JPH11151299A - Catheter guide wire holding tool and method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To move only an endoscope tip part in the state of fixing a guide wire just by operating an endoscope rear end part even in the catheter of a type for which the guide wire is passed through. SOLUTION: This holding tool is usable in an endoscope catheter in which at least the guide wire 10 and an optical fiber 11 capable of being rotated, let out and drawn back are incorporated and an endoscope connector 20 for rotating or letting out and drawing back the optical fiber 11 is provided near the rear end part. In this case, the guide wire 11 is fixed by a guide wire fixing tool 40, the guide wire fixing tool 40 is nipped and fixed by a clip 103 attached to one end part of a U-shaped plate 101 and a Y-shaped connector 18 for flash is fixed near the catheter rear end and nipped and fixed by the clip 102 attached to the other end part of the U-shaped plate 101.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a catheter guide wire holder and a method for making the catheter insertion member slidable with the guide wire position of a catheter having a guide wire penetrated substantially fixed. It is.

[0002]

2. Description of the Related Art In recent years, for example, for diagnosis of heart disease,
2. Description of the Related Art An endoscope is inserted into an artery, for example, to position the distal end at a desired confirmation position around the heart or the heart, and the endoscope is used to visually confirm, for example, a blood vessel wall at the desired confirmation position.

In this case, in a catheter-type endoscope having a guide wire penetrated, in order to introduce and position the distal end of the endoscope to, for example, a target site in an artery, the guide wire is first extended and the end of a desired position is advanced. , And then the catheter is placed on the guide wire and inserted to the target site.

When the distal end of the endoscope of the catheter reaches a target position, the balloon at the distal end is inflated to cut off the flow of blood and a transparent liquid, for example, a physiological saline solution is injected, and the endoscope is visually checked. . Then, the balloon was returned, and the blood flow was returned, and the catheter was withdrawn along with the guide wire.

In such a case, it is sufficient that the end of the endoscope is located at a site to be checked, but the initial target position often does not always coincide with the position at which a disease or the like to be checked exists. In such a case, there is a case where it is desired to confirm the target by extending, rewinding, or rotating the distal end portion of the endoscope.

In such a case, it is possible to extend / retract the distal end by moving the rear end of the endoscope back and forth, or to rotate the distal end by rotating the rear end of the endoscope. It is possible.

[0007]

However, in a catheter of a type in which a guide wire is penetrated, the distal end portion is extended / retracted by sliding the rear end portion of the endoscope forward and backward, and the endoscope is extended. If an attempt is made to rotate the distal end by rotating the rear end, the guide wire also moves at the same time due to the frictional force between the guide wire and the catheter.

If the guide wire portion moves, for example, the end portion of the endoscope that has been returned cannot be extended again. This is because when the distal end portion of the endoscope is moved back, the guide wire is also moved back at the same time, and it is no longer possible to extend the end portion of the endoscope again along the guide wire.

[0009]

SUMMARY OF THE INVENTION The present invention has been made to solve the above-mentioned problems, and operates a rear end of an endoscope even in a catheter of a type in which a guide wire is penetrated. It is an object of the present invention to make it possible to move only the distal end portion of an endoscope with a guide wire fixed to a catheter with respect to an arterial blood vessel. As one means for achieving the object, for example, the following configuration is provided.

That is, the catheter is used for a catheter having at least a guide wire and a sliding portion capable of rotating, extending, and returning, and an operating portion for rotating or extending and returning the sliding portion near the rear end. A possible catheter guidewire holder, wherein the guidewire inserted into the catheter is fixed near the rear end of the catheter, and the catheter is fixed near the distal end of the operation section, and the operation section is It is characterized in that the positional relationship between the catheter tip balloon and the guidewire remains unchanged even when operated.

[0011] For example, the catheter is an endoscope catheter, the sliding portion is an endoscope portion, and the endoscope portion is extended near the distal end portion of the catheter, rotated back, and rotated.
It is characterized in that the visual spot at the distal end of the catheter can be adjusted.

Further, for example, a guide wire fixing tool having a torker portion through which the guide wire is inserted and which tightens and fixes the guide wire is fixed to the guide wire fixing position near the rear end of the catheter. Is connected by one of the holding devices, and the catheter fixing position near the distal end of the operation section is held by the other holding device, and the two holding devices are positioned and fixed at the holding position. The guide wire inserted into the catheter by a member is fixed in the vicinity of the rear end of the catheter, and the catheter is fixed in the vicinity of the distal end of the operating section, and the distal end balloon is operated even when the operating section is operated. And the positional relationship between the guide wire and the guide wire is unchanged. Alternatively, the connection member is formed so as to be separated from the operation unit by a certain distance so as not to hinder the operation when operating the operation unit.

[0013]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, an embodiment of the present invention will be described in detail with reference to the drawings. In the following description, an example of an endoscope catheter of a type in which a guide wire is penetrated will be described.

FIG. 1 is a view showing a configuration of a catheter guide wire holder according to an embodiment of the present invention.

In FIG. 1, reference numeral 100 denotes a catheter guide wire holder according to an embodiment of the present invention. In order to reduce the weight of the catheter guide wire, for example, a plastic material such as acrylic is used to form a substantially U-shape. Molded U-shaped board 1
01 and plastic or metal clips 102 and 103 fixed to both ends of a U-shaped plate 101.

The clips 102 and 103 clamp and hold the guide wire fixing tool 40, fix the guide wire 10 inserted into the catheter near the rear end of the catheter, and connect the Y connector 17 for flushing the catheter.
Is fixed in the vicinity of the distal end portion, and the positional relationship between the catheter distal end portion balloon and the guide wire 10 remains unchanged even when the operation section 30 is operated.

The clips 102 and 103 are not limited to the crocodile clip shown in FIG. 1 but may be any clips as long as they can clamp and fix the Y connector 17 for flash and the guide wire fixture 40 described later. It can be composed of format clips. Further, even if the clip is fixed by a screw or the like instead of a clip, for example, a flashing Y connector 17 or a guide wire fixing tool 40 described later is positioned in a fishhook-shaped tip, and is housed in the tip with a separate member. The flash Y connector 19 and the guide wire fixing tool 40 may be sandwiched and fixed, and various applications are possible.

Reference numeral 10 denotes a guide wire penetrating into the catheter, and reference numeral 10a denotes a distal end portion penetrating the catheter. Reference numeral 11 denotes an optical fiber section (endoscope section) having a guide wire 10 formed at a substantially central portion thereof so as to be able to penetrate the light guide section and a light guide as a light source light introducing fiber section and an image guide as a received light guiding fiber section. There is a configuration in which the guide light is emitted from the distal end of the light guide, the surrounding light is introduced from the image guide, and the image of the blood vessel lumen near the distal end can be visually recognized.

The optical fiber section 11 extends from the flexible tube 13 by extending an operation section 30 described later, and is housed in the flexible tube 13 by repeating the operation section 30.

Reference numeral 12 denotes a balloon for blocking the flow of blood, and reference numeral 13 denotes a flexible tube. Flexible tube 13
The optical fiber section (endoscope) insertion section is disposed at the center of the optical fiber section, and the optical fiber section 11 is slidably housed in the optical fiber section insertion section. For example, a medicine tube, a balloon tube, and a flash tube are sequentially disposed outside the optical fiber insertion portion, respectively, and the whole is covered with a jacket portion formed of, for example, polyethylene. And
For example, it is formed to an outer diameter of about 0.04 inch φ. In addition,
Even if the input tube, balloon tube, and flash tube consist of independent tubes,
Further, a space formed between other tubes may be used instead.

Reference numeral 14 denotes a balloon tube separator for separating the balloon tube in the flexible tube 13, and reference numeral 15 denotes a balloon duct connected to the balloon tube separated by the balloon tube separator 14.

Reference numeral 16 denotes a loading adapter for connecting the flexible tube to the flashing Y connector 17 (catheter), and 17 denotes a flashing Y connector.
The flash Y connector 17 is configured so that at least the central portion where the scale 25 is provided is partially transparent, and the endoscope section (optical fiber section and guide wire) is fed out into the catheter and returned. It is configured to be checkable. In addition, a part of the endoscope part in the flash Y connector 17 is colored differently from the others (20a in the figure),
It can be visually confirmed that the endoscope section slides inside the Y connector 17 for flash.

Numeral 18 denotes a flush duct to which a flush tube in the flexible tube 13 is connected, and which injects a transparent liquid, for example, physiological saline, and discharges it from the distal end to improve the visibility in the blood vessel. Used to 1
Reference numeral 9 denotes a Y connector cap for flash, into which a rigid tube 20 for an endoscope in which a tube for a guide wire, a tube for a light guide, and a tube for an image guide are housed is introduced.

Reference numeral 21 denotes an optical fiber branch portion for branching an optical fiber handle composed of a light guide 28 and an image guide 29 from the endoscope 20; 27, an optical fiber separator for separating the light guide and the image guide; A light source connection connector 29 connected to the guide and connected to the endoscope light source unit is a camera connection connector 29 connected to the image guide and connected to the endoscope camera unit. In the operation unit 30, reference numeral 33 denotes a medication duct to which a medication tube in the operation unit 30 is connected. For example, a necessary drug solution or the like is injected from here, discharged from the distal end, and moved to a desired position in a blood vessel. It is used to inject chemicals. 34
Denotes an operation unit cap fixed to the operation unit 30, and guides the guide wire 10 into the guide wire insertion unit at the center of the endoscope unit 20.

Reference numeral 40 denotes a guide wire fixing device, which is provided with a torker portion for fixing the guide wire 10 substantially at the center and a guide wire insertion hole formed integrally with the torker portion at the center so that the clip 103 can be clamped. And a grip portion. By rotating the operation unit 30, the optical fiber 11 rotates in conjunction with it, so that the image captured by the endoscope can also be rotated.

Further, according to the present embodiment, as shown in the figure, even if the operation section 30 is operated with the catheter guide wire holder 100, the positional relationship between the balloon at the distal end of the catheter and the guide wire 10 remains unchanged. Therefore, the guide wire position does not change even if the operation unit 30 is extended and returned, so that only the optical fiber unit (endoscope unit) 11 can be extended and returned. Can,
It is possible to move the viewing range of the endoscope forward and backward. For example, this movable range is a range in which the operation unit 30 can slide, and in the present embodiment, it is possible to extend and return about 5 cm. Reference numeral 33 denotes a medication duct to which a medication tube in the tube 20 is connected, for example, for injecting a necessary drug solution or the like from the tube, discharging the drug from the distal end portion, and feeding the drug solution to a desired position in a blood vessel. Used. Reference numeral 34 denotes an operation portion cap fixed to the operation portion 30, and guides the guide wire 10 into the guide wire insertion portion.

Reference numeral 40 denotes a guide wire fixing device, which is provided with a torker portion for fixing the guide wire 10 substantially at the center and a guide wire insertion hole formed integrally with the torker portion at the center so that the clip 103 can be clamped. And a grip portion.

A method of using the endoscope catheter according to the embodiment of the present invention having the above-described configuration will be described below. In the catheter according to the embodiment of the present invention, for example, before use, the guide wire fixing device 40 and the guide wire holding device 100 at the rear of the operation unit 30 shown in FIG.

For this reason, in use, first, a necessary flushing device and a necessary dosing device are connected to each of the ducts 18 and 33 as necessary, and a balloon control device for expanding the balloon is connected to the balloon duct 15. Connect to Further, the light source unit for the endoscope is connected to the light source connector 28, and the camera unit for the endoscope is connected to the camera connector 29.
Connect to

Then, for example, the guide wire fixing device 40 is inserted from the rear end of the guide wire 10 and brought to the vicinity of the rear portion of the operation unit 30. Then, the guide wire 10 is inserted into the living body, for example, the blood vessel from the introduction port, and the guide wire 1 is inserted.
The leading end 10a of the “0” is introduced slightly to the destination. The introduction mechanism and the introduction method of the guide wire 10 are known, and therefore detailed description is omitted.

A guide wire insertion portion is provided substantially at the center of the catheter, and then the catheter is inserted into a living body or a blood vessel according to the guide wire 10. Then, the distal end (the distal end of the optical fiber unit 11) is introduced to the target position.

In this state, the Y connector 17 for flushing is held by the clip 102 of the catheter guide wire holder 100 according to the embodiment of the present invention. The guide wire fixing tool 40 is fixed to the guide wire 10 by tightening the portion. Then, the guide wire fixing device 40 is clamped by the clip 103. As described above, the positional relationship between the guidewire 10 and the Y connector 17 for flashing (the positional relationship between the guidewire 10 and the catheter) is fixed.

Now that the operation preparation of the endoscope is completed,
For example, a physiological saline solution or the like is injected from the balloon duct 15 to inflate the balloon 12 at the distal end to cut off the blood flow. If necessary, flash is performed from the flash duct 18 to improve the visibility and improve the optical fiber 11.
An endoscope is used to visually confirm the vicinity of the distal end.

Here, if the target position can be confirmed, the balloon is deflated to restore the blood flow, and the catheter is pulled out together with the guide wire.

In such a case, it is sufficient that the end of the endoscope is located at a site to be checked, but in many cases, the initial target position does not always coincide with the position where the disease or the like to be checked exists. In such a case, there is a case where it is desired to confirm the target by extending, rewinding, or rotating the distal end portion of the endoscope.

In such a case, the operation section 30 is rotated to rotate the endoscope image, or the operation section 30 is extended or retracted to extend or retract the optical fiber section 11. Visually check before and after the initial position.

In this case, in the embodiment of the present invention, the positional relationship between the guide wire 10 and the Y connector 17 for flushing is fixed by the catheter guide wire holder 100. For this reason, even if the operation unit 30 is extended, the guide wire 10
Is fixed, the guide wire 10 is not fed out together, for example, even if the optical fiber portion 11 is fed out.

Also in this case, since the U-shaped plate 101 of the catheter guide wire holder 100 is formed in a U-shape, when the operation unit 30 is rotated or slid by a finger or the like, The U-shaped plate 101 does not hinder the operation.

In the above description, the case where the catheter guide wire holder 100 is formed in a U-shape has been described as an example. However, the present invention is not limited to the above-described shape, and the operation obstruction of the operation section 30 is obstructed. If the shape does not
For example, an arbitrary shape such as a C-shape can be used.

Further, the guide wire fixing device 40 is constituted by a grip portion and a torquer portion, and the grip portion is
3, the present invention is not limited to the above example, and instead of the grip portion, an entry needle for inserting the guide wire 10 for a predetermined distance is fixed to the torker portion, and the torker portion is used. The guide wire 10 may be tightened and fixed, and the torquer portion may be clamped by the clip 103.

Further, although the U-shaped plate 101 is formed in a plate shape,
The present invention is not limited to the above-described example, and may be one in which a columnar material is bent to form, for example, a U-shape, and a clip or the like is attached to an end. Further, instead of a material in the dark, a material having a hollow central portion may be used to reduce the weight.

As described above, according to the present invention, even in a catheter of a type in which a guide wire is penetrated,
Only by manipulating the rear end of the endoscope, it is possible to move only the front end of the endoscope with the guidewire fixed.

[0042]

[Brief description of the drawings]

FIG. 1 is a diagram showing the configuration of an embodiment of the present invention according to the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 10 Guide wire 11 Optical fiber part (endoscope part) 12 Balloon 13 Flexible tube 14 Balloon tube separator 15 Balloon duct 16 Loading adapter 17 Y connector for flash 18 Duct for flash 19 Operation cap 20 Endoscope Rigid tube 21 optical fiber separation unit 27 optical fiber separator 28 light source connection connector 29 camera connection connector 30 operation unit 33 medication duct 34 medication Y connector cap 40 guide wire fixing tool 100 catheter guide wire holding tool 101 U-shaped plate 102 103 clips

Claims (5)

[Claims] 1. A catheter provided with at least a guide wire and a sliding portion capable of rotating and extending and rewinding, and having an operating portion near the rear end portion for rotating or extending and rewinding the sliding portion. A possible catheter guidewire holder, wherein the guidewire inserted into the catheter is fixed near the rear end of the catheter, and the catheter is fixed near the distal end of the operation unit, and the operation unit is A catheter guide wire holder, wherein the positional relationship between the catheter distal end balloon and the guide wire remains unchanged even when operated. 2. A catheter as an endoscope catheter, wherein a sliding portion is an endoscope portion, and the endoscope portion is extended, returned, and rotated in the vicinity of the catheter distal end portion to adjust a visual point at the catheter distal end portion. The catheter guidewire holder according to claim 1, wherein the catheter guidewire holder is capable of being used. 3. A guide wire fixing device including a guide wire inserted therein and a torker portion for tightening and fixing the guide wire is fixed to the guide wire fixing position near the rear end of the catheter, and the guide wire fixing portion is fixed to the guide wire fixing portion. A connecting member that holds the catheter in the vicinity of the distal end of the operation portion with the other holding tool and holds and fixes the two holding tools at the holding position, By fixing the guide wire inserted in the catheter in the vicinity of the rear end of the catheter, and fixing the catheter in the vicinity of the distal end of the operation unit, and operating the operation unit, the distal end balloon and 3. The catheter guidewire holder according to claim 1, wherein a positional relationship of the guidewire is invariable. Ingredients. 4. The device according to claim 5, wherein the connecting member is formed so as to be separated from the operation unit by a certain distance so as not to hinder the operation when operating the operation unit. Catheter guidewire holder. 5. An interior in which at least a guide wire and an endoscope unit capable of rotating and extending and rewinding are provided, and an operation unit for rotating or extending and rewinding the endoscope unit is provided near a rear end portion. In the endoscope catheter, the guide wire inserted into the catheter is fixed near the rear end of the catheter, and the catheter is fixed near the distal end of the operation unit, and the catheter is operated even when the operation unit is operated. A catheter guidewire holding method, wherein a positional relationship between a distal balloon and the guidewire is kept unchanged.