JPH07227427A - Catheter set for medical treatment - Google Patents

Abstract

PURPOSE:To make it possible to surely remove a thrombus in succession after PTCA. CONSTITUTION:This catheter set consists of a combination of a balloon catheter 2 having a balloon 2a, a receiving tray catheter 3 having a receiving tray 3a and an internal cavity in which this balloon catheter 2 passes freely slidably therein and a guiding catheter 4 in which the balloon catheter 2 and receiving tray catheter 3 pass freely slidably therein. The material (thrombus) scraped by the balloon catheter 2 is held and captured between the balloon 2a in an expanded state and the receiving tray 3a and is passed in the guiding catheter 4 until his material is taken outside.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical catheter, and more particularly to a medical catheter set for removing thrombus.

[0002]

Coronary Artery Bypass Graft (CABG) has been conventionally used for ischemic heart disease caused by arteriosclerotic coronary lesions, but it is now a less invasive method. As a percutaneous coronary angioplasty, a balloon catheter is percutaneously advanced into the lumen of the blood vessel to expand the stenosis of the coronary artery by the internal pressure of the balloon.
ty, PTCA) is the mainstream, but the treatment method for acute myocardial infarction is thrombolytic therapy (PTC) in addition to the above PTCA.
R) is still common.

However, in acute myocardial infarction, PTC
Both A and PTCR have a problem that restenosis is likely to occur due to a thrombus occurring at the site to be treated, and therefore a new method is being sought.

Conventionally, as a general method for removing thrombus, a method of scraping out the thrombus using a balloon (for example, with a Fogarty catheter) and a method of sucking the thrombus have been devised, but in these methods, the thrombus is removed. It was difficult to remove it reliably.

Further, since the concept itself of removing thrombus as a series of operations subsequent to PTCA has been weak, devices suitable for such thrombus removal have not been developed so far.

[0006]

Therefore, the object of the present invention is to solve the above-mentioned problems of PTCA and to make this technique more effective, so that the thrombus can be reliably removed successively after PTCA. To provide equipment.

[0007]

In order to achieve the above object, a medical catheter set according to the present invention includes a balloon catheter having an inner cavity through which a guide wire passes and a balloon, and a saucer and a balloon. The balloon catheter comprises a combination of a saucer catheter having a lumen through which the balloon catheter slidably penetrates in a contracted state, and a guiding catheter through which the balloon catheter and the saucer catheter slidably penetrate. The scraped substance (thrombus) is sandwiched between the balloon and the tray, captured, passed through the guiding catheter, and taken out to the outside.

In the above catheter set, the saucer can be formed by expanding one end of the lumen of the saucer catheter near the balloon into a cup shape, and the shape thereof is funnel-shaped, hemispherical, semi-loaded ellipsoidal, cylindrical. It may be in the form of a shape or a combination thereof.

In the above catheter set, the outer diameter of the pan is equal to or slightly larger than the maximum outer diameter of the balloon when inflated.

In the above catheter set, the guiding catheter has an inner diameter that exceeds the maximum outer diameter when the balloon is inflated.

In the above catheter set, the saucer catheter is made of synthetic resin.

In the above catheter set, the synthetic resin is any one of fluororesin, polyvinyl chloride resin, polyurethane resin, polyamide resin, polyimide resin, polyester resin and polyolefin resin.

In the above catheter set, the balloon catheter has a double-lumen structure in which a balloon made of natural rubber, polyurethane, polyester, or polyolefin and having a volume of 0.1 to 3.0 cc is attached near the distal tip. It may be a catheter for selective coronary angioplasty (PTCA).

In the above catheter set, the tube portion of the balloon catheter, at least the saucer portion of the saucer catheter, and the guiding catheter may have an X-ray contrast property.

[0015]

Most of the thrombus generated after PTCA shows a rice cake-like semi-fluidity and can be scraped out by a balloon catheter. However, the balloon catheter alone may sometimes cause the thrombus that has been scratched out to come off the balloon, and it is not always easy to move this thrombus inside the guiding catheter and take it out.

Therefore, the medical catheter set according to the present invention is inserted into the coronary artery along the previously set guide wire to inflate the balloon. Then, the saucer catheter with a cup-shaped saucer is placed close to the balloon in the inflated state, so the thrombus scratched by the balloon is caught between the balloon and the saucer, and the guiding catheter is pulled out as it is. It becomes possible to move it. Thus, the thrombus does not come off from the balloon in the middle, and the thrombus can be easily and reliably taken out of the body.

As described above, since the saucer catheter is pulled out together with the balloon catheter in the expanded state, the outside diameter of the saucer is almost the same as the outside diameter of the balloon, and the inside diameter of the guiding catheter is larger than that. There must be.

Various synthetic resins are suitable for the material of the saucer catheter, but in this case, the saucer catheter has appropriate hardness, has a low affinity for thrombus, and has a small friction coefficient between the balloon catheter and the guiding catheter. From the viewpoint that the resin is desirable, a fluororesin is particularly preferable.

If the guide wire is left in the body as it is when removing the catheters used for PTCA, the medical catheter set according to the present invention can be easily inserted into the body along the guide wire. So
The thrombus can be easily removed as described above.

When the thrombus is to be removed immediately after PTCA, only the saucer catheter according to the present invention is inserted into the body through the guiding catheter with the PTCA catheter and the guiding catheter left in the body. Good.

[0021]

EXAMPLES Examples of the medical catheter set according to the present invention will be described with reference to the attached FIGS. 1 and 2. Although the following description will be given for a thrombus for convenience, the target is similarly effective as an atheroma, an atheroma composed of calcium and cholesterol, and coagulated blood. Moreover, it is needless to say that it can be widely applied not only to remove thrombi but also to remove foreign substances such as gallstones.

In FIG. 1, reference numeral 10 is a medical catheter set according to this embodiment, 2 is a balloon catheter, 2a is a balloon, 3 is a saucer catheter, 3a is a saucer, and 4 is a guiding catheter.

Reference numeral 1 is a guide wire.
Generally, when using a medical catheter, first, the guide wire 1 is inserted into the body. Then, the bent portion of the tip exerts an anchor effect and is localized at a desired position in the body, and the catheter is inserted along this. The same applies to the medical catheter set according to the present invention.

The balloon catheter 2 is usually provided with two lumens therein, one of which is slidably penetrated by the guide wire 1 and the other of which is provided with a liquid-feeding or pumping pump (not shown). To inflate the liquid from the balloon to the balloon 2a. The length of the balloon catheter 2 is 120
cm to 140 cm, outer diameter 0.83 mm to 1.6 m
m. The dimensions listed here are selected according to the thickness of the blood vessel at the site to be treated.

The balloon 2a, when inflated, forms a spindle-shaped spheroid and has a maximum outer diameter of 1.5 m.
It is preferably from m to 4.2 mm and has a capacity of 0.1 to 3 cc. However, when the balloon 2a is not inflated, it is folded with wrinkles,
It can be passed through the lumen of the saucer catheter 3 described below.

Balloon catheter 2 and balloon 2a
Is formed of synthetic resin such as polyurethane resin, polyolefin resin, polyvinyl chloride resin, polyamide resin (nylon), polyimide resin, polyester resin, fluororesin, or natural rubber or silicone rubber.

The saucer catheter 3 is provided therein with one lumen, through which the balloon catheter 2 slidably penetrates. The length of the saucer catheter 3 may be shorter than the length of the balloon catheter 2, 90 to 140
cm is fine. The outer diameter is 0.86 mm to 1.86 mm.

One end of the inner cavity of the saucer catheter 3 near the balloon is expanded in a cup shape to form a saucer 3a. 2A to 2E are a side view of the saucer catheter 3 and a perspective view corresponding thereto. As shown in FIG. 2, the shape of the tray 3a may be funnel-shaped, hemispherical, semi-ellipsoidal, cylindrical, or a combination thereof. FIG. 2 (e) shows a funnel shape having a fold.
Other shapes can have folds as well. In this embodiment shown in FIG. 1, the funnel shape of FIG. 2 (c) is adopted. The maximum outer diameter of the tray 3a is almost the same as the maximum outer diameter of the balloon 2a, and is 1.5 mm to 4.2 mm.

The material constituting the saucer catheter 3 and the saucer 3a may be the same as the constituent material of the balloon catheter 2 described above, but is provided with an appropriate hardness for capturing the thrombus,
Fluorine resin is particularly preferable from the viewpoint that it has a low affinity for the thrombus so that the thrombus can be easily discharged from the tray 3a, has a small friction coefficient with other catheters, and slides well.

The guiding catheter 4 is provided with a single thick lumen therein and the balloon 2a is placed therein.
Balloon catheter 2 and saucer 3a in an inflated state
The saucer catheter 3 with is penetrated slidably. Therefore, its inner diameter needs to be equal to or larger than the maximum outer diameter of the balloon 2a and the tray 3a. As with the saucer catheter 3, it is sufficient that the guiding catheter 4 has a length of 90 to 140 cm. The constituent material thereof may be the same as the material of the balloon catheter 2.

Incidentally, the tube portion of the balloon catheter 2, the whole or the saucer portion 3a of the saucer catheter 3, and the guiding catheter 4 are provided with X-ray contrast, whereby the insertability is improved.

Medical catheter set 1 according to the present embodiment
0 is configured by combining the above-described components in the order of the balloon catheter 2, the saucer catheter 3, and the guiding catheter 4 from the inside, and the rear end (hand side) of the balloon 2a is located at the open end of the saucer 3a. Face to face. Hereinafter, the medical catheter set 10 configured as described above
The method of use and the action will be described.

After performing PTCA, when removing catheters, the guide wire 1 is left in the coronary artery as it is. The medical catheter set 10 according to the present embodiment is assembled as described above and inserted into the body along the guide wire 1. Since the tip of the guide wire 1 is located at the site where PTCA was performed, the balloon 2a of the medical catheter set 10 is easily guided to the affected area. The guiding catheter 4 may be inserted first along the guide wire 1, the balloon catheter 2 may be inserted next, and the saucer catheter 3 may be inserted last.

Further, the balloon catheter 2 is advanced past the site where the thrombus is present, and the tip of the saucer 3a of the saucer catheter 3 is stopped at a position before the site where the thrombus is present.
In this state, the balloon 2a is inflated, the balloon catheter 2 is pulled toward the hand side, and the rear end portion of the balloon 2a is returned to the position of the tray 3a.

Thus, the thrombus is sandwiched between the balloon 2a and the saucer 3a while being scraped by the rear end of the balloon 2a. If the balloon catheter 2 and the saucer catheter 3 are both slid in the guiding catheter 4 and pulled out of the body while maintaining this state, the thrombus will not fall off from the balloon 2a during the process. Outside the body, the space between the balloon 2a and the saucer 3a is expanded and the thrombus is discharged.

Subsequently, the set of the balloon catheter 2 and the saucer catheter 3 is inserted along the guide wire 1 to the target site, and the above operation is repeated until the thrombus can be completely removed.

[0037]

In the medical catheter set according to the present invention, since the saucer catheter having the cup-shaped saucer is arranged close to the balloon in the inflated state, the thrombus scraped by the balloon catheter is separated between the balloon and the saucer. It is possible to capture by sandwiching it between them, and then pulling out and moving the guiding catheter as it is. Thus, the thrombus does not come off from the balloon in the middle, and the thrombus can be easily and reliably taken out of the body.

Further, since the present catheter set can be constructed by combining a PTCA catheter, a saucer catheter, and a guiding catheter, the thrombus can be easily removed after the PTCA treatment. Thereby, restenosis, which is a problem of PTCA, can be prevented and the effectiveness of PTCA can be enhanced.

[Brief description of drawings]

FIG. 1 is a configuration diagram of a medical catheter set according to an embodiment of the present invention.

2 (a) to 2 (e) are views showing saucer catheters of various shapes.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Guide wire 2 ... Balloon catheter 2a ... Balloon 3 ... Saucet catheter 3a ... Saucet 4 ... Guiding catheter 10 ... Medical catheter set

Claims (1)

[Claims] 1. A saucer catheter having a balloon having a lumen through which a guide wire passes, and a saucer having a saucer and having a lumen through which the balloon catheter slidably penetrates when the balloon is in a deflated state. And a combination of a guiding catheter in which the balloon catheter and the saucer catheter slidably pass through the balloon catheter in an expanded state of the balloon,
The substance raked up by the balloon catheter is captured by being sandwiched between the balloon and the saucer in an expanded state,
A medical catheter set characterized by being passed through the guiding catheter and taken out to the outside.