JPH1071152A - Percutaneous angiorrhapy device - Google Patents

Percutaneous angiorrhapy device

Info

Publication number
JPH1071152A
JPH1071152A JP8235732A JP23573296A JPH1071152A JP H1071152 A JPH1071152 A JP H1071152A JP 8235732 A JP8235732 A JP 8235732A JP 23573296 A JP23573296 A JP 23573296A JP H1071152 A JPH1071152 A JP H1071152A
Authority
JP
Japan
Prior art keywords
sheath
inserted
blood vessel
thread
yarn
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
JP8235732A
Other languages
Japanese (ja)
Inventor
Yasuhiro Umetsu
泰洋 梅津
Original Assignee
Umetsu Hiroko
梅津 裕子
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Umetsu Hiroko, 梅津 裕子 filed Critical Umetsu Hiroko
Priority to JP8235732A priority Critical patent/JPH1071152A/en
Publication of JPH1071152A publication Critical patent/JPH1071152A/en
Application status is Pending legal-status Critical

Links

Abstract

PROBLEM TO BE SOLVED: To execute percutaneous angiorrhapy for homeostasis after arterial pricking accompanying percutaneous angiography and intra-vascular treatment. SOLUTION: (a) A sheath 1 is inserted into the blood vessel. (b) A thread capturing device 5 provided with many looped threads 6 at the front end of a rod is inserted into the intra-vascular cavity through this sheath 1. (c) Two pieces of fine hollow needles 2 are pricked into the intra-vascular cavity from both sides of the section where the sheath 1 is inserted into the blood vessel. (d) A suture 3 and a guide thread 4 are inserted into the blood vessel through the inside cavities of the hollow needles 2 and are passed in the loop of the thread capturing device. The device is constituted in the manner described above.

Description

【発明の詳細な説明】 DETAILED DESCRIPTION OF THE INVENTION

【0001】 [0001]

【産業上の利用分野】この発明は経皮的血管造影や血管内処置にともなう大腿動脈穿刺後の止血のための経皮的血管縫合術をおこなう器具に関するものである。 BACKGROUND OF THE INVENTION This invention relates to instruments for performing percutaneous vascular sutures for hemostasis after femoral artery puncture with a percutaneous angiographic and intravascular treatment.

【0002】 [0002]

【従来の技術】現在市販されている経皮的血管縫合器は縫合糸をつけた2本の針をシース抜去後の穴から血管内に挿入し,その針を血管壁をつらぬいて外に引き出すことにより,穴の周囲に縫合糸を通し,それを結ぶという構造である。 BACKGROUND OF THE INVENTION Percutaneous vascular suturing device that are currently marketed are the two needles with the suture inserted from the hole after sheath removal in the vessel, draw out the needle through the blood vessel wall by, through a suture around the hole, the structure that connects it. しかし以下のような多くの欠点を有するため普及していない。 But not widespread because it has many disadvantages as follows. 構造が複雑なためきわめて高価である。 Since the structure is complex is very expensive. 構造上の制約のため小型化が困難であり,小径のシースには対応不可能である。 It is difficult to miniaturize because of structural constraints, the small diameter of the sheath is impossible correspond. 操作面では,操作に熟練を要し,しばしばX線透視が必要であり,一度不成功に終わった時は同じ器具で再度やりなおしができないため不経済である。 The operating surface, requires skill in operation, often it is necessary X-ray fluoroscopy, when finished once failure is uneconomical because it can not try again with the same instrument. また,血管穿刺部位が瘢痕化した症例には適用困難である。 Further, the case where the blood vessel puncture site has scarring is difficult to apply. 他の止血補助手段としては,コラーゲンプラグにより穿刺部位を充填し,血栓化を促進させる方法があるが,基本原理は圧迫法と同じであり,数時間の安静を必要とし,合併症の発生も少なくない。 Other hemostatic aids, the puncture site was filled with collagen plugs, there is a method of promoting thrombosis, the basic principle is the same as the compression method requires a rest of a few hours, the occurrence of complications Not a few. また材料を牛のアキレス腱から調達するため高価につく。 Also costly to procure the material from bovine Achilles tendon. そのため依然としてほとんどすべての施設で,シース抜去後は同部位を10分前後,指または圧迫器で圧迫止血し, Therefore still in almost all facilities, after sheath removal is about 10 minutes to the same sites, and astriction a finger or constrictor,
その後3〜24時間の絶対安静を保つ方法がおこなわれている。 Then how to keep absolute rest 3 to 24 hours is performed. この間,食事排泄等をベッド上で片足を延ばした状態でおこなわなければならない。 During this time, it must be performed in a state in which extended one foot a meal excretion, such as on the bed. この絶対安静は患者に多大な苦痛を与える。 This absolute rest gives a great deal of pain to the patient. 安静解除後も股関節の強度の屈曲は禁じられる。 After the release of rest also bending of the strength of the hip joint is prohibited. また止血が不完全なため出血が持続し,大きな血腫をつくったり,輸血を必要とする出血をおこしたり仮性動脈瘤の発生もある。 The hemostasis sustained bleeding because it is incomplete, or made a large hematoma, there is also the occurrence of pseudoaneurysm or cause bleeding that requires a transfusion. 近年カテーテルによる治療が飛躍的に進み,より太いカテーテルを必要とする場合が急速に増加してきた。 In recent years treatment with catheter is advanced by leaps and bounds, it has increased the case is rapidly that require a thicker catheter. しかしカテーテルの太さに比例して止血は困難となり,術後の安静時間は長引き患者の苦痛は増大する。 However hemostasis in proportion to the thickness of the catheter becomes difficult, pain of patients after surgery of the rest time is prolonged is increased. 長い間止血の器械の開発が待たれていたが,満足できるものはいまだ無かった。 The development of a long time hemostasis instrument has been waiting for, but satisfactory was still no.

【0003】 [0003]

【発明が解決しようとする課題】カテーテル抜去後の血管穿刺部位を確実に,縫合止血し,術後の安静をまったく不用とすること。 [0007] reliably vascular puncture site after catheter removal, sutured hemostatic totally be useless the rest of the post-operative. またこれにより、外来にて検査,処置を可能とし,入院という患者の大きな負担を軽減し、 Also As a result, the inspection at the foreign, to allow the treatment, to reduce the heavy burden of patients that hospital,
ひいては国民医療費の削減にも貢献することを目的としている。 Which is an object of the present invention to thus contribute to the reduction of the national health care costs.

【0004】 [0004]

【課題を解決するための手段】シース1を血管へ挿入し、柔軟性を有する棒の先端部に多数のループ状の糸6 The sheath 1 Means for Solving the Problems] was inserted into the blood vessel, the yarn number of looped at the distal end of the rod with a flexible 6
を設けた糸捕捉器5をシース1内を通して血管内腔に挿入する。 The yarn trap 5 provided with insertion into the vessel lumen through inner sheath 1. 2本の細い中空の針2をシース1の血管への挿入点の約1mm両脇から血管内腔に刺入する。 Two thin hollow needle 2 to penetrate the vessel lumen from about 1mm both sides of the insertion point to the vascular sheath 1. 縫合糸3 Suture 3
および誘導糸4を中空の針2の内腔を通して十分な長さを血管内に挿入し、糸捕捉器のループをくぐらせる。 And sufficient length inserted into a blood vessel induction thread 4 through the hollow lumen of the needle 2, thereby preferably under the loop of the thread catcher. 糸捕捉器を引き出すと縫合糸と誘導糸がともにシース内より体外に引き出されるので、この2本を連結し誘導糸の他端を引くとシース挿入孔の周囲に縫合糸がかかり、これを結んで縫合止血する。 Since yarn guided draw the thread trap and suture are both withdrawn from the sheath outside the body, the suture takes Subtracting the other end of the induction yarns connecting the two around the sheath insertion hole, connecting this in the suture hemostasis.

【0005】 [0005]

【作用】カテーテルの挿入,操作のために血管内にすでに挿入されているシース1の内部を通して血管内に糸捕捉器5を挿入する。 [Action] insertion of the catheter, inserting the yarn trap 5 into the vessel through the sheath 1 that is already inserted into the vessel for operation. 糸捕捉器の先端部に設けたループ状の糸6は適度の弾性を有するため、シース内に挿入時には受動的に折り畳まれるが,シース内から血管内腔に出ると自らの弾性によってループは軸に直角方向に面して立つような形態で血管内腔に拡がる。 For loop-shaped thread 6 provided on the tip portion of the thread trap is having a suitable elasticity, but at the time of insertion into the sheath are folded passive, loop axis by its own elasticity upon exiting the vessel lumen from the sheath spread vascular lumen in the form as stand facing perpendicular to. 血管壁へシースが挿入されている部位から約1mm離れた位置で中空針2 Hollow at a position where the sheath to the vessel wall is a distance of about 1mm from the site being inserted needle 2
を血管内に刺入する。 The to penetrate into the blood vessel. これは中空針からの血液の逆流により確認できる。 This can be confirmed by the backflow of blood from the hollow needle. 中空針の中に縫合糸3を挿入すると, Upon insertion of the suture thread 3 into the hollow needle,
縫合糸は血管内に入っていき,糸捕捉器の先端部に設けられた多数のループの内のいくつかのループをくぐる。 The suture will fall within the blood vessel, it passes through a number of loops of a number of loops provided at the distal end of the thread catcher.
別の中空針をシースに対してはじめの中空針の180度対側の位置に刺入し,この中空針の中に誘導糸4を挿入すると,糸捕捉器の先端に設けられた多数のループの内のいくつかのループをくぐる。 Another hollow needle puncture the 180-degree opposite side position of the beginning of the hollow needle relative to the sheath, inserting the induction yarn 4 into the hollow needle, a large number of loops provided at the tip of the thread catcher Passing through some of the loop of the. 糸捕捉器をシースから引き出すと,ループに絡まった縫合糸と誘導糸はシースを通って体外に引き出される。 Pulling the thread catcher from the sheath, yarn guided suture entangled loop is pulled from the body through the sheath. この縫合糸と誘導糸を連結する。 Connecting the inductive threads and the suture. 誘導糸の他端を引くと,縫合糸はシース内を通り血管内に引き込まれ誘導糸の通路を逆に通り血管外に誘導される。 Subtracting the other end of the induction, suture is guided outside through a blood vessel the retracted induction yarn passage back into the through blood vessels within the sheath. つまりシース挿入部の穴が縫合可能な形に糸がかかる。 That hole in the sheath insertion portion yarn according to suture a form. シースを抜去すると同時に、この縫合糸を糸結紮器を用いて結ぶ。 And simultaneously removing the sheath, connecting the suture using a ligation instrument.

【0006】 [0006]

【実施例】中空針2は血管壁へシースが挿入されている部位から約1mm離れた位置で血管内に刺入する。 EXAMPLES hollow needle 2 to penetrate into the vessel at a position about 1mm from the site where the sheath to the vessel wall is inserted. このためには中空針がシースに平行にスライドしながら動くように,シースに中空針のガイド機構を設けておく。 As hollow needle for this purpose is moved while slide parallel to the sheath, preferably provided a hollow needle guide mechanism to the sheath. 太いシースを用いた場合は1本の糸での縫合では不十分なので,あらかじめ中空針を4か所に刺入しておき,4本の糸を糸捕捉器で一度に引き出し,2本の糸で縫合する。 Since insufficient suturing of a single yarn in the case of using a thick sheath, leave puncture pre hollow needle at four positions, drawers four yarn at a time in the thread trap, the two yarns in suturing. この方法はあらゆる太さのシースに適用可能であり,大動脈バルーンポンプ用のバルーンの抜去時にも使用できる。 This method is applicable to the sheath of any thickness can be used when removal of the balloon for aortic balloon pump. 糸捕捉器に糸が捕捉されなかった時は,その糸だけを抜き,糸捕捉器をもう一度挿入し同じ操作を繰り返すことができる。 When the yarn to the yarn trap has not been captured, disconnect the yarn only, can be repeated again inserted same operation the yarn trap. 縫合糸と誘導糸の連結部に相当する部分の糸をあらかじめ細く作っておくことによって連結部の結び目が太くなることを防止すると,結び目が血管壁を通過するとき血管壁を傷めにくい。 When the knot of the connecting portion is prevented from becoming thick by idea to make yarn of a portion corresponding to the connecting portion of the induction thread and suture advance thin, hardly damage the vessel wall when the knot passes through the vessel wall. 必要以上に幅広く血管壁に糸がかかることもありうるので,縫合部の狭窄の防止のため縫合糸には一定期間後に抗張力を失う吸収糸を用いるのも一つの方法である。 Since yarn widely vessel wall more than necessary can also take and the suture for prevention of the constriction of the suturing section is also one way to use an absorbent yarn to lose tensile strength after a period of time.

【0007】 [0007]

【発明の効果】従来の圧迫止血法では検査後の合併症のない場合においても最低2〜3日間の入院を必要とした。 In the conventional pressure hemostatic method according to the present invention required the hospitalization of at least two to three days even in the absence of complications after the inspection. 後出血,血腫等の合併症を起こすと更に入院期間は2〜3週間にも延長した。 Post-hemorrhage, further hospitalization period and cause complications of hematoma and the like were extended to 2-3 weeks. 経皮的血管縫合が容易におこなわれることにより合併症の頻度は激減する。 Frequency of complications by percutaneous vascular suture is easily done depleted. 術後の安静が不用となることにより,外来での日帰り検査が可能となり,患者の身体的,経済的負担は軽減し,ひいては国民総医療費の削減にもつながる。 By rest of post-operative is unnecessary, it is possible to day inspection of an outpatient, specifically the body of the patient, the economic burden reduced, leading to and thus reduction of the gross national medical expenses.

【図面の簡単な説明】 BRIEF DESCRIPTION OF THE DRAWINGS

【図−1】本発明の使用時斜透視図 Oblique perspective view when using [Figure 1] The present invention

【図−2】糸捕捉器の斜視図 [Figure 2 is a perspective view of a yarn trap

【符号の説明】 DESCRIPTION OF SYMBOLS

1シース 2中空の針 3縫合糸 4誘導糸 5糸捕捉器 6ループ状の糸 7皮膚 8血管 1 sheath 2 hollow needle 3 suture 4 induced yarn 5 yarn trap 6 looped thread 7 Skin 8 vessels

Claims (1)

    【特許請求の範囲】 [The claims]
  1. 【請求項1】(イ)シース1を血管へ挿入する。 [Claim 1] The (a) sheath 1 is inserted into a blood vessel. (ロ)棒の先端部に多数のループ状の糸6を設けた糸捕捉器5をシース1内を通して血管内腔に挿入する。 (B) inserting the yarn trap 5 that a large number of looped yarn 6 is provided at the distal end of the rod to the vessel lumen through inner sheath 1. (ハ)2本の細い中空の針2をシース1が血管へ挿入されている部位の両脇から血管内腔に刺入する。 (Iii) two thin hollow needle 2 sheath 1 is to penetrate the vessel lumen from both sides of the site being inserted into a blood vessel. (ニ)縫合糸3および誘導糸4を中空の針2の内腔を通して血管内に挿入し糸捕捉器のループをくぐらせる。 (D) inserting into a blood vessel to preferably under the loop of the thread trap the suture thread 3 and inducing fiber 4 through the hollow lumen of the needle 2. 以上の如く構成される経皮的血管縫合器 Percutaneous vascular suturing device constructed as described above
JP8235732A 1996-08-02 1996-08-02 Percutaneous angiorrhapy device Pending JPH1071152A (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
JP8235732A JPH1071152A (en) 1996-08-02 1996-08-02 Percutaneous angiorrhapy device

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
JP8235732A JPH1071152A (en) 1996-08-02 1996-08-02 Percutaneous angiorrhapy device

Publications (1)

Publication Number Publication Date
JPH1071152A true JPH1071152A (en) 1998-03-17

Family

ID=16990414

Family Applications (1)

Application Number Title Priority Date Filing Date
JP8235732A Pending JPH1071152A (en) 1996-08-02 1996-08-02 Percutaneous angiorrhapy device

Country Status (1)

Country Link
JP (1) JPH1071152A (en)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003090628A1 (en) * 2002-04-25 2003-11-06 Terumo Kabushiki Kaisha Organism tissue suturing apparatus

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003090628A1 (en) * 2002-04-25 2003-11-06 Terumo Kabushiki Kaisha Organism tissue suturing apparatus
US8603110B2 (en) 2002-04-25 2013-12-10 Terumo Kabushiki Kaisha Organism tissue suturing apparatus

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