JPH07108318B2 - Catheter with balloon for vasodilation - Google Patents

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a percutaneous angioplasty performed to improve blood flow in a stenosis site or an occlusion site of a blood vessel.
(Percutaneous Transluminal Angioplasty: Abbreviation PTA)
The present invention relates to a catheter with a balloon for vasodilation used in.

[0002]

2. Description of the Related Art Conventionally known as a catheter with a balloon for vasodilation used in the above PTA is:
As shown in FIG. 6, this catheter 51 with a balloon is provided with a balloon 53 made of polyvinyl chloride or polyethylene that pressurizes and expands a blood vessel at the distal end of the catheter body 52, and both ends of the balloon 53. A metallic marker 54 is provided on the outer periphery of the nearby catheter body 52 so that the position of the balloon 53 can be confirmed under fluoroscopy. The catheter body 52 has a lumen leading to the tip opening and a balloon.
A lumen communicating with 53 is provided (not shown). 55
Is a port that communicates with the distal port through the lumen of the catheter body 52,
56 is a mouth communicating with the lumen of the balloon.

An example of using the catheter 51 with a balloon as described above will be explained with reference to FIG. 7. First, the inserted J-type guide wire 57 is operated under fluoroscopy to send it ahead of the stenosis portion A of the blood vessel (see FIG. A). After that, the guide wire 57 is inserted into the lumen of the catheter main body 52 and is advanced under fluoroscopy, and the balloon 53 is sent to the stenosis portion a (FIG. B). At this time, the markers 54 provided at both ends of the balloon 53 serve as position indicators. Now slowly remove the guide wire 57,
Inject heparin saline.

Next, the balloon 53 is expanded by using a contrast medium, and while watching the gauge of the pressure gauge 59, the balloon 53 is pressurized and expanded (FIG. 6C). Repeat this several times. Since the constriction of the balloon 53 disappears each time the expansion is repeated, it is confirmed that the stenosis a has expanded and the balloon 53
The catheter 51 with a balloon is removed in a state where the catheter is contracted (DEF in the figure).

After that, the catheter is replaced with a contrast-enhancing catheter to perform contrast-enhancement to confirm the dilated state, and the series of operations is completed.

[0006]

By the way, in the conventional catheter 51 with a balloon, since the stenosis (i) is physically pressurized and expanded by the balloon 53, this pressurizing and expanding action causes the inner wall of the blood vessel to be expanded. Damage and blood clots flow to the periphery,
There was a problem of causing embolism. As a countermeasure against such a thing, it is possible to dissolve the thrombus using, for example, heparin or urokinase, but especially in the case of a cerebral blood vessel, there is a very high risk, and it is safer to consider these thrombus and the like. At present, there is no dilatation balloon catheter.

Therefore, the present invention solves the above-mentioned conventional problems and provides a catheter with a balloon for vasodilation which can prevent the transfer of thrombus or the like to the periphery or other sites. To aim.

[0008]

In order to achieve the above object, the present invention provides a first balloon for expanding a narrowed portion of a blood vessel at a position near the distal end of a catheter body having a lumen communicating with the distal opening. A first lumen having an opening opening in the peripheral wall of the catheter body having the first balloon, the first lumen communicating with the inside of the balloon is provided in the catheter body along the lumen, and near both ends of the first balloon In the above-described balloon-equipped catheter in which a marker for confirming a balloon is provided on the outer circumference of the catheter body, a second balloon that occludes the blood vessel at a position closer to the distal end than the first balloon of the catheter body is separated from the first balloon by a predetermined distance. Is provided in advance. A second lumen having an opening opening in the peripheral wall of the catheter body having the second balloon and communicating with the inside of the balloon is provided in the catheter body along the lumen. Further, a third lumen having an opening opening in the peripheral wall of the catheter body between the first balloon and the second balloon is provided in the catheter body along the lumen. At this time, a fourth lumen having an opening opening in the peripheral wall of the catheter body between the first balloon and the second balloon may be provided in the catheter body along the lumen.

[0009]

With the above structure, the first balloon is positioned in the stenosis portion of the blood vessel, and fluid is introduced from the second lumen to inflate the second balloon slightly before pressurizing and expanding, and the blood vessel is occluded to prevent blood flow. Cut off. Next, the fluid is quickly introduced from the first lumen to inflate the first balloon, and the narrowed portion is pressurized and expanded. Thereafter, the fluid contained in the first balloon is deflated and the first balloon is deflated, and at the same time, the first balloon is expanded from its opening using an aspirator or an injector connected to the third lumen. Blood that contains blood clots or the like is aspirated, or a thrombolytic solution such as heparin or urokinase is injected. As described above, in the case of suction, the thrombus or the like is discharged to the outside of the body, and in the case of injection, it is dissolved to prevent these from flowing to the periphery. In the case of claim 2, since two lumens can be used, one can be used for inhalation and the other can be used for infusion, so that continuous suction and infusion can be performed.

[0010]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS In FIGS. 1 and 2, reference numeral 1 denotes a catheter with a balloon for vasodilation, which comprises a polyurethane main body 2 of a predetermined length, which extends from a connector 3 on the rear end side to a front end port 4. A lumen 5 is provided over the length. A first balloon 6 made of polyvinyl chloride or polyethylene or polyurethane supported by a nylon mesh for expanding the narrowed portion of the blood vessel is provided at a position near the tip of the catheter body 2.
A first lumen 8 that has an opening 7 that opens to the peripheral wall of the catheter body 2 having a balloon 6 and that communicates with the inside of the balloon.
Are provided in the catheter body 2 along the lumen 5 over the length from the connector 3 to the opening 7.

Numerals 10 and 10 'are metallic markers for confirming the balloon, which are provided on the outer circumference of the catheter body 2 in contact with both ends of the first balloon 6, and are made of, for example, thin stainless steel or platinum. A second balloon 12 made of silicone rubber or latex that blocks a blood vessel is provided at a position distal to the first balloon 6 of the catheter main body 2 at a predetermined interval from the first balloon 6, and the catheter having the second balloon 12 is present. A second lumen 13 having an opening 15 opening in the peripheral wall of the body 2 and communicating with the inside of the balloon is provided in the catheter body 2 along the lumen 5 over the length from the connector 3 to the opening 15. .

Reference numeral 16 is a third lumen having an opening 17 opened in the peripheral wall of the catheter body 2 between the first balloon 6 and the second balloon 12, and the third lumen 16 has a cross-sectional area substantially equal to that of the inner lumen 5. , Is provided in the catheter body 2 over the length from the connector 3 to the opening 17. 1
Reference numerals 8, 19, 20, 21 are branch tubes connected to the lumen 5 of the connector 3 and the first to third lumens 8, 13, 16 and are connected to each other. Are provided with ports 18a, 19a, 20a, 21a, respectively.

The operation of the above embodiment will be described with reference to FIG. The catheter 1 with a balloon is advanced by inserting the lumen 5 into the guide wire 57 from the distal end port 4 and positioning the first balloon 6 at the stenosis portion a of the blood vessel as shown in FIGS.
As shown in FIG. After positioning the first balloon 6 of the catheter 1 in this way, the first balloon 6 is positioned.
Shortly before pressurizing and expanding the fluid, a fluid such as a physiological saline solution is introduced from the second lumen 13 by an unillustrated syringe connected to the mouth 20a of the branch tube 20, the second balloon 12 is inflated, and the blood vessel is closed. Blocks blood flow.

Next, a fluid is similarly introduced from the first lumen 8 by an injection cylinder (not shown) connected to the mouth 19a of the branch tube 19 to inflate the first balloon 6 and pressurize and expand the narrowed portion a. After that, the fluid contained in the first balloon 6 is removed to deflate the first balloon 6, and at the same time, the branch tube
A syringe (not shown) connected to the mouth 21a of 21 sucks blood containing thrombus generated by the expansion of the first balloon 6 from the opening 17 opened between the balloons 6 and 12, and discharges it out of the body. To do. This prevents blood clots and the like from flowing to the periphery. At this time, when the blood vessel is not located near the brain, a thrombolytic solution such as heparin or urokinase may be injected by a syringe instead of the suction.

After the suction or injection work as described above, the fluid contained in the second lumen 13 is removed to deflate the second balloon 12, and then the catheter 1 is removed from the blood vessel.

4 and 5 show another embodiment of the present invention,
In this embodiment, a fourth lumen 24 having an opening 23 opened in the peripheral wall of the catheter body 2 between the first balloon 6 and the second balloon 12 is added to the above embodiment. Therefore, in the case of this embodiment, the cross-sectional area of the inner cavity 5 is slightly smaller as shown in FIG.
And the cross-sectional areas of the fourth lumen 24 are formed to have substantially the same size. Since other structures are the same as those of the above-mentioned embodiment, the same parts are designated by the same reference numerals and the description thereof will be omitted.

In the case of the above-mentioned embodiment, suction or injection can be performed only when the first balloon 6 is deflated,
In the case of this embodiment, the two lumens 16 and 24 can be used, and one can be used for inhalation and the other for infusion, so that suction or infusion can be performed regardless of inflation or deflation of the first balloon 6. Can last.

It is needless to say that each of the above-mentioned embodiments is only a preferable example, and the detailed structure can be appropriately changed without changing the gist.

[0019]

According to the first aspect of the present invention, the second balloon, which is located at the distal end side of the first balloon and closes the blood vessel, causes a thrombus or the like generated at the time of dilation of the narrowed portion of the blood vessel by the first balloon, to the periphery or another. It can be reliably prevented from metastasizing to the site of and causing embolism. In particular, it is effective for application to cerebral blood vessels and has high safety. In the case of claim 2, in addition to the effect, suction or infusion of blood containing thrombus and the like can be performed using the third lumen and the fourth lumen regardless of expansion and contraction of the first balloon. It is easier to use and safer than the case of 1.

[Brief description of drawings]

FIG. 1 is an overall schematic front view showing an embodiment of the present invention.

FIG. 2 is an enlarged sectional view taken along line II-II of FIG.

FIG. 3 is a view for explaining the operation of the above.

FIG. 4 is an enlarged sectional view corresponding to FIG. 2 showing another embodiment.

FIG. 5 is a drawing for explaining the operation of another embodiment.

FIG. 6 is an overall schematic front view showing a conventional typical catheter with a balloon for vasodilation.

7 (A) to 7 (F) are views for explaining the operation.

[Explanation of symbols]

 1 Catheter with balloon for vasodilation 2 Catheter body 3 Connector 4 Tip opening 5 Lumen 6 First balloon 7, 15, 17 Opening 8 First lumen 10, 10 'Metallic marker 12 Second balloon 13 Second lumen 16th 3-lumen 18, 19, 20, 21 branch tube

Claims (2)

[Claims] 1. A first part for expanding a stenosis part of a blood vessel to a position near a tip part of a catheter body having a lumen communicating with a tip opening.
A balloon is provided and has a first lumen communicating with the inside of the balloon, the first lumen having an opening opening in the peripheral wall of the catheter body having the first balloon, and the first balloon. In a catheter with a balloon for vasodilation used for percutaneous angioplasty, in which a marker for confirming a balloon is provided on the outer circumference of the catheter body near both ends of the blood vessel, the blood vessel is located at a position closer to the tip side than the first balloon of the catheter body. A second balloon that closes the first balloon at a predetermined distance from the first balloon, has an opening that opens to the peripheral wall of the catheter body with the second balloon, and has a second lumen that communicates with the inside of the balloon. Is provided on the catheter body along the first balloon and the second balloon
A catheter with a balloon for vasodilation, characterized in that a third lumen having an opening opening in the peripheral wall of the catheter body between the balloons is provided in the catheter body along the lumen. 2. The catheter with a balloon according to claim 1, wherein a fourth lumen having an opening opening in a peripheral wall of the catheter body between the first balloon and the second balloon is provided in the catheter body along the lumen. A catheter with a balloon for vasodilation.