively fixed at different eccentric positions within the cross section of the tube body. Catheter tube as described.

[0027]

[Operation] The tube body accommodates an observation or medical treatment instrument in the first lumen, and operates the observation or medical treatment instrument within the blood vessel or tubular organ through the open portion at the tip.

[0028] The tip of the second lumen is closed, and the linear body within the second lumen is not exposed to the outside of the tube, so body fluids etc. do not enter the second lumen. The tip of the linear body is fixed at an eccentric position near the tip of the tube body, so if the linear body is pulled with a pulling tool, the tip of the tube body will be able to pull the stored observation or medical treatment instruments, etc. It curves with.

On the other hand, since the second lumen accommodates a rigidity imparting body that imparts a predetermined rigidity to the tube body, only the tip portion where the rigidity imparting body is not housed is curved. Here, by reducing the bending stiffness of the tip, only the tip can be bent more easily. When the modulus of longitudinal elasticity of the tip material is E and the moment of inertia of the cross section is I, the bending stiffness is E.
Defined by I. In other words, to reduce bending stiffness,
A material with a small modulus of longitudinal elasticity E may be used, and/or a cross-sectional shape may be formed such that the moment of inertia I is small.

[0030] When an expansion body is provided, the rigidity imparting body is housed on the proximal end side of the expansion body so that the distal end side of the expansion body can be bent, and the distal end is located on the distal side of the tube body from the expansion body. do.

[0031] When the stiffening body is made slidable in the axial direction,
By sliding the stiffening body in the direction of the tip after bending the tip, the wire end can be reliably restored. Furthermore, by changing the position of the tip of the stiffening body within the tube tip, the bending position of the tip can be adjusted as desired.

[0032] The rigidity imparting body may be a tube or a rod, but in the case of a tube, the linear body can be accommodated in the interior space, and a space for the linear body to operate can be secured.

[0033] By providing a plurality of linear bodies and fixing their tips at different eccentric positions within the cross section of the tube body, it is possible to select the linear body to be pulled and curve the tube body in a desired direction. Become.

[0034]

[Specific Structure] [First Structure Example] FIG. 1 is a partial longitudinal cross-sectional view showing a structure example of the catheter tube of the present invention, and FIG. 2 is a cross-sectional view taken along the line II--II in FIG. 1.

As shown in these figures, the catheter tube 1A has a tube body 2, and an expander 8 is installed around the outer circumferential wall of the tube body near its distal end (left side in FIG. 1). This expansion body 8 is made of silicone rubber, for example.
It is made of a rubber material such as latex rubber, urethane, polyvinyl chloride, polyimide, ethylene-vinyl acetate copolymer, etc., and is expandable and contractable.

The tube body 2 is made of a flexible material such as polyvinyl chloride, polyamide, polyurethane, polypropylene, polytetrafluoroethylene, silicone rubber, polyethylene, nylon, ethylene-vinyl acetate copolymer, etc. It is configured. In particular, the tip portion 22 of the tube body is configured to have enough flexibility to be easily bent when the linear body 13 is pulled, which will be described later, by appropriately selecting the above-mentioned material and the diameter of the tube body. is preferable. Examples include urethane resin, vinyl chloride resin, polyamide, and the like.

[0037] Since the catheter tube 1A of the present invention is normally used while being inserted and left in a blood vessel, the position of the catheter tube can be confirmed under X-ray fluoroscopy while performing observation and treatment. There is a strong need to do so. Therefore, it is preferable to impart X-ray contrast properties to the catheter tube 1A. Specifically, it is preferable that the constituent materials of the tube body 2 and/or the expansion body 8 contain an X-ray contrast agent. Examples of the X-ray contrast agent include barium sulfate, bismuth oxide, and metal compounds such as tungsten.

The tube body 2 is formed with various lumens having different uses and functions as described below.

The first lumen 3 houses an optical fiber bundle 9 as an observation instrument for observing the inner wall of a blood vessel when the catheter tube 1A is used in an endoscope. Note that the optical fiber bundle 9 can also be used for medical treatment such as irradiation of laser light onto the inner wall of a blood vessel or a tubular organ, for example.

As shown in FIG. 2, this optical fiber bundle 9 is composed of a light transmitting fiber (light guide) 10 and a light receiving fiber (image fiber) 11, and these optical fibers are made of epoxy, acrylic, silicone, etc. It is made into a bundle by hardening it with resin such as rubber.

A lens 92 is attached to the tip of the optical fiber bundle 9, and this portion is located near the opening at the tip of the first lumen 3.

Light emitted from a light source (not shown) at the proximal end of the catheter tube (right side in FIG. 1) is transmitted through the light transmitting fiber 10, and is irradiated from its tip to the observation area, where it is reflected. Light is taken in from the tip of the light-receiving fiber 11, and its image is transmitted within the fiber 11 and guided to an image-receiving section (not shown) on the proximal end side of the catheter tube.

[0043] These light transmitting and light receiving fibers are both composed of optical fibers made of quartz, plastic, multi-component glass, or the like.

Note that it is preferable that the optical fiber bundle 9 is fixedly installed in the first lumen 3.

The third lumen 4 opens to the distal end of the tube body 2, and fluid is injected into the blood vessel through the opening.
Alternatively, fluid can be aspirated from within a blood vessel or the like. Specifically, the third lumen 4 is used to administer a drug solution into a blood vessel into which the catheter tube 1A is inserted or indwelled, or to provide a visual field when observing the inside of a blood vessel with an endoscope. It can also be used as a flush channel that sprays a transparent liquid (eg, physiological saline, glucose solution) to push out blood that is obstructing the flow.

As shown in FIG. 2, the fourth lumen 5 communicates with the expandable body 8, and supplies fluid into the expandable body 8 to inflate the expandable body 8, or discharges fluid to expand the expandable body 8. This is for contracting 8. Note that examples of the fluid for inflation of the expandable body include gases such as air, CO2 gas, and O2 gas, and liquids such as physiological saline and the liquid containing the above-mentioned X-ray contrast agent.

The second lumen 6 is for accommodating a linear body for bending the distal end portion 22 of the tube body 2.

Inside the second lumen 6, a rigidity imparting body 61 for increasing the rigidity of the tube body 2 is provided in a tubular shape along the inner wall of the second lumen 6. The rigidity imparting body 61 is a tubular body as described above, and is provided continuously from the tip corresponding to the expansion body 8 to the proximal end of the tube body 2. The rigidity imparting body 61 is provided slidably with respect to the tube body 2, as will be described later.

Furthermore, the tip of the second lumen 6 is closed.

The linear body 13 is accommodated in the inner space 610 of the rigidity imparting body 61. The distal end of the linear body 13 reaches the distal end closing part 62 of the second lumen 6, and is fixed to the tube body 2 at the distal end closing part 62 at the distal end of the tube body 2.

The fixed position of the tip of the linear body 13 is at an eccentric position within the cross section of the tube body 2, and by setting such an eccentric position, the tip of the tube can be bent by pulling the linear body 13. becomes. Therefore, it is preferable that the distal end of the linear body 13 is fixed at a position farthest from the center of the cross section, for example, near the peripheral edge within the cross section.

Further, the fixed position of the linear body 13 in the axial direction of the tube body 2 must be closer to the tip than the rigidity imparting body 61, but it is preferably closer to the tip of the tube body 2.

The rigidity imparting body 61 is provided to impart rigidity to the tube body 2 and to bend only the tip portion 22. Therefore, it is desirable that the tube body has at least more rigidity than the tube body 2. Furthermore, since the entire tube also needs to be bendable, it is preferable that the tube has some degree of flexibility. Such rigidity imparting body 61 is made of, for example, stainless steel, superelastic alloy, quartz, polyamide,
It is composed of materials such as polyarylate, polyethylene terephthalate, polytetrafluoroethylene, polyvinyl chloride, polyimide, and composite materials thereof.

Furthermore, the rigidity imparting body 61 may be provided intermittently from the distal end to the proximal end.

The interior space 610 of the stiffening body 61 may be coated with a lubricating substance in order to smooth the movement of the linear body 13 due to tension.

Examples of lubricating substances include polyethylene,
Examples include polytetrafluoroethylene, silicone, and hydrophilic resins.

The lubricating substance may also be applied or coated on the surface of the linear body 13.

In order to ensure smooth movement of the linear body 13,
The inner diameter of the tubular stiffening body 61 must be larger than the outer diameter of the linear body 13, but in order to maintain sufficient rigidity, the difference between the outer diameter and the inner diameter should be about 0.06 to 2.0 mm. More preferably, it is about 0.1 to 0.3 mm.

On the other hand, the linear body 13 preferably has a tensile strength that does not cause wire breakage, and specific examples thereof include stainless steel, piano wire, metal wire such as superelastic alloy, and polyamide (nylon). Examples include single wires, fiber bundles, and carbon fibers made of polyimide, polyarylate, polyester, and the like. The diameter of the linear body depends on the material of the linear body, but for example, in the case of stainless steel wire, the diameter of the linear body is 1
The thickness is preferably about 0 to 100 μm.

[0060] Such a linear body 13 is used as a tensioning tool 1 to be described later.
2 toward the proximal end of the tube, the distal end portion 22 of the tube body is bent, and accordingly, the distal end portion 91 of the optical fiber bundle 9 in the first lumen 3 is bent.

[0061] In this specification, the term "bending" is a concept that includes bending of an optical fiber bundle or the like into one or more stages of polygonal lines, and continuous curving into a curved line.

Average inclination angle (angle with respect to the axial direction of the tube body) α in the bent state of the tube body tip 22
substantially determines the observation angle by the optical fiber bundle, and the preferred range of the average inclination angle α is 5 to 80°.
It is. The reason for this is that if the angle α is less than 5°, it may not be possible to observe the inner wall surface of the blood vessel sufficiently;
This is because if the angle exceeds 0°, the bending angle of the optical fiber bundle becomes large and there is a possibility that the optical fibers will break.

Note that, as shown in FIGS. 1 and 7, the bending stiffness of the tip portion 22 is reduced so that the tip portion 22
In order to make the bending easier, the tip 22 may be made of a material with a small modulus of longitudinal elasticity E, and/or the moment of inertia I of the cross section of the tip may be made small. With such a configuration, the tip portion can be easily bent, but the restoring force is weakened, making it difficult for the tip portion 22 to return straight after the bending operation. Here, by sliding the stiffening body 61 toward the distal end, the distal end portion 22 can be reliably restored to the straight state. The material having a small longitudinal elastic modulus E has already been described. As an example of reducing the second moment of area, for example, as shown in FIG. 7, there is a case where only the peripheral wall surface of the tube body 2 is made hollow.

On the other hand, a groove portion is formed in the circumferential direction on all or part of the outer periphery of the tube body 2 (for example, inside the bent portion of the tube body) to assist in bending the tube body tip 22, that is, to make it easy to bend. It's okay. Further, two or more grooves may be formed in the longitudinal direction of the tube body.

[0065] Expansion body 8 installed in tube body 2
As will be described later, when inflated, the catheter tube 1A comes into close contact with the inner wall surface of the blood vessel, etc. into which it is inserted, and serves to fix the catheter tube 1A to the blood vessel, etc., and to improve visibility in front of the expandable body 8 (on the tube tip side). It has the role of blocking blood inflow when replacing blood with transparent liquid.

[0066] It is preferable that such an expander 8 expands radially from the center of the tube body 2 when expanded.

Further, the cross-sectional shape of the expansion body 8 may be a circle, an ellipse, or
Although other shapes similar to this are possible, it is preferable to have a cross-sectional shape that approximates the cross-sectional shape of the blood vessel or tubular organ to be inserted or indwelled, since the blood vessel will have good adhesion to the tubular organ. In particular, the diameter (minimum diameter) Dmin of the part where the diameter in the tube radial direction is the minimum when the expandable body 8 is expanded, and the diameter of the inner wall of the blood vessel to be inserted or placed (when the expandable body is contracted) is the maximum. The relationship with the diameter (maximum diameter) dmax is D
It is preferable to satisfy min≧dmax because the expandable body 8 will surely come into close contact with the inside of the blood vessel, for example.

Further, a plurality of such expansion bodies may be formed along the longitudinal direction of the tube body 2. The expansion body 8 must be attached to the tube body 2 in an air-tight or liquid-tight manner, and the attachment methods include gluing a separate member (ring-shaped or bag-shaped rubber member, etc.) with adhesive, or How to tie using thread,
Alternatively, any method that can maintain the air-tightness or liquid-tightness of the expansion body, such as integral molding with the tube or two-color molding, is possible.

Furthermore, in the present invention, the above-mentioned first, second and third
In addition to the fourth lumen, one or more other lumens may be formed. The purpose of the lumen is
For example, it can be used for expanding a plurality of expansion bodies when a plurality of expansion bodies are provided, for injecting a liquid different from the transparent liquid, for sucking blood, etc.

Furthermore, if a plurality of second lumens 6 are provided at equal intervals in the circumferential direction in the cross section of the tube body 2, and the linear bodies 13 are accommodated in each second lumen 6, each linear body 13 or a part of the linear bodies 13 can be By manipulating a plurality of linear bodies 13 at once, it is possible to bend the distal end portion 22 of the tube body 2 in a desired direction.

For example, if four second lumens 6 are provided at equal intervals in the circumferential direction of the cross section, and a linear body 13 is housed in each, if each linear body 13 is pulled alone, the tip portion 2
2 can be bent in four directions.

Furthermore, if two adjacent linear bodies 13 are pulled simultaneously, it becomes possible to bend them in four more directions, making it possible to bend them in a total of eight directions.

Furthermore, by manipulating the two linear bodies 13 by varying the respective tensile forces, it is possible to bend them in any direction.

[0074] In this way, if the distal end of the tube body 2 can be freely bent in multiple directions, observation and medical treatment inside blood vessels and tubular organs become easier.

As shown in FIG. 3, the proximal end of the catheter tube 1A of the present invention is provided with a tensioner 12 for pulling the linear body 13 toward the proximal end of the tube body and a stiffening member 61.
An operating tool 12 for sliding operation is installed.

A cylindrical connector 211 is connected to the proximal end 21 of the tube body 2. Connector 21
A spiral is cut on the inner wall 212 of the connector 2.
A portion of the operating tool 12 inserted into the operating tool 11 is threadedly engaged with the outer circumferential surface thereof. This operating tool 12 is similarly formed into a cylindrical shape, with a tip end 121 having a large diameter, and a spiral 122 cut into the peripheral surface of the operating tool 12, which is connected to the spiral in the connector 211 as described above. match.

On the other hand, a flange 12 is provided at the rear end of the operating tool 12.
3 is formed. When the operating tool 12 is rotated via this flange 123, the operating tool 12 can move in the axial direction within the connector 211, and when not rotated, it is fixed in the axial direction with respect to the connector 211. be done.

[0078] A rear end portion 611 of the rigidity imparting body 61 is inserted into the tip of the operating tool 12 and is rotatably connected thereto. That is, on the circumferential surface of the rear end portion 611 of the rigidity imparting body 61,
The operating tool 1 has a plurality of protrusions 612 formed in the circumferential direction.
2, and by the protrusion 612, the rigidity imparting body 61 is fixed to the operating tool 12 in the axial direction, and is slidably connected in the circumferential direction.

[0079] Inside the operation tool 12, a tension tool 14 is further provided.
is inserted. The tip 141 of the tensioning tool 14 has a large diameter like the operating tool 12, and its outer peripheral surface is in sliding contact with the inner peripheral wall 124 of the operating tool 12, so that it can slide in the axial direction with respect to the operating tool 12. It is freely configured. In addition, operating tool 1
The rear end of the tensioner 2 has a smaller inner diameter than the tip 141 of the tensioning tool 14, and functions as a rear stopper 125 of the tensioning tool 14. Such a stopper 125 is integrated with the flange 123, and is connected to the operating tool 12.
It is preferable to have a structure in which the tensioning tool 14 is inserted therein and then bonded to the operating tool 12.

[0080] The rear end of the linear body 13 is connected to the tip of the tensioning tool 14, and the rear end of the linear body 13 extends through the tensioning tool 14 to the rear end, and is fixed at the rear end. There is. Further, a flange 142 is formed at the rear end. The flange 142 is also a separate body like the operating tool 12.
It is preferable to have a structure in which the second flange 123 is bonded and then the second flange 123 is bonded. The tensioner 14 can be pulled through such a flange 142.

In the above configuration, when the tensioning tool 14 is moved in the axial direction, the linear body 13 is also moved in the second lumen 6 in the axial direction of the tube body.

[0082] This moving distance is
It may correspond to a range from a state where the tip portion 22 is not bent (the state shown in FIG. 4) to a state where the tip portion 22 is bent by the predetermined angle α (the state shown in FIG. 5).

[0083] In order to prevent the bending angle of the tube body tip 22 from becoming too large, when the tensioning tool 14 comes into contact with the stopper 125, the tube body tip 22
What is necessary is to adjust the fixing position etc. so that it is bent at a predetermined angle α. Further, the tension tool 14 may be provided with a scale so that the tension length of the linear body 13, that is, the bending angle of the tip portion 22 can be known.

In order to restore the bending of the distal end portion 22, the operating tool 12 is rotated and moved toward the distal end, and as a result, the rigidity imparting body 61 moves inside the second lumen 6 toward the distal end of the tube body. Moving. Thereby, the bent portion at the tip is reliably restored to the straight state by the rigidity imparting body 61 (the state shown in FIG. 6).

As shown in FIG. 8, the distal end of the stiffening body 61 is moved in advance in the distal direction, so that the distal end 2
It is also possible to adjust the bendable range of the tip portion 22, and the bending point of the tip portion 22 can be arbitrarily set. Note that it goes without saying that the operating tool 12 and the tensioning tool 14 are not limited to the configurations described above.

Next, the function of the catheter tube 1A of the present invention will be explained. 4 to 6 are partially sectional side views showing how the catheter tube 1A of the present invention is used.

As shown in FIG. 4, a catheter tube 1A serving as an endoscope is inserted into, for example, a blood vessel 16, and
Fluid is sent into the expansion body 8 from the lumen 5 to expand the expansion body 8.
When inflated, the expansion body 8 expands the inner wall surface 161 of the blood vessel 16.
The catheter tube 1A is firmly attached to the blood vessel 16, and the flow of blood 17 within the blood vessel 16 is blocked.

Furthermore, a transparent liquid 18 such as physiological saline or glucose solution is fed into the third lumen 4 from the proximal end, and is ejected from the opening at the tip to push out the blood in front of the expansion body 8 (on the tube tip side). The transparent liquid 18 is filled instead.

[0089] If the minimum diameter of the expandable body 8 when inflated is approximately equal to or greater than the maximum inner diameter of the blood vessel 16, the expandable body 8 will surely come into close contact with the inner wall surface 161 of the blood vessel 16, and the expandable body The blood 17 at the rear of the expansion body 8 (on the proximal end side of the tube) does not flow into the front of the expansion body 8, that is, into the observation area, making it possible to observe a clear image.

Next, the operating flange 142 of the tensioning tool 14 shown in FIG. 3 is grasped, and the linear body 13 is pulled a predetermined length toward the tube proximal end (in the direction of the arrow in FIG. 4). As a result, Figure 5
As shown in FIG. 2, the tip 22 of the tube body 2 is bent at a predetermined angle, and accordingly, the tip 91 of the optical fiber bundle 9 housed in the first lumen 3 is also bent. The tip portion 22 is configured to have smaller bending stiffness than other portions, and is therefore easily bent. Note that if a groove is provided, the tube main body distal end portion 22 is more easily bent than the groove.

In this state, the tip of the optical fiber bundle 9 is directed toward the inner wall surface 161 of the blood vessel, and the inner wall surface 161 of the blood vessel 16 can be observed through the light transmitting and light receiving fibers 10 and 11.

[0092] The inclination angle of the optical fiber bundle tip 91, that is, the direction of the field of view, can be changed by adjusting the pulling length of the linear body 13 or by adjusting the tip position of the stiffening body 61. is possible. Furthermore, by rotating the catheter tube 1A itself within the blood vessel 16, the entire circumference of the inner wall surface 161 of the blood vessel can be observed.

The flange 142 of the tensioning tool 14 is operated in the opposite direction to the above to release the tension on the linear body 13, and as shown in FIG. If it is slid toward the distal end, the tube body distal end 22 returns to the straight state shown in FIG. 4 again.

[Second Configuration Example] FIG. 9 is a partial longitudinal sectional view showing another configuration example of the catheter tube of the present invention, and FIG. 10 is a sectional view taken along the line XX in FIG.

[0095] Catheter tube 1B shown in each figure below.
In explaining the configuration and operation of the catheter tube, points different from the catheter tube 1A of the first configuration example will be described.
Other details shall be the same.

[0096] Inside the second lumen 6 of the tube body 2,
The rigidity imparting body 61 is not provided, and only the linear body 13 is housed.

[0097] The rigidity imparting body 61 is connected to the third lumen 4.
It is housed inside and has a rod-like shape. The position of the tip of the stiffening body 61 is the same as in the first configuration example.

The relationship between the diameter D of the stiffening body 61 and the inner diameter d of the third lumen 4 is preferably OD/20<D<d. The reason is that when D=d, fluid cannot flow through the third lumen 4, and when D<OD/20 (OD is the outer diameter of the tube body), sufficient rigidity cannot be obtained.

According to this configuration, it is sufficient to provide the rigidity imparting body 61 within the existing lumen, and the problem of increasing the tube diameter does not occur. Furthermore, since the rigidity imparting body 61 has a simple shape, there are advantages such as low processing and assembly costs.

[0100] In addition, a fifth lumen (not shown) may be formed to accommodate the rod-shaped stiffening body 61, or the stiffening body 61 may be embedded within the tube body 2.

Note that it is preferable to provide a coating layer on the surface of the stiffening body 61 in order to prevent corrosion. Specifically, it is preferable to apply a coating of silicone, polyvinyl chloride, nylon, polyethylene, ethylene-vinyl acetate copolymer, or the like.

[0102] The catheter tube of the present invention has the above-mentioned first
The present invention is not limited to the second configuration example, and in particular, in the first and second configuration examples described above, the catheter tube having the expandable body 8 and the fourth lumen for expanding the expandable body has been described. Needless to say, a catheter tube that does not have this may also be used.

Furthermore, in the above description, the case where the inside of a blood vessel is observed using light transmitting and light receiving fibers has been described, but the use of the catheter tube of the present invention is not limited to this, and for example, the use of the catheter tube is not limited to this. It can be applied to a wide range of fields, including irradiation of laser beams through optical fibers, and guiding the tip when inserting it into a target site.

[0104] Furthermore, in the above explanation, the examples were mainly described in which the device was inserted and indwelled into a blood vessel, but in addition to this, it could also be applied to tubular organs such as the trachea, esophagus, stomach, intestine, bladder, ureter, biliary tract, and pancreatic duct. Alternatively, it may be used by inserting it into a body cavity.

[0105]

EXAMPLE A catheter tube having the structure shown in FIG. 1 was prepared. The conditions of this catheter tube are as follows.

<Tube main body> Main body material: Polyvinyl chloride containing X-ray contrast agent Tip material: Polyurethane Outer diameter: Approximately 2.3 mm Total length: Approximately 1.5 m Lumen: 4 lumens 1 lumen for ejecting clear liquid, fiber 1 lumen for storage, 1 lumen for expansion body expansion, 1 lumen for linear body storage

<Optical fiber> An image fiber (a bundle of about 2,000 quartz fibers of about 2 to 3 μm) and a light guide (a bundle of 25 quartz fibers of about 50 μm) are integrated, and the outer diameter is about 0. 8mmφ
One fiber bundle with .

Further, a convex lens is attached to the end face of the image fiber, and receives the light emitted from the light guide to form a subject image on the end face of the image fiber.

0109 <Bending aid groove> None

<Rigidity imparting body> Material: Superelastic alloy Outer diameter: 0.4 mm Inner diameter: 0.2 mm Tip position: 50 mm from the tip of the tube body to the proximal end

<String body> Material: Polyimide Wire thickness: 100 denier Tip fixing position: 1 mm from the center of the cross section of the tube body and 1 mm from the tip of the tube body toward the proximal end

0112
] <Expansion body> Material: Latex rubber Thickness: Approximately 150μm Shape: Cylindrical Effective length: 7mm Diameter when expanded: 6mm

<Proximal end of catheter tube> Puller/
Connector structure shown in Figure 4: Total length: 40 mm Maximum movement distance of operating tool: 150 mm Maximum movement distance of pulling tool: 5 mm An eyepiece was attached to the base end of the image fiber to enable direct observation. An optical connector was attached to the base end of the light guide, and this was connected to a white light source. A stopcock with a Luer taper socket was attached to the proximal end of the lumen for ejecting transparent liquid, and syringe A was connected to this so that physiological saline could be supplied to the lumen.

[0114] A valve having a Luer taper socket was attached to the proximal end of the lumen for inflation of the expandable body, and a syringe B was connected to this valve so that the inflation fluid (physiological saline) could be injected into the expandable body. The inside of a blood vessel was observed using such a catheter tube.

[0115] First, make a catheter tube with an inner diameter of about 5 mm.
The catheter tube was inserted into the blood vessel, and the syringe B was manually operated to inflate the expansion body to fix the catheter tube to the blood vessel and block the flow of blood.

[0116] Next, operate syringe A to infuse 1.5 liters of physiological saline into the blood vessel in front of the expansion body (on the tube tip side).
ml was injected and the blood was discarded. The blood vessels in front of the expanded body were filled with physiological saline.

[0117] Next, manually operate the flange of the tensioning tool,
The linear body was pulled toward the rear end of the catheter tube by 5 mm to bend the tube tip. As a result, the tip of the optical fiber bundle was bent, and when confirmed by X-ray fluoroscopy, the inclination angle α was about 30°.

In this state, the inner wall surface of the blood vessel was observed through the eyepiece lens and on the video monitor screen, and clear observation was possible without blood flowing into the observed area. Furthermore, when the inclination angle of the fiber bundle tip was adjusted by changing the degree of traction (distance) of the linear body, a change in the viewing direction was confirmed on the monitor image.

On the other hand, the tensioning operation of the linear body could be carried out smoothly without any problems. The bending of the tube body was only at the tip, and no bending occurred in other parts due to the tension of the linear body. Furthermore, the tensioning operation was released, the operating tool was rotated and moved toward the distal end, and the stiffening body was pushed into the distal end of the tube body. The tip of the tube returned to its original state.

[0120]

[Effects of the Invention] According to the catheter tube of the present invention,
With a simple structure, the distal end of the catheter tube can be bent easily and reliably, and the operation can be performed smoothly. Therefore, observation of the inner walls of blood vessels, tubular organs, etc. and medical treatment become easier.

[0121] Furthermore, since the structure is simple, the diameter of the catheter tube can be reduced, and therefore it can be applied to smaller diameter blood vessels, tubular organs, and the like.

[Brief explanation of the drawing]

FIG. 1 is a partial vertical sectional view showing an example of the configuration of a catheter tube of the present invention.

FIG. 2 is a sectional view taken along line II-II in FIG. 1.

FIG. 3 is a partial vertical sectional view showing an example of the configuration of the proximal end portion of the catheter tube of the present invention.

FIG. 4 is a partially sectional side view showing an example of use of the catheter tube shown in FIG. 1;

5 is a partially sectional side view showing an example of use of the catheter tube shown in FIG. 1 in a state where the distal end thereof is bent; FIG.

FIG. 6 is a partially sectional side view showing a state in which a stiffening body is pushed into the distal end of the catheter tube shown in FIG. 1 and restored.

FIG. 7 is a partially sectional side view showing an embodiment in which the moment of inertia of the tip portion is reduced.

8 is a partially sectional side view showing a state in which the bending position of the catheter tube shown in FIG. 1 is adjusted depending on the position of the stiffening body.

9 shows another example of the structure of the catheter tube of the present invention, and is a partial vertical sectional view taken along the line IX-IX in FIG. 10. FIG.

FIG. 10 is a cross-sectional view in FIG. 9;

[Explanation of symbols]

1A, 1B Catheter tube 2
Tube body 21 Proximal end 211 Connector 212 Inner wall 22 Distal end 23 Groove 3 First lumen 4
3rd lumen 5
Fourth lumen 6 Second lumen 61 Rigidity imparting body 610 Inner space 611 Rear end 612 Projection 62 Closure 71 Channel 72 Opening 8 Expansion body 9 Optical fiber bundle 91
Tip part 92 Lens 10 Light transmitting fiber 11
Light receiving fiber 12
Operating tool 121 Tip part 122 Spiral 123 Flange 124 Inner peripheral wall 125 Stopper 13 Linear body 14 Pulling tool 141 Tip part 142 Flange 16 Blood vessel 161 Inner wall surface 17 Blood 18 Transparent liquid

Claims (9)

[Claims] 1. A catheter tube used by being inserted into a blood vessel or a tubular organ, the catheter tube comprising: a tube body;
A first lumen that opens to the distal end of the tube body, a second lumen that has a closed distal end, an observation or medical treatment instrument stored in the first lumen, and a distal end of the tube body that is disposed within the tube body. at least one linear body that is installed in the second lumen without being exposed outside the tube body and whose tip is fixed at an eccentric position near the tip of the tube body; , a pulling tool capable of pulling the linear body toward the proximal end of the tube body, and by pulling the linear body toward the proximal end of the tube body, the distal end of the observation or medical treatment instrument can be pulled toward the proximal end of the tube body. A catheter tube characterized in that it is configured to be bent. 2. The catheter tube according to claim 1, wherein the distal end portion of the tube body where the stiffening member is not present has less bending stiffness than other portions. 3. The catheter tube according to claim 1, further comprising at least one expandable body disposed around the outer circumferential wall of the tube body and capable of being expanded and contracted. 4. The distal end of the stiffening body is located on the distal end side of the tube body or at the same position as the expansion body.
3. The catheter tube according to any one of 3. 5. The catheter according to claim 1, wherein the rigidity imparting body is slidable in the axial direction of the tube body, and includes an operating tool for operating sliding movement of the rigidity imparting body. tube. 6. The catheter tube according to claim 5, wherein the stiffening body can be fixed at any position. 7. The stiffening body is a tube, the stiffness imparting body is housed in the second lumen, and the linear body is housed in the inner lumen of the tube. 6. The catheter tube according to any one of 6. 8. The catheter tube according to claim 1, wherein the stiffening body is a rod-shaped body. 9. The catheter tube according to claim 1, wherein a plurality of the linear bodies are provided, and the distal ends of the plurality of linear bodies are respectively fixed at different eccentric positions within the cross section of the tube main body. .