JPH08112289A - High-frequency therapeutic apparatus for medical care - Google Patents

Abstract

PURPOSE: To provide a high frequency therapeutic apparatus with excellent operability wherein the effect of therapy for a vascular constriction part can be confirmed. CONSTITUTION: An electrode chip 6 for high frequency heating is provided on the apex of a guide wire 1 to be percutaneously inserted into a blood vessel. In addition, on the apex side of the guide wire, an ultrasonic sensor 21 is provided. A display apparatus 29 for detecting and displaying the change in reflective wave of the ultrasonic wave reflected on a vascular constriction part is provided. Therefore, it is possible by means of the display apparatus 29 to perform a therapy while the change in the vascular constriction part caused by heating of the electrode chip 6 is being confirmed.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical high-frequency treatment apparatus for treating a narrowed portion of a blood vessel such as a coronary artery with a medical high-frequency treatment device such as a catheter, a hot tip guide wire and a hot tip balloon catheter.

[0002]

2. Description of the Related Art PTCA (Percutaneous Transluminal Coronary Angioplasty)
In recent years, as a surgery for expanding a blood vessel narrowed due to arteriosclerosis, it has been widely performed on arteries such as the coronary arteries and feet. The arteriosclerosis is one of the causes of death due to adult diseases. When arteriosclerosis occurs in the heart blood vessels, it causes myocardial infarction, and when arteriosclerosis occurs in the foot and the like, it becomes arterial thrombus or arterial pool. For example, when treating a stenosis of a coronary artery, devices such as hot balloon catheters and roto-ablator have been used in recent years, and even a stenosis that could not be conventionally treated can be treated by a medical treatment if the guide wire passes through. You can do it. As the catheter, for example, as proposed by the applicant of the present application in Japanese Patent Application Laid-Open No. 2-68073, a balloon having an expandable and contractible balloon is provided at the tip, and an electrode for high frequency heating is provided inside the balloon. In addition, in this type of catheter, a thermocouple is provided on the distal end side of the catheter in order to confirm the heating state of the narrowed portion by the heating electrode.

[0003]

In the above-mentioned conventional balloon catheter, a high-frequency voltage is applied between the high-frequency heating electrode inside the balloon and the electrode outside the body to inflate the balloon while heating the vascular stenosis. By pressurizing, the vascular stenosis can be satisfactorily expanded. Then, in the expansion method using this balloon catheter, the temperature is measured by a thermocouple incorporated on the distal end side of the catheter to confirm the heating state of the stenosis. However, in the conventional thermocouple, since the heating state of the constriction is detected only by the temperature information from the thermocouple, it is necessary to detect the actual state of the constriction due to heating. Was difficult.

Further, in order to use a thermocouple, a pair of conducting wires, such as a copper wire and a constantan wire, must be incorporated over the entire length of the thin catheter or guide wire, which complicates the manufacturing process. The conductor used for the pair is used in an atmosphere where the temperature changes due to the heating of the electrodes, so it is easy to cause wire breakage, and when passing a catheter or guide wire through a stenosis of the blood vessel, it is advantageous to have a smaller diameter. Since two conductor wires are inserted, there is also a problem that the diameter dimension becomes large. And as the diameter size increases in this way, 2
The operability of the catheter or guide wire deteriorates because the lead wire of the book is inserted, that is, with this type of guide wire, etc., it is inserted into a blood vessel percutaneously and pushed down into the stenosis while operating along a curved blood vessel. However, there is a problem that the operability is deteriorated.

Therefore, an object of the present invention is to provide a medical high-frequency treatment apparatus which is excellent in operability and can confirm the therapeutic effect on a vascular stenosis.

[0006]

According to a first aspect of the present invention, there is provided a high-frequency medical treatment apparatus for heating a stenosis of a blood vessel.
A guide wire to be inserted into a blood vessel percutaneously, an electrode tip for high frequency heating provided on the tip side of the guide wire, a high frequency generator having an output side connected to the other end side of the guide wire, An ultrasonic wave transmitting section which is provided on the distal end side of the guide wire and which transmits an ultrasonic wave to the vascular stenosis and an ultrasonic wave receiving section which receives the ultrasonic wave reflected by the vascular stenosis, and the received ultrasonic wave causes the vascular stenosis. And a display device for displaying changes in the parts.

According to a second aspect of the present invention, in a medical high-frequency treatment apparatus for warming and treating a vascular stenosis, a guide wire that is percutaneously inserted into a blood vessel and high-frequency heating provided on the distal end side of the guide wire. Electrode tip, a high frequency generator connected to the other end of the guide wire, impedance detection means for detecting the output impedance of the high frequency generator, and a change in the blood vessel stenosis due to a change in this impedance. And a display device for displaying.

According to a third aspect of the present invention, in a medical high-frequency treatment device for heating and treating a vascular stenosis, a guide wire that is percutaneously inserted into a blood vessel and high-frequency heating provided on the distal end side of the guide wire. And a high frequency generator connected to the other end of the guide wire, and a display device for displaying changes in the blood vessel stenosis by a nuclear magnetic resonance apparatus.

According to a fourth aspect of the present invention, in a medical high-frequency treatment apparatus for heating and treating a vascular stenosis, a guide wire for percutaneously inserting into a blood vessel and high-frequency heating provided at the tip of the guide wire. Electrode tip, a high frequency generator connected to the other end of the guide wire, and a display device for displaying the temperature change of the blood vessel stenosis due to thermal noise on the output side of the high frequency generator. is there.

[0010]

In the structure according to the first aspect, the change in the blood vessel stenosis can be detected and displayed by the reflected wave from the stenosis which changes depending on the heating state of the electrode tip.

In the above-mentioned structure, the change in the blood vessel stenosis can be detected and displayed by the output impedance that changes depending on the heating state of the electrode tip.

According to the third aspect of the present invention, the nuclear magnetic resonance apparatus can detect the hydrogen spin resonance wave of the blood vessel stenosis, thereby detecting and displaying the change of the blood vessel stenosis.

In the structure according to the fourth aspect, the thermal noise generated by the heating temperature of the electrode tip can detect and display the temperature change on the side of the blood vessel stenosis.

[0014]

Embodiments of the present invention will be described below with reference to the accompanying drawings. 1 to 4 show a first embodiment of the present invention, and FIG. 1 shows a hot tip guide wire 1 (hereinafter referred to as a guide wire), in which 2 is an SUS304 stainless steel having an outer diameter of 320 microns. This stainless steel pipe 2 is a pipe that is hardened and has an extremely high hardness. An insulating layer 3 is provided on the outer circumference of the stainless steel pipe 2 by Teflon coating over its entire length. The outer diameter of the layer 3 is formed to be 370 microns or less. Further, a taper portion 4 having a length H that shrinks toward the tip is approximately 10 mm is formed at the tip of the stainless steel pipe 2, and the diameter of the tip of the taper portion 4 is formed to be 250 microns or less. Further, by forming the tapered portion 4, the insulating layer 3 on the tip side is removed. Further, on the outer circumference of the tip of the tapered portion 4, a tight coil 5 formed of a stainless steel wire having a diameter of 50 μm and having an insulated outer circumference is welded and joined by laser welding or the like, and the stainless steel coil 5 is
It gives appropriate flexibility and elastic restoring force to the tip of the guide wire 1, and has an outer diameter of 350 microns and an inner diameter of 250.
The micron and the length Hc are 5 to 30 mm. An electrode tip 6 for high frequency heating made of stainless steel or the like is provided at the tip of the coil 5 which constitutes a part of the guide wire 1. The guide wire 1 has a length of 140 cm required to reach the heart percutaneously, and if it is too long, it is difficult to use, so use a guide wire of 190 cm or less, or replace the catheter with about 360 cm or less. What is used. Further, in place of the stainless steel pipe 2, a hardened steel pipe, a beryllium bronze pipe, a beryllium steel pipe, an iron-nickel alloy night roll pipe, and a nickel-chromium steel MP.
A metal having high rigidity such as a 35N pipe or a tungsten pipe can be used.

In FIG. 3, the high frequency generator 7 has a frequency of 1
3.56MHz, output 2-8W, one output terminal 8
Is electrically connected to the electrode tip 6 via an external lead wire 9, the stainless steel pipe 2 and the coil 5, and the other output terminal 8A of the high frequency generator 7 is externally connected via an external lead wire 10. Connect to electrode 11. The external electrode 11 forms a counter electrode with the electrode tip 6. The high frequency generator 7 is limited to a crystal control oscillator. 12
Is a potential control device, and 13 is a monitor device such as an oscilloscope. The external electrode 11 is attached to the front side or the back side of the living body and has a metal disc structure.
Therefore, by observing the monitor device 13 and adjusting the potential control device 12, an induced current is passed through the living body to perform local heating by the counter electrode heating method.

As shown in FIGS. 1 and 2, an ultrasonic sensor 21 is provided at the tip of the electrode tip 6, and as the ultrasonic sensor 21, for example, a piezo element using a piezoelectric ceramic is used. The ultrasonic sensor 21 is an ultrasonic wave transmitter.
22U is also used as the ultrasonic receiver 22I. That is, the piezo element is an electric vibrator, which emits an ultrasonic wave when a transmission pulse is applied and converts the ultrasonic wave into a voltage when the ultrasonic wave is received. Further, a pair of conductive wires 23, 24 are inserted into the guide wire 1, and the conductive wires 23, 24 are electrically insulated at their outer surfaces, and the ends thereof are electrically connected to the ultrasonic sensor 21. The guide wire 1 is connected to the measuring device 25 by inserting the other end from the proximal side which is the rear end of the guide wire 1 to the outside. This measuring device 25 has a switchable transmitter 26 and receiver.
27 and the like, the transmission unit 26 outputs a pulse signal to the ultrasonic sensor 21 via the wires 23 and 24,
As a result, the ultrasonic sensor 21 is 5 to 10M on the vascular constriction 28.
The ultrasonic sensor 21 transmits the ultrasonic wave of Hz as an incident wave, and the ultrasonic sensor 21 receives the ultrasonic wave reflected by the blood vessel stenosis part 28, and the ultrasonic sensor 21 converts the reflected wave into an electric signal and the receiving part. The signal is output to 27, and the electric signal is amplified and detected by the receiving section 27 and displayed on the display device 29. As the display device 29, a cathode ray tube type oscilloscope, various monitor devices, a printer or the like is used. Incidentally, FIG.
30 is a plastic insulating shaft having a diameter of 1 mm and an inner diameter of 0.8 mm, for example, and the guide wire 1 is removably inserted into the insulating shaft 30. The heat generated from the guide wire 1 is insulated from the outside.

Next, a case where the stenosis 28 is heated by using the hot tip guide wire 1 will be described.
When the guide wire 1 is percutaneously inserted into the artery and the tip electrode tip 6 is positioned in the stenosis 28, an induction current is generated from the high frequency generator 7 via the electrode tip 6 and the external electrode 11 Then, the vicinity of the electrode tip 6 is heated by inductive heating to heat and soften the narrowed portion 28, and the guide wire 1 is inserted into the softened narrowed portion 28 as shown in FIG. To do. On the other hand, at this time, the measuring device 25 is operated to emit ultrasonic waves from the ultrasonic sensor 21 to the blood vessel stenosis portion 28, the reflected wave reflected by the blood vessel stenosis portion 28 is received, and the reflected wave is received via the receiving portion 27 to a display device. Display on 29. Then, the ultrasonic wave is reflected by the boundary layer of the substance, and this is reflected by the layer having a different dielectric constant (light transmission coefficient). Therefore, the constricted portion 28 is heated by the induction heating on the electrode tip 6 side, and the constricted portion 28 is When the water content of the protein decreases or the protein is burnt and denatured, ultrasonic waves are reflected and the reflected wave changes, which is received by the ultrasonic sensor 21 and output to the receiving unit 27 as an electric signal for display. A change due to heating of the blood vessel stenosis 28 can be confirmed by the display device 29 displayed on the device 29 and showing the reflected wave of the ultrasonic wave. In this way, the display device 29
The treatment is performed while confirming the change in the blood vessel stenosis 28 due to the heating of the electrode tip 6, and the guide wire 1 is pushed in to open the stenosis 28 as shown by the alternate long and short dash line in FIG.
Thereafter, a balloon catheter (not shown) inserted through the outer circumference of the guide wire 1 is positioned at the narrowed portion 28, and the balloon is inflated to expand the narrowed portion 28.

As described above, in the present embodiment, in accordance with claim 1, in the medical high-frequency treatment apparatus for heating and treating the vascular stenosis 28, the guide wire 1 which is percutaneously inserted into the blood vessel.
An electrode tip 6 for high frequency heating provided on the tip side of the guide wire 1, a high frequency generator 7 having the output side connected to the other end side of the guide wire 1, and the guide wire 1
An ultrasonic wave transmitting unit 22U that transmits ultrasonic waves to the blood vessel stenosis 28 and an ultrasonic wave receiving unit 22I that receives the ultrasonic waves reflected by the blood vessel stenosis 28 and a vascular stenosis by the received ultrasonic waves. Since the display device 29 for displaying the change in the portion 28 is provided, the change in the blood vessel narrowing portion 28 is detected and displayed by the reflected wave from the narrowed portion 28 which changes depending on the heating state of the electrode tip 6. Therefore, it is possible to perform reliable heating treatment while observing the actual change of the stenosis portion 28 due to heating, as compared with the conventional method of detecting temperature by a thermocouple. Further, unlike the conventional thermocouple, the conductive wire is not limited to copper or constantan wire, so that the conductive wires 23 and 24 can be prevented from being broken, and the operability of the guide wire 1 is improved. .

As an effect of the embodiment, an ultrasonic sensor
Since 21 is provided at the tip of the guide wire 1, the vascular stenosis
The reflection of the ultrasonic wave reflected by 28 can be directly detected, and the detection accuracy can be improved. Further, the guide wire 1 percutaneously inserted into an artery has appropriate flexibility obtained by the coil 5 provided on the distal end side, and the coil 5 has an elastic restoring force, so that the guide wire 1 is guided along the bend of the blood vessel. 1 can be pushed in satisfactorily. If the flexible coil 5 has a length of 5 mm or less, the blood vessel cannot follow the curve. On the contrary, if the coil 5 has a length of more than 30 mm, the waist is lost and the tip of the electrode tip 6 is narrowed.
It becomes impossible to push it in well.

FIG. 5 shows a second embodiment of the present invention, in which the same parts as those of the first embodiment are designated by the same reference numerals and detailed description thereof will be omitted. This is an example of detecting the change of the blood vessel stenosis 28 using ultrasonic waves without using the ultrasonic sensors 21 at the tip of No. 1 and without using the conducting wires 23 and 24, and the tip of the stainless steel pipe 2. The electrode tip 6 is directly attached to. A measuring device 125 is connected to the rear end of the guide wire 1, and this measuring device 125 sends ultrasonic waves from the rear end side of the guide wire 1 and transmits ultrasonic waves from the electrode tip 6 at the tip to the blood vessel stenosis part 28. The reflected wave that is transmitted and reflected by the constricted portion 28 is transmitted from the tip electrode tip 6 through the guide wire 1 to the rear end and receives this reflected wave. An ultrasonic wave having an ultrasonic transducer (not shown) is provided. Transmitter
It has a 126 and an ultrasonic receiver 127. This ultrasonic transmitter
Reference numeral 126 denotes an ultrasonic wave of 5 to 10 MHz, and the ultrasonic wave receiver 127 outputs the reflected wave reflected by the narrowed portion 28 through the guide wire 1 and input from the rear end of the guide wire 1. It is converted into a signal, further amplified and detected, and displayed on the display device 29. And in this example, guide wire 1
The tip of the electrode tip 6, which is the tip of the above, constitutes an ultrasonic transmitter 122U and an ultrasonic receiver 122I. The ultrasonic transmitter 122U and the ultrasonic receiver 122I may be provided with a transmitter and a receiver, respectively, or one ultrasonic transducer may be used for both transmitting and receiving ultrasonic waves. The length of the stainless steel pipe 2 is set to, for example, about 2 meters, and a measuring device 125 is provided at the rear end.
Can also be connected.

When the guide wire 1 is percutaneously inserted into the artery and the electrode tip 6 at the tip is positioned in the stenosis 28, an induction current is generated from the high frequency generator 7 and the electrode tip 6 and the external electrode 11 are induced. Flow through the living body through the living body, and the vicinity of the electrode tip 6 is heated by inductive heating, thereby heating and softening the narrowed portion 28, and the softened narrowed portion 28 is covered with the guide wire 1 as shown in FIG. Insert it by pushing it in. On the other hand, at this time, the measuring device 125 is operated to operate the measuring device 12
An ultrasonic wave is input from the ultrasonic transmitter 126 of 5 to the rear end of the guide wire 1, and the ultrasonic wave propagates through the guide wire 1 and is emitted from the tip of the electrode tip 6. In this case, the guide wire 1 is solid. Since the attenuation of the ultrasonic wave is relatively small, the propagation is excellent, and the reflected wave reflected by the blood vessel stenosis 28 is received by the tip of the electrode tip 6, and the received reflected wave is on the rear end side of the guide wire 1. The ultrasonic receiver 127 converts the electric signal into an electric signal, further amplifies and detects the electric signal, and displays it on the display device 29.

As described above, in the present embodiment, in accordance with claim 1, in the medical high-frequency treatment device for heating and treating the vascular stenosis 28, the guide wire 1 that is percutaneously inserted into the blood vessel.
An electrode tip 6 for high frequency heating provided on the tip side of the guide wire 1, a high frequency generator 7 having the output side connected to the other end side of the guide wire 1, and the guide wire 1
An ultrasonic wave transmitting portion 122U which transmits ultrasonic waves to the blood vessel stenosis portion 28 and an ultrasonic wave receiving portion 122I which receives the ultrasonic waves reflected by the blood vessel stenosis portion 28, which are provided on the distal side of the blood vessel stenosis portion 28, and the received ultrasonic waves cause vascular stenosis. Since the display device 29 for displaying the change in the portion 28 is provided, the change in the blood vessel narrowing portion 28 is detected and displayed by the reflected wave from the narrowed portion 28 which changes depending on the heating state of the electrode tip 6. As compared to the conventional method of detecting the temperature of a thermocouple, it becomes possible to perform a reliable heating treatment while observing the actual change of the stenotic portion 28 due to heating,
It has the same operation and effect as the first embodiment.

As an effect of the embodiment, an ultrasonic wave generator 126 for inputting an ultrasonic wave is provided at the rear end of the guide wire 1,
An ultrasonic wave receiver 127 for converting the ultrasonic wave returned as a reflected wave into an electric signal is provided, and the electrode tip 6 for high frequency heating uses the stainless steel pipe 2 which is the guide wire body constituting the guide wire 1 as a conductor. Therefore, it is not necessary to insert a conductor wire into the guide wire 1,
The structure is simplified to facilitate manufacturing, and the diameter of the guide wire 1 can be reduced.
The operability of can be improved.

FIG. 6 shows a third embodiment of the present invention. The same parts as those of the first embodiment are designated by the same reference numerals and detailed description thereof will be omitted. The hot-tip guide wire 1 having the same structure as that of 1. is used, and the conductor wires 23 and 24 are not used for this guide wire 1. As shown in FIG. 6, the output circuit of the high frequency generator 7 is provided with impedance detecting means 31 for detecting a change in impedance of the high frequency generator 7. The impedance detecting means 31 detects the output voltage. Output voltage detection means 32, output current detection means 33 for detecting the output voltage, and C
There is provided a control means 35 including a PU and the like, which divides the output voltage detected by the detection means 32, 33 by the output current to obtain the impedance of the output circuit and displays it on the display device 34. As the display device 33, a display device for numerically displaying the impedance is used, such as an LCD.

When the guide wire 1 is percutaneously inserted into the artery and the electrode tip 6 at the tip is positioned at the stenosis 28, an induction current from the high frequency generator 7 is applied to the electrode tip 6 and the external electrode 11. Flow through the living body through the living body, and the vicinity of the electrode tip 6 is heated by inductive heating, thereby heating and softening the narrowed portion 28, and the softened narrowed portion 28 is covered with the guide wire 1 as shown in FIG. Insert it by pushing it in. On the other hand, at this time, the electrode tip 6 at the tip of the guide wire 1
Is brought into contact with the constricted portion 28 to carry out induction heating, and when the protein in the constricted portion 28 is denatured due to the heating, resulting in a burned state, the electric resistance, that is, the impedance of the output circuit rises. This is a phenomenon that appears relatively clearly.
Changes from 0 ohms to 1 kilo ohm can be seen. The change in voltage and current accompanying this is detected by the output voltage detection means 32 and the output current detection means 33 and displayed on the display device 34 via the control means 35. Due to the change in impedance displayed by the display device 34, the constricted portion 28 The heat treatment status of can be confirmed. That is, it can be seen that as the impedance value rises, the blood vessel stenosis 28 is heated and burned. In this way, the display device 35 performs the treatment while confirming the change in the blood vessel stenosis portion 28 due to the heating of the electrode tip 6.

As described above, in the present embodiment, in accordance with claim 2, in the medical high-frequency treatment apparatus for treating the stenosis 28 with heat, the guide wire 1 is inserted percutaneously into the blood vessel.
An electrode tip 6 for high frequency heating provided on the distal end side of the guide wire 1, a high frequency generator 7 connected to the other end side of the guide wire 1, and an output side impedance of the high frequency generator 7 is detected. Impedance detection means
31 and the display device 34 for displaying the change of the blood vessel stenosis 28 by the change of the impedance, the high frequency generator 7 that changes according to the heating state of the electrode tip 6 is provided.
The actual state of the blood vessel stenosis portion 28 can be confirmed by detecting and displaying the impedance of the output circuit. Further, unlike the conventional thermocouple, there is no need to insert a conductor wire into the guide wire 1, the structure is simplified and manufacturing is facilitated, and the diameter of the guide wire 1 can be reduced. Operability can be improved.

FIG. 7 shows a fourth embodiment of the present invention. The same parts as those of the first embodiment are designated by the same reference numerals and detailed description thereof will be omitted. The hot-tip guide wire 1 having the same structure as that of 1. is used, and the conductor wires 23 and 24 are not used for this guide wire 1. This example is an example in which a change in the blood vessel stenosis portion 28 is detected by the nuclear magnetic resonance apparatus 41 shown in FIG.
Is an electrostatic magnetic field coil 42 that is a magnetic field magnet that forms an electrostatic magnetic field in a living body, a coil power source 43 of the electrostatic magnetic field coil 42,
A transmitter coil 44 and a receiver coil 45 arranged to sandwich a living body
And a transmission unit 46 and a reception unit 47 electrically connected to each of them, and a control unit that controls each unit of the nuclear magnetic resonance apparatus 41.
48, the control unit 48 controls the electrostatic magnetic field formed by the electrostatic magnetic field coil 42 to be constant, and controls the control unit 48 to generate a high frequency pulse between the transmitting coil 44 and the receiving coil 45. After the application, the receiving unit 47 detects the hydrogen spin resonance wave, and the control unit 48 calculates the density distribution of hydrogen atoms and displays it on the display device 49. More specifically, when a high-frequency pulse is applied between the transmitting coil 44 and the receiving coil 45 in the electrostatic magnetic field formed by the electrostatic magnetic field coil 42, hydrogen of water molecules forming a living body causes magnetic resonance, which causes high frequency noise. The received signal is amplified and detected by the receiver 45, and the electric signal obtained by this is detected by C
The control unit 48 having a PU or the like displays the converted image on the display device 49 including a monitor device,
For example, a portion containing many water molecules is displayed as a bright portion, and a portion containing few water molecules is displayed as a dark portion.

When the guide wire 1 is percutaneously inserted into the artery and the electrode tip 6 at the tip is positioned in the stenosis 28, an induction current from the high frequency generator 7 is applied to the electrode tip 6 and the external electrode 11. Flow through the living body through the living body, and the vicinity of the electrode tip 6 is heated by inductive heating, thereby heating and softening the narrowed portion 28, and the softened narrowed portion 28 is covered with the guide wire 1 as shown in FIG. Insert it by pushing it in. On the other hand, at this time, the nuclear magnetic resonance device 41 causes
The hydrogen spin resonance wave around 28 is detected and displayed.
The image is displayed as image data and the like, and the display device 49 confirms the amount of water in the vicinity of the blood vessel stenosis portion 28 and the like to confirm the change in the blood vessel stenosis portion 28 and perform the treatment. At this time, when the blood vessel stenosis portion 28 is heated by the induction heating of the electrode tip 6, the amount of water in the blood vessel stenosis portion 28 decreases, so that the change in the blood vessel stenosis portion 28 due to the heating can be confirmed. Then, as shown by the alternate long and short dash line in FIG. 4, the guide wire 1 is pushed in to open the narrowed portion 28, and thereafter, a balloon catheter (not shown) inserted through the outer periphery of the guide wire 1 is positioned in the narrowed portion 28, and the balloon is inserted. Inflate to expand the constriction 28.

As described above, in the present embodiment, in accordance with claim 3, in the medical high-frequency treatment apparatus for heating and treating the vascular stenosis 28, the guide wire 1 is inserted percutaneously into the blood vessel.
The electrode tip 6 for high frequency heating provided on the distal end side of the guide wire 1, the high frequency generator 7 connected to the other end side of the guide wire 1, and the vascular constriction portion 28 by the nuclear magnetic resonance apparatus 41. Since the display device 49 for displaying the change is included, the vascular stenosis part 29 is formed by the nuclear magnetic resonance device 41.
The hydrogen spin resonance wave of the
It is possible to detect and display the change in the amount of water. Also, unlike the one using a conventional thermocouple, the guide wire 1
Since it is not necessary to insert a conductive wire into the structure, the structure is simplified and manufacturing is facilitated, the diameter of the guide wire 1 can be reduced, and the operability of the guide wire 1 can be improved.

FIGS. 8 and 9 show a fifth embodiment of the present invention, in which the same parts as those in the first embodiment are designated by the same reference numerals, and detailed description thereof will be omitted. Using the hot tip guide wire 1 having the same configuration as that of the first embodiment,
Conductor wires 23 and 24 are not used for this guide wire 1. The output circuit of the high frequency generator 7 is provided with thermal noise detecting means 51 for detecting thermal noise. This thermal noise detecting means 51 is a thermal noise separating means 52 for separating thermal noise from a high frequency component having a frequency of 13.56 MHz which is used for induction heating in this example, and an amplified detection of the thermal noise obtained by this separation. The thermal noise measuring means 53 and the control means 55 for displaying the obtained thermal noise on the display device 54 are provided.
As the cathode ray tube 54, a cathode ray tube type oscilloscope, various monitor devices or printers, and an indicator such as an LED are used. Further, the control means 55 is provided with a conversion means 56 for converting temperature from thermal noise.

Then, if the guide wire 1 is percutaneously inserted into the artery and the electrode tip 6 at the tip is positioned at the stenosis 28, an induced current is generated from the high frequency generator 7 and the electrode tip 6 and the external electrode 11 are supplied. Flow through the living body through the living body, and the vicinity of the electrode tip 6 is heated by inductive heating, thereby heating and softening the narrowed portion 28, and the softened narrowed portion 28 is covered with the guide wire 1 as shown in FIG. Insert it by pushing it in. On the other hand, at this time, when the electrode tip 6 side is induction-heated and the temperature of the guide wire 1 on the electrode tip 6 side rises, thermal noise occurs in the output circuit, for example, 500 KHz in this example.
A certain amount of thermal noise is generated, and the thermal noise increases as the temperature rises. This thermal noise is electrical noise generated by thermal disturbance of electrons, becomes stronger in proportion to temperature, has a substantially constant frequency, and appears as so-called white noise. The thermal noise is separated by the thermal noise separating means 52 and displayed on the display device 56 through the thermal noise measuring means 53 and the control means 55, and the thermal treatment state of the stenosis part 28 is displayed by the thermal noise displayed by the display device 54. You can check. In this manner, the display device 54 performs treatment while confirming the heating state of the blood vessel stenosis portion 28 due to the heating of the electrode tip 6.

As described above, in the present embodiment, in accordance with claim 4, in the medical high-frequency treatment apparatus for heating and treating the vascular stenosis portion 28, the guide wire 1 which is percutaneously inserted into a blood vessel is used.
The electrode tip 6 for high frequency heating provided at the tip of the guide wire 1, the high frequency generator 7 connected to the other end of the guide wire 1, and the thermal noise on the output side of the high frequency generator 7 The display device 54 for displaying the temperature change of the blood vessel stenosis 28 is provided, and the temperature change of the blood vessel stenosis 28 side can be detected and displayed by the thermal noise generated by the heating temperature of the electrode tip 6. Also, unlike the conventional thermocouple, there is no need to insert a conductor wire into the guide wire 1, the structure is simplified and manufacturing is facilitated, and the diameter of the guide wire 1 can be reduced. The operability of No. 1 can be improved.

FIG. 10 shows a sixth embodiment of the present invention. The same parts as those of the above-mentioned embodiments are designated by the same reference numerals, and detailed description thereof will be omitted. 5 to 10 show an example of constructing a hot tip balloon catheter by attaching an inflatable and deflatable balloon to the distal end side of the guide wire 1 of the fifth embodiment. For example, as shown in FIG. 10, the guide wire 1 of the first embodiment is made of Teflon. Shaft 61
And fixed to the shaft 61 to be integrated,
Attach both sides of a balloon 62 having a diameter of about 2 mm to the distal end side of the guide wire 1 and the distal end of the shaft 61,
This forms a hot tip balloon catheter. The shaft 61 is electrically insulated and thermally insulated during high frequency heating. Further, the balloon 62 is made of an inflatable and contractible plastic film or the like, and a distal end 63A of a liquid feeding hole 63 formed over the entire length of the shaft 61 communicates with the inside of the balloon 62 and is shown at the rear end on the proximal side. The liquid feed pump and the suction pump are selectively connected. Therefore, if the liquid feeding pump is operated to feed the liquid into the balloon 62, the balloon 62 can be inflated, and if the suction pump is operated to suck the liquid in the balloon 62, the balloon 62 is removed. Can be shrunk.

As described above, according to the present embodiment, the guide wire 1 having the same structure as that of the first embodiment is used.
Corresponding to the above, the same action and effect as those of the first embodiment are provided, and by providing the balloon 62, the distal end side of the guide wire 1 is pushed into the blood vessel stenosis portion 28 to open it, and then the balloon 62, the balloon 62 can be inflated to expand the stenosis 28, and the balloon 62 and the shaft 61 are incorporated into the guide wire 1 of the second to fifth embodiments, which are not shown in the drawings, respectively. A tip balloon catheter can also be constructed.

The present invention is not limited to the above embodiment, but various modifications can be made within the scope of the gist of the present invention. For example, various methods can be used for transmitting ultrasonic waves to the stenosis of blood vessels and receiving reflected waves. Further, it can also be used for those which generate a high frequency of 2 to 20 MHz by a high frequency generator. further,
The medical radiofrequency treatment apparatus of the present invention can also be applied to a catheter.

[0036]

According to the first aspect of the present invention, in a medical high-frequency treatment device for heating and treating a stenosis of a blood vessel, a guide wire that is percutaneously inserted into a blood vessel and a distal end side of the guide wire is provided. An electrode tip for high frequency heating, a high frequency generator having an output side connected to the other end side of the guide wire, an ultrasonic wave transmitting section which is provided on the distal end side of the guide wire and transmits ultrasonic waves to the blood vessel stenosis portion, and An ultrasonic wave reception unit that receives the ultrasonic waves reflected by the blood vessel stenosis portion and a display device that displays changes in the blood vessel stenosis portion by the received ultrasonic waves are provided. It is possible to provide a medical high-frequency treatment device capable of confirming the therapeutic effect of a part.

According to a second aspect of the present invention, in a medical high-frequency treatment device for heating and treating a vascular stenosis, a guide wire that is percutaneously inserted into a blood vessel and high-frequency heating provided on the distal end side of the guide wire. Electrode tip, a high frequency generator connected to the other end of the guide wire, impedance detection means for detecting the output impedance of the high frequency generator, and a change in the blood vessel stenosis due to a change in this impedance. It is possible to provide a medical high-frequency treatment device that is provided with a display device for displaying, has excellent operability, and can confirm the treatment effect on a vascular stenosis.

According to a third aspect of the present invention, in a medical high-frequency treatment device for heating and treating a vascular stenosis, a guide wire that is percutaneously inserted into a blood vessel and high-frequency heating provided on the distal end side of the guide wire. The electrode tip for use, a high-frequency generator connected to the other end of the guide wire, and a display device for displaying changes in the blood vessel stenosis by a nuclear magnetic resonance apparatus, and are excellent in operability. It is possible to provide a medical high-frequency treatment device capable of confirming the therapeutic effect on a vascular stenosis.

According to a fourth aspect of the present invention, in a medical high-frequency treatment device for heating and treating a stenosis of a blood vessel, a guide wire for percutaneously inserting into a blood vessel and high-frequency heating provided at the tip of the guide wire. Electrode tip, a high frequency generator connected to the other end of the guide wire, and a display device for displaying the temperature change of the blood vessel stenosis due to thermal noise on the output side of the high frequency generator. Therefore, it is possible to provide a medical high-frequency treatment device which is excellent in operability and can confirm the treatment effect on a vascular stenosis.

[Brief description of drawings]

FIG. 1 is a sectional view of a guide wire showing a first embodiment of the present invention.

FIG. 2 is an enlarged sectional view of the distal end side of the guide wire showing the first embodiment of the present invention.

FIG. 3 is a schematic explanatory view of a treatment state by a counter electrode heating system showing the first embodiment of the present invention.

FIG. 4 is a cross-sectional view showing a first embodiment of the present invention in use.

FIG. 5 is a sectional view of a guide wire showing a second embodiment of the present invention.

FIG. 6 is a schematic explanatory view of a treatment state by a counter electrode heating system showing a third embodiment of the present invention.

FIG. 7 is a schematic explanatory view of a treatment state by a counter electrode heating system showing a fourth embodiment of the present invention.

FIG. 8 is a schematic explanatory view of a treatment state by a counter electrode heating system showing a fifth embodiment of the present invention.

FIG. 9 is an explanatory diagram of a thermal noise detecting means showing a fifth embodiment of the present invention.

FIG. 10 is a sectional view of a hot tip catheter showing a sixth embodiment of the present invention.

[Explanation of symbols]

 1 Hot tip guide wire 6 Electrode tip 7 High frequency generator 22U 122U Transmitter 22I 122I Receiver 28 Blood vessel stenosis 29 Display device 31 Impedance detection means 34 Display device 41 Nuclear magnetic resonance device 49 Display device 51 Thermal noise detection means 54 Display device

Continuation of front page (51) Int.Cl. ⁶ Identification number Office reference number FI technical display area A61M 29/02

Claims (4)

[Claims] 1. A medical high-frequency treatment device for heating and treating a vascular stenosis, comprising: a guide wire that is percutaneously inserted into a blood vessel; and an electrode tip for high-frequency heating provided on the distal end side of the guide wire. , A high-frequency generator having an output side connected to the other end of the guide wire, an ultrasonic wave transmitting section that is provided on the distal side of the guide wire and transmits ultrasonic waves to the vascular stenosis, and reflected to the vascular stenosis A medical high-frequency treatment device comprising: an ultrasonic wave receiving unit that receives an ultrasonic wave; and a display device that displays changes in the blood vessel stenosis by the received ultrasonic wave. 2. A high-frequency medical treatment device for heating a stenosis of a blood vessel, the guide wire being inserted into a blood vessel percutaneously, and an electrode tip for high-frequency heating provided on the distal end side of the guide wire. A high frequency generator connected to the other end of the guide wire, impedance detection means for detecting an output side impedance of the high frequency generator, and a display device for displaying a change in the blood vessel stenosis due to a change in the impedance. A high-frequency medical treatment device for medical use, comprising: 3. A medical high-frequency treatment apparatus for heating a vascular stenosis, wherein a guide wire is inserted percutaneously into a blood vessel, and an electrode tip for high-frequency heating is provided on the distal end side of the guide wire. A high-frequency medical treatment apparatus for medical use, comprising: a high-frequency generator connected to the other end of the guide wire; and a display device for displaying changes in the blood vessel stenosis by a nuclear magnetic resonance apparatus. 4. A medical high-frequency treatment apparatus for heating a vascular stenosis, wherein a guide wire is inserted percutaneously into a blood vessel, and an electrode tip for high-frequency heating is provided at the tip of the guide wire. A medical device comprising: a high frequency generator connected to the other end of the guide wire; and a display device for displaying a temperature change of the blood vessel stenosis due to thermal noise on the output side of the high frequency generator. Radiofrequency treatment device.